2019 Coronavirus: a quick
review of the articles issued
by WHO, CDC and other
It was first noted in Wuhan City, Hubei Province, China last
December 2019 causing acute respiratory disease to the
affected patients. Investigations about the virus is still
ongoing up to now.
Just recently, Who declared the outbreak as a global health
2019-nCoV belongs to the Coronavirus Family, which cause
illnesses to people causing the Common Colds, SARS and
MERS. It also affects animals which can rarely spread to
humans, and then causes human to humans transmission which
happened in SARS and MERS. Human to human transmission
has already been confirmed in China, Vietnam, Japan, Germany
Just recently, WHO reported one case of death related to the
2019-nCoV in Philippines, the first death outside of China.
Clinically, most patients presented as a viral pneumonia which
range from mild to severe in presentation with 20% case
progression to become a severe disease.
Patients usually presents with fever, cough and shortness of
breath. There are patients who has myalgia, fatigue, sputum
production, confusion, hemoptysis, diarrhea and nausea and
vomiting. Some patient may be asymptomatic. Thirty-three percent
of cases may have complications like ARDS, Acute Respiratory
Injury, Acute Cardiac Injury, Septic Shock, AKI and even cause
Early detection and rapid confirmation is important for
prevention of spread and giving of supportive treatment to the
affected individuals. At the triage area, implementation of
infection prevention and control measures should be done. Most
countries are already implementing isolation of suspected and
confirmed cases, during triaging of patients, they used
Screening Questionnaires as a guide and includes travel history
as a key.
ECDC Case Definition for Surveillance:
> a person with clinical signs and symptoms suggestive of
pneumonia or Severe Respiratory infection with breathlessness
AND travel to Mainland China within 14 days before the onset of
> a person with acute respiratory illness of any degree of severity
who within 14 days before the onset of illness had:
a) Been to Wuhan City or Hubei Province, China or
b) Been to Hospital in Mainland China or
c) Had a close contact with a case of 2019 Novel Coronavirus
Types of Specimen:
Lower Respiratory Tract:
- Bronchoalveolar Lavage
- Endotracheal Aspirate
- Expectorated Sputum
Upper Respiratory Tract:
- Nasopharyngeal Swab
- Oropharyngeal Swab
- Nasopharyngeal Aspirate or Nasal Wash
Additional Specimen for later testing:
- when serological testing becomes available: Serum, acute
and convalescent (2-4weeks after acute phase) specimen
- other specimens to consider: blood, urine, feces
Based on the WHO, incubation period range from 2 to 10days
CXR/ Chest CT: 25% of cases showed unilateral infiltrates
and 75% with Bilateral Infiltrates.
Reverse Transcriptase-PCR (RT-PCR): is need to
confirm the diagnosis
China's National Health Commission classified 2019 Novel
Coronavirus as a Grade A infectious Disease which requires
Mandatory quarantine of patients, observation for those who has
close contact with patients.
WHO advised to practice Hand Hygiene which includes frequent
hand washing with soap and water after contact with person with
illness or their environment, avoid close contact with person who has
Acute respiratory infection and practice cough etiquette.
Wear mask only if you have a fever, cough, or runny nose and you
are recovering from illness.
The case fatality rate of 2019 NCov is 2-3%. Most of the
deaths are older person and/or had underlying health
Case fatality for SARS is 10% and MERS37%.