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2019 Novel Coronavirus

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a quick review of the articles issued by WHO, CDC and other medical experts...
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on its epidemiology, etiology, clinical manifestations, diagnosis, management and prevention.

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2019 Novel Coronavirus

  1. 1. 2019 Coronavirus: a quick review of the articles issued by WHO, CDC and other experts
  2. 2. 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 emergency concern.
  3. 3. Etiology: 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 and US. Just recently, WHO reported one case of death related to the 2019-nCoV in Philippines, the first death outside of China.
  4. 4. Clinical Manifestations: 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 Secondary Infections.
  5. 5. Diagnosis: 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.
  6. 6. 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 illness or > 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 infection
  7. 7. 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
  8. 8. 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
  9. 9. Prevention: 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.
  10. 10. Prognosis: The case fatality rate of 2019 NCov is 2-3%. Most of the deaths are older person and/or had underlying health conditions. Case fatality for SARS is 10% and MERS37%.
  11. 11. Source: WHO CDC BMJ ECDC

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