This document provides information about 2019-nCoV (now known as SARS-CoV-2), the virus that causes COVID-19. It discusses the virus's origin in Wuhan, China in December 2019. It describes the virus's structure and transmission methods. It also outlines the signs and symptoms of COVID-19, recommendations for prevention and treatment, and the current situation regarding confirmed cases in Bangladesh.

1. 2019-nCoV
Dr Arifa Akram
MBBS MD (Virology) BCS (Health)
Assistant Professor (Virology)
National Institute of Laboratory Medicine and referral center, Agargaon, Dhaka, Bangladesh.

2. Human Coronavirus Types
• Coronaviruses are named for the crown-like spikes on their surface.
There are four main sub-groupings of coronaviruses, known as alpha,
beta, gamma, and delta.
• Human coronaviruses were first identified in the mid-1960s.
• Coronaviruses are a broad family of viruses, but only six
(229E, NL63, OC43, HKU1, MERS-CoV, and SARS-CoV) were previously
known to infect people; 2019-nCoV made it seven.

4. Introduction
• In December 2019, a pneumonia outbreak occurs in Wuhan city, Hubei province
of China
• The virus was genomically sequenced from samples of 5 patients at the early
stage of the outbreak
The sequences were almost identical & share 79.5% similarity to the SARS-CoV &
96% identical to a bat coronavirus.
• 2019-nCoV is a positive-sense, single-stranded RNA virus.

5. Cont…
• The International Virus Classification Commission (ICTV) classified
2019-nCoV as Severe Acute Respiratory Syndrome Coronavirus 2
(SARS-CoV-2) on February 11, 2020.
• WHO named the disease caused by 2019-nCoV as COVID-19. In
COVID-19, ‘CO’ stands for ‘corona,’ ‘VI’ for ‘virus,’ and ‘D’ for disease.
• Because the strain was first discovered in Wuhan, China, it is
sometimes referred to informally as the Wuhan coronavirus or
Wuhan seafood market pneumonia virus.

6. 2019-nCoV outbreak
• In late December 2019, a cluster of pneumonia cases of unknown cause was reported by
health authorities in Wuhan, Hubei Province, China. The initial cases mostly had links to
the Huanan Seafood Wholesale Market and consequently, the virus is thought to have
a zoonotic origin.
• The earliest reported symptoms occurred on 1 December 2019, in a person who had not
had any exposure to the Huanan Seafood Wholesale Market or the remaining 40 of the
first cluster detected with the new virus.
• The Huanan Seafood Wholesale Market was closed off on 1 January 2020, and people
who showed signs and symptoms of the coronavirus infection were isolated.
• The WHO decided against declaring the outbreak a public health emergency of
international concern on 23 January 2020
• As of 9 march 2020, there are 113584 confirmed cases, of which 80735 are within China
and the number of deaths is 3996.

7. On 23 January 2020, WHO declared the outbreak as a
public health emergency

8. WHO said 'More powerful' than terrorist attack’

9. Signs and symptoms
• Incubation period: 2-14 days
most commonly 5 days.
• Most of these patients also
presented underlying conditions
such as hypertension, diabetes or
cardiovascular disease
Fever 87.9%
Dry cough 67.7%
Fatigue 38.1%
Sputum production 33.4%
Shortness of breath 18.6%
Muscle pain or joint pain 14.8%
Sore throat 13.9%
Headache 13.6%
Chills 11.4%
Nausea or vomiting 5.0%
Nasal congestion 4.8%
Diarrhoea 3.7%
Haemoptysis 0.9%
Conjunctival congestion 0.8%

10. Transmission
• Most commonly spread from an infected person to others through the air
by coughing and sneezing within a range of about 6 feet (1.8 m)
• Also can spread by close personal contact, such as touching or shaking
hands
• Droplets only stay suspended in the air for a short time but may stay viable
and contagious on metal, glass or plastic surface.
• Details for the COVID-19 virus are not available as of 26 February 2020, and
it is assumed that they are similar to other coronaviruses, which survive for
up to 9 days at room temperature.
• rarely, fecal contamination (doi:10.1056/NEJMoa2001191. PMID 32004427.)

11.  Like other coronaviruses, SARS-CoV-2 has 4 structural proteins, known as the S
(spike), E (envelope), M (membrane), and N (nucleocapsid) proteins;
the N protein holds the RNA genome, and
the S, E, and M proteins together create the viral envelope.
The spike protein is responsible for allowing the virus to attach to the membrane of
a host cell.
Protein modeling experiments on the spike protein of the virus soon suggested that
SARS-CoV-2 has sufficient affinity to the angiotensin converting enzyme 2 (ACE2)
receptors of human cells to use them as a mechanism of cell entry. Studies have
shown that SARS-CoV-2 has a higher affinity to human ACE2 than the original SARS
virus strain. (doi:10.1126/science.abb2507. PMID 32075877).
Structural biology

12. Reservoir
• It is 96% identical at the whole genome level to other bat coronavirus
samples (BatCov RaTG13).
• In February 2020, Chinese researchers found that there is only one amino
acid difference in certain genome sequences between the viruses found in
pangolins and those from human patients, implying that pangolins may
have been an intermediate host.
https://sciencemonk.com/everything-you-need-to-know-about-coronavirus-ncov-2019/#Transmission_Of_Coronavirus_How_Coronavirus_affects_Human
Human Coronavirus Natural Host/ Reservoir
HCoV-229E Bats
HCoV-OC43 Rodents
HCoV-NL63 Bats
HCoV-HKU1 Rodents
MERS-CoV Bats
SARS-CoV Bats
nCoV-2019 Bats (?)

14. Fig: Animated map of confirmed COVID-19 cases from 12 January to 29 February 2020.

15. Fig: Case fatality rates by age group in China.
Data through 11 February 2020.
Fig: Semi-log plot of coronavirus daily deaths by region:
Hubei Province, mainland China excluding Hubei, the rest
of the world (ROW), and the world total

16. Diagnosis
Real-time RT-PCR
test can be done on respiratory or blood
samples.
Results are generally available within a few
hours to days

17. Prevention
CDC always recommends everyday preventive actions to help prevent the spread of
respiratory diseases, including:
• Avoid close contact with people who are sick.
• Avoid touching your eyes, nose, and mouth.
• Stay home when you are sick.
• Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
• Clean and disinfect frequently touched objects and surfaces using a regular
household cleaning spray or wipe.
• Wash your hands often with soap and water for at least 20 seconds, especially
after going to the bathroom; before eating; and after blowing your nose,
coughing, or sneezing.
• If soap and water are not readily available, use an alcohol-based hand sanitizer with at least
60% alcohol. Always wash hands with soap and water if hands are visibly dirty.

18. Follow CDC’s recommendations for using a facemask.
• CDC does not recommend that people who are well wear a facemask to
protect themselves from respiratory diseases, including COVID-19.
• Facemasks should be used by people who show symptoms of COVID-19 to
help prevent the spread of the disease to others. The use of facemasks is also
crucial for health workers and people who are taking care of someone in close
settings (at home or in a health care facility).

21. Self-isolation and self-quarantine
• Self-isolation at home has been recommended for those diagnosed
with COVID-19 and those who suspect they have been infected.
• Those who have recently travelled to a country with widespread
transmission or who have been in direct contact with someone
diagnosed with COVID-19 have also been asked by some government
health agencies to self-quarantine or practise social distancing for 14
days from the time of last possible exposure.

22. Treatment
• There are no specific treatments for illnesses caused by human
coronaviruses. Most people with common human coronavirus illness
will recover on their own. However, you can do some things to relieve
your symptoms
• take pain and fever medications (Caution: do not give Aspirin to
children)
• use a room humidifier or take a hot shower to help ease a sore throat
and cough
If you are mildly sick, you should
• drink plenty of liquids
• stay home and rest

23. Bangladesh scenario
• 3 confirmed cases in Bangladesh among 127 samples (upto
10/03/2020)
• Case detection is done in IEDCR by Real time PCR.
• IDH, Kurmitola General Hospital, Kuwait Moitry Hospital and
Mohanogor Hospital have arranged for coronavirus isolation ward.
• Thermo scanner screening with health card for observing symptoms
in airport.
• History taking & health cards of travellers in land ports.

25. Thank you