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Dr Gerardo Valdez Vargas R2MI
Profesor Titular: Dr Arturo Salas Mendiola MB Infectología
WHO Disease outbreak news: Novel Coronavirus – Republic of Korea (ex-China). January 21, 2020. https://www.who.int/csr/don/21-january-
2020-novel-coronavirus-republic-of-korea-ex-china/en/ (Accessed on January 21, 2020).
Enjuanes L, Development of protection against coronavirus induced diseases. A
review. Adv Exp Med Biol. 1995;380:197.
Enjuanes L, Development of protection against coronavirus induced diseases. A
review. Adv Exp Med Biol. 1995;380:197.
Stanley P. 2020 Another Decade, Another Coronavirus, NEJM. DOI: 10.1056/NEJMe2001126
WHO Disease outbreak news: Novel Coronavirus – Republic of Korea (ex-China). January 21, 2020. https://www.who.int/csr/don/21-january-
2020-novel-coronavirus-republic-of-korea-ex-china/en/ (Accessed on January 21, 2020).
Chaolin Huang, Clinical features of patients infected with 2019 novel coronavirus in
Wuhan, China, 2020. The Lancet, https://doi.org/10.1016/ S0140-6736(20)30183-5
Chaolin Huang, Clinical features of patients infected with 2019 novel coronavirus in
Wuhan, China, 2020. The Lancet, https://doi.org/10.1016/ S0140-6736(20)30183-5
WHO/2019-nCoV/SurveillanceGuidance/2020.3
WHO/2019-nCoV/SurveillanceGuidance/2020.3
WHO/2019-nCoV/SurveillanceGuidance/2020.3
WHO/2019-nCoV/SurveillanceGuidance/2020.3
National Health Commission of the People's Republic of China. New coronavirus cases rise to 571 in
Chinese mainland. January 23, 2020. http://en.nhc.gov.cn/2020-01/23/c_76004.htm
20% de los casos reportados se registraron falla
respiratoria, choque séptico y falla orgánica múltiple.
WHO/2019-nCoV/SurveillanceGuidance/2020.3
WHO/2019-nCoV/SurveillanceGuidance/2020.3
WHO/2019-nCoV/SurveillanceGuidance/2020.3
WHO/2019-nCoV/SurveillanceGuidance/2020.3
Keyaerts E, 2004, In vitro inhibition of severe acute respiratory syndrome coronavirus by
chloroquine. Biochem Biophys Res Commun. 2004;323(1):264.
01/01/20: El mercado de mariscos Huanan en Wuhan fue desinfectado y
cerrado luego de que fue vinculado al brote de coronavirus
La OMS califica la epidemia de “emergencia de salud pública de
alcance internacional”
El 31/01/20 China anuncia el peor balance diario desde el
inicio de la epidemia: 43 muertos en 24 horas, con lo que
la cifra total asciende a 213 muertos en China y 10.000
casos confirmados.
Coronavirus 2019
Coronavirus 2019

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Coronavirus 2019

Editor's Notes

  1. Este betacoronavirus es diferente al asociado a l SARS y MERS
  2. Los pasos de replicación del coronavirus son blancos terapéuticos para los antivirales y vacunas. Glucoproteina S (picos) en la envoltura del virus, tiene la forma de una corona, es altamente glucosilada, es la que se encarga de la unión y fusión con la membrana de la celula huésped. La glucoproteína S es un buen candidato para crear vacunas y neutralizar los anticuerpos específicos. Proteina M (membrana) tiene un dominio N- terminal que se proyecta a la superficie, que se envuelve tres veces, para el rol de ensamblaje viral. Nucleoproteina N asociada con el RNA genoma que forma la nucleocápside. La proteína de envoltura pequeña (E) con una funcion desconocida
  3. Negative-stained 2019-nCoV particles are shown in Panel A, and 2019-nCoV particles in the human airway epithelial cell ultrathin sections are shown in Panel B Arrowheads indicate extracellular virus particles, arrows indicate inclusion bodies formed by virus components triangles indicate cilia.
  4. La probabilidad de la transmisión del virus al humona si puede deberse a la ingesta de platillos exóticos, por el reservorio primario del murciélago, asi como el MERS-CoV es tarnsmitido de camellos a humanos.
  5. La carecteristica clínica es la fiebre, tos, disnea, con reportes del 20% de los pacientes confirmados con casos graves.
  6. A= Tomografia de paciente masculino de 40 años con consolidaciones bilaterales multiples, lobulares y subsementarias, en el dia numero 15 del inicio de los síntomas. B y C
  7. Paciente femenino de 53 años con patron de vidrio despulido bilateral y áreas de consolidación a los 12 días del inicio de los síntomas
  8. El paciente de 35 años, que acude a la clínica de urgencias de Washington, con 4 dias de tos seca, con fiebre no cuantificada, se le toma una radiografia de torax ap y lateral sin anormalidades. Teniendo una asociación de viaje a Wuhan, china, regresando el 15 de enero a Washington. Debido a que vio la alerta epidemiológica de la CDC, decidio acudir a valoración. No se registraron enfermedades cronicodegenerativas, no fumador. Se realiza NAAT para influenza A y B negativo, asi como muestra para adenovirus, rinovirus, virus sincitial respiratorio, Parainfluenza, coronavirus(HKU1, NL63, 229E, OC43) todos negativos, se realiza rRT-PCR para 2019 nCoV resultando positivo.   Dentro de la exploración física se reporto tos seca de 2 dias de evolución, acompañado de nausea y vomito, sin disnea o dolor toracico, se registraron picos febriles y evacuaciones disminuidas en cosistencia. Al cuarto dia de la enfermedad, las muestras tomadas de la nasofaringe y orofaringe resultaron positivas para RT-PCR de 2019 nCoV, con secuencia genética idéntica en obtenida de otros pacientes.   Al dia 6 intrahospitalario, presenta disminución de saturación hasta 90% al aire ambiente y se inicia oxigeno suplementario a 2 lts por minuto, iniciando tratamiento con vancomicina y Cefepime, con radiografia de torax con opacidad basal izquierda, posteriormente al dia 7 y 8 se suspenden antibioticoterapia por niveles de procalcitonina normales, asi como PCR negativo para S. aureus. Al octavo dia de hospitalización y dia numero 12 del inicio de la enfermedad, la condición del paciente mejoro, sin oxigeno suplementario, saturando en 94-96%, desaparecieron los crepitantes subescapulares bilaterales, manteniéndose solo con tos seca y rinorrea. Al 30 de enero del 2020, sigue hospitalizado para vigilancia.   No es clara al momento la dinámica de la transmisión asi como el completo espectro clínico, ya que este paciente no visito el mercado de Wuhan, o estuvo en contacto con personas enfermas en su estancia en china. Los contactos del paciente se mantienen asintomáticos y continúan en vigilancia.
  9. WHO/2019-nCoV/SurveillanceGuidance/2020.3
  10. Miembros del personal toman la temperatura de los pasajeros después de la llegada de un tren procedente de Wuhan a Hangzhou, en la provincia oriental china de Zhejiang.