A NOVEL CORONAVIRUS THREATENS THE WORLD

Abstract

A novel coronavirus (nCoV) was first identified amid a recent outbreak of respiratory disease cases in China, Wuhan City. This infection was initially reported to the World Health Organization (WHO) on December 31, 2019. One month later, the WHO declared the 2019-nCoV outbreak a global health emergency(1). The WHO named the disease caused by 2019-nCoV as COVID-19, an acronym derived from “coronavirus disease 2019”. According to WHO, “Coronaviruses (CoV) are a large family of viruses that cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). A novel coronavirus (nCoV) is a new strain which has not been previously identified in humans”(2). The recent emergence of COVID-19 in China raised many questions regarding risk factors in the general population, transmission patterns, clinical characteristics, efficient protection methods for health workers or in household and other settings. The medical world is also concerned about the most appropriate means to predict the future evolution of the disease and to limit human-to-human transmission, preventing also further international spread from China. The rapid identification of the new cases and close follow up of their contacts, together with preventive health measures for travelers may be useful methods to prevent a possible pandemia of COVID-19. In mid-February 2020, COVID-19 has been confirmed in more than 64,000 individuals (the majority in China) and has resulted in more than 1300 deaths. The respiratory infection has been reported also in other countries from Middle East, Europe, United States etc. The disease seems to be transmitted by respiratory droplets from sneezing or cough and is usually limited to close contacts with the patients, such as family members and healthcare workers. A more severe evolution was encountered in elderly patients, with comorbidities(3). There are no validated diagnostic tests for COVID-19. In the USA, the Center for Disease Control has developed a diagnostic test and has requested special emergency authorization from the Food and Drug Administration for its use4. This test is a real-time reverse transcription–polymerase chain reaction (rRT-PCR) assay and can diagnose the virus in respiratory and serum samples from clinical specimens. There is no specific treatment until now for infections with COVID-19, the treatment is only supportive. Researchers have started to investigate possible drug treatments for COVID-19. In China there are more than 80 running or pending clinical trials on potential treatments for COVID-19, including old traditional Chinese therapies. Some of these studies were criticized because of their study protocol, lack of specific standards, such as methods of randomization, control groups and measures of clinical outcomes. Until now, there is no specific cure for the disease. The WHO initiated a clinical trial that will compare two or three therapies supported by initial scientific evidence, a HIV-drug combination (lopinavir and ritonavir) and an experimental antiviral (remdesivir). Up to now, the most important measure is the prevention of infection, by limiting the contact with potentially infected patients, travel restrictions for persons originating in the endemic areas of China, use of protection equipment (surgical masks, gloves, protection eyeglasses etc).