#Importation and #H2H #Transmission of a Novel #Coronavirus in #Vietnam (N Engl J Med., summary)

[Source: The New England Journal of Medicine, full page: (LINK). Summary, edited.]

Importation and Human-to-Human Transmission of a Novel Coronavirus in Vietnam

 

TO THE EDITOR:

The emergence and spread of a novel coronavirus (2019-nCoV) from Wuhan, China, has become a global health concern.1 Since the detection of the coronavirus in late December 2019, several countries have reported sporadic imported cases among travelers returning from China.2 We report one family cluster of 2019-nCoV originating from a Chinese man.

On January 22, 2020, a 65-year-old man with a history of hypertension, type 2 diabetes, coronary heart disease for which a stent had been implanted, and lung cancer was admitted to the emergency department of Cho Ray Hospital, the referral hospital in Ho Chi Minh City, for low-grade fever and fatigue. He had become ill with fever on January 17, a total of 4 days after he and his wife had flown to Hanoi from the Wuchang district in Wuhan, where outbreaks of 2019-nCoV were occurring. He reported that he had not been exposed to a “wet market”(a market where dead and live animals are sold) in Wuhan.

(…)

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Lan T. Phan, Ph.D., Thuong V. Nguyen, M.D., Ph.D., Quang C. Luong, M.D., Thinh V. Nguyen, M.D., Hieu T. Nguyen, B.Sc., Pasteur Institute Ho Chi Minh City, Ho Chi Minh City, Vietnam – nguyenthuong@yahoo.com; Hung Q. Le, M.D., Ph.D., Thuc T. Nguyen, M.D., Cho Ray Hospital, Ho Chi Minh City, Vietnam; Thang M. Cao, Pharm.D., Quang D. Pham, M.D., Ph.D., Pasteur Institut Ho Chi Minh City, Ho Chi Minh City, Vietnam

Disclosure forms provided by the authors are available with the full text of this letter at NEJM.org.

This letter was published on January 28, 2020, at NEJM.org.

Keywords: 2019-nCoV; Vietnam; China.

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#Sofosbuvir Can Inhibit the Newly Emerged #Coronavirus (2019-nCoV) in Wuhan, #China (SSRN, abstract)

[Source: SSRN, full page: (LINK). Abstract, edited.]

Sofosbuvir Can Inhibit the Newly Emerged Coronavirus (2019-nCoV) in Wuhan, China

19 Pages Posted: 28 Jan 2020

Abdo Elfiky, Cairo University – Biophysics Department; Al Jouf University – College of Applied Medical Sciences

 

Abstract

A newly emerged Human Coronavirus (HCoV) is reported last month in Wuhan, China (2019-nCoV). Until today three deaths and more than 200 confirmed cases reported in China, Thailand, and Japan. HCoVs are zoonotic viruses that transmit from animals to humans through direct contact. Six different strains of HCoV were reported, during the last century, which has a different pathogenic burden and spread potentials. The two most famous strains of HCoVs that have significant health complications are the Severe Acute Respiratory Syndrome coronavirus (SARS CoV) and the Middle East Respiratory Syndrome coronavirus (MERS CoV). Based on the World Health Organization (WHO) reports, SARS HCoV is responsible for more than 8000 cases with confirmed 774 deaths. Additionally, MERS HCoV is responsible for 858 deaths out of about 2500 reported cases. In this study, the newly emerged Wuhan HCoV is targeted by anti-polymerase drugs including the approved Sofosbuvir and Ribavirin. Sequence analysis, modeling and docking are used to build a model for Wuhan 2019-nCoV RNA dependent RNA polymerase (RdRp). The results suggest the effectiveness of Sofosbuvir, IDX-184 and Ribavirin as a potent drug against the newly emerged HCoV disease.

Funding: None.

Declaration of Interest: All the authors declare that there is no competing interest in this work.

Keywords: Wuhan coronavirus; 2019-nCoV; RdRp; docking; structural bioinformatics; Sofosbuvir; nucleotide inhibitors

Suggested Citation: Elfiky, Abdo, Sofosbuvir Can Inhibit the Newly Emerged Coronavirus (2019-nCoV) in Wuhan, China (1/20/2020). Available at SSRN: https://ssrn.com/abstract=3523869

Keywords: Antivirals; Sofosbuvir; 2019-nCoV.

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#Potential for #global #spread of a novel #coronavirus from #China (J Trav Med., summary)

[Source: Journal of Travel Medicine, full page: (LINK). Summary, edited.]

Rapid Communication

Potential for global spread of a novel coronavirus from China

Authors: Isaac I. Bogoch, MD1,2 Alexander Watts, PhD3,4 Andrea Thomas-Bachli, PhD3,4
Carmen Huber, MSA3,4 Moritz U.G. Kraemer, DPhil5,6 Kamran Khan, MD, MPH1,3,4

Affiliations: 1. Department of Medicine, University of Toronto, Toronto, Canada; 2. Divisions of General Internal Medicine and Infectious Diseases, University Health
Network, Toronto, Canada; 3. Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada; 4. BlueDot, Toronto, Canada; 5. Department of Zoology, University of Oxford, Oxford, UK; 6. Centre for the Mathematical Modelling of Infectious Diseases, London School of Hygiene & Tropical Medicine, London, UK

*Correspondence: Isaac I. Bogoch, Divisions of General Internal Medicine and Infectious
Diseases, Toronto General Hospital, 14EN 209, 200 Elizabeth Street, Toronto, ON, Canada M5G 2C4. E-mail: isaac.bogoch@uhn.ca; Kamran Khan, St. Michael’s Hospital, 30 Bond Street, Toronto, Ontario, Canada, M5B 1W8. Email: khank@smh.ca.

Keywords: SARS; Travel; Coronavirus; Pneumonia; Outbreak; Zoonosis; Wuhan

Highlight: An epidemic of a novel coronavirus emerged from Wuhan, China, in late December 2019 and has since spread to several large Chinese cities. Should a scenario arise where this coronavirus spreads more broadly across China, we evaluate how patterns of international disease transmission could change.

Downloaded from https://academic.oup.com/jtm/advance-article-abstract/doi/10.1093/jtm/taaa011/5716260 by guest on 28 January 2020

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A novel coronavirus emerging from Wuhan, China in late December 2019 is currently spreading to other provinces in mainland China and international destinations across East Asia. At the time of writing, cases have been confirmed in Beijing, Shanghai, Hong Kong, Macau, and multiple cities in Guangdong province, with more than 500 cases confirmed across China.1 Furthermore, several cases have spread internationally via air travel2 to Japan, South Korea, Taiwan, Thailand, and the United States. A recent modelling study concluded that for these international exportations to be observed, the outbreak in China should be substantially larger than is reflected by confirmed case counts.3 Currently, many public health interventions are based on scenarios where Wuhan is the primary source of new cases.4 While there are currently no documented
transmission chains outside of the Wuhan region, should a scenario arise where this novel coronavirus spreads more broadly to and within other Chinese cities, we evaluated how global patterns of disease dispersion might change.

(…)

Keywords: 2019-nCoV; Travel medicine; China.

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#Epidemiological and #Clinical Characteristics of 99 Cases of 2019-Novel #Coronavirus (2019-nCoV) #Pneumonia in #Wuhan, #China (SSRN, abstract)

[Source: SSRN, full page: (LINK). Abstract, edited.]

Epidemiological and Clinical Characteristics of 99 Cases of 2019-Novel Coronavirus (2019-nCoV) Pneumonia in Wuhan, China

26 Pages Posted: 27 Jan 2020

Nanshan Chen, Wuhan Jinyintan Hospital – Department of Tuberculosis and Respiratory; Min Zhou, Shanghai Jiao Tong University (SJTU); Xuan Dong, Wuhan Jinyintan Hospital – Department of Tuberculosis and Respiratory; Jieming Qu, Shanghai Jiao Tong University (SJTU); Fengyun Gong, Wuhan Jinyintan Hospital; Yang Han, Chinese Academy of Sciences (CAS) – State Key Laboratory of Virology; Yang Qiu, Chinese Academy of Sciences (CAS) – State Key Laboratory of Virology; Jingli Wang, Wuhan Jinyintan Hospital; Ying Liu, Wuhan Jinyintan Hospital; Yuan Wei, Wuhan Jinyintan Hospital – Department of Tuberculosis and Respiratory; Jia’an Xia, Wuhan Jinyintan Hospital – Department of Tuberculosis and Respiratory; Ting Yu, Wuhan Jinyintan Hospital – Department of Tuberculosis and Respiratory; Xinxin Zhang, Shanghai Jiao Tong University (SJTU) – Research Laboratory of Clinical Virology; Li Zhang, Wuhan Jinyintan Hospital – Department of Tuberculosis and Respiratory et al.
Abstract

Background:

Since December 2019, a novel coronavirus (2019-nCoV) associated pneumonia has emerged in Wuhan, China. The study aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia.

Methods:

99 cases admitted to Wuhan Jinyintan Hospital during January 1 to 20, 2020 and confirmed by real-time reverse-transcriptase polymerase-chain-reaction (RT-PCR) test were analyzed for epidemiological, demographic, clinical, radiological features, and laboratory data.

Findings:

Of the 99 patients with 2019-nCoV pneumonia, 49 (49%) had a history of exposure to the South China Seafood Wholesale Market. The average age of the patients was 62.85 ± 11.99 years, including 67 males and 32 females. 2019-nCoV was detected in all patients by RT-PCR, and some of them also by serological testing, and metagenomics sequencing analysis. 50 cases (50.51%) had chronic basic diseases. Patients had clinical manifestations of fever (83%), cough (82%), shortness of breath (31%), muscle aches (11%), headache (8%), fuzzy confusion (7%), chest pain (2%), and diarrhea (2%). According to imaging examination, 74 patients showed bilateral pneumonia (74.75%), 25 patients showed multiple mottled and ground-glass opacity, and 1 patient had pneumothorax. Most patients received antiviral, antibiotics, supportive treatments, continuous renal replacement therapy (CRRT) and extracorporeal membrane oxygenation (ECMO), and had good prognosis. 17 patients developed acute Respiratory Distress Syndrome (ARDS) and among them, 2 patients worsened in a short period of time and died of multiple organ failure.

Interpretation:

The infection of the 2019-nCoV can result in severe and even fatal respiratory disease like ARDS. It is very important to actively prevent complications and secondary infections, treat underlying diseases, and provide timely organ function support. Early diagnosis, early isolation, multiple treatment, and intervention of CRRT and ECMO when necessary can effectively reduce mortality caused by severe coronavirus pneumonia.

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Funding: National Key R&D Program of China (No. 2017YFC1309700)

Declaration of Interest: The author reports no conflicts of interest in this work.

Ethical Approval: The study was approved by Jinyintan Hospital Ethics Committee and written informed consent was obtained from all patients involved before enrolment.

Keywords: novel coronavirus; 2019-nCoV pneumonia; diagnosis; treatment

Suggested Citation: Chen, Nanshan and Zhou, Min and Dong, Xuan and Qu, Jieming and Gong, Fengyun and Han, Yang and Qiu, Yang and Wang, Jingli and Liu, Ying and Wei, Yuan and Xia, Jia’an and Yu, Ting and Zhang, Xinxin and Zhang, Li, Epidemiological and Clinical Characteristics of 99 Cases of 2019-Novel Coronavirus (2019-nCoV) Pneumonia in Wuhan, China (1/21/2020). Available at SSRN: https://ssrn.com/abstract=3523861

Keywords: 2019-nCoV; ARDS; ECMO.

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Early #Transmissibility #Assessment of a Novel #Coronavirus in #Wuhan, #China (SSRN, abstract)

[Source: SSRN, full page: (LINK). Abstract, edited.]

Early Transmissibility Assessment of a Novel Coronavirus in Wuhan, China

7 Pages Posted: 24 Jan 2020 Last revised: 27 Jan 2020

Maimuna Majumder, Harvard University – Computational Health Informatics Program; Kenneth D. Mandl, Harvard University – Computational Health Informatics Program

Date Written: January 26, 2020

 

Abstract

Between December 1, 2019 and January 26, 2020, nearly 3000 cases of respiratory illness caused by a novel coronavirus originating in Wuhan, China have been reported. In this short analysis, we combine publicly available cumulative case data from the ongoing outbreak with phenomenological modeling methods to conduct an early transmissibility assessment. Our model suggests that the basic reproduction number associated with the outbreak (at time of writing) may range from 2.0 to 3.1. Though these estimates are preliminary and subject to change, they are consistent with previous findings regarding the transmissibility of the related SARS-Coronavirus and indicate the possibility of epidemic potential.

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Keywords: novel coronavirus, Wuhan, China, transmission, emerging infectious diseases

Suggested Citation: Majumder, Maimuna and Mandl, Kenneth D., Early Transmissibility Assessment of a Novel Coronavirus in Wuhan, China (January 26, 2020). Available at SSRN: https://ssrn.com/abstract=3524675

Keywords: 2019-nCoV.

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Factors associated with #hemolysis during extracorporeal membrane oxygenation (#ECMO)—Comparison of VA- versus VV ECMO (PLOS One, abstract)

[Source: PLOS One, full page: (LINK). Abstract, edited.]

OPEN ACCESS /  PEER-REVIEWED / RESEARCH ARTICLE

Factors associated with hemolysis during extracorporeal membrane oxygenation (ECMO)—Comparison of VA- versus VV ECMO

Hannah Appelt, Alois Philipp, Thomas Mueller, Maik Foltan, Matthias Lubnow, Dirk Lunz, Florian Zeman, Karla Lehle

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Published: January 27, 2020 / DOI: https://doi.org/10.1371/journal.pone.0227793

 

Abstract

Venovenous (VV) and venoarterial (VA) extracorporeal membrane oxygenation (ECMO) are effective support modalities to treat critically ill patients. ECMO-associated hemolysis remains a serious complication. The aim was to disclose similarities and differences in VA- and VV ECMO-associated hemolysis. This is a retrospective single-center analysis (January 2012 to September 2018) including 1,063 adult consecutive patients (VA, n = 606; VV, n = 457). Severe hemolysis (free plasma hemoglobin, fHb > 500 mg/l) during therapy occurred in 4% (VA) and 2% (VV) (p≤0.001). VV ECMO showed significantly more hemolysis by pump head thrombosis (PHT) compared to VA ECMO (9% vs. 2%; p≤0.001). Pretreatments (ECPR, cardiac surgery) of patients who required VA ECMO caused high fHb pre levels which aggravates the proof of ECMO-induced hemolysis (median (interquartile range), VA: fHb pre: 225.0 (89.3–458.0); VV: fHb pre: 72.0 (42.0–138.0); p≤0.001). The survival rate to discharge from hospital differed depending on ECMO type (40% (VA) vs. 63% (VV); p≤0.001). Hemolysis was dominant in VA ECMO patients, mainly caused by different indications and not by the ECMO support itself. PHT was the most severe form of ECMO-induced hemolysis that occurs in both therapies with low frequency, but more commonly in VV ECMO due to prolonged support time.

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Citation: Appelt H, Philipp A, Mueller T, Foltan M, Lubnow M, Lunz D, et al. (2020) Factors associated with hemolysis during extracorporeal membrane oxygenation (ECMO)—Comparison of VA- versus VV ECMO. PLoS ONE 15(1): e0227793. https://doi.org/10.1371/journal.pone.0227793

Editor: Andrea Ballotta, IRCCS Policlinico S.Donato, ITALY

Received: August 28, 2019; Accepted: December 29, 2019; Published: January 27, 2020

Copyright: © 2020 Appelt et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the manuscript and its Supporting Information files.

Funding: The authors received no specific funding for this work.

Competing interests: The authors have declared that no competing interests exist.

Keywords: ECMO; ARDS.

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Persistent severe #ARDS for the #prognostic enrichment of trials (PLOS One, abstract)

[Source: PLOS One, full page: (LINK). Abstract, edited.]

OPEN ACCESS /  PEER-REVIEWED / RESEARCH ARTICLE

Persistent severe acute respiratory distress syndrome for the prognostic enrichment of trials

Elizabeth Sanchez , David R. Price , Kuei-Pin Chung, Clara Oromendia, Augustine M. K. Choi, Edward J. Schenck, Ilias I. Siempos

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Published: January 27, 2020 / DOI: https://doi.org/10.1371/journal.pone.0227346

 

Abstract

Background

Acute respiratory distress syndrome (ARDS) is heterogeneous. As an indication of the heterogeneity of ARDS, there are patients whose syndrome improves rapidly (i.e., within 24 hours), others whose hypoxemia improves gradually and still others whose severe hypoxemia persists for several days. The latter group of patients with persistent severe ARDS poses challenges to clinicians. We attempted to assess the baseline characteristics and outcomes of persistent severe ARDS and to identify which variables are useful to predict it.

Methods

A secondary analysis of patient-level data from the ALTA, EDEN and SAILS ARDSNet clinical trials was conducted. We defined persistent severe ARDS as a partial pressure of arterial oxygen to fraction of inspired oxygen ratio (PaO2:FiO2) of equal to or less than 100 mmHg on the second study day following enrollment. Regularized logistic regression with an L1 penalty [Least Absolute Shrinkage and Selection Operator (LASSO)] techniques were used to identify predictive variables of persistent severe ARDS.

Results

Of the 1531 individuals with ARDS alive on the second study day after enrollment, 232 (15%) had persistent severe ARDS. Of the latter, 100 (43%) individuals had mild or moderate hypoxemia at baseline. Usage of vasopressors was greater [144/232 (62%) versus 623/1299 (48%); p<0.001] and baseline severity of illness was higher in patients with versus without persistent severe ARDS. Mortality at 60 days [95/232 (41%) versus 233/1299 (18%); p<0.001] was higher, and ventilator-free (p<0.001), intensive care unit-free [0 (0–14) versus 19 (7–23); p<0.001] and non-pulmonary organ failure-free [3 (0–21) versus 20 (1–26); p<0.001] days were fewer in patients with versus without persistent severe ARDS. PaO2:FiO2, FiO2, hepatic failure and positive end-expiratory pressure at enrollment were useful predictive variables.

Conclusions

Patients with persistent severe ARDS have distinct baseline characteristics and poor prognosis. Identifying such patients at enrollment may be useful for the prognostic enrichment of trials.

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Citation: Sanchez E, Price DR, Chung K-P, Oromendia C, Choi AMK, Schenck EJ, et al. (2020) Persistent severe acute respiratory distress syndrome for the prognostic enrichment of trials. PLoS ONE 15(1): e0227346. https://doi.org/10.1371/journal.pone.0227346

Editor: Christophe Leroyer, Universite de Bretagne Occidentale, FRANCE

Received: July 31, 2019; Accepted: December 15, 2019; Published: January 27, 2020

Copyright: © 2020 Sanchez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: Patient-level data from randomized controlled trials for this secondary analysis were obtained through the Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) of National Institutes of Health-National Heart, Lung, and Blood Institute (NIH-NHLBI) (relevant reference: Coady SA, Mensah GA, Wagner EL, Goldfarb ME, Hitchcock DM, Giffen CA: Use of the National Heart, Lung, and Blood Institute Data Repository. N Engl J Med 2017; 376:1849-58; https://biolincc.nhlbi.nih.gov/home). Others would be able to access these data in the same manner as the authors; i.e., after submission of a protocol to the Biologic Specimen and Data Repository Information Coordinating Center (BioLINCC) of National Institutes of Health-National Heart, Lung, and Blood Institute (NIH-NHLBI) and institution review board (IRB) approval from their institution. Details on how others can assess the datasets are provided both in website https://biolincc.nhlbi.nih.gov/home and the article Coady SA, Mensah GA, Wagner EL, Goldfarb ME, Hitchcock DM, Giffen CA: Use of the National Heart, Lung, and Blood Institute Data Repository. N Engl J Med 2017; 376:1849-58. The authors confirm that they did not have any special access privileges that others would not have.

Funding: This work was supported by National Institutes of Health grants UL1 TR000457-06 (to DRP), KL2 TR000458-10 (to EJS), R01 HL055330 (to AMKC) and P01 HL108801 (to AMKC). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The corresponding author has read the journal’s policy and the authors of this manuscript have the following competing interests: AMC is a co-founder of Proterris and serving as a consultant for an advisory board meeting of Teva Pharmaceutical Industries, July 2018. None declared (ES, DRP, KPC, CO, EJS, IIS). This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials.

Keywords: ARDS.

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