The epidemiology, diagnosis and treatment of COVID-19

Pan Zhai, Yanbing Ding, Xia Wu, Junke Long, Yanjun Zhong, Yiming Li, Pan Zhai, Yanbing Ding, Xia Wu, Junke Long, Yanjun Zhong, Yiming Li

Abstract

In December 2019, the outbreak of the novel coronavirus disease (COVID-19) in China spread worldwide, becoming an emergency of major international concern. SARS-CoV-2 infection causes clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus. Human-to-human transmission via droplets, contaminated hands or surfaces has been described, with incubation times of 2-14 days. Early diagnosis, quarantine, and supportive treatments are essential to cure patients. This paper reviews the literature on all available information about the epidemiology, diagnosis, isolation and treatments of COVID-19. Treatments, including antiviral agents, chloroquine and hydroxychloroquine, corticosteroids, antibodies, convalescent plasma transfusion and vaccines, are discussed in this article. In addition, registered trials investigating treatment options for COVID-19 infection are listed.

Keywords: COVID-19; Clinical trials; Diagnosis; Isolation; Pandemic; Remdesivir.

Copyright © 2020 Elsevier Ltd. All rights reserved.

References

    1. Zhu N., Zhang D., Wang W., Li X., Yang B., Song J. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382:727–733.
    1. Lu R., Zhao X., Li J., Niu P., Yang B., Wu H. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395:565–574.
    1. Xiao C., Li X., Liu S., Sang Y., Gao S.J., Gao F. HIV-1 did not contribute to the 2019-nCoV genome. Emerg Microbes Infect. 2020;9:378–381.
    1. Paraskevis D., Kostaki E.G., Magiorkinis G., Panayiotakopoulos G., Sourvinos G., Tsiodras S. Full-genome evolutionary analysis of the novel corona virus (2019-nCoV) rejects the hypothesis of emergence as a result of a recent recombination event. Infect Genet Evol. 2020;79
    1. Harcourt J., Tamin A., Lu X., Kamili S., Sakthivel S.K., Murray J. Severe Acute Respiratory Syndrome Coronavirus 2 from patient with 2019 novel Coronavirus disease, United States. Emerging Infect Dis. 2020;26
    1. Wu F., Zhao S., Yu B., Chen Y.M., Wang W., Song Z.G. A new coronavirus associated with human respiratory disease in China. Nature. 2020;579:265–269.
    1. Li Q., Guan X., Wu P., Wang X., Zhou L., Tong Y. Early transmission dynamics in Wuhan, China, of novel Coronavirus-infected pneumonia. N Engl J Med. 2020;382:1199–1207.
    1. Backer J.A., Klinkenberg D., Wallinga J. Incubation period of 2019 novel coronavirus (2019-nCoV) infections among travellers from Wuhan, China, 20-28 January 2020. Euro Surveill. 2020;25
    1. Bai Y., Yao L., Wei T., Tian F., Jin D.Y., Chen L. Presumed asymptomatic carrier transmission of COVID-19. JAMA. 2020
    1. Jiang X., Rayner S., Luo M.H. Does SARS-CoV-2 has a longer incubation period than SARS and MERS? J Med Virol. 2020;92:476–478.
    1. Zhao S., Lin Q., Ran J., Musa S.S., Yang G., Wang W. Preliminary estimation of the basic reproduction number of novel coronavirus (2019-nCoV) in China, from 2019 to 2020: A data-driven analysis in the early phase of the outbreak. Int J Infect Dis. 2020;92:214–217.
    1. Tang B., Wang X., Li Q., Bragazzi N.L., Tang S., Xiao Y. Estimation of the transmission risk of the 2019-nCoV and Its implication for public health interventions. J Clin Med. 2020;9
    1. Lai C.C., Shih T.P., Ko W.C., Tang H.J., Hsueh P.R. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020
    1. To K.K., Tsang O.T., Chik-Yan Yip C., Chan K.H., Wu T.C., Chan J.M.C. Consistent detection of 2019 novel coronavirus in saliva. Clin Infect Dis. 2020
    1. Bhadra S., Jiang Y.S., Kumar M.R., Johnson R.F., Hensley L.E., Ellington A.D. Real-time sequence-validated loop-mediated isothermal amplification assays for detection of Middle East respiratory syndrome coronavirus (MERS-CoV) PLoS One. 2015;10
    1. Chan J.F., Choi G.K., Tsang A.K., Tee K.M., Lam H.Y., Yip C.C. Development and evaluation of novel real-time reverse transcription-PCR Assays with locked nucleic acid probes targeting leader sequences of human-pathogenic Coronaviruses. J Clin Microbiol. 2015;53:2722–2726.
    1. Huang P., Wang H., Cao Z., Jin H., Chi H., Zhao J. A Rapid and Specific Assay for the Detection of MERS-CoV. Front Microbiol. 2018;9:1101.
    1. Lee S.H., Baek Y.H., Kim Y.H., Choi Y.K., Song M.S., Ahn J.Y. One-pot reverse transcriptional loop-mediated isothermal amplification (RT-LAMP) for detecting MERS-CoV. Front Microbiol. 2016;7:2166.
    1. Chu D.K.W., Pan Y., Cheng S.M.S., Hui K.P.Y., Krishnan P., Liu Y. Molecular diagnosis of a novel Coronavirus (2019-nCoV) causing an outbreak of pneumonia. Clin Chem. 2020
    1. Chan J.F., Yip C.C., To K.K., Tang T.H., Wong S.C., Leung K.H. Improved molecular diagnosis of COVID-19 by the novel, highly sensitive and specific COVID-19-RdRp/Hel real-time reverse transcription-polymerase chain reaction assay validated in vitro and with clinical specimens. J Clin Microbiol. 2020
    1. Konrad R., Eberle U., Dangel A., Treis B., Berger A., Bengs K. Rapid establishment of laboratory diagnostics for the novel coronavirus SARS-CoV-2 in Bavaria, Germany, February 2020. Euro Surveill. 2020;25
    1. Cordes A.K., Heim A. Rapid random access detection of the novel SARS-coronavirus-2 (SARS-CoV-2, previously 2019-nCoV) using an open access protocol for the Panther Fusion. J Clin Virol. 2020;125
    1. Corman V.M., Landt O., Kaiser M., Molenkamp R., Meijer A., Chu D.K.W. Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro Surveill. 2020;25
    1. Liu R., Han H., Liu F., Lv Z., Wu K., Liu Y. Positive rate of RT-PCR detection of SARS-CoV-2 infection in 4880 cases from one hospital in Wuhan, China, from Jan to Feb 2020. Clin Chim Acta. 2020;505:172–175.
    1. Zhang W., Du R.H., Li B., Zheng X.S., Yang X.L., Hu B. Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes. Emerg Microbes Infect. 2020;9:386–389.
    1. Fang Y., Zhang H., Xie J., Lin M., Ying L., Pang P. Sensitivity of chest CT for COVID-19: comparison to RT-PCR. Radiology. 2020
    1. Huang P., Liu T., Huang L., Liu H., Lei M., Xu W. Use of chest CT in combination with negative RT-PCR assay for the 2019 novel Coronavirus but high clinical suspicion. Radiology. 2020
    1. Cobb B., Simon C.O., Stramer S.L., Body B., Mitchell P.S., Reisch N. The cobas(R) 6800/8800 system: a new era of automation in molecular diagnostics. Expert Rev Mol Diagn. 2017;17:167–180.
    1. Marlowe E.M., Hardy D., Krevolin M., Gohl P., Bertram A., Arcenas R. High-throughput testing of urogenital and extragenital specimens for detection of Chlamydia trachomatis and Neisseria gonorrhoeae with Cobas((R)) CT/NG. Eur J Microbiol Immunol (Bp) 2017;7:176–186.
    1. Greub G., Sahli R., Brouillet R., Jaton K. Ten years of R&D and full automation in molecular diagnosis. Future Microbiol. 2016;11:403–425.
    1. Eigner U., Reucher S., Hefner N., Staffa-Peichl S., Kolb M., Betz U. Clinical evaluation of multiplex RT-PCR assays for the detection of influenza A/B and respiratory syncytial virus using a high throughput system. J Virol Methods. 2019;269:49–54.
    1. Pfefferle S., Reucher S., Nörz D., Lütgehetmann M. Evaluation of a quantitative RT-PCR assay for the detection of the emerging coronavirus SARS-CoV-2 using a high throughput system. Euro Surveill. 2020;25
    1. Xie X., Zhong Z., Zhao W., Zheng C., Wang F., Liu J. Chest CT for typical 2019-nCoV pneumonia: relationship to negative RT-PCR testing. Radiology. 2020
    1. Ai T., Yang Z., Hou H., Zhan C., Chen C., Lv W. Correlation of chest CT and RT-PCR testing in Coronavirus disease 2019 (COVID-19) in China: A Report of 1014 Cases. Radiology. 2020
    1. Das K.M., Lee E.Y., Al Jawder S.E., Enani M.A., Singh R., Skakni L. Acute Middle East Respiratory Syndrome Coronavirus: temporal lung changes observed on the chest radiographs of 55 patients. AJR Am J Roentgenol. 2015;205:W267–W274.
    1. Chung M., Bernheim A., Mei X., Zhang N., Huang M., Zeng X. CT imaging features of 2019 novel Coronavirus (2019-nCoV) Radiology. 2020
    1. Pan F., Ye T., Sun P., Gui S., Liang B., Li L. Time course of lung changes on chest CT During recovery from 2019 novel Coronavirus (COVID-19) pneumonia. Radiology. 2020
    1. Shi H., Han X., Jiang N., Cao Y., Alwalid O., Gu J. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis. 2020;20:425–434.
    1. Xu X., Yu C., Qu J., Zhang L., Jiang S., Huang D. Imaging and clinical features of patients with 2019 novel coronavirus SARS-CoV-2. Eur J Nucl Med Mol Imaging. 2020;47:1275–1280.
    1. Wang Y., Kang H., Liu X., Tong Z. Combination of RT-qPCR testing and clinical features for diagnosis of COVID-19 facilitates management of SARS-CoV-2 outbreak. J Med Virol. 2020
    1. Wilder-Smith A., Freedman D.O. Isolation, quarantine, social distancing and community containment: pivotal role for old-style public health measures in the novel coronavirus (2019-nCoV) outbreak. J Travel Med. 2020;27
    1. Zhong N.S., Zeng G.Q. Pandemic planning in China: applying lessons from severe acute respiratory syndrome. Respirology. 2008;13(Suppl 1):S33–S35.
    1. Chan K.S., Lai S.T., Chu C.M., Tsui E., Tam C.Y., Wong M.M.L. Treatment of severe acute respiratory syndrome with lopinavir/ritonavir: a multicentre retrospective matched cohort study. Hong Kong Med J. 2003;9:399–406.
    1. Yao T.-T., Qian J.-D., Zhu W.-Y., Wang Y., Wang G.-Q. A systematic review of lopinavir therapy for SARS coronavirus and MERS coronavirus-A possible reference for coronavirus disease-19 treatment option. J Med Virol. 2020
    1. Falzarano D., de Wit E., Rasmussen A.L., Feldmann F., Okumura A., Scott D.P. Treatment with interferon-α2b and ribavirin improves outcome in MERS-CoV-infected rhesus macaques. Nat Med. 2013;19:1313–1317.
    1. Elfiky A.A. Anti-HCV, nucleotide inhibitors, repurposing against COVID-19. Life Sci. 2020;248
    1. Mulangu S., Dodd L.E., Davey R.T., Jr., Tshiani Mbaya O., Proschan M., Mukadi D. A randomized, controlled trial of Ebola virus disease therapeutics. N Engl J Med. 2019;381:2293–2303.
    1. Tchesnokov E.P., Feng J.Y., Porter D.P., Gotte M. Mechanism of inhibition of Ebola virus RNA-dependent RNA Polymerase by remdesivir. Viruses. 2019;11
    1. Sheahan T.P., Sims A.C., Leist S.R., Schafer A., Won J., Brown A.J. Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV. Nat Commun. 2020;11:222.
    1. Sheahan T.P., Sims A.C., Graham R.L., Menachery V.D., Gralinski L.E., Case J.B. Broad-spectrum antiviral GS-5734 inhibits both epidemic and zoonotic coronaviruses. Sci Transl Med. 2017;9
    1. de Wit E., Feldmann F., Cronin J., Jordan R., Okumura A., Thomas T. Prophylactic and therapeutic remdesivir (GS-5734) treatment in the rhesus macaque model of MERS-CoV infection. Proc Natl Acad Sci USA. 2020;117:6771–6776.
    1. Gordon C.J., Tchesnokov E.P., Feng J.Y., Porter D.P., Gotte M. The antiviral compound remdesivir potently inhibits RNA-dependent RNA polymerase from Middle East respiratory syndrome coronavirus. J Biol Chem. 2020
    1. Holshue M.L., DeBolt C., Lindquist S., Lofy K.H., Wiesman J., Bruce H. First case of 2019 novel Coronavirus in the United States. N Engl J Med. 2020;382:929–936.
    1. Martinez M.A. Compounds with therapeutic potential against novel respiratory 2019 coronavirus. Antimicrob Agents Chemother. 2020
    1. Wang Z., Chen X., Lu Y., Chen F., Zhang W. Clinical characteristics and therapeutic procedure for four cases with 2019 novel coronavirus pneumonia receiving combined Chinese and Western medicine treatment. Biosci Trends. 2020;14:64–68.
    1. Savarino A., Di Trani L., Donatelli I., Cauda R., Cassone A. New insights into the antiviral effects of chloroquine. Lancet Infect Dis. 2006;6:67–69.
    1. Yan Y., Zou Z., Sun Y., Li X., Xu K.F., Wei Y. Anti-malaria drug chloroquine is highly effective in treating avian influenza A H5N1 virus infection in an animal model. Cell Res. 2013;23:300–302.
    1. Rolain J.M., Colson P., Raoult D. Recycling of chloroquine and its hydroxyl analogue to face bacterial, fungal and viral infections in the 21st century. Int J Antimicrob Agents. 2007;30:297–308.
    1. Vincent M.J., Bergeron E., Benjannet S., Erickson B.R., Rollin P.E., Ksiazek T.G. Chloroquine is a potent inhibitor of SARS coronavirus infection and spread. Virol J. 2005;2:69.
    1. Gao J., Tian Z., Yang X. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends. 2020;14:72–73.
    1. [Expert consensus on chloroquine phosphate for the treatment of novel coronavirus pneumonia] Zhonghua Jie He He Hu Xi Za Zhi. 2020;43:185–188.
    1. Colson P., Rolain J.M., Lagier J.C., Brouqui P., Raoult D. Chloroquine and hydroxychloroquine as available weapons to fight COVID-19. Int J Antimicrob Agents. 2020
    1. Jallouli M., Galicier L., Zahr N., Aumaitre O., Frances C., Le Guern V. Determinants of hydroxychloroquine blood concentration variations in systemic lupus erythematosus. Arthritis Rheumatol. 2015;67:2176–2184.
    1. Biot C., Daher W., Chavain N., Fandeur T., Khalife J., Dive D. Design and synthesis of hydroxyferroquine derivatives with antimalarial and antiviral activities. J Med Chem. 2006;49:2845–2849.
    1. Yao X., Ye F., Zhang M., Cui C., Huang B., Niu P. In vitro antiviral activity and projection of optimized dosing design of hydroxychloroquine for the treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Clin Infect Dis. 2020
    1. Huang C., Wang Y., Li X., Ren L., Zhao J., Hu Y. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497–506.
    1. Chen L., Liu H.G., Liu W., Liu J., Liu K., Shang J. [Analysis of clinical features of 29 patients with 2019 novel coronavirus pneumonia] Zhonghua Jie He He Hu Xi Za Zhi. 2020;43:203–208.
    1. Schrezenmeier E., Dorner T. Mechanisms of action of hydroxychloroquine and chloroquine: implications for rheumatology. Nat Rev Rheumatol. 2020;16:155–166.
    1. Savarino A., Boelaert J.R., Cassone A., Majori G., Cauda R. Effects of chloroquine on viral infections: an old drug against today's diseases. Lancet Infect Dis. 2003;3:722–727.
    1. Touret F., de Lamballerie X. Of chloroquine and COVID-19. Antiviral Res. 2020;177
    1. Colson P., Rolain J.M., Raoult D. Chloroquine for the 2019 novel coronavirus SARS-CoV-2. Int J Antimicrob Agents. 2020
    1. Arabi Y.M., Mandourah Y., Al-Hameed F., Sindi A.A., Almekhlafi G.A., Hussein M.A. Corticosteroid therapy for critically ill patients with Middle East Respiratory Syndrome. Am J Respir Crit Care Med. 2018;197:757–767.
    1. Lee N., Allen Chan K.C., Hui D.S., Ng E.K., Wu A., Chiu R.W. Effects of early corticosteroid treatment on plasma SARS-associated Coronavirus RNA concentrations in adult patients. J Clin Virol. 2004;31:304–309.
    1. Lee D.T., Wing Y.K., Leung H.C., Sung J.J., Ng Y.K., Yiu G.C. Factors associated with psychosis among patients with severe acute respiratory syndrome: a case-control study. Clin Infect Dis. 2004;39:1247–1249.
    1. Russell C.D., Millar J.E., Baillie J.K. Clinical evidence does not support corticosteroid treatment for 2019-nCoV lung injury. Lancet. 2020;395:473–475.
    1. Tian X., Li C., Huang A., Xia S., Lu S., Shi Z. Potent binding of 2019 novel coronavirus spike protein by a SARS coronavirus-specific human monoclonal antibody. Emerg Microbes Infect. 2020;9:382–385.
    1. Wrapp D., Wang N., Corbett K.S., Goldsmith J.A., Hsieh C.L., Abiona O. Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation. Science. 2020;367:1260–1263.
    1. Mair-Jenkins J., Saavedra-Campos M., Baillie J.K., Cleary P., Khaw F.M., Lim W.S. The effectiveness of convalescent plasma and hyperimmune immunoglobulin for the treatment of severe acute respiratory infections of viral etiology: a systematic review and exploratory meta-analysis. J Infect Dis. 2015;211:80–90.
    1. van Griensven J., Edwards T., de Lamballerie X., Semple M.G., Gallian P., Baize S. Evaluation of convalescent plasma for Ebola virus disease in Guinea. N Engl J Med. 2016;374:33–42.
    1. Zhou P., Yang X.L., Wang X.G., Hu B., Zhang L., Zhang W. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579:270–273.
    1. Du L., He Y., Zhou Y., Liu S., Zheng B.J., Jiang S. The spike protein of SARS-CoV–a target for vaccine and therapeutic development. Nat Rev Microbiol. 2009;7:226–236.
    1. Agnandji S.T., Huttner A., Zinser M.E., Njuguna P., Dahlke C., Fernandes J.F. Phase 1 Trials of rVSV Ebola vaccine in Africa and Europe. N Engl J Med. 2016;374:1647–1660.
    1. Zhang N., Wang L., Deng X., Liang R., Su M., He C. Recent advances in the detection of respiratory virus infection in humans. J Med Virol. 2020;92:408–417.
    1. Mackenzie J.S., Jeggo M. Reservoirs and vectors of emerging viruses. Curr Opin Virol. 2013;3:170–179.
    1. Kampf G., Todt D., Pfaender S., Steinmann E. Persistence of coronaviruses on inanimate surfaces and its inactivation with biocidal agents. J Hosp Infect. 2020;104:246–251.
    1. Chen N., Zhou M., Dong X., Qu J., Gong F., Han Y. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395:507–513.
    1. Chen H., Guo J., Wang C., Luo F., Yu X., Zhang W. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. Lancet. 2020;395:809–815.
    1. Schwartz D.A., Graham A.L. Potential maternal and infant outcomes from (Wuhan) Coronavirus 2019-nCoV Infecting pregnant women: Lessons from SARS, MERS, and other human Coronavirus infections. Viruses. 2020;12
    1. Xu X.W., Wu X.X., Jiang X.G., Xu K.J., Ying L.J., Ma C.L. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ. 2020;368:m606.
    1. Xu Z., Shi L., Wang Y., Zhang J., Huang L., Zhang C. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020
    1. Zou X., Chen K., Zou J., Han P., Hao J., Han Z. Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Front Med. 2020
    1. Wang D., Hu B., Hu C., Zhu F., Liu X., Zhang J. Clinical characteristics of 138 hospitalized patients with 2019 novel Coronavirus-infected pneumonia in Wuhan, China. JAMA. 2020
    1. Zhang Q., Wang Y., Qi C., Shen L., Li J. Clinical trial analysis of 2019-nCoV therapy registered in China. J Med Virol. 2020

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