Is the COVID-19 virus man-made?

Submitted by: PJasmina 80

No. The studies in this list for which we have identified answers are unanimous on this conclusion.
NOTE: New research on COVID-19 comes out nearly every day. The state of our knowledge may change quickly so take this answer with a grain of salt.
This short answer was generated by aggregating the answers that each of the 8 studies below gave to the question (as indicated by State of K members) and adjusting for source quality and other factors. If key studies are missing or the answers attributed to individual studies are incorrect, the above answer could be wrong. For medical questions, don't rely on the information here. Consult a medical professional.


Chart summary of 8 studies examining this question

All answers are assigned by State of K users. The label Couldn't Identify means that State of K was not able to determine whether a study answers the question "yes" or "no". This could be due to several factors. One possibility is that a study found some evidence to indicate that the answer to the question is "yes" and some evidence to indicate that the answer is "no". This often happens when a study uses two or more proxies to study the same phenomenon (i.e. firearm sales figures and self-reported firearm ownership rates as proxies for the prevalence of firearms) and the proxies yield different results when looking for correlations with another phenomenon (i.e. firearm-related deaths). Alternatively, the label may be applied if the phenomenon under study (i.e. whether breast milk improves cognitive function) is true for one group, but not another (i.e. true for girls, but not for boys). Yet another possibility is that a study found there was insufficient evidence to reach a conclusion regarding the question. Finally, the full text or abstract of a study may not have been written clearly or was inaccessible. This would make it difficult to determine how a study answered a question.

All labels of Literature Reviews and source quality are assigned by State of K. For academic journals, the label "Q[NUMBER]" is an indication of the quality of the publication. The "NUMBER" refer to the best quartile in which the journal appeared among all the subjects in which the journal was ranked by Scimago Institutions Rankings. For example, if a journal was ranked in the third quartile (Q3) in infectious diseases, but in the second quartile in Ebola studies (Q2), you would see "Q2". The best quartile is "Q1". Publications other than academic journals may be labeled as "Highly Regarded Sources". Government sources receive this label as do NGOs ranked by the TTCSP Global Go To Think Tank Index Reports. The information contained in a source that is labeled "highly regarded" or "Q1" is not necessarily more accurate than information contained in a source without that label, but these are rough guides to source quality.

Additional Recommended Studies Not in this List (yet)

SUMMARIES OF STUDIES
Total studies in list: 8
Sorted by publication year
1
The Proximal Origin of SARS-CoV-2
"Since the first reports of a novel pneumonia (COVID-19) in Wuhan city, Hubei province, China there has been considerable discussion and uncertainty over the origin of the causative virus, SARS-CoV-2. Infections with SARS-CoV-2 are now widespread in China, with cases in every province. As of 14 February 2020, 64,473 such cases have been confirmed, with 1,384 deaths attributed to the virus. These official case numbers are likely an underestimate because of limited reporting of mild and asymptomatic cases, and the virus is clearly capable of efficient human-to-human transmission. Based on the possibility of spread to countries with weaker healthcare systems, the World Health Organization has declared the COVID-19 outbreak a Public Health Emergency of International Concern (PHEIC). There are currently neither vaccines nor specific treatments for this disease."
AUTHORS
Robert F. Garry
W. Ian Lipkin
Edward C. Holmes
Kristian G. Andersen
Andrew Rambaut
PUBLISHED
2020 in Virological
UNRANKED SOURCE
No
No
2
Receptor recognition by novel coronavirus from Wuhan: An analysis based on decade-long structural studies of SARS
"Recently a novel coronavirus (2019-nCoV) has emerged from Wuhan, China, causing symptoms in humans similar to those caused by SARS coronavirus (SARS-CoV). Since SARS-CoV outbreak in 2002, extensive structural analyses have revealed key atomic-level interactions between SARS-CoV spike protein receptor-binding domain (RBD) and its host receptor angiotensin-converting enzyme 2 (ACE2), which regulate both the cross-species and human-to-human transmissions of SARS-CoV. Here we analyzed the potential receptor usage by 2019-nCoV, based on the rich knowledge about SARS-CoV and the newly released sequence of 2019-nCoV. First, the sequence of 2019-nCoV RBD, including its receptor-binding motif (RBM) that directly contacts ACE2, is similar to that of SARS-CoV, strongly suggesting that 2019-nCoV uses ACE2 as its receptor. Second, several critical residues in 2019-nCoV RBM (particularly Gln493) provide favorable interactions with human ACE2, consistent with 2019-nCoV's capacity for human cell infection. Third, several other critical residues in 2019-nCoV RBM (particularly Asn501) are compatible with, but not ideal for, binding human ACE2, suggesting that 2019-nCoV has acquired some capacity for human-to-human transmission. Last, while phylogenetic analysis indicates a bat origin of 2019-nCoV, 2019-nCoV also potentially recognizes ACE2 from a diversity of animal species (except mice and rats), implicating these animal species as possible intermediate hosts or animal models for 2019-nCoV infections. These analyses provide insights into the receptor usage, cell entry, host cell infectivity and animal origin of 2019-nCoV, and may help epidemic surveillance and preventive measures against 2019-nCoV."
AUTHORS
F Li
RS Baric
R Graham
J Shang
Y Wan
PUBLISHED
2020 in Journal of Virology
High quality source
No
No
3
The 2019‐new coronavirus epidemic: evidence for virus evolution
"There is a worldwide concern about the new coronavirus 2019‐nCoV as a global public health threat. In this article, we provide a preliminary evolutionary and molecular epidemiological analysis of this new virus. A phylogenetic tree has been built using the 15 available whole genome sequences of 2019‐nCoV, 12 whole genome sequences of 2019‐nCoV, and 12 highly similar whole genome sequences available in gene bank (five from the severe acute respiratory syndrome, two from Middle East respiratory syndrome, and five from bat SARS‐like coronavirus). Fast unconstrained Bayesian approximation analysis shows that the nucleocapsid and the spike glycoprotein have some sites under positive pressure, whereas homology modeling revealed some molecular and structural differences between the viruses. The phylogenetic tree showed that 2019‐nCoV significantly clustered with bat SARS‐like coronavirus sequence isolated in 2015, whereas structural analysis revealed mutation in Spike Glycoprotein and nucleocapsid protein. From these results, the new 2019‐nCoV is distinct from SARS virus, probably trasmitted from bats after mutation conferring ability to infect humans."
AUTHORS
A Ciccozzi
M Giovannetti
D Benvenuto
PUBLISHED
2020 in Journal of Medical Virology
Q2
No
No
4
Full-genome evolutionary analysis of the novel corona virus (2019-nCoV) rejects the hypothesis of emergence as a result of a recent recombination event
"BackgroundA novel coronavirus (2019-nCoV) associated with human to human transmission and severe human infection has been recently reported from the city of Wuhan in China. Our objectives were to characterize the genetic relationships of the 2019-nCoV and to search for putative recombination within the subgenus of sarbecovirus.MethodsPutative recombination was investigated by RDP4 and Simplot v3.5.1 and discordant phylogenetic clustering in individual genomic fragments was confirmed by phylogenetic analysis using maximum likelihood and Bayesian methods.ResultsOur analysis suggests that the 2019-nCoV although closely related to BatCoV RaTG13 sequence throughout the genome (sequence similarity 96.3%), shows discordant clustering with the Bat_SARS-like coronavirus sequences. Specifically, in the 5′-part spanning the first 11,498 nucleotides and the last 3′-part spanning 24,341–30,696 positions, 2019-nCoV and RaTG13 formed a single cluster with Bat_SARS-like coronavirus sequences, whereas in the middle region spanning the 3′-end of ORF1a, the ORF1b and almost half of the spike regions, 2019-nCoV and RaTG13 grouped in a separate distant lineage within the sarbecovirus branch.ConclusionsThe levels of genetic similarity between the 2019-nCoV and RaTG13 suggest that the latter does not provide the exact variant that caused the outbreak in humans, but the hypothesis that 2019-nCoV has originated from bats is very likely. We show evidence that the novel coronavirus (2019-nCov) is not-mosaic consisting in almost half of its genome of a distinct lineage within the betacoronavirus. These genomic features and their potential association with virus characteristics and virulence in humans need further attention."
AUTHORS
G Magiorkinis
EG Kostaki
D Paraskevis
PUBLISHED
2020 in Infection
High quality source
No
No
5
Identification of a novel coronavirus causing severe pneumonia in human: a descriptive study
"Background: Human infections with zoonotic coronaviruses (CoVs), including severe acute respiratory syndrome (SARS)-CoV and Middle East respiratory syndrome (MERS)-CoV, have raised great public health concern globally. Here, we report a novel bat-origin CoV causing severe and fatal pneumonia in humans.Methods: We collected clinical data and bronchoalveolar lavage (BAL) specimens from five patients with severe pneumonia from Jin Yin-tan Hospital of Wuhan, Hubei province, China. Nucleic acids of the BAL were extracted and subjected to next-generation sequencing. Virus isolation was carried out, and maximum-likelihood phylogenetic trees were constructed.Results: Five patients hospitalized from December 18 to December 29, 2019 presented with fever, cough, and dyspnea accompanied by complications of acute respiratory distress syndrome. Chest radiography revealed diffuse opacities and consolidation. One of these patients died. Sequence results revealed the presence of a previously unknown β-CoV strain in all five patients, with 99.8% to 99.9% nucleotide identities among the isolates. These isolates showed 79.0% nucleotide identity with the sequence of SARS-CoV (GenBank NC_004718) and 51.8% identity with the sequence of MERS-CoV (GenBank NC_019843). The virus is phylogenetically closest to a bat SARS-like CoV (SL-ZC45, GenBank MG772933) with 87.6% to 87.7% nucleotide identity, but is in a separate clade. Moreover, these viruses have a single intact open reading frame gene 8, as a further indicator of bat-origin CoVs. However, the amino acid sequence of the tentative receptor-binding domain resembles that of SARS-CoV, indicating that these viruses might use the same receptor.Conclusion: A novel bat-borne CoV was identified that is associated with severe and fatal respiratory disease in humans."
AUTHORS
L Guo
ZC Xiang
ZQ Wu
YM Wang
LL Ren
PUBLISHED
2020 in Chinese Medical Journal
Q2
No
No
6
A novel coronavirus from patients with pneumonia in China, 2019
"In December 2019, a cluster of patients with pneumonia of unknown cause was linked to a seafood wholesale market in Wuhan, China. A previously unknown betacoronavirus was discovered through the use of unbiased sequencing in samples from patients with pneumonia. Human airway epithelial cells were used to isolate a novel coronavirus, named 2019-nCoV, which formed a clade within the subgenus sarbecovirus, Orthocoronavirinae subfamily. Different from both MERS-CoV and SARS-CoV, 2019-nCoV is the seventh member of the family of coronaviruses that infect humans. Enhanced surveillance and further investigation are ongoing. (Funded by the National Key Research and Development Program of China and the National Major Project for Control and Prevention of Infectious Disease in China.)"
AUTHORS
B Yang
X Li
W Wang
D Zhang
N Zhu
PUBLISHED
2020 in The New England journal of medicine
High quality source
No
No
7
Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding
"BackgroundIn late December, 2019, patients presenting with viral pneumonia due to an unidentified microbial agent were reported in Wuhan, China. A novel coronavirus was subsequently identified as the causative pathogen, provisionally named 2019 novel coronavirus (2019-nCoV). As of Jan 26, 2020, more than 2000 cases of 2019-nCoV infection have been confirmed, most of which involved people living in or visiting Wuhan, and human-to-human transmission has been confirmed.MethodsWe did next-generation sequencing of samples from bronchoalveolar lavage fluid and cultured isolates from nine inpatients, eight of whom had visited the Huanan seafood market in Wuhan. Complete and partial 2019-nCoV genome sequences were obtained from these individuals. Viral contigs were connected using Sanger sequencing to obtain the full-length genomes, with the terminal regions determined by rapid amplification of cDNA ends. Phylogenetic analysis of these 2019-nCoV genomes and those of other coronaviruses was used to determine the evolutionary history of the virus and help infer its likely origin. Homology modelling was done to explore the likely receptor-binding properties of the virus.FindingsThe ten genome sequences of 2019-nCoV obtained from the nine patients were extremely similar, exhibiting more than 99·98% sequence identity. Notably, 2019-nCoV was closely related (with 88% identity) to two bat-derived severe acute respiratory syndrome (SARS)-like coronaviruses, bat-SL-CoVZC45 and bat-SL-CoVZXC21, collected in 2018 in Zhoushan, eastern China, but were more distant from SARS-CoV (about 79%) and MERS-CoV (about 50%). Phylogenetic analysis revealed that 2019-nCoV fell within the subgenus Sarbecovirus of the genus Betacoronavirus, with a relatively long branch length to its closest relatives bat-SL-CoVZC45 and bat-SL-CoVZXC21, and was genetically distinct from SARS-CoV. Notably, homology modelling revealed that 2019-nCoV had a similar receptor-binding domain structure to that of SARS-CoV, despite amino acid variation at some key residues.Interpretation2019-nCoV is sufficiently divergent from SARS-CoV to be considered a new human-infecting betacoronavirus. Although our phylogenetic analysis suggests that bats might be the original host of this virus, an animal sold at the seafood market in Wuhan might represent an intermediate host facilitating the emergence of the virus in humans. Importantly, structural analysis suggests that 2019-nCoV might be able to bind to the angiotensin-converting enzyme 2 receptor in humans. The future evolution, adaptation, and spread of this virus warrant urgent investigation."
AUTHORS
H Wu
B Yang
P Niu
J Li
X Zhao
R Lu et al
PUBLISHED
2020 in The Lancet
High quality source
No
No
8
A pneumonia outbreak associated with a new coronavirus of probable bat origin
"Since the outbreak of severe acute respiratory syndrome (SARS) 18 years ago, a large number of SARS-related coronaviruses (SARSr-CoVs) have been discovered in their natural reservoir host, bats1,2,3,4. Previous studies have shown that some bat SARSr-CoVs have the potential to infect humans5,6,7. Here we report the identification and characterization of a new coronavirus (2019-nCoV), which caused an epidemic of acute respiratory syndrome in humans in Wuhan, China. The epidemic, which started on 12 December 2019, had caused 2,794 laboratory-confirmed infections including 80 deaths by 26 January 2020. Full-length genome sequences were obtained from five patients at an early stage of the outbreak. The sequences are almost identical and share 79.6% sequence identity to SARS-CoV. Furthermore, we show that 2019-nCoV is 96% identical at the whole-genome level to a bat coronavirus. Pairwise protein sequence analysis of seven conserved non-structural proteins domains show that this virus belongs to the species of SARSr-CoV. In addition, 2019-nCoV virus isolated from the bronchoalveolar lavage fluid of a critically ill patient could be neutralized by sera from several patients. Notably, we confirmed that 2019-nCoV uses the same cell entry receptor—angiotensin converting enzyme II (ACE2)—as SARS-CoV."
AUTHORS
W Zhang
L Zhang
B Hu
XG Wang
XL Yang
P Zhou
PUBLISHED
2020 in Nature
High quality source
No
No







ADDITIONAL STUDIES TO CONSIDER ADDING TO LIST
Total additional studies: 77
State of K's algorithms generated the list of studies below based on the studies that were added to the above list. Some of these studies may also examine: "Is the COVID-19 virus man-made?" If a study examines this question, add it to the list by pressing the button.

Only add studies that examine the same question. Do not add studies that are merely on the same topic.

Study of the lymphocyte change between COVID-19 and non-COVID-19 pneumonia cases suggesting other factors besides uncontrolled inflammation contributed to multi-organ injury
"Background:
The corona virus disease 2019 (COVID-19) shows unusually high transmission rate and unique clinical characteristics, with key pathological mechanism remaining unclear. Here, we analysed the laboratory data based on clinical samples from COVID-19 patients, in parallel comparison with non-COVID-19 pneumonia cases, in an attempt to elucidate the key pathological features of COVID-19 during its infection of the human body.
Methods:
We analysed biochemical indices and lymphocyte subpopulation in COVID-19 patients, and compare these data from non-COVID-19 pneumonia cases. Correlation analysis was performed between leukocyte subgroups count and biochemical indexes in COVID-19 patients.
Results:
The study enrolled 110 patients, comprising 88 COVID-19 patients and 22 non-COVID-19 pneumonia cases. We observed significant differences, including abnormal biochemical indices (CRP, LDH, AST, eGFR, and sodium ion concentration) and reduced lymphocyte subsets count, between the COVID-19 patients and non-COVID-19-caused pneumonia cases. Correlation analysis indicates that the count for lymphocyte subsets-but not that for neutrophils and monocytes-exhibits a significant negative correlation with biochemical indices relating to organ injury, in the COVID-19 infected patients.
Conclusions:
The study indicates significantly different clinical features between 2019 novel coronavirus (2019-nCoV)-caused and non-2019-nCoV-caused pneumonia, especially in terms of lymphocytopenia and organ injury. Notably, correlation analysis demonstrates that tissue damage in COVID-19 patients is attributed to virus infection itself rather than uncontrolled inflammatory responses ("cytokine storm"). These findings provide new insights for developing efficient therapeutic strategies against COVID-19 infection."
AUTHORS
Guoping Ying
Yishan Zheng
Yan Song
Hongxia Wei
Zhen Huang
Chunming Wang et al
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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FEP-based screening prompts drug repositioning against COVID-19
"AbstractThe new coronavirus COVID-19, also known as SARS-CoV-2, has infected more than 300,000 patients and become a global health emergency due to the very high risk of spread and impact of COVID-19. There are no specific drugs or vaccines against COVID-19, thus effective antiviral agents are still urgently needed to combat this virus. Herein, the FEP (free energy perturbation)-based screening strategy is newly derived as a rapid protocol to accurately reposition potential agents against COVID-19 by targeting viral proteinase Mpro. Restrain energy distribution (RED) function was derived to optimize the alchemical pathway of FEP, which greatly accelerated the calculations and first made FEP possible in the virtual screening of the FDA-approved drugs database. As a result, fifteen out of twenty-five drugs validated in vitro exhibited considerable inhibitory potencies towards Mpro. Among them, the most potent Mpro inhibitor dipyridamole potentially inhibited NF-κB signaling pathway and inflammatory responses, and has just finished the first round clinical trials. Our result demonstrated that the FEP-based screening showed remarkable advantages in prompting drug repositioning against COVID-19."
AUTHORS
Yuxia Zhang
Hao Liu
Runduo Liu
Yaoxing Wu
Zhe Li
Xin Li et al
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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How is COVID-19 affecting South Korea? What is our current strategy?
"Abstract
The outbreak of coronavirus disease 2019 (COVID-19) caused by the virus SARS-CoV-2 is expanding globally. South Korea is one of the countries most affected by COVID-19 from the very early stages of this pandemic. Explosive outbreaks occurred across South Korea in the first two months, and efforts to control this new virus have involved everyone across the country. To curb the transmission of the virus, health care professionals, committees, and governments have combined many approaches, such as extensive COVID-19 screening, effective patient triage, the transparent provision of information, and the use of information technology. This experience could provide some valuable ideas and lessons to others who are fighting against COVID-19."
AUTHOR
Minyoung Her
PUBLISHED
2020 in Disaster Medicine and Public Health Preparedness

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A model for COVID-19 prediction in Iran based on China parameters
"Background: The rapid spread of COVID-19 virus from China to other countries and outbreaks of disease require an epidemiological analysis of the disease in the shortest time and an increased awareness of effective interventions. The purpose of this study was to estimate the COVID-19 epidemic in Iran based on the SIR model. The results of the analysis of the epidemiological data of Iran from January 22 to March 8, 2020 were investigated and the prediction was made until March 29, 2020.
Methods: By estimating the three parameters of time-dependent transmission rate, time-dependent recovery rate, and time-dependent mortality rate from Covid-19 outbreak in China, and using the number of Covid-19 infections in Iran, we predicted the number of patients for the next month in Iran. Each of these parameters was estimated using GAM models. All analyses were conducted in R software using the mgcv package.
Findings: On average, 925 people with COVID-19 are expected to be infected daily in Iran. The epidemic peaks within one week (15.03.2020 to 03.21.2020) and reaches its highest point on 03.18.2020 with 1126 infected cases.
Conclusion: The most important point is to emphasize the timing of the epidemic peak, hospital readiness, government measures and public readiness to reduce social contact."
AUTHORS
Mohammad Ali Mansournia
Mohammad Aziz Rasouli
Amin Roshani
Bushra Zareie
Ghobad Moradi
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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Generation of antibodies against COVID-19 virus for development of diagnostic tools
"The COVID-19 China coronavirus started in Dec 2019 was challenged by the lack of accurate serological diagnostic tool for this deadly disease to quickly identify and isolate the infected patients. The generation of COVID-19-specific antibodies is essential for such tasks. Here we report that polyclonal and monoclonal antibodies were generated by immunizing animals with synthetic peptides corresponding to different areas of Nucleoprotein (N) of COVID-19. The specificities of the COVID-19 antibodies were assessed by Western Blot analysis against NPs from COVID-19, MERS and SARS. Antibodies were used for immunohistochemistry staining of the tissue sections from COVID-19 infected patient, as a potential diagnostic tool. A Sandwich ELISA kit was quickly assembled for quantitation of the virus/NP of COVID-19 concentrations in the vaccine preparations. Development of POCT is also aggressively undergoing."
AUTHORS
Wenlin Ren
Maohua Li
Yali Cui
Le Sun
Hao Song
Feng Fang et al
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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Dispositional and situational attribution of COVID-19 risk: A content analysis of response typology
"In the current COVID-19 pandemic, there have been official health recommendations of social distancing, thorough handwashing, and self-isolation to prevent the spread of the virus. However, compliance with these recommendations has been mixed. We suggest that non-compliance may be justified by one’s (mis)perception of their own COVID-19 risk. In this paper, we explore the dispositional and situational attribution of self-reported COVID-19 risk, as per Heider’s Attribution Theory. We conducted a content and framework analysis of responses to an online survey, in which participants (N = 114) were asked to rate their likelihood of contracting the COVID-19 virus, before providing textual responses to explain their rating. Overall, we observed that generally, participants who rated their risk to be low made more dispositional attributions (i.e. attributing their risk to factors such as age and own personal hygiene) whereas higher risk participants made more situational attributions (i.e. attributing COVID-19 risk to government decision-making and other people’s cleanliness). A finalised framework of five response typologies including intrinsic, behavioural, balanced, contextual, and disengaged responses was systematically applied to the data. These results will be discussed in the context of attribution theory and risk perception, whilst providing future recommendations for research that tackles non-compliance of COVID-19 behaviours."
AUTHORS
Madeleine Pownall
Alice Dunning
PUBLISHED
2020 in Center for Open Science

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Current State and Predicting Future Scenario of Highly Infected Nations for COVID-19 Pandemic
"Since the first report of COVID-19 from Wuhan China, the virus has rapidly spread across the globe now presently reported in 177 countries with positive cases crossing 400 thousand and rising. In the current study, prediction is made for highly infected countries by a simple and novel method using only cumulative positive cases reported. The rate of infection per week (R_w) coefficient delineated three phases for the current COVID-19 pandemic. All the countries under study have passed Phase 1 and are currently in Phase 2 except for South Korea which is in Phase 3. Early detection with rapid and large-scale testing helps in controlling the COVID-19 pandemic. Staying in Phase 2 for longer period would lead to increase in COVID-19 positive cases."
AUTHOR
Nandan L Patil
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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SDA-COVID-19: Social Distancing App for COVID-19 Track and Control (Preprint)
"
UNSTRUCTURED
COVID-19 is a highly contagious and lethal virus-based disease. Social distancing is the only way to stop the virus from spreading. In this context, the researchers suggest a social distancing application named SDA-COVID-19. The suggested App (SDA-COVID-19) will help individuals maintain social distancing by the exchange of data among phones about potentially infected and/or contaminated people with COVID-19, with whom an individual socialized or came in contact, whereby, an individual will be alerted if a COVID-19 infected person is in close proximity. Two versions are suggested for SDA-COVID-19 one is Service-Oriented and the other is Bluetooth oriented.
"
AUTHORS
Issam AlHadid
Evon Abu-Taieh
Jeihan Abu-Tayeh
Ali Zolait
PUBLISHED
2020 in JMIR Publications Inc.

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Lactoferrin as potential preventative and treatment for COVID-19
"The novel coronavirus 2019 (COVID-19) pandemic is rapidly advancing across the globe despite public and personal health measures. Antivirals and nutritional supplements have been proposed as potentially useful against SARS-CoV-2 (virus that causes COVID-19), but few have been clinically established. Lactoferrin (Lf) is a naturally occurring and non-toxic glycoprotein that is orally available as a nutritional supplement and has established in vitro anti-viral efficacy against a wide range of virus including SARS-CoV, a closely related corona virus to SARS-CoV-2 (virus that causes COVID-19). Furthermore, Lf possesses unique immunomodulatory and anti-inflammatory effects that maybe especially relevant to the pathophysiology of severe COVID-19 cases. We review the underlying biological mechanisms of Lf as antiviral and immune regulator, and propose its unique potential as preventative and adjunct treatment for COVID-19. We hope that further research and development of Lf nutritional supplementation would establish its role for COVID-19."
AUTHORS
Wei-Zen Sun
Raymond Chang
Tzi Bun Ng
PUBLISHED
2020 in Center for Open Science

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Understand Research Hotspots Surrounding COVID-19 and Other Coronavirus Infections Using Topic Modeling
"Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a virus that causes severe respiratory illness in humans, which eventually results in the current outbreak of novel coronavirus disease (COVID-19) around the world. The research community is interested to know what are the hotspots in coronavirus (CoV) research and how much is known about COVID-19. This study aimed to evaluate the characteristics of publications involving coronaviruses as well as COVID-19 by using a topic modeling analysis.
Methods: We extracted all abstracts and retained the most informative words from the COVID-19 Open Research Dataset, which contains all the 35,092 pieces of coronavirus related literature published up to March 20, 2020. Using Latent Dirichlet Allocation modeling, we trained an eight-topic model from the corpus. We then analyzed the semantic relationships between topics and compared the topic distribution between COVID-19 and other CoV infections.
Results: Eight topics emerged overall: clinical characterization, pathogenesis research, therapeutics research, epidemiological study, virus transmission, vaccines research, virus diagnostics, and viral genomics. It was observed that COVID-19 research puts more emphasis on clinical characterization, epidemiological study, and virus transmission at present. In contrast, topics about diagnostics, therapeutics, vaccines, genomics and pathogenesis only accounted for less than 10% or even 4% of all the COVID-19 publications, much lower than those of other CoV infections.
Conclusions: These results identified knowledge gaps in the area of COVID-19 and offered directions for future research.
Keywords: COVID-19, coronavirus, topic modeling, hotspots, text mining"
AUTHORS
Mingbiao Liang
Mengying Dong
Lijuan Li
Xiaojun Cao
Guangjian Liu
Huiying Liang
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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Sitagliptin: a potential drug for the treatment of SARS-CoV-2?
"Recently, an outbreak of fatal coronavirus, SARS-CoV-2, has emerged from China and is rapidly spreading worldwide. As the coronavirus pandemic rages, drug discovery and development become even more challenging. Drug repurposing of the antimalarial drug chloroquine and its hydroxylated form had demonstrated apparent effectiveness in the treatment of COVID-19 associated pneumonia in clinical trials. SARS-CoV-2 spike protein shares 31.9% sequence identity with the spike protein presents in the Middle East Respiratory Syndrome Corona Virus (MERS-CoV), which infects cells through the interaction of its spike protein with the DPP4 receptor found on macrophages. Sitagliptin, a DPP4 inhibitor, that is known for its antidiabetic, immunoregulatory, anti-inflammatory, and beneficial cardiometabolic effects has been shown to reverse macrophage responses in MERS-CoV infection and reduce CXCL10 chemokine production in AIDS patients. We suggest that Sitagliptin may be beneficial alternative for the treatment of COVID-19 disease especially in diabetic patients and patients with preexisting cardiovascular conditions who are already at higher risk of COVID-19 infection."
AUTHOR
Sanaa Bardaweel
PUBLISHED
2020 in Center for Open Science

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Sitagliptin: a potential drug for the treatment of SARS-CoV-2?
"Recently, an outbreak of fatal coronavirus, SARS-CoV-2, has emerged from China and is rapidly spreading worldwide. As the coronavirus pandemic rages, drug discovery and development become even more challenging. Drug repurposing of the antimalarial drug chloroquine and its hydroxylated form had demonstrated apparent effectiveness in the treatment of COVID-19 associated pneumonia in clinical trials. SARS-CoV-2 spike protein shares 31.9% sequence identity with the spike protein presents in the Middle East Respiratory Syndrome Corona Virus (MERS-CoV), which infects cells through the interaction of its spike protein with the DPP4 receptor found on macrophages. Sitagliptin, a DPP4 inhibitor, that is known for its antidiabetic, immunoregulatory, anti-inflammatory, and beneficial cardiometabolic effects has been shown to reverse macrophage responses in MERS-CoV infection and reduce CXCL10 chemokine production in AIDS patients. We suggest that Sitagliptin may be beneficial alternative for the treatment of COVID-19 disease especially in diabetic patients and patients with preexisting cardiovascular conditions who are already at higher risk of COVID-19 infection."
AUTHOR
Sanaa Bardaweel
PUBLISHED
2020 in Center for Open Science

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Highly regarded source
An Analysis of 38 Pregnant Women with COVID-19, Their Newborn Infants, and Maternal-Fetal Transmission of SARS-CoV-2: Maternal Coronavirus Infections and Pregnancy Outcomes
" The emergence of a novel coronavirus, termed SARS-CoV-2, and the potentially life-threating respiratory disease that it can produce, COVID-19, has rapidly spread across the globe creating a massive public health problem. Previous epidemics of many emerging viral infections have typically resulted in poor obstetrical outcomes including maternal morbidity and mortality, maternal-fetal transmission of the virus, and perinatal infections and death. This communication reviews the effects of two previous coronavirus infections - severe acute respiratory syndrome (SARS) caused by SARS-CoV and Middle East respiratory syndrome (MERS) caused by MERS-CoV - on pregnancy outcomes. In addition, it analyzes literature describing 38 pregnant women with COVID-19 and their newborns in China to assess the effects of SARS-CoV-2 on the mothers and infants including clinical, laboratory and virologic data, and the transmissibility of the virus from mother to fetus. This analysis reveals that unlike coronavirus infections of pregnant women caused by SARS and MERS, in these 38 pregnant women COVID-19 did not lead to maternal deaths. Importantly, and similar to pregnancies with SARS and MERS, there were no confirmed cases of intrauterine transmission of SARS-CoV-2 from mothers with COVID-19 to their fetuses. All neonatal specimens tested, including in some cases placentas, were negative by rt-PCR for SARS-CoV-2. At this point in the global pandemic of COVID-19 infection there is no evidence that SARS-CoV-2 undergoes intrauterine or transplacental transmission from infected pregnant women to their fetuses. Analysis of additional cases is necessary to determine if this remains true. "
AUTHOR
David A. Schwartz
PUBLISHED
2020 in Archives of Pathology & Laboratory Medicine

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Highly regarded source
An Analysis of 38 Pregnant Women with COVID-19, Their Newborn Infants, and Maternal-Fetal Transmission of SARS-CoV-2: Maternal Coronavirus Infections and Pregnancy Outcomes
"The emergence of a novel coronavirus, termed SARS-CoV-2, and the potentially life-threatening respiratory disease that it can produce, COVID-19, has rapidly spread across the globe creating a massive public health problem. Previous epidemics of many emerging viral infections have typically resulted in poor obstetrical outcomes including maternal morbidity and mortality, maternal-fetal transmission of the virus, and perinatal infections and death. This communication reviews the effects of two previous coronavirus infections - severe acute respiratory syndrome (SARS) caused by SARS-CoV and Middle East respiratory syndrome (MERS) caused by MERS-CoV - on pregnancy outcomes. In addition, it analyzes literature describing 38 pregnant women with COVID-19 and their newborns in China to assess the effects of SARS-CoV-2 on the mothers and infants including clinical, laboratory and virologic data, and the transmissibility of the virus from mother to fetus. This analysis reveals that unlike coronavirus infections of pregnant women caused by SARS and MERS, in these 38 pregnant women COVID-19 did not lead to maternal deaths. Importantly, and similar to pregnancies with SARS and MERS, there were no confirmed cases of intrauterine transmission of SARS-CoV-2 from mothers with COVID-19 to their fetuses. All neonatal specimens tested, including in some cases placentas, were negative by rt-PCR for SARS-CoV-2. At this point in the global pandemic of COVID-19 infection there is no evidence that SARS-CoV-2 undergoes intrauterine or transplacental transmission from infected pregnant women to their fetuses. Analysis of additional cases is necessary to determine if this remains true."
AUTHOR
Schwartz DA
PUBLISHED
2020 in Archives of Pathology & Laboratory Medicine

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No SARS-CoV-2 in expressed prostatic secretion of patients with coronavirus disease 2019: a descriptive multicentre study in China
"Abstract
Purpose: The aim of the present study was to assess whether SARS-CoV-2 can be detected in the expressed prostatic secretion (EPS) of patients with corona virus disease 2019 (COVID-19).
Methods: 18 cases of COVID-19, and 5 suspected cases, were selected from three medical centers to detect the RNA expression of SARS-CoV-2 in their EPS with RT-PCR.
Results: Results were negative in all EPS samples for SARS-CoV-2 of suspected and confirmed patients.
Conclusions: No SARS-CoV-2 was expressed in EPS of patients with COVID-19."
AUTHORS
jinfei tian
qingyou zheng
weihe quan
yong zhao
haijia xu
hao chu et al
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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Development of CRISPR as a prophylactic strategy to combat novel coronavirus and influenza
"ABSTRACTThe outbreak of the coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), has infected more than 100,000 people worldwide with over 3,000 deaths since December 2019. There is no cure for COVID-19 and the vaccine development is estimated to require 12-18 months. Here we demonstrate a CRISPR-Cas13-based strategy, PAC-MAN (Prophylactic Antiviral CRISPR in huMAN cells), for viral inhibition that can effectively degrade SARS-CoV-2 sequences and live influenza A virus (IAV) genome in human lung epithelial cells. We designed and screened a group of CRISPR RNAs (crRNAs) targeting conserved viral regions and identified functional crRNAs for cleaving SARS-CoV-2. The approach is effective in reducing respiratory cell viral replication for H1N1 IAV. Our bioinformatic analysis showed a group of only six crRNAs can target more than 90% of all coronaviruses. The PAC-MAN approach is potentially a rapidly implementable pan-coronavirus strategy to deal with emerging pandemic strains."
AUTHORS
Laine Goudy
Lei S. Qi
Girija Dhamdhere
Xueqiu Lin
Timothy R. Abbott
David B. Lewis et al
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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Comparative Pathogenesis Of COVID-19, MERS And SARS In A Non-Human Primate Model
"AbstractA novel coronavirus, SARS-CoV-2, was recently identified in patients with an acute respiratory syndrome, COVID-19. To compare its pathogenesis with that of previously emerging coronaviruses, we inoculated cynomolgus macaques with SARS-CoV-2 or MERS-CoV and compared with historical SARS-CoV infections. In SARS-CoV-2-infected macaques, virus was excreted from nose and throat in absence of clinical signs, and detected in type I and II pneumocytes in foci of diffuse alveolar damage and mucous glands of the nasal cavity. In SARS-CoV-infection, lung lesions were typically more severe, while they were milder in MERS-CoV infection, where virus was detected mainly in type II pneumocytes. These data show that SARS-CoV-2 can cause a COVID-19-like disease, and suggest that the severity of SARS-CoV-2 infection is intermediate between that of SARS-CoV and MERS-CoV.One Sentence SummarySARS-CoV-2 infection in macaques results in COVID-19-like disease with prolonged virus excretion from nose and throat in absence of clinical signs."
AUTHORS
Judith van den Brand
Geert van Amerongen
Dennis de Meulder
Mart M. Lamers
Theo Bestebroer
Bart L. Haagmans et al
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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An Update on SARS-COV-2/COVID-19 with Particular Reference on Its Clinical Pathology, Pathogenesis, Immunopathology and Mitigation Strategies – A Review
"Coronavirus Disease 2019 (COVID-19), caused by a novel coronavirus named Severe Acute Respiratory Syndrome - Coronavirus-2 (SARS-CoV-2), emerged in early December 2019 in China and attained a pandemic situation worldwide by its rapid spread to nearly 167 countries with 287.239 confirmed cases and 11.921 human deaths with a case fatality rate (CFR) of around 4 per cent. Bats were considered as the reservoir host, and the search of a probable intermediate host is still going on. Animals have anticipated culprit of SARS-CoV-2 as of now. The disease is mainly manifested by pneumonia and related respiratory signs and symptoms, but the involvement of the gastrointestinal system and nervous system is also suggested. The severe form of the disease associated with death is mainly reported in older and immune-compromised patients with pre-existing disease history. Death in severe cases is attributed to respiratory failure associated with hyperinflammation. Cytokine storm syndrome associated with rampant inflammation in response to SARS-CoV-2 infection is considered as the leading killer of COVID-19 patients. COVID-19 patients were reported with higher levels of many pro-inflammatory cytokines and chemokines like IFN-g, IL-1b, IP-10, and MCP-1. Furthermore, severe cases of COVID-19 revealed higher levels of TNF-α, G-CSF, and MIP-1A. Blood profile of the COVID-19 patients exhibits lymphopenia, leucopenia, thrombocytopenia and RNAaemia along with increased levels of aspartate aminotransferase. SARS-CoV-2 infection in pregnant women does not lead to fetus mortalities unlike other zoonotic coronaviruses like SARS-CoV and MERS-CoV, with no evidence of intrauterine transmission to neonates. Rapid and confirmatory diagnostics have been developed, and high efforts are being made to develop effective vaccines and therapeutics. In the absence of any virus-specific therapeutic, internationally health care authorities are recommending adoption of effective prevention and control measures to counter and contain this pandemic virus. This paper is an overview of this virus and the disease with a particular focus on SARS-COV-2 / COVID-19 clinical pathology, pathogenesis and immunopathology along with a few recent research developments."
AUTHORS
Mamta Pathak
Shailesh Kumar Patel
Rajendra Singh
Kuldeep Dhama
Alfonso J. Rodriguez-Morales
D. Katterine Bonilla-Aldana et al
PUBLISHED
2020 in MDPI AG

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Ocular manifestations of a hospitalised patient with confirmed 2019 novel coronavirus disease
FUNDERS
National Natural Science Foundation of China
"PurposeTo report the ocular characteristics and the presence of viral RNA of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in conjunctival swab specimens in a patient with confirmed 2019 novel coronavirus disease (COVID-19).Participant and methodsA 30-year-old man with confirmed COVID-19 and bilateral acute conjunctivitis which occurred 13 days after illness onset. Based on detailed ophthalmic examination, reverse transcription PCR (RT-PCR) was performed to detect SARS-CoV-2 virus in conjunctival swabs. The ocular characteristics, presence of viral RNA and viral dynamics of SARS-CoV-2 in the conjunctival specimens were evaluated.ResultsSlit lamp examination showed bilateral acute follicular conjunctivitis. RT-PCR assay demonstrated the presence of viral RNA in conjunctival specimen 13 days after onset (cycle threshold value: 31). The conjunctival swab specimens remained positive for SARS-CoV-2 on 14 and 17 days after onset. On day 19, RT-PCR result was negative for SARS-CoV-2.ConclusionSARS-CoV-2 is capable of causing ocular complications such as viral conjunctivitis in the middle phase of illness. Precautionary measures are recommended when examining infected patients throughout the clinical course of the infection. However, conjunctival sampling might not be useful for early diagnosis because the virus may not appear initially in the conjunctiva."
AUTHORS
Zheng Zhang
Kun Qiao
Meizhou Liu
Na Xin
Jiantao Wang
Guoming Zhang et al
PUBLISHED
2020 in British Journal of Ophthalmology

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Travellers give wings to novel coronavirus (2019-nCoV)
"A novel coronavirus, probably of bat origin, has caused an outbreak of severe respiratory infection in humans in Wuhan, China and has been dispersed globally by travelers. The WHO has declared the spread of the infection a Public Health Emergency of International Concern."
AUTHORS
Lin H Chen
Mary E Wilson
PUBLISHED
2020 in Journal of Travel Medicine

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Homology Models of Wuhan Coronavirus 3CLpro Protease
"A regional outbreak of pneumonia in Wuhan, Hubei Province of China in late 2019 was associated with a novel coronavirus. Rapid release of genomic data for the isolated virus enabled the construction of first-generation homology models of the new CoV 3CL<sup>pro</sup> cysteine protease. Whilst the overall viral genome was most closely associated with bat coronaviruses, the main protease is most closely related (96% identity) to SARS CoV protease."
AUTHOR
Martin Stoermer
PUBLISHED
2020 in American Chemical Society (ACS)

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Homology Models of Coronavirus 2019-nCoV 3CLpro Protease
"A regional outbreak of pneumonia in Wuhan, Hubei Province of China in late 2019 was associated with a novel coronavirus. Rapid release of genomic data for the isolated virus enabled the construction of first-generation homology models of the new CoV 3CL<sup>pro</sup> cysteine protease. Whilst the overall viral genome was most closely associated with bat coronaviruses, the main protease is most closely related (96% identity) to SARS CoV protease."
AUTHOR
Martin Stoermer
PUBLISHED
2020 in American Chemical Society (ACS)

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Homology Models of Coronavirus 2019-nCoV 3CLpro Protease
"A regional outbreak of pneumonia in Wuhan, Hubei Province of China in late 2019 was associated with a novel coronavirus. Rapid release of genomic data for the isolated virus enabled the construction of first-generation homology models of the new CoV 3CL<sup>pro</sup> cysteine protease. Whilst the overall viral genome was most closely associated with bat coronaviruses, the main protease is most closely related (96% identity) to SARS CoV protease."
AUTHOR
Martin Stoermer
PUBLISHED
2020 in American Chemical Society (ACS)

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Homology Models of Coronavirus 3CLpro Protease
"A regional outbreak of pneumonia in Wuhan, Hubei Province of China in late 2019 was associated with a novel coronavirus. Rapid release of genomic data for the isolated virus enabled the construction of first-generation homology models of the new CoV 3CL<sup>pro</sup> cysteine protease. Whilst the overall viral genome was most closely associated with bat coronaviruses, the main protease is most closely related (96% identity) to SARS CoV protease."
AUTHOR
Martin Stoermer
PUBLISHED
2020 in American Chemical Society (ACS)

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Literature review
Review of bats and SARS.
"Bats have been identified as a natural reservoir for an increasing number of emerging zoonotic viruses, including henipaviruses and variants of rabies viruses. Recently, we and another group independently identified several horseshoe bat species (genus Rhinolophus) as the reservoir host for a large number of viruses that have a close genetic relationship with the coronavirus associated with severe acute respiratory syndrome (SARS). Our current research focused on the identification of the reservoir species for the progenitor virus of the SARS coronaviruses responsible for outbreaks during 2002-2003 and 2003-2004. In addition to SARS-like coronaviruses, many other novel bat coronaviruses, which belong to groups 1 and 2 of the 3 existing coronavirus groups, have been detected by PCR. The discovery of bat SARS-like coronaviruses and the great genetic diversity of coronaviruses in bats have shed new light on the origin and transmission of SARS coronaviruses."
AUTHORS
Bryan T Eaton
Peter Daszak
Lin-Fa Wang
Shuyi Zhang
Hume Field
Zhengli Shi
PUBLISHED
2006 in Emerging Infectious Diseases

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Homology Models of the Papain-Like Protease PLpro from Coronavirus 2019-nCoV
"The December 2019 outbreak of pneumonia in Wuhan, Hubei Province of China was rapidly linked to a novel coronavirus 2019-nCoV. The rapid spread and severity of the virus has led the World Health Organization to declare it a Public Health Emergency of International Concern. We recently described the first homology models of the main 3CL protease from 2019-nCoV, and now present models of the other viral protease, the papain-like protease or PLpro. Whilst the overall viral genome is most closely associated with bat coronaviruses, no bat PLpro crystal structures are known. Wuhan 2019-nCoV PLpro is most closely related to a bat coronavirus PLpro (97% identity), then SARS (80 %) and MERS (29%) and the most promising models presented here are prepared from SARS crystal structure templates."
AUTHOR
Martin Stoermer
PUBLISHED
2020 in American Chemical Society (ACS)

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Homology Models of the Papain-Like Protease PLpro from Coronavirus 2019-nCoV
"The December 2019 outbreak of pneumonia in Wuhan, Hubei Province of China was rapidly linked to a novel coronavirus 2019-nCoV. The rapid spread and severity of the virus has led the World Health Organization to declare it a Public Health Emergency of International Concern. We recently described the first homology models of the main 3CL protease from 2019-nCoV, and now present models of the other viral protease, the papain-like protease or PLpro. Whilst the overall viral genome is most closely associated with bat coronaviruses, no bat PLpro crystal structures are known. Wuhan 2019-nCoV PLpro is most closely related to a bat coronavirus PLpro (97% identity), then SARS (80 %) and MERS (29%) and the most promising models presented here are prepared from SARS crystal structure templates."
AUTHOR
Martin Stoermer
PUBLISHED
2020 in American Chemical Society (ACS)

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[Bats, viruses and humans: coronaviruses on the rise?].
"The outbreak of the SARS coronavirus in 2002/2003 and the recent disease cases with a new human coronavirus (originally designated EMC-CoV, recently renamed MERS-CoV) have put the focus onto the virus family Coronaviridae. Both viruses appeared to have managed to jump over the species barrier from a bat reservoir to the human population. Bats are considered to serve as a natural reservoir for coronaviruses infecting mammals. An important factor for crossing the species-barrier is the adaptation to a new receptor on cells of the new host species. During evolution coronaviruses have developed a large diversity of binding specificities demonstrating the high flexibility of the coronaviral spike protein, which is responsible for binding to target cells."
AUTHORS
Christine Winter
Georg Herrler
PUBLISHED
2014 in Berliner und Munchener Tierarztliche Wochenschrift

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Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding
FUNDERS
Nanjing Agricultural University , State Key Research Development Program of China , Strategic Priority Research Programme of the Chinese Academy of Sciences , Taishan Scholars Programme of Shandong Province , Academic Promotion Programme of Shandong First Medical University , National Major Project for Control and Prevention of Infectious Disease in China
You can view the abstract at: https://doi.org/10.1016/s0140-6736(20)30251-8
AUTHORS
Ji Wang
Wenling Wang
Baoying Huang
Peihua Niu
Yang Lin
Weifeng Shi et al
PUBLISHED
2020 in The Lancet

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Genomic and protein structure modelling analysis depicts the origin and pathogenicity of 2019-nCoV, a new coronavirus which caused a pneumonia outbreak in Wuhan, China
"Background: A pandemic outbreak caused by a novel coronavirus, 2019-nCoV, has originated from Wuhan, China and spread to many countries around the world. The outbreak has led to around 45 thousand cases and over one thousand death so far. Methods: Phylogenetic analysis and sequence alignment were used to align the whole genome sequence of 2019-nCoV with other over 200 sequences of coronaviruses to predict the origin of this novel virus. In addition, protein modeling and analysis were performed to access the potential binding of the spike protein of 2019-nCoV with human cell receptor, angiotensin-converting enzyme 2 (ACE2). Results: Detailed genomic and structure-based analysis of a new coronavirus, namely 2019-nCoV, showed that the new virus is a new type of bat coronavirus and is genetically fairly distant from the human SARS coronavirus. Structure analysis of the spike (S) protein of this new virus showed that its S protein only binds much weaker to the ACE2 receptor on human cells whereas the human SARS coronavirus exhibits strongly affinity to the ACE receptor. Conclusions: These findings suggest that the new virus should theoretically not be able to cause very serious human infection when compared to human SARS virus. However, the lower pathogenicity of this new virus may lead to longer incubation time and better adaption to human, which may favor its efficient transmission in human. These data are important to guide design of infection control policy and inform the public on the nature of threat imposed by 2019-nCov. Most importantly, using the analysis platform that we have developed, we should be able to predict whether the new mutations could lead to the increase of infectivity of the mutated virus in a very short time."
AUTHORS
Sheng Chen
Edward Wai-Chi Chan
Xuemei Yang
Ning Dong
Lianwei Ye
Kaichao Chen et al
PUBLISHED
2020 in F1000Research

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Genomic and protein structure modelling analysis depicts the origin and pathogenicity of 2019-nCoV, a new coronavirus which caused a pneumonia outbreak in Wuhan, China
"Background: A pandemic outbreak caused by a novel coronavirus, 2019-nCoV, has originated from Wuhan, China and spread to many countries around the world. The outbreak has led to around 45 thousand cases and over one thousand death so far. Methods: Phylogenetic analysis and sequence alignment were used to align the whole genome sequence of 2019-nCoV with other over 200 sequences of coronaviruses to predict the origin of this novel virus. In addition, protein modeling and analysis were performed to access the potential binding of the spike protein of 2019-nCoV with human cell receptor, angiotensin-converting enzyme 2 (ACE2). Results: Detailed genomic and structure-based analysis of a new coronavirus, namely 2019-nCoV, showed that the new virus is a new type of bat coronavirus and is genetically fairly distant from the human SARS coronavirus. Structure analysis of the spike (S) protein of this new virus showed that its S protein only binds much weaker to the ACE2 receptor on human cells whereas the human SARS coronavirus exhibits strongly affinity to the ACE receptor. Conclusions: These findings suggest that the new virus should theoretically not be able to cause very serious human infection when compared to human SARS virus. However, the lower pathogenicity of this new virus may lead to longer incubation time and better adaption to human, which may favor its efficient transmission in human. These data are important to guide design of infection control policy and inform the public on the nature of threat imposed by 2019-nCov. Most importantly, using the analysis platform that we have developed, we should be able to predict whether the new mutations could lead to the increase of infectivity of the mutated virus in a very short time."
AUTHORS
Sheng Chen
Ning Dong
Edward Wai-Chi Chan
Kaichao Chen
Xuemei Yang
Lianwei Ye
PUBLISHED
2020 in F1000Research

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The genomic recombination events may reveal the evolution of coronavirus and the origination of 2019-nCoV
"Abstract

To trace the evolution of coronavirus and reveal the possible origination of the novel pneumonia coronavirus (2019-nCoV), we collected and thoroughly analyzed 2966 publicly available coronavirus genomes, including 182 2019-nCoVs strains. We observed 3 independent recombination events with statistical significance between some isolates from bats and pangolins. In consistence with previous records, we also detected the putative recombination between Bat-CoV-RaTG13 and Pangolin-CoV-2019 covering the receptor bind domain (RBD) of the spike glycoprotein (S protein), which may lead to the origination of 2019-nCoV. Population genetic analyses give estimations indicating that the recombinant region around RBD is possibly undergoing directional evolution. This may result to the adaption of the virus to be infectious in hosts. Not surprisingly, we find that the S protein of coronavirus keeps high diversity among bat isolates, which may provide a genetic pool for the origination of 2019-nCoV.
"
AUTHORS
Kaiwen Meng
Geng Meng
Zhenglin Zhu
PUBLISHED
2020 in Research Square

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Evidence of recombination in coronaviruses implicating pangolin origins of nCoV-2019
"SUMMARYA novel coronavirus (nCoV-2019) was the cause of an outbreak of respiratory illness detected in Wuhan, Hubei Province, China in December of 2019. Genomic analyses of nCoV-2019 determined a 96% resemblance with a coronavirus isolated from a bat in 2013 (RaTG13); however, the receptor binding motif (RBM) of these two genomes share low sequence similarity. This divergence suggests a possible alternative source for the RBM coding sequence in nCoV-2019. We identified high sequence similarity in the RBM between nCoV-2019 and a coronavirus genome reconstructed from a viral metagenomic dataset from pangolins possibly indicating a more complex origin for nCoV-2019."
AUTHORS
Matthew C. Wong
Sara J. Javornik Cregeen
Nadim J. Ajami
Joseph F. Petrosino
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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Isolation and Characterization of 2019-nCoV-like Coronavirus from Malayan Pangolins
"AbstractThe outbreak of 2019-nCoV in the central Chinese city of Wuhan at the end of 2019 poses unprecedent public health challenges to both China and the rest world1. The new coronavirus shares high sequence identity to SARS-CoV and a newly identified bat coronavirus2. While bats may be the reservoir host for various coronaviruses, whether 2019-nCoV has other hosts is still ambiguous. In this study, one coronavirus isolated from Malayan pangolins showed 100%, 98.2%, 96.7% and 90.4% amino acid identity with 2019-nCoV in the E, M, N and S genes, respectively. In particular, the receptor-binding domain of the S protein of the Pangolin-CoV is virtually identical to that of 2019-nCoV, with one amino acid difference. Comparison of available genomes suggests 2019-nCoV might have originated from the recombination of a Pangolin-CoV-like virus with a Bat-CoV-RaTG13-like virus. Infected pangolins showed clinical signs and histopathological changes, and the circulating antibodies reacted with the S protein of 2019-nCoV. The isolation of a coronavirus that is highly related to 2019-nCoV in the pangolins suggests that these animals have the potential to act as the intermediate host of 2019-nCoV. The newly identified coronavirus in the most-trafficked mammal could represent a continuous threat to public health if wildlife trade is not effectively controlled."
AUTHORS
Fanfan Shu
Jie-Jian Zou
Niu Zhou
Junqiong Zhai
Xiaobing Li
Kangpeng Xiao et al
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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Receptor Recognition by the Novel Coronavirus from Wuhan: an Analysis Based on Decade-Long Structural Studies of SARS Coronavirus
FUNDERS
National Institute of Allergy and Infectious Diseases
"ABSTRACT
Recently, a novel coronavirus (2019-nCoV) has emerged from Wuhan, China, causing symptoms in humans similar to those caused by severe acute respiratory syndrome coronavirus (SARS-CoV). Since the SARS-CoV outbreak in 2002, extensive structural analyses have revealed key atomic-level interactions between the SARS-CoV spike protein receptor-binding domain (RBD) and its host receptor angiotensin-converting enzyme 2 (ACE2), which regulate both the cross-species and human-to-human transmissions of SARS-CoV. Here, we analyzed the potential receptor usage by 2019-nCoV, based on the rich knowledge about SARS-CoV and the newly released sequence of 2019-nCoV. First, the sequence of 2019-nCoV RBD, including its receptor-binding motif (RBM) that directly contacts ACE2, is similar to that of SARS-CoV, strongly suggesting that 2019-nCoV uses ACE2 as its receptor. Second, several critical residues in 2019-nCoV RBM (particularly Gln493) provide favorable interactions with human ACE2, consistent with 2019-nCoV’s capacity for human cell infection. Third, several other critical residues in 2019-nCoV RBM (particularly Asn501) are compatible with, but not ideal for, binding human ACE2, suggesting that 2019-nCoV has acquired some capacity for human-to-human transmission. Last, while phylogenetic analysis indicates a bat origin of 2019-nCoV, 2019-nCoV also potentially recognizes ACE2 from a diversity of animal species (except mice and rats), implicating these animal species as possible intermediate hosts or animal models for 2019-nCoV infections. These analyses provide insights into the receptor usage, cell entry, host cell infectivity and animal origin of 2019-nCoV and may help epidemic surveillance and preventive measures against 2019-nCoV.
IMPORTANCE The recent emergence of Wuhan coronavirus (2019-nCoV) puts the world on alert. 2019-nCoV is reminiscent of the SARS-CoV outbreak in 2002 to 2003. Our decade-long structural studies on the receptor recognition by SARS-CoV have identified key interactions between SARS-CoV spike protein and its host receptor angiotensin-converting enzyme 2 (ACE2), which regulate both the cross-species and human-to-human transmissions of SARS-CoV. One of the goals of SARS-CoV research was to build an atomic-level iterative framework of virus-receptor interactions to facilitate epidemic surveillance, predict species-specific receptor usage, and identify potential animal hosts and animal models of viruses. Based on the sequence of 2019-nCoV spike protein, we apply this predictive framework to provide novel insights into the receptor usage and likely host range of 2019-nCoV. This study provides a robust test of this reiterative framework, providing the basic, translational, and public health research communities with predictive insights that may help study and battle this novel 2019-nCoV."
AUTHORS
Fang Li
Rachel Graham
Yushun Wan
Jian Shang
Ralph S. Baric
PUBLISHED
2020 in Journal of Virology

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Genomic and protein structure modelling analysis depicts the origin and infectivity of 2019-nCoV, a new coronavirus which caused a pneumonia outbreak in Wuhan, China
"AbstractDetailed genomic and structure-based analysis of a new coronavirus, namely 2019-nCoV, showed that the new virus is a new type of bat coronavirus and is genetically fairly distant from the human SARS coronavirus. Structure analysis of the spike (S) protein of this new virus showed that its S protein only binds weakly to the ACE2 receptor on human cells whereas the human SARS coronavirus exhibits strongly affinity to the ACE receptor. These findings suggest that the new virus does not readily transmit between humans and should theoretically not able to cause very serious human infection. These data are important to guide design of infection control policy and inform the public on the nature of threat imposed by 2019-nCov when results of direct laboratory tests on this virus are not expected to be available in the near future."
AUTHORS
Sheng Chen
Edward Wai-Chi Chan
Xuemei Yang
Ning Dong
Lianwei Ye
Kaichao Chen et al
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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Genomic variance of the 2019-nCoV coronavirus
"AbstractThere is rising global concern for the recently emerged novel Coronavirus (2019-nCov). Full genomic sequences have been released by the worldwide scientific community in the last few weeks in order to understand the evolutionary origin and molecular characteristics of this virus. Taking advantage of all the genomic information currently available, we constructed a phylogenetic tree including also representatives of other coronaviridae, such as Bat coronavirus (BCoV) and SARS. We confirm high sequence similarity (>99%) between all sequenced 2019-nCoVs genomes available, with the closest BCoV sequence sharing 96.2% sequence identity, confirming the notion of a zoonotic origin of 2019-nCoV. Despite the low heterogeneity of the 2019-nCoV genomes, we could identify at least two hyper-variable genomic hotspots, one of which is responsible for a Serine/Leucine variation in the viral ORF8-encoded protein. Finally, we perform a full proteomic comparison with other coronaviridae, identifying key aminoacidic differences to be considered for antiviral strategies deriving from previous anti-coronavirus approaches."
AUTHORS
Carmine Ceraolo
Federico M. Giorgi
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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Clinical Characteristics of Patients with Severe Pneumonia Caused by the 2019 Novel Coronavirus in Wuhan, China
"Abstract
Background: A new virus broke out in Wuhan, Hubei, China, and was later named 2019 novel coronavirus (2019-nCoV). The clinical characteristics of severe pneumonia caused by 2019-nCoV are still not clear.
Objectives: The aim of this study was to explore the clinical characteristics and risk factors of the severe pneumonia caused by the 2019-nCoV in Wuhan, China.
Method: The study included patients hospitalized at the central hospital of Wuhan who had been diagnosed with a pneumonia caused by the novel coronavirus. Clinical features, chronic co-morbidities, demographic data, laboratory examinations, and chest computed tomography (CT) scans were reviewed through electronic medical records. SPSS was used for data analysis to explore the clinical characteristics and risk factors of the patients with the severe pneumonia.
Results: A total of 110 patients diagnosed with 2019 novel coronavirus pneumonia were included in the study, including 38 with severe pneumonia and 72 with non-severe pneumonia. Statistical analysis showed that advanced age, an increase of D-dimer, and a decrease of lymphocytes were characteristics of the patients with severe pneumonia. Moreover, in the early stage of the disease, chest CT scans of patients with the severe pneumonia showed the illness can progress rapidly.
Conclusions: Advanced age, lymphocyte decline, and D-dimer elevation are important characteristics of patients with severe pneumonia. Clinicians should focus on these characteristics to identify high-risk patients at an early stage."
AUTHORS
Dongping Xia
Zhen Yang
Shuang Geng
Yafei Wang
Ying Zhou
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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Clinical and Epidemiological Characteristics of Coronavirus Disease 2019 in the Early Stage of Outbreak
"In December 2019, a novel coronavirus, which is now designated as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first identified as the etiology of pneumonia of unknown cause in patients from Wuhan of central China. Since the first report of coronavirus disease 2019 (COVID-19), the disease became pandemic causing the large-scale outbreak all over the world. In this review, we discuss the clinical and epidemiological characteristics of COVID-19 in the early stage of outbreak based on recent reports from China."
AUTHOR
Jung Yeon Heo
PUBLISHED
2020 in The Korean Journal of Medicine

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Analysis of clinical characteristics and laboratory findings of 95 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a retrospective analysis.
"Abstract

Background: Since December 2019, 2019 novel coronavirus pneumonia emerged in Wuhan city and rapidly spread throughout China and even the world. We sought to analyse the clinical characteristics and laboratory findings of some cases with 2019 novel coronavirus pneumonia .Methods: In this retrospective study, we extracted the data on 95 patients with laboratory-confirmed 2019 novel coronavirus pneumonia in Wuhan Xinzhou District People's Hospital from January 16th to February 25th , 2020. Cases were confirmed by real-time RT-PCR and abnormal radiologic findings. Outcomes were followed up until March 2th , 2020. Results: Higher temperature, blood leukocyte count, neutrophil count, neutrophil percentage, C-reactive protein level, D-dimer level, alanine aminotransferase activity, aspartate aminotransferase activity, α - hydroxybutyrate dehydrogenase activity, lactate dehydrogenase activity and creatine kinase activity were related to severe 2019 novel coronavirus pneumonia and composite endpoint, and so were lower lymphocyte count, lymphocyte percentage and total protein level. Age below 40 or above 60 years old, male, higher Creatinine level, and lower platelet count also seemed related to severe 2019 novel coronavirus pneumonia and composite endpoint, however the P values were greater than 0.05, which mean under the same condition studies of larger samples are needed in the future. Conclusion: Multiple factors were related to severe 2019 novel coronavirus pneumonia and composite endpoint, and more related studies are needed in the future.
"
AUTHORS
Shiming Qiu
Xionglin Zhu
Gemin Zhang
Jie Zhang
Bowen Wang
Qiang Wang
PUBLISHED
2020 in Research Square

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Characterization of codon usage pattern in novel coronavirus 2019-nCoV
"Abstract

The outbreak of viral pneumonia in China due to a novel coronavirus 2019-nCoV poses significant threats to international health. In this study we perform bioinformatic analysis to take a snapshot of the codon usage pattern of 2019-nCoV and uncover that this novel coronavirus has a relatively low codon usage bias. The information from this research may not only be helpful to get new insights into the evolution of 2019-nCoV, but also have potential value for developing coronavirus vaccines.
"
AUTHOR
Wei Hou
PUBLISHED
2020 in Research Square

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A precision medicine approach to managing 2019 novel coronavirus pneumonia
FUNDERS
National Key Development Plan for Precision Medicine Research
"Abstract
In December 2019, several patients with pneumonia of an unknown cause were detected in Wuhan, China. On 7 January 2020, the causal organism was identified as a new coronavirus, later named as the 2019 novel coronavirus (2019-nCoV). Genome sequencing found the genetic sequence of 2019-nCoV homologous to that of severe acute respiratory syndrome-associated coronavirus. As of 29 January 2020, the virus had been diagnosed in more than 7000 patients in China and 77 patients in other countries. It is reported that both symptomatic and asymptomatic patients with 2019-nCoV can play a role in disease transmission via airborne and contact. This finding has caused a great concern about the prevention of illness spread. The clinical features of the infection are not specific and are often indistinguishable from those of other respiratory infections, making it difficult to diagnose. Given that the virus has a strong ability to spread between individuals, it is of top priority to identify potential or suspected patients as soon as possible—or the virus may cause a serious pandemic. Therefore, a precision medicine approach to managing this disease is urgently needed for detecting and controlling the spread of the virus. In this article, we present such an approach to managing 2019-nCoV-related pneumonia based on the unique traits of the virus recently revealed and on our experience with coronaviruses at West China Hospital in Chengdu, China."
AUTHORS
Binwu Ying
Yan Kang
Yanbing Zhou
Hong Tang
Bin Song
Yu Cao et al
PUBLISHED
2020 in Precision Clinical Medicine

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A Novel Coronavirus from Patients with Pneumonia in China, 2019
You can view the abstract at: https://doi.org/10.1056/nejmoa2001017
AUTHORS
Guizhen Wu
Faxian Zhan
Xuejun Ma
Roujian Lu
Weifeng Shi
Dayan Wang et al
PUBLISHED
2020 in New England Journal of Medicine

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A novel coronavirus transmission from China to Pakistan via different countries; A review.
"A review of novel coronavirus transmission from China to globally is a serious illness or just a thread to world population. In the beginning cases of novel coronavirus (COVID-19), were found with infected pneumonia (NCIP) in Wuhan city, China, during December 2019 and January 2020. An outbreak of 2019 novel coronavirus diseases (COVID-19) in Wuhan, China has spread quickly national and international wide through transportation and travelling of people. Covid-19 outbreak was idiopathic, and it got attention not only nationally but internationally. Health authorities got activated and they took immediate actions for prevention, diagnosis, and treatment of the condition. They use precaution by isolating the people infected with it even who were suspected, did close monitoring of the patients and discovered different treatment procedures and diagnostic tests to combat the disease. Electronic articles search and data collected were done through PubMed, Google Scholar and Medline, using the following keywords: coronavirus, coronavirus transmission and outbreak, and coronavirus review. All types of articles were included to discuss Covid-19 transmission national as well as international included Pakistan."
AUTHORS
Jais Kumar
Syed Ali Naqi
Naveed Arshad
PUBLISHED
2020 in The Professional Medical Journal

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Multiple Negative of RT-PCR Testing of COVID-19 Pneumonia: A Case Report
"Abstract

Background: Since the 2019 novel coronavirus outbreak in Wuhan, Hubei Province, China in 2019, there have been a few reports of multiple negative of RT-PCR tests in patients infected by 2019 novel coronavirus.Case presentation: The patient was a 64-year-old man with fever. His son returned from Hubei 17 days before the patient had fever. Ancillary examinations indicated a decreased lymphocyte count and ground-glass opacities in lung. However, the first five reverse transcriptase polymerase chain reaction tests of 2019 novel coronavirus were negative until the sixth turned to positive.Conclusion: when epidemiological history, clinical manifestation and imaging are highly suggestive of COVID-19 Pneumonia, we should repeat reverse transcriptase polymerase chain reaction tests and treat patients in isolation.
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AUTHORS
Yinhao Wu
Lamei Chen
Junton Feng
Yongjun Tang HuiLi
Yongjun Tang
Yan Su et al
PUBLISHED
2020 in Research Square

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The 2019 novel coronavirus disease with secondary ischemic stroke: two cases report
"Abstract

Background : The 2019 novel coronavirus disease is an outbreak of respiratory illness first detected in Wuhan, China in the end of Dec, 2019. The older patients complicated with underlying diseases are reported more likely to have clinical symptoms. But its secondary lesion is rarely reported. Case presentation : We reported two cases of coronavirus infected pneumonia with acute ischemic stroke in patients at their middle-age. In both 2019 coronavirus diseases cases, neurological physical examination are normal before infection. Lymphocytopenia and high expression of cytokines and D-dimer were found from serum clinical laboratory test at admission. The tongue palsy, dysarthria and limb muscle weakness are initial manifestations in one week after 2019 novel coronavirus infection. The head CT and head/neck arterial CTA showed small-vessel occlusion. The patients were diagnosed with coronavirus diseases with secondary acute ischemic stroke. They were treated with tirofiban and followed up with daily aspirin and atorvastatin. Conclusion : The present cases suggest that secondary ischemic stroke, which mainly manifested as small-vessel occlusion, should be considered for coronavirus disease patients with prompt diagnosis and treatment.
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AUTHORS
Ping Li
Yun Chen
Bin Fu
PUBLISHED
2020 in Research Square

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Stability of the COVID-19 virus under wet, dry and acidic conditions
"COVID-19 has become a pandemic and is spreading fast worldwide. The COVID-19 virus is transmitted mainly through respiratory droplets and close contact. However, the fecal-oral transmission of the virus has not been ruled out and it is important to ascertain how acidic condition in the stomach affects the infectivity of the virus. Besides, it is unclear how stable the COVID-19 virus is under dry and wet conditions. In the present study, we have shown that the COVID-19 virus is extremely infectious as manifested by the infection of Vero-E6 cells by one PFU (Plaque Forming Unit) of the virus. We then investigated the stability of the COVID-19 virus in wet, dry and acidic (pH2.2) environments at room temperature. Results showed that the COVID-19 virus could survive for three days in wet and dry environments, but the dry condition is less favorable for the survival of the virus. Our study also demonstrated that the COVID-19 virus at a relative high titer (1.2 x 103 PFU) exhibits a certain degree of tolerance to acidic environment at least for 60 minutes. When the virus titer was ≤1.0 x 103 PFU, acid treatment (pH2.2) for 30 or 60 minute resulted in virus inactivation. It suggests that the virus at a high concentration may survive in the acidic environment of the stomach. The finding of the present study will contribute to the control of the spread of the COVID-19 virus."
AUTHORS
Chen-jian Gu
Zhi-ping Sun
Rong Zhang
Yun Qian
Di Qu
Wei Xu et al
PUBLISHED
2020 in Cold Spring Harbor Laboratory

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SARS-CoV-2, COVID-19 and inherited arrhythmia syndromes
"Ever since the first case was reported at the end of 2019, the SARS-COV-2 virus and associated lung disease COVID-19 has spread throughout the world and has become a pandemic. In particular, the high transmission rate of the virus has made it a threat to public health globally. Currently, there is no proven effective therapy against the virus, and the impact on other diseases is also uncertain, especially inherited arrhythmia syndrome. Arrhythmogenic effect of COVID-19 can be expected, potentially contributing to disease outcome. This may be of importance for patients with an increased risk for cardiac arrhythmias, either secondary to acquired conditions or co-morbidities or consequent to inherited syndromes. Management of patients with inherited arrhythmia syndromes such as Long QT syndrome, Brugada syndrome, Short QT syndrome and Catecholaminergic Polymorphic Ventricular Tachycardia in the setting of the COVID-19 pandemic may prove particularly challenging. Depending on the inherited defect involved, these patients may be susceptible to pro-arrhythmic effects of COVID-19-related issues such as fever, stress, electrolyte disturbances and use of antiviral drugs. We here describe the potential COVID-19 associated risks and therapeutic considerations for patients with distinct inherited arrhythmia syndromes and provide recommendations, pending local possibilities, for their monitoring and management during this pandemic."
AUTHORS
Carlo Napolitano
Connie R. Bezzina
Elijah R. Behr
Cheng-I. Wu
Vincent Probst
Pieter G. Postema et al
PUBLISHED
2020 in Heart Rhythm

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Will plant-made biopharmaceuticals play a role in the fight against COVID-19?
"Given the dramatic impact of the COVID-19 pandemic, it is imperative to divulge all the available technologies with the potential to fight against this virus. Plant biotechnology offers potential solutions to this pandemic through the development of low-cost vaccines and antibodies useful for therapy, prophylaxis, and diagnosis. The technology to produce plant-made biopharmaceuticals is already established; two examples of these are: a therapeutic enzyme that has entered the market and the influenza vaccines that are currently under clinical trials with encouraging results. Thus far, some companies have started developing anti-COVID-19 antibodies and vaccines. In particular, plant-made antibodies might be timely produced and approved for human use in the short term, while the development of vaccines will take longer time (clinical evaluations could be concluded by the end of 2021); nonetheless, the candidates obtained will be valuable tools for future outbreaks. The key aspects that will define the exploitation of this technology in the fight against COVID-19 are discussed."
AUTHOR
Sergio Rosales-Mendoza
PUBLISHED
2020 in Expert Opinion on Biological Therapy

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Prevalence and impact of cardiovascular metabolic diseases on COVID-19 in China
FUNDERS
National Natural Science Foundation of China , Key Technology Research and Development Program of Shandong
"Background: Studies have reminded that cardiovascular metabolic comorbidities made patients more susceptible to suffer 2019 novel corona virus (2019-nCoV) disease (COVID-19), and exacerbated the infection. The aim of this analysis is to determine the association of cardiovascular metabolic diseases with the development of COVID-19.

Methods: A meta-analysis of eligible studies that summarized the prevalence of cardiovascular metabolic diseases in COVID-19 and compared the incidences of the comorbidities in ICU/severe and non-ICU/severe patients was performed. Embase and PubMed were searched for relevant studies.

Results: A total of six studies with 1527 patients were included in this analysis. The proportions of hypertension, cardia-cerebrovascular disease and diabetes in patients with COVID-19 were 17.1%, 16.4% and 9.7%, respectively. The incidences of hypertension, cardia-cerebrovascular diseases and diabetes were about twofolds, threefolds and twofolds, respectively, higher in ICU/severe cases than in their non-ICU/severe counterparts. At least 8.0% patients with COVID-19 suffered the acute cardiac injury. The incidence of acute cardiac injury was about 13 folds higher in ICU/severe patients compared with the non-ICU/severe patients.

Conclusion: Patients with previous cardiovascular metabolic diseases may face a greater risk of developing into the severe condition and the comorbidities can also greatly affect the prognosis of the COVID-19. On the other hand, COVID-19 can, in turn, aggravate the damage to the heart.

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AUTHORS
Zhaohui Bi
Xiqian Wang
Lili Zhi
Faming Zhao
Lin Liu
Bo Li et al
PUBLISHED
2020 in Clinical Research in Cardiology

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