Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (COVID-19) - Centers for Disease Control and Prevention (Updated 27 Oct. 2020) [An account of the symptoms of COVID-19 is described here]:
“Symptoms differ with severity of disease. For example, fever, cough, and shortness of breath are more commonly reported among people who are hospitalized with COVID-19 than among those with milder disease (non-hospitalized patients). Atypical presentations occur often, and older adults and persons with medical comorbidities may have delayed presentation of fever and respiratory symptoms.10,14 In one study of 1,099 hospitalized patients, fever was present in only 44% at hospital admission but eventually developed in 89% during hospitalization.1 Fatigue, headache, and muscle aches (myalgia) are among the most commonly reported symptoms in people who are not hospitalized, and sore throat and nasal congestion or runny nose (rhinorrhea) also may be prominent symptoms. Many people with COVID-19 experience gastrointestinal symptoms such as nausea, vomiting or diarrhea, sometimes prior to developing fever and lower respiratory tract signs and symptoms.9 Loss of smell (anosmia) or taste (ageusia) preceding the onset of respiratory symptoms has been commonly reported in COVID-19 especially among women and young or middle-aged patients who do not require hospitalization.11,12 While many of the symptoms of COVID-19 are common to other respiratory or viral illnesses, anosmia appears to be more specific to COVID-19. Several studies have reported that the signs Signs and symptoms of COVID-19 in children are similar to adults vary by age of the child, and are usually milder compared to adults.”
China’s Response to the COVID-19 Outbreak: A Model for Epidemic Preparedness and Management - N.S. Al Takarli - Dubai Medical Journal (19 May 2020):
“This paper is a narrative review of the literature where a comparison of the Chinese response to the SARS outbreak and the current COVID-19 outbreak was conducted using various databases. Epidemic preparedness and management strategies under comparison, such as the country’s epidemic response capacity, case identification and surveil- lance, healthcare facilities, and medical team preparation, were selected based on CDC and WHO frameworks, regulations, and guidelines on the implementation of mitigation strategies for communities responding to epidemics.”
[Reasons why China managed to limit spread of the virus to the general population with the initial outbreak are given as:]
“1. Epidemic response capacity. Since the 2003 SARS outbreak, China has been strengthening and improving their epidemic response capacity for future outbreaks.
2. Case identification and large-scale surveillance. A community-wide temperature screening was implemented, and thousands of quarantine stations were established in airports, railway stations, bus stations and ferry terminals. The government invested in a mobile tracking application that categorizes individuals into color groups according to health status and travel history, enabling quarantine if warranted.
3. National reporting system. As soon as a COVID-19 case is diagnosed, the responsible doctor is required to report electronically. Each province is required to submit daily reports with epidemiological curves, with data used to focus on areas with more cases and requiring further measures.
4. Health-care facilities and medical team preparations. Anticipating hospitals could be overwhelmed, they built additional facilities nationwide to accommodate all patients.
5. City lockdown and social distancing. Large-scale quarantine and social distancing were imposed, locking millions of people at huge human and economic costs.
6. Improvements. With all the measures taken and the people’s commitment, a decline in the new cases and deaths was observed thereafter.
7. Removal of lockdown. In April, lockdown and travel restrictions on Wuhan were lifted. They restarted the economy but warned of possible resurgence as the pandemic continues in other countries and 80 percent of infected cases, with mild to moderate symptoms, are still infectious.”
Coronavirus disease 2019 (COVID-19) Situation Report 94 - World Health Organization [WHO] - 23 Apr. 2020 [This early communication includes a refutation of the much disseminated idea that ‘SARS-CoV-2’ was laboratory made]:
“SUBJECT IN FOCUS: Origin of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the virus causing COVID-19 - The first human cases of COVID-19, the disease caused by the novel coronavirus causing COVID-19, subsequently named SARS-CoV-2 were first reported by officials in Wuhan City, China, in December 2019. Retrospective investigations by Chinese authorities have identified human cases with onset of symptoms in early December 2019. While some of the earliest known cases had a link to a wholesale food market in Wuhan, some did not. Many of the initial patients were either stall owners, market employees, or regular visitors to this market. Environmental samples taken from this market in December 2019 tested positive for SARS-CoV-2, further suggesting that the market in Wuhan City was the source of this outbreak or played a role in the initial amplification of the outbreak. The market was closed on 1 January 2020. SARS-CoV-2 was identified in early January and its genetic sequence shared publicly on 11-12 January. The full genetic sequence of SARS-CoV-2 from the early human cases and the sequences of many other virus isolated from human cases from China and all over the world since then show that SARS-CoV-2 has an ecological origin in bat populations. All available evidence to date suggests that the virus has a natural animal origin and is not a manipulated or constructed virus. Many researchers have been able to look at the genomic features of SARS-CoV-2 and have found that evidence does not support that SARS-CoV-2 is a laboratory construct. If it were a constructed virus, its genomic sequence would show a mix of known elements. This is not the case.”
Ongoing Clinical Trials for the Management of the COVID-19 Pandemic - Mark P. Lythgoe & Paul Middleton - Trends in Pharmacological Science (11 Apr. 2020):
“There are currently no approved treatments or preventative therapeutic strategies. Hundreds of clinical studies have been registered with the intention of discovering effective treatments. Here, we review currently registered interventional clinical trials for the treatment and prevention of COVID-19 to provide an overall summary and insight into the global response.”
Coronaviruses and SARS-CoV-2: A Brief Overview - Stephan Ludwig & Alexander Zarbock - Anesthesia & Analgesia (31 Mar. 2020) [A helpful early article on the current pandemic]:
“In late December 2019, several cases of pneumonia of unknown origin were reported from China, which in early January 2020 were announced to be caused by a novel coronavirus. The virus was later denominated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and defined as the causal agent of coronavirus disease 2019 (COVID-19). Despite massive attempts to contain the disease in China, the virus has spread globally, and COVID-19 was declared a pandemic by the World Health Organization (WHO) in March 2020. Here we provide a short background on coronaviruses, and describe in more detail the novel SARS-CoV-2 and attempts to identify effective therapies against COVID-19.”
The Proximal Origin of SARS-CoV-2 - Kristian G. Andersen, Andrew Rambaut, W. Ian Lipkin, Edward C. Holmes & Robert F. Garry - Nature Medicine (17 Mar. 2020) [Like the WHO guidelines from April, this article refutes a laboratory origin]:
“The genomic features described here may explain in part the infectiousness and transmissibility of SARS-CoV-2 in humans. Although the evidence shows that SARS-CoV-2 is not a purposefully manipulated virus, it is currently impossible to prove or disprove the other theories of its origin described here. However, since we observed all notable SARS-CoV-2 features, including the optimized RBD and polybasic cleavage site, in related coronaviruses in nature, we do not believe that any type of laboratory-based scenario is plausible.”
The Architecture of SARS-CoV-2 Transcriptome - Dongwan Kim, Joo-Yeon Lee, Jeong-Sun Yang, Jun Won Kim, V. Narry Kim & Hyeshik Chang - Cell (14 May 2020) [NB: the ‘Transcriptome’ is “the sum total of all the messenger RNA molecules expressed from the genes of an organism”]:
“Utilizing two complementary sequencing techniques, we present a high-resolution map of the SARS-CoV-2 transcriptome and epi-transcriptome. DNA nanoball sequencing shows that the transcriptome is highly complex owing to numerous discontinuous transcription events. In addition to the canonical genomic and 9 sub-genomic RNAs, SARS-CoV-2 produces transcripts encoding unknown ORFs with fusion, deletion, and/or frameshift. Using nanopore direct RNA sequencing, we further find at least 41 RNA modification sites on viral transcripts, with the most frequent motif, AAGAA.”
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SARS-CoV-2 is an Appropriate Name for the New Coronavirus - Yuntao Wu, Wenzhe Ho, Yaowei Huang, Dong-Yan Jin, Shiyue Li, Shan-Lu Liu, Xuefeng Liu, Jianming Qiu, Yongming Sang, Qiuhong Wang, Kwok-Yung Yuen & Zhi-Ming Zheng - The Lancet (6 Mar. 2020) [Explanation of why the new virus is named ‘SARS-CoV-2 instead of ‘HCoV-2019’]:
“To facilitate good practice and scientific exchange, the International Committee on Taxonomy of Viruses has established standardised formats for classifying viruses. Under these rules, a newly emerged virus is normally assigned to a species based on phylogeny and taxonomy. Through diversity partitioning by hierarchical clustering-based analyses, the newly emerged coronavirus was deemed not sufficiently novel but is a sister virus to SARS-CoV, the primary viral isolate defining the species. The SARS-CoV species includes viruses such as SARS-CoV, SARS-CoV_PC4-227, and SARSr-CoV-btKY72. SARS-CoV-2 is the newest member of this viral species. The use of SARS in naming SARS-CoV-2 does not derive from the name of the SARS disease but is a natural extension of the taxonomic practice for viruses in the SARS species. The use of SARS for viruses in this species mainly refers to their taxonomic relationship to the founding virus of this species, SARS-CoV. In other words, viruses in this species can be named SARS regardless of whether or not they cause SARS-like diseases.”
Update: Public Health Response to the Coronavirus Disease 2019 Outbreak — United States, February 24, 2020 - Centers for Disease Control and Prevention [CDC] - 24 Feb. 2020 [One of the earliest reports by the United States’ ‘CDC’]:
“This report summarizes the aggressive measures that CDC, state and local health departments, multiple other federal agencies, and other partners are implementing to slow and try to contain transmission of COVID-19 in the United States. These measures require the identification of cases and contacts of persons with COVID-19 in the United States and the recommended assessment, monitoring, and care of travelers arriving from areas with substantial COVID-19 transmission. Although these measures might not prevent widespread transmission of the virus in the United States, they are being implemented to 1) slow the spread of illness; 2) provide time to better prepare state and local health departments, health care systems, businesses, educational organizations, and the general public in the event that widespread transmission occurs; and 3) better characterize COVID-19 to guide public health recommendations and the development and deployment of medical countermeasures, including diagnostics, therapeutics, and vaccines.”
Risk assessment: Outbreak of acute respiratory syndrome associated with a novel coronavirus, China: first local transmission in the EU/EEA [third update] - European Centre for Disease Prevention and Control [ECDC] (31 Jan. 2020) [One of the earliest public announcements on the COVID-19 pandemic in the western hemisphere, of historical interest]:
“On 24 January 2020, the first three cases of 2019-nCoV imported into the EU/EEA were identified in France and one additional case was reported on 29 January 2020. On 28 January, a cluster of four locally-acquired cases, with indirect links to Wuhan, was reported from Germany. On 29 January, Finland reported an imported case from Wuhan.
China CDC assesses the transmissibility of this virus to be sufficient for sustained community transmission without unprecedented control measures. Further cases and deaths in China are expected in the coming days and weeks. Further cases or clusters are also expected among travellers from China, mainly Hubei province. Therefore, health authorities in the EU/EEA Member States should remain vigilant and strengthen their capacity to respond to such an event.
There are considerable uncertainties in assessing the risk of this event, due to lack of detailed epidemiological analyses.
On the basis of the information currently available, ECDC considers that:
- the potential impact of 2019-nCoV outbreaks is high;
- the likelihood of infection for EU/EEA citizens residing in or visiting Hubei province is estimated to be high;
- the likelihood of infection for EU/EEA citizens in other Chinese provinces is moderate and will increase;
- there is a moderate-to-high likelihood of additional imported cases in the EU/EEA;
- the likelihood of observing further limited human-to-human transmission within the EU/EEA is estimated as very low to low if cases are detected early and appropriate infection prevention and control (IPC) practices are implemented, particularly in healthcare settings in EU/EEA countries;
- assuming that cases in the EU/EEA are detected in a timely manner and that rigorous IPC measures are applied, the likelihood of sustained human-to-human transmission within the EU/EEA is currently very low to low;
- the late detection of an imported case in an EU/EEA country without the application of appropriate infection prevention and control measures would result in the high likelihood of human-to-human transmission, therefore in such a scenario the risk of secondary transmission in the community setting is estimated to be high.”
Genomic Characterisation and Epidemiology of 2019 Novel Coronavirus: Implications for Virus Origins and Receptor Binding - Roujian Lu, Xiang Zhao, Juan Li, Peihua Niu, Bo Yang, Honglong Wu, Wenling Wang, Hao Song, Baoying Huang, Na Zhu, Yuhai Bi, Xuejun Ma, Faxian Zhan, Liang Wang, Tao Hu, Hong Zhou, Zhenhong Hu, Weimin Zhou, Li Zhao, Jing Chen, Yao Meng, Ji Wang, Yang Lin, Jianying Yuan, Zhihao Xie, Jinmin Ma, William J Liu, Dayan Wang, Wenbo Xu, Edward C. Holmes, George F. Gao, Guizhen Wu, Weijun Chen, Weifeng Shi & Wenjie Tan - The Lancet (29 Jan. 2020).
Coronavirus Infections-More Than Just the Common Cold - C.I. Paules, H.D. Marston & A.S. Fauci - JAMA (23 Jan. 2020) [Noteworthy for one contributor being Dr. Anthony Fauci and written at the earliest stage of the SARS-CoV-2 crisis]:
“During SARS, researchers moved from obtaining the genomic sequence of SARS-CoV to a phase 1 clinical trial of a DNA vaccine in 20 months and have since compressed that timeline to 3.25 months for other viral diseases. For 2019-nCoV, they hope to move even faster, using messenger RNA (mRNA) vaccine technology. Other researchers are similarly poised to construct viral vectors and subunit vaccines. While the trajectory of this outbreak is impossible to predict, effective response requires prompt action from the standpoint of classic public health strategies to the timely development and implementation of effective countermeasures. The emergence of yet another outbreak of human disease caused by a pathogen from a viral family formerly thought to be relatively benign underscores the perpetual challenge of emerging infectious diseases and the importance of sustained preparedness.”
Efficient Replication of the Novel Human Betacoronavirus EMC on Primary Human Epithelium highlights its Zoonotic Potential - Eveline Kindler, Hulda R Jónsdóttir, Doreen Muth, Ole J. Hamming, Rune Hartmann, Regulo Rodriguez, Robert Geffers, Ron A.M. Fouchier, Christian Drosten, Marcel A. Müller, Ronald Dijkman & Volker Thiel - mBio (19 Feb. 2019) [Wide-ranging and significant article on the MERS Coronavirus]:
“In summary, we provide here conclusive evidence that the novel coronavirus HCoV-EMC can productively infect human bronchial epithelia cultures, suggesting that all necessary host cell factors for virus entry, RNA synthesis, and virus assembly and release are available in the human host. HCoV-EMC replication in HAE cultures was at least as efficient as replication of SARS-CoV (this study) and HCoV-229E (12). We conclude that HCoV-EMC is capable of infecting the primary target tissue, the human respiratory epithelium, which is in accordance to the reported clinical presentation of severe respiratory symptoms.”
Origin and Evolution of Pathogenic Coronaviruses - J. Cui, F. Li & Z.L. Shi - Nature reviews Microbiology (10 Dec. 2018) [General exploration of origins of pathogenic Coronaviruses]:
“Severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) are two highly transmissible and pathogenic viruses that emerged in humans at the beginning of the 21st century. Both viruses likely originated in bats, and genetically diverse coronaviruses that are related to SARS-CoV and MERS-CoV were discovered in bats worldwide. In this Review, we summarize the current knowledge on the origin and evolution of these two pathogenic coronaviruses and discuss their receptor usage; we also highlight the diversity and potential of spillover of bat-borne coronaviruses, as evidenced by the recent spillover of swine acute diarrhoea syndrome coronavirus (SADS-CoV) to pigs.”
SARS and MERS: Recent Insights into Emerging Coronaviruses - E. de Wit, N. van Doremalen, D. Falzarano & V.J. Munster - Nature reviews Microbiology (27 Jun. 2016) [Looking at the advancement in our understanding and management of the SARS and MERS illnesses]:
“Scientific advancements since the 2002-2003 severe acute respiratory syndrome coronavirus (SARS-CoV) pandemic allowed for rapid progress in our understanding of the epidemiology and pathogenesis of MERS-CoV and the development of therapeutics. In this Review, we detail our present understanding of the transmission and pathogenesis of SARS-CoV and MERS-CoV, and discuss the current state of development of measures to combat emerging coronaviruses.”
Coronaviruses - Drug Discovery and Therapeutic Options - A. Zumla, J.F. Chan, E.I. Azhar, D.S. Hui & K.Y. Yuen - Nature Reviews Drug Discovery (2016) [Review of virus- and host-based therapeutic options for the MERS and SARS viruses]:
“In humans, infections with the human coronavirus (HCoV) strains HCoV-229E, HCoV-OC43, HCoV-NL63 and HCoV-HKU1 usually result in mild, self-limiting upper respiratory tract infections, such as the common cold. By contrast, the CoVs responsible for severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), which were discovered in Hong Kong, China, in 2003, and in Saudi Arabia in 2012, respectively, have received global attention over the past 12 years owing to their ability to cause community and health-care-associated outbreaks of severe infections in human populations. These two viruses pose major challenges to clinical management because there are no specific antiviral drugs available.”
Epidemiology, Genetic Recombination, and Pathogenesis of Coronaviruses - Shuo Su, Gary Wong, Weifeng Shi, Jun Liu, Alexander C.K. Lai, Jiyong Zhou, Wenjun Liu, Yuhai Bi, George F. Gao - Trends in Microbiology (21 Mar. 2016) [Provides a general view of the subject of human Coronaviruses]:
“Human coronaviruses (HCoVs) were first described in the 1960s for patients with the common cold. Since then, more HCoVs have been discovered, including those that cause severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), two pathogens that, upon infection, can cause fatal respiratory disease in humans. It was recently discovered that dromedary camels in Saudi Arabia harbor three different HCoV species, including a dominant MERS HCoV lineage that was responsible for the outbreaks in the Middle East and South Korea during 2015. In this review we aim to compare and contrast the different HCoVs with regard to epidemiology and pathogenesis, in addition to the virus evolution and recombination events which have, on occasion, resulted in outbreaks amongst humans.”
Delayed Induction of Proinflammatory Cytokines and Suppression of Innate Antiviral Response by the Novel Middle East Respiratory Syndrome Coronavirus: Implications for Pathogenesis and Treatment - S.K. Lau, C.C. Lau, K.H. Chan, C.P. Li, H. Chen, D.Y. Jin et al. - The Journal of General Virology (2013) [Report on analysis of the mRNA levels of eight cytokines genes at various stages of the infection]:
“The high mortality associated with the novel Middle East respiratory syndrome coronavirus (MERS-CoV) has raised questions about the possible role of a cytokine storm in its pathogenesis. Although recent studies showed that MERS-CoV infection is associated with an attenuated IFN response, no induction of inflammatory cytokines was demonstrated during the early phase of infection. [...] Whilst our data supported recent findings that MERS-CoV elicits attenuated innate immunity, this represents the first report to demonstrate delayed proinflammatory cytokine induction by MERS-CoV. Our results provide insights into the pathogenesis and treatment of MERS-CoV infections.”
Recent Developments in Anti-Severe Acute Respiratory Syndrome Coronavirus Chemotherapy - Dale L. Barnard & Yohichi Kumaki - Future Virology (May 2011) [Almost one decade earlier, this review was written on Coronavirus treatments]:
“Thus, it seems prudent to continue to explore and develop antiviral chemotherapies to treat SARS-CoV infections. To this end, the various efficacious anti-SARS-CoV therapies recently published from 2007 to 2010 are reviewed in this article. In addition, compounds that have been tested in various animal models and were found to reduce virus lung titers and/or were protective against death in lethal models of disease, or otherwise have been shown to ameliorate the effects of viral infection, are also reported. [...] In 2003, SARS-CoV emerged as a virus of grave concern to the world community due to its ability to cause severe, life-threatening disease with an appalling mortality rate. Since then it has ‘disappeared’ from the public health scene due, in part, to vigilant public health measures. Owing to the potential of SARS-CoV to reemerge due to a variety of factors or the possibility of a SARS-like virus to arise to cause serious disease, it is still prudent to develop and get approved antiviral therapies that could be used to treat the disease caused by this as yet untreatable virus. [...] Three approaches should be actively pursued: vaccines, postexposure prophylaxis to help isolate focus cases and contacts to prevent spread, and therapeutic efficacious drugs targeting either virus-encoded functions, host targets necessary for virus replication or host functions modulated by virus infection that exacerbate disease. Any of these remedies should be developed to be able to contend with rapid virus evolution and host safety, and to be able to cope with the rapidity with which this disease can become pandemic.”
Detection of Four Human Coronaviruses in Respiratory Infections in Children: a One-Year Study in Colorado - S.R. Dominguez, C.C. Robinson & K.V. Holmes - Journal of Medical Virology (Sep. 2009) [Looks at the frequency of Coronaviruses as causative factors of respiratory infections in children]:
“The majority of HCoV infections occurred during winter months, and over 62% were in previously healthy children. Twenty-six (41%) coronavirus positive patients had evidence of a lower respiratory tract infection (LRTI), 17 (26%) presented with vomiting and/or diarrhea, and 5 (8%) presented with meningoencephalitis or seizures. Respiratory specimens from one immunocompromised patient were persistently positive for HCoV-229E RNA for 3 months. HCoV-NL63-positive patients were nearly twice as likely to be hospitalized (P = 0.02) and to have a LRTI (P = 0.04) than HCoV-OC43-positive patients. HCoVs are associated with a small, but significant number (at least 2.4% of total samples submitted), of both upper and lower respiratory tract illnesses in children in Colorado.”
Interferon and Cytokine Responses to SARS-Coronavirus Infection - V. Thiel & F. Weber - Cytokine & Growth Factor Reviews (2008) [Looks at multiple active and passive mechanisms of SARS virus to avoiding activating some anti-viral responses]:
“The imbalance in the IFN response is thought to contribute to the establishment of viremia early in infection, whereas the production of chemokines by infected organs may be responsible for (i) massive immune cell infiltrations found in the lungs of SARS victims, and (ii) the dysregulation of adaptive immunity. Here, we will review the most recent findings on the interaction of SARS-CoV and related Coronaviridae members with the type I interferon and cytokine responses and discuss implications for pathogenesis and therapy.”
Characterization and Complete Genome Sequence of a Novel Coronavirus, Coronavirus HKU1, from Patients with Pneumonia - Patrick C.Y. Woo, Susanna K.P. Lau, Chung-ming Chu, Kwok-hung Chan, Hoi-wah Tsoi, Yi Huang, Beatrice H.L. Wong, Rosana W.S. Poon, James J. Cai, Wei-kwang Luk, Leo L.M. Poon, Samson S.Y. Wong, Yi Guan, J.S. Malik Peiris & Kwok-yung Yuen - Journal of Virology (Jan. 2005) [Consideration of the CoV-HKU1 virus as a causative factor of respiratory tract infections in humans]:
“The prevalence of CoV-HKU1 in humans as a cause of respiratory tract infections remains to be determined. HCoV-OC43, HCoV-229E, and probably HCoV-NL63 are endemic in humans. On the other hand, isolation of SARS-CoV-like coronavirus from civet cats and the absence of a resurgent SARS epidemic in 2004 apart from sporadic laboratory-acquired cases imply that SARS-CoV probably originated from animals. For CoV-HKU1, the detection of its existence in the NPAs of two patients almost 1 year apart suggests that it may have been endemic in humans, or alternatively, it may originally have been an animal coronavirus but may have crossed the species barrier in the past few years.”
Severe Acute Respiratory Syndrome - J.S. Peiris, Y. Guan & K.Y. Yuen - Nature Medicine (2004) [This early article on SARS provides a good general overview of that illness]:
“Severe acute respiratory syndrome (SARS) was caused by a previously unrecognized animal coronavirus that exploited opportunities provided by 'wet markets' in southern China to adapt to become a virus readily transmissible between humans. Hospitals and international travel proved to be 'amplifiers' that permitted a local outbreak to achieve global dimensions. In this review we will discuss the substantial scientific progress that has been made towards understanding the virus — SARS coronavirus (SARS-CoV) — and the disease. We will also highlight the progress that has been made towards developing vaccines and therapies The concerted and coordinated response that contained SARS is a triumph for global public health and provides a new paradigm for the detection and control of future emerging infectious disease threats.”
Coronavirus 229E-Related Pneumonia in Immunocompromised Patients - F. Pene, A. Merlat, A. Vabret, F. Rozenberg, A. Buzyn, F. Dreyfus, A. Cariou, F. Freymuth & P. Lebon - Clinical Infectious Diseases (1 Oct. 2003) [This article addresses Coronaviruses as causal factors of pneumonia in immunocompromised patients]:
“Here we report 2 well-documented cases of pneumonia related to coronavirus 229E, each with a different clinical presentation. Diagnosis was made on the basis of viral culture and electron microscopy findings that exhibited typical crown-like particles and through amplification of the viral genome by reverse transcriptase-polymerase chain reaction. On the basis of this report, coronaviruses should be considered as potential causative microorganisms of pneumonia in immunocompromised patients.”
Infectious RNA transcribed In Vitro from a cDNA Copy of the Human Coronavirus Genome Cloned In Vaccinia Virus - V. Thiel, J. Herold, B. Schelle & S.G. Siddell - The Journal of General Virology (Jun. 2001) [On the gene mapping of Coronavirus 229E]:
“The coronavirus genome is a positive-strand RNA of extraordinary size and complexity. It is composed of approximately 30000 nucleotides and it is the largest known autonomously replicating RNA. It is also remarkable in that more than two-thirds of the genome is devoted to encoding proteins involved in the replication and transcription of viral RNA. Here, a reverse-genetic system is described for the generation of recombinant coronaviruses. This system is based upon the in vitro transcription of infectious RNA from a cDNA copy of the human coronavirus 229E genome that has been cloned and propagated in vaccinia virus.”
[For further information on Coronaviruses see the article entitled ‘Coronavirus’ on Wikipedia which is based on over 140 relevant sources.]
Bibliographic Research Information provided courtesy of The Academy of the Third Millennium (A3M) 2020
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