Novel Coronavirus 2019 Infections Current Status

Öz

Coronaviruses are enveloped RNA viruses that take their name from the thorny protrusions (Corona; Crown) on their surface in electron microscopy.They can cause respiratory,enteric,hepatic, and neurological diseases in humans and animals.Human infections are usually caused by Alpha and Beta types. Human Coronaviruses (HCoV) were first described in the 1960s,and these are mainly 229E,NL63,OC43 and HKU1 Coronaviruses, causing typical mild/moderate respiratory diseases in humans.In addition,occasional outbreaks of different severe Coronavirus infections (MERS-CoV,SARS-CoV) have been reported.Apart from these,new(novel) Coronavirus infections (2019-nCoV,SARS-CoV-2 or COVID-19) have been reported which started in Wuhan,Hubei,China in December 2019 and tend to spread all over the world.In this review,it is aimed to present the epidemiological course,genetic factors,transmission,prevention of this novel Coronavirus infections with the clinical findings in adults and children,diagnosis,treatment,prevention methods and current information in our country.As of February 12,2020, 45.171 proven cases have been reported in the world and 25 different countries have been affected by this epidemic.The average incubation period of COVID-19 infection was 5.2days (1-14 days).The fatality rate was 2.5% on average in all cases,but 4.3-15% in severe or hospitalized patients.In adult cases,it begins clinically with non-specific upper respiratory tract infections such as fever,cough and weakness.In severe cases,symptoms such as pneumonia and severe respiratory failure develop within days.In laboratory findings;lymphopenia was observed in hospitalized patients,lung involvement was in almost all cases with bilateral and multilobuler and/or subsegmental consolidation. Pediatric cases were usually asymptomatic or with mild upper respiratory tract infection findings. Pneumonia has been rarely seen.Mortality has not been reported in pediatric cases.Treatment of COVID-19 mainly consists of supportive therapy. Droplet isolation measures and hand hygiene play an important role in protection.Rigorous application of infection control measures is expected to be helpful in breaking the epidemics and pandemics.

Anahtar Kelimeler

• China,Coronavirus,COVID-19,pandemic,SARS-CoV-2,2019-nCoV

Yenı Coronavirüs 2019 Enfeksıyonları Güncel Durum

Öz

Coronavirüsler zarflı, adlarını yüzeylerindeki dikensi çıkıntılardan (Corona; Taç) alan RNA virüsleridir. İnsan ve hayvanlarda, respiratuar, enterik, hepatik ve nörolojik hastalıklara neden olabilirler. İnsanlarda genellikle Alfa ve Beta tipleri görülür. İnsan Coronavirüsleri (HCoV) ilk defa 1960’lı yıllarda tanımlanmıştır, ve bunlar genellikle 229E, NL63, OC43 ve HKU1 Coronavirüsleri olup insanlarda tipik hafif/orta solunum yolu hastalıklarına sebep olmaktadır. Ayrıca zaman zaman salgınlar yapan ve ağır seyirli Coronavirüs enfeksiyonları da (MERS-CoV, SARS-CoV) bildirilmiştir. Bunlardan farklı olarak Aralık 2019 da Çin’in Hubei eyaletinin Wuhan şehrinden başlayıp tüm dünyaya yayılma eğilimi gösteren yeni (novel) Coronavirüs enfeksiyonları (2019-nCoV, daha yeni tanımlarıyla SARS-CoV-2 veya COVID-19) bildirilmiştir. Bu derlemede bu yeni Coronavirüs enfeksiyonlarının epidemiyolojik seyri, genetik faktörleri, bulaş mekanizmaları, erişkin ve çocuk olgularda kliniği, tanı, tedavi, korunma yöntemleri ve ülkemizdeki durum ile ilgili güncel bilgilerin sunulması amaçlanmıştır. Dünya’da 12 Şubat itibariyle 45,171 kanıtlı vaka bildirilmiş olup 25 farklı ülke bu salgından etkilenmiştir. COVID-19 enfeksiyonunun ortalama inkübasyon süresi 5,2 gün (1-14 gün), fatalite hızı tüm olgularda ortalama %2,5, ancak yatan hastalarda ise %4,3-15 bildirilmiştir. Erişkin olgularda klinik olarak ateş, öksürük, halsizlik gibi non-spesifik üst solunum yolu enfeksiyonu benzeri bulgularla başlar. Ağır olgularda günler içerisinde pnömoni, ağır solunum yetersizliği gibi bulgular gelişir. Laboratuvar bulgularında; lenfopeninin dikkat çektiği, yatan/ağır olgularda, akciğer tutulumunun hemen tüm olgularda bilateral ve multilobuler ve/veya subsegmental konsolidasyon şeklinde olduğu gözlenmiştir. Çocuk olgularda genellikle asemptomatik ya da çok hafif üst solunum yolu enfeksiyonu şeklinde seyredip pnömoni nadir görülmüştür. Çocuk olgularda fatalite bildirilmemiştir. Korunmada damlacık izolasyon önlemleri ve el hijyeni önemli yere sahiptir. Enfeksiyon kontrol önlemlerinin titizlikle uygulanmasının epidemi ve pandemilerin gücünün kırılmasında yararı olması beklenmektedir.

Anahtar Kelimeler

• Coronavirüs,COVID-19,Çin,pandemi,SARS-CoV-2,2019-nCoV

Kaynakça

1. 1.T.C. Sağlık Bakanlığı, Halk Sağlığı Genel Müdürlüğü, 2019-nCoV Hastalığı Sağlık Çalışanları Rehberi. 30 Ocak 2020. Ankara.
2. 2.Heimdal I, Moe N, Krokstad S, et al. Human Coronavirus in Hospitalized Children With Respiratory Tract Infections: A 9-Year Population-Based Study From Norway. J Infect Dis. 2019;219:8:1198-206.
3. 3.Zhu N, Zhang D, Wang W, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020.
4. 4.Center for Disease Control and Prevention. Severe Acute Respiratory Syndrome (SARS). https://www.cdc.gov/sars/index.html. Erişim Tarihi: 30 Ocak 2020.
5. 5.Center for Disease Control and Prevention. Middle East Respiratory Syndrome (MERS), https://www.cdc.gov/Coronavirus/mers/index.html. Erişim Tarihi: 30 Ocak 2020.
6. 6.Center for Disease Control and Prevention. 2019 Novel Coronavirus, https://www.cdc.gov/Coronavirus/index.html. Erişim Tarihi: 30 Ocak 2020.
7. 7.World Health Organization. Novel Coronavirus Situation Reports. https://www.who.int/emergencies/diseases/novel-Coronavirus-2019/situation-reports. Erişim Tarihi: 03 Şubat 2020.
8. 8.Gorbalenya AE, Baker SC, Baric RS, et al. Severe acute respiratory syndrome-related Coronavirus: The species and its viruses – a statement of the Coronavirus Study Group bioRxiv. 2020;937862.

9. 9.Coronavirus latest: WHO officially names disease COVID-19. https://www.nature.com/ Erişim Tarihi: 12.02.2020.
10. 10.Chen ZM, Fu JF, Shu Q, et al. Diagnosis and treatment recommendations for pediatric respiratory infection caused by the 2019 novel Coronavirus. World J Pediatr. 2020.
11. 11.Lu R, Zhao X, Li J, et al. Genomic characterisation and epidemiology of 2019 novel Coronavirus: implications for virus origins and receptor binding. Lancet. 2020.
12. 12.Malik YS, Sircar S, Bhat S, et al. Emerging novel Coronavirus (2019-nCoV) - Current scenario, evolutionary perspective based on genome analysis and recent developments. Vet Q. 2020: 1-12.
13. 13.Chan JF, Yuan S, Kok KH, et al. A familial cluster of pneumonia associated with the 2019 novel Coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet. 2020.
14. 14. Wong CM, Cregeen SJJ, Ajami NJ, Petrosino JF. Evidence of recombination in coronaviruses implicating pangolin origins of nCoV-2019. bioRxiv. 2020:937862.
15. 15.Guan Y, Zheng BJ, He YQ, et al. Isolation and characterization of viruses related to the SARS Coronavirus from animals in southern China. Science. 2003;302:5643:276-8.
16. 16.Alagaili AN, Briese T, Mishra N, et al. Middle East respiratory syndrome Coronavirus infection in dromedary camels in Saudi Arabia. mBio. 2014;5:2:884-14.
17. 17.Cui J, Li F, Shi ZL. Origin and evolution of pathogenic Coronaviruses. Nat Rev Microbiol. 2019;17(3):181-92.
18. 18.World Health Organization. Statement on the second meeting of the International Health Regulations (2005) Emergency Committee regarding the outbreak of novel Coronavirus (2019-nCoV). https://www.who.int/news-room/detail/30-01-2020-statement-on-the-second-meeting-of-the-international-health-regulations-(2005)-emergency-committee-regarding-the-outbreak-of-novel-Coronavirus-(2019-ncov). Erişim Tarihi: 01 Şubat 2020.
19. 19.Timeline of the Coronavirus outbreak’s key events. https://www.id-hub.com/2020/01/06/pneumonia-unknown-etiology-causing-cases-china/. Erişim Tarihi: 08 Şubat 2020.
20. 20.Rothe C, Schunk M, Sothmann P, et al. Transmission of 2019-nCoV Infection from an Asymptomatic Contact in Germany. N Engl J Med. 2020.
21. 21.Chen H, Guo J, Wang C, et al. Clinical characteristics and intrauterine vertical transmission potential of COVID-19 infection in nine pregnant women: a retrospective review of medical records. wwwthelancetcom. 2020.
22. 22.Wang D, Hu B, Hu C, et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. JAMA. 2020.
23. 23.Chowell G, Abdirizak F, Lee S, et al. Transmission characteristics of MERS and SARS in the healthcare setting: a comparative study. BMC Med. 2015;13:210.
24. 24.Zhao S, Musa SS, Lin Q, et al. Estimating the Unreported Number of Novel Coronavirus (2019-nCoV) Cases in China in the First Half of January 2020: A Data-Driven Modelling Analysis of the Early Outbreak. J Clin Med. 2020;9:2.
25. 25.Tuite AR, Fisman DN. Reporting, Epidemic Growth, and Reproduction Numbers for the 2019 Novel Coronavirus (2019-nCoV) Epidemic. Ann Intern Med. 2020.
26. 26.Mahase E. China Coronavirus: what do we know so far? BMJ. 2020;368:308.
27. 27.Li Q, Guan X, Wu P, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020.
28. 28.World Health Organization. Questions & Answers On Coronavirus. https://www.who.int/emergencies/diseases/novel-Coronavirus-2019. Erişim Tarihi: 08.02.2020.
29. 29.Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel Coronavirus in Wuhan, China. Lancet. 2020.
30. 30.World Health Organization. Middle East respiratory syndrome Coronavirus, Turkey. https://www.who.int/csr/don/24-october-2014-mers/en/. Erişim Tarihi: 08.02.2020.
31. 31.China Demographics. https://www.worldometers.info/demographics/china-demographics/ - broad-age. Erişim Tarihi: 08.02.2020.
32. 32. Shen K, Yang Y, Wang T, et al. Diagnosis, treatment, and prevention of 2019 novel Coronavirus infection in children: experts' consensus statement. World J Pediatr. 2020.
33. 33. Wei M, Yuan J, Liu Y, et al. Novel Coronavirus Infection in Hospitalized Infants Under 1 Year of Age in China. JAMA. 2020.
34. 34. Keyaerts E, Vijgen L, Maes P, Neyts J, Van Ranst M. In vitro inhibition of severe acute respiratory syndrome Coronavirus by chloroquine. Biochem Biophys Res Commun. 2004;323:1: 264-8.
35. 35. Shen KL, Yang YH. Diagnosis and treatment of 2019 novel Coronavirus infection in children: a pressing issue. World J Pediatr. 2020.