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Latest advances in the biology of the Coronavirus Disease 2019 (COVID-19). *This page is updated throughout the day to include essential publications on COVID-19.*
Last Updated: 10:48 AM GMT March 29, 2020
Life around the world has changed. One-third of the world’s population is now under lockdown. Hospitals are approaching full capacity. While uncertainty is sweeping the globe, scientists around the world are scrambling to learn more about the Coronavirus Disease 2019. Science and facts are critical at this moment.
Confirmed cases of the coronavirus disease (COVID-19) have risen sharply and spanned the globe.
Worldometer’s algorithms have recorded more than 677,000 COVID-19 cases and over 31,000 deaths as of 10:48 AM GMT March 29, 2020.1
The World Health Organization (WHO) in a statement2 on March 3, 2020, revealed that about 3.4% of reported COVID-19 cases have died.
The speed with which the COVID-19 outbreak has moved from epidemic to pandemic is being touted as unprecedented in modern times.
Find some of the latest research breakthroughs in understanding the biology of COVID-19 below.
See near-realtime global COVID-19 cases and deaths estimates here.
See all US Centers for Disease Control and Prevention (CDC) guidelines here.
See the WHO’s latest COVID-19 situation report here.
Find all other information on the COVID-19 (by the WHO) outbreak here.
The coronavirus (COVID-19) is a highly contagious disease caused by Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
COVID-19 was first identified in Wuhan, a city in Central China in late 2019, and was reported to the WHO by the Chinese authorities on December 31, 2019.3
The first known case has been traced back to November 17, 2019.4
The WHO characterized COVID-19 as pandemic on March 11, 2020.5
Common symptoms according to the WHO6 include:
According to the US CDC, symptoms of COVID-19 may start to appear between 2 to 14 days after exposure, and they include trouble breathing, pressure in the chest, and bluish face or lips.7
Other minor symptoms include runny nose, nasal congestion, and diarrhea.
According to the WHO, only 1 out of 6 people who get infected become seriously ill, and more than 80% of people recover without medical intervention.
People of all ages are at risk, but older adults and people with underlying medical conditions such as diabetes, asthma, and heart disease, are at a higher risk for severe illness.
To prevent spread, the WHO has urged people to maintain at least 3 feet distance between themselves and people who are coughing or sneezing.
Clean and disinfect touched surfaces such as doorknobs, light switches, handles, faucets, and keyboards. Also avoid sharing personal household items such as spoon and cups.
Face masks won’t do all the magic, but contrary to some of the information out there and giving what we know so far about COVID-19, yes, the right face mask — worn correctly — can reduce the wearer’s exposure to the virus. This should complement other hygiene measures.
Proper fitting respirators — airtight and snug — with certified filters inside them (such as N99, N95, KN95, etc.) are effective at filtering out the tiny airborne particles they are designed to block.
Avoid loose-fitting masks in COVID-19 high-risk environments.
Most surgical masks are designed to catch bacteria from the wearer’s mouth or nose; they do not not always protect the wearer from tiny particles and infectious droplets due to how loose they fit.
Strictly follow the fitting instructions in the manual that came with your respirator.
There are already dozens of scientific discoveries on COVID-19, as you can see in the WHO database of publications on COVID-19.
Below are some of the most relevant scientific breakthroughs on COVID-19 so far:
According to a new study published (March 17, 2020) in The New England Journal of Medicine10 by scientists at CDC, Princeton University, The University of California, Los Angeles, and National Institute of Health, SARS-CoV-2 can be stable for hours to days in aerosols and on surfaces such as copper, plastic, and stainless steel.
SARS-CoV-2 is detectable for up to 3 hours in aerosols, and up to 3 days on plastic and stainless steel, according to the study. This suggests that people may get infected through the air and after touching contaminated surfaces.
See the full study here.
A new study — published on March 17, 2020, in the journal Nature Medicine11 — by scientists at the Scripps Research Institute has found no evidence that COVID-19 was engineered or man-made in a laboratory.
The researchers analyzed public genome sequence data from SARS-CoV-2. They found that the receptor-binding domain portion of the virus spike protein had evolved to target the enzyme Angiotensin converting enzyme 2. The finding points to natural selection, not genetic engineering, the scientists concluded.
Read the study here.
Scientists at the University of Texas at Austin have identified how quickly the coronavirus can spread in a new study published in the journal Emerging Infectious Diseases.12
The researchers examined 468 confirmed cases of COVID-19 and found that 12.6% of the infected patients were infected by someone/people who had the virus but did not yet show symptoms.
“This provides evidence that extensive control measures including isolation, quarantine, school closures, travel restrictions and cancellation of mass gatherings may be warranted,” said Lauren Ancel Meyers, one of the researchers.
Read the full study here.
Stephen Lauer and other researchers studied 181 confirmed cases and estimated the median incubation period for COVID-19 to be approximately 5 days. They found that 97.5% of people who develop symptoms will do so within 11.5 days, implying that around 101 out of every 10,000 cases will develop symptoms after 14 days of active monitoring.
Scientists at Columbia University Mailman School of Public Health have found in a new study that undocumented cases were responsible for the fast spread of COVID-19 outbreak in China14, underscoring the pandemic potential of SARS-CoV2.
According to the study, 86% of all cases were undocumented before January 23, 2020, Wuhan travel restrictions. The study found that undocumented infections were 55% of documented infections and the infection source for 79% of documented cases.
“The explosion of COVID-19 cases in China was largely driven by individuals with mild, limited, or no symptoms who went undetected,” says Jeffrey Shaman, co-author of the study.
“Heightened awareness of the outbreak, increased use of personal protective measures, and travel restriction have helped reduce the overall force of infection; however, it is unclear whether this reduction will be sufficient to fully stem the virus spread,” Shaman added in a statement.
The study was published in the journal Science. See it here.
A study by infection biologists with the German Primate Center has found that the drug camostat mesilate can suppress protease TMPRSS2, an enzyme present in the our body, which SARS-CoV-2 uses as a gateway into human cells.
Camostat mesilate is presently approved in Japan for pancreatic inflammation treatment.
“Our results show that SARS-CoV-2 requires the protease TMPRSS2, which is present in the human body, to enter cells,” said Stefan Pöhlmann, one of the co-authors.
“Our results suggest that camostat mesilate might also protect against COVID-19,” said Markus Hoffmann, another researcher familiar with the study.
See the study here.
A new study which studied 191 patients with confirmed COVID-1915 from two hospitals — Jinyintan and Wuhan Pulmonary Hospital — in Wuhan has associated old age and underlying conditions such as diabetes and blood clotting when hospitalized with a higher risk of death from the virus.
“Older age, showing signs of sepsis on admission, underlying diseases like high blood pressure and diabetes, and the prolonged use of non-invasive ventilation were important factors in the deaths of these patients. Poorer outcomes in older people may be due, in part, to the age-related weakening of the immune system and increased inflammation that could promote viral replication and more prolonged responses to inflammation, causing lasting damage to the heart, brain, and other organs,” said Dr Zhibo Liu, one of the co-authors.
The study was published in The Lancet. Read the full study here.
A new study published in The Lancet16 has documented the first known locally-transmitted case of SARS-CoV-2 from a woman in her 60s who had returned from China around mid-January, 2020, to her husband, who had not traveled with her but had frequent contact with her.
The woman, codenamed Patient 1, tested positive for SARS-CoV-2 a week later. Her husband (Patient 2), who had not traveled to China, but had close contact with her also tested positive 8 days later.
Overall, 372 people were identified as contacts for both cases, but none of them tested positive for SARS-CoV-2 despite active monitoring.
Dr Jeniffer Layden, who co-authored the study said in a statement: “This report suggests that person-to-person transmission of SARS-CoV-2 might be most likely to occur through unprotected, prolonged exposure to an individual with symptomatic COVID-19.”
“Without using appropriate facemasks or other personal protective equipment, individuals living in the same household as, or providing care in a non-healthcare setting for, a person with symptomatic COVID-19 are likely to be at high risk of infection. Current CDC recommendations for individuals with high-risk exposures to remain quarantined with no public activities might be effective in reducing onward person-to-person transmission of SARS-CoV-2,” co-lead author, Dr Tristan added.
The study was published in The Lancet. Full text is available here.
Factors such as old age, history of smoking, and respiratory failure can contribute to the progression of pneumonia in COVID-19 patients, a Chinese study has found17.
The study was published in the Chinese Medical Journal. See the study here.
A combination of quarantining infected individuals and their close contacts, workplace distancing, and school closure, is most effective at reducing SARS-CoV-2 infections compared with other intervention designs, a Singapore modelling study18 published in The Lancet Infectious Diseases has found.
“Should local containment measures, such as preventing disease spread through contact tracing efforts and, more recently, not permitting short-term visitors, be unsuccessful, the results of this study provide policy makers in Singapore and other countries with evidence to begin the implementation of enhanced outbreak control measures that could mitigate or reduce local transmission rates if deployed effectively and in a timely manner,” said Alex R Cook, co-author of the study.
Read the full study here.
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© 2020 Muntaka Chasant
March 23, 2020
14 Min read time