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• Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China.JAMA. 2020.Main Outcomes and Measures: Epidemiological, demographic, clinical, laboratory, radiological, and treatment data were collected and analyzed. Outcomes of critically ill patients and noncritically ill patients were compared. Presumed hospital-related transmission was suspected if a cluster of health professionals or hospitalized patients in the same wards became infected and a possible source of infection could be tracked.Results:
  Of 138 hospitalized patients with NCIP, the median age was 56 years (interquartile range, 42-68; range, 22-92 years) and 75 (54.3%) were men. Hospital-associated transmission was suspected as the presumed mechanism of infection for affected health professionals (40 [29%]) and hospitalized patients (17 [12.3%]). Common symptoms included fever (136 [98.6%]), fatigue (96 [69.6%]), and dry cough (82 [59.4%]). Lymphopenia (lymphocyte count, 0.8 × 109/L [interquartile range {IQR}, 0.6-1.1]) occurred in 97 patients (70.3%), prolonged prothrombin time (13.0 seconds [IQR, 12.3-13.7]) in 80 patients (58%), and elevated lactate dehydrogenase (261 U/L [IQR, 182-403]) in 55 patients (39.9%). Chest computed tomographic scans showed bilateral patchy shadows or ground glass opacity in the lungs of all patients. Most patients received antiviral therapy (oseltamivir, 124 [89.9%]), and many received antibacterial therapy (moxifloxacin, 89 [64.4%]; ceftriaxone, 34 [24.6%]; azithromycin, 25 [18.1%]) and glucocorticoid therapy (62 [44.9%]). Thirty-six patients (26.1%) were transferred to the intensive care unit (ICU) because of complications, including acute respiratory distress syndrome (22 [61.1%]), arrhythmia (16 [44.4%]), and shock (11 [30.6%]). The median time from first symptom to dyspnea was 5.0 days, to hospital admission was 7.0 days, and to ARDS was 8.0 days. Patients treated in the ICU (n = 36), compared with patients not treated in the ICU (n = 102), were older (median age, 66 years vs 51 years), were more likely to have underlying comorbidities (26 [72.2%] vs 38 [37.3%]), and were more likely to have dyspnea (23 [63.9%] vs 20 [19.6%]), and anorexia (24 [66.7%] vs 31 [30.4%]). Of the 36 cases in the ICU, 4 (11.1%) received high-flow oxygen therapy, 15 (41.7%) received noninvasive ventilation, and 17 (47.2%) received invasive ventilation (4 were switched to extracorporeal membrane oxygenation). As of February 3, 47 patients (34.1%) were discharged and 6 died (overall mortality, 4.3%), but the remaining patients are still hospitalized. Among those discharged alive (n = 47), the median hospital stay was 10 days (IQR, 7.0-14.0).Conclusions and Relevance:
  In this single-center case series of 138 hospitalized patients with confirmed NCIP in Wuhan, China, presumed hospital-related transmission of 2019-nCoV was suspected in 41% of patients, 26% of patients received ICU care, and mortality was 4.3%.
  
• Genomic variance of the 2019-nCoV coronavirus.J Med Virol. 2020.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. This article is protected by copyright. All rights reserved.
  
• Initial Public Health Response and Interim Clinical Guidance for the 2019 Novel Coronavirus Outbreak - United States, December 31, 2019-February 4, 2020.MMWR Morb Mortal Wkly Rep. 2020.
• Emerging Coronavirus 2019-nCoV Pneumonia.Radiology. 2020.Background The chest CT findings of patients with coronavirus 2019-nCoV pneumonia have not previously been described in detail. Purpose To investigate the clinical, laboratory, and imaging findings of emerging coronavirus 2019-nCoV pneumonia in humans. Materials and Methods Fifty-one patients (25 men and 26 women, 16-76 years old) with 2019-nCoV pneumonia confirmed with the positive new coronavirus nucleic acid antibody underwent thin-section CT. The imaging findings, clinical and laboratory data were evaluated. Results Fifty of 51 patients (98%) had a history of the endemic center Wuhan contact. Fever (49/51, 96%) and cough (24/51, 47%) were the most common symptoms. Most patients had a normal white blood cell count (37/51, 73%), neutrophil count (44/51, 86.3%) and normal (17/51, 35.3%) or reduced (33/51, 64.7%) lymphocyte count. CT images showed pure ground grass opacity (GGO) in 39/51 (77%) patients, GGO with reticular and/or interlobular septal thickening in 38/51 (75%) patients. GGO with consolidation was present in 30/51 (59%) and pure consolidation in 28/51 (55%) patients. 44/51 (86%) patients had bilateral lung involvement, while 41/51 (80%) involved the posterior part of the lungs and 44/51 (86%) were peripheral. There were more consolidated lung lesions in patients 5 or more days from disease onset to CT scan versus 4 or fewer days (431/712 lesions vs. 129/612 lesions, p < 0.001). Patients more than 50 years old had more consolidated lung lesions than those 50 years or younger (212/470 vs. 198/854, p < 0.001). Follow up CT in 13 patients showed improvement in 7 (54%) patients and progression in 4 (31%) patients. Conclusions Patients with fever and/or cough and with conspicuous ground grass opacity lesions in the peripheral and posterior lungs on CT images combined with normal or decreased white blood cells and a history of epidemic exposure are highly suspected of 2019-nCoV pneumonia.
• 2019-nCoV acute respiratory disease, Australia: Epidemiology Report 1 (Reporting week 26 January - 1 February 2020).Commun Dis Intell (2018). 2020.