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Epidemic Alert Management of Patients with COVID (Coronavirus Disease 19 – State of Knowledge

Alerte épidémique Prise en charge des patients atteints de COVID (Coronavirus disease 19 * Etat des connaissances
(Last Updated On: )

1- Virology:

  1. seasonal hCoV: 220E, OC43, NL63, HKU1
  2. Emerging coVs with increased pathogenicity
  1. 80% genetic identity with SARS-CoV
  2. 96% identity with a bat virus (Rhinolophusaffinis)

2- Epidemiology:

3- Transmission:

Contaminated health professionals:

4- Protection:

ELIMINATION EPI in DASRI before leaving the room, except for glasses and APR that will be removed after leaving the room

5- Clinical, Biological and Imaging Table:





Clinic, imaging:

Clinical and radiological aggravation with patient death
Clinical and radiological improvement at J14


J8 J9 period of clinical aggravation


Antiviral treatments:

Antibiotic treatments:

Support treatments:


CHINESE CDC, No. 72672





Monocentric study, retrospective, intensive care unit, No. 52


Average age (years): 59.7 (up 13.3)

Male: 35 (67%)







6- Support:

"Information for UAS and other 1st line carers – COREB" regularly updated on the COREB website to be consulted here

From the patient suspect REB to the confirmed case… or excluded


From the patient suspect REB to the confirmed case… or excluded


7- Samples:

Professionals in the events performing the samples: personal protective equipment (EPI)

Type of respiratory samples Collectibles
Nasopharyngeal and oropharyngeal swab Flaky swabs in dacron or polyester
Washing Broncho alveolar Sterile container
Tracheal aspiration, nasopharyngeal suction or nasal wash Sterile container
Sputum Sterile container 


Transport temperature: 4C – Storage time until test completion: If 5 days: 4 C, if 5 days: 70 C

SARS-CoV-2: Group 2 biological agent, requiring triple packaging:

Note the virus may be present in stool, urine…

PCR SARS-CoV-2 negative, depending on condition, may require verification

8- SARS-CoV treatments, MERS-CoV:

  1. Model of the mouse hepatitis virus: inhibition of viral replication in vitro
  2. MERS-CoV: higher re-ctivity than LPVrin vitro

9- References:

  1. Na Zhu et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. NEJM – Jan 24, 2020
  2. Wu Z et al. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72314 Cases From the Chinese Center for Disease Control and Prevention. JAMA – 24 Feb 2020
  3. Liu Y et al. The reproductive number of COVID-19 is higher compared to SARS coronavirus. J Travel Med – 13 Feb2020
  4. Imperial College London. Report 3: Estimating the potential total number of novel coronavirus cases in Wuhan City, China. 22 Jan2020
  5. Wu JT et al. Nowcastingand forecasting the potential domestic and international spread of the 2019-nCoV outbreak outbreaking in Wuhan, China: a modelling study. Lancet. 2020 Jan 31
  6. QunLi et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. NEJM – Jan 29,
  7. Nanshan Chen et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet – Jan 29, 2020
  8. Jasper Fuk-Woo Chan et al. A family cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet – Jan 24, 2020
  9. Wang D et al. Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China. Jama. 2020Feb
  10. French Hygiene Society hospitalière
  11. Xiaoboet al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study Lancet RespirMed 2020 -21 fev2020 (20)30079-5/fulltext
  12. ChaolinHuanget al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet – Jan 24, 2020
  13. French Society of Microbiology
  17. Chu CM et al. Role of lopinavir/ritonavir in the treatment of SARS: initial virologicaland clinical findings. Thorax Mar 2004
  18. Arabi YM et al. Treatment of Middle East Respiratory Syndrome with a combination of lopinavir-ritonavir and interferon-1b (MIRACLE trial): study protocol for a randomized controlled trial. Trials Jan 2018
  19. Maria L. Agostini et al. Coronavirus Susceptibility to the Antiviral Remdesivir (GS5734) Is Mediated by the Viral Polymerase and the Proofreading Exoribonuclease. mBio -Mar 2018
  20. Sheahan TP et al. Comparative therapeutic efficacy of remdesivirand combination lopinavir, ritonavir, and interferon beta against MERS-CoV. Nat Commun-10 Jan 2020
  21. Public Health France, documentation

Contributions: JM Chapplain-G Mellon (Mission COREB), S van der Werf (CNR coronavirus), B Grandbastien (SF2H), B Hoen (SPILF Emergences),D Malvy -D Nguyen (ESR Bordeaux) and infectious scientists ref. Esr

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