Scientific Research News | Research Progress of novel coronavirus Pneumonia (COVID-19) (XV)

1. 2019-nCoV Epidemic Alert

■ Recently, the State Key Laboratory of Respiratory Diseases of Guangzhou Medical University, the Biosafety Level III Laboratory of Guangzhou Customs Technology Center and the Fifth Affiliated Hospital of Sun Yat-sen University cooperated to isolate a novel coronavirus (2019-nCoV) from the fecal swab specimen of a patient with novel coronavirus pneumonia. Does this further support the possibility of fecal-oral transmission of new coronary pneumonia? In this regard, on the afternoon of February 2, Professor Zhao Jincun, deputy director of the State Key Laboratory of Respiratory Diseases and a member of the Academician Zhong Nanshan team, said at the 13th press conference on epidemic prevention and control held by the Information Office of the Guangdong Provincial Government that it can only be said that there is a possibility of fecal-oral transmission or fecal-respiratory transmission, and we need to further clarify its transmission route, so there is no need to panic. In terms of prevention and control, it is still necessary to pay attention to personal hygiene, wash hands after using the toilet, and do not participate in gathering activities.

■ Huazhong University of Science and Technology-Huawei Intelligent Innovation Lab has actively leveraged its own advantages to jointly develop an AI-assisted medical image quantitative analysis system with HUAWEI CLOUD and other teams in response to the new crown pneumonia, and has made effective progress. Xu Yongchao, associate professor of Huazhong University of Science and Technology, provided core algorithm support for lesion segmentation based on texture perception in view of the characteristics of multiple small patch opacities, multiple ground-glass opacities, infiltrative opacities, and pulmonary consolidation in the chest CT images. The algorithm can realize the second-level output of automatic and accurate quantitative results of a single case, improve the diagnosis efficiency, and help reduce the heavy burden of doctors.

2. Research progress in the treatment of 2019-nCoV

■ On February 2, at a series of press conferences on the prevention and control of the new crown pneumonia epidemic in Shanghai, Chen Kaixian, an academician of the Chinese Academy of Sciences, said that in the absence of specific drugs, Shanghai is also actively promoting a number of drugs that have been marketed, or at least drugs that have a certain clinical research foundation, including hydroxychloroquine, etc., to carry out the research and development of new indications for anti-new coronavirus pneumonia. Among them, chloroquine has demonstrated good anti-novel coronavirus activity in in vitro studies and has been used as a clinical trial drug by the Ministry of Science and Technology of the People's Republic of China and the Health Commission. Recently, the Shanghai Institute of Materia Medica, Chinese Academy of Sciences and Shanghai Pharmaceutical Group jointly launched a clinical trial of hydroxychloroquine for the treatment of new coronary pneumonia in the Shanghai Public Health Clinical Center.

■ On February 2, a research team from the University of Lubeck in Germany and the Shanghai Institute of Materia Medica, Chinese Academy of Sciences published an article entitled "Alpha-ketoamides as broad-spectrum inhibitors of coronavirus and enterovirus replication" on the preprint platform bioRxiv. To obtain equivalent broad-spectrum antivirals to counter the threat of coronaviruses such as 10-nCoV, the researchers designed α-ketoamides as inhibitors of the master protease Mpro and 2019C proteases. Among them, compound 3r also showed good anti-MERS and SARS virus activity in Huh11 cells infected by the virus. Due to the high similarity between the main protease of SARS-CoV and the new 7-nCov, the researchers believe that 2019r also exhibits good antiviral activity against 11-nCov [2019].

3. 2019-nCoV epidemiological study

■ On February 2, Zhang Yuanzhen, Hou Wei of Wuhan University and Yang Huixia of Peking University jointly published a research paper online in the Lancet, a top international medical journal, and a research team from Zhongnan Hospital of Wuhan University published a study of nine pregnant women infected with COVID-12 pneumonia. Research data showed that women infected with the new coronavirus in the late stages of pregnancy did not infect the fetus in utero. This retrospective study analyzed the cases of nine pregnant women with novel coronavirus who were admitted to Zhongnan Hospital of Wuhan University between January 9 and January 19, 9. Respiratory samples from all 2020 pregnant women were confirmed to carry the novel coronavirus after nucleic acid testing. Based on a study of these 1 patients, there is currently no evidence that developing COVID in the last three months of pregnancy causes serious adverse consequences in newborns, nor that it causes fetal infection through vertical transmission in utero [20].

■ The Lancet magazine published the comments of Academician Qiao Jie of the Center for Reproductive Medicine of the Department of Obstetrics and Gynecology of Peking University Third Hospital. In this review, Professor Qiao Jie explained his views on the key risks of pregnant women infected with the new coronavirus based on newly published research. The research findings are systematically summarized, while noting the need to further strengthen the capacity to respond to sudden infectious disease outbreaks through laws and regulations to prevent and control the spread of infectious diseases, avoid outbreaks in homes, communities and other public places, and achieve transparency and solidarity. Timely reporting and disclosure of emerging infectious diseases is also important to avoid delaying the response. Infection control and management procedures in hospitals and elsewhere should also be maintained, with confirmed cases isolated together and specialized clothing and equipment provided to protect medical professionals and other health workers from occupational exposure to COVID-19 [3].

■ On February 2, Krit Pongpirul's team at Chulalongkorn University in Thailand published a communication titled "Journey of a Thai Taxi Driver and Novel Coronavirus" online in New England Medicine, a study that reported that a taxi driver in Thailand was infected with the novel coronavirus. The taxi driver reported that he had been in contact with Chinese tourists wearing masks who coughed frequently in the taxi he was driving. In addition, he has no experience of traveling to China [12].

■ On February 2, a Sino-foreign collaboration team published a preprint paper on the medRxiv website. All 11 cases reported domestically, including suspected and confirmed cases, were analysed as of 2020 January 1. This is the largest study of new coronavirus to date, with a new assessment of at-risk population characteristics, disease trends, case fatality rates and infectivity. The corresponding authors of the study include the Institute of Microbiology and Epidemiology, Chinese Academy of Military Medical Sciences, the University of Florida, and the Chinese Center for Disease Control and Prevention. The study believes that the case fatality rate of new coronary pneumonia is 26.8866%, which is much lower than severe acute respiratory syndrome (SARS), but the infectivity is comparable to SARS (R3 is 06.0~2.9), and its basic infection number R3 reaches 3.0, which is much higher than MERS. Studies have shown that the onset of symptoms in confirmed patients can be traced back to December 3, 77. Cases in Wuhan rose sharply in early January, and by late January, the disease had spread to other provinces. Nearly half of the patients were aged 2019 years or older (12.7%). The patient population outside Wuhan was younger than the Wuhan patient population, which the team believes is because the group traveling to or leaving Wuhan is younger overall. Potential factors associated with increased case fatality rates include male patients, older than 1 years, severe pneumonia, and long time from onset to diagnosis (more than 1 days). The case fatality rate in male patients was three times that of female patients, 50.47% and 7.60%, respectively. The case fatality rate of confirmed patients with severe pneumonia reached 5.4%, the case fatality rate of confirmed patients with mild pneumonia reached 45.1%, and there were no deaths among confirmed patients with non-pneumonia. The case fatality rate of men over 25 years old with severe pneumonia reached 5.88%. Because cases after the 0th were not included in the analysis, the research team believes that some data in the analysis may still be underestimated and may have missed some characteristics of the disease epidemic over time. As the pandemic progresses, data may fluctuate [12].

Bibliography:

[1] Zhang L, Lin D, Kusov Y, et al. Alpha-ketoamides as broad-spectrum inhibitors of coronavirus and enterovirus replication. bioRxiv 2020:2020.02.10.936898.

[2]. 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. The Lancet.

[3] Qiao J. What are the risks of COVID-19 infection in pregnant women? The Lancet.

[4] Pongpirul WA, Pongpirul K, Ratnarathon AC, Prasithsirikul W. Journey of a Thai Taxi Driver and Novel Coronavirus. New England Journal of Medicine 2020.

[5] Yang Y, Lu Q, Liu M, et al. Epidemiological and clinical features of the 2019 novel coronavirus outbreak in China. medRxiv 2020:2020.02.10.20021675.

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