Coronavirus Disease: From Origin to Outbreak

By Adnan I. Qureshi and Omar Saeed

Coronavirus Disease: From Origin to Outbreak provides a comprehensive review of coronaviruses, particularly COVID-19, its transmission, and disease pathology. The book covers the viral structure and genetics of coronaviruses, the pathogenesis and unique characteristics of coronavirus infection, and the evolving nature of our understanding of coronaviruses and disease. It also looks at the history of SARS-CoV and MERS-CoV infections and its global spread. The book examines the effectiveness of various preventive measures and new therapeutic agents that are either currently available or expected to available. Finally, it details the psychological and societal impact the virus and disease has in outbreak regions and what the financial impact an outbreak has on the healthcare system and local economies.

• Provides an overview of the nature of infection, methods of spread, and history to better understand the principles of prevention and treatment of not only coronaviruses but also zoonotic infections in general
• Makes comparisons with the impact of other viral infections such as Ebola virus disease, Zika virus disease, and Dengue virus disease which is key to learning from previous successful and unsuccessful strategies
• Examines the global health perspective, population reaction, medical response to the COVID-19 pandemic

• Language: English
• Publisher: Academic Press
• Release date: Oct 21, 2021
• ISBN: 9780323859646

Book preview

Coronavirus Disease

From Origin to Outbreak

Editor

Adnan I. Qureshi

Zeenat Qureshi Institutes and Department of Neurology, University of Missouri, Columbia, MO, United States

Omar Saeed

Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, United States

Uzma Syed

South Shore Infectious Diseases, Bayshore

Travel Medicine Consultants and Antibiotic Infusion Center, Syosset, NY, United States

Table of Contents

Cover image

Title page

Copyright

Contributors

Chapter 1. Introduction

Chapter 2. History of SARS-CoV-2

Chapter 3. Zoonotic infections

Definition

Transmission

History of zoonoses

Emerging infections and virus spillover

Bat ecology

Challenges to control outbreak

Chapter 4. Global response

An enemy emerges

The virus marches on: East Asian countries

Europe will not be spared: Italy

Let us worship in peace: Pakistan

The new norm: the United States gets caught in a storm

The city that never sleeps

The dilemma of one of the largest gathering in the world

The search for a prevention

The need to monitor the cases

As Earth completes its revolution

Chapter 5. Coronavirus infection outbreak: comparison with other viral infection outbreak

Understanding SARS-CoV-2

Epidemic versus pandemic

Common features of epidemics

Comparing SARS-CoV-2 with SARS-CoV and influenza pandemics

Gene structure of MERS-CoV, SARS-CoV, and SARS-CoV-2

Transmissibility and the basic reproductive rate

Incubation period of SARS-CoV-2 and viral excretion

Case fatality and risk of severe illness

Population-based mortality

Incidence of SARS-CoV-2 infections

Comparing SARS-CoV-2 and SARS-CoV spread

Conclusion

Chapter 6. SARS-CoV-2 viral structure and genetics

Introduction

Viral structure

Molecular genetics

Replication and gene expression

Replication transcription complexes

Basics of immune response

Viral host immune interactions

SARS-CoV-2 vaccines

Conclusions

Chapter 7. Clinical manifestation and diagnosis

Introduction

Transmission of COVID-19

Clinical manifestations

Diagnosis

Differential diagnosis

Viral persistence, convalescence, and recovery period

Precautionary guidelines set up by the Centers for Disease Control and Prevention regarding the testing process of COVID-19 and laboratory biosafety

Chapter 8. Treatment and therapeutic agents

Emergency use authorizations during the SARS-CoV-2 pandemic

Part I: Antiviral drug therapy Fig. 8.2

Part II: Immunomodulatory agents

Part III: Convalescent plasma, Intravenous immunoglobulin, and Cell-based therapies

Clinical Research

Part IV: Vaccine

Conclusion

Chapter 9. The economic repercussions of Coronavirus disease 2019 (COVID-19)

World economy December 2019

Major conflicts

Political impact of COVID-19

China's economic response to COVID-19

What industry relied on Wuhan for trade globally

Governments' economic response to COVID-19

A recession caused by SARS-CoV-2

Chapter 10. Psychological and social implications of COVID-19

Introduction

Impact on the society

Role of social platforms and media

Role of government and political leaders

Conclusion

Index

Copyright

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Notices

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A catalogue record for this book is available from the British Library

ISBN: 978-0-12-824409-8

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Contributors

Iqra Naveed Akhtar,     Zeenat Qureshi Stroke Institute, Columbia, MO, United States

Yasemin Akinci

Zeenat Qureshi Stroke Institute, University of Missouri, Columbia, MO, United States

Istanbul University - Cerrahpasa, Cerrahpasa School of Medicine, Department of Neurology, Istanbul, Turkey

Imaan Bashir,     Albirr Medical Research Consultants, Gainesville, FL, United States

Mohammad Rauf A. Chaudhry

Department of Neurology, Texas Tech University Health Science Center, El Paso, TX, United States

Zeenat Qureshi Stroke Institute, St. Cloud, MN, United States

Iryna Lobanova,     Zeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, MO, United States

Ahmed A. Malik

Department of Internal Medicine, UCF-COM/HCA GME Consortium, North Florida Regional Medical Center, Gainesville, FL, United States

Zeenat Qureshi Stroke Institutes, Columbia, MO, United States

Abhi Pandhi,     University of Tennessee Health Science Center, Memphis, TN, United States

Adnan I. Qureshi,     Zeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, MO, United States

Ihtesham Qureshi,     Fellowship Physician, Epilepsy, Department of Neurology, University of Texas Health Science Center at Houston, Houston, TX, United States

Usman Saeed,     Independent Advisor on Internationals Political Economy

Ishita Vasudev,     Sir Ganga Ram Hospital, New Delhi, Delhi, India

Ghaida Zaid,     Department of Neurology, University of Tennesse Health Science Center, Memphis, TN, United States

Chapter 1: Introduction

Adnan I. Qureshi     Zeenat Qureshi Stroke Institute and Department of Neurology, University of Missouri, Columbia, MO, United States

The goal of this book is to provide a detailed description with easy-to-understand accounts of one of the fastest growing infections in the world. An outbreak of respiratory disease was caused by a novel coronavirus that was first detected in China and which has now been detected in almost every location internationally. The respiratory disease caused by virus has been named coronavirus disease 2019 (COVID-19). An outbreak of COVID-19 began in Wuhan, Hubei Province, China, in December 2019. On January 30, 2020, the World Health Organization declared the Chinese outbreak of COVID-19 to be a Public Health Emergency of International Concern posing a high risk to countries with vulnerable health systems. By February 23, 2020, there were 76,936 reported cases in mainland China and 1875 cases in locations outside mainland China. By March 5th, 2020, 360 cases of COVID- 19 were reported in the United States. As of April 2021, 136 million persons had been infected by the novel coronavirus with 2.94 million persons dying from the infection worldwide. Several web-based resources have been created to provide real-time updates on the occurrence of COVID-19. One of the most widely used is developed at Johns Hopkins University available at COVID-19 Map - Johns Hopkins Coronavirus Resource Center (jhu.edu). The interface is shown in Fig. 1.1.

The progression of COVID-19 over time is shown in Fig. 1.2 adapted from Wikipedia.

The top five countries with the highest rates of COVID-19 are shown in Table 1.1 (adapted from Wikipedia):

Paradoxically, there is a disproportionately high burden faced by some of the most developed countries in terms of both health care and economic infrastructure in the COVID-19 pandemic. This is very different from previous pandemics such as those caused by Ebola virus or Dengue virus. Also, there appears to be differences in COVID-19-related mortality between countries. The differences in rates of COVID-19-related deaths between countries are a function of the total number of cases, the proportion of the population who are at high risk for severe COVID-19, the implementation of precautionary measures by respective governments and populations, and effectiveness of medical treatment. Countries can be divided based on ratio of between observed mortality and vulnerability index to quantify how effective the preventive measures and medical treatment were in reducing mortality (measure of performance) [1]. The three groups of countries are presented on the world map (see Fig. 1.3) with countries depicted in green as those with high performance in reducing mortality, in yellow as moderate performance, and red as low performance. Countries for which no statistics or data was available on COVID-19-related deaths or mortality per 1,000,000 persons have been marked in gray on the map. Countries in the high-performance group included several African and south-east Asian nations that are typically resource-deprived and are thought to face the worst brunt of any infectious disease. Another interesting finding was that Taiwan was in the high-performance group despite the island comprising 23 million inhabitants is located just 81 miles from mainland China. Frequent travel back and forth between China and Taiwan occurs on a daily basis and thousands of Taiwanese nationals live and work in China. Despite the challenges, the COVID-19-related mortality was low in Taiwan after adjusting for vulnerability to severe COVID-19 infection. Among countries in the low-performance tier were the wealthy and resourceful countries of western Europe and North America, supporting the argument that mere healthcare resources and finances are not enough when it comes to effectively dealing with the current pandemic. These countries have high proportion of persons at risk for severe COVID-19 and poor performance was still identified despite adjustment for vulnerability index.

Figure 1.1 Interface of Johns Hopkins Coronavirus Resource Center.

Figure 1.2 Global progression of COVID-19 over time.

Figure 1.3 Performance of various countries in reducing COVID-19-related mortality.

Table 1.1

Coronaviruses are a large family of viruses that are responsible for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV). The causative agent was identified from throat swab samples conducted by the Chinese Center for Disease Control and Prevention on January 7, 2020 and was subsequently named Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). The SARS-CoV-2 virus is a betacoronavirus, like MERS-CoV and SARS-CoV. All three of these viruses have their origins in bats. The SARS-CoV was transmitted from civet cats to humans and MERS-CoV from dromedary camels to humans.

Common signs of infection include respiratory symptoms, fever, cough, and shortness of breath. In more severe cases, infection can cause pneumonia, severe acute respiratory syndrome, and even respiratory failure leading to death. COVID-19 is not limited to pulmonary system but results in multiorgan dysfunction involving gastrointestinal, cardiac, hepatic, neurologic, and renal systems. Another feature that gained prominence was inflammatory thrombosis, which resulted in ischemic stroke, pulmonary embolisms, cardiac ischemia, and peripheral venous thromboembolism. There was a secondary component 2–4 weeks after primary infection attributed to excessive immunological response (cytokine storm) resulting in multisystem inflammatory syndrome consisting of shock, cardiac involvement, and gastrointestinal symptoms. Anecdotal data suggests that a proportion of persons after contact with COVID-19-infected individuals develop symptoms of COVID-19 but do not have the disease, an entity we term as COVID-19 mimic. The pooled prevalence of COVID-19 mimic was 16 per 100 persons under surveillance (95% confidence interval 11–23 per 100 persons) [2]. In the analysis of a priori subgroups, by region of the studies, prevalence of COVID-19 mimic was 16 (95% CI 11–23) in North America, 15 (95% CI 4–40) in Europe, and 15 (95% CI 7–32) per 100 persons in Asia.

The COVID-19 pandemic resulted in widespread and unprecedented institution of mandated societal lockdown. Mandated social distancing comprising a combination of travel restrictions, closure of nonessential group meeting venues (restaurants, schools, shops), and steps to avoid close contact at essential meeting venues (hospitals, food supply, pharmacies). Using publicly available data, we had examined the effect of timing of mandated social distancing on the rate of COVID-19 in 119 geographic regions derived from 41 states within the United States and 78 countries [3]. The primary outcome was the highest number of new COVID-19 cases per day recorded within each geographic unit. We found that highest number of new COVID-19 cases per day per million persons was significantly associated with total number of COVID-19 cases per million persons on the day before mandated social distancing (β   =   0.66, P   <   .0001). Our findings suggested that the initiation of mandated social distancing after doubling in number of existing COVID-19 cases would result in eventual peak with 58% higher number of COVID-19 cases per day. Initiating mandated social distancing with smaller number of COVID-19 cases within a region significantly reduces the number of daily new COVID-19 cases and perhaps also reduces the total number of cases in the region.

Wearing facemask to cover mouths and noses with filtering materials has been widely used to prevent inhalation of particulates containing SARS-CoV-2 virus. By February 2020, Centers for Disease Control and Prevention had recommended that persons with suspected SARS-CoV-2 infection should wear facemasks [4]. By July 2020, Centers for Disease Control and Prevention had recommended facemask use during all public encounters for all persons. A study from a large healthcare system in Massachusetts with more than 75,000 employees evaluated the effect of mandatory policy of universal masking for all healthcare workers and for all patients [5]. After the universal masking policy was in place, the proportion of symptomatic healthcare workers with positive test results steadily declined, from 14.7% to 11.5% (a mean decrease of 0.49% per day). Another study that looked at transmission among 139 clients exposed to two hair stylist with COVID-19 found no case of SARS-CoV-2 transmission when both hair stylists and clients were wearing facemasks [6].

One of the unique aspects of developing diagnostic tests, vaccines, and medications for prevention and treatment of SARS-CoV-2 infection was the use of Emergency Use Authorization (EUA) by Food and Drug Administration (FDA). On February 4, 2020, pursuant to section 564(b)(1)(C) of the FD&C Act (21 U.S.C. 360bbb3(b)(1)(C)), the Secretary of Health and Human Services determined that there is a public health emergency that has a significant potential to affect national security or the health and security of US citizens living abroad, and that involves the virus that causes COVID-19. On the basis of such determination, on March 27, 2020, the Secretary then declared that circumstances exist justifying the authorization of emergency use of drugs and biological products during the COVID-19 pandemic, pursuant to section 564(b)(1) of the FD&C Act (21 U.S.C. 360bbb-3(b)(1)). A copy of the notice is provided in Fig. 1.4.

Several in vitro diagnostic (IVD) devices were approved under EUA for performing tests on samples such as swabs of mucus from inside the nose or back of the throat or blood taken from a vein or fingerstick. The FDA classifies these IVDs as follows:

Diagnostic Tests: Molecular tests and antigen tests that detect components of the SARS-CoV-2 to diagnose infection with the SARS-CoV-2.

Serology/Antibody and Other Adaptive Immune Response Tests: Tests that detect IgM and IgG antibodies to the SARS-CoV-2 virus or that measure a different adaptive immune response (such as T cell immune response) to the SARS-CoV-2 virus. These types of tests are best suited for identifying previous infection.

Tests for Management of COVID-19 Patients: Tests that are authorized for use in the management of patients with COVID-19, such as to detect biomarkers related to inflammation and guide patient management decisions.

Several medications were approved for use in patients with COVID-19 under EUA. A list is provided in Table 1.2 as adapted from https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/.

Figure 1.4 Emergency use authorization declaration [7].

Table 1.2

Development of vaccine for prevention of SARS-CoV-2 infection was a healthcare priority with the first clinical trial of a vaccine candidate for SARS-CoV-2 beginning in March 2020 [8]. The FDA prespecified some of the requirements for approval under Development and Licensure of Vaccines to Prevent COVID-19 guidance, which included a point estimate for a placebo-controlled efficacy trial of at least 50%, with a lower bound of the appropriately alpha-adjusted confidence interval around the primary efficacy endpoint point estimate of >30% with additional safety and effectiveness data. Messenger ribonucleic acid (mRNA)-based vaccines assumed a major role in vaccine candidates for SARS-CoV-2. The genetic information for the antigen is delivered by mRNA (with modifications) or a self-replicating RNA. The antigen is then expressed in the cells of the vaccinated individual invoking an immune response.

Several vaccines were approved for use under EUA. A list is provided in Table 1.3 as adapted from https://www.fda.gov/medical-devices/coronavirus-disease-2019-covid-19-emergency-use-authorizations-medical-devices/.

Table 1.3

Another issue that is gaining importance is reinfection. A better understanding of reinfection became one of the priorities for Centers for Disease Control and Prevention to inform public health action

Reviews for Coronavirus Disease

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