PMC:7253235 / 2262-4681 JSONTXT

{"target":"http://pubannotation.org/docs/sourcedb/PMC/sourceid/7253235","sourcedb":"PMC","sourceid":"7253235","source_url":"https://www.ncbi.nlm.nih.gov/pmc/7253235","text":"Introduction\nThe spread of novel Coronavirus (2019-nCoV, COVID-19) shook the world with its highly virulent transmissibility, manifesting largely as a severe acute respiratory syndrome, with more than 4.3 million people confirmed to be infected—with approximately 1.3 million cases in the USA—and over 294,000 deaths worldwide at the time of this writing [1]. Originating in China, the COVID-19 epidemic has surpassed its predecessors in the number of hospitalizations and intensive care unit admissions required to handle an infectious process within a short period of time and of such grand scale [2]. The early SARS epidemic that emerged in 2002 similarly involved human-to-human transmission, with animal vectors linked to outbreaks and confirmed in laboratory isolates [3]. Initially described as pneumonia of unknown origin, COVID-19 is believed to be linked to bats based on its genomic similarity to known bat coronavirus BatCoV RaTG13 [4]. Though most coronaviruses are mild, two beta-coronaviruses, severe acute respiratory syndrome (SARS-CoV) and Middle East Respiratory Syndrome Coronavirus (MERS-CoV), also took place within the last two decades [5]. These two unique predecessors preceded the pandemic that began in China in 2019. The virus, originating in Wuhan, Hubei province, China, in late December, resulted in nearly 96,000 cases initially and is now considered a worldwide pandemic [6].\nRoutes of transmission of the virus have been documented to include respiratory droplets, contact, fomites, and fecal-oral transmission [7, 8]. The most common symptoms at onset of illness include fever, cough, myalgia, and fatigue, with rare complaints of sputum production, headache, hemoptysis, loss of taste and/or smell, and diarrhea. In addition to clinical characteristics, patients showcased ground-glass opacities on chest computed tomography scans. However, more than half of the patients in early studies notably developed dyspnea that correlated with patchy infiltrates on chest radiographs. The mean duration of symptoms was roughly 8 days, with progression to acute respiratory distress syndrome (ARDS) occurring between days 8 and 14 [9]. Patients receiving mechanical ventilation in the Wuhan Cohort typically required ICU admission of up to 1–2 weeks following symptom development which foreshadowed the scale of the pandemic and mirrored data obtained from the MERS epidemic in 2015 [10, 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