Another Decade, Another Coronavirus (2020/01/24)

For the third time in as many decades, a zoonotic coronavirus has crossed species to infect human populations. This virus, provisionally called 2019-nCoV, was first identified in Wuhan, China, in persons exposed to a seafood or wet market. The rapid response of the Chinese public health, clinical, and scientific communities facilitated recognition of the clinical disease and initial understanding of the epidemiology of the infection. First reports indicated that human-to-human transmission was limited or nonexistent, but we now know that such transmission occurs, although to what extent remains unknown. Like outbreaks caused by two other pathogenic human respiratory coronaviruses (severe acute respiratory syndrome coronavirus [SARS-CoV] and Middle East respiratory syndrome coronavirus [MERS-CoV]), 2019-nCoV causes respiratory disease that is often severe.1 As of January 24, 2020, there were more than 800 reported cases, with a mortality rate of 3% (https://promedmail.org/. opens in new tab).

As now reported in the Journal, Zhu et al.2 have identified and characterized 2019-nCoV. The viral genome has been sequenced, and these results in conjunction with other reports show that it is 75 to 80% identical to the SARS-CoV and even more closely related to several bat coronaviruses.3 It can be propagated in the same cells that are useful for growing SARS-CoV and MERS-CoV, but notably, 2019-nCoV grows better in primary human airway epithelial cells than in standard tissue-culture cells, unlike SARS-CoV or MERS-CoV. Identification of the virus will allow the development of reagents to address key unknowns about this new coronavirus infection and guide the development of antiviral therapies. First, knowing the sequence of the genome facilitates the development of sensitive quantitative reverse-transcriptase–polymerase-chain-reaction assays to rapidly detect the virus. Second, the development of serologic assays will allow assessment of the prevalence of the infection in humans and in potential zoonotic sources of the virus in wet markets and other settings. These reagents will also be useful for assessing whether the human infection is more widespread than originally thought, since wet markets are present throughout China. Third, having the virus in hand will spur efforts to develop antiviral therapies and vaccines, as well as experimental animal models.

Author: Stanley Perlman

Link: https://www.nejm.org/doi/full/10.1056/NEJMe2001126?query=RP