The French Ministry of Health, with reference to the Pasteur Institute, reported that at the moment it has been proven that the coronavirus is transmitted between people. Most direct infections are now in China, but cases have also been reported in Vietnam, Germany, Japan, the United States and France. On January 30, a Parisian doctor consulted a Chinese citizen with the virus, after which the coronavirus was detected in him.
Symptoms are similar to those of a moderate flu. "The virus can cause symptoms similar to those of mild flu," says the Ministry of Health. The 2019-nCoV coronavirus also causes fever, coughing and shortness of breath. More severe symptoms may occur in patients with pre-existing chronic medical conditions (hypertension, diabetes, or cardiovascular disease).
“This coronavirus is likely similar to other human coronaviruses, which are usually transmitted by close contact after inhalation of infectious droplets emitted when a patient sneezes or coughs, or after contact with surfaces recently contaminated with these secretions,” adds French public health.
The level of infection is comparable to ARVI. One of the important parameters for determining the severity of an epidemic is the level of transmission of the virus. To establish it, you need to count the number of people infected with a sick person. This is what scientists call the "base rate of reproduction" or R0. Several evaluations were carried out by various research groups, ranging from 1.4 to 5.5. A Chinese study published in the New England Journal of Medicine thus, each patient contracted an average of 2.2 people. This is higher than the winter flu (about 1.3), but significantly lower than measles (over 12), and comparable to the torso (3), which claimed 349 victims in 2002-2003 in China and 774 worldwide.
The exact origin of the virus. According to the Chinese authorities, most of the first patients became infected in the market in Wuhan city (closed from January 1, 2020). Despite the fact that 2019-nCoV is very close to the virus found in the bat, the exact animal that transmitted the virus to humans has not yet been accurately identified, according to the Pasteur Institute.
Exact incubation duration. Scientists have established the first estimates of the incubation period for coronavirus, that is, the delay between infection with the virus and the appearance of the first symptoms. WHO estimates it on average from two to ten days. According to a study published in the New England Journal of Medicine, it averages 5.2 days and varies greatly between patients. Previous work done in the Netherlands averaged 5.8 days. At the Pasteur Institute, they said that incubation lasts about 7 days, but can reach up to 14 days.
Mortality rate. It is currently impossible to know for sure the death rate associated with this coronavirus, as it is not known how many people are actually infected. These estimates of mortality range from 2% to 3%. “Two percent of confirmed cases have died, which remains high compared to seasonal flu,” Michael Ryan, director of emergency programs at WHO, said Wednesday. This is less than the mortality rate from ARVI, which was 9.5%, the organization recalls. But this is an indicative figure, as the number of new cases is growing faster than the number of deaths.
Infection stage. At what point does a patient become contagious? This question remains unanswered so far. The Chinese authorities argued that infection is possible even before the onset of symptoms, as in the case of influenza, but not SARS. However, this assumption was not confirmed. If the patient was indeed infectious prior to the onset of symptoms, this would complicate case detection and therefore could make it difficult for the virus to spread.
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Precise patient profile. An analysis of the first 99 cases in China, published in the medical journal The Lancet, provides an accurate clinical picture of the disease. The average age of such patients is 55 years, two thirds are men, half of them suffer from chronic diseases (cardiovascular problems, diabetes …). But many questions remain unanswered. “How to explain that children under the age of 15 were practically not affected? We do not know the answer to this question, although this news is encouraging,”emphasizes Professor Yazdan Yazdanpanah, head of the infectious diseases department of the Bichat hospital in Paris, La Crest. “Why does the condition of some patients deteriorate on the seventh day? Also not known."
How to prevent and treat disease. There is no vaccine or cure for the coronavirus yet. Medical care at this stage is to relieve symptoms, including fever. But potential treatments are being explored. Chinese researchers very quickly shared the genetic sequence of the coronavirus. This allowed several countries, including France, to develop their own diagnostic tests.
Laboratories around the world are working to develop a vaccine. In France, the Pasteur Institute began cultivation of coronavirus strains on Friday, an important step towards the development of a vaccine and treatment.
Meanwhile, Chinese researcher Tsaibin Fan from the urology department of Nanjing University Hospital, together with co-authors, published a study "Expression of angiotensin-converting enzyme (ACE2) in the kidneys and testicles can lead to kidney and testicular damage after a 2019-nCoV infection", which says that approximately 3-10 percent of patients infected with 2019 nCoV had renal abnormalities, and 7% had acute renal failure.
Another highlight in this study is the high level of expression of angiotensin-converting enzyme (ACE2) in testicular cells. It is well known that viruses such as HIV, hepatitis B and mumps can invade testicular cells and cause viral orchitis. In addition, in some cases, damage to testicular tissue caused by the virus can lead to male infertility and testicular tumor. SARS-CoV, like its "cousin" 2019-nCoV, has the same ACE2 receptor. Previous studies have also investigated possible testicular damage in SARS patients and the effect of SARS on spermatogenesis. Their results showed that orchitis is a complication after SARS and can interfere with spermatogenesis. The scientists noted that damage to the testicle caused by the virus can occur as a late complication.
“… Our results indicate that physicians need to take care of the possible occurrence of orchitis. Monitoring and assessment of reproductive function should be carried out in patients who have recovered from SARS, especially in young men,”the study says.