Sars-CoV-2 (synonyms: novel coronavirus (2019-nCoV); 2019-nCoV (2019-novel coronavirus; coronavirus 2019-nCoV); Wuhan coronavirus; ICD-10 B34. 2: Infection by coronavirus, unspecified location) can lead to a lung disease that has been given the name Covid-19 (Corona virus disease 2019; synonym: Novel coronavirus-infected pneumonia (NCIP)). It is an atypical pneumonia (lung infection). The Coronavirus Study Group of the International Committee on Taxonomy of Viruses, which named the new coronavirus disease, refers to the name Sars-CoV-2 as a very close relationship to the Sars virus (Sars-CoV-1). Sars-CoV-2 belongs to lineage B of the beta-coronaviruses; it is an enveloped (+)ssRNA virus. In December 2019, the first infections occurred in central China in the metropolis of Wuhan (population 11 million) and Hubei province, which includes Wuhan. In 2020, the disease spread, infecting more than 80,200 people in China so far, and approximately 2.3% died from Covid-19. During the course, approximately 2,500 Sars-CoV2 infections also occurred in other countries ((Australia, Canada, France, Germany, Italy, Japan, Cambodia, Malaysia, Singapore, Sri Lanka, South Korea, Thailand, and other Asian countries). [As of 02/25/2020.]
A “public health emergency of international concern” was declared by WHO on Jan. 30, 2020. Online listing of global distribution of confirmed Sars-CoV-2 infections (Johns Hopkins CSSE).
The disease is one of the viral zoonoses (animal diseases). The natural reservoir of the pathogen is bats/horseshoe-nosed bats. The intermediate host is not yet known. The baseline reproduction number R0 (basic reproduction rate; number of people an infected person infects on average) for Sars-CoV-2 is estimated to be 2.2, with an uncertainty range of 1.4 to 3.8. (Measles: 15-18; smallpox: 5-7; polio: 5-7; mumps: 4-7; HIV/AIDS: 2-5; SARS-CoV (Sars-CoV-1): 2-5; influenza: 2-3; Ebola: 1.5-2.5).Pathogen transmission (route of infection):
- By droplet infection, i.e., primarily via secretions from the respiratory tract (respiratory system).
- Possibly also fecal-oral/smear infection is conceivable – the Sars-CoV-2 was also found in stool samples of some affected persons.
- In liquid or dried material, the coronavirus Sars-CoV-2 remains infectious for 9 days, e.g., on door handles, doorbells, etc.
- Vertical infection, i.e., through infected mothers:
- 30 hours postpartum (after birth).
In a small observational study (9 women), no vertical transmission (transmission) of the pathogen was detected in women who became ill in the 3rd trimester (third trimester of pregnancy).
Transmission in the incubation period is now proven. It is certain that patients with only very mild symptoms of the disease will transmit the virus.Most experts assume that asymptomatic transmission, ie without the presence of symptoms, is possible. The pathogen enters the body parenterally (the pathogen does not enter through the intestine, but through the respiratory tract (inhalation infection)). Human-to-human transmission: Yes
Incubation period (time from infection to onset of disease) is usually 1-3-6-14 days.Duration of illness is approximately two weeks. Sex ratio: Men more often than women
Peak incidence: The maximum incidence of the infection is in adulthood. The median age is 50-55 years. Children and adolescents have rarely been affected. The duration of infectiousness (contagiousness) is not yet known; likewise, the period of highest infectiousness is not known. It is certain that infected persons can spread the virus after the disease has spread. Course and prognosis: The infection is asymptomatic in most cases or with mild symptoms in 80.9% of cases. The China CDC published data from 72,314 patient records: the disease was mild in 80.9%, severe in 13.8, and critical in 4.7%. 1,023 patients died, which would correspond to a mortality rate (death rate) of 2.3%.26% of patients who were hospitalized required intensive care.In severe cases, acute respiratory distress syndrome (ARDS) can occur within 2 days.Deaths occurred mainly in patients who already suffered from severe underlying diseases (diabetes mellitus, hypertension (high blood pressure), cardiovascular diseases, or cerebrovascular diseases/diseases affecting the blood vessels of the brain, i.e., the cerebral arteries or cerebral veins). The lethality (mortality related to the total number of people suffering from the disease; case-fatality rate; CFR) is currently 2.3%. Taking into account that most infections are likely to be asymptomatic, the lethality rate is probably considerably lower. For MERS-CoV (37%) and for SARS (Sars-CoV-1) (10%), the lethality rates were much higher.According to the report of the Chinese disease control agency, most deaths occurred in the age group of 70 to 79 years, 30.5%. Men have a significantly higher risk of death, at 2.8%, than women, at 1.7%.There was only one death in the 10 to 19 age group through Feb. 11, according to the China Disease Control Agency report. Note: “Superspreading” events (“superspreaders”) can occur: in one child, milk glass infiltrates were detected on computed tomography despite the absence of symptoms.A series of patients from Wuhan documented a “superspreading” event (138 infected persons): the proportion of nosocomial infections was 41%. According to the Robert Koch Institute (RKI), the situation is developing very dynamically and must be taken seriously. The extent to which the disease leads to immunity is not yet known. Vaccination: A vaccine does not yet exist. Suspicion of illness with Sars-CoV-2 must be reported to the public health department in accordance with the Infection Protection Act.
