Abstract
The ongoing pandemic of 2019 novel coronavirus (2019-nCoV), which originated from Wuhan, China, has led to 68,279 deaths due to 2019-nCoV pneumonia as of May 5, 2020. We conducted a systematic review and included 16 case reports to summarize the transmission and pathology of 2019-nCoV, and clinical presentation, laboratory and imaging findings, and treatment in 2019-nCoV pneumonia. The disease is mild in most people; in some, it may progress to severe pneumonia with acute respiratory distress syndrome (ARDS). Patients with mild illness usually recover at home, with supportive care and isolation in accordance with guidelines. Patients who have moderate to severe pneumonia are usually monitored in the hospital. Although there is no definitive treatment for 2019-nCoV pneumonia so far, some antiviral drugs have shown promising results. The use of lopinavir/ritonavir and remdesivir was associated with significant clinical improvement in severe pneumonia. Nonetheless, we need more randomized clinical trials (RCTs) and treatment guidelines for developing effective management of the 2019-nCoV and improve patient outcomes by reducing mortality in high-risk patients. We also need more clinical trials and management guidelines for the effective management of 2019-nCoV pneumonia.
Highlights
BackgroundThe ongoing outbreak of the 2019 novel coronavirus (2019-nCoV) has posed significant threats to international health and the economy [1]
The disease is mild in most people; in some, it may progress to severe pneumonia with acute respiratory distress syndrome (ARDS)
On February 11, 2020, the World Health Organization (WHO) DirectorGeneral announced that the disease caused by this new CoV was called as coronavirus disease 2019 (COVID19)
Summary
The ongoing outbreak of the 2019 novel coronavirus (2019-nCoV) has posed significant threats to international health and the economy [1]. One of the cases received supportive treatment initially and later on received vancomycin and cefepime This patient developed severe pneumonia with high 2019-nCoV viral load, and so received antiviral therapy with intravenous remdesivir (a novel nucleotide analog prodrug in development) on day 7, and the day, patient’s clinical condition significantly improved [14]. COVID-19: coronavirus disease 2019; b/l: bilateral; CXR: chest x-ray; WBC: white blood cell; BID: twice daily; IV: intravenous; CRP: C-reactive protein; RT-PCR: real-time reverse transcription-polymerase chain reaction; SARS-CoV-2: severe acute respiratory syndrome coronavirus 2; AST: aspartate aminotransferase; ALT: alanine aminotransferase; LDH: lactate dehydrogenase; VDRL: venereal disease research laboratory; ESR: erythrocyte sedimentation rate; ARDS: acute respiratory distress syndrome; SFJDC: Shufeng Jiedu Capsule; IV IG: intravenous immunoglobulin; HIV: human immunodeficiency virus; IU/L: international units per liter; pg/mL: picogram per milliliter; mmol/L: millimoles per liter
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