THE LANCET’s recent publication entitled “Clinical features of patients infected with the 2019 novel coronavirus in Wuhan, China”, described the correlation of cytokine storm (high levels of circulating inflammatory cytokines) and the severity of illness in patients infected with the 2019-nCoV (2019 Novel Coronavirus).
Huang, et al. noted the clinical course of the 41 hospitalised patients infected with the 2019-nCoV and categorised them who did, or did not, required treatment in the intensive care unit (ICU). Those that were admitted to the ICU, particularly those with severe disease, exhibited significantly higher levels of inflammatory cytokines compared to those that did not. This “cytokine storm” can trigger a viral sepsis in coronavirus infection, where viral replication and excessive, uncontrolled systemic inflammation can lead to pneumonitis, acute respiratory distress syndrome, respiratory failure, shock, organ failure, secondary bacterial pneumonia, and potentially death. This same correlation between cytokine storm and severity of illness was observed previously in both SARS (Severe Acute Respiratory Syndrome) and MERS (Middle East Respiratory Syndrome) patients.
The 2019-nCoV has a possible asymptomatic incubation period for up to 2 weeks, though who were infected often experience dry cough and fatigue. While the carrier can transmit the virus to others during this incubation, fever and the development of viral pneumonia follows.
Hong Kong researchers have warned that the number of people infected by the 2019-nCoV could be multi-fold of the already reported cases. The contagiousness, lack of specific treatments or vaccines, and feared mortality has created a health scare in China and in many countries around the world similar to the 2002-2003 SARS coronavirus outbreak in China that infected 8,098 people and killed 774 (or 1 in 10 died), and the 2012 MERS coronavirus contagion with 2,494 confirmed cases and 858 deaths to date (approximately 1 in 3 died).
UPDATES on FEB 19 2020:
TheWorld Health Organization (WHO) announced the official new name of the disease caused by nCoV2019 as COVID-19.