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A novel coronavirus from patients with pneumonia in China, 2019

Our take —

This study reports sequencing results from patients with acute respiratory illness in Wuhan, establishing a SARS-related coronavirus as the likely etiological agent. The similarity between the novel coronavirus and other viruses from bats suggest that bats are likely hosts of the novel coronavirus, but it remains unclear if humans were first infected by bats or another animal that served as an intermediate host.

Study design

Ecological

Study population and setting

A selection of three patients admitted to hospitals with severe pneumonia in Wuhan, Hubei province, China identified on December 21, 2019. Seven patients with pneumonia from Beijing served as controls. Wuhan patients were present at the Huanan Seafood Market close to the time of their clinical presentation.

Summary of Main Findings

Genetic code from viruses sequenced from three pneumonia patients from Wuhan match with 86.9% sequence identity with SARS-related betacoronaviruses previously detected in bats: bat-SL-CoVZXC21 and bat-SL-CoVZC45 (GenBank isolate names), identified in 2015 and 2017 from the insectivorous bat species Rhinolophus sinicus in Zhejiang province. Investigators also infected human cells from the upper respiratory tract with the SARS-CoV-2 virus and showed that the virus was able to infect and kill cells.

Study Strengths

Rapid detection and identification of the infectious agent through sequencing technology. Successful culture of the virus in human cells from the upper respiratory tract agrees with observed respiratory symptoms in infected patients.

Limitations

Evidence from sequencing alone is not sufficient to conclude that the detected virus caused the symptoms and mortality in humans. The similarity of genomes and the number of animal hosts sampled is insufficient to establish whether humans were infected directly from bats or through another intermediate animal host.

Value added

This is one of the earliest reports establishing a coronavirus as the probable etiological agent of the acute respiratory disease, including genetic information about the novel coronavirus and a potential zoonotic link with bats.