key: cord-343001-a6xrs0jy authors: Sahu, Kamal Kant; Mishra, Ajay Kumar; Lal, Amos title: Novel coronavirus (2019-nCoV): Update on 3rd Coronavirus Outbreak of 21st Century date: 2020-03-03 journal: QJM DOI: 10.1093/qjmed/hcaa081 sha: doc_id: 343001 cord_uid: a6xrs0jy nan Dear Editor, We read with great interest the recent article by Fang et al on novel coronavirus infection (2019-nCoV) published in February issue (1) . It was in early December 2019, when the 1st case of Coronavirus disease-2019 (COVID-2019) was detected in a patient who was admitted for pneumonia of unknown etiology (Figure 1 ). We would like to mention a few additional comments about this deadly virus which has been a matter of health concern worldwide. 2019-nCoV has been found to be epidemiologically linked to the Huanan seafood wholesale market in Wuhan, China which is known for selling exotic animals (2) . While, the exact host is yet to be determined, but based on the genomic studies done till now it has been postulated that possibly bats may be one of the suspected hosts responsible for transmitting this virus to humans However, when compared to the MERS outbreak (mortality rate of 35-40%) and SARS outbreak (mortality rate of 9-10%), the mortality rate of 2019-nCoV is significantly lower (1-3%). The possible reason postulated is the excessive cytokine release with MERS and SARS as compared to 2019-nCoV infection, however, this needs to be confirmed in further studies (6) (7) . With regards to the identification, health care professionals should be aware of the diagnostic criteria laid down by WHO to evaluate any suspected case. Hence, detailed travel and sick contact history are of utmost importance to ensure that any suspect gets thoroughly evaluation to rule out 2019-nCoV infection. With regards to symptomatology, it has been reported that fever, fatigue, and dry cough are the three most common reported symptoms related to 2019-nCoV (8, 9) . Interesting to note that as compared to previous coronavirus outbreaks, diarrhea is rarely reported with 2019-nCoV infection (8-10). In conclusion, the current situation with regards to the 2019-nCoV outbreak is alarming as the number of cases is increasing day by day. At an individual level, every attempt should be made to follow all the civic responsibilities and mannerism in order to prevent the spread of this infection. Changes of CT Findings in a 2019 Novel Coronavirus (2019-nCoV) pneumonia patient Full-genome evolutionary analysis of the novel corona virus (2019-nCoV) rejects the hypothesis of emergence as a result of a recent recombination event Novel Coronavirus-Important Information for Clinicians Plasma inflammatory cytokines and chemokines in severe acute respiratory syndrome MERS-CoV infection in humans is associated with a pro-inflammatory Th1 and Th17 cytokine profile Clinical features of patients infected with 2019 novel coronavirus in Wuhan Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China Comprehensive update on current outbreak of novel coronavirus infection (2019-nCoV). Annals of Translational Medicine Disseminated herpes zoster following treatment with benralizumab A Rare Case of Hemorrhagic Cystitis in Allogeneic Hematopoietic Stem Cell Transplant Patient Herpes zoster complicating bortezomib therapy Mycobacterium Avium complex: A rare cause of pancytopenia in HIV infection Philippines 3 22 India 3 23 Russia 2 24 Spain 2 25 Lebanon 1 26 Nepal 1 27 Cambodia 1 28 Israel 1 29 Belgium 1 30 Finland 1 31 Sweden 1 32 Egypt 1 33 Sri Lanka 1