key: cord-1055492-p8bb2tsj authors: Pérez-Campos Mayoral, Laura; Mayoral-Andrade, Gabriel; Pérez-Campos Mayoral, Eduardo; Hernández-Huerta, María Teresa; Pérez-Campos, Eduardo title: A Letter to the Editor on “World Health Organization declares global emergency: A review of the 2019 novel Coronavirus (COVID-19)” date: 2020-05-28 journal: Int J Surg DOI: 10.1016/j.ijsu.2020.05.066 sha: 4408d9e5f09df13eed00d76c94168cf1eb52267c doc_id: 1055492 cord_uid: p8bb2tsj nan Dear Editor, In reference to the comments by Sohrabi C, et al. [1] , we have reviewed the data on the Coronavirus, COVID-19 outbreak. To be more specific, we have looked at comparisons between Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) diagnostic criteria based on symptoms and history of travel, and classify clinical features and epidemiological risk. We are particularly interested in focusing this commentary on the suspected case stage, as countries with limited economic resources are not able to provide mass nucleic acid assays or identification by specific antibodies tests to their populations. Faced with a new disease, such as COVID-19, diagnostic criteria must be established and formulated temporarily and constantly updated. In this case, the Chinese Medical Association has been presenting different versions of diagnostic criteria since January 22, 2020 [2] . The identification of a clinical case must meet two conditions, the first is that the detection method has high sensitivity, and the second is that it gives rapid results to obtain a diagnosis without delay. For this reason Tan HZ comments as the best detection method is the one that classifies it in three stages: suspected case, clinical diagnosed case, and definite diagnosed case [2] . According to the WHO, patients with mild illness, to quote the WHO, 13 March 2020, are those with "uncomplicated upper respiratory tract viral infection with symptoms such as fever, fatigue, cough, anorexia, malaise, muscle pain, sore throat, dyspnea, nasal congestion or headache, in addition, but not often, with diarrhoea, nausea and vomiting''. Since 20 March, 2020 [3] , the case definition for global surveillance of monitoring trends in COVID-19 at national levels has 3 options; A, B and C. All are based on fever and acute or severe respiratory illness and history of travel and are considered suspected cases [4] . CDC indicate COVID-19 patients as those who have cough, shortness of breath or difficulty breathing, fever, chills, muscle pain, sore throat, and loss of taste or smell as symptoms [5] , and close contact with confirmed COVID-19 patients. tomography/X-ray imaging characteristic of pneumonia, normal or reduced white blood cell count, or reduced lymphocyte count, and epidemiologic risk [6] . However, based on the case definition of the WHO, other reports, such as that of Guan WJ et al [7] , focused on interim guidance, with stratification stages in disease severity, January 28, 2020 [8] found that of 1099 patients, 43.8% presented fever at admission, and 67.8% had a cough. Wang D et al. based on interim guidance, also from January 28, 2020, stratifying patients in intensive care unit (ICU) and no ICU, found fever in 98%, and a cough in 76% of 138 patients [9] . It is likely that, depending on the stage of disease, some of the subjects did not meet the diagnostic criteria of the WHO [10] . To date, most COVID-19 cases have no history of travel, indicating the infection has spread by community transmission. Apart from this, on admission, patients with COVID-19 show other symptoms. A multicentre European study of 417 mild-to-moderate COVID-19 patients found 11.8% had olfactory dysfunction before the onset of other symptoms, 79.6% were anosmic and 20.4% were hyposmic, and 78,9% had a reduced sense of taste [11] . However, initial reports from China did not include olfactory dysfunction. Could the expression of different symptoms in Europe but not found in China be related to genetic variations [12] in SARS-Cov-2? With more updating of criteria by region, clinical detection of cases will increase, and we will learn more about COVID-19 and its impact on countries that do-little testing. No ethical approval required. No funding received. EPC conceptualization; LPCM, MTHH, GMA, EPCM and ECP writing and manuscript revision. Not commissioned, internally reviewed. No conflicts of interest to declare. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19) An Epidemiologic Thinking on the Diagnosis Criteria of COVID-19 Global surveillance for COVID-19 caused by human infection with COVID-19 virus Interim guidance World Health Organization, Clinical Management of Severe Acute Respiratory Infection when Novel Coronavirus (nCoV) Infection Is Suspected: Interim Guidance A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version) Clinical Characteristics of Coronavirus Disease 2019 in China Clinical management of severe acute respiratory infection when novel coronavirus (2019-nCoV) infection is suspected: interim guidance Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Clinical Characteristics of Covid-19 in China Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study Phylogenetic network analysis of SARS-CoV-2 genomes International Journal of Surgery Author Disclosure Form The following additional information is required for submission. Please note that failure to respond to these questions/statements will mean your submission will be returned We declare no competing interests. None. Please enter the name of the registry, the hyperlink to the registration and the unique identifying number of the study. You can register your research at http://www.researchregistry.com to obtain your UIN if you have not already registered your study. This is mandatory for human studies only. Name of the registry: Unique Identifying number or registration ID: Hyperlink to your specific registration (must be publicly accessible and will be checked): Please specify the contribution of each author to the paper, e.g. study design, data collections, data analysis, writing. Others, who have contributed in other ways should be listed as contributors.EPC conceptualization; LPCM, MTHH, GMA, EPCM and ECP writing and manuscript revision. The Guarantor is the one or more people who accept full responsibility for the work and/or the conduct of the study, had access to the data, and controlled the decision to publish. Please note that providing a guarantor is compulsory.