A precision medicine approach to managing 2019 novel coronavirus pneumonia

Wang, Minjin; Zhou, Yanbing; Zong, Zhiyong; Liang, Zongan; Cao, Yu; Tang, Hong; Song, Bin; Huang, Zixing; Kang, Yan; Feng, Ping; Ying, Binwu; Li, Weimin

By 29 January 2020, the virus had infected more than 7000 people in China and had caused 170 deaths. 6 At the same time, the disease is gradually being spread to several other countries as the virus can be transmitted through air and contact. 4 Fortunately, at least 124 patients have been cured, according to a recent report of the National Health Commission of the People's Republic of China. 6 According to the research that examined the infectious patients in Wuhan Jinyintan Hospital, 7 typical clinical features included fever (98%, 40 of 41), cough (76%, 31 of 41), malaise (44%, 18 of 41), sputum production (28%, 11 of 39), and other less-common symptoms (headache, haemoptysis, diarrhoea, etc.). The median age of the infected patients was 47 years (interquartile range [IQR], 41.0-58.0), and the median time from onset to admission was 7 days (IQR, 4.0-8.0). Severely ill patients may have acute respiratory distress syndrome (ARDS), acute cardiac injury, secondary infection, septic shock, and acute kidney injury. Laboratory findings include lymphopenia, leucopenia, elevated concentrations of procalcitonin, serum amyloid A, D-dimer, and hypersensitive troponin and longer prothrombin times. 7 The 2019-nCoV epidemic is suspected to be highly similar to other highly threatening coronavirus diseases such as SARS and Middle Eastern respiratory syndrome (MERS), both intensely infectious diseases related to animals. 2, 3 Like with other epidemics, health systems need to respond quickly and accurately to control the spread of the virus. Here, we describe our understanding of the 2019-nCoV epidemic and our experience with other coronavirus-related diseases in West China Hospital. Based on this, we aim to establish a precision medicine approach to managing Wuhan coronavirus pneumonia, starting from accurate and rapid recognition of individuals infected by 2019-nCoV. It will facilitate decision-making by health care workers with necessary clinical information, laboratory detection, and imaging findings. The approach consists of the following four parts: screening, diagnosis, preventive control, and treatment of 2019-CoV pneumonia (Fig. 1) . Given our clinical experience in preventing and treating various viral pneumonia, including those caused by coronaviruses, we believe that such an approach would help in preventing further the spreading of 2019-nCoV.