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

In December 2019, several patients with pneumonia of unknown cause were identified in Wuhan, China. 1 The results of genome sequencing, released on 10 January 2020, showed that the pneumonia outbreak was related to a new coronavirus, named 2019 novel coronavirus (2019-nCoV), whose genetic sequence is homologous to that of the coronavirus causing severe acute respiratory syndrome (SARS). 2 Coronaviruses are enveloped with a positive-sense, single-stranded RNA genome and with a nucleocapsid. 3 Although the 2019-nCoV is a new coronavirus, it has characteristics common to other coronaviruses, such as sensitivity to heat (it can be inactivated after 30 minutes at 56 • C), diethyl ether, 75% ethanol, chlorine-containing disinfectants, peracetic acid, and chloroform. 4 Further genetic and amino acid sequencing of the S-protein of 2019-nCoV established that the receptorbinding domain of the S-protein binds to recipient cells and interacts strongly with human angiotensinconverting enzyme 2 (ACE2) receptor molecules. 2 This finding shows that the underlying pathogenesis of the virus is to infect the human respiratory epithelium through the S-protein-ACE2 binding pathway. The sequencing from isolated 2019-nCoV became available to the World Health Organization (WHO) on 12 January 2020, 5 and the genomic sequence substantially facilitated the development of real-time reverse transcription-PCR (RT-PCR) assays to detect the virus.