Identification of a novel coronavirus causing severe pneumonia in human: a descriptive study

• Main Authors: Li-Li Ren, Ye-Ming Wang, Zhi-Qiang Wu, Zi-Chun Xiang, Li Guo, Teng Xu, Yong-Zhong Jiang, Yan Xiong, Yong-Jun Li, Xing-Wang Li, Hui Li, Guo-Hui Fan, Xiao-Ying Gu, Yan Xiao, Hong Gao, Jiu-Yang Xu, Fan Yang, Xin-Ming Wang, Chao Wu, Lan Chen, Yi-Wei Liu, Bo Liu, Jian Yang, Xiao-Rui Wang, Jie Dong, Li Li, Chao-Lin Huang, Jian-Ping Zhao, Yi Hu, Zhen-Shun Cheng, Lin-Lin Liu, Zhao-Hui Qian, Chuan Qin, Qi Jin, Bin Cao, Jian-Wei Wang, Xiu-Yuan Hao, Pei-Fang Wei
• Format: Article
• Language: English
• Published: Wolters Kluwer 2020-05-01
• Series: Chinese Medical Journal
• Online Access: http://journals.lww.com/10.1097/CM9.0000000000000722
• ISSN: 0366-6999; 2542-5641

Abstract. Background. Human infections with zoonotic coronaviruses (CoVs), including severe acute respiratory syndrome (SARS)-CoV and Middle East respiratory syndrome (MERS)-CoV, have raised great public health concern globally. Here, we report a novel bat-origin CoV causing severe and fatal pneumonia in humans. Methods. We collected clinical data and bronchoalveolar lavage (BAL) specimens from five patients with severe pneumonia from Wuhan Jinyintan Hospital, Hubei province, China. Nucleic acids of the BAL were extracted and subjected to next-generation sequencing. Virus isolation was carried out, and maximum-likelihood phylogenetic trees were constructed. Results. Five patients hospitalized from December 18 to December 29, 2019 presented with fever, cough, and dyspnea accompanied by complications of acute respiratory distress syndrome. Chest radiography revealed diffuse opacities and consolidation. One of these patients died. Sequence results revealed the presence of a previously unknown β-CoV strain in all five patients, with 99.8% to 99.9% nucleotide identities among the isolates. These isolates showed 79.0% nucleotide identity with the sequence of SARS-CoV (GenBank NC_004718) and 51.8% identity with the sequence of MERS-CoV (GenBank NC_019843). The virus is phylogenetically closest to a bat SARS-like CoV (SL-ZC45, GenBank MG772933) with 87.6% to 87.7% nucleotide identity, but is in a separate clade. Moreover, these viruses have a single intact open reading frame gene 8, as a further indicator of bat-origin CoVs. However, the amino acid sequence of the tentative receptor-binding domain resembles that of SARS-CoV, indicating that these viruses might use the same receptor. Conclusion. A novel bat-borne CoV was identified that is associated with severe and fatal respiratory disease in humans.