A pneumonia outbreak associated with a new coronavirus of probable bat origin.
Level 4 - case-series / case-control
Case series with laboratory viral isolation, genomic sequencing, and in vitro characterization
PubMed 32015507 · doi:10.1038/s41586-020-2012-7
What was done
Full-length genome sequencing was performed on viral isolates from five early-stage pneumonia patients during the outbreak in Wuhan, China. Researchers analyzed pairwise protein sequence identity across seven conserved non-structural domains, compared whole-genome sequences against known coronaviruses, tested neutralization of bronchoalveolar lavage fluid viral isolates with patient sera, and evaluated cellular entry receptor usage.
What was found
The outbreak caused 2,794 laboratory-confirmed infections and 80 deaths between 12 December 2019 and 26 January 2020. Viral genome sequences from the five patients were almost identical, sharing 79.6% sequence identity with SARS-CoV and 96% identity at the whole-genome level with a bat coronavirus. The virus was confirmed to belong to the species SARS-related coronavirus (SARSr-CoV), was neutralized by sera from multiple patients, and was confirmed to use angiotensin-converting enzyme II (ACE2) as its entry receptor.
Why it matters
This study provided foundational identification of the causative agent of COVID-19 (2019-nCoV/SARS-CoV-2), demonstrating its probable bat reservoir origin and confirming ACE2 as the functional receptor for human cell entry.
Limits
Detailed viral sequencing was limited to five patients at an early stage of the outbreak. The abstract provides no data on transmission dynamics, intermediate animal hosts, or the broad clinical spectrum across the larger infected population.
Cited by
- supports SARS-CoV-2 uses ACE2 as its entry point to infect cells.