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It has infected more than 14 million individuals and resulted in more than 500,000 deaths as of 20 July 2020. The SARS-CoV-2 outbreak rapidly spread worldwide. These cases were characterized by acute pneumonia-associated symptoms, such as fever, dry cough, chills, shortness of breath, and muscle pain ( 9). In December 2019, cases of the new coronavirus disease 2019 (COVID-19), caused by a new betacoronavirus (SARS-CoV-2), were first reported in Wuhan, China ( 8). MERS-CoV spread to 27 countries and caused 2,519 infections and 866 deaths by January 2020, with a CFR of 34.4% ( 7). In September 2012, Saudi Arabia reported the first case of Middle East respiratory syndrome (MERS), which was caused by another type of betacoronavirus (MERS-CoV). However, since 2004, there have not been any SARS cases reported anywhere in the world. The SARS outbreak caused ~8,000 infections and 774 deaths before it was contained in July 2003, with a case fatality rate (CFR) of 9.6% (the CFR was ~50% among patients 65 or older) ( 6). In November 2002, before the fourth influenza A pandemic, an epidemic caused by a betacoronavirus (SARS-CoV) and known as severe acute respiratory syndrome (SARS) began in South China and spread to 29 countries. From September 2019 to February 2020, this virus caused at least 34 million flu illnesses and 20,000 deaths. Since that time, the novel influenza A virus has continued to spread as a seasonal flu virus. The fourth pandemic was caused by the influenza A (H1N1) pdm09 virus, also known as the “novel influenza A virus,” and resulted in 151,700–575,400 deaths worldwide from 2009 to 2010 ( 4, 5). The third pandemic, known as “Hong Kong flu,” occurred in 1968 and was caused by an H3N2 IAV strain, resulting in ~1 million deaths worldwide ( 3). The second pandemic, known as “Asian influenza,” occurred in 1957, was caused by an H2N2 IAV strain, and resulted in ~1.1 million deaths worldwide ( 2). Approximately 500 million people were infected, and 50 million people died during this pandemic. The first and most severe pandemic in recent history, known as “Spanish influenza,” occurred in 1918 and was caused by an H1N1 influenza A virus (IAV) strain ( 1). Since 1918, the influenza A viruses have caused four pandemics. Diseases associated with their infections vary from mild respiratory illness to acute pneumonia and even respiratory failure. The 2019 novel coronavirus (SARS-CoV-2), severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV), and influenza A viruses are major pathogens that primarily target the human respiratory system. Because the coronavirus disease 2019 (COVID-19) pandemic caused by SARS-CoV-2 is ongoing, this evaluation may inform public health administrators and medical experts to aid in curbing the pandemic's progression. ![]() ![]() This comparative study provides a critical evaluation of the origin, genomic features, transmission, and pathogenicity of these viruses. The outbreak of this virus has raised a number of questions: What is SARS-CoV-2? How transmissible is SARS-CoV-2? How severely affected are patients infected with SARS-CoV-2? What are the risk factors for viral infection? What are the differences between this novel coronavirus and other coronaviruses? To answer these questions, we performed a comparative study of four pathogenic viruses that primarily attack the respiratory system and may cause death, namely, SARS-CoV-2, severe acute respiratory syndrome (SARS-CoV), Middle East respiratory syndrome (MERS-CoV), and influenza A viruses (H1N1 and H3N2 strains). The 2019 novel coronavirus (SARS-CoV-2) pandemic has caused a global health emergency.
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