冠状病毒是一种对人类及动物生命健康造成严重威胁的病原微生物,历史上的三次人冠状病毒感染都给社会带来了深重的灾难。我国自2019年12月底发现新型冠状病毒肺炎(Corona Virus Disease 2019,COVID-19,下称新冠肺炎)以来,迅速采取有效的强有力的防控措施,目前新冠肺炎疫情已经得到有效控制,但其中间宿主仍不是十分清楚,传播途径、疾病自然史与临床治疗方法仍在不断认识过程中。COVID-19不仅对我国公共卫生事业发展带来严重冲击,严重影响经济社会的发展,同时也对世界带来严重的威胁,引起世界各国的高度关注,日内瓦当地时间3月11日,世界卫生组织(WHO)正式宣布将COVID-19列为全球性大流行病(Pandemic)。截止到北京时间2020年3月16日全球累计确诊病例已超过160 000人,已波及151个国家及地区(数据来源:国家卫健委、世界卫生组织)。为比较全面了解新冠肺炎研究现状,本文对COVID-19的发展、生物学特点、传播、临床表现、病理诊断、治疗及挑战与展望等这几个方面进行综述。
Abstract
Coronavirus was a kind of pathogenic microorganism that poses a serious threat to the life of human and animals.Three times of human coronavirus infection in history had brought great disaster to the society.Since the discovery of Corona Virus Disease 2019 (COVID-19) at the end of December 2019 in China,effective prevention and control measures had been taken rapidly and effectively.At present,the epidemic situation of COVID-19 had been effectively controlled,but its intermediate host was still not very clear.The route of transmission,natural history of the disease and clinical treatment methods were still in the process.COVID-19 not only severely impacted the development of China's public health cause and seriously affected economic and social development,but also posed a serious threat to the world and had drawn great attention from all countries in the world.On March 11,local time in Geneva,the World Health Organization (WHO) officially declared COVID-19 as a global pandemic.As of March 16,2020,Beijing time,the total number of confirmed cases in the world has exceeded 160,000,affecting 151 countries and regions (data sources: National Health Commission of China,World Health Organization).In order to fully understand the current research situation of COVID-19,this paper reviewed the development,biological characteristics,transmission,clinical manifestations,pathological diagnosis, treatment,challenges and prospects of COVID-19.
关键词
冠状病毒 /
COVID-19 /
SARS-CoV-2 /
临床特点 /
新发传染病
Key words
Coronavirus /
COVID-19 /
SARS-CoV-2 /
Clinical characteristics /
New infectious diseases
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Weiss SR,Navas-Martin S.Coronavirus pathogenesis and the emerging pathogen severe acute respiratory syndrome coronavirus[J].Microbiol Mol Biol Rev.2005;69(4):635-664.
[2] Su S,Wong G,Shi W,et al.Epidemiology,Genetic Recombination,and Pathogenesis of Coronaviruses[J].Trends Microbiol.2016;24(6):490-502.
[3] 黄平,俞守义,人类冠状病毒与SARS-CoV[J].中国预防医学杂志,2005,6(6):552-555.
[4] Zhu N,Zhang D,Wang W,et al.A Novel Coronavirus from Patients with Pneumonia in China[J],2019.N Engl J Med.2020;382(8):727-733.
[5] Yang Y,Peng F,Wang R,et al.The deadly coronaviruses: The 2003 SARS pandemic and the 2020 novel coronavirus epidemic in China[published online ahead of print,2020 Mar 3][J].J Autoimmun.2020;102434.https://linkinghub.elsevier.com/retrieve/pii/S0896-8411(20)30047-0.
[6] 殷震,刘景华.动物病毒学[M].2版.北京:科学出版社,1997.
[7] 方飞,林乾.WHO重新评估SARS的病死率和潜伏期.国外医学情报,2003,24(8):3-4.
[8] Liu C,Yang Y,Gao YZ,et al.Viral Architecture of SARS-CoV-2 with Post-Fusion Spike Revealed by Cryo-EM[EB/OL].(2020-03-05).bioRxiv.https://www.biorxiv.org/content/10.1101/2020.03.02.972927v1.full-text.
[9] Lu R,Zhao X,Li J,et al.Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding[J].Lancet.2020;395(10224):565-574.
[10] Zhou P,Yang XL,Wang XG,et al.A pneumonia outbreak associated with a new coronavirus of probable bat origin[J].Nature.2020;579(7798):270-273.
[11] Guo Q,Li M,Wang CH,et al.Host and infectivity prediction of Wuhan 2019 novel coronavirus using deep learning algorithm[EB/OL](2020-02-02).https://www.biorxiv.org/content/10.1101/2020.01.21.914044v3.
[12] Huang C,Wang Y,Li X,et al.Clinical features of patients infected with 2019 novel coronavirus in Wuhan,China[J].Lancet.2020;395(10223):497-506.
[13] Zou L,Ruan F,Huang M,et al.SARS-CoV-2 Viral Load in Upper Respiratory Specimens of Infected Patients[J].N Engl J Med.2020;10.1056/NEJMc2001737.
[14] Holshue ML,DeBolt C,Lindquist S,et al.First Case of 2019 Novel Coronavirus in the United States[J].N Engl J Med.2020;382(10):929-936.
[15] Xu Y,Li X,Zhu B.et al.Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding[J].Nat Med (2020).https://www.nature.com/articles/s41591-020-0817-4#citeas.
[16] Wang W,Xu Y,Gao R,et al.Detection of SARS-CoV-2 in Different Types of Clinical Specimens[J].JAMA.2020;10.1001/jama.2020.3786.
[17] Deng W,Bao L,Gao H,et al.Rhesus macaques can be effectively infected with SARS-CoV-2 via ocular conjunctival route[EB/OL].(2020-03-14).bioRxiv.https://www.biorxiv.org/content/10.1101/2020.03.13.990036v1.full.pdf+html.
[18] Lu CW,Liu XF,Jia ZF.2019-nCoV transmission through the ocular surface must not be ignored[J].Lancet.2020;395(10224):e39.
[19] Daniel W,Nianshuang W,Kizzmekia S.C,et al.Cryo-EM Structure of the 2019-nCoV Spike in the Prefusion Conformation[EB/0L].bioRxiv (2020-02-11).https://www.biorxiv.org/content/10.1101/2020.02.11.944462v1.
[20] Porcheddu R,Serra C,Kelvin D,et al.Similarity in Case Fatality Rates (CFR) of COVID-19/SARS-COV-2 in Italy and China[J].J Infect Dev Ctries.2020;14(2):125-128.
[21] Chen N,Zhou M,Dong X,et al.Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan,China: a descriptive study[J].Lancet.2020;395(10223):507-513.
[22] Liu Y,Chen H,Tang K,et al.Clinical manifestations and outcome of SARS-CoV-2 infection during pregnancy[J].J Infect.2020;S0163-4453(20)30109-2.https://www.journalofinfection.com/article/S0163-4453(20)30109-2/fulltext.
[23] Hui DS,I Azhar E,Madani TA,et al,The continuing SARS-CoV-2 epidemic threat of novel coronaviruses to global health - The latest 2019 novel coronavirus outbreak in Wuhan,China.[J]Int J Infect Dis.2020;91:264-266.
[24] Mao L,Wang MD,Chen SH,et al.Neurological Manifestations of Hospitalized Patients with COVID-19 in Wuhan,China: a retrospective case series study[EB/OL].(2020-02.25).medRxic.https://www.medrxiv.org/content/10.1101/2020.02.22.20026500v1.
[25] Wang D,Hu B,Hu C,et al.Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan,China[J].JAMA.2020;e201585.https://jamanetwork.com/journals/jama/fullarticle/2761044.
[26] Zhou F,Yu T,Du Rh,et al.Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan,China: a retrospective cohort study[J].The Lancet,March 11,2020.https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30566-3/fulltext.
[27] Xu Z,Shi L,Wang Y,et al.Pathological findings of COVID-19 associated with acute respiratory distress syndrome[published online ahead of print,2020 Feb 18][published correction appears in Lancet Respir Med.2020 Feb 25;:].Lancet Respir Med.2020;S2213-2600(20)30076-X.https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30076-X/fulltext.
[28] Liu T,Zhang JY,Yang YH,et al.The potential role of IL-6 in monitoring severe case of coronavirus disease 2019[EO/OL].(2020-03-10).medRxiv.https://www.medrxiv.org/content/10.1101/2020.03.01.20029769v2.full.pdf+html.
[29] Hoffmann M,Kleine-Weber H,Schroeder S,et al.SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor[published online ahead of print,2020 Mar 4].Cell.2020;S0092-8674(20)30229-4.
[30] Fan CB,Li K,Ding YH,et al.ACE2 Expression in Kidney and Testis May Cause Kidney and Testis Damage After 2019-nCoV Infection[EB/OL].medRxiv (2020.02.12).https://www.medrxiv.org/content/10.1101/2020.02.12.20022418v1.
[31] Wang K,Chen W,Zhou Y,et al.SARS-CoV-2 invades host cells via a novel route:CD147-spike protein[EB/OL].(2020-03-14).bioRxiv.https://www.biorxiv.org/content/10.1101/2020.03.14.988345v1.
[32] 匡慧慧,于梅,于帅,等.新型冠状病毒实验室核酸检测方法及实践[J].中华医院感染学杂志,2020,30(6):806-809.
[33] 陈炜,张春阳,朱颖,等.4例新型冠状病毒感染病例咽拭子与痰标本病毒核酸检测的比较[J/OL].[2020-02-12].中国人兽共患病学报:1-7.https://kns-cnki-net.webvpn.bjmu.edu.cn/KXReader/Detail?TIMESTAMP=637198641966278750&DBCODE=CAPJ&TABLEName=CAPJLAST&FileName=ZRSZ20200211000&RESULT=1&SIGN=ucoNTD%2B%2Fs2uGMu0hjxIgCYaS2CU%3D.
[34] 国家卫生健康委员会.新型冠状病毒感染的肺炎诊疗方案(试行第五版 修正版)[J].中国中西医结合杂志,2020,40(2):136-138.DOI:10.7661/j.cjim.2020,40(2):136-138.
[35] Deng Ls,Li Cn,Zeng Q,et al.Arbidol combined with LPV/r versus LPV/r alone against Corona Virus Disease 2019:a retrospective cohort study[J].Journal of Infection.(2020-03-11).https://www.journalofinfection.com/article/S0163-4453(20)30113-4/fulltext.
[36] 李春波,苏韫,刘永琦等.清肺排毒汤治疗新型冠状病毒肺炎的中医理论及现代药理学机制探讨[J/OL].(2020-02-02)[2020-03-11].中医杂志:1-4.https://kns-cnki-net.webvpn.bjmu.edu.cn/KXReader/Detail?TIMESTAMP=637198640822372500&DBCODE=CAPJ&TABLEName=CAPJLAST&FileName=ZZYZ20200309000&RESULT=1&SIGN=jhkRUh%2BtrAZ%2FlKMu8saqy6MEGFg%3D.
[37] Pappalardo F,Pieri M,Greco T,et al.Predicting mortality risk in patients undergoing venovenous ECMO for ARDS due to influenza A (H1N1) pneumonia: the ECMOnet score[J].Intensive Care Med.2013;39(2):275-281.
[38] 陈倩,裴茂华,王瑶等.糖皮质激素在新型冠状病毒肺炎中应用的利与弊[J].[2020-03-09].武汉大学学报医学版.https://kns-cnki-net.webvpn.bjmu.edu.cn/KXReader/Detail?TIMESTAMP=637198646271747500&DBCODE=CAPJ&TABLEName=CAPJLAST&FileName=HBYK20200308000&RESULT=1&SIGN=PxciDIjpmoCnRgIhpaZae0KAu8w%3D.
[39] 冯缤、陈正贤、金龙伟,CoVID-19的临床特征及药物治疗思考[J/OL].[2020-03-11].今日药学.https://kns-cnki-net.webvpn.bjmu.edu.cn/KXReader/Detail?TIMESTAMP=637198649490341250&DBCODE=CAPJ&TABLEName=CAPJLAST&FileName=YAXU20200223000&RESULT=1&SIGN=RVIsppsesxjDFjr9HAdex0snFzc%3D.
[40] Yang Y,Peng F,Wang R,et al.The deadly coronaviruses: The 2003 SARS pandemic and the 2020 novel coronavirus epidemic in China[J].J Autoimmun.2020;102434.
[41] Wang FS,Zhang C.What to do next to control the 2019-nCoV epidemic?[J].Lancet.2020;395(10222):391-393.
[42] 里进,叶光明,陈良君等,新型冠状病毒(2019-nCoV)核酸检测假阴性结果原因分析及对策[J].中华检验医学杂志,2020,43(00): E006-E006.
[43] Ge YY,Tian TZ,Huang Sl,et al.A data-driven drug repositioning framework discovered a potential therapeutic agent targeting COVID-19[J].(2020-03-11).bioRxiv.https://www.biorxiv.org/content/10.1101/2020.03.11.986836v1.
[44] Li J,Li JJ,Xie X,et al.Game consumption and the 2019 novel coronavirus[J].Lancet Infect Dis.2020;20(3):275-276.
[45] Shi Z,Hu Z.A review of studies on animal reservoirs of the SARS coronavirus.Virus Res.2008;133(1):74-87.
基金
国家十三五传染病重大科技专项(2018ZX10711001-005-002),安徽省科技厅新型冠状病毒应急攻关项目(202004a07020010)
PDF(4781 KB)
