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无症状携带者状态、急性呼吸道疾病和严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)引起的肺炎:事实与误区。

Asymptomatic carrier state, acute respiratory disease, and pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): Facts and myths.

机构信息

Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan, Taiwan.

Department of Internal Medicine, Cardinal Tien Hospital and School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.

出版信息

J Microbiol Immunol Infect. 2020 Jun;53(3):404-412. doi: 10.1016/j.jmii.2020.02.012. Epub 2020 Mar 4.

Abstract

Since the emergence of coronavirus disease 2019 (COVID-19) (formerly known as the 2019 novel coronavirus [2019-nCoV]) in Wuhan, China in December 2019, which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), more than 75,000 cases have been reported in 32 countries/regions, resulting in more than 2000 deaths worldwide. Despite the fact that most COVID-19 cases and mortalities were reported in China, the WHO has declared this outbreak as the sixth public health emergency of international concern. The COVID-19 can present as an asymptomatic carrier state, acute respiratory disease, and pneumonia. Adults represent the population with the highest infection rate; however, neonates, children, and elderly patients can also be infected by SARS-CoV-2. In addition, nosocomial infection of hospitalized patients and healthcare workers, and viral transmission from asymptomatic carriers are possible. The most common finding on chest imaging among patients with pneumonia was ground-glass opacity with bilateral involvement. Severe cases are more likely to be older patients with underlying comorbidities compared to mild cases. Indeed, age and disease severity may be correlated with the outcomes of COVID-19. To date, effective treatment is lacking; however, clinical trials investigating the efficacy of several agents, including remdesivir and chloroquine, are underway in China. Currently, effective infection control intervention is the only way to prevent the spread of SARS-CoV-2.

摘要

自 2019 年 12 月中国武汉暴发由严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)引起的 2019 年新型冠状病毒(2019-nCoV)疾病(以前称为冠状病毒病 2019,COVID-19)以来,全球 32 个国家/地区已报告超过 75000 例病例,导致全球 2000 多人死亡。尽管大多数 COVID-19 病例和死亡发生在中国,但世界卫生组织(WHO)已宣布此次疫情为第六次国际关注的突发公共卫生事件。COVID-19 可表现为无症状携带者状态、急性呼吸道疾病和肺炎。成年人是感染率最高的人群;然而,新生儿、儿童和老年患者也可能被 SARS-CoV-2 感染。此外,住院患者和医务人员的医院感染以及无症状携带者的病毒传播是可能的。肺炎患者胸部影像学最常见的表现是双侧磨玻璃影。与轻症病例相比,重症病例更可能是有基础合并症的老年患者。事实上,年龄和疾病严重程度可能与 COVID-19 的结局相关。迄今为止,尚无有效的治疗方法;然而,在中国正在进行几项药物(包括瑞德西韦和氯喹)疗效的临床试验。目前,有效的感染控制干预是预防 SARS-CoV-2 传播的唯一方法。

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