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对 2019 年新型冠状病毒的洞察——来自 SARS-CoV 和 MERS-CoV 的更新中期综述和经验教训。

Insight into 2019 novel coronavirus - An updated interim review and lessons from SARS-CoV and MERS-CoV.

机构信息

Department of Geriatrics / Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China.

Department of Geriatrics / Department of Respiratory Medicine, Xiangya Hospital, Central South University, Changsha 410008, China; National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China.

出版信息

Int J Infect Dis. 2020 May;94:119-124. doi: 10.1016/j.ijid.2020.03.071. Epub 2020 Apr 1.

Abstract

BACKGROUND

The rapid spread of the coronavirus disease 2019 (COVID-19), caused by a zoonotic beta-coronavirus entitled 2019 novel coronavirus (2019-nCoV), has become a global threat. Awareness of the biological features of 2019-nCoV should be updated in time and needs to be comprehensively summarized to help optimize control measures and make therapeutic decisions.

METHODS

Based on recently published literature, official documents and selected up-to-date preprint studies, we reviewed the virology and origin, epidemiology, clinical manifestations, pathology and treatment of 2019-nCoV infection, in comparison with severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV) infection.

RESULTS

The genome of 2019-nCoV partially resembled SARS-CoV and MERS-CoV, and indicated a bat origin. The COVID-19 generally had a high reproductive number, a long incubation period, a short serial interval and a low case fatality rate (much higher in patients with comorbidities) than SARS and MERS. Clinical presentation and pathology of COVID-19 greatly resembled SARS and MERS, with less upper respiratory and gastrointestinal symptoms, and more exudative lesions in post-mortems. Potential treatments included remdesivir, chloroquine, tocilizumab, convalescent plasma and vaccine immunization (when possible).

CONCLUSION

The initial experience from the current pandemic and lessons from the previous two pandemics can help improve future preparedness plans and combat disease progression.

摘要

背景

由一种名为 2019 年新型冠状病毒(2019-nCoV)的人畜共患β冠状病毒引起的 2019 年冠状病毒病(COVID-19)迅速传播,已成为全球性威胁。应及时了解 2019-nCoV 的生物学特征,并进行全面总结,以帮助优化控制措施并做出治疗决策。

方法

基于最近发表的文献、官方文件和选定的最新预印本研究,我们回顾了 2019-nCoV 感染的病毒学和起源、流行病学、临床表现、病理学和治疗,与严重急性呼吸综合征冠状病毒(SARS-CoV)和中东呼吸综合征冠状病毒(MERS-CoV)感染进行了比较。

结果

2019-nCoV 的基因组部分类似于 SARS-CoV 和 MERS-CoV,提示蝙蝠起源。COVID-19 的繁殖数一般较高,潜伏期较长,序列间隔较短,病死率(合并症患者更高)较低。COVID-19 的临床和病理学表现与 SARS 和 MERS 非常相似,上呼吸道和胃肠道症状较少,尸检时渗出性病变较多。潜在的治疗方法包括瑞德西韦、氯喹、托珠单抗、恢复期血浆和疫苗接种(如有可能)。

结论

从当前大流行中获得的初步经验和前两次大流行中的教训,可以帮助改进未来的防范计划并控制疾病的进展。

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