SARS-CoV-2与SARS-CoV:病原学、流行病学、临床与病理

2019年12月在武汉暴发了由SARS-CoV-2感染引起的新型冠状病毒肺炎(Coronavirus disease 2019,COVID-19),并迅速扩散至全国.SARS-CoV-2和SARS冠状病毒(SARS-CoV)都属于套式病毒目、冠状病毒科、冠状病毒属中的SARS相关冠状病毒种,本文总结了两者在来源、病毒结构、流行病学、临床表现和病理学特征等方面的差异,以期更全面认识SARS-CoV和SARS-CoV-2,为COVID-19的防治研究提供帮助.     

COVID-19确诊病例居住环境病毒检测结果分析及防控探讨

新型冠状病毒肺炎(COVID-19)传播速度快、感染范围广,其感染方式主要是聚集性感染,感染途径主要是呼吸道飞沫和接触传播。了解环境中,特别是COVID-19确诊病人生活环境中的病毒存在情况,是做好环境消毒,阻断新型冠状病毒(SARS-CoV-2)传播的重要步骤,对COVID-19防控具有重要意义。本研究旨在探讨COVID-19患者生活环境中SARS-CoV-2的存在情况,从SARS-CoV-2存在的空间部位、病毒核酸含量、消毒效果等方面对SARS-CoV-2的相关特点做出初步研究,为制定有效的SARS-CoV-2防控措施提供科学依据。本研究以COVID-19病例治疗前的3个家庭居住环境和治疗出院后隔离期间的2个宾馆居住环境中采集的样本为研究材料,采用RT-PCR方法检测样本中的SARS-CoV-2核酸并进行比较分析。结果显示,首次从3个家庭环境中采样48份,RTPCR检测SARS-CoV-2核酸阳性5份(10.42%),3个家庭的环境样本中均有阳性样本检出。首次采样48h后在家庭3进行第二次采样16份,SARS-CoV-2核酸检测阳性2份(12.5%),检测Ct值比首次升高。家庭3消毒后24h采集的16份样本SARS-CoV-2核酸检测均为阴性,并且两处宾馆环境采集的24份样本SARS-CoV-2核酸检测也均为阴性。本研究提示,COVID-19病例的生活环境中可以检出SARS-CoV-2,病毒存在区域、存在物品、病毒核酸含量均有差异;对外环境进行消毒可以达到消毒目的,能够起到阻断SARS-CoV-2传播的防控效果。     

新型冠状病毒PLpro蛋白酶结构与功能的生物信息学分析

2019年12月,由新型冠状病毒(SARS-CoV-2)引起的新型冠状病毒肺炎(COVID-19)在中国武汉暴发。SARS-CoV-2的基因组编码2种病毒蛋白酶,即木瓜样蛋白酶(Papain-like protease,PLpro)和3C样蛋白酶(3C-like protease)。其中PLpro是SARS-CoV-2复制酶复合体(RC)形成的重要调节蛋白分子,对于病毒基因组转录和复制至关重要。因此,将SARS-CoV-2 PLpro作为药物的靶点对COVID-19的治疗具有积极意义。本研究应用生物信息学工具分析新型冠状病毒的木瓜样蛋白酶的结构和功能,首先利用BLAST和BioEdit获取SARS-CoV-2 PLpro蛋白酶(SC2-PLpro)及其同源蛋白的氨基酸序列,并利用BLAST和MEGA 6.0进行同源性分析。之后,利用ProParam和Proscale分别对SC2-PLpro蛋白酶的理化性质、亲水性和疏水性进行分析。然后,通过SOMPA、ScanProsite和InterPro分别预测SC2-PLpro蛋白酶的二级结构和功能区域,进一步利用SignalP 4.0和TMHMM对SC2-PLpro蛋白酶的信号肽和跨膜区进行分析。最后,通过SWISS-MODEL对SARS-CoV-2 PLpro蛋白酶进行三级结构同源建模。结果显示,对SARS-CoV-2 PLpro蛋白酶与已报道的PLpro蛋白酶进行多序列比对后,发现SARS-CoV-2 nsp3的746~1063段氨基酸与多种冠状病毒PLpro蛋白酶氨基酸序列高度相似。同时,同源性分析发现SARS-CoV-2与蝙蝠冠状病毒的PLpro蛋白酶具有同源性,其中与QHR63299、AVP78030相似性最高。对SC2-PLpro进行理化性质预测结果显示,其由318个氨基酸所组成,为稳定亲水性蛋白。二级结构预测结果显示SC2-PLpro主要含有α-螺旋、延伸链、β-转角、无规卷曲,四种结构贯穿整条氨基酸链。进一步进行功能分析,发现其具有完整的催化三联体、锌结合域、泛素样N末端结构域,故推测该蛋白具有去泛素化的功能。然后,信号肽假说和跨膜结构域分析结果表明,SC2-PLpro既不是分泌蛋白,也不属于跨膜蛋白。本研究提示,生物信息学分析SC2-PLpro为稳定性亲水蛋白,属于非跨膜蛋白,比较保守,具有去泛素化的功能,利用此功能可以进一步规避宿主的固有免疫反应。通过制备PLpro蛋白酶小分子抑制剂,可能有助于治疗新型冠状病毒肺炎。     

新型冠状病毒基因组序列的网络平台与基因分型

新型冠状病毒(SARS-CoV-2)是引起2019新型冠状病毒肺炎(COVID-19)的病原体,目前COVID-19仍在世界范围内大规模流行。随着学者对SARS-CoV-2研究的不断深入,以及各大数据库的序列资源共享,一些学者开发了SARS-CoV-2相关序列分析网络在线平台,并发表了对SARS-CoV-2基因分型、命名的规则。"GISAID"是目前SARS-CoV-2基因组序列共享和储存最大的数据库,"Nextstrain"和"CoV-GLUE"是国际最常用的SARS-CoV-2序列分析平台。目前有四种比较通用的SARS-CoV-2的基因分型方法,在本文中分别简称为:"中国分型法"、"Pangolin分型法"、"GISAID分型法"和"Nextstrain分型法"。这四种分型方法的定义不尽相同,但又有相似之处。本综述对目前SARS-CoV-2在线分析网络平台和不同的基因分型方法进行了较为系统的介绍、对比和总结。     

新型冠状病毒的结构基础与新型冠状病毒肺炎的临床药物治疗

新型冠状病毒肺炎(corona virus disease 2019, COVID-19)是指由新型冠状病毒(severe acute respiratory syndrome coronavirus2, SARS-CoV-2)感染导致的肺炎。SARS-CoV-2结合细胞表面受体——血管紧张素转化酶2 (angiotensin-converting enzyme 2,ACE2)感染肺部细胞,导致白细胞浸润,血管和肺泡壁通透性增加,肺表面活性物质减少,引起呼吸系统症状。局部的炎症加重引起细胞因子风暴,造成全身性炎症反应综合征。2019年12月,武汉市卫生健康委员会报告了多例新型肺炎,分离并确定了病原体SARS-CoV-2。截至2020年9月13日,全世界216个国家或地区受累,2 860余万人确诊COVID-19,90余万人死于该疾病,病死率高达3.20%。到目前为止,尚无特效药物可治疗COVID-19,因此解析病毒结构,探索治疗药物显得尤其重要。本文总结了SARS-CoV-2的病毒结构和COVID-19的临床药物治疗,并分析了他们之间可能的相关性。     

用于新型冠状病毒检测的核酸等温扩增技术研究进展

核酸检测作为新型冠状病毒肺炎(COVID-19)筛查诊断和病情监测的主要手段,在疫情防控中发挥了重要作用。虽然实时荧光定量PCR被认为是新型冠状病毒(SARS-CoV-2)核酸检测的金标准,但其依赖荧光定量PCR仪且扩增检测时间较长,难以实现现场快速检测。因此许多基于核酸等温扩增的SARS-CoV-2检测方法相继诞生。等温扩增对仪器温控要求不高,通过与微流控芯片和可视化检测技术结合,可进一步简化操作、降低成本,为SARS-CoV-2现场快速筛查提供有力的技术支撑。本文围绕已报道的SARS-CoV-2等温扩增检测方法原理、检测性能及优缺点进行探讨,为进一步发展SARS-CoV-2现场快速检测平台提供参考。     

新型冠状病毒Wuhan-Hu-1株Np空间结构及其B细胞抗原表位的预测

新型冠状病毒(Severe Acute Respiratory Syndrome Coronavirus 2,SARS-CoV-2)是最新发现的一种可侵染人体的β属冠状病毒,该病毒入侵机体可引发新型冠状病毒肺炎(Coronavirus Disease 2019,COVID-19),该疫情的暴发在国内甚至国际上造成了严重...     

基于Web of Science对COVID-19的研究现状分析

在新型冠状病毒肺炎(COVID-19)疫情暴发的大背景之下,为进一步了解和明确COVID-19当前研究的全球现状和热点,本研究基于Web of Science数据库对该主题进行检索,对自疫情暴发到2020年4月30日新型冠状病毒(SARS-CoV-2)领域的SCI文献进行计量学分析,探讨SARS-CoV-2的研究重点以及研究现状.本研究通过对SARS-CoV-2相关文献的信息获取、处理、分析,应用文献计量学方法对该研究领域进行研究态势分析.统计分析数据及可视化数据分析结果表明,以"COVID-19 or Novel coronavirus pneumonia"为主题词,搜索到文献共计1 523篇;在现阶段处于研究的初期,在该领域中国发文量排名第一位;伦敦大学、哈佛大学和华中科技大学是世界范围内发文量前三名的机构;并对高频关键词进行类群整理明确研究热点为COVID-19、SARS以及public health(公共卫生).研究发现,中国学者在"COVID-19"领域的研究取得了快速发展,在文章的影响力、发文量上都属于世界前沿水平.     

新型冠状病毒纳米PCR快速检测方法的建立

新型冠状病毒(SARS-CoV-2)感染可导致致命性肺炎,且极具传染性。自2019年年末在我国出现以来,已在全球蔓延。为了建立一种灵敏、快速检测SARS-CoV-2的分子检测方法,本研究使用金纳米颗粒配合普通PCR检测方法,针对SARS-CoV-2核衣壳蛋白建立了SARS-CoV-2 NanoPCR新型分子检测方法。特异性结果显示,该方法对猪流行性腹泻病毒、牛冠状病毒、犬冠状病毒、水貂冠状病毒、猫传染性腹膜炎病毒均无交叉反应,表明该方法的特异性良好。敏感性结果显示,该方法的最低检测量为3.69×10⁴拷贝/μL,高于普通PCR最低检测量10倍,表明该方法的敏感性良好。使用建立的方法对3份临床样品进行检测,该方法与普通PCR方法结果一致,10倍稀释样品后,NanoPCR相比较普通PCR条带仍然具有较高辨识度。综上,本研究建立的灵敏、特异的NanoPCR方法可以对临床样品进行快速诊断和鉴定。     

新型冠状病毒肺炎与mNGS技术

新型冠状病毒肺炎(Coronavirus Disease 2019,COVID-19)是指2019新型冠状病毒(Severe Acute Respiratory Syndrome Coronavirus 2,SARS-CoV-2)感染导致的肺炎。截至2020年5月21日已造成全球超过496万人感染、30万人以上死亡。宏基因组下一代测序(metagenomic next-generation sequencing,mNGS)技术是在发现和检测新冠肺炎中发挥重要作用的技术。本文介绍了mNGS在新冠肺炎疫情中的作用及核心技术特点,并为mNGS在抗击全球疫情中的应用做出技术性归纳总结。     

An Impaired Inflammatory and Innate Immune Response in COVID-19

The recent appearance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected millions of people around the world and caused a global pandemic of coronavirus disease 2019 (COVID-19). It has been suggested that uncontrolled, exaggerated inflammation contributes to the adverse outcomes of COVID-19. In this review, we summarize our current understanding of the innate immune response elicited by SARS-CoV-2 infection and the hyperinflammation that contributes to disease severity and death. We also discuss the immunological determinants behind COVID-19 severity and propose a rationale for the underlying mechanisms.     

Assessment of global asymptomatic SARS-CoV-2 infection and management practices from China

With ongoing research, it was found that asymptomatic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection was widespread in coronavirus disease 2019 (COVID-19) populations. Studies have confirmed asymptomatic patients with COVID-19 have potential infectivity, and most of the transmission occurred before symptoms appear. Asymptomatic infection rates varied widely in different countries and regions. Identifying the asymptomatic infected persons and cutting off the infection source is an effective way to prevent the spread of this disease. However, asymptomatic patients have hidden clinical symptoms, and screening based only on the clinical symptoms of COVID-19 can easily lead to a missed diagnosis. Therefore, determining asymptomatic infection patients by SARS-CoV-2 nucleic acid testing is the gold standard. A series of prevention and control measures adopted by the Chinese government, especially the “Four Early” policy, have achieved outstanding achievements, which are worth learning from by other countries.     

Severe Acute Respiratory Syndrome Coronavirus 2: Manifestations of Disease and Approaches to Treatment and Prevention in Humans

The coronavirus disease 2019 (COVID-19) pandemic was caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This virus has challenged civilization and modern science in ways that few infectious diseases and natural disasters have previously, causing globally significant human morbidity and mortality and triggering economic downturns across financial markets that will be dealt with for generations. Despite this, the pandemic has also brought an opportunity for humanity to come together and participate in a shared scientific investigation. Clinically, SARS-CoV-2 is associated with lower mortality rates than other recently emerged coronaviruses, such as SARS-CoV and the Middle East respiratory syndrome coronavirus (MERS-CoV). However, SARS-CoV-2 exhibits efficient human-to-human spread, with transmission often occurring before symptom recognition; this feature averts containment strategies that had worked previously for SARS-CoV and MERS-CoV. Severe COVID-19 disease is characterized by dysregulated inflammatory responses associated with pulmonary congestion and intravascular coagulopathy leading to pneumonia, vascular insults, and multiorgan disease. Approaches to treatment have combined supportive care with antivirals, such as remdesivir, with immunomodulatory medications, including corticosteroids and cytokine-blocking antibody therapies; these treatments have advanced rapidly through clinical trials. Innovative approaches to vaccine development have facilitated rapid advances in design, testing, and distribution. Much remains to be learned about SARS-CoV-2 and COVID-19, and further biomedical research is necessary, including comparative medicine studies in animal models. This overview of COVID-19 in humans will highlight important aspects of disease, relevant pathophysiology, underlying immunology, and therapeutics that have been developed to date.

In December 2019, a cluster of cases of pneumonia without a clear etiology occurred in Wuhan, China. With remarkable speed and efficiency, the etiology of this illness was soon identified as a novel coronavirus; the complete viral genome was sequenced and published on January 10, 2020.¹⁸² These events introduced the world to coronavirus disease 2019 (COVID-19). The disease, now known to be caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has developed into the most significant pandemic of recent times. In less than a year since the virus was first recognized, multiple candidate vaccines were developed worldwide, and some of them rapidly progressed to clinical trials and widespread administration. As the pandemic continues, a number of sequence variants of the virus have emerged around the world. This continued viral evolution highlights the need for continued biomedical research to facilitate understanding of the pathogenesis of COVID-19, seeking innovative therapeutic and preventative strategies for the current and possibly future pandemics. This article will review aspects of SARS-CoV-2 infection of humans and COVID-19, focusing on important aspects of clinical disease, pathophysiology, immunology, and the development of therapeutic and preventative measures to provide context for discussion of the animal models used to study SARS-CoV-2 and COVID-19.     

SARS-CoV-2 infection in the Syrian hamster model causes inflammation as well as type I interferon dysregulation in both respiratory and non-respiratory tissues including the heart and kidney

COVID-19 (coronavirus disease 2019) caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection is a disease affecting several organ systems. A model that captures all clinical symptoms of COVID-19 as well as long-haulers disease is needed. We investigated the host responses associated with infection in several major organ systems including the respiratory tract, the heart, and the kidneys after SARS-CoV-2 infection in Syrian hamsters. We found significant increases in inflammatory cytokines (IL-6, IL-1beta, and TNF) and type II interferons whereas type I interferons were inhibited. Examination of extrapulmonary tissue indicated inflammation in the kidney, liver, and heart which also lacked type I interferon upregulation. Histologically, the heart had evidence of myocarditis and microthrombi while the kidney had tubular inflammation. These results give insight into the multiorgan disease experienced by people with COVID-19 and possibly the prolonged disease in people with post-acute sequelae of SARS-CoV-2 (PASC).     

Immunological aspects of COVID-19: What do we know?

The newly emerged coronavirus (severe acute respiratory syndrome coronavirus 2 SARS-CoV-2) and the disease that it causes coronavirus disease 2019 (COVID-19) have changed the world we know. Yet, the origin and evolution of SARS-CoV-2 remain mostly vague. Many virulence factors and immune mechanisms contribute to the deteriorating effects on the organism during SARS-CoV-2 infection. Both humoral and cellular immune responses are involved in the pathophysiology of the disease, where the principal and effective immune response towards viral infection is the cell-mediated immunity. The clinical picture of COVID-19, which includes immune memory and reinfection, remains unclear and unpredictable. However, many hopes are put in developing an effective vaccine against the virus, and different therapeutic options have been implemented to find effective, even though not specific, treatment to the disease. We can assume that the interaction between the SARS-CoV-2 virus and the individual's immune system determines the onset and development of the disease significantly.     

COVID-19疫苗研究现状*

2019年底于中国武汉暴发的新型冠状病毒肺炎疫情来势凶猛,迅速蔓延全球,并被世界卫生组织列为“国际关注的突发公共卫生事件”,给全人类的健康及经济发展造成难以估量的损害。新型冠状病毒对人群普遍易感且传染性强,在无特效药物及治疗手段的情况下,疫苗接种是防控COVID-19疫情最有效且最经济的途径。目前全球疫苗研发正在加速进行,各国之间通力合作,共同应对此次疫情。主要对目前正在研发的针对SARS-CoV-2的灭活疫苗、病毒载体疫苗、基因工程重组亚单位疫苗、核酸疫苗的研究进展进行综述。     

SARS-CoV-2 cell receptor gene ACE2 -mediated immunomodulation in breast cancer subtypes

The recent outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has impacted the world severely. The binding of the SARS-CoV-2 virus to the angiotensin-converting enzyme 2 (ACE2) and its intake by the host cell is a necessary step for infection. ACE2 has garnered widespread therapeutic possibility as it is entry/interactive point for SARS-CoV-2, responsible for coronavirus disease 2019 (COVID-19) pandemic and providing a critical regulator for immune modulation in various disease. Patients with suffering from cancer always being on the verge of being immune compromised therefore gaining knowledge about how SARS-CoV-2 viruses affecting immune cells in human cancers will provides us new opportunities for preventing or treating virus-associated cancers. Despite COVID-19 pandemic got center stage at present time, however very little research being explores, which increase our knowledge in context with how SARS-CoV-2 infection affect cancer a cellular level. Therefore, in light of the ACE-2 as an important contributor of COVID-19 global, we analyzed correlation between ACE2 and tumor immune infiltration (TIL) level and the type markers of immune cells were investigated in breast cancer subtypes by using TIMER database. Our findings shed light on the immunomodulatory role of ACE2 in the luminal A subtype which may play crucial role in imparting therapeutic resistance in this cancer subtype.     

Antibodies at work in the time of severe acute respiratory syndrome coronavirus 2

In view of devastating effects of COVID-19 on human life, there is an urgent need for the licened vaccines or therapeutics for the SARS-CoV-2 infection. Age-old passive immunization with protective antibodies to neutralize the virus is one of the strategies for emergency prophylaxis and therapy for coronavirus disease 2019 (COVID-19). In this review, the authors discuss up-to-date advances in immune-based therapy for COVID-19. The use of convalescent plasma therapy as the first line of defense to treat severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been established, with encouraging results. Monoclonal antibodies (mAbs) that bind to the receptor-binding domain (RBD) of the SARS-CoV-2 spike protein or block the interaction between SARS-CoV-2 RBD and the human angiotensin-converting enzyme 2 receptor have been found to be very promising as a countermeasure for tackling the SARS-CoV-2 infection, and clinical trials are underway. Considering the counterproductive antibody-dependent enhancement of the virus, mAbs therapy that is safe and efficacious, even in people with underlying conditions, will be a significant breakthrough. In addition, emerging immunotherapeutic interventions using nanobodies and cellular immunotherapy are promising avenues for tackling the COVID-19 pandemic. The authors also discuss the implication of mAbs as mediators of cytokine storm syndrome to modify the immune response of COVID-19 patients, thus reducing the fatality rate of COVID-19 infection.     

Phenotypes and Functions of SARS-CoV-2-Reactive T Cells

Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), which is an ongoing pandemic disease. SARS-CoV-2-specific CD4⁺ and CD8⁺ T-cell responses have been detected and characterized not only in COVID-19 patients and convalescents, but also unexposed individuals. Here, we review the phenotypes and functions of SARS-CoV-2-specific T cells in COVID-19 patients and the relationships between SARS-CoV-2-specific T-cell responses and COVID-19 severity. In addition, we describe the phenotypes and functions of SARS-CoV-2-specific memory T cells after recovery from COVID-19 and discuss the presence of SARS-CoV-2-reactive T cells in unexposed individuals and SARS-CoV-2-specific T-cell responses elicited by COVID-19 vaccines. A better understanding of T-cell responses is important for effective control of the current COVID-19 pandemic.     

MUC1-C influences cell survival in lung adenocarcinoma Calu-3 cells after SARS-CoV-2 infection

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induces coronavirus disease 2019 (COVID-19) and may increase the risk of adverse outcomes in lung cancer patients. In this study, we investigated the expression and function of mucin 1 (MUC1) after SARS-CoV-2 infection in the lung epithelial cancer cell line Calu-3. MUC1 is a major constituent of the mucus layer in the respiratory tract and contributes to pathogen defense. SARS-CoV-2 infection induced MUC1 C-terminal subunit (MUC1-C) expression in a STAT3 activation-dependent manner. Inhibition of MUC1-C signaling increased apoptosis-related protein levels and reduced proliferation-related protein levels; however, SARS-CoV-2 replication was not affected. Together, these results suggest that increased MUC1-C expression in response to SARS-CoV-2 infection may trigger the growth of lung cancer cells, and COVID-19 may be a risk factor for lung cancer patients.