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.     

新型冠状病毒SARS-CoV-2研究进展

在武汉发生的由新型冠状病毒SARS-CoV-2引发的人类冠状病毒病COVID-19,仅仅2个多月时间在我国及国际上70多个国家出现迅速传播,致病和死亡率高,人类生命受到了极大威胁。一些科学家火速投入研究,对SARS-CoV-2的来源和进化、形态特征和基因结构、感染和致病分子机制开展深入研究,取得了重大进展,为科学防控COVID-19提供了重要依据。根据上述研究的基础,文中对COVID-19病毒疫苗、抗体和抑制剂研发提出了设想,在研究防控COVID-19核心技术上具有一定的参考价值。     

新型冠状病毒(SARS-CoV-2)概述

2019冠状病毒病(coronavirus disease 2019,COVID-19)是由严重急性呼吸综合征冠状病毒-2(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)感染引起的新型肺炎.SARS-CoV-2具有高传染性、高致病性以及高死亡率的特...     

新型冠状病毒肺炎的诊断、治疗和预防

新型冠状病毒肺炎（coronavirus disease 2019，COVID-19）是一种由严重急性呼吸系统综合征冠状病毒2（severe acute respiratory syndrome coronavirus 2，SARS-CoV-2）引发的传染病. 此种病毒传染性强，患者感染后会出现严重的急性呼吸道感染症状，部分患者感染后预后极差甚至死亡，其严重地影响到人们的正常生活. 现阶段各个国家正在积极地进行相关研究，并对疫情爆发后所要采取的应对方案进行了深入探讨. 本文围绕SARS-CoV-2的病原学特点、致病机理和检测方法以及COVID-19的治疗和预防等方面进行重点讲述.     

严重急性呼吸综合征冠状病毒2的预存免疫

新型冠状病毒肺炎(corona virus disease 2019, COVID-19)由严重急性呼吸综合征冠状病毒2 (severe acute respiratory syndrome-coronavirus 2, SARS-CoV-2)感染引起,临床表现多样。近来,在未感染SARS-CoV-2的人群检测出了SARS-CoV-2特异性记忆CD4~+、CD8~+ T细胞和能识别SARS-CoV-2的抗体,这揭示了人群中存在SARS-CoV-2的预存免疫。这种预存免疫可由4种人冠状病毒(human coronavirus, HCoVs)感染诱导。这些HCoVs是季节性感冒的致病因子,其抗原表位和SARS-CoV-2有广泛的同源性。HCoV诱导的SARS-CoV-2的预存免疫可影响SARS-CoV-2感染的发生和COVID-19症状的轻重。该发现有助于SARS-CoV-2感染的血清学检测方法的改进和SARS-CoV-2疫苗的升级换代。     

严重急性呼吸综合征冠状病毒2变异体对全球疫情防控的影响分析

由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的新型冠状病毒肺炎（COVID-19，简称新冠肺炎）的出现，对国际公众健康构成了严重威胁，伴随COVID-19大流行而来的是SARS-CoV-2基因组的不断突变，尤其是受关注的变异体（variants of concern，VOCs）给全球COVID-19疫情防控带来了挑战。本文综述了SARS-CoV-2的突变情况和现阶段主要流行的VOCs的特征，总结了现有及潜在的COVID-19预防、诊断和治疗手段，并通过分析SARS-CoV-2变异体对全球COVID-19疫情防控措施的影响，提出合理的建议，以期为今后可能爆发的大范围流行病的防控提供理论依据。     

新型冠状病毒抗体和小分子抑制剂的研究现状

世界卫生组织已宣布新型冠状病毒感染（coronavirus disease 2019,COVID-19）的爆发为全球大流行。中和抗体和小分子抑制剂在预防及治疗COVID-19中发挥重要作用。尽管已开发出了多种中和抗体以及疫苗,但是随着病原体严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)的不断变异,现有的抗体及疫苗面临巨大的挑战。小分子抑制剂主要通过干扰病毒与宿主的结合以及病毒自身的复制达到消灭病毒以及抑制病毒感染的作用,并且对SARS-CoV-2突变株具有广谱抑制作用,是当前研究的热点。近年来国内外学者对SARS-CoV-2的小分子抑制剂做了大量的研究工作,本文根据中和抗体识别的抗原表位以及小分子抑制剂的作用机制分别对用于预防及治疗COVID-19的中和抗体和小分子抑制剂进行综述,讨论其研究现状,并展望小分子抑制剂的应用前景,以期为该领域的进一步研究提供参考。     

新型冠状病毒的糖基化、糖受体识别及糖链抑制剂的发现北大核心CSCD

新型冠状病毒疫情(COVID-19)是21世纪截至目前人类面对的最为严重的公共卫生事件。疫苗、中和抗体以及小分子化合药物的出现有效预防和阻止了COVID-19的快速传播,而不断出现的病毒突变体却使这些疫苗及药物的效价降低,这对COVID-19的预防及治疗提出了新的挑战。新型冠状病毒(SARS-CoV-2)通常会先黏附于呼吸道表面的大分子糖链——硫酸乙酰肝素,进而与特异性受体人血管紧张素转化酶2(human angiotensin-converting enzyme 2,hACE2)结合,从而实现对人体的侵入。SARS-CoV-2的刺突(spike,S)蛋白是高度糖基化的,而糖基化对于hACE2与S蛋白的结合也有着重要影响,S蛋白在宿主体内还会被一系列凝集素受体所结合,这意味着糖链在SARS-CoV-2的入侵及感染过程中有着重要的作用。基于SARS-CoV-2的糖基化及糖受体识别机制开发糖链抑制剂可能是预防或治疗新型冠状病毒感染的有效手段,相关研究发现海洋来源的硫酸化多糖、肝素分子及其他的一些糖类具有抗SARS-CoV-2的活性。本文系统阐述了新型冠状病毒的糖基化及其糖链在入侵、感染中的作用,并对抗SARS-CoV-2糖链抑制剂的发现和机制研究现状进行了总结,在此基础上还对糖类抗病毒药物的机遇与挑战进行了展望。     

从多角度分析SARS-CoV-2和SARS冠状病毒(SARS-CoV)差异

新型冠状病毒肺炎(COVID-19)在全球范围内持续肆虐,感染人数与日俱增.COVID-19的病毒SARS-CoV-2与2003年发生的严重急性呼吸系统综合症冠状病毒(SARS coronavirus,SARS-CoV)同属冠状病毒.本研究就COVID-19与SARS冠状病毒的差异以及两种冠状病毒的中间宿主进行分析和探...     

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。     

Regional TMPRSS2 V197M Allele Frequencies Are Correlated with COVID-19 Case Fatality Rates

Coronavirus disease, COVID-19 (coronavirus disease 2019), caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), has a higher case fatality rate in European countries than in others, especially East Asian ones. One potential explanation for this regional difference is the diversity of the viral infection efficiency. Here, we analyzed the allele frequencies of a nonsynonymous variant rs12329760 (V197M) in the TMPRSS2 gene, a key enzyme essential for viral infection and found a significant association between the COVID-19 case fatality rate and the V197M allele frequencies, using over 200,000 present-day and ancient genomic samples. East Asian countries have higher V197M allele frequencies than other regions, including European countries which correlates to their lower case fatality rates. Structural and energy calculation analysis of the V197M amino acid change showed that it destabilizes the TMPRSS2 protein, possibly negatively affecting its ACE2 and viral spike protein processing.     

Neuroinflammation and COVID-19

Coronavirus disease 2019 (COVID-19) has caused a historic pandemic of respiratory disease. COVID-19 also causes acute and post-acute neurological symptoms, which range from mild, such as headaches, to severe, including hemorrhages. Current evidence suggests that there is no widespread infection of the central nervous system (CNS) by SARS-CoV-2, thus what is causing COVID-19 neurological disease? Here, we review potential immunological mechanisms driving neurological disease in COVID-19 patients. We begin by discussing the implications of imbalanced peripheral immunity on CNS function. Next, we examine the evidence for dysregulation of the blood-brain barrier during SARS-CoV-2 infection. Last, we discuss the role myeloid cells may play in promoting COVID-19 neurological disease. Combined, we highlight the role of innate immunity in COVID-19 neuroinflammation and suggest areas for future research.     

Risk stratification by long non-coding RNAs profiling in COVID-19 patients

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic worldwide. Long non-coding RNAs (lncRNAs) are a subclass of endogenous, non-protein-coding RNA, which lacks an open reading frame and is more than 200 nucleotides in length. However, the functions for lncRNAs in COVID-19 have not been unravelled. The present study aimed at identifying the related lncRNAs based on RNA sequencing of peripheral blood mononuclear cells from patients with SARS-CoV-2 infection as well as health individuals. Overall, 17 severe, 12 non-severe patients and 10 healthy controls were enrolled in this study. Firstly, we reported some altered lncRNAs between severe, non-severe COVID-19 patients and healthy controls. Next, we developed a 7-lncRNA panel with a good differential ability between severe and non-severe COVID-19 patients using least absolute shrinkage and selection operator regression. Finally, we observed that COVID-19 is a heterogeneous disease among which severe COVID-19 patients have two subtypes with similar risk score and immune score based on lncRNA panel using iCluster algorithm. As the roles of lncRNAs in COVID-19 have not yet been fully identified and understood, our analysis should provide valuable resource and information for the future studies.     

Repurposing FDA-approved drugs for SARS-CoV-2 through an ELISA-based screening for the inhibition of RBD/ACE2 interaction

Dear Editor, The ongoing coronavirus disease 2019(COVID-19)global pandemic is caused by a novel coronavirus,severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),which instigates severe and often fatal symptoms.As of September 4th,2020,more than 26 million cases of COVID-19 and almost 900,000 deaths have been reported to WHO.Based on Kissler and colleagues'modeled projections of future viral transmission scenarios,a resurgence in SARS-CoV-2 could occur over the next five years(Kissler et al.,2020).Research and clinical trials are underway to develop vacci-nes and treatments for COVID-19,but there are currently no specific vaccines or treatments for COVID-19(www.who.int),and therapeutic and prophylactic interventions are urgently needed to combat the outbreak of SARS-CoV-2.Of partic-ular importance is the identification of drugs which are effective,less-intrusive,most socioeconomic,and ready-to-use.     

A mini-review on the effects of COVID-19 on younger individuals

Coronavirus disease 2019 (COVID-19) pandemic has uprooted our lives like never before since its onset in the late December 2019. The world has seen mounting infections and deaths over the past few months despite the unprecedented measures countries are implementing, such as lockdowns, social distancing, mask-wearing, and banning gatherings in large groups. Interestingly, young individuals seem less likely to be impacted by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for COVID-19. While the rate of transmission, symptom presentation, and fatality is lower in children than people from other age groups, they have been disproportionately affected by strict lockdown measures needed to curb viral spread. In this review, we describe the association between patient age and COVID-19, epidemiology of SARS-CoV-2 infection in children, psychological effects associated with lockdowns and school closures, and possible mechanisms underlying lower transmission rate of COVID-19 in children.     

A Multiple-Hit Hypothesis Involving Reactive Oxygen Species and Myeloperoxidase Explains Clinical Deterioration and Fatality in COVID-19

Multi-system involvement and rapid clinical deterioration are hallmarks of coronavirus disease 2019 (COVID-19) related mortality. The unique clinical phenomena in severe COVID-19 can be perplexing, and they include disproportionately severe hypoxemia relative to lung alveolar-parenchymal pathology and rapid clinical deterioration, with poor response to O₂ supplementation, despite preserved lung mechanics. Factors such as microvascular injury, thromboembolism, pulmonary hypertension, and alteration in hemoglobin structure and function could play important roles. Overwhelming immune response associated with “cytokine storms” could activate reactive oxygen species (ROS), which may result in consumption of nitric oxide (NO), a critical vasodilation regulator. In other inflammatory infections, activated neutrophils are known to release myeloperoxidase (MPO) in a natural immune response, which contributes to production of hypochlorous acid (HOCl). However, during overwhelming inflammation, HOCl competes with O₂ at heme binding sites, decreasing O₂ saturation. Moreover, HOCl contributes to several oxidative reactions, including hemoglobin-heme iron oxidation, heme destruction, and subsequent release of free iron, which mediates toxic tissue injury through additional generation of ROS and NO consumption. Connecting these reactions in a multi-hit model can explain generalized tissue damage, vasoconstriction, severe hypoxia, and precipitous clinical deterioration in critically ill COVID-19 patients. Understanding these mechanisms is critical to develop therapeutic strategies to combat COVID-19.     

Mesenchymal stem cells and COVID-19: What they do and what they can do

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) or coronavirus disease 2019 (COVID-19) pandemic has exhausted the health systems in many countries with thousands cases diagnosed daily. The currently used treatment guideline is to manage the common symptoms like fever and cough, but doesn’t target the virus itself or halts serious complications arising from this viral infection. Currently, SARS-CoV-2 exhibits many genetic modulations which have been associated with the appearance of highly contagious strains. The number of critical cases of COVID-19 increases markedly, and many of the infected people die as a result of respiratory failure and multiple organ dysfunction. The regenerative potential of mesenchymal stem cells (MSCs) has been extensively studied and confirmed. The impressive immunomodulation and anti-inflammatory activity of MSCs have been recognized as a golden opportunity for the treatment of COVID-19 and its associated complications. Moreover, MSCs regenerative and repairing abilities have been corroborated by many studies with positive outcomes and high recovery rates. Based on that, MSCs infusion could be an effective mechanism in managing and stemming the serious complications and multiple organ failure associated with COVID-19. In the present review, we discuss the commonly reported complications of COVID-19 viral infection and the established and anticipated role of MSCs in managing these complications.     

Epidemiological,Clinical and Serological Characteristics of Children with Coronavirus Disease 2019 in Wuhan: A Single-centered,Retrospective Study

In December 2019, SARS-CoV-2 was first detected in the samples obtained from three adult patients who suffered from an unknown viral pneumonia in Wuhan (Li et al. 2020). This unknown viral pneumonia is further named as coronavirus disease 2019 (COVID-19) by the World Health Organization. To date, the number of new COVID-19 cases has continued to skyrocket and the impact of SARS-CoV-2 on humans is far greater than any pathogen of this century in both breadth and depth. Previous studies have shown that adults with COVID-19 have symptoms of fever, dry cough, dyspnea, fatigue and lymphocytopenia. Moreover, COVID-19 is more likely to cause death in the elderly, especially those with chronic comorbidities (Huang et al. 2020). In Wuhan, more than 50, 000 COVID-19 cases have been confirmed, including over 780 pediatric patients, and only one child death case (Lu et al. 2020). Although the number of children cases was far fewer than that of adults, COVID-19 might endanger children's health and the information on children remains limited, especially in serological study. In the retrospective study, the investigators analyzed the epidemiological, clinical and serological characteristics of children with COVID-19 in Wuhan in the early stages of the outbreak, which might provide theoretical and practical help in controlling COVID-19 and similar emerging infectious diseases in the future.