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讨,并对SARS冠状病毒中间宿主果子狸的关系进行分析,以期为从野生动物角度防控病毒疾病提供参考,也为了解冠状病毒的的传播途径提供借鉴.     

群体免疫理论与COVID-19的管控

2019年12月底,不明原因的肺炎病例在全球爆发,经检测是新型冠状病毒感染所致.感染该病毒引起的肺炎被命名为"COVID-19".从早期的"不明肺炎",到如今疫情在全球持续传播,急剧增长的肺炎病例确诊数字背后,各个国家(如中国,英国)对于新型冠状病毒的认知和防范都有着哪些不同的应对策略?热搜中的英国的"群体免疫"策略是否可行?为重点解决第二个问题,本研究试图通过介绍群体免疫的原理、获得方式以及以往的案例,结合应用于COVID-19的理论模型,讨论并阐述"群体免疫"策略在COVID-19管控中的成效及可行性.结果表明,在遏制COVID-19传播过程中,"群体免疫"策略实施较困难.本研究可为其他传染病的预防研究提供参考.     

广谱抗冠状病毒疫苗及抗冠状病毒多肽的研究进展

由严重急性呼吸综合征冠状病毒2型(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)感染引起的2019冠状病毒病(coronavirus disease 2019,COVID-19)暴发,给人类公共卫生安全和全球经济发展造成了严重威胁。疫苗和药物是防治疫情的重要手段,但目前研发的针对冠状病毒的疫苗和药物大多以SARS-CoV-2为靶点,该病毒若发生重大突变或出现新的高致病性冠状病毒,目前研发的有效疫苗或药物可能会无效,而且疫苗和新药的研发往往比较滞后,难以在疫情发生早期投入使用。因此,亟须研发高效、安全、广谱的冠状病毒疫苗和药物,以应对未来可能出现的冠状病毒疫情。本文对广谱冠状病毒疫苗和抗冠状病毒多肽的研究进展进行综述,期望为研发此类疫苗和药物提供参考。     

本期导读

自2019年12月以来,新型冠状病毒肺炎在全球蔓延,2020年1月30日,世界卫生组织(World Health Organization,WHO)将新型冠状病毒肺炎疫情列为"国际关注的突发公共卫生事件",我国也将该病作为急性呼吸道传染病纳入《中华人民共和国传染病防治法》规定的乙类传染病,并按照甲类传染病管理。2020年2月11日,WHO正式将新型冠状病毒肺炎命名为COVID-19(Corona Virus Disease 2019)。国际病毒分类委员会将该病毒命名为严重急性呼吸系统综合征冠状病毒(severe acute respiratory syndrome coromavirus 2,SARS-CoV-2)。截止2020年8月28日全球已累计确诊24356983人,累计死亡826791人。严重危害着人类的健康和生命安全。虽然中国政府采取了最强有力的措施,社会各界一起抗击疫情,取得了显著成效。但是由于目前COVID-19疫苗尚未上市,也无特效药物,COVID-19的全球快速蔓延势头仍没有得到有效遏制。世界各国的科学家、医学家们正在努力开发针对SARS-CoV-2和COVID-19的安全有效的预防疫苗和治疗方法。     

核酸检测技术进展及其在SARS-CoV-2核酸检测中的应用

2020年初至今，新型冠状病毒肺炎（COVID-19）疫情仍在全球多个国家流行，给全球公共卫生安全造成了严重威胁.中国在应对COVID-19的实践中，最先完成病毒核酸测序并共享序列信息，最早有效控制疫情蔓延、恢复生产，并在病毒作用人体机制研究、疫苗研发、中和性抗体发现等环节均处于世界前沿. 其中，针对病毒核酸的检测工作——试剂盒研发、检测配套设备研制、10合1混检策略及相关政策制订，有效提高了疫情防控效率、保障了百姓健康. 本文就严重急性呼吸系统综合症冠状病毒2（SARS-CoV-2）核酸检测多种方法的原理、优劣势及其配套设备等进行综述.     

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。     

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。     

冠状病毒对天然免疫的抑制作用

由严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2, SARS-CoV-2)引起的新型冠状病毒肺炎(corona virus disease 2019, COVID-19),至今仍在全球范围内流行。21世纪以来,数次冠状病毒感染疫情促使人类更加重视冠状病毒,尤其是COVID-19疫情的暴发与大流行,更将新冠病毒提升为全球的研究重点。免疫反应与病毒的感染、清除以及病理损伤等密切相关。天然免疫是机体防御体系的重要组成部分和首道防线,在病毒感染早期对于抑制病毒的复制和扩散具有至关重要的作用,并且在获得性免疫的启动及后续的发展中也发挥着关键的调控功能。研究表明,免疫逃逸是冠状病毒的重要致病机制,冠状病毒能够通过多种方式抑制宿主的天然免疫应答。现对SARS-CoV-2等主要的冠状病毒抑制天然免疫的分子机制作一概述,以期为抗冠状病毒感染的疫苗及治疗性药物的研发提供帮助。     

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...     

COVID-19的流行及研究现状

2019年12月,武汉市发现多例不明原因肺炎病例,随后被证实由一种新型冠状病毒引起。2020年2月11日WHO将该疾病命名为COVID-19(Coronavirus disease 2019)。此后,疫情蔓延至全国。全球多个国家和地区也出现了COVID-19。COVID-19主要经呼吸道飞沫和密切接触传播,潜伏期1～14d,多为3～7d,大部分患者症状较轻,少数患者出现呼吸困难和/或低氧血症,甚至进展为急性呼吸窘迫综合征、多器官功能衰竭等。目前尚无针对该疾病的疫苗和特异性治疗药物。本文将从病原学、流行病学、致病机制、预防与治疗等方面对COVID-19进行综述,希望对疫情防控、药物和疫苗研究提供参考。     

The outlook for diagnostic purposes of the 2019-novel coronavirus disease

At the end of December 2019, a novel acute respiratory syndrome coronavirus 2 (SARS-CoV2) appeared as the third unheard of outbreak of human coronavirus infection in the 21st century. First, in Wuhan, China, the novel SARS-CoV2 was named by the World Health Organization (WHO), as 2019-nCOV (COVID-19), and spread extremely all over the world. SARS-CoV2 is transmitted to individuals by human-to-human transmission leading to severe viral pneumonia and respiratory system injury. SARS-CoV2 elicits infections from the common cold to severe conditions accompanied by lung injury, acute respiratory distress syndrome, and other organ destruction. There is a possibility of virus transmission from asymptomatic cases as active carriers, in addition to symptomatic ones, which is a crucial crisis of COVID-19 that should be considered. Hence, paying more attention to the accurate and immediate diagnosis of suspected and infected cases can be a great help in preventing the rapid spread of the virus, improving the disease prognosis, and controlling the pandemic. In this review, we provide a comprehensive and up-to-date overview of the different types of Clinical and Para-clinical diagnostic methods and their practical features, which can help understand better the applications and capacities of various diagnostic approaches for COVID-19 infected cases.     

基于多源地理数据精细尺度的武汉市人居环境新型冠状病毒肺炎疫情传播风险评估

新型冠状病毒肺炎的迅速传播和扩散警示着疾病风险评估的重要性。但现有的风险评估方法受数据限制，缺少实时性和准确性。此外，多数研究以行政统计单元作为分析尺度，存在可变面元问题。为解决这些问题，耦合精细尺度下武汉市疫情数据及多源地理数据，基于随机森林算法构建社区尺度的市域疫情传播风险评估模型并进行了疫情风险制图。模型测试精度达到0.85，Kappa系数达到0.70。此外，本研究还建立基于随机森林算法的社区及场所尺度的"空间变量-感染风险"模型，评估了不同场所设施疫情传播的风险程度。研究表明，（1）武汉中心区域感染风险最高并呈现出向外围递减的趋势；（2）感染风险排名前五的一级场所类型分别为购物服务、医疗服务、金融服务、交通设施以及公共设施；（3）小学、中学的疫情传播风险较低，而高等院校传播风险较高；（4）社区尺度下的疫情风险程度，预测购物场所与交通场所是疫情传播风险最高的驱动因子。本研究基于精细尺度提出风险评估新方法，可为未来疾病风险评估提供新思路，为疫情防控提供决策支持，人民群众提供安全保障。     

A Study of Two Cases Co-Infected with SARS-CoV-2 and Human Immunodeficiency Virus

Since December 2019, A new type of coronavirus pneumonia (coronavirus disease 2019, COVID-19) has become endemic in Wuhan, China. So far, COVID-19 has developed into a global epidemic. The body's immune system plays an important role in the fight against COVID-19. Here, we followed up the clinical data and treatment of two COVID-19 patients diagnosed with acquired immunodeficiency syndrome (AIDS), hoping to be helpful for the subsequent diagnosis and treatment of patients with related diseases.     

A global treatments for coronaviruses including COVID-19

In late December 2019 in Wuhan, China, several patients with viral pneumonia were identified as 2019 novel coronavirus (2019-nCoV). So far, there are no specific treatments for patients with coronavirus disease-19 (COVID-19), and the treatments available today are based on previous experience with similar viruses such as severe acute respiratory syndrome-related coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV), and Influenza virus. In this article, we have tried to reach a therapeutic window of drugs available to patients with COVID-19. Cathepsin L is required for entry of the 2019-nCoV virus into the cell as target teicoplanin inhibits virus replication. Angiotensin-converting-enzyme 2 (ACE2) in soluble form as a recombinant protein can prevent the spread of coronavirus by restricting binding and entry. In patients with COVID-19, hydroxychloroquine decreases the inflammatory response and cytokine storm, but overdose causes toxicity and mortality. Neuraminidase inhibitors such as oseltamivir, peramivir, and zanamivir are invalid for 2019-nCoV and are not recommended for treatment but protease inhibitors such as lopinavir/ritonavir (LPV/r) inhibit the progression of MERS-CoV disease and can be useful for patients of COVID-19 and, in combination with Arbidol, has a direct antiviral effect on early replication of SARS-CoV. Ribavirin reduces hemoglobin concentrations in respiratory patients, and remdesivir improves respiratory symptoms. Use of ribavirin in combination with LPV/r in patients with SARS-CoV reduces acute respiratory distress syndrome and mortality, which has a significant protective effect with the addition of corticosteroids. Favipiravir increases clinical recovery and reduces respiratory problems and has a stronger antiviral effect than LPV/r. currently, appropriate treatment for patients with COVID-19 is an ACE2 inhibitor and a clinical problem reducing agent such as favipiravir in addition to hydroxychloroquine and corticosteroids.     

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.     

新冠肺炎疫情防控常态化背景下医院信息化建设的实践与探索

摘要：近年来随着信息化技术的深入发展,其在人们的生产生活中的作用日益突出,对提高工作效率方面作用显著。2020年新年伊始,湖北省武汉市爆发新冠肺炎（COVID-19）疫情并迅速蔓延全国,国家高度重视,医务人员迅速行动,积极投入到这场与病毒作战的没有硝烟的战争中。经过全国上下艰苦努力,我国新冠肺炎疫情防控向好态势进一步巩固,防控工作已从应急状态转为常态化防控状态。医院信息化建设是医院现代化建设和新冠疫情防控的客观要求,在新冠肺炎疫情防控常态化背景下有重要意义。本文从新冠肺炎疫情背景下医院信息化建设概述,医院信息化建设存在的问题,医院信息化建设实践和医院信息化建设探索四个方面进行阐述,致力于探索出疫情防控背景下医院信息化建设的整体思路。     

SARS-CoV-2 pathophysiology and assessment of coronaviruses in CNS diseases with a focus on therapeutic targets

The novel Coronavirus disease of 2019 (nCOV-19) is a viral outbreak noted first in Wuhan, China. This disease is caused by Severe Acute Respiratory Syndrome (SARS) Coronavirus (CoV)-2. In the past, other members of the coronavirus family, such as SARS and Middle East Respiratory Syndrome (MERS), have made an impact in China and the Arabian peninsula respectively. Both SARS and COVID-19 share similar symptoms such as fever, cough, and difficulty in breathing that can become fatal in later stages. However, SARS and MERS infections were epidemic diseases constrained to limited regions. By March 2020 the SARS-CoV-2 had spread across the globe and on March 11th, 2020 the World Health Organization (WHO) declared COVID-19 as pandemic disease. In severe SARS-CoV-2 infection, many patients succumbed to pneumonia. Higher rates of deaths were seen in older patients who had co-morbidities such as diabetes mellitus, hypertension, cardiovascular disease (CVD), and dementia. In this review paper, we discuss the effect of SARS-CoV-2 on CNS diseases, such as Alzheimer's-like dementia, and diabetes mellitus. We also focus on the virus genome, pathophysiology, theranostics, and autophagy mechanisms. We will assess the multiorgan failure reported in advanced stages of SARS-CoV-2 infection. Our paper will provide mechanistic clues and therapeutic targets for physicians and investigators to combat COVID-19.     

Ocular transmissibility of COVID-19: possibilities and perspectives

Since the initial outbreak of coronavirus disease 2019 (COVID-19), extensive research has emerged from across the globe to understand the pathophysiology of this novel coronavirus. Transmission of this virus is a subject of particular interest as researchers work to understand which protective and preventative measures are most effective. Despite the well understood model of aerosol-respiratory mediated transmission, the exact mechanism underlying the inoculation, infection and spread of COVID-19 is currently unknown. Given anatomical positioning and near constant exposure to aerosolized pathogens, the eye may be a possible gateway for COVID-19 infection. This critical review explores the possibility of an ocular-systemic or ocular–nasal–pulmonic pathway of COVID-19 infection and includes novel insights into the possible immunological mechanisms leading to cytokine surge.

     

Clinical characteristics and co-infections of 354 hospitalized patients with COVID-19 in Wuhan,China: a retrospective cohort study

From December 2019, a novel coronavirus, SARS-CoV-2, caused an outbreak of pneumonia in Wuhan city and rapidly spread throughout China and globally. However, the clinical characteristics and co-infection with other respiratory pathogens of patients with COVID-19 and the factors associated with severity of COVID-19 are still limited. In this retrospective cohort study, we included 354 inpatients with COVID-19 admitted to Renmin Hospital of Wuhan University from February 4, 2020 to February 28, 2020. We found levels of interleukin-6, interleukin-10, C-reactive protein, D-dimer, white blood cell count and neutrophil count were clearly elevated in males and critical cases compared with females and severe and mild cases, respectively. However, lymphopenia was more severe in males than females and levels of tumor necrosis factor alpha were reduced significantly in critical cases than severe and mild cases. 23.5% of severe cases and 24.4% of critical cases were co-infected with other respiratory pathogens. Additionally, stepwise multivariable regression analysis suggested that co-infection, lymphocyte count and levels of D-dimer were associated with severity of COVID-19.These findings provide crucial clues for further identification of the mechanisms, characteristics and treatments of patients with COVID-19.     

Characteristics of SARS-CoV-2 transmission in a medium-sized city with traditional communities during the early COVID-19 epidemic in China

The nationwide COVID-19 epidemic ended in 2020, a few months after its outbreak in Wuhan, China at the end of 2019. Most COVID-19 cases occurred in Hubei Province, with a few local outbreaks in other provinces of China. A few studies have reported the early SARS-CoV-2 epidemics in several large cities or provinces of China. However, information regarding the early epidemics in small and medium-sized cities, where there are still traditionally large families and community culture is more strongly maintained and thus, transmission profiles may differ, is limited. In this study, we characterized 60 newly sequenced SARS-CoV-2 genomes from Anyang as a representative of small and medium-sized Chinese cities, compared them with more than 400 reference genomes from the early outbreak, and studied the SARS-CoV-2 transmission profiles. Genomic epidemiology revealed multiple SARS-CoV-2 introductions in Anyang and a large-scale expansion of the epidemic because of the large family size. Moreover, our study revealed two transmission patterns in a single outbreak, which were attributed to different social activities. We observed the complete dynamic process of single-nucleotide polymorphism development during community transmission and found that intrahost variant analysis was an effective approach to studying cluster infections. In summary, our study provided new SARS-CoV-2 transmission profiles representative of small and medium-sized Chinese cities as well as information on the evolution of SARS-CoV-2 strains during the early COVID-19 epidemic in China.