2019新型冠状病毒疫苗研究进展及展望

新型冠状病毒肺炎(coronavirus disease 2019, COVID-19)正在全球大流行,疫苗研发工作也在积极推进.截至2021年3月2日,全球正在研制的新型冠状病毒疫苗共有258种,疫苗种类囊括灭活疫苗、减毒活疫苗、亚单位疫苗、病毒载体疫苗、DNA疫苗、RNA疫苗和病毒样颗粒,有76种疫苗已进入临床试验阶段.疫苗的安全性和有效性是两个最重要的指标,临床试验结束后将获取疫苗的这些关键指标,安全且有效的疫苗上市指日可待.本文对目前进入临床试验的疫苗类型、构建策略、优缺点、最新进展进行比较分析,同时针对新冠疫苗研制和免疫策略进行了探讨.     

新型冠状病毒肺炎的治疗进展

2019年12月在湖北武汉出现不明原因肺炎,随后在国内和全球引起传播.目前,全球已有200多个国家出现感染病例,WHO将新型冠状病毒(简称为"新冠")引起的疫情暴发定义为全球大流行,严重危害人类的生命健康.我国经过前期的精准施策、科学防治,我国疫情已得到良好控制,取得了阶段性的胜利.在新冠肺炎患者的治疗中,通过对治疗方法的探索和实践,全国90％以上患者达到出院标准,在新冠肺炎的治疗中积累了宝贵的经验.本文就新冠肺炎的治疗作一综述,以期为新冠肺炎救治提供参考.     

新型冠状病毒亚单位疫苗研究进展及现状*

自新型冠状病毒肺炎在2019年年末暴发以来,如何高效防控疫情一直是紧急的全球公共安全事件。疫苗是有效阻止病毒感染人体、保护高危人群免于疾病快速进展以及遏制疫情进一步扩大的手段之一,其中亚单位疫苗的主要成分为特定的病毒抗原蛋白或多肽,通过加入疫苗佐剂提高抗原的免疫原性。由于机体仅针对重组蛋白表面的特定抗原表位进行识别并产生抗体,因此亚单位疫苗具有较高的保护能力和安全性。通过对目前已上市及处于临床阶段的各类新型冠状病毒亚单位疫苗进行梳理,介绍了各类亚单位疫苗的抗原设计策略和佐剂选择、整体保护能力及研究进展,并对亚单位疫苗的应用及技术优势进行分析,期望能为亚单位疫苗研发及全球疫情防控提供参考。     

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。     

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。     

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,...     

密切关注新型冠状病毒肺炎并发、继发侵袭性真菌感染

新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)在中国武汉暴发波及全国,截至2月14日,死亡人数已经超过 1 300,严重威胁人类的生命。《新型冠状病毒感染的肺炎诊疗方案(试行第五版)》中采用的抗病毒、抗细菌、激素、机械通气和循环支持等治疗手段,均为引发真菌感染的高危因素。当患者继发真菌感染时,病死率会大幅提升。因此,应制定科学、规范的预警技术,以便早期发现真菌感染;研发便捷、高效、低廉和覆盖面广的抗高发侵袭性真菌感染的诊断试剂盒以及新型抗菌材料防护物品,确保做到早期预警、明确诊断、精准治疗和有效防护,以应对可能出现的COVID-19继发严重真菌感染的状况。密切关注COVID-19并发、继发性真菌感染具有重要的现实意义。     

新型冠状病毒疫苗研究策略分析

新型冠状病毒(SARS-CoV-2)是一种可引起人新型冠状病毒肺炎(COVID-19)的新发呼吸道病原体,与重症急性呼吸道综合症冠状病毒(SARS-CoV)和中东呼吸综合征冠状病毒(MERS-CoV)同属于β-冠状病毒,具有较高的传染性和一定的致死率。2019年12月在我国武汉被发现,随后蔓延到我国大部分省份,给我国人民健康和经济发展造成巨大损失。疫苗接种是预防和控制传染病的常规和有效手段,国内外多个机构已启动COVID-19疫苗研究工作。文中基于SARS和MERS疫苗研究的经验和教训,对COVID-19疫苗的研究策略和需要注意的关键问题进行了阐述,为相关研究人员提供参考。     

间充质干细胞在新型冠状病毒肺炎治疗中的研究现状

新型冠状病毒肺炎(COVID-19)由新型冠状病毒(SARS-CoV-2)导致,可发生严重肺部损伤甚至死亡,目前为止仍在全球范围内广泛蔓延。SARS-CoV-2感染依赖于血管紧张素转换酶2(ACE2)和Ⅱ型跨膜丝氨酸蛋白酶,可导致机体免疫紊乱,促发炎症风暴从而损伤靶器官。COVID-19目前尚无特效药物,间充质干细胞(MSCs)具有组织修复和免疫调节等功能,而且在流感病毒相关性肺炎及其他肺疾病中有一定疗效,因此可能是治疗COVID-19潜在有效药物。目前部分研究也显示出积极的治疗效果,而具体的疗效仍需进一步的临床研究来验证。     

HIV感染者接种新型冠状病毒疫苗的必要性及免疫效果研究进展

目前,接种新型冠状病毒疫苗(简称新冠疫苗)是预防严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2, SARS-CoV-2)感染及降低新型冠状病毒肺炎(corona virus disease 2019, COVID-19)重症率、死亡率的重要措施之一。人类免疫缺陷病毒(human immunodeficiency virus, HIV)感染者(HIV infector)是COVID-19的高风险人群,多国疾病预防控制机构和相关学术团体均建议优先为HIV感染者接种新冠疫苗,且已有研究显示HIV感染者接种新冠疫苗后的益处远大于风险。现通过梳理和总结近两年的相关研究,就HIV感染者接种新冠疫苗的必要性、接种效果、影响HIV感染者接种新冠疫苗效果的因素及接种新冠疫苗对HIV感染者的影响等作一概述,以期为HIV感染者新冠疫苗预防接种提供参考。     

2019新型冠状病毒及其诊疗与防控:回顾与展望

2019新型冠状病毒的暴发持续至今,导致了世界各地数以百万计的感染个例,更夺去了数十万人的生命。世界卫生组织在2020年2月将此病毒引起的疾病定名为2019冠状病毒病(Coronavirus disease 2019,COVID-19),而国际病毒分类委员会也将此病毒命名为SARS-Co V-2。COVID-19的典型临床症状类似感冒,少数病人可发展为重症甚至死亡。21世纪以来,人类冠状病毒有3次大暴发,分别是2003年暴发的严重急性呼吸综合征(SARS)、2012年暴发的中东呼吸综合征(MERS)和本次的新型肺炎。自2003年以来,对SARS和MERS冠状病毒的研究从未间断,对其自然起源、致病机理、药物筛选及疫苗研发等已取得一定进展。鉴于SARS-Co V-2和SARS-Co V的基因组序列高度相似,以往对SARS-Co V的研究对深入探讨SARS-Co V-2生物学特性、诊断、治疗和防控有很强的借鉴性。文中通过回顾过往的研究进展,对比SARS-Co V和SARS-Co V-2的生物学特性,分析当前亟需的防控和诊疗措施,探讨疫苗研发所面对的一些难题,并展望疫情发展趋势及对本领域研究与开发的主要挑战,冀为我国和全世界有效控制COVID-19疫情提供参考。     

Increased sTREM-1 plasma concentrations are associated with poor clinical outcomes in patients with COVID-19

Patients with sepsis display increased concentrations of sTREM-1 (soluble Triggering Receptor Expressed on Myeloid cells 1), and a phase II clinical trial focusing on TREM-1 modulation is ongoing. We investigated whether sTREM-1 circulating concentrations are associated with the outcome of patients with coronavirus disease 2019 (COVID-19) to assess the role of this pathway in COVID-19. This observational study was performed in two independent cohorts of patients with COVID-19. Plasma concentrations of sTREM-1 were assessed after ICU admission (pilot cohort) or after COVID-19 diagnosis (validation cohort). Routine laboratory and clinical parameters were collected from electronic patient files. Results showed sTREM-1 plasma concentrations were significantly elevated in patients with COVID-19 (161 [129–196] pg/ml) compared to healthy controls (104 [75–124] pg/ml; P<0.001). Patients with severe COVID-19 needing ICU admission displayed even higher sTREM-1 concentrations compared to less severely ill COVID-19 patients receiving clinical ward-based care (235 [176–319] pg/ml and 195 [139–283] pg/ml, respectively, P = 0.017). In addition, higher sTREM-1 plasma concentrations were observed in patients who did not survive the infection (326 [207–445] pg/ml) compared to survivors (199 [142–278] pg/ml, P<0.001). Survival analyses indicated that patients with higher sTREM-1 concentrations are at higher risk for death (hazard ratio = 3.3, 95%CI: 1.4–7.8). In conclusion, plasma sTREM-1 concentrations are elevated in patients with COVID-19, relate to disease severity, and discriminate between survivors and non-survivors. This suggests that the TREM-1 pathway is involved in the inflammatory reaction and the disease course of COVID-19, and therefore may be considered as a therapeutic target in severely ill patients with COVID-19.     

A Prognostic Model to Predict Recovery of COVID-19 Patients Based on Longitudinal Laboratory Findings

Virologica Sinica - The temporal change patterns of laboratory data may provide insightful clues into the whole course of COVID-19. This study aimed to evaluate longitudinal change patterns of key...     

Cell-Type-Specific Immune Dysregulation in Severely Ill COVID-19 Patients

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Dynamic Changes of Antibodies to SARS-CoV-2 in COVID-19 Patients at Early Stage of Outbreak

Virologica Sinica - The coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2, has spread around the world with high mortality. To diagnose promptly and accurately is the vital step to...     

COVID-19: Antiviral Agents,Antibody Development and Traditional Chinese Medicine

Virologica Sinica - The World Health Organization (WHO) has declared coronavirus disease 2019 (COVID-19) is the first pandemic caused by coronavirus named severe acute respiratory syndrome...     

Viral and Antibody Kinetics of COVID-19 Patients with Different Disease Severities in Acute and Convalescent Phases: A 6-Month Follow-Up Study

Virologica Sinica - Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread rapidly around the world, posing a major threat to human...     

COVID-19: Antiviral agents and enzyme inhibitors/receptor blockers in development

Novel 2019 coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2]) and coronavirus disease 2019 (COVID-19), the respiratory syndrome it causes, have shaken the world to its core by infecting and claiming the lives of many people since originating in December 2019 in Wuhan, China. World Health Organization and several states have declared a pandemic situation and state of emergency, respectively. As there is no treatment for COVID-19, several research institutes and pharmaceutical companies are racing to find a cure. Advances in computational approaches have allowed the screening of massive antiviral compound libraries to identify those that may potentially work against SARS-CoV-2. Antiviral agents developed in the past to combat other viruses are being repurposed. At the same time, new vaccine candidates are being developed and tested in preclinical/clinical settings. This review provides a detailed overview of select repurposed drugs, their mechanism of action, associated toxicities, and major clinical trials involving these agents.     

Role of biochemical markers in the monitoring of COVID-19 patients

COVID-19 is an infectious disease caused by the SARSCoV-2 virus, which has given rise to a global sanitary emergency. The clinical characteristics of COVID-19 are varied and can range from an asymptomatic infection to a mild to severe pneumonia. Recent studies have shown that different laboratory parameters become altered in these patients, and as such are useful as biomarkers to assess the progression of the disease and categorize patients that may present a severe and/or fatal clinical condition. This review analyzes biochemical and immunological markers that become altered in COVID-19 patients and their impact on different organs at a hepatic, cardiac, renal and pancreatic level, as well as markers of inflammation, analyzing their implications in the evolution of the disease.