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。

Analysis of The Impact of SARS-CoV-2 Variants on Global Epidemic Prevention and Control

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has posed a serious threat to international public health. The SARS-COV-2 gene continues to mutate in COVID-19 outbreaks. Mutation mainly manifests in 3 forms: point mutation, gene recombination and epigenetic modification. Viral mutations are driven by multiple factors, with mutation rates modulated at 3 levels, the nature of virus, host-virus interactions and natural selection. Therefore, it is particularly important to strengthen the monitoring of the global novel coronavirus genome and the protection of immunosuppressed populations. In the early stage of virus evolution, the mutant strains exhibit greater transmissibility and less virulence than the wild-type strain, although 5 variants of concern (VOCs) showed different stability, transmission capacity, adaptability and pathogenicity. So physical interventions need to be further strengthened. As herd immunity is established, novel mutant strains tend to mutate against vaccines and antibodies. In that case, VOCs, especially the prevailing Omicron variant, bring challenges to the prevention and control of COVID-19 worldwide. The existing and potential prevention, diagnosis and treatment approaches for COVID-19 were summarized. In the vaccination part, the protective efficacy of COVID-19 vaccine against VOCs and the factors influencing the efficacy of COVID-19 vaccine were analyzed. In the detection part, the detection methods based on nucleic acid, antigen and antibody were summarized in order to satisfy the requirements for point-of-care testing and timely recognition of novel variants. And in the treatment part, the potential therapeutic drugs and targets of SARS-CoV-2 were summarized. Drug targets are generally divided into extracellular targets and intracellular targets. In general, this review proposes possible countermeasures by analyzing the impact of mutations on global epidemic prevention and control, hoping to provide theoretical basis for possible large-scale epidemic prevention and control in the future.