Corman V M, Lienau J, Witzenrath M
Institut für Virologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Deutschland.
Arbeitsbereich Pulmonale Inflammation, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Deutschland.
Internist (Berl). 2019 Nov;60(11):1136-1145. doi: 10.1007/s00108-019-00671-5.
There are six human pathogenic coronaviruses (CoV), which mainly cause infections of the respiratory system. In everyday clinical practice, it is helpful to know the relevance and characteristics of these pathogens.
To present the epidemiology, clinical picture and differences of human pathogenic CoV and to provide information on the diagnostics and treatment of patients suspected of having CoV infections.
Selective literature search, presentation of results and discussion of fundamental works and expert recommendations, including publications by the World Health Organization (WHO), the European Centre for Disease Prevention and Control (ECDC) and the Robert Koch Institute.
The four endemic human CoVs (HCoV-NL63, HCoV-229E, HCoV-OC43 and HCoV-HKU1) mainly cause mild respiratory tract infections. In addition to these four endemic HCoV, the two epidemic CoV, severe acute respiratory syndrome (SARS)-CoV and Middle East respiratory syndrome (MERS)-CoV can cause severe pneumonia. The SARS-CoV has not been detected in humans in the last 15 years and MERS-CoV has been circulating mainly on the Arabian Peninsula since 2012; however, neither a specific treatment nor approved vaccines exist for any of the six human pathogenic CoVs.
All six human CoVs can be diagnosed using RT-PCR on respiratory specimens but this is rarely necessary for the four endemic strains. In current clinical practice SARS-CoV has no importance as it has not been detected in humans for 15 years; however, a possible MERS-CoV infection should be taken into account in patients with typical symptoms and travel history to endemic regions. In this case, rapid diagnostic and general hygiene practices are important to prevent further transmission.
有六种人类致病性冠状病毒（CoV），主要引起呼吸系统感染。在日常临床实践中，了解这些病原体的相关性和特征很有帮助。
介绍人类致病性CoV的流行病学、临床表现及差异，并提供疑似CoV感染患者的诊断和治疗信息。
进行选择性文献检索，呈现结果并讨论基础研究及专家建议，包括世界卫生组织（WHO）、欧洲疾病预防控制中心（ECDC）和罗伯特·科赫研究所的出版物。
四种地方性人类CoV（HCoV-NL63、HCoV-229E、HCoV-OC43和HCoV-HKU1）主要引起轻度呼吸道感染。除这四种地方性HCoV外，另外两种流行的CoV，即严重急性呼吸综合征（SARS）-CoV和中东呼吸综合征（MERS）-CoV可导致严重肺炎。过去15年未在人类中检测到SARS-CoV，自2012年以来MERS-CoV主要在阿拉伯半岛传播；然而，六种人类致病性CoV均没有特异性治疗方法或获批疫苗。
所有六种人类CoV均可通过对呼吸道标本进行逆转录聚合酶链反应（RT-PCR）诊断，但对于四种地方性毒株而言，很少有必要进行此项检测。在当前临床实践中，SARS-CoV已无实际意义，因为已15年未在人类中检测到；然而，对于有典型症状且有前往流行地区旅行史的患者，应考虑可能感染MERS-CoV。在这种情况下，快速诊断和一般卫生措施对于防止进一步传播很重要。
