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新型冠状病毒肺炎(COVID-19)具有独特的流行病学和临床特征,提示应采取特殊的控制措施。

Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures.

机构信息

Laboratory of Human Virology and Oncology, Shantou University Medical College, Shantou, Guangdong, China.

Department of Pediatric, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

J Med Virol. 2020 Jun;92(6):568-576. doi: 10.1002/jmv.25748. Epub 2020 Mar 29.

Abstract

By 27 February 2020, the outbreak of coronavirus disease 2019 (COVID-19) caused 82 623 confirmed cases and 2858 deaths globally, more than severe acute respiratory syndrome (SARS) (8273 cases, 775 deaths) and Middle East respiratory syndrome (MERS) (1139 cases, 431 deaths) caused in 2003 and 2013, respectively. COVID-19 has spread to 46 countries internationally. Total fatality rate of COVID-19 is estimated at 3.46% by far based on published data from the Chinese Center for Disease Control and Prevention (China CDC). Average incubation period of COVID-19 is around 6.4 days, ranges from 0 to 24 days. The basic reproductive number (R ) of COVID-19 ranges from 2 to 3.5 at the early phase regardless of different prediction models, which is higher than SARS and MERS. A study from China CDC showed majority of patients (80.9%) were considered asymptomatic or mild pneumonia but released large amounts of viruses at the early phase of infection, which posed enormous challenges for containing the spread of COVID-19. Nosocomial transmission was another severe problem. A total of 3019 health workers were infected by 12 February 2020, which accounted for 3.83% of total number of infections, and extremely burdened the health system, especially in Wuhan. Limited epidemiological and clinical data suggest that the disease spectrum of COVID-19 may differ from SARS or MERS. We summarize latest literatures on genetic, epidemiological, and clinical features of COVID-19 in comparison to SARS and MERS and emphasize special measures on diagnosis and potential interventions. This review will improve our understanding of the unique features of COVID-19 and enhance our control measures in the future.

摘要

截至 2020 年 2 月 27 日,2019 年冠状病毒病(COVID-19)疫情已在全球范围内造成 82623 例确诊病例和 2858 例死亡,超过了 2003 年和 2013 年严重急性呼吸综合征(SARS)(8273 例,775 例死亡)和中东呼吸综合征(MERS)(1139 例,431 例死亡)的发病数。COVID-19 已在国际上传播到 46 个国家。根据中国疾病预防控制中心(China CDC)发布的已发表数据,COVID-19 的总病死率估计迄今为 3.46%。COVID-19 的平均潜伏期约为 6.4 天,范围为 0 至 24 天。COVID-19 的基本繁殖数(R )在早期阶段无论采用哪种预测模型都在 2 到 3.5 之间,高于 SARS 和 MERS。中国疾病预防控制中心的一项研究表明,大多数患者(80.9%)被认为是无症状或轻度肺炎,但在感染的早期阶段会大量释放病毒,这给 COVID-19 的传播控制带来了巨大挑战。医院内传播也是另一个严重的问题。截至 2020 年 2 月 12 日,共有 3019 名卫生工作者感染,占总感染人数的 3.83%,这给卫生系统带来了极大的负担,尤其是在武汉。有限的流行病学和临床数据表明,COVID-19 的疾病谱可能与 SARS 或 MERS 不同。我们总结了 COVID-19 与 SARS 和 MERS 相比在遗传、流行病学和临床特征方面的最新文献,并强调了诊断和潜在干预措施的特殊措施。本综述将增进我们对 COVID-19 独特特征的了解,并增强我们未来的控制措施。

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