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冠状病毒病(COVID-19)的特征、评估与治疗

Features, Evaluation, and Treatment of Coronavirus (COVID-19)

作者信息

Cascella Marco, Rajnik Michael, Aleem Abdul, Dulebohn Scott C., Di Napoli Raffaela

机构信息

Istituto Nazionale Tumori - IRCCS - Fondazione Pascale, Via Mariano Semmola 80100, Napoli. Italy

Uniformed Service University of the Health Sciences

Abstract

Coronavirus disease 2019 (COVID-19) is a highly contagious viral illness caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 has had a catastrophic effect on the world, resulting in more than 6 million deaths worldwide. After the first cases of this predominantly respiratory viral illness were reported in Wuhan, Hubei Province, China, in late December 2019, SARS-CoV-2 rapidly disseminated worldwide. This compelled the World Health Organization (WHO) to declare it a global pandemic on March 11, 2020. Even though substantial progress in clinical research has led to a better understanding of SARS-CoV-2, many countries continue to have outbreaks of this viral illness. These outbreaks are primarily attributed to the emergence of mutant variants of the virus. Like other RNA viruses, SARS-CoV-2 adapts with genetic evolution and developing mutations. This results in mutant variants that may have different characteristics than their ancestral strains. Several variants of SARS-CoV-2 have been described during the course of this pandemic, among which only a few are considered variants of concern (VOCs). Based on the epidemiological update by the WHO, 5 SARS-CoV-2 VOCs have been identified since the beginning of the pandemic: First variant of concern, which was described in the United Kingdom (UK) in late December 2020. : First reported in South Africa in December 2020. : First reported in Brazil in early January 2021.  First reported in India in December 2020.   First reported in South Africa in November 2021. Despite the unprecedented speed of vaccine development against the prevention of COVID-19 and robust global mass vaccination efforts, the emergence of new SARS-CoV-2 variants threatens to overturn the progress made in limiting the spread of this disease. This review aims to comprehensively describe the etiology, epidemiology, pathophysiology, and clinical features of COVID-19. This review also provides an overview of the different variants of SARS-CoV-2 and the guideline-recommended treatment (as of January 2023) for managing this disease.

摘要

2019冠状病毒病(COVID-19)是一种由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的高度传染性病毒性疾病。COVID-19对世界产生了灾难性影响,导致全球超过600万人死亡。2019年12月下旬,中国湖北省武汉市报告了首例这种主要为呼吸道的病毒性疾病病例后,SARS-CoV-2迅速在全球传播。这迫使世界卫生组织(WHO)于2020年3月11日宣布其为全球大流行。尽管临床研究取得了重大进展,人们对SARS-CoV-2有了更好的了解,但许多国家仍不断爆发这种病毒性疾病。这些疫情主要归因于病毒突变变体的出现。与其他RNA病毒一样,SARS-CoV-2通过基因进化和突变进行适应。这导致突变变体可能具有与其原始毒株不同的特征。在这次大流行过程中,已经描述了几种SARS-CoV-2变体,其中只有少数被视为值得关注的变体(VOC)。根据WHO的流行病学更新,自大流行开始以来,已确定了5种SARS-CoV-2 VOC:第一种值得关注的变体,于2020年12月下旬在英国被描述;第二种于2020年12月在南非首次报告;第三种于2021年1月初在巴西首次报告;第四种于2020年12月在印度首次报告;第五种于2021年11月在南非首次报告。尽管针对预防COVID-19的疫苗研发速度空前,全球也大力开展了大规模疫苗接种工作,但新出现的SARS-CoV-2变体有可能颠覆在限制该疾病传播方面取得的进展。本综述旨在全面描述COVID-19的病因、流行病学、病理生理学和临床特征。本综述还概述了SARS-CoV-2的不同变体以及(截至2023年1月)指南推荐的该疾病管理治疗方法。

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