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关于 SARS-CoV-2 感染潜在发病机制的假说——病毒性肺炎患者免疫变化的综述。

Hypothesis for potential pathogenesis of SARS-CoV-2 infection-a review of immune changes in patients with viral pneumonia.

机构信息

Department of Infectious Diseases, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.

Center for AIDS Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.

出版信息

Emerg Microbes Infect. 2020 Dec;9(1):727-732. doi: 10.1080/22221751.2020.1746199.

Abstract

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with droplets and contact as the main means of transmission. Since the first case appeared in Wuhan, China, in December 2019, the outbreak has gradually spread nationwide. Up to now, according to official data released by the Chinese health commission, the number of newly diagnosed patients has been declining, and the epidemic is gradually being controlled. Although most patients have mild symptoms and good prognosis after infection, some patients developed severe and die from multiple organ complications. The pathogenesis of SARS-CoV-2 infection in humans remains unclear. Immune function is a strong defense against invasive pathogens and there is currently no specific antiviral drug against the virus. This article reviews the immunological changes of coronaviruses like SARS, MERS and other viral pneumonia similar to SARS-CoV-2. Combined with the published literature, the potential pathogenesis of COVID-19 is inferred, and the treatment recommendations for giving high-doses intravenous immunoglobulin and low-molecular-weight heparin anticoagulant therapy to severe type patients are proposed.

摘要

新型冠状病毒病(COVID-19)是由严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)引起的传染病,飞沫和接触是主要的传播途径。自 2019 年 12 月中国武汉首次出现病例以来,疫情已逐渐蔓延至全国。截至目前,根据中国卫生健康委员会发布的官方数据,新诊断患者数量呈下降趋势,疫情逐渐得到控制。虽然大多数患者感染后症状轻微,预后良好,但仍有部分患者出现严重并发症而死亡。SARS-CoV-2 感染人类的发病机制尚不清楚。免疫功能是抵御入侵病原体的强大防御机制,目前尚无针对该病毒的特效抗病毒药物。本文综述了 SARS、MERS 等类似 SARS-CoV-2 的冠状病毒的免疫学变化,并结合已发表的文献,推断 COVID-19 的潜在发病机制,提出对重型患者给予大剂量静脉注射免疫球蛋白和低分子量肝素抗凝治疗的建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/989b/7170333/9d62450a84ee/TEMI_A_1746199_F0001_OC.jpg

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