Wang X, Ding Y Q
Huayin Pathology Test Center of Southern Medical University, Guangzhou 510700, China.
Department of Pathology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
Zhonghua Bing Li Xue Za Zhi. 2020 Jun 8;49(6):647-652. doi: 10.3760/cma.j.cn112151-20200318-00220.
COVID-19 is an infectious disease caused by 2019-nCoV and characterizes as an atypical pneumonia. Since 2019-nCoV is a newly emerging virus, the pathogenesis of COVID-19 is not well known. Most patients had a self-limited course, and some became severe even death. In this review, the authors compared two coronavirus outbreaks during the past two decades: the SARS-CoV and 2019-nCoV. Among the biological nature of the pathogens, viral receptor distribution on the human cells, and the pathological findings in the targeted organs and clinical features of the patients with the diseases, found similarities and differences between the two diseases had been found. Due to the shared receptor ACE2 and the pathological similarities of the SARS-CoV and 2019-nCoV diseases,authors proposed a pathogenesis model for COVID-19. Like the SARS-CoV disease, COVID-19 is a systematic disease and targets the lungs, vasculatures, and the immune system. The basic pathogenesis involves two interlinked processes: a severe lung inflammation and immune deficiency, both of which were related to an inappropriate immune response and over-production of cytokines. Thus, treatment approaches should include antiviral and anti-proinflammatory cytokines, anti-infectious and life support therapies, especially in patients with severe diseases.
新型冠状病毒肺炎（COVID-19）是由2019新型冠状病毒（2019-nCoV）引起的一种传染病，其特征为非典型肺炎。由于2019-nCoV是一种新出现的病毒，COVID-19的发病机制尚不清楚。大多数患者病程呈自限性，部分患者病情会发展为重症甚至死亡。在本综述中，作者比较了过去二十年中的两次冠状病毒爆发：严重急性呼吸综合征冠状病毒（SARS-CoV）和2019-nCoV。在病原体的生物学特性、病毒在人体细胞上的受体分布以及患病患者靶器官的病理表现和临床特征方面，发现了这两种疾病之间的异同。由于SARS-CoV和2019-nCoV疾病共享受体血管紧张素转换酶2（ACE2）且病理相似，作者提出了COVID-19的发病机制模型。与SARS-CoV疾病一样，COVID-19是一种系统性疾病，主要累及肺、血管和免疫系统。其基本发病机制涉及两个相互关联的过程：严重的肺部炎症和免疫缺陷，这两者均与不适当的免疫反应和细胞因子过度产生有关。因此，治疗方法应包括抗病毒和抗促炎细胞因子、抗感染和生命支持治疗，尤其是对于重症患者。
