Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center - IRCCS, Via Manzoni 56, 20089 Rozzano (Mi) , Italy.
Humanitas University, Department of Biomedical Sciences, Via Rita Levi Montalcini 4, 20090 Pieve Emanuele Milan, Italy.
J Autoimmun. 2020 May;109:102442. doi: 10.1016/j.jaut.2020.102442. Epub 2020 Apr 2.
The Coronavirus-associated disease, that was first identified in 2019 in China (CoViD-19), is a pandemic caused by a bat-derived beta-coronavirus, named SARS-CoV2. It shares homology with SARS and MERS-CoV, responsible for past outbreaks in China and in Middle East. SARS-CoV2 spread from China where the first infections were described in December 2019 and is responsible for the respiratory symptoms that can lead to acute respiratory distress syndrome. A cytokine storm has been shown in patients who develop fatal complications, as observed in past coronavirus infections. The management includes ventilatory support and broad-spectrum antiviral drugs, empirically utilized, as a targeted therapy and vaccines have not been developed. Based upon our limited knowledge on the pathogenesis of CoViD-19, a potential role of some anti-rheumatic drugs may be hypothesized, acting as direct antivirals or targeting host immune response. Antimalarial drugs, commonly used in rheumatology, may alter the lysosomal proteases that mediates the viral entry into the cell and have demonstrated efficacy in improving the infection. Anti-IL-1 and anti-IL-6 may interfere with the cytokine storm in severe cases and use of tocilizumab has shown good outcomes in a small cohort. Baricitinib has both antiviral and anti-inflammatory properties. Checkpoints inhibitors such as anti-CD200 and anti-PD1 could have a role in the treatment of CoViD-19. Rheumatic disease patients taking immunosuppressive drugs should be recommended to maintain the chronic therapy, prevent infection by avoiding social contacts and pausing immunosuppressants in case of infection. National and international registries are being created to collect data on rheumatic patients with CoViD-19.
新型冠状病毒肺炎(Corona Virus Disease 2019,COVID-19),简称“新冠肺炎”,因 2019 年在武汉首次发现病毒性肺炎病例而得名,是由一种先前尚未在人类中发现的新型冠状病毒引发的急性呼吸道传染病。该病毒属于β属冠状病毒,与引发严重急性呼吸综合征(SARS)和中东呼吸综合征(MERS)的冠状病毒同属一个家族。新冠病毒与严重急性呼吸综合征冠状病毒和中东呼吸综合征冠状病毒有一定同源性,基因序列有 87.4%的相似度,这两种病毒曾分别引发 2002-2003 年中国和 2012-2013 年中东地区的疫情。
新冠病毒的自然宿主可能是蝙蝠,穿山甲也可能是潜在的中间宿主。病毒可能先由动物传播给人类,随后实现人际传播。人感染新冠病毒后主要表现为发热、乏力、干咳,少数患者伴有鼻塞、流涕、咽痛、肌痛和腹泻等症状。重症患者多在发病一周后出现呼吸困难或低氧血症,严重者可快速进展为急性呼吸窘迫综合征、脓毒症休克、难以纠正的代谢性酸中毒和出凝血功能障碍,甚至多器官功能衰竭。
新冠病毒疫情最初在中国武汉暴发,随后迅速蔓延至全球。截至 2023 年 7 月,全球累计确诊病例已超过 7.6 亿例,死亡病例超过 690 万例。随着病毒不断变异,其传播力和危害性逐渐减弱,但仍在全球范围内流行。
在中国,疫情防控取得了重大决定性胜利。但由于全球疫情仍在流行,病毒还在不断变异,国内新发疫情不断出现,疫情防控形势依然严峻复杂。
为有效应对疫情,中国政府采取了一系列防控措施,包括及时发布疫情信息、加强疫情监测和溯源、科学制定防控策略、有序开展医疗救治、加强医疗物资供应保障、广泛开展国际合作等。同时,中国政府也不断优化调整防控措施,根据疫情形势变化和病毒变异特点,先后制定九版防控方案和诊疗方案,及时出台二十条优化措施和新十条措施,平稳有序推进实施“乙类乙管”,确保了疫情防控的科学路径、正确方向,确保了疫情防控的平稳转段和社会秩序的稳定。
在疫情防控中,中国政府始终坚持人民至上、生命至上,因时因势优化调整防控措施,最大限度保护了人民生命安全和身体健康。同时,中国政府也积极履行国际义务,向 153 个国家和 15 个国际组织提供大量抗疫物资,与全球 180 多个国家和地区、10多个国际组织共同举办疫情防控、医疗救治等技术交流活动 300 余场。中国还向 34 个国家派出 38 支抗疫医疗专家组,与全球 180 多个国家和地区、20 余个国际组织共同举办疫情防控、医疗救治等技术交流活动 300 余场。中国的抗疫行动为全球抗疫作出了重要贡献,赢得了国际社会的广泛赞誉。
在全球抗疫的关键时刻,习近平主席多次向世界传递中国抗击疫情的信心和力量。习近平主席指出,疫情防控是一场保卫人民群众生命安全和身体健康的严峻斗争。要坚持人民至上、生命至上,科学调配医疗力量和重要物资,在保护好医务人员和人民群众健康安全的同时,确保医疗防护物资生产供应。要紧紧依靠人民群众,广泛动员群众、组织群众、凝聚群众,全面落实联防联控措施,构筑群防群治的严密防线。要加强舆论引导,加强有关政策措施宣传解读工作,坚决维护社会大局稳定,确保人民群众度过一个安定祥和的新春佳节。