Emory University School of Medicine, Atlanta, Georgia, USA.
Centre for Global Health, Usher Institute, University of Edinburgh, Edinburgh, UK.
J Glob Health. 2020 Jun;10(1):011001. doi: 10.7189/jogh.10.011001.
On 31 December, 2019, the World Health Organization China Country Office was informed of cases of pneumonia of unknown aetiology. Since then, there have been over 75 000 cases globally of the 2019 novel coronavirus (COVID-19), 2000 deaths, and over 14 000 cases recovered. Outbreaks of novel agents represent opportunities for clinical research to inform real-time public health action. In 2018, we conducted a systematic review to identify priority research questions for Severe Acute Respiratory Syndrome-related coronavirus (SARS-CoV) and Middle East Respiratory Syndrome-related coronavirus (MERS-CoV). Here, we review information available on COVID-19 and provide an evidenced-based framework for priority clinical research in the current outbreak.
Three bibliographic databases were searched to identify clinical studies published on SARS-CoV and MERS-CoV in the outbreak setting. Studies were grouped thematically according to clinical research questions addressed. In February 2020, available information on COVID19 was reviewed and compared to the results of the SARS-CoV and MERS-CoV systematic review.
From the research objectives for SARS-CoV and MERS-CoV, ten themes in the literature were identified: Clinical characterisation, prognosis, diagnosis, clinical management, viral pathogenesis, epidemiological characterisation, infection prevention and control/transmission, susceptibility, psychosocial, and aetiology. For COVID19, some information on clinical presentation, diagnostic testing, and aetiology is available but many clinical research gaps have yet to be filled.
Based on a systematic review of other severe coronaviruses, we summarise the state of clinical research for COVID-19, highlight the research gaps, and provide recommendations for the implementation of standardised protocols. Data based on internationally standardised protocols will inform clinical practice real-time.
2019 年 12 月 31 日，世界卫生组织中国国家办事处接到不明原因肺炎病例报告。自那时以来，全球已有超过 75000 例 2019 年新型冠状病毒（COVID-19）病例，2000 人死亡，超过 14000 人康复。新型病原体的爆发为临床研究提供了机会，可以为实时公共卫生行动提供信息。2018 年，我们进行了一项系统评价，以确定严重急性呼吸综合征相关冠状病毒（SARS-CoV）和中东呼吸综合征相关冠状病毒（MERS-CoV）的优先研究问题。在这里，我们回顾了关于 COVID-19 的信息，并为当前疫情中的优先临床研究提供了一个基于证据的框架。
我们检索了三个文献数据库，以确定在爆发环境中发表的关于 SARS-CoV 和 MERS-CoV 的临床研究。根据所解决的临床研究问题，将研究按主题分组。2020 年 2 月，我们回顾了 COVID19 的可用信息，并将其与 SARS-CoV 和 MERS-CoV 系统评价的结果进行了比较。
从 SARS-CoV 和 MERS-CoV 的研究目标中，我们确定了文献中的十个主题：临床特征、预后、诊断、临床管理、病毒发病机制、流行病学特征、感染预防和控制/传播、易感性、心理社会和病因。对于 COVID19，已经有一些关于临床表现、诊断检测和病因的信息，但仍有许多临床研究空白需要填补。
基于对其他严重冠状病毒的系统评价，我们总结了 COVID-19 的临床研究状况，强调了研究空白，并就实施标准化方案提出了建议。基于国际标准化方案的数据将实时为临床实践提供信息。
