Division of Infection and Global Health Research, School of Medicine, University of St Andrews, UK.
Wellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
Clin Microbiol Infect. 2020 Jul;26(7):842-847. doi: 10.1016/j.cmi.2020.04.023. Epub 2020 Apr 25.
The COVID-19 pandemic caused by SARS-CoV-2 remains a significant issue for global health, economics and society. A wealth of data has been generated since its emergence in December 2019, and it is vital for clinicians to keep up with this data from across the world at a time of uncertainty and constantly evolving guidelines and clinical practice.
Here we provide an update for clinicians on the recent developments in the virology, diagnostics, clinical presentation, viral shedding, and treatment options for COVID-19 based on current literature.
We considered published peer-reviewed papers and non-peer-reviewed pre-print manuscripts on COVID19 and related aspects with an emphasis on clinical management aspects.
We describe the virological characteristics of SARS-CoV-2 and the clinical course of COVID-19 with an emphasis on diagnostic challenges, duration of viral shedding, severity markers and current treatment options.
The key challenge in managing COVID-19 remains patient density. However, accurate diagnosis as well as early identification and management of high-risk severe cases are important for many clinicians. For improved management of cases, there is a need to understand test probability of serology, qRT-PCR and radiological testing, and the efficacy of available treatment options that could be used in severe cases with a high risk of mortality.
由 SARS-CoV-2 引起的 COVID-19 大流行仍然是全球健康、经济和社会的重大问题。自 2019 年 12 月出现以来,已经产生了大量数据,在不确定和不断变化的指南和临床实践的情况下,临床医生及时掌握来自世界各地的数据至关重要。
基于当前文献,我们为临床医生提供了关于 COVID-19 的病毒学、诊断、临床表现、病毒脱落和治疗选择方面的最新进展。
我们考虑了关于 COVID19 及相关方面的已发表同行评议论文和非同行评议预印本手稿,重点是临床管理方面。
我们描述了 SARS-CoV-2 的病毒学特征和 COVID-19 的临床过程,重点介绍了诊断挑战、病毒脱落持续时间、严重程度标志物和当前的治疗选择。
管理 COVID-19 的主要挑战仍然是患者密度。然而,对于许多临床医生来说,准确的诊断以及对高危重症病例的早期识别和管理都很重要。为了更好地管理病例,需要了解血清学、qRT-PCR 和影像学检测的检测概率,以及可用治疗方法在死亡率高的重症病例中的疗效。