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2019冠状病毒病(COVID-19):一场完美风暴的写照。

Coronavirus disease 2019 (COVID-19): the portrait of a perfect storm.

作者信息

Lippi Giuseppe, Sanchis-Gomar Fabian, Henry Brandon M

机构信息

Section of Clinical Biochemistry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Verona, Italy.

Department of Physiology, Faculty of Medicine, University of Valencia and INCLIVA Biomedical Research Institute, Valencia, Spain.

出版信息

Ann Transl Med. 2020 Apr;8(7):497. doi: 10.21037/atm.2020.03.157.

Abstract

The "novel" coronavirus disease 2019 (abbreviated "COVID-19") is the third coronavirus outbreak emerging during the past two decades. This infectious disease, sustained by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has been recently declared a global pandemic by the World Health Organization. Despite the concerning epidemiological burden, many people, including some policymakers, are underestimating this pandemic and are remaining enigmatically inactive against a human pathology which, for a combination of reasons, can be reasonably defined as a perfect storm (i.e., the "wrong virus" at the "wrong time"). These many paradigmatic aspects include SARS-CoV-2 structure and peculiar biology of infection, high risk of inter-human transmission, long incubation time combined with early and sustained viral load, existence of asymptomatic or mildly-symptomatic carriers, viral shedding for days after symptom relief, unfavorable progression towards respiratory distress and death in up to 5-10% of patients thus causing dramatic healthcare challenges, as well as environmental contamination. Last but not least, the combination of the current case fatality rate with the extraordinary number of people that could be potentially infected by SARS-CoV-2 would permit to estimate that the worldwide deaths for COVID-19 may even approximate those recorded during World War II if appropriate restrictive measures for preventing human-to-human transmission are not readily undertaken. Everybody should be inexcusably aware that this is not a drill, and that the consequences of inadequate action will be tragedy.

摘要

2019年“新型”冠状病毒病(简称“COVID-19”)是过去二十年间出现的第三次冠状病毒疫情。这种由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引发的传染病,最近已被世界卫生组织宣布为全球大流行。尽管流行病学负担令人担忧,但包括一些政策制定者在内的许多人仍在低估这场大流行,面对这种因多种原因可被合理地定义为一场完美风暴(即在“错误的时间”出现“错误的病毒”)的人类病理状况,他们仍莫名其妙地无所作为。这些诸多典型方面包括SARS-CoV-2的结构和独特的感染生物学特性、人际传播的高风险、较长的潜伏期以及早期和持续的病毒载量、无症状或轻症携带者的存在、症状缓解后数天的病毒排出、高达5%-10%的患者出现向呼吸窘迫和死亡的不利进展从而带来巨大的医疗挑战,以及环境污染。最后但同样重要的是,如果不立即采取适当的预防人际传播的限制措施,将当前的病死率与可能被SARS-CoV-2感染的大量人群相结合来估计,那么COVID-19在全球造成的死亡人数甚至可能接近第二次世界大战期间的死亡人数。每个人都应无可辩驳地意识到,这不是一次演习,行动不力的后果将是悲剧。

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