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新型冠状病毒肺炎:一场全球性的人畜共患病大流行疫情。

COVID-19: A Worldwide, Zoonotic, Pandemic Outbreak.

作者信息

Khan Tahseen, Agnihotri Kartikeya, Tripathi Aditi, Mukherjee Suneet, Agnihotri Namita, Gupta Gaurav

出版信息

Altern Ther Health Med. 2020 Aug;26(S2):56-64.

Abstract

CONTEXT

An outbreak of a novel, zoonotic coronavirus occurred in December 2019 in the city of Wuhan, China and has now affected almost the entire world, with the maximum confirmed cases being 1 521 252 as of April 10, 2020. The WHO named this coronavirus 2019-nCoV, with COVID-19 being the name for diseases allied with it.

OBJECTIVE

The study intended to examine the features and characteristics of existing human coronaviruses and identify their resemblance to the newly identified 2019-nCoV.

DESIGN

The research team performed a literature review, searching relevant literature databases. We searched four databases, PubMed, EMBASE, Web of Science and CNKI (Chinese Database), to identify studies reporting COVID-19. Articles published on or before April 10, 2020 were eligible for inclusion. We used the following search terms: "Coronavirus" or "2019-nCoV" or "COVID-19" or "SARS-CoV" or "MERS-CoV" or "Bat SARS-CoV" or "ACE2 receptor".

SETTING

This study was take place in School of Pharmacy, Suresh Gyan Vihar University, Jaipur, India.

RESULTS

The undistinguishable similarity of the genomic sequences of Severe Respiratory Syndrome (SARS)-CoV, Middle East Respiratory Syndrome (MERS)-CoV, and Bat SARS-CoV-bat-SL-CoVZC45 and bat-SL-CoVZXC21-to nCoV-2019 has facilitated the process of identifying primary treatment measures. Researchers are presuming the existence of angiotensin-converting enzyme 2 (ACE2) receptor binding in nCoV-2019, as in SARS-CoV. Researchers have been examining human-to-human transmission, the possibility of an intermediate host between bats and humans, and the existence of asymptomatic cases. An incubation period of 0 to 14 days has been reported, with acute to chronic symptoms being cough, nasal congestion, high fever, dyspnea, pneumonia, invasive lesions in both lungs, respiratory failure, and even death, including in pediatric cases. Mechanical ventilation, extracorporeal membrane oxygenation, repurposing of antivirals, and plasma infusion have proven to be somewhat effective. Several countries have started clinical trials to evaluate the safety and effectiveness of some drugs, but the ability to vaccinate people with existing or new molecules will require time. Previously learned lessons from SARS and MERS have led some areas to be well equipped in terms of the ability to take speedy action.

CONCLUSIONS

First-level treatments include repurposing antivirals and antimalarials, and plasma infusion should help, but development of existing or new molecules into vaccines will take time. The unpredictable trajectory of this outbreak demands careful surveillance to monitor the situation, draw strategies, implement control measures, and create proper ethical laws and medical guidelines.

摘要

背景

2019年12月,一种新型人畜共患冠状病毒在中国武汉市爆发,目前已影响到几乎整个世界,截至2020年4月10日,确诊病例最多达1521252例。世界卫生组织将这种冠状病毒命名为2019 - nCoV,与之相关的疾病名为COVID - 19。

目的

本研究旨在研究现有人类冠状病毒的特征,并确定它们与新发现的2019 - nCoV的相似之处。

设计

研究团队进行了文献综述,搜索相关文献数据库。我们搜索了四个数据库,即PubMed、EMBASE、科学网和中国知网(中文数据库),以识别报告COVID - 19的研究。2020年4月10日或之前发表的文章符合纳入标准。我们使用了以下搜索词:“冠状病毒”或“2019 - nCoV”或“COVID - 19”或“严重急性呼吸综合征冠状病毒(SARS - CoV)”或“中东呼吸综合征冠状病毒(MERS - CoV)”或“蝙蝠严重急性呼吸综合征冠状病毒(Bat SARS - CoV)”或“血管紧张素转换酶2受体(ACE2受体)”。

地点

本研究在印度斋浦尔苏雷什·吉安·维哈尔大学药学院进行。

结果

严重急性呼吸综合征(SARS)冠状病毒、中东呼吸综合征(MERS)冠状病毒以及蝙蝠严重急性呼吸综合征冠状病毒(Bat SARS - CoV) - bat - SL - CoVZC45和bat - SL - CoVZXC21的基因组序列与新型冠状病毒2019(nCoV - 2019)的难以区分的相似性,有助于确定主要治疗措施。研究人员推测,与SARS冠状病毒一样,新型冠状病毒2019(nCoV - 2019)中存在血管紧张素转换酶2(ACE2)受体结合。研究人员一直在研究人际传播、蝙蝠与人类之间中间宿主的可能性以及无症状病例的存在。据报道,潜伏期为0至14天,急性至慢性症状为咳嗽、鼻塞、高烧、呼吸困难、肺炎、双肺浸润性病变、呼吸衰竭,甚至死亡,包括儿科病例。机械通气、体外膜肺氧合、抗病毒药物的重新利用以及血浆输注已被证明有一定效果。几个国家已经开始临床试验,以评估一些药物的安全性和有效性,但用现有或新分子为人们接种疫苗的能力还需要时间。以前从SARS和MERS中吸取的教训使一些地区在迅速采取行动的能力方面装备良好。

结论

一级治疗包括重新利用抗病毒药物和抗疟药物,血浆输注应该会有帮助,但将现有或新分子开发成疫苗需要时间。这次疫情不可预测的发展轨迹需要仔细监测,以监控形势、制定策略、实施控制措施并制定适当的伦理法律和医学指南。

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