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新型冠状病毒肺炎:最新综述——从形态学到发病机制

COVID-19: An up-to-date review - from morphology to pathogenesis.

作者信息

Bal Amanjit, Agrawal Ranjan, Vaideeswar Pradeep, Arava Sudheer, Jain Amita

机构信息

Department of Pathology, PGIMER, Chandigarh, India.

Department of Pathology, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India.

出版信息

Indian J Pathol Microbiol. 2020 Jul-Sep;63(3):358-366. doi: 10.4103/IJPM.IJPM_779_20.

Abstract

The entire world is under a devastating pandemic caused by COVID-19 with a high mortality rate. Knowledge of the viral structure, factors that help in its progression and spread, pathological findings, diagnostic methods and, treatment modalities helps in understanding the viral disease and also in treating the patients in a better way besides preventing the community spread of this deadly infection. The causative agent is a single- stranded RNA virus. The clinical spectrum varies in symptomatic and asymptomatic patients, who later become potential silent carriers, thus unknowingly spreading the virus. The virus constantly undergoes recombination, with reports of cross-species infections. Studies have indicated a strong immunological basis of COVID-19 infection. Not only does it weaken the immune system causing multi-organ involvement but also helps in its progression and spread to others.Multiple organs especially lungs, heart, kidney, gastrointestinal and hepatic system, brain and skin are affected varying in their severity. Similarly, persons with associated co-morbidities are likely to be affected more in terms of the number as well as in the severity. Real- time reverse transcription polymerase chain reaction confirms the presence of COVID-19 infection. Serological diagnosis helps in diagnosing an ongoing outbreak or retrospective infection. Furthermore, it also identifies individuals who have been infected or have recovered from the disease especially the asymptomatic. This helps in the development of an effective vaccine indicating the status of herd immunity in the community. Different treatment modalities are being tried and under trial. This review article thus highlights the global epidemiological status, characteristic of the virus, symptomatology of the patients, role of diagnostic tests available, organs affected including their morphological changes and the latest line of treatment of COVID-19.

摘要

整个世界正处于由新冠病毒引起的毁灭性大流行之中,其死亡率很高。了解病毒结构、有助于其进展和传播的因素、病理发现、诊断方法以及治疗方式,不仅有助于理解这种病毒性疾病,还能更好地治疗患者,同时防止这种致命感染在社区传播。病原体是一种单链RNA病毒。有症状和无症状患者的临床症状各不相同,无症状患者后来可能成为潜在的隐性携带者,从而在不知不觉中传播病毒。该病毒不断发生重组,并有跨物种感染的报道。研究表明新冠病毒感染有很强的免疫学基础。它不仅会削弱免疫系统导致多器官受累,还会促进其进展并传播给他人。多个器官尤其是肺、心脏、肾脏、胃肠道和肝脏系统、大脑和皮肤都会受到影响,严重程度各不相同。同样,患有相关合并症的人在感染人数和严重程度方面可能受影响更大。实时逆转录聚合酶链反应可确诊新冠病毒感染。血清学诊断有助于诊断正在发生的疫情或回顾性感染。此外,它还能识别已感染或已从该病康复的个体,尤其是无症状感染者。这有助于开发有效的疫苗,表明社区中群体免疫的状况。目前正在尝试并试验不同的治疗方式。因此,这篇综述文章重点介绍了新冠病毒的全球流行病学状况、病毒特征、患者症状、现有诊断测试的作用、受影响的器官(包括其形态变化)以及新冠病毒的最新治疗方法。

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