Voto Christian, Berkner Paul, Brenner Carol
Internal Medicine, College of Osteopathic Medicine, University of New England, Biddeford, USA.
Pediatrics, College of Osteopathic Medicine, University of New England, Biddeford, USA.
Cureus. 2020 Sep 10;12(9):e10357. doi: 10.7759/cureus.10357.
In December 2019, numerous cases of "pneumonia of unknown origin" were presenting throughout Wuhan, China. The pathogen was described to be a novel coronavirus and was subsequently classified as SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) due to similarities in its pathogenesis and conserved replicase sequence with SARS-CoV-1 (severe acute respiratory syndrome coronavirus 1). Containment measures were initiated; however, the virus began to spread rapidly to countries around the world, and on March 11, 2020, the World Health Organization (WHO) declared a worldwide pandemic. Since the WHO's declaration, the scientific community has produced an abundance of information about this virus. In this report, we provide a comprehensive review of original articles, clinical trials, and case series in order to produce a concise overview of the pathogenesis and treatment of SARS-CoV-2 (COVID-19 [coronavirus disease 2019]) for clinicians. This review includes data on the roles of the S protein, ACE2 (angiotensin-converting enzyme 2) receptor, and various human secretory proteases, such as transmembrane protease/serine subfamily member 2 and furin, in the pathogenesis of SARS-CoV-2. In addition, a thorough review of treatment options including oxygenation/ventilation strategies, dexamethasone, remdesivir, chloroquine/hydroxychloroquine, immune-based therapies, and anticoagulation are included. Information on this topic is changing rapidly but the authors believe that this review serves as an accurate representation of the current state of knowledge on these topics.
2019年12月，中国武汉出现了多例“不明原因肺炎”病例。病原体被描述为一种新型冠状病毒，由于其发病机制与严重急性呼吸综合征冠状病毒1（SARS-CoV-1）相似，且具有保守的复制酶序列，随后被归类为严重急性呼吸综合征冠状病毒2（SARS-CoV-2）。防控措施随即启动；然而，该病毒开始迅速传播至世界各国，并于2020年3月11日，世界卫生组织（WHO）宣布全球大流行。自WHO宣布以来，科学界已产生了大量关于这种病毒的信息。在本报告中，我们对原始文章、临床试验和病例系列进行了全面综述，以便为临床医生提供关于SARS-CoV-2（2019冠状病毒病[COVID-19]）发病机制和治疗的简明概述。本综述包括了关于S蛋白、血管紧张素转换酶2（ACE2）受体以及各种人类分泌蛋白酶，如跨膜蛋白酶/丝氨酸亚家族成员2和弗林蛋白酶，在SARS-CoV-2发病机制中作用的数据。此外，还对治疗方案进行了全面综述，包括氧合/通气策略、地塞米松、瑞德西韦、氯喹/羟氯喹、免疫疗法和抗凝治疗。关于这一主题的信息变化迅速，但作者认为本综述准确呈现了这些主题的当前知识状态。
