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新型冠状病毒病(COVID-19)的流行病学、发病机制、临床病程和治疗的最新进展。

Novel coronavirus disease (COVID-19) update on epidemiology, pathogenicity, clinical course and treatments.

机构信息

Sisters of Charity" University Hospital, Zagreb, Croatia.

Faculty of Dental Medicine and Health, Osijek, Croatia.

出版信息

Int J Clin Pract. 2021 Apr;75(4):e13868. doi: 10.1111/ijcp.13868. Epub 2020 Dec 6.

Abstract

During the December of 2019, a series of patients with pneumonia caused by novel coronavirus; the severe acute respiratory syndrome (SARS) corona (COV-2), that is, COVID-19. Since the first cluster of cases was reported in China on 31 December 2019 until the 28 April 2020, there were internationally reported 3'000'000 cases, in over 185 countries, and 207'265 deaths. To date, it is still not unanimously clear which effects parameters of virus and host are important for the development of severe disease course. According to the most updated internationally available online cases register, COVID-19 disease has mild symptoms in around 85% of cases, there are 3%-10% of critical cases, and mortality is around 5%-7%. Since currently there is no available vaccine and no well-established specific antiviral therapy, numerous agents are being tested in clinical scenarios. The most common regimens include remdesivir, convalescent plasma. Widely used chloroquine, hydroxychloroquine and azithromycin combinations, as well as lopinavir-ritonavir were shown to have less efficient treatment effects. More severe cases of pneumonia and dyspnoea, or uncontrollable fever are treated as inpatients, and nearly 10% in intensive care units. Oxygen supplementation is indicated to maintain peripheral blood oxygenation over 90%-96%. Advanced support systems include mechanical ventilation and extracorporeal membranous support; however, those without targeted antiviral therapy represent only temporary bridge for scarce potential restitution in patient themselves. The aim of review is to present current state of the art in epidemiology, pathogenesis, clinical course and treatment of COVID-19 patients.

摘要

在 2019 年 12 月,一系列由新型冠状病毒引起的肺炎患者;即严重急性呼吸系统综合症(SARS)冠状病毒(COV-2),也就是 COVID-19。自 2019 年 12 月 31 日中国首例病例报告以来,截至 2020 年 4 月 28 日,已有 300 万例国际报告病例,分布在 185 个以上国家,207265 人死亡。迄今为止,对于病毒和宿主的哪些影响参数对于严重疾病过程的发展更为重要,仍未达成共识。根据目前可获得的最新国际在线病例登记,COVID-19 疾病在大约 85%的病例中症状较轻,有 3%-10%的病例为危重症,死亡率约为 5%-7%。由于目前尚无可用的疫苗和成熟的特效抗病毒治疗方法,许多药物正在临床中进行测试。最常见的方案包括瑞德西韦、恢复期血浆。广泛使用的氯喹、羟氯喹和阿奇霉素联合用药以及洛匹那韦-利托那韦的治疗效果较差。更严重的肺炎和呼吸困难或无法控制的发热患者作为住院患者治疗,近 10%的患者在重症监护病房治疗。需要氧疗来维持外周血氧饱和度在 90%-96%以上。高级支持系统包括机械通气和体外膜氧合;然而,没有针对性抗病毒治疗的患者只是为患者自身恢复提供的短暂桥梁。本文的目的是介绍 COVID-19 患者的流行病学、发病机制、临床病程和治疗的最新进展。

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