Department of Medicine and Infectious Diseases, Faculty of Medicine and Infectious Diseases, Cairo University, Giza, 12211, Egypt.
Environ Sci Pollut Res Int. 2021 Apr;28(16):19589-19600. doi: 10.1007/s11356-021-12553-1. Epub 2021 Mar 2.
Bats act as a natural reservoir for many viruses, including coronaviruses, and have played a crucial epidemiological role in the emergence of many viral diseases. Coronaviruses have been known for 60 years. They are usually responsible for the induction of mild respiratory signs in humans. However, since 2002, the bat-borne virus started to induce fatal epidemics according to WHO reports. In this year, the first serious human coronavirus epidemic (severe acute respiratory syndrome; SARS) occurred (China, 8098 cases, 774 deaths [9.5% of the cases] in 17 countries). The case fatality was higher in elderly patients above 60 years and reached 50% of the cases. SARS epidemic was followed 10 years later by the emergence of the middle east respiratory syndrome (MERS) in Saudi Arabia (in 2012, 2260 cases, 803 deaths [35.5% of the cases] in 27 countries). Finally, in December 2019, a new epidemic in Wuhan, China, (corona virus disease 2019, COVID-19) emerged and could spread to 217 countries infecting more than 86,255,226 cases and killing 1,863,973 people by the end of 2020. There are many reasons why bats are ideal reservoir hosts for viral diseases such as the tolerance of their immune system to the invading viruses for several months. They can actively shed the viruses, although they develop no clinical signs (will be discussed in details later in the review). Bats were directly or indirectly involved in the three previous coronavirus epidemics. The indirect transmission takes place via intermediate hosts including civet cats for SARS and dromedary camels in the case of MERS. Although bats are believed to be the source of COVID-19 pandemic, direct pieces of evidence are still lacking. Therefore, coronaviruses' role in epidemics induction and the epidemiological role of bats are discussed. The current work also presents different evidence (phylogenetic data, animal experiments, bats artificial infection studies, and computerized models of SARS-CoV2 evolution) that underline the involvement of bats in the epidemiology of the pandemic.
蝙蝠是许多病毒(包括冠状病毒)的天然宿主,在许多病毒性疾病的出现中发挥了至关重要的流行病学作用。冠状病毒已经存在了 60 年。它们通常会导致人类出现轻微的呼吸道症状。然而,自 2002 年以来,据世界卫生组织报告,蝙蝠携带的病毒开始引发致命的流行。在这一年,首次发生了严重的人类冠状病毒流行(严重急性呼吸综合征;SARS)(中国,8098 例,17 个国家中有 774 人死亡[病例的 9.5%])。在 60 岁以上的老年患者中,病死率更高,达到病例的 50%。SARS 流行 10 年后,沙特阿拉伯又出现了中东呼吸综合征(MERS)(2012 年,2260 例,27 个国家中有 803 人死亡[病例的 35.5%])。最后,2019 年 12 月,中国武汉出现了一种新的疫情(2019 年冠状病毒病,COVID-19),并可能传播到 217 个国家,感染超过 86255226 例,截至 2020 年底,有 1863973 人死亡。蝙蝠之所以成为病毒疾病的理想宿主,有很多原因,例如它们的免疫系统能够耐受入侵病毒长达数月之久。它们可以主动排出病毒,尽管它们没有出现临床症状(这将在后面的综述中详细讨论)。蝙蝠直接或间接地参与了之前的三次冠状病毒流行。间接传播发生在中间宿主身上,包括 SARS 中的果子狸和 MERS 中的单峰骆驼。虽然蝙蝠被认为是 COVID-19 大流行的源头,但直接证据仍然缺乏。因此,讨论了冠状病毒在引发流行中的作用以及蝙蝠的流行病学作用。目前的工作还提供了不同的证据(系统发育数据、动物实验、蝙蝠人工感染研究以及 SARS-CoV2 进化的计算机模型),这些证据强调了蝙蝠在大流行流行病学中的参与。