Department of Pneumonology, Oncology and Allergology, Medical University, Lublin, Poland.
Department of Medical Biology, Institute of Rural Health, Lublin, Poland.
Ann Agric Environ Med. 2021 Mar 18;28(1):27-43. doi: 10.26444/aaem/133896. Epub 2021 Mar 16.
The course of COVID-19 caused by the SARS-CoV-2 may be aggravated by bioaerosols containing other viruses, bacteria, and fungi, occurring mainly in the occupational environment. Hence, the diagnostics and treatment of COVID-19 should address such a possibility in the anamnesis, treatment and final recommendations for avoiding of adverse exposure.
As SARS-CoV-2 attacks primarily the respiratory system and the severe manifestation of COVID-19 is interstitial pneumonia, diagnostics should include the following clinical and laboratory examinations: chest X-ray; high resolution computed tomography (HRCT); pulmonary function tests; arterial-blood gas test; genetic tests for the presence of SARS-CoV-2, in the future with the use of highly specific and sensitive nano-based biosensors; tests for the presence of specific immunity against the antigens of microorganisms causing other infectious or allergic pulmonary diseases (in the case of anamnestic indications). Because an universally accepted treatment for COVID-19 does not exist, the hitherto prescribed antiviral and immune-modulating drugs should be used be with caution. In many cases, a better alternative could be a safe supportive therapy, such as supplementation of the diet with probiotics, prebiotics, vitamins and microelements.
The most important preventive measures against COVID-19 should include: vaccination; the use of filter or surgical masks; disinfection and sterilization; maintaining of well-functioning ventilation and air conditioning systems; reduction of the community air pollution which has been identified as an important factor increasing the COVID-19 severity. In the choice of preventive measures, the above should be considered for their potential efficacy against other bioaerosols as potential disease-aggravating agents.
由 SARS-CoV-2 引起的 COVID-19 病程可能会因职业环境中主要存在的含有其他病毒、细菌和真菌的生物气溶胶而加重。因此，COVID-19 的诊断和治疗应在病史、治疗和最终避免不良暴露的建议中考虑到这种可能性。
由于 SARS-CoV-2 主要攻击呼吸系统，COVID-19 的严重表现为间质性肺炎，因此诊断应包括以下临床和实验室检查：胸部 X 光检查；高分辨率计算机断层扫描（HRCT）；肺功能检查；动脉血气检查；SARS-CoV-2 基因检测，未来将使用高度特异和敏感的基于纳米的生物传感器；存在引起其他传染性或过敏性肺部疾病的微生物抗原的特异性免疫检测（如有病史提示）。由于目前尚无通用的 COVID-19 治疗方法，因此应谨慎使用迄今规定的抗病毒和免疫调节药物。在许多情况下，更好的替代方法可能是安全的支持性治疗，例如用益生菌、益生元、维生素和微量元素补充饮食。
预防 COVID-19 的最重要措施应包括：接种疫苗；使用过滤器或手术口罩；消毒和灭菌；保持功能良好的通风和空调系统；减少已确定为增加 COVID-19 严重程度的重要因素之一的社区空气污染。在选择预防措施时，应考虑上述措施对其他生物气溶胶的潜在功效，因为这些气溶胶可能会加重疾病。
