Dr. Li Dak Sum & Yip Yio Chin Center for Stem Cells and Regenerative Medicine, Department of Orthopedic Surgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China.
Zhejiang University-University of Edinburgh Institute, Key Laboratory of Tissue Engineering and Regenerative Medicine of Zhejiang Province, Zhejiang University School of Medicine, Hangzhou 310058, China.
J Zhejiang Univ Sci B. 2021 Apr 15;22(4):310-317. doi: 10.1631/jzus.B2000523.
Since December 2019, the novel coronavirus (severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)) has spread to many countries around the world, developing into a global pandemic with increasing numbers of deaths reported worldwide. To data, although some vaccines have been developed, there are no ideal drugs to treat novel coronavirus pneumonia (coronavirus disease 2019 (COVID-19)). By examining the structure of the coronavirus and briefly describing its possible pathogenesis based on recent autopsy reports conducted by various teams worldwide, this review analyzes the possible structural and functional changes of the human body upon infection with SARS-CoV-2. We observed that the most prominent pathological changes in COVID-19 patients are diffuse alveolar damage (DAD) of the lungs and microthrombus formation, resulting in an imbalance of the ventilation/perfusion ratio and respiratory failure. Although direct evidence of viral infection can also be found in other organs and tissues, the viral load is relatively small. The conclusion that the injuries of the extra-pulmonary organs are directly caused by the virus needs further investigation.
自 2019 年 12 月以来,新型冠状病毒(严重急性呼吸综合征冠状病毒 2(SARS-CoV-2))已传播到世界许多国家,发展成为一种全球大流行疾病,全球报告的死亡人数不断增加。到目前为止,尽管已经开发出一些疫苗,但尚无理想的药物可用于治疗新型冠状病毒肺炎(COVID-19)。通过检查冠状病毒的结构,并根据全球各团队最近进行的尸检报告简要描述其可能的发病机制,本综述分析了 SARS-CoV-2 感染后人体可能发生的结构和功能变化。我们观察到,COVID-19 患者最突出的病理变化是肺部弥漫性肺泡损伤(DAD)和微血栓形成,导致通气/灌注比例失衡和呼吸衰竭。尽管在其他器官和组织中也可以发现病毒感染的直接证据,但病毒载量相对较小。关于肺外器官的损伤是直接由病毒引起的结论需要进一步调查。