Hui David S C, Zumla Alimuddin
Department of Medicine & Therapeutics and Stanley Ho Centre for Emerging Infectious Diseases, The Chinese University of Hong Kong, Hong Kong, Hong Kong Special Administrative Region, China.
Division of Infection and Immunity, Department of Infection, Centre for Clinical Microbiology, University College London, and NIHR Biomedical Research Centre, University College London Hospitals, London, UK.
Curr Opin Pulm Med. 2022 May 1;28(3):166-173. doi: 10.1097/MCP.0000000000000875. Epub 2022 Mar 9.
The current article reviews the latest information on the epidemiology, clinical features, diagnostics, clinical management and prevention of coronavirus disease 2019 (COVID-19).
Atypical pneumonia due to severe acute respiratory syndrome coronavirus-2 emerged in December 2019 in a market in Wuhan, China and rapidly evolved into a pandemic in March 2020. Viral loads of patients with COVID-19 peak in the first week of illness around day 2-4 and hence there is very high-transmission potential causing community outbreaks. Asymptomatic and presymptomatic transmission is a hallmark of COVID-19. Several variants of concern (VOC) have emerged over the last 2 years and Omicron is the predominant variant in many countries. PCR is the standard diagnostic test while rapid antigen test is a useful supplementary test. Serology tests provide indirect evidence of infection 1 -2 weeks after the onset of symptoms. Molnupiravir and nirmatrelvir are oral antiviral agents that may reduce the risk of hospitalization and deaths if administered early to high-risk subjects. Remdesivir, baricitinib, anti-IL-6 tocilizumab and dexamethasone are frequently used for treatment of patients with respiratory failure.
COVID-19 pandemic progresses relentlessly with substantial morbidity and mortality especially in unvaccinated subjects. Mass COVID-19 vaccinations are the most important measure for control of the COVID-19 pandemic.
本文综述了2019冠状病毒病（COVID-19）的流行病学、临床特征、诊断、临床管理及预防方面的最新信息。
2019年12月，中国武汉一个市场出现了由严重急性呼吸综合征冠状病毒2引起的非典型肺炎，并于2020年3月迅速演变成大流行。COVID-19患者的病毒载量在发病第一周的第2至4天左右达到峰值，因此具有很高的传播潜力，可导致社区暴发。无症状和症状前传播是COVID-19的一个标志。在过去两年中出现了几种值得关注的变异株（VOC），奥密克戎是许多国家的主要变异株。聚合酶链反应（PCR）是标准诊断检测方法，而快速抗原检测是一种有用的补充检测方法。血清学检测在症状出现后1至2周提供感染的间接证据。莫努匹拉韦和奈玛特韦是口服抗病毒药物，如果早期给予高危人群，可能会降低住院和死亡风险。瑞德西韦、巴瑞替尼、抗白细胞介素6托珠单抗和地塞米松常用于治疗呼吸衰竭患者。
COVID-19大流行无情地发展，发病率和死亡率很高，尤其是在未接种疫苗的人群中。大规模接种COVID-19疫苗是控制COVID-19大流行的最重要措施。
