Brust Karen B, Papineni Vinayika, Columbus Cristie, Arroliga Alejandro C
Division of Infectious Disease, Department of Internal Medicine, Baylor Scott & White Medical Center - Temple, Temple, Texas.
Texas A&M Health Science Center, Texas A&M University, Austin, Texas.
Proc (Bayl Univ Med Cent). 2022 May 9;35(4):468-475. doi: 10.1080/08998280.2022.2068940. eCollection 2022.
In December 2019, China witnessed the emergence of a novel coronavirus, SARS-CoV-2. Its ability to spread quickly made it a global pandemic. The United States has been greatly affected, with more than 980,000 lives lost so far. Diagnosis is made primarily through nasopharyngeal swab for polymerase chain reaction. Point-of-care testing by antigen is less sensitive and specific and may require polymerase chain reaction confirmation. Management of the COVID-19 patient remains largely supportive. Steroids are now a therapy mainstay if the patient is hypoxic. Direct antivirals, such as nirmatrelvir/ritonavir, remdesivir, or molnupirivir, can be used if certain criteria are met. SARS-CoV-2 is transmitted primarily by inhalation of large droplets, though transmission by aerosolization may occur, particularly via certain procedures. In the hospital setting, use of personal protective equipment for the care of COVID-19 patients has largely remained the same, with full use of gowns, gloves, respirators, and eye protection. Inadequate supply at the start of the pandemic required innovative ways to reprocess and extend the use of personal protective equipment. Three vaccines are now available in the US, all with excellent efficacy against severe disease and hospitalization, though booster doses are needed to bolster waning antibody levels. The possibility of emerging variants continues to remain a threat to control of the pandemic. The leader of the World Health Organization, Dr. Tedros, has stated, "The pandemic will not be over anywhere until it's over everywhere."
2019年12月,中国出现了一种新型冠状病毒——严重急性呼吸综合征冠状病毒2(SARS-CoV-2)。其快速传播的能力使其成为全球大流行病。美国受到了极大影响,截至目前已有超过98万人丧生。诊断主要通过采集鼻咽拭子进行聚合酶链反应。抗原即时检测的敏感性和特异性较低,可能需要聚合酶链反应确认。对新冠患者的治疗在很大程度上仍以支持治疗为主。如果患者出现低氧情况,类固醇药物现在是主要治疗手段。如果符合某些标准,可以使用直接抗病毒药物,如奈玛特韦/利托那韦、瑞德西韦或莫努匹韦。SARS-CoV-2主要通过吸入大飞沫传播,不过也可能通过气溶胶传播,特别是在某些特定操作过程中。在医院环境中,对新冠患者进行护理时使用个人防护装备的情况基本保持不变,要充分使用隔离衣、手套、呼吸器和眼部防护用品。疫情初期防护用品供应不足,需要创新方法对个人防护装备进行再处理和延长其使用期限。美国现在有三种疫苗可供使用,所有这些疫苗对重症疾病和住院治疗都有很好的疗效,不过需要接种加强针来提高逐渐下降的抗体水平。新变种出现的可能性仍然是控制疫情的一大威胁。世界卫生组织总干事谭德塞博士表示:“疫情在任何地方都不会结束,除非在所有地方都结束。”