《新型冠状病毒肺炎疫情下县域高血压管理的专家建议》解读

正自2019年12月下旬开始,我国各省份及境外均出现了新型冠状病毒(急性呼吸综合征冠状病毒2,severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)感染的疫情~[1],WHO宣布将SARS-CoV-2肺炎引发的疾病的英文名称定为"COVID-19(coronavirus disease 2019)"~[2]。疫情期间,针对我国庞大的高血压患者群体,尤其是更多分布于基层的高血压患者     

新型冠状病毒关切变异株的研究进展

[摘要]?新型冠状病毒（severe acute respiratory syndrome coronavirus 2, SARS-CoV-2）属于β属冠状病毒,是一类具有囊膜的线性单股正链RNA病毒,可引起人类罹患新型冠状病毒肺炎（coronavirus disease 2019, COVID-19）。自2019年12月被发现以来,SARS-CoV-2迅速在全球流行蔓延,已导致近650万人死亡,给各国医疗卫生体系带来沉重负担,成为自二战以来最严重的全球性突发公共卫生事件。SARS-CoV-2在广泛复制的过程中不断发生变异,产生新的变异株。截至目前,WHO共定义了5种关切变异株（variants of concern, VOC）,分别为Alpha、Beta、Gamma、Delta和Omicron。SARS-CoV-2 VOC在传染性、致病性、中和抗体敏感性和免疫逃逸等方面均有可能增强。本文从冠状病毒概况、SARS-CoV-2 VOC的分类以及VOC对COVID-19诊治的影响等几个方面进行了综述,为更精准疫情防控提供科学依据,为后续研究提供科学参考。     

新型冠状病毒肺炎合并消化道、肝脏、胰腺多系统损伤研究

新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)是目前国际关注的突发公共卫生事件。随着感染人数的不断增加,研究发现新型冠状病毒(SARS-CoV-2)感染患者除了典型的呼吸系统表现外,也出现了SARS-CoV-2感染相关的消化道、肝脏、胰腺等多脏器损伤。本文结合最新研究,对COVID-19相关的消化道、肝脏、胰腺等多系统损伤进行概述,旨在帮助临床医师提高对该疾病的认识,优化治疗方案,降低病死率。     

免疫炎症反应对高血压合并新型冠状病毒肺炎的影响

2019年12月,由严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome-coronavirus-2,SARS-CoV-2)引起的新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)暴发,对人类造成了巨大的威胁,截至2020年10月11日,W...     

2019新型冠状病毒肺炎的挑战和机遇——对新型冠状病毒肺炎的认识及防治思考

新型冠状病毒(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)引发的新型冠状病毒肺炎(coronavirus disease 2019,COVID-19)的持续爆发于2019年12月底在湖北武汉被首次报道,确诊病例每天都在增加,造成的死亡人数已超过2002/2003在我国爆发的SARS病毒,成为受全球关注的突发公共卫生事件,所有政府和医疗机构都处于高度戒备状态.在此,我们根据目前掌握的数据,大体对COVID-19的基因组学、流行病学、临床表现、诊断、治疗等方面进行了概述.     

新型冠状病毒病（COVID-19）并发心肌损伤的研究现状

新型冠状病毒病（coronavirus disease 2019,COVID-19）是由急性呼吸综合征新型冠状病毒（SARS-CoV-2）引起的一种感染性极强的严重呼吸系统综合征,目前已形成世界性大爆发,给人类健康和全球经济带来了极大的影响。现有研究表明,COVID-19除了影响呼吸系统外,还对心血管系统有侵害作用,引起心肌损伤,预后较差。本文就现有的COVID-19并发心肌损伤的病原学、潜在的发病机制、相关临床表现特征、治疗原则及预后等方面研究进行论述,旨在加深临床医师对COVID-19并发心肌损伤的认识。     

2019新型冠状病毒肺炎研究进展

自2019年12月下旬,不明原因肺炎迅速蔓延,中国疾控中心立即开展了流行病学和病因调查[1]。随后高福团队鉴定出一种新型冠状病毒为病原体[2],世界卫生组织将其命名为2019年新型冠状病毒(2019-nCoV),目前该病毒又有了新的命名:SARS-COV-2(severe acute respiratory syndrome coronavirus 2),由其引发的疾病命名为2019冠状病毒病(Corona Virus Disease-9,COVID-19),受感染患者多累及肺部,因此国家卫生健康委员会将其引起的肺炎命名为新型冠状病毒肺炎(新冠肺炎,NCP),并将COVID-19列为《中华人民共和国传染病防治法》规定的乙类传染病,采取甲类传染病的预防及控制措施。     

《2021年欧洲肝病学会专家立场声明:慢性肝病、肝胆恶性肿瘤及肝移植受者COVID-19疫苗的接种》摘译

正2019年以来,严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)引起的冠状病毒病-2019(coronavirus disease 2019,COVID-19;国内习惯称为新型冠状病毒肺炎)疫情肆虐全球。据世界卫生组织(WHO)评估,截至2021年1月,全球已有近1亿人感染SARSCoV-2。有慢性肝病(chronic liver diseases,CLD)的人群,     

新型冠状病毒感染相关心肌损伤研究现状

2019年年末,由严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)引起的新型冠状病毒感染(coronavirus disease 2019,COVID-19)迅速扩散,在全球范围内出现大流行,由于其毒株变异速度快、传染性强,给世界各国带来了沉重的医疗负担和经济负担。COVID-19可累及全身多个系统,除了典型的呼吸系统症状外,COVID-19患者还可并发心肌损伤。随着研究的不断深入,目前对COVID-19相关心肌损伤的认知也得到进一步提升。笔者对COVID-19相关心肌损伤的研究现状作一综述,以加深临床医生对该疾病的认识。     

2019冠状病毒病研究纪实:至2020年3月11日

2019年12月1日,武汉市出现首例不明原因肺炎病例,2020年1月8日确认病原体为新型冠状病毒,2020年1月31日世界卫生组织(WHO)将病原体暂命名为2019新冠病毒(2019-nCoV),2020年2月8日国家卫健委将该不明原因肺炎命名为新型冠状病毒肺炎(简称新冠肺炎,novel coronavirus pneumonia),2020年2月11日,WHO依据规则将新冠肺炎正式命名为2019冠状病毒病(COVID-19),同一天,国际病毒分类委员会将2019新冠病毒正式命名为严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)。2020年3月11日,WHO将新冠疫情流行趋势升级为全球大流行状态。新冠疫情暴发后,国内外研究人员迅速开展流行病学调查、短时间内分离鉴定病毒、开展病原学研究、建立检测方法、完善诊疗方案、探索致病机制、研发药物和疫苗,有效阻止了国内疫情蔓延,也为世界疫情防控赢得了时间窗口。本文拟以时间为轴线,从病原体、病毒宿主、流行病学、检测方法、致病机制和临床诊疗6个方面记述2019冠状病毒病研究的重要进展。     

Markers Associated with COVID-19 Susceptibility,Resistance, and Severity

In December 2019, the latest member of the coronavirus family, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in Wuhan, China, leading to the outbreak of an unusual viral pneumonia known as coronavirus disease 2019 (COVID-19). COVID-19 was then declared as a pandemic in March 2020 by the World Health Organization (WHO). The initial mortality rate of COVID-19 declared by WHO was 2%; however, this rate has increased to 3.4% as of 3 March 2020. People of all ages can be infected with SARS-CoV-2, but those aged 60 or above and those with underlying medical conditions are more prone to develop severe symptoms that may lead to death. Patients with severe infection usually experience a hyper pro-inflammatory immune reaction (i.e., cytokine storm) causing acute respiratory distress syndrome (ARDS), which has been shown to be the leading cause of death in COVID-19 patients. However, the factors associated with COVID-19 susceptibility, resistance and severity remain poorly understood. In this review, we thoroughly explore the correlation between various host, viral and environmental markers, and SARS-CoV-2 in terms of susceptibility and severity.     

新型冠状病毒肺炎心血管并发症研究现状

新型冠状病毒肺炎是由严重急性呼吸综合征冠状病毒2引起的一种传染性疾病,目前的临床证据表明,新型冠状病毒肺炎合并基础心血管系统疾病的患者死亡风险明显增加,大部分患者在病程中会发生心肌炎、心肌损伤、心律失常和心肌病等。该文主要阐述新型冠状病毒肺炎心血管并发症的研究现状。     

Favorable Outcome Following Sotrovimab Monoclonal Antibody in a Patient with Prolonged SARS-CoV-2 Omicron Infection with HIV/AIDS

Persistent viral shedding or prolonged coronavirus disease 2019 (COVID-19) symptom is one of unresolved problem in immunocompromised individuals. We herein report an HIV/AIDS patient with Pneumocystis jirovecii pneumonia and prolonged COVID-19, possibly due to immune reconstitution inflammatory syndrome. His viral shedding and COVID-19 symptoms persisted for 39 days but were promptly resolved following sotrovimab monoclonal antibody therapy. This case suggests that prolonged COVID-19 and persistent viral shedding due to severe cellular immunodeficiency can occur in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron infection and that sotrovimab is effective in the treatment of prolonged COVID-19 caused by omicron/BA.1.     

Implications of the Immune Polymorphisms of the Host and the Genetic Variability of SARS-CoV-2 in the Development of COVID-19

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is responsible for the current pandemic affecting almost all countries in the world. SARS-CoV-2 is the agent responsible for coronavirus disease 19 (COVID-19), which has claimed millions of lives around the world. In most patients, SARS-CoV-2 infection does not cause clinical signs. However, some infected people develop symptoms, which include loss of smell or taste, fever, dry cough, headache, severe pneumonia, as well as coagulation disorders. The aim of this work is to report genetic factors of SARS-CoV-2 and host-associated to severe COVID-19, placing special emphasis on the viral entry and molecules of the immune system involved with viral infection. Besides this, we analyze SARS-CoV-2 variants and their structural characteristics related to the binding to polymorphic angiotensin-converting enzyme type 2 (ACE2). Additionally, we also review other polymorphisms as well as some epigenetic factors involved in the immunopathogenesis of COVID-19. These factors and viral variability could explain the increment of infection rate and/or in the development of severe COVID-19.     

Alcohol use disorder as a potential risk factor for COVID-19 severity: A narrative review

In Dec. 2019-January 2020, a pneumonia illness originating in Wuhan, China, designated as coronavirus disease 2019 (COVID-19) was shown to be caused by a novel RNA coronavirus designated as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). People with advanced age, male sex, and/or underlying health conditions (obesity, type 2 diabetes, cardiovascular disease, hypertension, chronic kidney disease, and chronic lung disease) are especially vulnerable to severe COVID-19 symptoms and death. These risk factors impact the immune system and are also associated with poor health, chronic illness, and shortened longevity. However, a large percent of patients without these known risk factors also develops severe COVID-19 disease that can result in death. Thus, there must exist risk factors that promote exaggerated inflammatory and immune response to the SARS-CoV-2 virus leading to death. One such risk factor may be alcohol misuse and alcohol use disorder because these can exacerbate viral lung infections like SARS, influenza, and pneumonia. Thus, it is highly plausible that alcohol misuse is a risk factor for either increased infection rate when individuals are exposed to SARS-CoV-2 virus and/or more severe COVID-19 in infected patients. Alcohol use is a well-known risk factor for lung diseases and ARDS in SARS patients. We propose that alcohol has three key pathogenic elements in common with other COVID-19 severity risk factors: namely, inflammatory microbiota dysbiosis, leaky gut, and systemic activation of the NLRP3 inflammasome. We also propose that these three elements represent targets for therapy for severe COVID-19.     

How to manage inflammatory bowel disease during the COVID-19 pandemic: A guide for the practicing clinician

Managing inflammatory bowel disease (IBD) during the coronavirus disease 2019 (COVID-19) pandemic has been a challenge faced by clinicians and their patients, especially concerning whether to proceed with biologics and immunosuppressive agents in the background of a global outbreak of a highly contagious new coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2). The knowledge about the impact of this virus on patients with IBD, although it is still scarce, is rapidly evolving. In particular, concerns surrounding medications’ impact for IBD on the risk of acquiring SARS-CoV-2 infection or developing COVID-19, and potentially exacerbate viral replication and the COVID-19 course, are a current thinking of both practicing clinicians and providers caring for patients with IBD. Managing patients with IBD infected with SARS-CoV-2 depends on both the clinical activity of the IBD and the occasional development and severity of COVID-19. In this review, we summarize the current data regarding gastrointestinal involvement by SARS-CoV-2 and pharmacologic and surgical management for IBD concerning this infection, and the COVID-19 impact on both the patient's psychological functioning and endoscopy services, and we concisely summarize the telemedicine roles during the COVID-19 pandemic.     

Current understanding of the impact of COVID-19 on gastrointestinal disease: Challenges and openings

The novel coronavirus disease-2019(COVID-19)is caused by a positive-sense single-stranded RNA virus which belongs to the Coronaviridae family.In March 2019 the World Health Organization declared that COVID-19 was a pandemic.COVID-19 patients typically have a fever,dry cough,dyspnea,fatigue,and anosmia.Some patients also report gastrointestinal(GI)symptoms,including diarrhea,nausea,vomiting,and abdominal pain,as well as liver enzyme abnormalities.Surprisingly,many studies have found severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)viral RNA in rectal swabs and stool specimens of asymptomatic COVID-19 patients.In addition,viral receptor angiotensin-converting enzyme 2 and transmembrane protease serine-type 2,were also found to be highly expressed in gastrointestinal epithelial cells of the intestinal mucosa.Furthermore,SARS-CoV-2 can dynamically infect and replicate in both GI and liver cells.Taken together these results indicate that the GI tract is a potential target of SARS-CoV-2.Therefore,the present review summarizes the vital information available to date on COVID-19 and its impact on GI aspects.     

Case report: Nutrition therapy and side-effects monitoring in critically ill coronavirus disease 2019 patients

An outbreak of pneumonia proved to be infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), named Coronavirus Disease 2019 (COVID-19) by World Health Organization (WHO), has rapidly and widely spread to the whole world, affecting thousands of people. COVID-19 patients have poor gastrointestinal function and microecological disorders, which lead to the frequent occurrence of aspiration pneumonia, gastric retention, and diarrhea. In the meanwhile, it takes a certain period of time for nutrition therapy to reach the patient's physiological amount. Refeeding syndrome and hypoglycemia may occur during this period, causing the high risk of death in critical patients. Therefore, we reported the nutrition therapy and side-effects monitoring as well as the adjustment of the nutrition therapy of 2 critical COVID-19 patients, thus provide clinical evidence for nutrition therapy and prevention of the side effects.     

Coronavirus disease–2019 and the intestinal tract: An overview

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can progress to a severe respiratory and systemic disease named coronavirus disease–2019 (COVID-19). The most common symptoms are fever and respiratory discomfort. Nevertheless, gastrointestinal infections have been reported, with symptoms such as diarrhea, nausea, vomiting, abdominal pain, and lack of appetite. Importantly, SARS-CoV-2 can remain positive in fecal samples after nasopharyngeal clearance. After gastrointestinal SARS-CoV-2 infection and other viral gastrointestinal infections, some patients may develop alterations in the gastrointestinal microbiota. In addition, some COVID-19 patients may receive antibiotics, which may also disturb gastrointestinal homeostasis. In summary, the gastrointestinal system, gut microbiome, and gut-lung axis may represent an important role in the development, severity, and treatment of COVID-19. Therefore, in this review, we explore the current pieces of evidence of COVID-19 gastrointestinal manifestations, possible implications, and interventions.