严重急性呼吸综合征冠状病毒2与新型冠状病毒肺炎

目前正在暴发流行的新型冠状病毒肺炎（COVID-19）的病原体是严重急性呼吸综合征冠状病毒2（SARS-CoV-2）,这是近年来继严重急性呼吸综合征冠状病毒（SARS-CoV）和中东呼吸综合征冠状病毒（MERSCoV）之后发现的能够感染人的第7种冠状病毒。SARS-CoV-2系单股正链RNA病毒,传染性强,人群普遍对其缺乏免疫力,疫情目前仍在持续。2020年1月30日（当地时间）,WHO将此次疫情列为国际关注的突发公共卫生事件（PHEIC）。本文就SARS-CoV-2病原学、致病性及COVID-19的检测诊断、预防控制和临床治疗等领域的进展进行讨论。     

蝙蝠相关的冠状病毒

2019年12月,新型冠状病毒肺炎（COVID-19）暴发,继2003年严重急性呼吸综合征（SARS）暴发后又给人类敲响了一记警钟。研究者通过溯源分析,发现COVID-19病原体严重急性呼吸综合征冠状病毒2（SARS-CoV-2）的自然宿主可能是中华菊头蝠。21世纪以来,全球共出现4次冠状病毒[严重急性呼吸综合征冠状病毒（SARS-CoV）、中东呼吸综合征冠状病毒（MERS-CoV）、猪急性腹泻综合征冠状病毒（SADS-CoV）、SARS-CoV-2]的暴发,给人类健康、公共卫生、经济发展及社会稳定造成了巨大的威胁与损失。大量证据表明,这4种冠状病毒的自然宿主可能均为蝙蝠。本文对蝙蝠相关冠状病毒的种类、全球地理分布及引起暴发的蝙蝠相关冠状病毒作一综述。     

Structural basis of SARS-CoV-2 3CLpro and anti-COVID-19 drug discovery from medicinal plants

The recent pandemic of coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 has raised global health concerns. The viral 3-chymotrypsin-like cysteine protease (3CL^pro) enzyme controls coronavirus replication and is essential for its life cycle. 3CL^pro is a proven drug discovery target in the case of severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV). Recent studies revealed that the genome sequence of SARS-CoV-2 is very similar to that of SARS-CoV. Therefore, herein, we analysed the 3CL^pro sequence, constructed its 3D homology model, and screened it against a medicinal plant library containing 32,297 potential anti-viral phytochemicals/traditional Chinese medicinal compounds. Our analyses revealed that the top nine hits might serve as potential anti- SARS-CoV-2 lead molecules for further optimisation and drug development process to combat COVID-19.     

新型冠状病毒肺炎的流行病学、临床治疗与疫情防控

本文系统介绍新型冠状病毒肺炎的病原学、流行病学、传播动力学、临床特征、治疗及防控等多个领域的最新研究进展,同时比较新型冠状病毒与严重急性呼吸综合症冠状病毒、中东呼吸综合症冠状病毒及H1N1流感病毒所致疫情特征的异同。新型冠状病毒的原始宿主可能为蝙蝠,患者和无症状感染者为传染源,可借助飞沫和接触途径进行人际传播,人群普遍易感。患者临床症状主要表现为发热和咳嗽,伴有白细胞和淋巴细胞减少,但目前尚无特效治疗药物。防控策略上,一方面应着力研发疫苗开展一级预防;另一方面继续贯彻对患者和密切接触者的隔离、佩戴口罩、及时进行公共场所消毒,同时大力研发快速检测试剂盒,实现对疾病的血清学监测,开展早发现、早诊断、早隔离、早治疗的二级防控策略。此外,应着力降低人群对疾病恐慌、加强防疫宣传与健康教育,共同防控疫情蔓延。     

三种人类高致病性冠状病毒的增殖和传播机制研究进展

严重急性呼吸综合征冠状病毒（SARS-CoV）、中东呼吸综合征冠状病毒（MERS-CoV）和严重急性呼吸综合征冠状病毒2（SARS-CoV-2）是目前已知的三种人类高致病性冠状病毒,由非结构蛋白、结构蛋白、附属蛋白和核糖核酸组成。病毒粒子通过冠状病毒的刺突糖蛋白（S蛋白）识别宿主受体,以膜融合方式进入宿主细胞,通过大型复制转录复合体在宿主细胞内复制,并通过干扰和抑制宿主的免疫应答来促进增殖。人类高致病性冠状病毒的宿主是人和脊椎动物,病毒粒子通过飞沫、接触、气溶胶等途径感染肺部细胞,也可能通过消化道、尿液、眼部等其他途径传播。本文基于现有研究结果讨论人类高致病性冠状病毒的增殖和传播机制,以期为阻断其传播和致病提供依据。     

Potential immunomodulatory role of sesamin in combating immune dysregulation associated with COVID-19

The ongoing outbreak of novel coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused an unprece...     

Antiviral,immunomodulatory, and anticoagulant effects of quercetin and its derivatives: Potential role in prevention and management of COVID-19

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has caused a devastating health crisis worldwide. In this review, we have discussed that prophylactic phytochemical quercetin supplementation in the form of foods or nutraceuticals may help manage the COVID-19 pandemic. The following evidence supports our argument. First, nuclear factor erythroid-derived 2-like 2 (NRF2) agonists abrogate replication of SARS-CoV-2 in lung cells, and quercetin is a potent NRF2 agonist. Second, quercetin exerts antiviral activity against several zoonotic coronaviruses, including SARS-CoV-2, mainly by inhibiting the entry of virions into host cells. Third, inflammatory pathways activated by nuclear factor kappa B, inflammasome, and interleukin-6 signals elicit cytokine release syndrome that promotes acute respiratory distress syndrome in patients with COVID-19, and quercetin inhibits these pro-inflammatory signals. Fourth, patients with COVID-19 develop thrombosis, and quercetin mitigates coagulation abnormalities by inhibiting plasma protein disulfide isomerase. This review provides a strong rationale for testing quercetin for the management of COVID-19.     

从一对夫妻患者的诊治过程探讨2019冠状病毒病(COVID-19)疑似患者的管理

观察2例2019冠状病毒病（COVID-19）疑似患者诊断、治疗以及隔离管理的过程,结合文献分析COVID-19疑似患者的临床特征和管理重点。COVID-19是由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染所致的疾病,SARS-CoV-2具有很强的传染性,甚至无症状感染者也可能传播病毒。SARS-CoV-2可通过接触传播、飞沫传播,并可能通过气溶胶传播。在临床发热门诊的患者管理中,准确识别并管理好疑似患者,采取严格的隔离措施,对院内感染的防控极为重要。     

SARS-CoV-2对神经系统损害的研究进展

由严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)所引起 的2019 冠状病毒病(coronavirus disease 2019,COVID-19)疫情在全球大暴发。SARS-CoV-2 感染除了可累及呼吸系统 外,还可导致严重的神经系统损伤。研究表明SARS-CoV-2 可通过血行和跨神经元途径入侵神经系统,并可能通过抑 制细胞免疫、低氧血症及炎症作用,诱导神经元变性与细胞凋亡,以及血管紧张素转化酶2(angiotensin converting enzyme 2,ACE2)机制造成COVID-19 患者的神经系统损害,导致患者颅内感染、中毒性脑病、急性脑血管疾病、肌 肉损害、周围神经系统损伤、急性脊髓炎、脱髓鞘疾病或其他神经系统疾病。     

Discovery of human coronaviruses pan-papain-like protease inhibitors using computational approaches

The papain-like protease (PL^pro) is vital for the replication of coronaviruses (CoVs), as well as for escaping innate-immune responses of the host. Hence, it has emerged as an attractive antiviral drug-target. In this study, computational approaches were employed, mainly the structure-based virtual screening coupled with all-atom molecular dynamics (MD) simulations to computationally identify specific inhibitors of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PL^pro, which can be further developed as potential pan-PL^pro based broad-spectrum antiviral drugs. The sequence, structure, and functional conserveness of most deadly human CoVs PL^pro were explored, and it was revealed that functionally important catalytic triad residues are well conserved among SARS-CoV, SARS-CoV-2, and middle east respiratory syndrome coronavirus (MERS-CoV). The subsequent screening of a focused protease inhibitors database composed of ∼7,000 compounds resulted in the identification of three candidate compounds, ADM_13083841, LMG_15521745, and SYN_15517940. These three compounds established conserved interactions which were further explored through MD simulations, free energy calculations, and residual energy contribution estimated by MM-PB(GB)SA method. All these compounds showed stable conformation and interacted well with the active residues of SARS-CoV-2 PL^pro, and showed consistent interaction profile with SARS-CoV PL^pro and MERS-CoV PL^pro as well. Conclusively, the reported SARS-CoV-2 PL^pro specific compounds could serve as seeds for developing potent pan-PL^pro based broad-spectrum antiviral drugs against deadly human coronaviruses. Moreover, the presented information related to binding site residual energy contribution could lead to further optimization of these compounds.     

qSOFA score poorly predicts critical progression in COVID-19 patients

Wiener Medizinische Wochenschrift - In December 2019, the new virus infection coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)...     

基于刺突蛋白靶点的抗新型冠状病毒药物研究进展

重症急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的新型冠状病毒肺炎(COVID-19)目前仍在不断蔓延,但针对该病毒的特效治疗药物尚在研发当中。本文基于冠状病毒生物学特点和病毒复制过程中的关键蛋白——刺突蛋白,介绍了相关药物作用位点及研究进展,为抗SARS-CoV-2药物的临床应用提供信息依据,为治疗COVID-19药物研发提供思路。     

Mobile Triage Applications: A Systematic Review in Literature and Play Store

Journal of Medical Systems - COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), spread rapidly and affected most of the world since its outbreak in Wuhan, China,...     

支气管镜技术在新型冠状病毒肺炎诊断中的应用及相关职业防护

由严重急性呼吸综合征冠状病毒2（SARS-CoV-2）引起的新型冠状病毒肺炎（COVID-19）已发展为全球大流行,对民众健康和经济发展造成严重影响。本文总结了SARS-CoV-2首次分离、鉴定样本的来源及病毒RNA病原学检测过程中存在的问题,探讨了支气管镜技术应用于COVID-19诊断的必要性和局限性,阐述了在对COVID-19患者进行支气管镜操作中的职业防护措施,提出加快研发支气管镜操作相关的一次性防护装置的重要性。     

男性新型冠状病毒肺炎患者生殖系统损伤机制研究进展

新型冠状病毒肺炎(COVID-19)在发病率和严重程度上存在显著的性别差异,同年龄段中男性患者多于女性患者。新型冠状病毒(SARS-CoV-2)利用血管紧张素转换酶(ACE)2受体进入人体细胞。由于ACE2在人类多个器官系统上有不同程度的表达,SARS-CoV-2除感染呼吸系统外,同样可以感染消化系统、神经系统、免疫系统等。睾丸为富含ACE2的器官之一,部分男性COVID-19患者精液中检出SARS-CoV-2,SARS-CoV-2可能损伤生殖系统。但SARS-CoV-2参与男性生殖系统损害的机制尚未完全阐明,目前研究主要集中在SARS-CoV-2对男性生殖的短期影响,并越来越重视其长期影响。本文总结了SARS-CoV-2介导男性COVID-19患者的生殖细胞损伤、性腺功能减退、睾丸炎症的可能机制,并指出目前研究存在的问题,为男性COVID-19患者生殖系统损伤的机制研究扩宽思路。     

The latest research progress of COVID-19 mutant strain "Mu" virus strain

Novel coronavirus pneumonia(COVID-19) is a highly pathogenic infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).Until now, the new crown pneumonia has caused hundreds of millions of people worldwide to be infected. Novel coronavirus pneumonia is still a high level of variation. Due to the high variability of COVID-19, there are already a large number of COVID-19 variant strains that are still at a high level of infection worldwide. Recently, WHO (WHO) released a new variant, "Mu" (μ, B.1.621) may be a high vaccine tolerance. This paper reviews the latest research progress of "Mu" virus strain in detail.     

Functional mutations of SARS-CoV-2: implications to viral transmission,pathogenicity and immune escape

The pandemic of coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to major public health challenges globally. The increasing viral lineages identified indicate that the SARS-CoV-2 genome is evolving at a rapid rate. Viral genomic mutations may cause antigenic drift or shift, which are important ways by which SARS-CoV-2 escapes the human immune system and changes its transmissibility and virulence. Herein, we summarize the functional mutations in SARS-CoV-2 genomes to characterize its adaptive evolution to inform the development of vaccination, treatment as well as control and intervention measures.     

A Comprehensive Review of COVID-19 Virology,Vaccines,Variants,and Therapeutics

Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),the causative pathogen of the coronavirus disease 2019(COVID-19),has caused more than 179 million in...     

营养支持在新型冠状病毒感染防治中的重要作用

新型冠状病毒（新冠病毒）感染导致了一场持续的全球大流行,适宜的营养支持有助于增强机体免疫力,提升高危人群对新冠病毒的防御能力,降低患病率,预防轻症感染者发展为重症,同时减少康复期不良症状的发生,是预防病毒感染、促进患者康复及改善预后的重要保障。以新冠病毒感染者病症特点为基础设计的全营养配方食品可提供配比适宜的全面营养支持,可有效改善患者营养状况、为提高生存质量提供有力技术支持。在当前新型冠状病毒防控的关键时期,需更加重视营养支持的核心作用,充分发挥营养支持的临床功效。     

新型冠状病毒肺炎患者围手术期处理策略与要点

新型冠状病毒肺炎（COVID-19）已发展成全球大流行,对公共卫生安全造成严重威胁。由于其病原体严重急性呼吸综合征冠状病毒2（SARS-CoV-2）可通过飞沫、接触等途径在人与人之间传播,疑似或确诊COVID-19患者在手术室或ICU接受治疗时,如何在实施全面有效治疗的过程中避免病毒进一步播散成为医务人员关注的重点与难点。本文针对SARS-CoV-2的传播特征、围手术期特殊环境及特定操作下的疾病处理和感染控制措施展开讨论。