新型冠状病毒肺炎药物治疗的研究进展

2019年12月,中国以湖北省武汉市为中心暴发了一场新型冠状病毒导致的肺炎疫情,称为新型冠状病毒肺炎(coronavirus disease 2019, COVID-19)疫情。截至2020年3月1日24时,据我国31个省(自治区、直辖市)和新疆生产建设兵团报告,累计确诊病例80 026例,中国港澳台地区确诊148例。目前,COVID-19无特效抗病毒药物或疫苗,治疗药物的选择主要是基于既往严重急性呼吸综合征、中东呼吸综合征及其他一些流感病毒的治疗经验。瑞德西韦、氯喹、法匹拉韦、恢复期血浆在临床上初见疗效,但其安全性和疗效,还须要大样本量进一步验证。利巴韦林、洛匹那韦/利托那韦、干扰素-α、阿比多尔联合应用,应注意其不良反应,慎重选择。达鲁那韦目前还停留在体外实验阶段,中医辩证治疗还须进一步验证。本文围绕目前临床上治疗COVID-19药物的研究进展进行综述,为COVID-19治疗提供参考。     

新型冠状病毒肺炎诊断研究进展

新型冠状病毒肺炎(COVID-19)疫情以来,疾病的高传染性使确诊人数剧增,同时死亡人数也在日益增加。现全球已有200余个国家或地区出现感染病例。疾病的早诊可以有效控制疾病传播,同时使感染者得到有效的隔离和救治,提高生存率。目前,中国COVID-19的控制取得了阶段性胜利。本文对COVID-19的临床表现、实验室检查、...     

新型冠状病毒肺炎诊治

2019年12月在武汉市爆发新型冠状病毒肺炎新型冠状病毒肺炎(COVID-19)中国引起严重疫情并在世界多个国家引起疫情,疫情来势凶猛及传染性强。我们对引起此次疫情的病原体-2019新型冠状病毒知之甚少,我们在此结合近期在新冠肺炎方面发表相关的研究,介绍新冠肺炎的诊断与治疗体会。     

冠状病毒及新型冠状病毒肺炎防控策略

随着科学技术的发展和医学研究不断取得新进步,人们认识到病毒引发的传染性疾病仍然对人类健康构成巨大威胁,据世界卫生组织(World Health Organization,WHO)宣布,地球上对人类危害最大的有九大病毒:(1)克里米亚-刚果出血热病毒(Crimean-Congo haemorrhagic fever virus,CCHFV);(2)埃博拉病毒(Ebola virus,EBOV);(3)马尔堡病毒(Marburg virus,MBV);(4)艾滋病病毒(Human immunodeficiency virus,HIV);(5)寨卡病毒(Zika virus,ZKV);(6)狂犬病毒(rabies virus,RBV);(7)流感病毒(influenza virus,FLV);(8)尼帕病毒和裂谷热病毒(Nipah virus and riftvelley fever virus,NV-RFV);(9)冠状病毒(coronavirus,CoV),其中包括中东呼吸综合征(Middle East respiratory syndrome,MERS)和重症急性呼吸综合征(severe acute respiratory syndrome,SARS)等。特别是EBOV和CoV传播较快,病死率高,造成了严重公共健康危机[1-3]。     

老年人新型冠状病毒肺炎1例的治疗

1临床资料患者,女性,71岁,湖北钟祥市人。因发热、干咳半天入院。于2020年1月22日下午出现低热、干咳,自觉诱因是1月21日游漓江时吹风所致,最高体温37.3℃,伴咽痒、鼻塞、流涕。入院查体急查血常规:白细胞6.06×10^9/L,血红蛋白140 g/L,血小板164×10^9/L,淋巴细胞百分比32.2%。     

1例危重型新型冠状病毒肺炎患者的护理体会

新型冠状病毒肺炎(2019 novel corona virus COVID-19)病原体为2019新型冠状病毒(2019 novel coronavirus,2019-nCoV)[1],2019年12月,中国武汉曝发了COVID-19疫情[2-3],随着疫情的蔓延,我国其他地区及境外也相继出现了此病例.该病作为急性呼吸道传染病已纳入 中华人民共和国传染病防治法 规定乙类传染病,按甲类传染病管理.截至2020年2月20日,中国确诊病例已达75465例,累计出院18264例,累计死亡2236例.NCP分为轻型、普通型、重型及危重型[1].患者最初表现为发烧,有或没有呼吸道症状,但所有患者后来在胸部CT成像[2,4]上出现不同程度的肺部异常.     

Guangdong's experience in defeating the COVID-19

To provide valuable experience for other countries currently fighting the COVID-19 pandemic by systematically analyzing the effects of control policies on coping with COVID-19 in Guangdong Province of China.Integrating qualitative and quantitative methods to systematically analyze the effects of control policies on fighting COVID-19 with official data in Guangdong Province.Between January 19, 2020 and February 26, 2020, Guangdong Province issued 6 critical control policies to cope with COVID-19 and achieved effects in the following 3-phase.

• 1.Phase 1: from January 19 to February 7, 2020, Guangdong Province issued the following 4 policies: activating the first-level response to public health emergencies; holding press conferences during the epidemic; carrying out grid investigation; and taking the lead in covering the treatment expenses of suspected patients in basic medical insurance. In this phase, the number of confirmed cases increased rapidly and the number of recovered cases increased gradually.
• 2.Phase 2: from February 8 to 14, Guangdong Province issued the following 2 polices: applying Toujie Quwen granules to 30 designated hospitals and launching a registration and report system for the sale of fever and cough drugs. In this phase, the growth trend of confirmed cases had slowed down on February 10 and then increased slowly on February 14. The number of recovered cases increased rapidly on February 10 and then increased rapidly on February 14.
• 3.Phase 3: from February 15 to 26, the increase number of confirmed cases was a small in magnitude on February 20 and then increased slowly on February 26. The number of recovered cases increased rapidly on February 20 and then increased rapidly on February 26.

Guangdong Province implemented 6 control policies in 3-phase and finally successfully defeated the COVID-19. In the first phase, the first 4 control policies showed initial effects on COVID-19 epidemic control. In the second phase, the last 2 control policies greatly contributed to containing the COVID-19 epidemic. In the third phase, the 6 control policies completely overcame the COVID-19 in Guangdong Province, China.     

Nanotechnology as a Shield against COVID-19: Current Advancement and Limitations

The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global health problem that the WHO declared a pandemic. COVID-19 has resulted in a worldwide lockdown and threatened to topple the global economy. The mortality of COVID-19 is comparatively low compared with previous SARS outbreaks, but the rate of spread of the disease and its morbidity is alarming. This virus can be transmitted human-to-human through droplets and close contact, and people of all ages are susceptible to this virus. With the advancements in nanotechnology, their remarkable properties, including their ability to amplify signal, can be used for the development of nanobiosensors and nanoimaging techniques that can be used for early-stage detection along with other diagnostic tools. Nano-based protection equipment and disinfecting agents can provide much-needed protection against SARS-CoV-2. Moreover, nanoparticles can serve as a carrier for antigens or as an adjuvant, thereby making way for the development of a new generation of vaccines. The present review elaborates the role of nanotechnology-based tactics used for the detection, diagnosis, protection, and treatment of COVID-19 caused by the SARS-CoV-2 virus.     

Extra-pulmonary complications of 45 critically ill patients with COVID-19 in Yichang,Hubei province,China: A single-centered,retrospective, observation study

Mortality of critically ill patients with coronavirus disease 2019 (COVID-19) was high. Aims to examine whether time from symptoms onset to intensive care unit (ICU) admission affects incidence of extra-pulmonary complications and prognosis in order to provide a new insight for reducing the mortality. A single-centered, retrospective, observational study investigated 45 critically ill patients with COVID-19 hospitalized in ICU of The Third People''s Hospital of Yichang from January 17 to March 29, 2020. Patients were divided into 2 groups according to time from symptoms onset to ICU admission (>7 and ≤7 days) and into 2 groups according to prognosis (survivors and non-survivors). Epidemiological, clinical, laboratory, radiological characteristics and treatment data were studied. Compared with patients who admitted to the ICU since symptoms onset ≤7 days (55.6%), patients who admitted to the ICU since symptoms onset >7 days (44.4%) were more likely to have extra-pulmonary complications (19 [95.0%] vs 16 [64.0%], P = .034), including acute kidney injury, cardiac injury, acute heart failure, liver dysfunction, gastrointestinal hemorrhage, hyperamylasemia, and hypernatremia. The incidence rates of acute respiratory distress syndrome, pneumothorax, and hospital-acquired pneumonia had no difference between the 2 groups. Except activated partial thromboplastin and Na⁺ concentration, the laboratory findings were worse in group of time from symptoms onset to ICU admission >7 days. There was no difference in mortality between the 2 groups. Of the 45 cases in the ICU, 19 (42.2%) were non-survivors, and 16 (35.6%) were with hospital-acquired pneumonia. Among these non-survivors, hospital-acquired pneumonia was up to 12 (63.2%) besides higher incidence of extra-pulmonary complications. However, hospital-acquired pneumonia occurred in only 4 (15.4%) survivors. Critically ill patients with COVID-19 who admitted to ICU at once might get benefit from intensive care via lower rate of extra-pulmonary complications.     

新冠肺炎疫情形势下医学寄生虫学课程在线教学的探索与应用

2019年底,突发的新型冠状病毒引起的肺炎疫情迫使2020年春季高校开学日期推迟.根据教育主管部门"推迟开学不停学"的指导意见,笔者通过中国大学慕课平台开展了医学寄生虫学课程的在线教学工作.本文就教学准备、教学设计、教学过程、阶段考试、实验教学、案例教学以及成绩构成等方面进行了探索和应用,以期为同行教学提供参考.     

Heart,COVID-19, and echocardiography

Although clinical manifestations of coronavirus disease of 2019 (COVID-19) mainly consist of respiratory symptoms, a severe cardiovascular damage may occur. Moreover, previous studies reported a correlation of cardiovascular metabolic diseases with severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), and actually, many COVID-19 patients show comorbidities (systemic hypertension, cardio-cerebrovascular disease, and diabetes) and have a raised risk of death. The purpose of this review is to focus the cardiovascular effects of 2019-nCoV on the base of the most recent specific literature and previous learnings from SARS and MERS and analyze the potential role of echocardiography during the current critical period and short- and long-term follow-up.     

Coagulation System Activation for Targeting of COVID-19: Insights into Anticoagulants,Vaccine-Loaded Nanoparticles,and Hypercoagulability in COVID-19 Vaccines

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19, is currently developing into a rapidly disseminating and an overwhelming worldwide pandemic. In severe COVID-19 cases, hypercoagulability and inflammation are two crucial complications responsible for poor prognosis and mortality. In addition, coagulation system activation and inflammation overlap and produce life-threatening complications, including coagulopathy and cytokine storm, which are associated with overproduction of cytokines and activation of the immune system; they might be a lead cause of organ damage. However, patients with severe COVID-19 who received anticoagulant therapy had lower mortality, especially with elevated D-dimer or fibrin degradation products (FDP). In this regard, the discovery of natural products with anticoagulant potential may help mitigate the numerous side effects of the available synthetic drugs. This review sheds light on blood coagulation and its impact on the complication associated with COVID-19. Furthermore, the sources of natural anticoagulants, the role of nanoparticle formulation in this outbreak, and the prevalence of thrombosis with thrombocytopenia syndrome (TTS) after COVID-19 vaccines are also reviewed. These combined data provide many research ideas related to the possibility of using these anticoagulant agents as a treatment to relieve acute symptoms of COVID-19 infection.     

The Relationship Between Diabetes Mellitus and COVID-19 Prognosis: A Retrospective Cohort Study in Wuhan,China

BackgroundCoronavirus disease 2019 (COVID-19) is an emerging infectious disease that first appeared in Wuhan, China, and quickly spread throughout the world. We aimed to understand the relationship between diabetes mellitus and the prognosis of COVID-19.MethodsDemographic, clinical, laboratory, radiologic, treatments, complications, and clinical outcomes data were extracted from electronic medical records and compared between diabetes (n = 84) and nondiabetes (n = 500) groups. Kaplan-Meier method and multivariate Cox analysis were applied to determine the risk factors for the prognosis of COVID-19.ResultsCompared with nondiabetic patients, diabetic patients had higher levels of neutrophils (P = .014), C-reactive protein (P = .008), procalcitonin (P < .01), and D-dimer (P = .033), and lower levels of lymphocytes (P = .032) and albumin (P = .035). Furthermore, diabetic patients had a significantly higher incidence of bilateral pneumonia (86.9%, P = .020). In terms of complications and clinical outcomes, the incidence of respiratory failure (36.9% vs 24.2%, P = .022), acute cardiac injury (47.4% vs 21.2%, P < .01), and death (20.2% vs 8.0%, P = .001) in the diabetes group was significantly higher than that in the nondiabetes group. Kaplan-Meier survival curve showed that COVID-19 patients with diabetes had a shorter overall survival time. Multivariate Cox analysis indicated that diabetes (hazard ratio 2.180, P = .031) was an independent risk factor for COVID-19 prognosis. In subgroup analysis, we divided diabetic patients into insulin-required and non-insulin-required groups according to whether they needed insulin, and found that diabetic patients requiring insulin may have a higher risk of disease progression and worse prognosis after the infection of severe acute respiratory syndrome coronavirus 2.ConclusionsDiabetes is an independent risk factor for the prognosis of COVID-19. More attention should be paid to the prevention and treatment for diabetic patients, especially those who require insulin therapy.