Impact of COVID‐19 on access to healthcare in low‐ and middle‐income countries: Current evidence and future recommendations

The COVID‐19 pandemic continues to be a major public health threat globally and low‐ and middle‐income countries (LMICs) are not an exception. The impact of the COVID‐19 pandemic is far‐reaching on many areas including but not limited to global health security, economic and healthcare delivery with a potential impact on access to healthcare in LMICs. We evaluate the impact of the COVID‐19 pandemic on access to healthcare in LMICs, as well as plausible strategies that can be put in place to ensure that the delivery of healthcare is not halted. In order to mitigate the devastating effect of the COVID‐19 pandemic on the already weak health systems in LMICs, it is much necessary to reinforce and scale up interventions and proactive measures that will ensure that access to healthcare is not disrupted even in course of the pandemic.     

2020年宁夏新冠疫情期间SARS-CoV-2与常见发热呼吸道病原流行特征比较分析

目的 了解2020年宁夏新冠疫情期间SARS-CoV-2与常见6种发热呼吸道病原的检出情况、流行规律和感染特点,为新冠疫情常态化防控提供理论依据。方法 应用Real time RT-PCR技术对2020年1月20日至2020年2月16日期间宁夏疾病预防控制中心收检的COVID-19筛查样本进行SARS-CoV-2和Flu等常见发热呼吸道病原进行定性检测,并收集各病原阳性患者人口学特征资料。结果 529例COVID-19筛查样本中,SARS-CoV-2阳性检出率为13.23%（70/529）。对COVID-19筛查样本中180份符合条件的FRS病例样本进行6种其他呼吸道病毒病原检测,阳性检出率为12.78%（23/180）,其中检出率较高的病原为Flu和HRSV,阳性率分别为5.00%和2.78%。各时间段内SARS-CoV-2阳性检出率存在两个较为明显的峰值,其他呼吸道病毒总阳性检出率稳中有降。SARS-CoV-2阳性检出率男性和女性差异无统计学意义,41~ 60岁组及60岁以上组阳性率较高,分别为25.00%和24.39%,阳性病例在宁夏五市均有分布,银川市最多;其他呼吸道病原男性检出率显著高于女性,41~ 60岁组阳性率最高,其次为0~20岁组,阳性率分别为33.33%和12.20%,阳性主要集中于银川与中卫两市。结论 在常态下防控新冠疫情的背景下,应加强呼吸道传播病原快速筛查体系的建设以达到精准防控传染病的迫切需求。     

Spike protein mediated membrane fusion during SARS-CoV-2 infection

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has posed a serious threat to public health and has quickly become a global concern. The infection of SARS-CoV-2 begins with the binding of its spike protein to the receptor-angiotensin-converting enzyme 2 (ACE2), which, after a series of conformation changes, results in the fusion of viral-cell membranes and the release of the viral RNA genome into the cytoplasm. In addition, infected host cells can express spike protein on their cell surface, which will interact with ACE2 on neighboring cells, leading to cell membrane fusion and the formation of multinucleated cells or syncytia. Both viral entry and syncytia formation are mediated by spike-ACE2 interaction and share some common mechanisms of membrane fusion. Here in this review, we will summarize our current understanding of spike-mediated membrane fusion, which may shed light on future broad-spectrum antiviral development.     

Positive SARS-CoV-2 RT-qPCR of a nasal swab spot after 30 days of conservation on filter paper at room temperature

We tested the use of nasal swabs spotted onto filter paper (Whatman 3M) for the molecular diagnosis of SARS-CoV-2 infection. Spots of a positive nasal swab in conservation medium (B.1.177 strain, 21Ct) were still positive (duo E-gene/IP4) after 10, 20, and 30 days of conservation at room temperature, with Ct values of 28, 27, and 26, respectively. Direct spotting of the swab at bedside (omicron strain) still gave a positive result after 10 days in two RT-qPCR systems: 33.7 Ct using duo E-gene/IP4, and 34.8 using a specific Omicron system. Spotting of a dilution range of media spiked with the Delta (strain 2021/FR/0610, lineage B 1.617.2) and Omicron strains (strain UVE/SARS-CoV-2/2021/FR/1514) showed a threshold of 0.04 TCID₅₀ after 10 days of conservation. We show, for the first time, that this simple and low-cost conservation method can be used to store samples for RT-qPCR against SARS-CoV-2 for up to at least 1 month.     

SARS冠状病毒半胱氨酸蛋白酶3CLpro的克隆表达及分离纯化

SARS（严重急性呼吸综合征）是由一种新型的人类冠状病毒引起的。由于SARS冠状病毒3CL蛋白酶在病毒的复制翻译中起关键作用，所以成为抗SARS药物设计的关键靶标之一。该研究中，利用以pET28a为载体的高效原核表达系统，克隆表达出SARS冠状病毒3CL蛋白酶，然后由NTA-Ni^2＋亲和层析柱对表达的蛋白进行分离纯化。3CL蛋白酶在大肠杆菌表达系统中的成功表达为今后进一步筛选抗SARS病毒药物奠定基础。     

SARS-CoV S蛋白功能性受体ACE2在人、兔角膜、结膜中的表达

目的 SARS冠状病毒(SARS-CoV)的S蛋白介导了病毒与宿主细胞的结合。最近已鉴定出SARS-CoV S蛋白的功能性受体是血管紧张素转化酶2(angiotensin-converting enzyme2，ACE2)。本研究检测了ACE2在人、兔眼结膜、角膜中的表达，由此来初步推断SARS-CoV由眼部入侵的可能。方法 分别采取：(1)成人眼球破裂伤摘除的眼角膜和结膜组织；(2)4～6月中期引产胎儿的眼角膜、结膜、心、肺组织；(3)兔眼角膜、结膜、心、肺组织；(4)培养的人结膜成纤维细胞和兔角膜上皮细胞。分别采用RT-PCR和免疫组化方法检测各组织、细胞中ACE2的表达。取尸体解剖的成人心、肺组织作为对照、结果 RT-PCR法在上述各种组织和细胞中均检测到ACE2的扩增条带，其中胎儿、成人和兔的角膜、结膜扩增条带较心、肺稍弱，兔各组织的扩增条带亮度与对应的人体组织的扩增条带亮度相近。ACE2免疫组化反应产物主要位于胞浆和胞膜，呈棕黄色或棕褐色．角膜和结膜的上皮细胞及角膜内皮细胞呈明显的阳性表达，角膜和结膜的成纤维细胞呈弱阳性表达，培养的人结膜成纤维细胞和兔角膜上皮细胞亦可见阳性表达。兔组织中的ACE2表达强度及组织定位与人相近。结论 本研究从mRNA和蛋白质水平证实了眼组织存在SARS冠状病毒S蛋白的功能性受体ACE2，由此初步推断SARS-CoV存在由眼部入侵的可能，为临床进一步研究SARS的防护和致病机制提供了线索。同时，为新西兰大白兔可能成为研究SARS-CoV入侵途径的动物模型提供了初步的实验依据。     

SARS-CoV-2 Testing Before International Airline Travel,December 2020 to May 2021

Although there have been several case reports and simulation models of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission associated with air travel, there are limited data to guide testing strategy to minimize the risk of SARS-CoV-2 exposure and transmission onboard commercial aircraft. Among 9853 passengers with a negative SARS-CoV-2 polymerase chain reaction test performed within 72 hours of departure from December 2020 through May 2021, five (0.05%) passengers with active SARS-CoV-2 infection were identified with rapid antigen tests and confirmed with rapid molecular test performed before and after an international flight from the United States to Italy. This translates to a case detection rate of 1 per 1970 travelers during a time of high prevalence of active infection in the United States. A negative molecular test for SARS-CoV-2 within 72 hours of international airline departure results in a low probability of active infection identified on antigen testing during commercial airline flight.