Does SARS‐Cov‐2 invade the brain? Translational lessons from animal models

The current coronavirus disease (COVID‐19) outbreak, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), has raised the possibility of potential neurotropic properties of this virus. Indeed, neurological sequelae of SARS‐CoV‐2 infection have already been reported and highlight the relevance of considering the neurological impact of coronavirus (CoV) from a translational perspective. Animal models of SARS and Middle East respiratory syndrome, caused by structurally similar CoVs during the 2002 and 2012 epidemics, have provided valuable data on nervous system involvement by CoVs and the potential for central nervous system spread of SARS‐CoV‐2. One key finding that may unify these pathogens is that all require angiotensin‐converting enzyme 2 as a cell entry receptor. The CoV spike glycoprotein, by which SARS‐CoV‐2 binds to cell membranes, binds angiotensin‐converting enzyme 2 with a higher affinity compared with SARS‐CoV. The expression of this receptor in neurons and endothelial cells hints that SARS‐CoV‐2 may have higher neuroinvasive potential compared with previous CoVs. However, it remains to be determined how such invasiveness might contribute to respiratory failure or cause direct neurological damage. Both direct and indirect mechanisms may be of relevance. Clinical heterogeneity potentially driven by differential host immune‐mediated responses will require extensive investigation. Development of disease models to anticipate emerging neurological complications and to explore mechanisms of direct or immune‐mediated pathogenicity in the short and medium term is therefore of great importance. In this brief review, we describe the current knowledge from models of previous CoV infections and discuss their potential relevance to COVID‐19.     

家族性与散发性严重急性呼吸综合症（SARS）患者的病死率与重症率的研究

目的研究家族性与散发性SARS患者的重症率及病死率的区别。方法把61例SARS患者分为家族性病例和散发性病例两组，家族性病例23例，散发性病例38例，分别对重症率及病死率进行比较。结果家族性患者的重症率47．8％，散发性患者的重症率22．5％（P〈0．05），家族性患者的病死率21．7％，散发性患者的病死率5．2％（P〉0．05），本组资料尚未发现病死率有统计学明显差异。可能与病例数较少有关。结论家族性SARS患者的重症率明显高于散发性SARS患者。     

抗非典精神刍议

全同非典进行特死斗争过程中，医护人员表现出一种临危不惧、挺身而出、全力救治、不怕牺牲、恪尽职守、患者至上、竭诚服务、科学防治的“抗非典精神”值得宣传，学习和效法。     

抗击"非典"为改善医患关系提供了新契机

文章通过分析在抗击“非典”特殊时期医务人员为科学、为病人的献身精神，以及广大人民对医疗高风险、高费用的全面了解，论证抗击“非典”为病人重新认识医务人员，促进医患沟通，改善日趋紧张的医患关系提供了新契机。     

SARS引起部队战士与军校学生心理应激的对照研究

目的了解SARS事件引起武警部队战士与学员心理应激的中介因素与心理健康的关系.方法采用中国科学院心理研究所编制的"全国民众非典调查问卷"(新版),对SARS高发疫区的800名武警战士和学员进行测试.结果大多数人对SARS事件的看法比较乐观.战士较学员认知更为积极,心理恐慌和无助感也明显低于学员(P＜0.001).战士与学员多使用积极的应对方式来应对应激.学员采用某些回避性应对和积极应对与战士有显著差异,如注意转移、自我保护性应对等(P＜0.01).战士与学员获得主观和客观社会支持上大部分没有显著差异,只是个别条目有所不同.SARS对士兵与学员的心理影响不大,学员的心理适应要好于士兵(P＜0.05).相关因素分析显示认知、应对方式及社会支持与心理状态相关.结论认知、应对方式及社会支持影响人们对应激源的心理反应.     

从SARS流行看医院危机管理

医院是一个高风险的组织，在复杂、多变的市场环境中，危机是一种连续发生的常态。要借鉴SARS危机管理的经验教训，树立预警性反危机理念，尽量减少危机发生。要提高医院危机管理能力和水平，尽量减少危机造成的损害。要善于把危机变成推动医院发展的契机。