简介：AbstractThe present pandemic has posed a crisis to the economy of the world and the health sector. Therefore, the race to expand research to understand some good molecular targets for vaccine and therapeutic development for SARS-CoV-2 is inevitable. The newly discovered coronavirus 2019 (COVID-19) is a positive sense, single-stranded RNA, and enveloped virus, assigned to the beta CoV genus. The virus (SARS-CoV-2) is more infectious than the previously detected coronaviruses (MERS and SARS). Findings from many studies have revealed that S protein and RdRp are good targets for drug repositioning, novel therapeutic development (antibodies and small molecule drugs), and vaccine discovery. Therapeutics such as chloroquine, convalescent plasma, monoclonal antibodies, spike binding peptides, and small molecules could alter the ability of S protein to bind to the ACE-2 receptor, and drugs such as remdesivir (targeting SARS-CoV-2 RdRp), favipir, and emetine could prevent SASR-CoV-2 RNA synthesis. The novel vaccines such as mRNA1273 (Moderna), 3LNP-mRNAs (Pfizer/BioNTech), and ChAdOx1-S (University of Oxford/Astra Zeneca) targeting S protein have proven to be effective in combating the present pandemic. Further exploration of the potential of S protein and RdRp is crucial in fighting the present pandemic.

简介：AbstractBackground:Asymptomatic or symptomatic infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can be followed by reinfection. The protection conferred by prior infection among coronavirus disease 2019 (COVID-19) patients is unclear. We assessed the incidence of SARS-CoV-2 reinfection and the protection effect of previous infection against reinfection.Methods:We searched PubMed, EMBASE, Cochrane, Scopus, Web of Science, and ClinicalTrials.gov for publications up until the end date of May 1, 2021. The reinfection rate of recovered patients and the protection against reinfection were analyzed using meta-analysis.Results:Overall, 19 studies of 1096 reinfection patients were included. The pooled reinfection rate was 0.65% (95% confidence interval [CI] 0.39-0.98%). The symptomatic reinfection rate was a bit lower (0.37% [95% CI 0.11-0.78%], I2 = 99%). The reinfection rate was much higher in high-risk populations (1.59% [95% CI 0.30-3.88%], I2= 90%). The protection against reinfection and symptomatic reinfection was similar (87.02% [95% CI 83.22-89.96%] and 87.17% [95% CI 83.09-90.26%], respectively).Conclusions:The rate of reinfection with SARS-CoV-2 is relatively low. The protection against SARS-CoV-2 after natural infection is comparable to that estimated for vaccine efficacy. These data may help guide public health measures and vaccination strategies in response to the COVID-19 pandemic. High-quality clinical studies are needed to establish the relevant risk factors in recovered patients.

简介：摘要目的探讨新型冠状病毒（severe acute respiratory syndrome coronavirus 2，SARS-CoV-2）特异性IgM和IgG抗体检测应用于不同人群新型冠状病毒肺炎（corona virus disease 2019，COVID-19）诊断和筛查的作用价值。方法回顾性分析2020年4月至2020年7月间收集的48例SARS-CoV-2特异性IgM或IgG抗体阳性人员的血清抗体动态检测信息，分为COVID-19确诊病例组、疑似病例组、假阳性组。结果15例COVID-19确诊病例组在患者确诊后0~4 d、5~9 d单纯IgM抗体阳性率为6.67%和13.33%，10~14 dIgM和IgG双抗体阳性率达100.00%；19例疑似病例组中单纯IgM抗体观察期间全部转为IgG抗体；14例假阳性人群表现为单IgM阳性，观察期间无1例IgG转阳。结论动态检测SARS-CoV-2特异性抗体变化趋势可协助判断COVID-19感染情况，为临床提供一定的参考依据。

简介：摘要Coronavirus disease 2019 (COVID-19) is a contagious infection disease, which may cause respiratory, physical, psychological, and generalized systemic dysfunction. The severity of disease ranges from an asymptomatic infection or mild illness to mild or severe pneumonia with respiratory failure and/or death. COVID-19 dramatically affects the pulmonary system. There is a lack of knowledge about the long-term outcomes of the disease and the possible sequelae and rehabilitation. This clinical practice guideline includes pulmonary rehabilitation (PR) recommendations for adult COVID-19 patients and has been developed in the light of the guidelines on the diagnosis and treatment of COVID-19 provided by the World Health Organization and Republic of Turkey, Ministry of Health, recently published scientific literature, and PR recommendations for COVID-19 regarding basic principles of PR. In this guideline, the contagiousness of COVID-19, recommendations on limited contact of patient with healthcare providers, and the evidence about possible benefits of PR were taken into consideration.

简介：摘要COVID-19的全球大流行使冠状病毒再次引起重视。在本世纪大流行的三种高致病性冠状病毒(SARS-CoV、MERS-CoV、SARS-CoV-2)研究中，已有直接证据证明SARS-CoV及SARS-CoV-2可引起人眼部感染。冠状病毒感染除引起眼部症状外，也可通过眼部感染引发全身多种临床表现。两种高致病性冠状病毒(SARS-CoV和SARS-CoV-2)具有更强的流行性及更高的病死率，两种病毒眼部症状相似，病毒结构及眼部感染过程也具有相似性，主要是通过其特异性S蛋白与细胞表面相关受体结合，使其核酸进入细胞内并借用细胞内的蛋白合成通路对自身蛋白进行转录、组装、折叠并通过其受体蛋白激发多种细胞因子表达。本文就2003年流行的SARS-CoV以及2019年末流行的SARS-CoV-2两种高致病性冠状病毒的特点、眼部感染通路的研究进展及病毒眼部感染相关的研究现状进行综述，阐述眼部病毒防护及患者眼部检查的必要性。(国际眼科纵览，2020, 45: 374-379)

简介：AbstractIndirect effects of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic are difficult to calculate. Fear of intrahospital infection has led to a decrease in the use of emergency services and the performance of elective procedures. Several low- and middle-income countries have seen the number of institutional deliveries reduced, even in the absence of a follow-up program for home births. We present the case of a patient with adequate prenatal care and an institutional delivery plan who, due to the SARS-CoV-2 pandemic, chose to have a home delivery with unsafe conditions. The lack of supervision by health personnel and the absence of an immediate consultation plan facilitated the presentation of postpartum hemorrhage and poor neonatal results. Little attention has been paid during the pandemic to pregnant women who decide to have their birth at home. A broad discussion is necessary in this regard, to regain the confidence of the population and strengthen institutional births, or to strengthen midwife-assisted home births programs. Patients’ fear to acquiring SARS-CoV-2 infection inside hospitals is a factor that must be taken into account in prenatal care programs.

简介：AbstractBackground:Practitioners and researchers in the midst of overwhelming coronavirus disease 2019 (COVID-19) outbreaks are calling for new ways of looking at such pandemics, with an emphasis on human behavior and holistic considerations. Viral outbreaks are characterized by socio-behaviorally-oriented public health efforts aimed at reducing exposure and prevention of morbidity/mortality once infected. These efforts involve different points-of-view, generally, than do those aimed to understand the virus' natural history. Rampant spread of SARS-CoV-2infection in cities clearly signals that urban areas contain conditions favorable for rapid transmission of the virus.Main text:The Critical Medical Ecology model is a multidimensional, multilevel way of viewing pandemics comprehensively, rooted simultaneously in microbiology and in anthropology, with shared priority for evolution, context, stressors, homeostasis, adaptation, and power relationships. Viewing COVID-19 with a Critical Medical Ecological lens suggests three important interpretations: 1) COVID-19 is equally — if not more — a socially-driven disease as much as a biomedical disease, 2) the present interventions available for primary prevention of transmission are social and behavioral interventions, and 3) wide variation in COVID-19 hospitalization/death rates is not expected to significantly be attributable to a more virulent and rapidly-evolving virus, but rather to differences in social and behavioral factors — and power dynamics — rather than (solely) biological and clinical factors. Cities especially are challenged due to logistics and volume of patients, and lack of access to sustaining products and services for many residents living in isolation.Conclusions:In the end, SARS-CoV-2 is acting upon dynamic social human beings, entangled within structures and relationships that include but extend far beyond their cells, and in fact beyond their own individual behavior. As a comprehensive way of thinking, the Critical Medical Ecology model helps identify these elements and dynamics in the context of ecological processes that create, shape, and sustain people in their multidimensional, intersecting environments.

简介：摘要目的探讨新型冠状病毒（severe acute respiratory syndrome coronavirus 2，SARS-CoV-2）非结构蛋白1（nonstructural protein 1，NSP1）对I型干扰素（type I interferon，IFN-I）应答的影响及其作用机制。方法为研究SARS-CoV-2的NSP1对I型IFN产生的影响，构建NSP1表达质粒，并通过免疫荧光检测其蛋白表达能力。通过双荧光素酶报告基因实验检测NSP1对IFN-β启动子激活的作用。构建NSP1突变体M1（K163AH164A）和M2（△161-180），验证突变位点对IFN-β启动子激活的影响。结果NSP1显著抑制维甲酸诱导基因蛋白I、黑色素瘤分化相关蛋白5、线粒体抗病毒信号蛋白、TANK结合激酶1、干扰素调节因子3、干扰素调节因子7诱导的下游IFN-β启动子的激活，并对I型IFN通路的各关键分子的蛋白表达具有抑制作用，NSP1 C端的KH基序是其发挥抑制作用的关键位点。结论SARS-CoV-2 NSP1能够拮抗宿主I型干扰素免疫应答，实现病毒的天然免疫逃逸。

简介：【摘要】目的：构建新型冠状病毒突变株假病毒颗粒，研究Beta变异株假病毒对靶细胞感染嗜性的差异。方法：构建新型冠状Beta病毒突变株假病毒颗粒并对其进行验证与包装；比较其对靶细胞感染的细胞嗜性差异。结果：成功构建了Beta变异株S基因的表达载体并验证S蛋白成功表达。结论 Beta变异株比武汉株的感染力更强。

简介：Thecorona-likespikesorpeplomersonthesurfaceofthevirionunderelectronicmicroscopearethemoststrikingfeaturesofcoronaviruses.TheS(spike)proteinisthelargeststructuralprotein,with1,255aminoacids,intheviralgenome.Itsstructurecanbedividedintothreeregions:alongN-terminalregionintheexte-rior,acharacteristictransmembrane(TM)region,andashortC-terminusintheinteriorofavirion.WedetectedfifteensubstitutionsofnucleotidesbycomparisonswiththeseventeenpublishedSARS-CoVgenomesequences,eight(53.3%)ofwhicharenon-synonymousmutationsleadingtoaminoacidalternationswithpredictedphysiochemicalchanges.ThepossibleantigenicdeterminantsoftheSproteinarepredicted,andtheresultisconfirmedbyELISA(enzyme-linkedimmunosorbentassay)withsynthesizedpeptides.AnotherprofoundfindingisthatthreedisulfidebondsaredefinedattheC-terminuswiththeN-terminusoftheE(envelope)pro-tein,basedonthetypicalsequenceandpositions,thusestablishingthestructuralconnectionwiththesetwoimportantstructuralproteins,ifconfirmed.Phyloge-neticanalysisrevealsseveralconservedregionsthatmightbepotentdrugtargets.

简介：AbstractAlthough significant achievements have shown that the coronavirus disease 2019 (COVID-19) resurgence in Beijing, China, was initiated by contaminated frozen products and transported via cold chain transportation, international travelers with asymptomatic symptoms or false-negative nucleic acid may have another possible transmission mode that spread the virus to Beijing. One of the key differences between these two assumptions was whether the virus actively replicated since, so far, no reports showed viruses could stop evolution in alive hosts. We studied severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequences in this outbreak by a modified leaf-dating method with the Bayes factor. The numbers of single nucleotide variants (SNVs) found in SARS-CoV-2 sequences were significantly lower than those called from B.1.1 records collected at the matching time worldwide (P = 0.047). In addition, results of the leaf-dating method showed ages of viruses sampled from this outbreak were earlier than their recorded dates of collection (Bayes factors > 10), while control sequences (selected randomly with ten replicates) showed no differences in their collection dates (Bayes factors < 10). Our results which indicated that the re-emergence of SARS-CoV-2 in Beijing in June 2020 was caused by a virus that exhibited a lack of evolutionary changes compared to viruses collected at the corresponding time, provided evolutionary evidence to the contaminated imported frozen food should be responsible for the reappearance of COVID-19 cases in Beijing. The method developed here might also be helpful to provide the very first clues for potential sources of COVID-19 cases in the future.

简介：AbstractMany factors have been identified as having the ability to affect the sensitivity of rapid antigen detection (RAD) tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aimed to identify the impact of sample processing on the sensitivity of the RAD tests. We explored the effect of different inactivation methods, viral transport media (VTM) solutions, and sample preservation on the sensitivity of four RAD kits based on two SARS-CoV-2 strains. Compared with non-inactivation, heat inactivation significantly impacted the sensitivity of most RAD kits; however, β-propiolactone inactivation only had a minor effect. Some of the VTM solutions (VTM2, MANTACC) had a significant influence on the sensitivity of the RAD kits, especially for low viral-loads samples. The detection value of RAD kits was slightly decreased, while most of them were still in the detection range with the extension of preservation time and the increase of freeze-thaw cycles. Our results showed that selecting the appropriate inactivation methods and VTM solutions is necessary during reagent development, performance evaluation, and clinical application.

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简介：摘要：出现在中国武汉市的新型严重急性呼吸系统综合症冠状病毒（SARS-CoV-2）已在世界范围内传播，严重影响了人类健康和生产生活。室内“超级传播者”等传播感染事件的出现，让新型冠状病毒感染主要归咎于飞沫传播的观点受到了质疑。研究发现，气溶胶才是大多数呼吸道疾病最有可能的主要传播途径，然而对于新型冠状病毒通过气溶胶传播机制的认识仍然不足。为此，本文经文献复习，就病毒的传播方式的历史演进进行综述，评述了病毒气溶胶的产生及特点以及冠状病毒在室内外环境气溶胶中的赋存特征及生存能力，探讨了对未来疫情防控发展战略的展望，为 COVID-19防控策略提供依据。

简介：【摘要】目的：新型冠状病毒（SARS-CoV-2）实时荧光定量PCR核酸检测的性能验证与比对分析。方法：使用实时荧光定量PCR检测新型冠状病毒核酸参考品、室间质控品及临床样本。结果：试剂检测符合率为100％，试剂检出下限为200copies/mL。L1参考品的ORF-1ab和N基因的Ct值批间CV分别为2.45％和4.11％，L2参考品的ORF-1ab和N基因的Ct值批间CV分别为3.5％和3.43％，精密度CV≤5％。试剂无交叉反应、抗干扰实验阳性。同品牌扩增试剂在不同扩增系统的比对一致性为100％。结论：SARS-CoV-2实时荧光定量PCR核酸检测性能较好，可用以临床推广。

简介：摘要目的总结生物安全二级（bio-safety level 2，BSL-2）实验室开展新型冠状病毒（severe acute respiratory syndrome coronavirus 2，SARS-CoV-2）核酸检测过程中的生物安全管理经验与效果。方法检测样本来源于2020年2月21日到2020年11月5日送达中国疾控中心病毒病预防控制所病毒资源中心科室的人体咽拭子、鼻拭子、痰液、尿液、便液等。在遵循常规生物安全管理要求的基础上，在检测过程中积极进行人员、岗位、标本、过程、安全巡视等生物安全管理。结果共开展了27 692人次样本的SARS-CoV-2核酸检测，平均每天检测（2.32±0.11）批样本，每批平均检测（87.22±6.83）件样本，BSL-2实验室平均每天工作时间（3.43±0.23） h。在检测过程中未出现任何生物安全问题。结论BSL-2实验室在长时间的SARS-CoV-2核酸检测过程中，要积极从多方面加强生物安全管理，从而保障检测工作安全有序进行。

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简介：摘要目的建立基于SYBR Green I颜色判定的检测新型冠状病毒（severe acute respiratory syndrome coronavirus 2，SARS-CoV-2）ORF1ab基因的逆转录环介导等温扩增方法（reverse transcription loop-mediated isothermal amplification，RT-LAMP），为诊断SARS-CoV-2提供简便、快速和准确可靠的工具。方法基于GenBank中SARS-CoV-2 ORF1ab基因序列保守区设计引物，经引物筛选和RT-LAMP反应体系优化后进行灵敏度和特异性评价，并与实时荧光定量RT-PCR（quantitative real-time PCR，qRT-PCR）方法进行比较。结果基于颜色判定的RT-LAMP方法可在65℃45 min内完成SARS-CoV-2的快速检测，检测限为3 copies/reaction，与qRT-PCR的敏感度一致。RT-LAMP检测人冠状病毒OC43、人冠状病毒NL63和乙型流感病毒核酸样本结果为阴性，具有较好的特异性。经SARS-CoV-2临床样本验证，RT-LAMP与qRT-PCR的检测符合率达100%。结论基于颜色判定的RT-LAMP方法灵敏度高、特异性强，适用于SARS-CoV-2的快速可视化检测，具有应用于SARS-CoV-2样本的初筛及基层卫生医疗机构和现场推广的潜力。

简介：摘要人冠状病毒OC43(human coronavirus OC43，HCoV-OC43)与SARS-CoV-2(severe acute respiratory syndrome coronavirus 2)同属于β冠状病毒属，自1967年发现以来在人群中持续流行，现已成为常见的季节性呼吸道病毒之一。致病率和致死率更高的SARS-CoV-2在2019年底出现，后又伴随多种变异株的出现，其传播和感染能力不断增强。HCoV-OC43与SARS-CoV-2在基因组结构和功能、物种进化、流行特点及临床表现上可能具有一定的相似性。本综述对HCoV-OC43和SARS-CoV-2的流行病学、基因组学、种系进化等方面进行分析，有助于了解这两种病毒的关联与差异，为认识HCoV-OC43存在的潜在威胁提供参考。

简介：摘要严重急性呼吸综合征冠状病毒2(Severe acute respiratory syndrome coronavirus 2，SARS-CoV-2)感染流行，但因目前新生儿病例报道较少，证据资料欠完善，对新生儿SARS-CoV-2感染的途径、临床特征、治疗及预后甚至诊断标准等认识尚不清楚和统一，故围产界应积极对围产儿SARS-CoV-2感染进行系统全面研究，因为这些临床资料、统计数据和研究结果将对于此次乃至今后冠状病毒感染在这些最脆弱特殊人群防治具有十分重要的意义。为此，中国医师协会新生儿科医师分会循证学组、中华医学会围产医学分会重症学组联合组织专家组研制本建议，供围产学界同行拟定该方面具体项目计划参考。