Covid-19, an unfinished story

IF 3.2 3区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Yves Buisson
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引用次数: 7

Abstract

The Covid-19 pandemic appeared in China in December 2019 as a cluster of transmissible pneumonia caused by a new betacoronavirus. On March 11, 2020, the World Health Organization (WHO) declared it a pandemic. Covid-19 is a mild infection in 80% of cases, serious in 15% and critical in 5%. Symptomatic forms include a first phase of flu-like viral invasion, and at times a second phase, dysimmune and inflammatory, with acute respiratory distress syndrome, multiorgan failure and thromboembolic complications. Degree of severity is related to age and comorbidities.

SARS-CoV-2 is the third highly pathogenic Betacoronavirus to cross the species barrier. Its genome, an RNA of 29,903 nucleotides, shows strong homogeneity with bat coronaviruses from southern China, but the conditions for its passage in humans have yet to be elucidated. Mutations can give rise to variants of concern (VOC) that are more transmissible and able to evade the host's immune response. Several VOCs have succeeded and replaced one another: Alpha in October 2020, Beta and Gamma in December 2020, Delta in spring 2021 and Omicron in November 2021. The Covid-19 pandemic has evolved in five waves of unequal amplitude and severity, with geographical disparities. Worldwide, it has caused 395,000,000 confirmed cases including 5,700,000 deaths.

Epidemiological surveillance applies several indicators (incidence rate, test positivity rate, effective R and occupancy rate of intensive care beds) supplemented by genomic monitoring to detect variants by sequencing.

Non-pharmacological measures, particularly face mask wearing, have been effective in preventing the transmission of SARS-CoV-2. Few currently available drugs have proven useful, with the exception of dexamethazone for patients requiring oxygen therapy. Development of SARS-CoV-2 vaccines began early on many platforms. Innovation was brought about by the Pfizer-BioNTech and Moderna messenger RNA vaccines, which claim protective efficacy of 95% and 94.1% respectively, far higher than the 70% minimum set by the WHO.

Governments have hesitated between two strategies, mitigation and suppression. The second has been favored in critical periods such as April 2020, when 2.5 billion people throughout the world were confined. Vaccination campaigns got underway at the end of December 2020 and progressed without reaching sufficient herd immunity, leading some nations to consider compulsory vaccination or to require a vaccine or health pass, in order for persons to access different activities.

Will the pandemic stop with Omicron and become endemic? This part of the Covid-19 story remains to be told.

Abstract Image

Abstract Image

Covid-19,一个未完成的故事
2019年12月,新冠肺炎大流行以新型冠状病毒引起的聚集性传染性肺炎出现在中国。2020年3月11日,世界卫生组织(世卫组织)宣布其为大流行。80%的病例为轻度感染,15%为重症感染,5%为危重感染。症状形式包括第一阶段流感样病毒入侵,有时第二阶段免疫功能障碍和炎症,伴有急性呼吸窘迫综合征、多器官衰竭和血栓栓塞并发症。严重程度与年龄和合并症有关。SARS-CoV-2是第三种跨越物种屏障的高致病性乙型冠状病毒。它的基因组RNA有29903个核苷酸,与来自中国南方的蝙蝠冠状病毒具有很强的同质性,但其在人类中的传播条件尚未阐明。突变可引起关注变异(VOC),这种变异更具传染性,能够逃避宿主的免疫反应。一些VOCs已经成功地取代了彼此:Alpha在2020年10月,Beta和Gamma在2020年12月,Delta在2021年春季,Omicron在2021年11月。Covid-19大流行已演变成五波振幅和严重程度不等的大流行,存在地域差异。在世界范围内,它已造成3.95亿确诊病例,其中570万人死亡。流行病学监测采用几种指标(发病率、检测阳性率、有效R和重症监护床位占用率),辅以基因组监测,通过测序检测变异。非药物措施,特别是戴口罩,在防止SARS-CoV-2传播方面是有效的。除了需要氧疗的患者使用地塞米松外,目前可用的药物很少被证明是有用的。在许多平台上,SARS-CoV-2疫苗的开发很早就开始了。辉瑞- biontech和Moderna信使RNA疫苗带来了创新,它们分别声称保护效力为95%和94.1%,远远高于世界卫生组织规定的70%的最低限度。各国政府在缓解和抑制两种战略之间犹豫不决。第二种方法在关键时期受到青睐,比如2020年4月,当时全球有25亿人被隔离。疫苗接种运动于2020年12月底开始,但进展没有达到足够的群体免疫力,导致一些国家考虑强制接种疫苗或要求接种疫苗或健康通行证,以便人们参加不同的活动。大流行是否会随着欧米克隆而停止并成为地方病?Covid-19故事的这一部分仍有待讲述。
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来源期刊
Presse Medicale
Presse Medicale 医学-医学:内科
自引率
3.70%
发文量
40
审稿时长
43 days
期刊介绍: Seule revue médicale "généraliste" de haut niveau, La Presse Médicale est l''équivalent francophone des grandes revues anglosaxonnes de publication et de formation continue. A raison d''un numéro par mois, La Presse Médicale vous offre une double approche éditoriale : - des publications originales (articles originaux, revues systématiques, cas cliniques) soumises à double expertise, portant sur les avancées médicales les plus récentes ; - une partie orientée vers la FMC, vous propose une mise à jour permanente et de haut niveau de vos connaissances, sous forme de dossiers thématiques et de mises au point dans les principales spécialités médicales, pour vous aider à optimiser votre formation.
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