Covid - 19:传播、病死率、防护措施、实验室诊断和可能的实验室特征

M. Olaniyan, M. Muhibi, T. Ojediran
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引用次数: 1

摘要

Covid - 19是由Covid - 19病毒或严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)引起的冠状病毒疾病,以前被称为新型冠状病毒或武汉冠状病毒或2019-nCoV,引起致命的呼吸道感染。它是一种传染性病毒因子和正感(+ssRNA)单链RNA病毒,可引起急性呼吸道疾病,可为轻度、中度或重度疾病,包括死亡。这是一种人畜共患感染,也可以在人与人之间传播。病毒通过刺突与具有血管紧张素I转换酶2 (ACE2)受体的细胞结合进入细胞。ACE2受体存在于肺、动脉、心脏、肾脏和肠道细胞的细胞膜上。第一次疫情于2019年12月31日在中国武汉报告,因此最初被称为武汉冠状病毒。在全球范围内,截至2020年4月18日,它的死亡率为6.7%,尼日利亚的死亡率为3.5%。这种感染是通过感染者咳嗽、吐痰或打喷嚏时的飞沫传播的。它也可以通过用被污染的手接触眼睛、鼻子或嘴巴而感染。Covid - 19可引起炎症期和急性期免疫反应,克服机械先天免疫防御可引起严重肺炎。病毒通过肺细胞膜上的ACE2受体进入肺部,破坏纤毛,导致死亡组织、细胞/污垢/废物和液体积聚,从而取代肺部的正常空气含量,最终导致干咳和呼吸困难。可通过基本保护措施预防感染,包括定期用肥皂和水洗手,然后用含酒精的洗手液洗手,保持社交距离,避免聚集,特别适用于来自流行地区的人的隔离措施,对阳性或表现出相关体征和症状的人进行自我隔离,使用个人防护装备,早期诊断和适当干预。使用肥皂和酒精是有效的,因为肥皂可以突破病毒的脂质层,变成更小的颗粒,被水冲走,而酒精能够溶解病毒。Covid - 19是通过实时逆转录聚合酶链反应面板在实验室诊断的。Covid - 19可能导致肝功能异常,原因是脂肪潴留异常;血浆肌酐和尿素升高,原因可能是肾脏损害;二氧化碳升高,严重肺炎导致氧水平降低;抗炎细胞因子和促炎细胞因子分别下降和升高,表现为发烧、急性期反应、促红细胞生成素下降,原因可能是肾脏损害;延长凝血酶原时间/活化部分凝血活酶时间和血小板计数减少,这可能表现为弥散性血管内凝血。本文综述了Covid - 19的传播、病死率、基本防护措施、实验室诊断和可能的实验室特征。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Covid 19: Transmission, case fatality rate, protective measures, laboratory diagnosis, and possible laboratory features
Covid 19 is a coronavirus disease caused by Covid 19 virus or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) formerly referred to as novel coronavirus or Wuhan coronavirus or 2019-nCoV causes a deadly respiratory infection. It is an infectious viral agent and a positive-sense (+ssRNA), single-stranded RNA virus that causes acute respiratory disease which can be mild, moderate, or severe illness including death. It is a zoonotic infection and can also be transmitted from human to human. The virus enters the cell by binding with cell that has angiotensin I converting enzyme 2 (ACE2) receptor using the spike. ACE2 receptor is found on the cell membranes of cells in the lungs, arteries, heart, kidney, and intestines. The first outbreak was reported in Wuhan, China, on December 31, 2019, hence the initial name Wuhan coronavirus. Globally, it has a fatality rate of 6.7% with a fatality rate of 3.5% in Nigeria as at April 18, 2020. The infection is air borne through droplets from infected person during coughing, spiting or sneezing. It can also be contracted by touching eyes, nose, or mouth with contaminated hands. Covid 19 may elicit both inflammatory and acute phase immune responses while the mechanical innate immune defense can be overcome to cause severe pneumonia The virus enters the lung through ACE2 receptors on the cell membrane of the lung to destroy cilia resulting into the accumulation of dead tissues, cells/dirts/wastes, and fluids thereby displacing the normal air content of the lung which will eventually bring about dry cough, and difficulties in breathing. The infection can be prevented through basic protective measures which include regular washing of hands with soap and water followed by sanitizing hands with alcohol-based sanitizer, social distancing, avoidance of gathering, quarantine measure applicable to especially those from endemic areas, self-isolation for those who are positive or manifesting related signs and symptoms, use of personal protective equipment, early diagnosis, and adequate intervention. The use of soap and alcohol are effective as soap can break through the lipid layer of the virus to become smaller particles which are washed away by water while alcohol is capable of lysing the virus. Covid 19 is diagnosed in the laboratory by real-time reverse transcription polymerase chain reaction Panel. Covid 19 may result into abnormal liver function tests due to abnormal fat retention, elevated plasma creatinine and urea which may be due to kidney damage, elevated C02, and decreased oxygen, level due to severe pneumonia, decreased and elevated anti and pro-inflammatory cytokines respectively which may be manifested as fever, acute phase response, decreased erythropoietin due to possible kidney damage, prolong prothrombin time/activated partial thromboplastin time and depleted platelet count which may manifest as disseminated intravascular coagulation. This work reviewed the transmission, case fatality rate, basic protective measures, laboratory diagnosis, and possible laboratory features of Covid 19.
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