2019新型冠状病毒及其诊疗与防控：回顾与展望

Diagnosis, treatment, control and prevention of SARS-CoV-2 and coronavirus disease 2019: back to the future

摘要:

2019新型冠状病毒的暴发持续至今，导致了世界各地数以百万计的感染个例，更夺去了数十万人的生命。世界卫生组织在2020年2月将此病毒引起的疾病定名为2019冠状病毒病 (Coronavirus disease 2019，COVID-19)，而国际病毒分类委员会也将此病毒命名为SARS-CoV-2。COVID-19的典型临床症状类似感冒，少数病人可发展为重症甚至死亡。21世纪以来，人类冠状病毒有3次大暴发，分别是2003年暴发的严重急性呼吸综合征(SARS)、2012年暴发的中东呼吸综合征 (MERS) 和本次的新型肺炎。自2003年以来，对SARS和MERS冠状病毒的研究从未间断，对其自然起源、致病机理、药物筛选及疫苗研发等已取得一定进展。鉴于SARS-CoV-2和SARS-CoV的基因组序列高度相似，以往对SARS-CoV的研究对深入探讨SARS-CoV-2生物学特性、诊断、治疗和防控有很强的借鉴性。文中通过回顾过往的研究进展，对比SARS-CoV和SARS-CoV-2的生物学特性，分析当前亟需的防控和诊疗措施，探讨疫苗研发所面对的一些难题，并展望疫情发展趋势及对本领域研究与开发的主要挑战，冀为我国和全世界有效控制COVID-19疫情提供参考。

Abstract:

The ongoing outbreak of the coronavirus disease 2019 (COVID-19) as named by the World Health Organization has millions of confirmed cases around the world and has claimed hundreds of thousands of lives. The virus was named SARS-CoV-2 in February by International Committee on Taxonomy of Viruses. COVID-19 presents as fever, dry cough, dyspnea, headache and pneumonia. In a small subset of severe cases, the disease quickly progresses to respiratory failure and even death. Since the 21st century, there have been three major outbreaks caused by human coronaviruses, including the severe acute respiratory syndrome (SARS) that broke out in 2003, the Middle East respiratory syndrome (MERS) in 2012, and the recent pandemic of COVID-19. Since 2003, significant progress has been made in the study of SARS-CoV and MERS-CoV concerning their natural origins, pathogenesis, antiviral development and vaccine design. Since SARS-CoV-2 and SARS-CoV are closely related, previous findings on SARS-CoV are highly relevant to a better understanding as well as diagnosis, treatment, prevention and control of SARS-CoV-2. In this review, we highlight recent progresses in the field; compare the biological characteristics of SARS-CoV and SARS-CoV-2; summarize the urgently-needed diagnostic, treatment, prevention and control options; and provide future perspectives for the outcome of the outbreak and research questions to be answered, including some of the difficulties in vaccine development. Hopefully, our comments and suggestions would prove useful for the control of the SARS-CoV-2 epidemic in China and the world.