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中华临床医师杂志(电子版) ›› 2020, Vol. 14 ›› Issue (10) : 753 -758. doi: 10.3877/cma.j.issn.1674-0785.2020.10.001

所属专题: 急危重症 文献

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冠状病毒疾病2019发病机制若干热点问题的思考
刘军1,()   
  1. 1. 215001 江苏苏州,南京医科大学附属苏州医院东区ICU
  • 收稿日期:2020-03-18 出版日期:2020-10-15
  • 通信作者: 刘军
  • 基金资助:
    江苏省第五期“333工程”科研项目(BRA2016070); 苏州市科技发展计划项目(SS201874)

Several hot issues in pathogenesis of coronavirus disease 2019

Jun. Liu1,()   

  1. 1. Department of Critical Care Medicine, Suzhou Hospital Affiliated to Nanjing Medical University, Suzhou 215001, China
  • Received:2020-03-18 Published:2020-10-15
  • Corresponding author: Jun. Liu
引用本文:

刘军. 冠状病毒疾病2019发病机制若干热点问题的思考[J/OL]. 中华临床医师杂志(电子版), 2020, 14(10): 753-758.

Jun. Liu. Several hot issues in pathogenesis of coronavirus disease 2019[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2020, 14(10): 753-758.

严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)所致冠状病毒疾病2019(COVID-19)已构成国际关注的突发公共卫生事件。COVID-19传染性强,可导致患者出现严重呼吸道感染和多器官系统功能损害。COVID-19发病机制尚不明确,我们推测SARS-CoV-2直接致宿主靶细胞损伤及机体免疫炎症反应紊乱可能是COVID-19的主要致病机制。本文基于相关研究领域的进展,对COVID-19发病机制中的若干热点问题进行分析和讨论,并提出思考。

Coronavirus disease 2019 (COVID-19) induced by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) has constituted a public health emergency of international concern. COVID-19 is highly contagious and can lead to severe respiratory infections and multiple organ system dysfunction. The pathogenesis of COVID-19 remains unclear, and it is speculated that host cell injury directly caused by SARS-CoV-2 and immune inflammation disorder may be the main pathogenic mechanisms of COVID-19. Based on the achievements of related research, we summarize and interpret several hot issues in the pathogenesis of COVID-19, and put forward some viewpoints.

1
杨毅, 邱海波. 打赢新型冠状病毒感染肺炎疫情阻击战: 重症医学必须走在前面 [J/OL]. 中华重症医学电子杂志, 2020, 6(1): 27-28.
2
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China [J]. Lancet, 2020, 395(10223): 497-506.
3
Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China [J]. JAMA, 2020, 323(11): 1061-1069.
4
Yang X, Yu Y, Xu J, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study [J]. Lancet Respir Med, 2020, 8(5): 475-481.
5
Lu R, Zhao X, Li J, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding [J]. Lancet, 2020,395(10224):565-574.
6
Xu Z, Shi L, Wang Y, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome [J]. Lancet Respir Med, 2020, 8(4): 420-422.
7
Skariyachan S, Challapilli SB, Packirisamy S, et al. Recent aspects on the pathogenesis mechanism, animal models and novel therapeutic interventions for middle east respiratory syndrome coronavirus infections [J]. Front Microbiol, 2019,10:569.
8
Wu JT, Leung K, Leung GM. Nowcasting and forecasting the potential domestic and international spread of the 2019-nCoV outbreak originating in Wuhan, China: a modelling study [J]. Lancet, 2020, 395(10225):689-697.
9
Imai Y, Kuba K, Ohto-Nakanishi T, et al. Angiotensin-converting enzyme 2 (ACE2) in disease pathogenesis [J]. Circ J, 2010,74(3):405-410.
10
Kuba K, Imai Y, Rao S, et al. A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus-induced lung injury [J]. Nat Med, 2005,11(8):875-879.
11
Imai Y, Kuba K, Rao S, et al. Angiotensin-converting enzyme 2 protects from severe acute lung failure [J]. Nature, 2005,436(7047):112-116.
12
Zou L, Ruan F, Huang M, et al. SARS-CoV-2 viral load in upper respiratory specimens of infected patients [J]. N Engl J Med, 2020, 382(12): 1177-1179.
13
管向东. "奉命于病难之间, 受任于疫虐之际"的重症医学—从新型冠状病毒肺炎, 思考重症学科发展[J/OL]. 中华重症医学电子杂志, 2020, 6(1): 23-24.
14
Hill AA, Diehl GE. Identifying the patterns of pattern recognition receptors [J]. Immunity, 2018, 49(3):389-391.
15
Goo J, Jeong Y, Park YS, et al. Characterization of novel monoclonal antibodies against MERS-coronavirus spike protein [J]. Virus Res, 2020, 278:197863.
16
中华医学会重症医学分会, 中国医师协会重症医学医师分会, 中国病理生理学会危重病医学专业委员会. 重症新型冠状病毒肺炎管理专家推荐意见 [J/OL]. 中华重症医学电子杂志, 2020, 6(1): E026.
17
Yoshikawa N, Yoshikawa T, Hill T, et al. Differential virological and immunological outcome of severe acute respiratory syndrome coronavirus infection in susceptible and resistant transgenic mice expressing human angiotensin-converting enzyme 2 [J]. J Virol, 2009,83 (11): 5451-5465.
18
Xu J, Jia W, Wang P, et al. Antibodies and vaccines against Middle East respiratory syndrome coronavirus[J]. Emerg Microbes Infect, 2019,8 (1): 841-856.
19
刘军. 对全身性感染免疫与炎症关系的思考 [J].中华急诊医学杂志, 2017, 26 (11): 1230-1235.
20
Channappanavar R, Perlman S. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology [J]. Semin Immunopathol, 2017, 39 (5): 529-539.
21
刘军. 脓毒症免疫调节治疗的共识与争议 [J].中华医学杂志, 2019, 99 (45): 3597-3600.
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