新型冠状病毒奥密克戎变异株的病原学、临床特点、感染控制及治疗

Etiology,clinical features,infection control and therapy of SARS-CoV-2 Omicron variant

SARS冠状病毒2(SARS-CoV-2)奥密克戎(Omicron)变异株是继Alpha、Beta、Gamma及Delta变异株之后新出现的一种需关注的变异株,其抗原特别是刺突蛋白受体结合区(RBD)的氨基酸突变明显多于其他变异株,使得Omicron变异株的感染性、传播性及免疫逃逸性明显增强,疫苗接种的保护效果下降,感染潜伏期明显缩短,但致病力也明显下降,绝大多数感染者表现为无症状或轻症;重症患者的病情加重多与原有基础疾病的进展相关。及时筛查并医学隔离感染者,做好各项个人防护措施以切断传播途径,积极推进疫苗接种以保护易感人群,是控制疫情传播的重要举措。少部分患者可出现所谓长新型冠状病毒肺炎(COVID-19)、后COVID-19综合征或后COVID-19状态,应加强长期随访。有效的抗病毒治疗可以缩短感染进程及促进恢复,还有助于疫情控制,因此研发具有良好成本效益比且方便服用的抗病毒药物是今后重要的研究方向之一。

The Omicron variant of SARS-CoV-2 is a new variant of concern after Alpha,Beta,Gamma and Delta variants.The amino acid mutations in the viral antigens,especially in the receptor binding region(RBD)of spike protein,were significantly more than those of other variants,which lead to the significant increase of infectivity,transmissibility and immune escape of Omicron variant.In addition,those spike mutations impaired the protective effect of vaccination.When compared to the infection of other variants,the latency of Omicron variant infection was significantly shortened,and the pathogenicity decreased markedly,which is in consistence with the fact that the vast majority of infected individuals showed no symptoms or only mild disease.Exacerbations in patients infected by Omicron variant were often associated with the progress of underlying disease.Early detection and medical isolation of infected persons,careful personal protection measures to cut off transmission routes,and active vaccination to protect susceptible people are key measures to prevent the spread of Omicron variant epidemic.A small number of patients infected with Omicron variant may develop so-called long COVID-19,post-COVID-19 syndrome,or post-COVID-19 condition,which means that long-term follow-up is needed in those patients.Effective anti-Omicron variant therapy can shorten the course of infection,promote the recovery from infection,and also contribute to the control of infection.Therefore,the development of antiviral drugs with ideal cost-benefit ratio and convenient administration is one of the research hotspot in the future.