Angiotensin-converting enzyme 2 and hepatic SARS-CoV-2 infection:Regulation,association,and therapeutic implications

Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)enters host cells via the angiotensin-converting enzyme 2(ACE2)receptor.Mounting evidence has indicated the presence of hepatic SARS-CoV-2 infection and liver injury in pa-tients with coronavirus disease 2019(COVID-19).Understanding the mechanisms of hepatic SARS-CoV-2 infection is crucial for addressing COVID-19–related liver pathology and developing targeted therapies.This editorial discusses the signi-ficance of ACE2 in hepatic SARS-CoV-2 infection,drawing on the research by Jacobs et al.Their findings indicate that hepatic ACE2 expression,frequency of hepatic SARS-CoV-2 infection,and severity of liver injury are elevated in patients with pre-existing chronic liver diseases.These data suggest that hepatic ACE2 could be a promising therapeutic target for COVID-19.

SARS-CoV-2 proteins show great binding affinity to resin composite monomers and polymerized chains

BACKGROUND Due to saliva and salivary glands are reservoir to severe acute respiratory syndrome-coronavirus 2(SARS-CoV-2),aerosols and saliva droplets are primary sources of cross-infection and are responsible for the high human–human transmission of SARS-CoV-2.However,there is no evidence about how SARSCoV-2 interacts with oral structures,particularly resin composites.AIM To evaluate the interaction of SARS-CoV-2 proteins with monomers present in resin composites using in silico analysis.METHODS Four SARS-CoV-2 proteins[i.e.main protease,3C-like protease,papain-like protease(PLpro),and glycoprotein spike]were selected along with salivary amylase as the positive control,and their binding affinity with bisphenol-A glycol dimethacrylate,bisphenol-A ethoxylated dimethacrylate,triethylene glycol dimethacrylate,and urethane dimethacrylate was evaluated.Molecular docking was performed using AutoDock Vina and visualised in Chimera UCSF 1.14.The best ligand–protein model was identified based on the binding energy(ΔG–kcal/moL).RESULTS Values for the binding energies ranged from-3.6 kcal/moL to-7.3 kcal/moL.The 3-monomer chain had the lowest binding energy(i.e.highest affinity)to PLpro and the glycoprotein spike.Non-polymerised monomers and polymerised chains interacted with SARS-CoV-2 proteins via hydrogen bonds and hydrophobic interactions.Those findings suggest an interaction between SARS-CoV-2 proteins and resin composites.CONCLUSION SARS-CoV-2 proteins show affinity to non-polymerised and polymerised resin composite chains.

Genetic and biological properties of H9N2 avian influenza viruses isolated in central China from2020 to 2022

The H9N2 subtype of avian influenza virus(AIV)is widely prevalent in poultry and wild birds globally,and has become the predominant subtype circulating in poultry in China.The H9N2 AIV can directly or indirectly(by serving as a"donor virus")infect humans,posing a significant threat to public health.Currently,there is a lack of in-depth research on the prevalence of H9N2 viruses in Shanxi Province,central China.In this study,we isolated 14 H9N2 AIVs from October 2020 to April 2022 in Shanxi Province,and genetic analysis revealed that these viruses belonged to 7 different genotypes.Our study on animals revealed that the H9N2 strains we identified displayed high transmission efficiency among chicken populations,and exhibited diverse replication abilities within these birds.These viruses could replicate efficiently in the lungs of mice,with one strain also demonstrating the capacity to reproduce in organs like the brain and kidneys.At the cellular level,the replication ability of different H9N2 strains was evaluated using plaque formation assays and multi-step growth curve assays,revealing significant differences in the replication and proliferation efficiency of the various H9N2 viruses at the cellular level.The antigenicity analysis suggested that these isolates could be classified into 2 separate antigenic clusters.Our research provides crucial data to help understand the prevalence and biological characteristics of H9N2 AIVs in central China.It also highlights the necessity of enhancing the surveillance of H9N2 AIVs.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Coinfection with Malaria in Selected States in Nigeria

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Plasmodium species are the causative agents of coronavirus disease 2019 (COVID-19) and malaria respectively with similar clinical presentations. The objective of this study is to determine the burden of co-infection of SARS-CoV-2 and malaria in the general population. Five (5 mLs) of blood samples were collected for SARS-CoV-2 and malaria parasite test. The malaria test was performed using a commercially available one-step malaria antigen Plasmodium falciparum histidine-rich protein 2 (Pf HRP-II) rapid test kit. The results of the study showed that the participants that were coinfected with SARS-CoV-2 IgG and malaria were 13 (2.5%) in Lagos, 1114 (39.1%) in Delta and 49 (2.3%) in Sokoto States. The prevalence of coinfection of SARS-CoV-2 and malaria in urban areas in Lagos, Delta and Sokoto States were 7 (2.2%), 1373 (48.1%), and 5 (0.2%) respectively. In rural areas, the prevalence of coinfection of SARS-CoV-2 and malaria in Lagos, Delta and Sokoto States were 6 (0.3%), 365 (12.8%), and 44 (2.1%) respectively in this study. This suggests that participants in the urban areas were more prone to co-infections than the rural areas in Lagos and Delta states, while it was otherwise in Sokoto State. In conclusion, the co-infection of SARS-CoV-2 and malaria was very high in Delta State compared to the other States. It is important for clinics to screen for both diseases when patients present with symptoms of malaria. This is because the infections have similar symptoms and the public is quick to assume malaria infection without diagnosing for COVID-19 and vice versa.

Throat Lozenges and Spray Containing Chlorhexidine and Lidocaine Fixed Combination Show Virucidal Activity against Respiratory Syncytial Virus and SARS-CoV-2

The limitations of existing treatments for both Respiratory Syncytial Virus (RSV) and Severe Acute Respiratory Syndrome-related Coronavirus 2 (SARS-CoV-2) lie in their inability to provide universally accessible, easy-to-use, and effective solutions. A commercially available fixed combination of chlorhexidine and lidocaine in both, lozenge and spray form, were assessed for their antiviral efficacy against RSV and SARS-CoV-2 in a suspension test, the viral titres were measured by standard TCID50. Both formulations were able to reduce the RSV titre to undetectable levels (99.9% virus inactivation, 3 log10 reduction) in less than 1 minute. The lozenge formulation inactivated the viral activity of SARS-CoV-2 in 5 minutes (99% virus inactivation, 2 log10 reduction), while the spray formulation led to a reduction of SARS-CoV-2 titre to undetectable levels in less than 1 minute (99.9%, 3 log10 reduction). In conclusion, our results show that preparations combining chlorhexidine and lidocaine significantly reduce certain respiratory viruses in vitro. In this regard, physiological effects of these preparations become more obvious potentially affecting viral transmission to other individuals and spreading to the lower respiratory tract—thereby shortening the duration and severity of symptoms.

The high diversity of SARS-CoV-2-related coronaviruses in pangolins alerts potential ecological risks

Understanding the zoonotic origin and evolution history of SARS-CoV-2 will provide critical insights for alerting and preventing future outbreaks.A significant gap remains for the possible role of pangolins as a reservoir of SARS-CoV-2 related coronaviruses(SC2r-CoVs).Here,we screened SC2r-CoVs in 172 samples from 163 pangolin individuals of four species,and detected positive signals in muscles of four Manis javanica and,for the first time,one M.pentadactyla.Phylogeographic analysis of pangolin mitochondrial DNA traced their origins from Southeast Asia.Using in-solution hybridization capture sequencing,we assembled a partial pangolin SC2r-CoV(pangolin-CoV)genome sequence of 22895 bp(MP20)from the M.pentadactyla sample.Phylogenetic analyses revealed MP20 was very closely related to pangolin-CoVs that were identified in M.javanica seized by Guangxi Customs.A genetic contribution of bat coronavirus to pangolin-CoVs via recombination was indicated.Our analysis revealed that the genetic diversity of pangolin-CoVs is substantially higher than previously anticipated.Given the potential infectivity of pangolin-CoVs,the high genetic diversity of pangolin-CoVs alerts the ecological risk of zoonotic evolution and transmission of pathogenic SC2r-CoVs.

Digestive system involvement of infections with SARS-CoV-2 and other coronaviruses:Clinical manifestations and potential mechanisms

Although coronavirus(CoV)infection is often characterized by respiratory symptoms,the virus can also result in extrapulmonary symptoms,especially the symptoms related to the digestive system.The outbreak of coronavirus disease 2019(COVID-19)is currently the world’s most pressing public health threat and has a significant impact on civil societies and the global economy.The occurrence of digestive symptoms in patients with COVID-19 is closely related to the development and prognosis of the disease.Moreover,thus far,there are no specific antiviral drug or vaccine approved for the treatment or prevention of COVID-19.Therefore,we elaborate on the effects of CoVs on the digestive system and the potential underlying mechanisms.

A High-Throughput, Multi-Index Isothermal Amplification Platform for Rapid Detection of 19 Types of Common Respiratory Viruses Including SARS-CoV-2

快速、准确地诊断以及及时对感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的患者进行隔离被认为是抗击新冠病毒肺炎(COVID-19)大流行的最有效的措施。本文介绍了一款高通量、多指标的等温扩增检测平台(RTisochip^TM-W),该平台使用离心式微流控芯片,在90min内即可完成一次运行,从16个样本中检测出包括SARS-CoV-2在内的19种常见呼吸道病毒。通过RTisochip^TM-W系统检测的所有病毒的检出限均等于或小于50拷贝·μL^-1,与常规逆转录聚合酶链反应(RT-PCR)灵敏度相当。该系统具有重复性好、鲁棒性强和特异性高的优点。最后,使用RTisochip^TM-W系统对201例临床前样本、14例COVID-19阳性临床样本、25例临床确诊样本以及614例来自呼吸道感染或疑似感染的患者的临床样本进行了测试。测试结果与临床诊断结果吻合良好,也反映出呼吸道传染病的流行特征。在对SARS-CoV-2的诊断上,RTisochip^TM-W系统与参考试剂盒的一致性达到98.15%。基于大量的测试结果,我们相信RTisochip^TM-W系统是一款抗击COV ID-19大流行的强有力工具。

Coronaviruses in pregnant women in Saudi Arabia:A systematic comparative review of MERS-CoV and SARS-CoV-2

Objective:To compare the effects of coronaviruses,such as Middle East respiratory syndrome coronavirus(MERS-CoV)or coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus-2(SARS-CoV-2),on pregnant women in Saudi Arabia,and to understand the disease dynamics of these coronaviruses so as to konw how to provide care and management of infected pregnant women and infants.Methods:We conducted a systematic review of all published papers on MERS-CoV and SARS-CoV-2 infections in pregnant women in Saudi Arabia to identify knowledge gaps.Inclusion and exclusion criteria were based on the PRISMA system.The search included all papers which were published between September 1,2012 and November 29,2020 on pregnant women with MERS-CoV and/or COVID-19 in Saudi Arabia.Of 26 papers screened,five were included in the analysis.Results:A total of 11 pregnant women with MERS-CoV and four with COVID-19 were reported in Saudi Arabia in the medical literature during the review period.The mean ages of the women were 33 and 31 years old for MERS-CoV and COVID-19,respectively.Maternal and fetal mortality in cases of MERSCoV were 35%and 30%,respectively,while no maternal or fetal mortalities were reported in COVID-19 cases.Conclusions:Very limited data has emerged from Saudi Arabia on pregnant women MERS-CoV and COVID-19.With such high mortality observed with MERS-CoV compared to COVID-19,there is a need for greater reporting of cases to truly grasp the extent of these infections in pregnant women in a country where both coronaviruses are circulating.

SARS-CoV-2合并感染患者的病原微生物分布特征及耐药性分析

目的分析严重急性呼吸综合征冠状病毒2(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)合并感染患者病原微生物分布特点及耐药情况,为临床诊治提供依据。方法收集2022年12月至2023年2月延安大学附属医院收治的2019冠状病毒病(corona virus disease 2019,COVID-19)患者637例的临床资料,回顾性分析其临床特征及合并感染病原微生物情况。结果COVID-19患者以老年人为主,合并基础疾病患者占79.59%,好转及痊愈患者高达91.05%。培养阳性标本来源于呼吸道、血液和尿液,合并感染的病原微生物分别以肺炎克雷伯杆菌、凝固酶阴性葡萄球菌(coagulase negative staphylococci,CNS)和真菌为主。药敏试验结果显示,肺炎克雷伯杆菌对β内酰胺类抗生素及三代、四代头孢菌素类抗生素耐药率较低(14%~20%),鲍曼不动杆菌对氨基糖苷类抗生素和β内酰胺类复合物较为耐药(均>45%),大肠埃希菌对β内酰胺类抗生素及其复合物耐药率较低(14%~19%)。金黄色葡萄球菌、CNS、屎肠球菌、粪肠球菌均未发现对万古霉素、利奈唑胺、替加环素耐药。结论COVID-19合并感染病原体以革兰阴性菌及真菌为主,感染部位以呼吸道为主,主要病原菌为肺炎克雷伯杆菌。鲍曼不动杆菌对氨基糖苷类抗生素和β内酰胺类复合物耐药率高于全国细菌耐药平均水平,提示临床上应根据COVID-19患者的微生物鉴定和药敏试验结果,选择对症药物治疗,以改善患者预后。

Sequence Analysis of HA Genes from Three H9N2 Subtype Avian Influenza Viruses

[ Objective] The study aimed to understand the genetic characters of H9N2 subtype avian influenza viruses isolated in Belling area. [ Method] HA genes of three H9N2 subtype avian influenza viruses A/Chicken/Beijing/xu/00, A/Chicken/Beijing/bei/00 and A/Chicken/Beijing/ liu/00 were amplified by RT-PCR and then sequenced. [ Result] The results of phylogenetic analysis showed that A/Chicken/Beijing/xu/00, A/ Chicken/Beijing/bei/00 and A/Chicken/Beijing/liu/00 shared the nucleotide homologies of 84.8% （ Dk/HK/Y439/97 ） -98.0% （ Ck/GX17/00 ）, 85.1% （Dk/HK/Y439/97） - 99.1% （ Ck/GXl 7/00）, 90.7% （ Ck/BJ/3/01 ） - 99.1% （Ck/GX17/00） with the isolates from Hongkong and other are- as of Chinese Mainland respectively. At the same time, the analysis of amino acid indicated that the three isolates belonged to low pathogenic H9N2 isolates of avian origin. The 226^th amino acid of them were L （ Leu）, suggesting their high binding affinity to human cells. There were seven glyco- sylation sites in HA protein, five from HA1 and two from HA2. [ Cenclusien] By analysis at molecular level, it could be concluded that A/Chicken/ Beijing/xu/00, A/Chicken/Beijing/bei/00 and A/Chicken/Beijing/liu/00 were low pathogenic H9N2 isolates of avian origin.

糖尿病患者接种SARS-Cov-2疫苗后的免疫反应:系统评价

目的系统评价糖尿病患者在接种SARS-CoV-2疫苗后的体液和细胞免疫反应。方法检索Web of Science、PubMed、中国知网、万方数据知识服务平台、维普中文科技期刊全文数据库和中国生物医学文献数据库,获取国内外于2019年12月1日至2022年5月12日公开发表的有关糖尿病患者接种SARS-CoV-2疫苗后的体液和细胞免疫反应的观察性研究,经由2名研究者独立筛选文献和提取资料后,采用美国国立卫生研究质量评价工具对纳入文献进行偏倚风险评价,使用描述性统计方法进行汇总分析。结果13篇文献共纳入66651例研究对象,其中5874例(7.9%)患有糖尿病。7篇文献报道了接种第1剂疫苗后糖尿病患者和对照组的免疫反应,其中3篇文献表明,接种1剂SARS-CoV-2疫苗后,糖尿病患者血清抗体水平和阳性率低于对照组;11篇涉及接种2剂SARS-CoV-2疫苗后的免疫反应的文献中,2篇报道了糖尿病患者可产生与对照组相似的抗体反应,9篇报道了糖尿病患者的血清抗体水平、阳性率或细胞免疫反应低于对照组。结论接种SARS-CoV-2疫苗后糖尿病患者和对照组体液和细胞免疫反应均有所增加,但糖尿病患者增加幅度普遍低于对照组。

基于hACE2转导建立SARS-CoV-2 spike假病毒感染病证结合的小鼠病毒肺炎模型

目的建立与评价一种安全、经济、有效的病证结合小鼠新冠病毒感染肺炎模型。方法30只KM种小鼠随机分为空白组、对照组及实验1组、实验2组、实验3组,每组各6只。每天把KM小鼠置于模拟寒湿环境中4 h,将表达hACE2的重组腺相关病毒(pAAV-hACE2)采用改良悬挂法气管内给药转导至肺组织,继以新型冠状病毒(SARS-CoV-2)spike假病毒采用相同的气管内给药方式造模。观察各组小鼠一般情况,检测体重变化、肺指数、血清炎性因子及肺部病理变化。结果免疫组化法显示h ACE2在小鼠肺组织中有效表达;在寒湿环境中给予SARS-CoV-2 spike假病毒后,实验组小鼠表现出类似疫毒犯肺证候的体征;且同样喂养条件和时间下,与空白组和对照组小鼠比较,实验组小鼠出现体重下降;实验1、2、3组小鼠出现肺指数显著增大(P<0.05或P<0.01),血清炎性因子白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)显著升高(P<0.01),肺组织病理改变明显。结论本研究成功建立了一种安全、经济、有效的病证结合小鼠新冠病毒感染肺炎模型。

hiPSCs分化的细胞和类器官在SARS-CoV-2感染研究上的应用

SARS-CoV-2引起全球性传染病COVID-19的大流行,SARS-CoV-2感染研究对于了解人体细胞和器官被此种病毒感染后的病理反应具有重要意义。将hiPSCs分化为呼吸道、肺类器官、神经系统细胞、脑类器官、心肌细胞、血管、肠类器官和肾类器官,进行SARS-CoV-2感染研究,发现这些细胞和类器官受SARS-CoV-2感染,生理活性受损,生理功能削弱,促炎性因子分泌增加,类器官发生炎症反应和功能退化现象。因此,hiPSCs分化的细胞和类器官可用于SARS-CoV-2感染研究,病毒感染会影响这些细胞和类器官的功能。

黄芩苷对SARS-COV-2侵袭的抑制作用研究

目的在体外研究黄芩苷对新型冠状病毒(SARS-CoV-2)入侵细胞过程的抑制作用。方法利用构建有荧光素酶报告基因的SARS-CoV-2 S蛋白假病毒系统,通过荧光素酶试剂盒检测加入黄芩苷和假病毒后Huh-7细胞中的荧光素表达变化,进而绘制病毒抑制曲线。结果黄芩苷能显著抑制Huh-7细胞的病毒感染率,黄芩苷和病毒提前共孵育组与直接加入组在不同浓度下的病毒抑制曲线并无显著差别,表明黄芩苷并不能与病毒直接结合,而是通过作用于病毒S蛋白介导的细胞融合过程产生抑制作用;黄芩苷在0.125 mg·mL^(-1)浓度时,对病毒的抑制率在4 h组显著降低,在0 h和2 h组并无显著差别,表明黄芩苷可能在病毒入侵细胞(非吸附)阶段产生抑制作用,且介导的入侵抑制阶段发生在4 h内。结论黄芩苷可能通过介导抑制SARS-CoV-2病毒S蛋白与细胞表面受体的融合过程,在非吸附阶段抑制病毒的入侵,发挥抗新冠病毒活性。

SARS-CoV-2重组痘苗病毒疫苗rVTT△TK-RBD的构建、筛选及免疫原性研究

目的 构建重组痘苗病毒载体疫苗rVTT△TK-RBD,并评价其安全性和免疫原性。方法 参考严重急性呼吸综合征冠状病毒2(SARS-CoV-2)基因序列合成受体结合域(RBD)基因,并将其插入自主构建的重组质粒pSTKE的多克隆位点上,构建重组痘苗病毒穿梭载体pSTKE-RBD,并转染到预先感染天坛株痘苗病毒(VTT)的BHK-21细胞内,经多轮的荧光噬斑筛选成功获得重组痘苗病毒rVTT△TK-RBD;通过滴鼻方式免疫小鼠后,检测rVTT△TK-RBD对BALB/c小鼠体质量的影响;通过肌肉免疫小鼠后,分析rVTT△TK-RBD对BALB/c小鼠产生的特异性抗体和中和抗体的水平;通过流式细胞术检测rVTT△TK-RBD对BALB/c小鼠T细胞亚群的影响。结果 利用同源重组、增强型绿色荧光蛋白(EGFP)筛选标记和多次荧光噬斑筛选,成功筛选获得了表达RBD的胸腺激酶(TK)基因缺失型重组痘苗病毒rVTT△TK-RBD,且PCR验证成功。BALB/c小鼠体内实验表明rVTT△TK-RBD具有较好的抗SARS-CoV-2的免疫原性且相比于亲本株VTT明显降低了对机体的毒性作用。结论 成功构建并获得SARS-CoV-2重组痘苗病毒疫苗rVTT△TK-RBD并通过各项试验证明其安全性和免疫原性。

重组SARS-CoV-2 Omicron变异株S1蛋白的表达及免疫原性评价

目的构建表达新型冠状病毒(SARS-CoV-2)Omicron BA.1变异株S1蛋白的真核表达载体,在CHO-K1细胞中进行表达,评价其免疫原性,并对佐剂和抗原剂量进行研究。方法构建重组质粒UCOE-Omi-S1,转染至CHO-K1工程细胞中进行表达和纯化,通过SDS-PAGE和Western blot法实验鉴定重组S1蛋白。将BALB/c小鼠随机分为12组,即PBS组,无佐剂组(高、中、低剂量组),铝盐佐剂对照组,MF59佐剂对照组,铝盐佐剂实验组(高、中、低剂量组),MF59佐剂实验组(高、中、低剂量组),将按照分组要求配比的溶液经小鼠肌内注射3次,间隔14天,每2周尾静脉采血,末次免疫30天后取血分离血清,酶联免疫吸附试验(enzyme-linked immunosorbent assay,ELISA)检测血清抗体水平,并和SARS-CoV-2原型株的假病毒和SARS-CoV-2 Omicron BA.1变异株的假病毒进行假病毒中和实验。结果目的蛋白在CHO-K1工程细胞表达后可分泌到培养上清中,在相对分子质量约为70kDa处可见1条特异性蛋白表达条带,经Western blot法鉴定为Omi-S1蛋白。铝盐佐剂组和MF59佐剂组免疫诱导效果优于无佐剂组,铝盐佐剂组和MF59佐剂组免疫诱导效果相差不大,但MF59佐剂起效快;高、中、低剂量组的免疫诱导效果在第8周相差不大,但高剂量组起效快。假病毒中和实验表明,MF59佐剂实验组针对Omicron变异株的中和抗体水平高于铝盐佐剂组。结论本研究所构建的Omicron S1重组蛋白免疫原性良好,在小鼠体内产生了良好的体液免疫应答,并诱导高水平的对抗SARS-CoV-2假病毒的中和抗体,对佐剂和抗原剂量初步研究,结果显示,10μg以下抗原剂量搭配MF59佐剂可获得较好的免疫效果。本研究为SARS-CoV-2变异株的重组蛋白疫苗的研制提供了实验基础。

基于双核酸适配体的磁珠-SERS标签三明治结构用于SARS-CoV-2病毒表面S蛋白的快速检测

面对新型冠状病毒2019(COVID-19)传播速度极快的情况,发展快速、准确和低成本的诊断方法以检测SARS-CoV-2病毒的特定抗原非常必要。基于逆转录聚合酶链反应(RT-PCR)的COVID-19检测需要特定的实验室,耗时较长。本文针对SARS-CoV-2刺突蛋白,提出了一种基于核酸适配体特异性识别的一步捕获底物和检测探针的表面增强拉曼光谱(SERS)检测平台。利用模拟病毒(PSV)进行实验,不经预处理,在5 min内用便携式拉曼光谱仪检测SARS-CoV-2病毒及其变异株。实验结果表明,针对模拟病毒的检出限为200 TU/mL。此外,该方法可以检测另外5种SARS-CoV-2的变异病毒株,咽拭子体系中的极限检测限可以达到5000 TU/mL。实际大批量咽拭子的实验结果可以达到特异性为100%的效果。因此,该平台在SARS-CoV-2的医护点快速诊断中具有很大的应用潜力。

脑脊液二代基因检查确诊SARS-CoV-2脑炎临床分析

目的探讨脑脊液确诊的SARS-CoV-2脑炎患者的临床特点及诊治方法。方法收集2022年3月至2023年3月我院神经内科重症监护病房脑脊液确诊的SARS-CoV-2脑炎患者的临床资料,并结合国内外数据库中已报道相关文献资料进行分析总结。结果5例患者主要神经系统症状为意识水平下降(5/5)、精神行为异常(2/5)、癫痫发作(2/5)、四肢瘫痪(1/5)、头痛(1/5)。2例患者头颅磁共振(MRI)异常改变,累及颞叶及岛叶、丘脑、海马和脑桥。2例脑脊液蛋白轻度升高。5例脑脊液NGS检查均显示SARS-CoV-2阳性(序列数41-1620),其中1例同时检测到人类疱疹病毒1型(序列数21)。5例患者均接受抗病毒治疗,3例联合糖皮质激素,1例联合免疫球蛋白,所有患者预后良好(mRS:0~2分)。结论SARS-CoV-2因其嗜神经性,可导致脑炎。对于有相关流行病学史且伴有中枢神经系统症状的患者,需考虑该病的可能。脑脊液NGS检测有助于该病的早期诊断,积极的抗病毒及免疫治疗,有助于改善预后。

SARS-CoV-2 S蛋白引起呼吸道上皮细胞炎症反应的研究进展

严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)感染引起的肺炎对人类生命健康产生威胁,对社会经济造成巨大损失。病毒的结构蛋白刺突蛋白(S蛋白)一直被认为主要介导病毒侵入宿主细胞。S蛋白可独立于病毒引起多种细胞产生炎症反应,因此,了解S蛋白本身对呼吸道的影响能够为防治新型冠状病毒感染提供新视角。本文对SARS-CoV-2结构蛋白S蛋白引起呼吸道上皮细胞炎症反应的可能机制、临床表现等方面的研究进展进行了梳理,以期为疾病的预防和治疗提供参考。