The latest research progress of the Corona Virus Disease 2019 mutant strain"Omicron"

Coronavirus disease 2019(COVID-19)that broke out at the end of December 2019 has been raging for 3 years,bringing unpredictable harm to the physical and mental health of all mankind and global economic development.The new type of coronavirus pneumonia is a new type of respiratory infectious disease with a high incidence and fatality rate caused by SARS-CoV-2.Up to now,hundreds of millions of people have been infected with new coronary pneumonia worldwide,and millions of people have died.Due to the specificity of the new coronavirus itself and its high mutation rate,a series of different new coronavirus variants have appeared,which has caused the new crown pneumonia epidemic to repeat.Recently,the World Health Organization(WHO)announced a new variant"omicron"(omicron,B.1.1.529),and declared that the mutant strain may be highly infectious,antibody tolerant and highly resistant to vaccines.This article briefly reviews the latest research progress of the"omicron"variants.

SARS-CoV-2核酸检测试剂盒的制备及样本混检性能分析

目的开发一种适用于中国大规模人群新型冠状病毒(SARS-CoV-2)感染筛查的核酸检测试剂盒,分析对多样本混合检测的效果,为临床多样本混合检测提供理论指导。方法选用SARS-CoV-2的ORF1ab、N 2个靶基因,并加入RNase P作为内标基因进行试剂盒研发。采用单一变量及正交实验优化试剂盒中3个靶基因引物及探针浓度比例。评价试剂盒的准确性、特异性及灵敏度。收集阳性样本与阴性样本按不同比例混合,采用本试剂盒及市售参比试剂盒分别检测混合样本的SARS-CoV-2,比较不同试剂盒检测不同靶标的检出浓度及扩增Ct值。结果本试剂盒阳性符合率、阴性符合率及特异性均为100%,灵敏度为1×10^(3) copies/mL;不同试剂盒对混合样本中不同靶基因的检出浓度不同,本试剂盒对ORF1ab靶基因的检出限为混合比例1/20,灵敏度高于参比试剂盒(1/10),且检测相同浓度模板的扩增Ct值低于参比试剂盒(P<0.05)。结论本试剂盒ORF1ab靶基因检测灵敏度高,在SARS-CoV-2核酸多样本混合检测中更具优势,适用于大规模人群筛查。

新冠病毒轻型感染对献血者血液学指标及捐献单采血小板适宜性的影响

目的:通过对新冠病毒Omicron变异株轻型感染献血者血液学指标的变化分析,探讨新冠病毒轻型感染对成人血液学指标的影响,进而评估其对捐献单采血小板适宜性的影响。方法:以2022年12月-2023年1月期间出现新冠病毒轻型感染症状、连续捐献单采血小板3次的72例献血者(其中阳性组42例,疑似感染组30例)和2022年10月-11月期间未接种新冠疫苗、未感染新冠病毒、连续捐献3次单采血小板的42例献血者(对照组)为研究对象,通过重复测量方差分析法回顾性比较阳性组和疑似感染组出现症状前(Time1)后(Time2和Time3)及对照组连续3次(Time1、Time2、Time3)的血常规变化,并采用贝叶斯判别法建立近期是否感染新冠病毒的判别方程式。结果:阳性组和疑似感染组组内测量次数的简单效应显著(F_(阳性组)=6.98,P<0.001,偏η^(2)=0.79;F_(疑似感染组)=4.31,P<0.001,偏η^(2)=0.70);阳性组、疑似感染组Time2与Time1、Time3血常规指标相比较,RBC、HCT、HGB降低,PLT与PCT明显升高(P<0.05),阳性组、疑似感染组Time3的RDW-CV、RDW-SD与Time1、Time2相比均明显升高(P<0.001)。对照组组内测量次数简单效应不显著(F=0.96,P=0.55,偏η^(2)=0.34);组内3次血常规指标差异无统计学意义(P>0.05)。建立“近期是否感染新冠病毒”的判别方程式,方程特征值是0.22,典型相关性为0.43(χ^(2)=27.81,P<0.001),分析正确率为72.9%。结论:新冠病毒轻型感染献血者血液学指标中RBC、HCT、HGB、PLT、PCT、RDW-CV和RDW-SD呈动态变化,近期是否感染新冠病毒的判别方程式有较高的准确率。

Clinical andTransmission Characteristics of COVID-19-A Retrospective Study of 25 Cases from a Single Thoracic Surgery Department

The outbreak of corona virus disease 2019(COVID-19)imposes a major challenge in managing patients undergoing surgical operation.In this study,we analyzed clinical and transmission features of 25 cases of COVID-19 from a single thoracic department,including 13 patients and 12 health care staff.There were 13 males and 12 females.The median age of the patients was 61(range:51 to 69)years.The median age of the health care staff was 35(range:22 to 51)years.By the end of follow-up date(Mar.3,2020),there were 16 non-severe cases(64%)and 9 severe cases(36%),5 cases were dead(20%).Nineteen(76%)of the infected cases were confirmed by SARS-CoV-2 nucleic acid test,the rest were clinically diagnosed as suspected COVID-19 cases,and 19(76%)of the infected cases had positive exposure history.We found that COPD was significantly associated with severity and death(P-0.040,and P=0.038,respectively),and chest operation was significantly associated with death for COVID-19 patients(P-0.039).A potential“super spreader"may be the source of the transmission before the implementation of quarantine and comprehensive protcction.It was concluded that COVID-19 is associated with poor prognosis for patients undergoing thoracic operation,especially for those with COPD.Implementation of comprehensive protective measures is important to control nosocomial infection.

新型冠状病毒关键受体ACE2在眼部的分布及其临床意义

目前,新型冠状病毒(2019-nCoV)引起的新型冠状病毒肺炎(COVID-19)疫情呈大流行状态。2019-nCoV主要引起人类呼吸道感染并引起肺部组织结构和功能损害,已发现部分患者合并病毒性结膜炎,或以双眼病毒性结膜炎为首发症状,因此了解2019-nCoV的生物学行为及眼是否会被其感染非常重要。2019-nCoV主要通过与细胞表面的血管紧张素转化酶2(ACE2)结合侵入人类组织细胞,研究发现ACE2不仅表达于人肺脏、肾脏、心血管等器官,而且在人的结膜、角膜、房水及视网膜中也有表达。了解眼内ACE2的分布,有助于更加全面地认识COVID-19的感染机制和发病原因并且更好地了解眼科其他相关疾病的病理机制。ACE2是2019-nCoV侵染宿主的受体蛋白,同时也是肾素-血管紧张素系统(RAS)中的一个关键酶,眼部相对独立的RAS在维持眼的生理功能中发挥重要的调控作用,并且与许多眼科常见病有关。本文对ACE2在眼组织中的分布及其临床意义进行综述。

基于分子对接技术筛选中药“新冠2号”干预新型冠状病毒肺炎活性成分

目的:通过分子对接技术,筛选“新冠2号”中干预新型冠状病毒肺炎(Corona Virus Disease 2019,COVID-19)核心药物及其活性成分。方法:根据处方中药组分,通过ETCM、TCMID、TCMSP数据库收集“新冠2号”所有中药化学小分子;结合相关文献选取SARS-CoV-23L水解酶(Mpro)和组织蛋白酶L(Cathepsin L,CTSL)两种蛋白酶作为靶蛋白,将处理后小分子作为配体与两种处理过的靶蛋白进行分子对接筛选。结果:归纳“新冠2号”所含小分子,收集化合物共1720个,其中连翘酯苷F、厚朴苷B、1,2,3,4,6-五-O-没食子酰-β-d-葡萄糖等13个小分子与靶蛋白有较好亲和力,可能为干预新冠肺炎的活性成分。结论:从“新冠2号”处方中筛选出连翘中连翘酯苷F、半夏中1,2,3,4,6-五-O-没食子酰-β-d-葡萄糖、厚朴中厚朴苷B等13个小分子能与新型冠状病毒靶点结合,符合中医药“多成分-多靶点”学说,为寻找Mpro、CTSL抑制剂分子提供参考。

2型糖尿病患者味觉障碍与新型冠状病毒感染相关性的研究

目的调查T2DM患者味觉障碍现状,探讨新型冠状病毒(COVID-19)感染对味觉的影响在感染3个月后是否持续存在。方法选取2023年2月20日至3月10日于解放军总医院第九医学中心(原战略支援部队特色医学中心)内分泌科门诊治疗的T2DM患者(无COVID-19感染史或感染后3~4个月)95例,根据COVID-19感染史分为感染组(COVID-19,n=72)及单纯T2DM组(n=23)。应用味觉测试盒测试两组味觉功能,比较两组一般资料、生化指标、味觉障碍等。结果95例患者年龄(58.3±9.6)岁,男61例(64.2%),DM病程中位数11年,Hb A1c中位数7.3%。味觉测试中,存在酸、甜、苦、咸4种味觉障碍的比例分别为60.0%、45.3%、57.9%、41.1%、84.2%。COVID-19组患者入组时间距感染第1天时间平均为102.4 d。COVID-19组酸、甜、苦、咸味觉障碍的比例为61.1%、44.4%、55.6%、41.7%,T2DM组酸、甜、苦、咸味觉障碍的比例为56.5%、47.8%、65.2%、39.1%。以4种味觉任意1种存在障碍作为味觉障碍,COVID-19组味觉障碍患病率高于T2DM组(86.1%vs 78.3%)。结论味觉障碍在T2DM患者中较普遍,T2DM患者在COVID-19感染3个月后,味觉障碍患病率与未感染患者无明显差异。

Acquired immune thrombotic thrombocytopenic purpura(TTP)associated with inactivated COVID-19 vaccine CoronaVac

Corona virus disease 2019(COVID-19)due to severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection has affected the whole world.Acquired thrombotic thrombocytopenic purpura(TTP)has been reported after administration of mRNA-or adenoviral vector-based COVID-19 vaccines,including Ad26.COV2-S,BNT162b2,mRNA-1273,and ChAdOx1 nCov-19.However,whether inactivated vaccines,such as CoronaVac,could cause TTP and whether the symptoms in TTPs caused by inactivated vaccines are different from previously reported cases are unknown.In this study,two cases were reported.Both cases developed TTP after the second CoronaVac vaccination shot,but not the first.They demonstrated symptoms of fever,neurological abnormalities,renal dysfunction,thrombocytopenia,and hemolysis.Both patients achieved complete remission through several sessions of plasma exchanges and immune suppression.The incidence of TTP in Nanjing area was analyzed.The number of patients with TTP was 12 in 2019,6 in 2020,16 in 2021,and 19 in 2022.To the authors’knowledge,this report is the first report of TTP associated with inactivated COVID-19 vaccine(CoronaVac).The rarity and delayed onset may be due to the relatively milder immune response caused by the inactivated vaccines than mRNA-based ones.Timely plasma exchange is a vital treatment for CoronaVac-related TTP,similar to activated vaccine-related TTP.

抗击新型冠状病毒肺炎的医务人员身心体验状况调查

目的研究在新型冠状病毒肺炎(新冠肺炎)防控中医务人员的身心体验,为保障医疗人力资源提供参考。方法采用质性研究中的现象学研究法,对2020年1月28日至2020年1月31日来自深圳市第三人民医院及西安交通大学第一、二附属医院和西安市第四军医大学唐都医院一线接触疫情工作的16名医务人员进行深入访谈,了解医务人员对新冠肺炎防控中的身心感受,并对访谈资料进行归纳与分析。结果医务人员在新冠肺炎防控中的身心感受主要提取为五项主题:①震惊及恐惧心理;②知识缺乏,需要正确认知新冠肺炎;③医务人员需要正确面对,做好自身防护;④保家卫国,刻不容缓;⑤人民群众需要有效的防护及传染病知识宣传与重视度教育。结论医务人员在新冠肺炎的防控中身心感受复杂多样,需要各级领导主管部门高度重视,在保障防护用品及设施的供给外,确保足够的医疗人力资源梯队,以应对国际关注的突发公共卫生事件(PHEIC)。

新型冠状病毒感染临床分型的探讨

本文借鉴SARS病毒感染分型系统,建议将新型冠状病毒感染可分为隐匿型(已诊断、未诊断2个亚型)、顿挫型、轻症肺炎型、重症肺炎型、危重症肺炎型5个类型;或者隐匿型(已诊断、未诊断2个亚型)、顿挫型、肺炎型(轻症、重症、危重症3个亚型)3大类型。其中,轻症肺炎型、重症肺炎型和危重症肺炎型3个类型,分别对应目前通用分类的“普通型”、“重型”和“危重型”。新型冠状病毒感染新的临床分型,强调了显性感染和隐形感染的区别,弥补了传统分型不能覆盖部分临床患者的缺陷,兼顾了临床特征中病情轻重和有无肺炎2个诊断维度,提出了未诊断感染者的隐匿亚型,对未来新型冠状病毒防控具有重要意义。

Review of inflammatory bowel disease and COVID-19

The first cases of a novel corona virus infection were reported in Wuhan China in December of 2019,followed by the declaration of an international pandemic by the World Health Organization in March 2020.Early reports of the virus,now known as severe acute respiratory syndrome coronavirus 2,and its clinical disease coronavirus disease 2019(COVID-19),has shown higher rates of morbidity and mortality in the elderly and those with pre-existing medical conditions.Of particular concern is the safety of those with compromised immune systems.Inflammatory Bowel disease(IBD)is itself caused by a disordered immune response,with the most effective medical therapies being immune suppressing or modifying.As such,the risk of COVID-19,virus related outcomes,and appropriate management of IBD patients during the global pandemic is of immediate concern to gastroenterologists worldwide.There has been a rapid accumulation of clinical data and expert opinion on the topic.This review will highlight the latest source information on clinical observation/outcomes of the IBD population and provide a concise summary of the most up to date perspectives on IBD management in the age of COVID-19.

新型冠状病毒肺炎可疑暴露者睡眠状况和情绪调节对生存质量的影响

目的探讨新型冠状病毒肺炎可疑暴露者睡眠状况和情绪调节对生存质量的影响。方法选取2020年1月入住疗养中心与确诊病例有间接接触的疗养员和工作人员共127名,施测《匹兹堡睡眠质量指数》《认知情绪调节策略问卷》和《简明健康状况调查表》,分析睡眠状况和情绪调节与生存质量的相关性。结果有效回收问卷110份,有效率86.6%。睡眠量表得分与积极重新关注呈负相关(r=-0.256,P<0.01);生存质量量表得分与积极重新关注、积极重新评价和重新关注计划呈正相关(r=0.382、0.290、0.253,P<0.01),生存质量量表得分与睡眠量表得分呈负相关(r=-0.427,P<0.01)。结论新型冠状病毒肺炎可疑暴露者生存质量受其睡眠状况和情绪调节影响。在保证睡眠质量的同时,引导个体采取积极重新关注的情绪调节策略,可有效改善个体生存质量。

静脉注射利多卡因预防疑似及确诊新型冠状病毒肺炎患者气管插管应激反应的临床研究

目的探讨静脉注射利多卡因预防疑似及确诊新型冠状病毒肺炎患者行气管插管应激反应的临床效果。方法回顾性分析2020年1月20日-3月14日我院收治的行气管插管治疗的疑似及确诊新型冠状病毒肺炎患者38例。按照诱导麻醉方式不同分为观察组20例和对照组18例。对照组采用常规麻醉诱导;观察组在常规麻醉诱导前加用静脉注射利多卡因1.0 mg/kg。气管插管成功后给予呼吸机治疗。记录并比较2组患者插管前(T0)、插管即刻(T1)、插管后1 min(T2)、插管后5 min(T3)的心率、平均动脉压。比较2组患者插管期间不良事件发生情况。结果与T0时比较,2组T1~T3时平均动脉血压升高,心率增快,且观察组低于对照组(P<0.05)。观察组不良反应发生率低于对照组(P<0.05)。结论静脉注射利多卡应用于疑似及确诊新型冠状病毒肺炎患者气管插管,可使患者血流动力学更加平稳,降低了患者呛咳、低血压、窦性心动过速及高血压等不良事件发生率。

血管紧张素转换酶抑制剂/血管紧张素受体拮抗剂在新型冠状病毒肺炎疫情防控中的应用分析

根据《中国心血管病报告》,中国现患心血管病人数约2.9亿,而大量循证医学证据证实了血管紧张素转换酶抑制剂(ACEI)或血管紧张素受体拮抗剂(ARB)治疗心血管等疾病的价值。ACEI/ARB是肾素-血管紧张素-醛固酮系统(RAAS)的阻滞剂,可上调血管紧张素转换酶2(ACE2)表达水平。而ACE2是新型冠状病毒肺炎(COVID-19)发生发展的关键分子靶点,一方面它是侵入人体细胞的必须受体,触发了COVID-19的发生,另一方面在COVID-19的发展过程中发挥抗炎保护作用。本文探讨在疫情防控期间能否使用ACEI/ARB,以期为心血管疾病患者合理使用ACEI/ARB提供思路与参考。

Risk Factors Contributing in Increased Susceptibility and Severity of COVID-19 Infection during Pregnancy

The corona virus disease 2019 (COVID-19) pandemic has spread globally and pregnant women are considerably prone to COVID-19 infection with increased maternal and perinatal complications. Aim: This study aims to explore the risk factors that contribute to susceptibility and severity of COVID-19 infection among pregnant women. Method: A literature search of articles relating to COVID-19 infection during pregnancy, was conducted, using PubMed, Scopus and Google scholar engine. Result: A total of 168 articles were initially identified. Eighty four papers were excluded for failing to address the aim of the study. After screening titles and abstracts, eighty four full-text articles were retrieved for eligibility analysis. Nineteen studies addressed the susceptibility related to pregnancy, twenty-two studies evaluated the associated comorbidities, nineteen focused on immune system, thirty-six articles concentrated on the risk of coagulopathy and eleven addressed more than one risk factor. Conclusion: Pregnancy, associated comorbidities, modulated immune response during pregnancy and risk of coagulopathy are considerable risk factors contributing to COVID-19 pathogenesis among pregnant women and may predict the outcome.

Prospective treatment procedure of COVID-19 with siRNA-LDH nanoconjugate

COVID-19 is a devastating outbreak that has developed from December,2019.SARS-CoV-2 is the causative organism of this disease condition.However,as this is a novel virus human race do not know the curative measures of this disease.They don’t know the treatment procedure but only few preventive measures are known to them.In today’s era of nanotechnology,nanoparticles may be used to combat this disease condition.In this publication,a hypothesis is drawn on a prospective therapeutic procedure to combat COVID-19.A nanoconjugate comprising of siRNA and Layered double hydroxide may be used as an intranasal spray to treat this disease condition.Specific siRNA sequence that will target the RNA sequence of the virus will help to resist the replication and infection of the virus.As this nanoconjugate will not have any side effect it may become an optimum therapeutic measure for COVID-19.

Network pharmacology and molecular docking analysis on molecular targets and mechanism prediction of Huanglian Jiedu Decoction in the treatment of COVID-19

Objective To investigate and predict the molecular targets and mechanism of Huanglian Jiedu Decoction(黄连解毒汤,HLJDD)in the treatment of Corona Virus Disease 2019(COV-ID-19)through network pharmacology and molecular docking analysis.Methods The chemical constituents and action targets of HLJDD were retrieved on Tradi-tional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP),SymMap v2,Encyclopedia of Traditional Chinese Medicine(ETCM),a High-throughput Ex-periment-and Reference-guided Database of Traditional Chinese Medicine(HERB),and Tra-ditional Chinese Medicine Integrated Database(TCMID).UniProt and GeneCards were used to query the target genes that corresponding to the active compounds,and then a compound-target network was constructed using Cytoscape 3.7.2.Gene Ontology(GO)database was used to annotate GO functions.Kyoto Encyclopedia of Genes and Genomes(KEGG)was used to predict the possible mechanisms of active compounds.The Database for Annotation,Visu-alization and Integrated Discovery(DAVID)was used to analysis the tissue enrichment.The main active compounds in HLJDD are molecularly docked with their corresponding related targets.Results Seventy-six compounds were screened and 458 corresponding targets in the network were obtained.Gene annotation showed that the targets were involved mainly in 1953 biolo-gical processes.884 signaling pathways was enriched,involving signaling by interleukins,cy-tokine signaling in immune system,generic transcription pathway,and RNA polymerase II transcription.The targets mainly distributed in the lung,liver,and placenta,involving a vari-ety of immune cells,such as T cells and B cells.The molecular docking results showed that core compounds such as wogonin,berberine,and baicalein had high affinity with tumor nec-rosis factor(TNF),insulin(INS),and tumor protein 53(TP53).Conclusion The active compounds in HLJDD may have a therapeutic effect on COVID-19 through regulating multiple signal pathways by targeting genes such as vascular endothelial growth factor A(VEGFA),INS,interleukin-6(IL-6),TNF,caspase-3,TP53,and mitogen-activ-ated protein kinase 3(MAPK3).

2019冠状病毒病的中医诊治阶段体会

根据2019冠状病毒病(COVID-19)患者临床症状,结合《黄帝内经》五运六气理论分析,认为本病属于中医“伏燥寒湿疫”。在确立寒湿致病的同时,应高度关注伏燥致疫,燥邪为伏气、寒湿为时气,伏气与时气交互产生疫毒,导致了COVID-19患者内燥外寒(湿)的病机证候特征。在前期临床实践基础上将本病分为“伏邪内伤,燥热灼肺型”、“寒湿困脾,壅阻肺气型”、“余邪未尽,肺脾两虚型”,分别予葳蕤汤、升阳益胃汤、神术散合生脉散等加减运用。此外,龙砂开阖六气针法非药物疗法在缓解临床症状中有一定疗效,值得关注。

基于互联网问卷的2019冠状病毒病流行期人群情绪、应激及中医五脏症状调查

目的:了解2019冠状病毒病(COVID-19)流行期人群情绪-躯体等健康状况,为心理干预提供依据。方法:运用临床流行病学调查的方法,采用抑郁自评量表(PHQ-9)、广泛性焦虑量表(GAD-7)、急性应激障碍自评量表(ASDS)、失眠严重指数量表(ISI)及五脏健康问卷,基于网络平台对受疫情影响人群情绪-躯体健康状况进行问卷调查。结果:本研究共回收有效答卷5296份。ASDS平均(28.00±10.82)分,10.50%的被调查者符合急性应激障碍诊断;依据PHQ-9存在重度及极重度抑郁者577例(10.90%),依据GAD-7存在中度及重度焦虑986例(18.62%);各项评分在年龄段、性别、人群分级、湖北及非湖北地区组间有显著性差异(P<0.01,P<0.05);中医五脏症状分布以脾系(1623例,30.65%)、肝系(1124例,21.22%)和肺系(827例,15.62%)症状最为多见。结论:COVID-19流行期间人群存在不同程度的应激和焦虑、抑郁等负性情绪,病毒威胁风险较高人群尤为明显。启动并介入现场心理急救支援可能有助于改善人群(包括医务人员)的应激异常和负性情绪。

“四区脱卸法”在新冠肺炎重症病区的应用及防护效果

目的评估“四区脱卸法”脱防护用品流程避免医务人员受2019新型冠状病毒(SARS-CoV-2)污染的有效性。方法选取45名在2019冠状病毒病(COVID-19)重症病区工作的医务人员作为研究对象,在其结束工作时采样其防护服胸前至腿部区域、手套及鞋套部位,随后让其按照“四区脱卸法”去除个人防护用品,再采集他们的手术衣裤、手部皮肤、鞋子部位。另外每天在脱卸防护用品人流量高峰期(>30人次)后采集4个脱卸区域的地面样本,所有样本进行SARS-CoV-2病毒核酸检测。结果脱卸前,4人手套受到污染,整体污染率为8.89%(4/45);21人鞋套受到污染,整体污染率为46.67%(21/45);脱卸后,所有样本均未受到污染。脱卸间地面采样标本中,一区阳性率为66.67%(8/12),二区阳性率为33.33%(4/12),三区、四区均为阴性。结论该“四区脱卸法”能有效避免医务人员在脱卸防护用品过程中感染SARS-CoV-2,降低医务人员感染风险。