新冠肺炎疫情至今已影響全球49個國家,累計確診病例近82,000例,其中2,800人因病去世,新冠肺炎目前推估潛伏期為1-14天,甚至可長達24天,主要傳染途徑為飛沫傳染,但不排除有糞便或血液傳染的可能性。目前新冠肺炎的推估傳染數(reproductive number:由感染者傳染給另一人的期望值)為2到3人,臨床資料顯示病例平均年齡為50幾歲、且以男性居多、約83-98%有發燒症狀、76-82%有乾咳、11-44%有倦怠症狀、約25%須重症照護、10%須插管治療,部份病例有其他症狀,例如:頭痛、喉嚨痛和腹瀉,其他研究結果指出,年輕或孩童病例症狀較輕微;然而,臨床特徵以及與病程相關危險因子,均有待釐清。至於檢體採樣篩檢方面,建議採鼻咽,而非喉嚨檢體,以下呼吸道檢體最為理想。臨床照護與其他病毒性感染肺炎類似,主要為支持性療法及氧氣治療,此外,實驗性藥物「瑞德西韋」(Remdesivir)目前已在進行臨床試驗當中,新型冠狀病毒疫苗也正在研發當中。為避免醫療人員感染或傳播病毒,美國疾病管制中心建議醫療人員應做好防護裝備,儘量預防被輕症或無症狀者感染;面對新冠肺炎疫情,相關研究單位應加速檢測試劑、治療性藥物及疫苗的研發。

(財團法人國家衛生研究院 蔡慧如博士摘要整理)

Since first reported in Wuhan, China, in late December 2019, the outbreak of the novel coronavirus now known as SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) has spread globally. As of February 27, 2020, more than 82 000 cases of coronavirus disease 2019 (COVID-19) (the disease caused by SARS-CoV-2) and 2800 deaths have been reported, of which approximately 95% of cases and 97% of deaths are in China.1 Cases have now been reported in 49 other countries. A particularly large outbreak occurred among the passengers and crew of the Diamond Princess cruise ship, where more than 700 infections are reported.

The data surrounding the biology, epidemiology, and clinical characteristics of the SARS-CoV-2 virus have been growing daily, with more than 400 articles listed in PubMed. The virus genome was rapidly sequenced, which allowed the development of diagnostic tests and for research into vaccine and therapeutics to start. Meanwhile, the clinical spectrum of disease continues to be defined (including the potential for asymptomatic spread) and clinical trials evaluating treatments have begun. This Viewpoint updates previous guidance for clinicians2 and summarizes what is known, what is unknown, and what are the next steps based on available evidence to address and halt the outbreak.

Author:Carlos del Rio, Preeti N. Malani
原文連結:https://jamanetwork.com/journals/jama/fullarticle/2762510

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