Susceptibility of the Elderly to SARS-CoV-2 Infection: ACE-2 Overexpression, Shedding, and Antibody-dependent Enhancement (ADE).
老年人对SARS-CoV-2 感染的易感性: ACE-2 过表达、脱落和抗体依赖性增强 (ADE)。
- 作者列表："Peron JPS","Nakaya H
:The world is currently facing a serious SARS-CoV-2 infection pandemic. </mac_aq>This virus is a new isolate of coronavirus, and the current infection crisis has surpassed the SARS and MERS epidemics</mac_aq> that occurred in 2002 and 2013, respectively. SARS-CoV-2 has currently infected more than 142,000 people, causing </mac_aq>5,000 deaths and spreading across more than 130 </mac_aq>countries worldwide. The spreading capacity of the virus clearly demonstrates the potential threat </mac_aq>of respiratory viruses to human health, thereby reiterating to the governments around the world that preventive </mac_aq>health policies and scientific research are pivotal to overcoming the crisis. Coronavirus disease (COVID-19) causes flu-like symptoms in most cases. However, approximately 15% of the patients need hospitalization, and 5% require assisted ventilation, depending on the cohorts studied. What is intriguing, however, is the higher susceptibility of the elderly, especially individuals who are older than 60 years of age, and have comorbidities, including hypertension, diabetes, and heart disease. In fact, the death rate in this group may be up to 10-12%. Interestingly, children are somehow less susceptible and are not considered as a risk group. Therefore, in this review, we discuss some possible molecular and cellular mechanisms by virtue of which the elderly subjects may be more susceptible to severe COVID-19. Toward this, we raise two main </mac_aq>points, i) increased ACE-2 expression in pulmonary and heart tissues in users of chronic angiotensin 1 </mac_aq>receptor (AT1R) blockers; and ii) antibody-dependent enhancement (ADE) after previous exposure to other circulating coronaviruses. We believe that these points are pivotal for a better understanding of the pathogenesis of severe COVID-19, and must be carefully addressed by physicians and scientists in the field.
: 世界目前正面临严重的SARS-CoV-2 感染大流行。</Mac_aq> 这种病毒是一种新型的分离株冠状病毒病毒，目前感染危机已经超越了传染性非典型肺炎和中东呼吸综合征疫情 </mac_aq> 发生在 2002 年为 2013.SARS-CoV-2 目前已感染超过 142,000 人，导致 </mac_aq>5,000 人死亡，并在全球 130 多个 </mac_aq> 国家蔓延。病毒的传播能力清楚地表明了呼吸道病毒es对人类健康的潜在威胁 </mac_aq>，从而向世界各国政府重申，预防性 </mac_aq> 卫生政策和科学研究对克服危机至关重要。冠状病毒病 (新型冠状病毒肺炎) 在大多数情况下引起流感样症状。然而，大约 15% 的患者需要住院治疗，5% 需要辅助通气，这取决于研究的队列。然而，有趣的是老年人的易感性较高，尤其是 60 岁以上且有合并症的个体，包括高血压、糖尿病和心脏病。事实上，这一组的死亡率可能高达 10-12%。有趣的是，儿童在某种程度上不太容易受到影响，不被认为是一个风险群体。因此，在这篇综述中，我们讨论了一些可能的分子和细胞机制，使老年人更容易受到严重的新型冠状病毒肺炎。对此，我们提出两个主要的 </mac_aq> 点，i) 增加ACE-2 表达于肺和心脏组织中用户的慢性血管紧张素 1 </mac_aq> 受体 (1) 受体阻滞剂; 和ii) 抗体依赖性增强 (ADE) 之前暴露于其他循环冠状病毒后。我们认为，这些要点对于更好地理解严重新型冠状病毒肺炎的发病机制至关重要，必须由该领域的医生和科学家仔细研究。
METHODS::Since mid-December of 2019, coronavirus disease 2019 (COVID-19) infection has been spreading from Wuhan, China. The confirmed COVID-19 patients in South Korea are those who came from or visited China. As secondary transmissions have occurred and the speed of transmission is accelerating, there are rising concerns about community infections. The 54-year old male is the third patient diagnosed with COVID-19 infection in Korea. He is a worker for a clothing business and had mild respiratory symptoms and intermittent fever in the beginning of hospitalization, and pneumonia symptoms on chest computerized tomography scan on day 6 of admission. This patient caused one case of secondary transmission and three cases of tertiary transmission. Hereby, we report the clinical findings of the index patient who was the first to cause tertiary transmission outside China. Interestingly, after lopinavir/ritonavir (Kaletra, AbbVie) was administered, β-coronavirus viral loads significantly decreased and no or little coronavirus titers were observed.
METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.
METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.