I-Covid-19 (2019-nCoV) idale amakhulu ezigidi zezifo kanye nezigidi zokufa selokhu yagqashuka ekupheleni kuka-2019, okwenza kube yisimo esiphuthumayo sezempilo emhlabeni wonke.I-World Health Organisation (WHO) ibeke phambili "izinhlobo ezinhlanu zokukhathazeka"[1], okuyi-Alpha, i-Beta, i-Gamma, i-Delta ne-Omicron, kanye ne-Omicron mutant strain iwuhlobo oluhamba phambili kubhadane lomhlaba wonke njengamanje.Ngemva kokungenwa i-Omicron mutant, izimpawu azibambi kangako, kodwa kubantu abakhethekile njengabantu abangenawo amandla omzimba, asebekhulile, izifo ezingelapheki kanye nezingane, ingozi yokugula okubi kakhulu noma ukufa ngemva kokutheleleka isephezulu.Izinga lokufa kwecala lezinhlobo eziguquguqukayo e-Omicron, idatha yomhlaba wangempela ikhombisa ukuthi izinga lokufa kwabantu elimaphakathi licishe libe ngu-0.75%, okungaba izikhathi ezi-7 kuye kweziyi-8 kunomkhuhlane, kanye nezinga lokufa kwabantu asebekhulile, ikakhulukazi labo abangaphezu kweminyaka engama-80. endala, idlula i-10%, cishe izikhathi eziyi-100 zomkhuhlane ovamile[2].Ukubonakaliswa komtholampilo okuvamile kokutheleleka umkhuhlane, ukukhwehlela, umphimbo owomile, umphimbo obuhlungu, i-myalgia, njll. Iziguli ezinzima zingase zibe ne-dyspnea kanye/noma i-hypoxemia.
Kunezinhlobo ezine zamagciwane omkhuhlane: A, B, C kanye no-D. Izinhlobo zobhubhane eziyinhloko yi-subtype A (H1N1) ne-H3N2, kanye ne-strain B (i-Victoria ne-Yamagata).Umkhuhlane obangelwa igciwane lomkhuhlane uzodala ubhadane lwezinkathi ezithile zonyaka kanye nobhubhane olungalindelekile minyaka yonke, ngezinga eliphezulu lezigameko.Ngokwezibalo, babalelwa ezigidini ezingu-3.4 izigameko ezilashelwa izifo ezinjengomkhuhlane minyaka yonke[3], futhi cishe izigameko ezingu-88,100 zezifo zokuphefumula ezihlobene nomkhuhlane ziholela ekufeni, okubalelwa ku-8.2% wokufa kwezifo zokuphefumula.[4].Izimpawu zomtholampilo zihlanganisa imfiva, ikhanda elibuhlungu, i-myalgia kanye nokukhwehlela okomile.Amaqembu asengozini enkulu, njengabesifazane abakhulelwe, izinsana, asebekhulile kanye neziguli ezinezifo ezingalapheki, avame ukungenwa inyumoniya nezinye izinkinga, ezingase ziholele ekufeni ezimweni ezimbi kakhulu.
1 COVID-19 enobungozi bomkhuhlane.
Ukutheleleka kanyekanye komkhuhlane ne-COVID-19 kungase kubhebhethekise umthelela wesifo.Ucwaningo lwaseBrithani lubonisa lokho[5], uma kuqhathaniswa nokutheleleka kwe-COVID-19 kuphela, ubungozi bokungena komoya ngemishini kanye nobungozi bokushona esibhedlela ezigulini ze-COVID-19 ezinokutheleleka ngegciwane lomkhuhlane bukhuphuke izikhathi ezi-4.14 kanye nezikhathi ezingama-2.35.
I-Tongji Medical College yase-Huazhong University of Science and Technology ishicilele ucwaningo[6], okubandakanya izifundo ezingama-95 ezibandakanya iziguli ezingama-62,107 ku-COVID-19.Izinga lokusabalala kokutheleleka ngegciwane lomkhuhlane ngokuhlanganyela lalingu-2.45%, phakathi kwalo umkhuhlane A ubalwe ngenani eliphezulu kakhulu.Uma kuqhathaniswa neziguli ezitheleleke nge-COVID-19 kuphela, iziguli ezitheleleke ngokuhlanganyela umkhuhlane A zisengozini enkulu kakhulu yemiphumela emibi, okuhlanganisa nokungeniswa e-ICU, ukwesekwa komoya ngemishini nokufa.Nakuba izinga lokutheleleka nge-co-infection liphansi, iziguli ezine-co-infection zibhekene nengozi enkulu yemiphumela emibi kakhulu.
Ukuhlaziywa kwemeta kubonisa lokho[7], uma kuqhathaniswa nokusakaza kwe-B, ukusakaza kwe-A kungenzeka ukuthi kutheleleke nge-COVID-19.Phakathi kweziguli eziyi-143 ezitheleleke kanyekanye, ezingama-74% zitheleleke nge-A-stream, kanti ezingama-20% zingenwe yi-B-stream.Ukutheleleka ngezifo okuhlangene kungaholela ekuguleni okubi kakhulu kweziguli, ikakhulukazi phakathi kwamaqembu asengozini njengezingane.
Ucwaningo ngezingane kanye nentsha engaphansi kweminyaka engu-18 eyalaliswa esibhedlela noma eyabulawa umkhuhlane ngesikhathi somkhuhlane e-United States ngo-2021-22.[8]ukuthi into yokutheleleka ngokuhlanganyela nomkhuhlane ku-COVID-19 idinga ukunakwa.Phakathi kwamacala okulaliswa esibhedlela ahlobene nomkhuhlane, ama-6% angenwe yi-COVID-19 kanye nomkhuhlane, kanti inani lokufa okuhlobene nomkhuhlane lenyuke laya ku-16%.Lokhu okutholakele kusikisela ukuthi iziguli ezitheleleke kanye ne-COVID-19 kanye nomkhuhlane zidinga ukwesekwa kokuphefumula okuhlaselayo futhi okungahlaseli ngaphezu kwalezo ezingenwe umkhuhlane kuphela, futhi kukhomba ukuthi ukutheleleka kanyekanye kungaholela engcupheni enkulu yezifo ezinganeni. .
2 Ukuxilongwa okuhlukile komkhuhlane kanye ne-COVID-19.
Kokubili izifo ezintsha kanye nomkhuhlane kuyathathelana kakhulu, futhi kukhona ukufana kwezinye izimpawu zomtholampilo, njengomkhuhlane, ukukhwehlela kanye ne-myalgia.Kodwa-ke, amasu okwelapha lawa magciwane amabili ahlukile, kanti nemithi elwa namagciwane esetshenziswayo ihlukile.Ngesikhathi sokwelashwa, izidakamizwa zingashintsha ukubonakaliswa komtholampilo okujwayelekile kwesifo, okwenza kube nzima ukuxilonga lesi sifo kuphela ngezimpawu.Ngakho-ke, ukuhlonzwa okunembile kwe-COVID-19 kanye nomkhuhlane kudinga ukuncika ekutholeni umehluko wegciwane ukuze kuqinisekiswe ukuthi iziguli zingathola ukwelashwa okufanele futhi okusebenzayo.
Izincomo eziningi zokuvumelana mayelana nokuxilongwa nokwelashwa ziphakamisa ukuthi ukuhlonzwa okunembile kwe-COVID-19 kanye negciwane lomkhuhlane ngokuhlolwa kwaselabhorethri kubaluleke kakhulu ekwenzeni uhlelo lokwelapha oluphusile.
《Ukuxilongwa Komkhuhlane Nohlelo Lokwelapha (Ushicilelo luka-2020)》[9]kanye 《Ukuxilonga Umkhuhlane Wabantu Abadala kanye Nemvumelwano Yokwelapha Ejwayelekile Yezimo Eziphuthumayo (Ushicilelo luka-2022)》[10]konke kukwenza kucace ukuthi umkhuhlane uyafana nezinye izifo ku-COVID-19, futhi i-COVID-19 inezimpawu ezithambile nezivamile ezifana nomkhuhlane, ukukhwehlela okomile kanye nomphimbo obuhlungu, okungelula ukuwuhlukanisa nomkhuhlane;Ukubonakaliswa okunzima nokubucayi kuhlanganisa inyumoniya enzima, isifo sokuphefumula esinamandla kanye nokungasebenzi kahle kwezitho, okufana nokubonakaliswa komtholampilo komkhuhlane onzima futhi obucayi, futhi udinga ukuhlukaniswa nge-etiology.
《Ukuxilongwa kwe-coronavirus entsha kanye nohlelo lokwelapha (uhlelo lweshumi lokuqaliswa kokuhlolwa》[11]uthe ukutheleleka nge-Covid-19 kufanele kuhlukaniswe nokutheleleka komgudu wokuphefumula ongenhla obangelwa amanye amagciwane.
3 Umehluko ekwelapheni umkhuhlane kanye nokutheleleka nge-COVID-19
I-2019-nCoV kanye nomkhuhlane yizifo ezahlukene ezibangelwa amagciwane ahlukene, nezindlela zokwelapha zihlukile.Ukusetshenziswa ngendlela efanele kwemithi elwa namagciwane kungavimbela izinkinga ezinkulu kanye nobungozi bokufa kwalezi zifo ezimbili.
Kunconywa ukuthi kusetshenziswe imishanguzo emincane yamangqamuzana elwa namagciwane njenge-Nimatvir/Ritonavir, i-Azvudine, i-Monola kanye nezidakamizwa ezilwa namagciwane ezifana ne-Ambaviruzumab/Romisvir monoclonal antibody injection ku-COVID-19.[12].
Izidakamizwa ezilwa nomkhuhlane ikakhulukazi zisebenzisa i-neuraminidase inhibitors (oseltamivir, zanamivir), i-hemagglutinin inhibitors (Abidor) ne-RNA polymerase inhibitors (Mabaloxavir), enemiphumela emihle kumagciwane amanje omkhuhlane A no-B adumile.[13].
Ukukhetha uhlobo olufanele lwe-antiviral kubaluleke kakhulu ekwelapheni i-2019-nCoV kanye nomkhuhlane.Ngakho-ke, kubaluleke kakhulu ukukhomba i-pathogen ngokucacile ukuqondisa imithi yomtholampilo.
4 COVID-19/ Umkhuhlane A / Umkhuhlane B imikhiqizo yokuhlola ngokuhlanganyela kathathu kwe-nucleic acid
Lo mkhiqizo uhlinzeka ngokuhlonza okusheshayo nokunembile of 2019-nCoV, umkhuhlane A kanye namagciwane omkhuhlane B, futhi isiza ukuhlukanisa i-2019-nCoV kanye nomkhuhlane, izifo ezimbili ezithathelwanayo zokuphefumula ezinezimpawu ezifanayo zomtholampilo kodwa amasu okwelapha ahlukene.Ngokuhlonza i-pathogen, ingaqondisa ukuthuthukiswa komtholampilo kwezinhlelo zokwelapha ezihlosiwe futhi iqinisekise ukuthi iziguli zingathola ukwelashwa okufanele ngesikhathi.
Isixazululo esiphelele:
Ukuqoqwa kwesampula--Ukukhishwa kwe-Nucleic acid--I-reagent yokutholwa--i-polymerase chain reaction
Ukuhlonza okunembile: hlonza i-Covid-19 (ORF1ab, N), igciwane lomkhuhlane A kanye negciwane lomkhuhlane B eshubhuni elilodwa.
Izwela kakhulu: I-LOD ye-Covid-19 ingamakhophi angu-300/mL, futhi leyo yamagciwane omkhuhlane A no-B ingamakhophi angu-500/mL.
Ukufakwa okugcwele: I-Covid-19 ihlanganisa zonke izinhlobo ezaziwayo eziguqukayo, ezinomkhuhlane A ohlanganisa isizini H1N1, H3N2, H1N1 2009, H5N1, H7N9, njll., kanye nomkhuhlane B ohlanganisa izinhlobo ze-Victoria ne-Yamagata, ukuze kuqinisekiswe ukuthi ngeke kuphuthelwe ukutholwa.
Ukulawulwa kwekhwalithi okuthembekile: ukulawulwa okwakhelwe ngaphakathi okungalungile / okuhle, inkomba yangaphakathi kanye ne-enzyme ye-UDG yokulawula ikhwalithi ephindwe kane, ukuqapha ama-reagents kanye nokusebenza ukuze kuqinisekiswe imiphumela enembile.
Kusetshenziswa kakhulu: kuhambisana nethuluzi le-PCR elineziteshi ezine ezivamile emakethe.
Ukukhishwa okuzenzakalelayo: nge-Macro & Micro-Testuhlelo lokukhipha i-nucleic acid oluzenzakalelayo kanye nama-reagents okukhipha, ukusebenza kahle komsebenzi kanye nokuvumelana kwemiphumela kuyathuthukiswa.
Ulwazi lomkhiqizo
Izithenjwa
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2. Incazelo Egunyaziwe _ U-Liang Wannian: Izinga lokufa e-Omicron liphindwe izikhathi ezingu-7 kuya kweziyi-8 kunelomkhuhlane _ Umkhuhlane _ Epidemic _ Mick _ Sina News.http://k.sina.com.cn/article_3121600265_ba0fd7098001.html
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5. Swets MC, Russell CD, Harrison EM, et al.Ukutheleleka okuhlangene kwe-SARS-CoV-2 ngamagciwane omkhuhlane, igciwane le-syncytial yokuphefumula, noma i-adenoviruses.I-Lancet.2022;399(10334):1463-1464.
6. Yan X, Li K, Lei Z, Luo J, Wang Q, Wei S. Ukuvama kanye nemiphumela ehlobene yokuhlangana phakathi kwe-SARS-CoV-2 nomkhuhlane: ukubuyekezwa okuhlelekile nokuhlaziywa kwemeta.I-Int J Infect Dis.2023;136:29-36 .
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8. Adams K, Tastad KJ, Huang S, et al.Ukuvama kwe-SARS-CoV-2 kanye Ne-influenza Coinfection kanye Nezimpawu Zomtholampilo Phakathi Kwezingane Nentsha Eneminyaka Engaphansi kwe-18 Eyalaliswa Esibhedlela Noma Yashona Ngomkhuhlane - United States, 2021-22 Influenza Season.I-MMWR Morb Mortal Wkly Rep. 2022;71(50):1589-1596.
9. IKomidi Likazwelonke Lezempilo Nempilo Labantu BaseRiphabhulikhi Yabantu baseShayina (i-PRC), ukuphathwa kombuso wemithi yendabuko yamaShayina.Uhlelo Lokuhlonza Nokwelapha Umkhuhlane (Ushicilelo luka-2020) [J].Ijenali yaseShayina Yezifo Ezithathelwanayo Zomtholampilo, 2020, 13(6): 401-405,411.
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Isikhathi sokuthumela: Mar-29-2024