COVID-19 会像感冒一样变得温和吗?

IF 2.5 4区 医学 Q3 INFECTIOUS DISEASES Epidemiology and Infection Pub Date : 2024-10-07 DOI:10.1017/S0950268824001110
Patrick D Shaw Stewart
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引用次数: 0

摘要

最近的几项研究得出结论,不能排除 SARS-CoV-2 致病性增强的可能性。不过,应该指出的是,SARS-CoV-2 是一种 "直接 "呼吸道病毒--这意味着它通常通过呼吸途径传播,而不像麻疹和天花那样经常通过淋巴管传播。如果它的致病性不发生变化,其致病性就不会降低,直至与普通感冒病毒相似,这将是一种独特的病毒。埃瓦尔德在 20 世纪 80 年代指出,呼吸道病毒可能会进化出温和性,因为它们的传播得益于宿主的流动性。本综述探讨了通常会降低呼吸道病毒严重性的因素,包括热敏感性(限制在温暖的肺部复制)和病毒表面蛋白的变化。然而,其他因素可能会增加致病性,如在淋巴系统中复制以及通过固体表面或粪便传播。此外,人类活动和政治事件也可能增加 SARS-CoV-2 的危害性,其中包括:大规模检测,尤其是检测结果迟迟不出;在人与人之间距离很近、不能自由走动的环境中传播;卫生设施简陋;社会、政治或文化影响鼓励病人继续活动,包括战争等危机。如果我们能避免这些可能发生的情况,SARS-CoV-2 就有可能演变得更温和,尽管时间尺度还不确定。对类似流感大流行的观察表明,COVID-19 可能需要二十年左右的时间才能变得与季节性感冒一样温和。
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Will COVID-19 become mild, like a cold?

Several recent studies conclude that an increase in the pathogenicity of SARS-CoV-2 cannot be ruled out. However, it should be noted that SARS-CoV-2 is a 'direct' respiratory virus - meaning it is usually spread by the respiratory route but does not routinely pass through the lymphatics like measles and smallpox. Providing its tropism does not change, it will be unique if its pathogenicity does not decrease until it becomes similar to common cold viruses. Ewald noted in the 1980s that respiratory viruses may evolve mildness because their spread benefits from the mobility of their hosts. This review examines factors that usually lower respiratory viruses' severity, including heat sensitivity (which limits replication in the warmer lungs) and changes to the virus's surface proteins. Other factors may, however, increase pathogenicity, such as replication in the lymphatic system and spreading via solid surfaces or faecal matter. Furthermore, human activities and political events could increase the harmfulness of SARS-CoV-2, including the following: large-scale testing, especially when the results are delayed; transmission in settings where people are close together and not free to move around; poor hygiene facilities; and social, political, or cultural influences that encourage sick individuals to remain active, including crises such as wars. If we can avoid these eventualities, SARS-CoV-2 is likely to evolve to be milder, although the timescale is uncertain. Observations of influenza-like pandemics suggest it may take around two decades for COVID-19 to become as mild as seasonal colds.

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来源期刊
Epidemiology and Infection
Epidemiology and Infection 医学-传染病学
CiteScore
4.10
自引率
2.40%
发文量
366
审稿时长
3-6 weeks
期刊介绍: Epidemiology & Infection publishes original reports and reviews on all aspects of infection in humans and animals. Particular emphasis is given to the epidemiology, prevention and control of infectious diseases. The scope covers the zoonoses, outbreaks, food hygiene, vaccine studies, statistics and the clinical, social and public-health aspects of infectious disease, as well as some tropical infections. It has become the key international periodical in which to find the latest reports on recently discovered infections and new technology. For those concerned with policy and planning for the control of infections, the papers on mathematical modelling of epidemics caused by historical, current and emergent infections are of particular value.
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