Past lives of coronavirus
This is the 2329th article of Da Yi Xiao Hu.
Up to now, there have been three epidemic outbreaks caused by coronavirus in this century, namely, Severe Acute Respiratory Syndrome (SARS) in 2002-2003, Middle East Respiratory Syndrome (MERS) that began to spread in 2012, and novel coronavirus (COVID-19) that appeared at the end of 2019. China is a country with severe disasters in SARS and this time in novel coronavirus.
First, what is coronavirus?
Coronavirus exists widely in nature. Coronavirus was first isolated from chickens in 1930s, and it was isolated from human nasal wash more than 20 years later by scholars and named B814 virus. Later, scholars made an in-depth study of the virus from its morphology, and found that the envelope of the virus had a spinous process like a corona and a king’s crown, so the coronavirus was named from this. Its natural hosts are mainly vertebrates, and people, cows, pigs, cats and bats are all its natural hosts.
Coronavirus is slightly spherical in shape, with a diameter of 80-160nm. The "crown" on its surface is a fiber process of 12-24nm, and the end of the fiber process is also spherical. The envelope of the virus consists of two layers of lipids, with membrane protein M and fibrillary protein S interspersed between them, and some coronaviruses also have hemagglutinin glycoprotein HE. The interior of the virus is composed of RNA and nucleocapsid protein N, showing a spiral structure.
S protein is the key protein of coronavirus-infected cells, which contains host cell receptor recognition sites and is the main determinant of virus virulence. M protein is the main protein responsible for virus particle assembly. N protein is closely combined with viral RNA, which can protect viral genomic RNA through spiral stacking and encapsulation. At the same time, it can delay the growth of infected cells and make them stay in the division period for a longer time, so that viral RNA can be translated to the greatest extent. HE protein plays a key role in the formation of virus particles.
As far as virus classification is concerned, coronavirus belongs to single-strand positive-strand RNA virus, which indicates that the genetic information of coronavirus is carried by RNA, and the cloned progeny virus has a high mutation rate. After entering the host cell, it directly uses ribosomes in the host cell to produce protein needed for virus replication without transcription. Coronavirus can kill cells, thus damaging various organs, and persistent infection occurs simultaneously with acute infection, mainly attacking gastrointestinal tract, respiratory tract and nervous system.
Second, the coronavirus that humans have fought.
Before SARS, it was thought that only two kinds of coronaviruses could cause human infection. At present, there are seven kinds of coronaviruses that can infect humans, including highly lethal coronaviruses, severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV) and novel coronavirus virus (COVID-19).
The common feature of coronavirus is that it is generally sensitive to heat, and it is moderately stable in a suitable maintenance solution at 4℃, and can be stored for several years at -60℃. With the increase of temperature, the virus resistance decreases. Coronavirus is acid-resistant and alkali-resistant, and sensitive to organic solvents and disinfectants such as alcohol and ether.
The symptoms of coronavirus infection are mostly similar, mainly fever, chills, cough and so on. The main routes of transmission are droplet transmission and contact transmission.
1. SARS coronavirus (SARS-CoV)
Severe acute respiratory syndrome (SARS) was caused by SARS-CoV. By July 2003, it had spread to 24 provinces, autonomous regions, municipalities directly under the Central Government and 28 other countries in China. A total of 8096 clinically diagnosed cases were reported worldwide, and 774 cases died. Nearly 20%~30% of the patients needed mechanical ventilation due to respiratory failure, and the mortality rate was 9.6%. Epidemiology in many provinces and cities showed that the mortality rate increased with age, mostly over 60 years old. Its incubation period is within 2 weeks, usually 2~10 days. The population is generally susceptible and has a strong epidemic degree. The main onset age is 20-30 years old. The source hosts may be bats and civets. The transmission routes are mainly from person to person: droplet transmission in close respiratory tract, aerosol transmission and hand-to-hand contact transmission; Animals and people: civets/bats ~ people (possible). SARS-CoV has the general characteristics of coronavirus, but it is not a mutant of other known coronaviruses, nor is it a recombinant of known coronaviruses. SARS-CoV infects lung epithelial cells, and its S protein binds to angiotensin converting enzyme 2(hACE2) receptor, which invades and replicates in vivo. Because hACE2 is mainly in the lower respiratory tract, the symptoms of the upper respiratory tract are lacking, and the virus often peaks when hospitalized, which is easy to cause nosocomial infection of the lower respiratory tract.
2. MERS coronavirus (MERS-CoV)
Middle East Respiratory Syndrome (MERS) was caused by MERS-CoV, which was first confirmed in Saudi Arabia in 2012, affecting 27 countries and regions around the world, with a mortality rate of about 35%. According to statistics of a case, the mortality rate increases with age. The mortality rate is 39% in people younger than 50 years old and 75% in people over 60 years old. The longest incubation period is 14 days, and the population is generally susceptible. The median age of onset is 49 years old. Source host: it may be camel or bat. Transmission route: animal and human: dromedary ~ human (possible); People: Close contact. The infection site is epithelial cells in the lung, which causes explosive nosocomial transmission, and has obvious gastrointestinal symptoms and renal failure. It mainly binds to dipeptidyl peptidase 4(DPP4) in the lower respiratory tract, gastrointestinal tract and kidney, and there is no mutation that enhances human infection.
3. 2019 novel coronavirus (2019-nCOV)
Novel coronavirus was caused by 2019-nCOV. From mid-December 2019 to the beginning of 2020, 59 cases of unexplained pneumonia were reported in Wuhan, and similar cases were found in other regions and countries. On January 7, 2020, it was initially identified as "novel coronavirus", and on January 12, the WHO named the virus 2019-nCoV. Up to now, more than 70,000 cases have been diagnosed, and more than 2,400 cases have died, with a mortality rate of about 3.1%. It has spread to most provinces and cities in China and nearly 30 countries. The transmission routes may be droplet transmission, contact transmission and aerosol transmission. The incubation period is 1~14 days. At present, the source host may be a bat. Shi Zhengli’s team from Wuhan Institute of Virology has found that its genome is 79.5% identical to SARS-CoV and 40% similar to MERS-CoV. 2019-nCOV, like SARS-CoV, invaded by combining with human angiotensin converting enzyme 2(hACE2), infecting respiratory system, gastrointestinal tract and testis, affecting heart function and liver function. According to the current data, compared with SARS and MERS, it is more contagious and the mortality rate is not as high as the first two.
Third, actively protect against novel coronavirus
Personal protection requires frequent hand washing and hand hygiene. Cover your mouth and nose with paper towels when coughing or sneezing, which can effectively prevent the spread of droplets. Wear masks in public places, avoid contact with animals with unknown health conditions, and reduce the trading of live birds and wild animals.
At present, various industries have started to return to work. For the office, everyone should actively declare their health. If there are suspicious symptoms such as fever, fatigue and cough, it is recommended to seek medical advice in time, avoid going to work sick, strengthen ventilation and ventilation in public areas, clean and disinfect public areas and public goods regularly, keep the environment clean and hygienic, keep a proper distance when there are many people in the unified office area, and reduce centralized meetings by video and teleconference.
Authors: Shuguang Hospital affiliated to Shanghai University of Traditional Chinese Medicine
Written by Zhang Yijie
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