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😷 | (New Corona) 2,417 new infections confirmed in Gunma 4 dead (January 8)


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(New Corona) 2,417 new infections confirmed in Gunma 4 dead (January 8)

 
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The prefecture also announced that two people have died from a new coronavirus infection.
 

Gunma Prefecture announced on the 17th that 2,417 people were newly infected with the new coronavirus.The breakdown is Gunma prefecture jurisdiction 1,45… → Continue reading

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New Coronavirus Infection (2019)

The English name "COVID-19" in this article has the following notational fluctuations.
  • Covid 19
  • Covid 19

2019Occurred inNew coronavirus infection(Shingata coronavirus infectious disease)World Health Organization (WHO) International official name byCOVID-19[2]Good,SARS Coronavirus 2 (SARS-CoV-2) [Note 1] Human capitalToinfectionTo develop byRespiratory tract infection(ウ イ ル スIn a broad sense of sexcoldA kind of[3])[4].2020Since entering the world, the infection has spread,2022By April, the cumulative number of infected people exceeded 8 million.[5][6],Pandemic(Pandemic)[7].

Nosymptominfected person (Asymptomatic carrierincluding)[8]However, when it develops, the symptoms vary and range from mild to severe.[9]..Common symptoms includeheadache-Sense of smell,tastedisappearance ofNasal congestion(nasal congestion) andRhinorrhea-cough-muscle pain-Sore throat-Fever-diarrhea-Difficulty breathingThere is[10]..Often asymptomatic orcoldWith mild symptoms with similar symptomsspontaneous recoveryBut in severe casesAcute respiratory distress syndrome,septicemia-Multiple organ failureAccompanied by[4][11].. 81% of patients have mild to moderate symptoms (mild)pneumoniaUp to), and 14% have severe symptoms (dyspnea,Hypoxia,X-ray photographlungMore than 50% of them are reflected), and 5% are fatal symptoms (Respiratory failure,shock, Multiple organ failure)[12]..At least one-third of people infected with the virus have no noticeable symptoms at any given time[13][14][15][16][17].

prognosisabout,Harvard Medical SchoolCenters for Disease Control and PreventionIs the survivor of COVID-19MildEven so, he points out that it can be subject to long-term neurological effects, including thinking and concentration.[18][19].米 国ChicagoMany COVID-19 survivors have brain injuries and are widespread, according to doctors at the Large-scale Medical Center.CognitionThere is increasing evidence that it can cause behavioral and psychological problems[20][21].SequelaeIf it is long, some people have been infected for more than a year. WHO2021The definition of sequelae, which was first announced in October, is "a symptom that develops within 10 months after confirmation of virus infection, lasts for 3 months or more, and cannot be explained by other diseases."[22]("#SequelaeDetailed explanation).

The causative virusMutationAnd has strong infectivityVariant of SARS coronavirus 2about,Japanese Society of Infectious DiseasesProposes that "it should be treated as another virus"[23],TraditionalCOVID-19 vaccineBut especiallyBooster shotEvidence has been obtained to significantly reduce the likelihood of serious symptoms, hospitalization, and death for those affected.

Transmission routeIs a droplet infectionaerosolAvoid talking in tight spaces with people who may have the virus, such as infections.[24],Hygiene maskIs important.Omicron strainIs the most contagious mutant strain we have ever encountered, so we have a high quality and fit KN95, KF94, andN95 maskIs more important than ever[25][26].

In Japan, as of 2020Infectious disease lawForced based onHospitalizationDesignated infectious diseases that can take measures such asSecond kind infectious diseaseDesignated)[27]In addition,New influenza measures special measures lawThe above is also regarded as a new strain of influenza with a deadline,Japanese Government Emergency declarationCan now be announced (ReiwaBased on 2-year law No. 4).

January 2019People's Republic of ChinaHubei ProvinceWuhanFirst detected inEmerging infectious disease[Note 2]And generally from Wuhan cityInfection spreads around the worldIt is believed to have been (pandemic)[29][3],University of Barcelona(Spain) Has been announced that a new type of coronavirus has been detected in wastewater collected in March 2019.[30].ItalyAccording to a study by the National Cancer Institute, collected in September 2019 in the countrylung cancerFrom the blood of the examinee, the new coronavirusantibodyHas been detected, and it has been pointed out as of March 2020 that the virus may have spread all over the world before it was reported in Wuhan City.[31].

Name

20201/9,who (World Health Organization; WHO)201912/8ToPeople's Republic of ChinaHubei ProvinceWuhanOccurred inpneumoniaOutbreak of coronavirus is a new type of coronavirusnovel (or new) coronavirus)) statement[32]Was issued.At this point, Japan translated the statementMinistry of Health, Labor and WelfareQuarantine stationIs a "new coronavirus" or "Wuhan pneumonia"(In the original text,"pneumonia in Wuhan")[33].

same year2/1, "Defining the new coronavirus infectious disease as a designated infectious disease, etc."Cabinet OrderBy the enforcement of[27][34], By lawNew coronavirus infectionWas determined." Ministry of Health, Labor and Welfare[35],Japanese Society of Infectious Diseases[36]Also follows this.

same year2/11, WHOCOVID-19(Covid Nineteen[37]Or Covid Nineteen[38]) Was named[39].Covidteeth "coronavirus disase"CoronavirusDisease), where 19 represents 2019, when the virus was first discovered.[40].. in English "coronavirus disease 2019"[41][40][42][43][44] Or simply “coronavirus disease"[2] Also written as.In Japan, "New Coronavirus Infection (COVID-19)May be written together with[45][46][47][48][49][50].

WHO stipulates that the names of new infectious diseases and viruses that infect humans do not include region names, personal names, animal names, food names, and specific culture or industry names.[51][52][53][54], About this naming, by associating with a unique place name or country name, etc.StigmaExplained that consideration was given to prevent[55].

Republic of China(Taiwan)ofHealth and Welfare DepartmentAt the Taiwan Centers for Disease Control and Prevention, COVID-19 is called "COVID-XNUMX" in the official legal name.Severe special infectious pneumoniaHowever, the name "Wuhan pneumonia" is used in official documents as a shorthand.[56]. Also,Hong Kong, South Korea, Japan and other media also use the notation "China virus"[57][58][59][60].

pathology

SARS coronavirus 2Caused by infection with[3].

Transmission route

Transmission routeBy touching the nose, eyes, or mouth with your hands that have the virus attachedContact infectionWhen,cough,sneezebySplash infectionThere is[3]..Heavy droplets often fly about 2 meters for a few seconds and fall to the floor or ground, according to US guidelines 6 from infected individuals.フ ィ ー トWith exposure in the range (about 182 cm)Splash infectionIs going to happen[61].

AirborneCan occur, especially in high-risk environments indoors[62], With infected people in US guidelinesventilationAirborne infections can occur if you stay in a bad room for more than 15 minutes.[61]..Restaurant, nightclub,Gym, Offices, religious facilities,ChoirHigh risk in crowded areas or when there is little ventilation[63].

For contact infectionsHarvard UniversityAccording to the School of Medicine, the risk of infection from contact with contaminated surfaces and objects is considered to be very low.Center for Disease Control and Prevention According to the (CDC), contact with contaminated surfaces is less than 1 in 1 likely to cause infection.but,sillaginoidYou may be infected with a virus by doing[25].

Host cell receptor

SARS coronavirus 2SARS coronavirusLike the host cellAngiotensin converting enzyme II(ACE2)ReceptorIs expected to bind to and infect[64]..Human ACE2 receptor and SARS coronavirus 2Spike proteinReceptor binding domain[Note 3]And, a video simulating how they interact with each other has been released[65][66].. ACE2 receptorBronchi,lung,心 臓,kidney,Digestive organIs expressed in[67].. ACE2 receptor(English editionAccording to the kidneysIntestinesTo[68], And according to a study in Chinatongue OfEpithelial cellsIs highly expressed in[69].

Normally, when the ACE2 receptor is stimulatedAngiotensinFor increasing blood pressure by decomposing IIRenin-angiotensin system It inhibits (RA system), but this RA system inhibitory effect may be important for organ protection.[70][71][72].. With SARS coronavirusmouseAtAnimal experimentationIs said to reduce the expression of ACE2 receptor in[73], Of patients with coronavirus infectionplasmaThere is also information that angiotensin II is at a high level in[74].. Therefore, inhibition of RA system has been proposed in the treatment of novel coronavirus infection.[74][75].

Symptoms and signs

The main symptom was found on January 2020, 1, 21Moderately high fever (98%), drycough (76%), shortness of breath (55%), etc.[76]. other,General malaise,nausea, Reported to cause muscle aches, etc.[77]..Notable complicationspneumoniaIs.In inpatientsDifficulty breathingThere is also a lot of pressure on the chest.Also, at the time of admissionvital signsIs relatively stable[78].

In the case of this infectious disease, which is a viral disease, humans are associated with the administration of a large amount of therapeutic drug.ImmunologySecondary due to the decrease factor ofBacterial pneumoniaConcurrent[79][80], Severity of underlying disease[81][82]There is a concern that the disease may become severe due to a decrease in physical strength due to insufficient nutritional management due to loss of smell and taste, and early detection and early start of treatment are required.Therefore, the Republic of China (Taiwan) andAustraliaIn such cases, contact infectionApplicationBy making full use of such things as, we are building a mechanism that can directly request the people to request inspections, etc. using "contact data" and "follow-up data" with positive persons.[83][84]..In addition, it is said that it was the most successful in suppressing it in the world.New ZealandHas built a system that can report using the public interest report system when preventive measures are inadequate.[85].

No symptoms of illness appear even if infected with this virusSubclinical infectionThere is a personAsymptomatic pathogen carrierSay[29]..Asymptomatic pathogen carriers may infect others with the virus they carry[86].

symptom%
Fever87.9
Dry cough67.7
Malaise・Dullness38.1
sputum33.4
Olfactory disorder-Taste disorders[87]30 - 66[Needs verification]
shortness of breath18.6
muscle pain-Joint pain14.8
Sore throat13.9
headache13.6
Chills11.4
nausea-Vomiting5.0
Nasal congestion4.8
diarrhea3.7 - 31[88]
Hemoptysis0.9
conjunctivaHyperemia0.8
Source:[89]

Incubation period

Incubation periodIs 1 day-14 days[29],who TheAverage value5th-6th, Centers for Disease Control and Prevention (CDC)Median4 days-5 days[90][91].

The onset interval from the onset of an infected person (primary case) to the onset of a secondary infected person (secondary case) is estimated to be 1 days-2 days, and it has been pointed out that it may have infectious ability during the incubation period. ing[92][Note 4].

Initial symptoms

Symptoms are not specific and range from asymptomatic (asymptomatic) to severe pneumonia and death.Typical symptoms and signs include fever, dry cough, fatigue,sputum,shortness of breath,Sore throat(Throat pain), headache, diarrhea, etc. (see table)[29][89].sneeze, Runny nose, sore throat, etc.Upper respiratory tractFew symptoms[93].. WHONanako ShindoSenior adviserLower respiratory tractIt has a strong affinity for the virus, and it is reported that the peak of the excreted virus is about 3 to 4 days after the onset date.[77].

The initial symptoms are influenzacommon coldSimilar to, and difficult to distinguish in the early stages of onset[3][11][94]..After an incubation period from infection, low-grade fever, respiratory symptoms, and malaise continue for about a week. In China as of January 1, 2020, the initial symptoms are not limited to fever and cough peculiar to pneumonia, but diarrhea, nausea, headache and systemic.DullnessSuch,Digestive system,Nervous systemIt was reported that there may be symptoms of the disease, making early diagnosis difficult.[95]..In addition, fever does not always appear, especially in the early stages of onset, so it may not be possible to detect it with the fever detector alone.[96].

Progressive symptoms

Although the cause is awaited, secondary bacterial pneumonia also exists, and it is thought that most of the pneumonia that develops within 1 to 2 weeks after infection is viral.[97]..Although it is thought to be due to acute progression and complications with other diseases[Note 5], When it gets worseAcute respiratory distress syndrome (ARDS)Acute lung injury (ALI) etc.[98],Extracorporeal membrane oxygenator (ECMO) Often indicated[99].

Neurological symptoms

Olfactory disorder

2020 Year of 6 MonthSystematic reviewThe prevalence of sensory disorders ranged from 29% to 54%.[100]..On the other hand, the United States(English editionIn an August 2020 study by, 8% of patients had some form of sensory deficits and 96% had complete loss.[101] ..Another June 2020 systematic review reported a prevalence of hyposmia of 6% to 4%.[9].. August 2020European CDCThe prevalence of sensory loss is about 70%, according to the report.[10].

Taste disorders

Some people experience a temporary change in food taste (dysgeusia or ageusia) due to COVID-19[100][101].(English editionChanges have also been reported, and chemically-induced sensations such as pungency may be lost. As of January 2021, the mechanism of symptoms for taste and chemesissis has not been elucidated.[101].

In a systematic review in June 2020, the prevalence of dysgeusia ranged from 6% to 24%.[100]..Another June 2020 systematic review reported a prevalence of hypogeusia of 6% to 1%.[9].. The July 2020 European CDC report states that the prevalence of dysgeusia is approximately 7%.[10].

Disturbances of the sense of smell and taste have been found in many young patients, probably due to this.complicationsRisk is low[100].

Diagnosis

Other coronaviridae viral infections (SARS,MERSEtc.) is difficult to distinguish from the appearance.Since some patients died without fever, it may not be possible to detect it with the fever detector alone.

RadiographyAnd lungsComputed tomographyIt may be possible to distinguish by image inspection using.Of the 81 cases in China, unilateral, multifocal (multifocal), and ground glass-like shadows are predominant during the asymptomatic period, and bilateral ground-glass shadows are predominant and diffuse within 1 week after the onset. It becomes.More than a week after the onsetConsolidationAnd mixed lesions dominate[102]..Lesions are easily distributed in the periphery, and a ring-shaped shadow (reversed halo sign) is characteristic.Pleural effusion,Lymph nodeswellingIs less[102].

Under immunosuppressionEasy infectionIsPneumocystis pneumoniaIs important to distinguish[103].

Inspection

COVID-19Clinical examinationIsNucleic acid amplification test How to detect the presence of virus by (NAAT),antibodyOne of the recommended methods to detect[104].. To one of NAATPCR test method,LAMP methodThere is[104], From the gene region of SARS coronavirus 2 in Japan,Open reading frame (ORF) 1a andSpike protein2-step RT-PCR method (2 stepsReverse transcription polymerase chain reactionMethod) or real-time one-step RT-PCR method (TaqMan probe method) is used[105]. These testsClinical technologistIs doing.

Antigen testing is also used, but it is less sensitive and more specific than PCR testing.[104]..US guidelines oppose making a definitive diagnosis on the basis of antigen testing alone (Evidence AIII[104]..Additional NAAT is recommended if the person strongly suspected of being infected is antibody-negative and if the asymptomatic person is antibody-positive.[104].

As another auxiliary test,Blood testAlternatively, perform an imaging examination using chest X-ray or computed tomography.

Management

Only the therapies recommended by the guidelines are listed here.What is in clinical trialDrug research for COVID-19andDrug diversion study for COVID-19See

Some experimental treatmentsClinical trialActively researched in[106]However, there is no specific effective treatment for COVID-19[106][107]..Much research has been done, but there is still no high-quality evidence to recommend early treatment.[108][109].

Therefore, managementToad,InfusionTherapy,oxygenSupport, position management, etc., and use medicines and medical devices to protect organs as needed[110][111][112].Hydroxychloroquine,Lopinavir / RitonavirEtc. were considered promising in the early days of the pandemic, but subsequent studies have shown that they are ineffective and even harmful.[106][108][109] .

Most of COVID-19 are mild, and supportive care in that case is to relieve symptoms (fever, body aches, cough).Paracetamol or NSAIDThere are medications such as, proper fluid intake, rest, and nasal breathing.[113][107][114][115]..Proper hygiene and a healthy diet are also recommended[116]..In more severe cases, hospital treatment may be required.For patients with low oxygen levelsDexamethasoneIs highly recommended and can reduce the risk of death[77][117][118]..If you need breathing supportNon-invasive ventilation,EventuallyArtificial respiratorsWithintensive care unitMay be treated with[109].Extracorporeal membrane oxygenatorMay be used to address the problem of respiratory failure, but its benefits are still under consideration[119][120].

U.S. guidelines recommend one of the following therapies for mild to moderate outpatients at high risk of clinical progression:[109].

The approval for single-agent use of gamlanivimab has been revoked.

Contraindicated drug

There are no drugs designated as contraindicated drugs, but scientific verification is insufficient.

On March 3, a WHO spokesman responded without the advice of a doctor if suspected of being infected with the virus.InflammationMedicineIbuprofenI warned you not to take.Less anti-inflammatoryAcetaminophenIt was said that it was desirable to take[121]On March 3, "There were no reports of worsening symptoms other than the usual side effects", "there is no recommendation to refrain from it," and the previous announcement was effectively withdrawn.[122]..Therefore, as of March 3, there are no drugs designated as contraindicated drugs.However,LoxoninSuch asNon-steroidal anti-inflammatory drug(NSAIDS)Cytokine stormSince the risk of causing pneumonia and increasing the possibility of pneumonia has not been affirmed or denied, it is safer not to use it if possible.generalSide effectsAt present, it is appropriate to consider acetaminophen as the first choice as an antipyretic, including the viewpoint of preventing the disease.[Note 6].

Remedy

The following treatments are approved in Japan:[3][123].

  • Rem decivil --The antiviral drug remdesivirUS Food and Drug AdministrationThe only drug approved by the (FDA)[109] ..In Japan, it was officially approved as a therapeutic drug for the new coronavirus on May 5 under the special approval system.[3]..However, it is not recommended for patients with mechanical ventilation, and WHO does not recommend it as it has limited evidence of efficacy.[124][106].
  • Dexamethasone - steroidsystemAnti-inflammatory drugDexamethasone in June 2020United KingdomResearch results have been reported to reduce the mortality rate of critically ill patients infected with the new corona.Recommended for patients on mechanical ventilation according to US guidelines[109]..Not recommended for mild to moderate patients who do not require hospitalization or oxygen inhalation[125]..Approved by Japanese guidelines[3].
  • Baricitinib --On April 2021, 4, the Ministry of Health, Labor and Welfare approved the additional indication as a therapeutic agent for pneumonia caused by the new coronavirus (SARS-CoV-23).[126].
  • Molnupiravir - As an oral antiviral drug, special approval was granted by the Ministry of Health, Labor and Welfare on December 2021, 12 (trade name: Lagebrio).In order to secure the distribution volume, the Ministry of Health, Labor and Welfare initially purchased the product in bulk and distributed it to registered medical institutions.[127]However, after that, it will be covered by insurance on August 2022, 8 and will be listed in the drug price[128].
  • nirmatrelvir/ritonavir - As an oral antiviral drug, special approval was granted by the Ministry of Health, Labor and Welfare on February 2022, 2 (trade name: pakilovidpack).In order to secure the distribution volume, the Ministry of Health, Labor and Welfare will purchase in bulk for the time being and distribute it to registered medical institutions.[129]. In April 2022, the WHO issued a view strongly recommending its use in the elderly and immunocompromised. sluggish[130].
  • Heparin [123]
  • Rona Preve (Antibody cocktail)- Kasiri Bimab(Genetic recombination) andImdevimab(gene recombination)[131]
  • Sotrovimab(Sotrovimab<gene recombination>)[132]
  • Eversheld-tixagevimab (genetical recombination) and silgavimab (genetical recombination).England·AstraZenecaA therapeutic drug that is administered by intramuscular injection of two types of antibody drugs developed by Special approval by the Ministry of Health, Labor and Welfare on August 2, 2022 (Product name: Eversheld Intramuscular Injection Set)[133][134].

Drug discovery

Drug discoveryIs proceeding with the following two-sided strategy.

  1. PastSARS,MERS,Ebola, AIDS virus (HIV) And other existing drugs that were effective against viruses, actual MERS and this SARS-CoV-2Test tubeLevel (vitro) Search for candidate drugs in research (screening) that comprehensively searches for effective drugs, and divert (expand indications). Clinical research at COVID-19 will proceed individually.Drug diversion study for COVID-19See.
  2. Relying on new technology, at unprecedented speedvaccine,Antibody drugDevelop other new drugs.Drug research for COVID-19See.

In JapanClinical trialOr the drugs for which specific clinical research is being conducted are as follows.[3][123]..The list below is2022Based on the material on February 02th.

Approval applied
  1. Avigan (Fabipira Building
  2. 3CL protease inhibitor[135]
During clinical trial
  1. Actemra (Tocilizumab<gene recombination>)
  2. Kebuzara (Salilumab<gene recombination>)
  3. Olmient (Baricitinib
  4. Villacept (Nelfinavir
  5. Stromectol (Ivermectin
  6. Adrenomedullin (ADM-L1-01)
  7. Product name undecided (Sargramostim)
  8. Product name undecided (plasma fractionation preparation)
  9. Huoi bread (Camostat
Under specific clinical test
  1. Orbesco (Ciclesonide
  2. Fusan (Nafamostat
  3. Special cyclic peptide(Development code: PA-001)[136]

prevention

Harvard Medical School has received two COVID-19 infections, with or without a history of COVID-2 infection.COVID-19 vaccineInoculation and third time at least 5 months laterBooster shot, And points out that wearing a mask indoors is the most important preventive measure.[26][137][138].

Infection control is the main prevention[61]..No drug is suitable for prevention, and US guidelines recommend that you do not take the drug for prophylactic purposes unless it is in a clinical trial.[61]..The same is true even after virus exposure[61].UK government guidelines require healthcare workers and patients (if they do not interfere) to wear masks in all healthcare facilities, andSocial distanceIt is said that hand hygiene is also necessary.[139].

vaccine

In 2022, the Centers for Disease Control and Prevention and Harvard Medical School strongly recommend a third booster shot at least 2 months after the second vaccination.[26][137].. Data investigating how well the COVID-19 vaccine can protect against Omicron mutants show that people who receive a third booster shot have a significantly reduced chance of serious symptoms, hospitalization, and death. Evidence is also available[25][26]..large-scalePlacebo-controlled trialThen, twicevaccineAdministration has been shown to be 19% to 94% effective in preventing COVID-95.[61].. Most people hospitalized or died from COVID-19 are not vaccinated[140].

In addition, the Centers for Disease Control and Prevention and Harvard Medical School recommend that certain immunocompromised patients over the age of 50 and 12 be given a second booster dose at least 4 months after the first booster dose. is doing[26][137].

Vaccine administration contributes significantly to the suppression of infection and onset, but depending on the type of vaccine, side effects after administration and exacerbation of underlying disease[141][142],ThrombosisIt has been pointed out that the onset of strains and weakness in dealing with mutant strains have been pointed out.[143][144][145].. The efficacy of the COVID-19 vaccine is indexed by the onset of COVID-19, not by infection.Therefore, it does not develop even if infected.Subclinical infectionMay become a source of infection as an asymptomatic pathogen carrier[146]..Therefore, even after vaccination, it is necessary to use usual preventive methods (washing hands, wearing protective equipment, maintaining social distance), etc., until the number of infected people is significantly reduced by herd immunity.[147][148].

Vaccinated people should continue to wear masks when visiting confined public spaces or using public transportation in areas with community transmission of COVID-19.Vaccines are highly effective in preventing severe illness and death, but vaccinated people can still become infected and transmit the infection.Wearing a mask reduces the risk of this happening[149].

MASKS

Masks offer additional protection to wearers, including those who are fully vaccinated. In July 2021, the CDC advised everyone, including those who have been vaccinated, to wear masks in public indoor places in areas with high virus transmission.[150].. Where the number of COVID-19 cases is increasing, experts can save many lives and greatly increase the chances of controlling a pandemic if they follow mask guidelines and other standard precautions. I'm presuming that I can[140]..In addition, before wearing, adjusting and removing the maskHand sanitizerMust be used[151].

Personal protective equipment

In medical institutions, as equipment to prevent droplet infection and contact infectionPersonal protective equipment There are various (personal protective equipment, PPE)[139]..Protective clothing (gowns and aprons), masks (N95 masks and surgical masks), goggles, face shields, hats (caps), shoe covers, sterile gloves, etc.These should be thrown away only once unless instructed by the manufacturer or recommendations.[152][139]..Appropriate disposal is required if there is a risk of infection[139].

gloves
The English Public Health Agency states that gloves are not needed except for infectious activities such as contact with mucous membranes such as the mouth and eyes and body fluids.[139]..Medical gloves are supposed to be disposable once used, and due to the tightness of personal protective equipment in many countries, they should not be used in situations where disposable gloves are not required in the United Kingdom and Japan. In situations where non-sterile gloves can be used as a substitute, non-sterile gloves are given priority.[139][153].
Harvard Medical School says you don't need to wear gloves on a daily basis[154]..If you touch the mucous parts such as eyes and mouth with your hands with the virus, you will get infected, but gloves cannot prevent the infection at this time, and on the contrary, it may increase the possibility of touching your face.[154].
Many medical institutions, such as the CDC and Harvard Medical School, often wash and disinfect their hands rather than gloves, calling for them not to touch their faces with their virus-bearing hands.[154][148].

Hand washing

WHO石 鹸And often with waterHand washingIt is recommended to take at least 20 seconds, especially after going to the bathroom, when your hands are visibly dirty, before eating, after blowing your nose[155]..Thorough hand washing is required after coughing or sneezing[61][156] ..Fingers before leaving the storedisinfectantIt is recommended to wash your hands as soon as you get home and regularly clean objects and surfaces that you frequently touch.[25][26].

CDC only if soap and water are not readily availablealcoholIt is recommended to use a hand sanitizer (concentration of 60% or more).WHO can be produced locally in areas where hand sanitizers are difficult to obtainethanol or IsopropanolDisinfectant is recommended.hydrogen peroxideIs mixed with alcoholBacteriasporeAttached for removal of, not substance for aseptic technique of hands[157].

ventilation

Splashes that can be a source of infectionaerosolTo prevent dust from staying indoors, expertsventilationIs recommended to be thorough[158].

intensive care unitFor (ICU) patients, it is recommended that aerosol-generating procedures be performed in a negative pressure unit if possible.[159].

Self-isolation

For those who have been diagnosed with COVID-19 or who are suspected of being infected, self at homeisolationIs recommended.National health organizations provide detailed instructions for proper self-isolation[160] ..Many governments mandate or recommend self-quarantine for the entire population.Maximum self-quarantine instructions are given to high-risk groups of people[161].

Social distance (social distance)

Social distance(Physical distance) aims to delay the spread of the disease by minimizing close contact between individuals.Infection controlIt is an action.Many governments now mandate or recommend greater social distance in affected areas.[162].

Restrict outing to limit the spread of infections around the worldCity blockade (lockdown)Policy was taken.

It is recommended to meet friends and family outdoors.Coronavirus has been shown to spread when an infected person inhales, talks, or breathes the virus released through coughing or sneezing.It is also recommended to avoid large gatherings.Studies have shown that in a limited laboratory setting, droplets containing virus particles can remain floating for 8-14 minutes.Small infectious virus particles, called aerosols, can float in the air for longer periods of time.This makes it possible to take various preventive measures against infectious diseases, such as banning food in indoor restaurants and avoiding crowds.Can be adopted or discarded depending on the local COVID risk level[25][26].

Eating habits

In an observational study conducted at Harvard University Hospital,fruit,Vegetables,Beansfound that those who reported eating the most fruits and vegetables had a 19% lower risk of developing severe COVID-41 compared to those who reported eating the least fruits and vegetables.[163].Researchers also found links between COVID-19 and poor diets and socioeconomic disadvantage, and removing just one of these factors could reduce COVID-1 cases by almost one-third. indicated that it was possible to prevent[163].However, this studyObservational studyand there is no conclusive proof that a healthy diet prevents COVID.[163].Vaccination and indoor mask-wearing remain the most important approaches to prevent the disease, researchers say[163].Harvard University isSocial distance,MASKS,vaccineOther preventive measures include fruits, vegetables,Whole grainrecommends a diet rich in[25][26].

Improving immunity

When a harmful intruder, such as the coronavirus that causes COVID-19, enters the body, the immune system attacks.This attackImmune responseIt is a series of events that involve various cells and develop over time.Following general health guidelines is the best way to keep your immune system strong and healthy.The function of all parts of the body, including the immune system, is protected from environmental coronavirus attacks and enhanced by healthy living strategies such as:[25][26].

  • tobaccoDoes not smoke.
  • If you think you're not getting the nutrients you need from your diet, mulchvitaminIngest.Vitamin C, Vitamin D, Zinc and Melatonin are effective in preventing and treating coronaScientific evidenceNot, but in general it may be useful for people with deficiency[164].
  • Exercise regularly.
  • Maintain a healthy weight.
  • stressControl the level.
  • Control blood pressure.
  • If you drink alcohol, keep the proper amount (up to 1-1 cups a day for men and 2 cup a day for women).
  • Get enough sleep.

prognosis

The severity of COVID-19 varies.The disease may have a mild course, in which case it is almost or completely asymptomatic and common, such as a cold.Upper respiratory tract infectionSimilar to a disease.However, in 3-4% (65% for people over 7.4), it can be severe enough to require hospitalization.[166]..Mild cases usually recover within 2 weeks, but severe or fatal cases can take 3-6 weeks to recover.According to the Italian National Institutes of Health, the median time between symptoms and death was 12 days, and he was hospitalized for 7 days. In the case of ICU transport, the median time from admission to death was 10 days.[167].

Some early studies show that 19-10% of people with COVID-20 have sequelae that last for more than a month (1-XNUMX%)Long COVID) Suggests to experience[168][169].

Brain injury

prognosisAbout the United StatesChicagoDoctors say that more than 19% of COVID-40 patients are firstNeurologyShows symptoms, more than 30%Cognitive impairmentI found that I have. It suggests that survivors of COVID-19 may have long-term neurological effects. There is increasing evidence that many survivors of COVID-19 develop brain damage and can cause widespread cognitive, behavioral, and psychological problems.[20].

Sequelae

Various sequelae of COVID-19 (long-term sequelae are also called "Long COVID") even after negative confirmationSubjective symptomsHas been reported to be left behind.Meta-analysisCommon symptoms were fatigue (58%), headache (44%), attention deficit (27%), hair loss (25%), and dyspnea (24%).[170]..Studies have shown that more than 19% of people who recover from COVID-50 continue to suffer from some symptoms after 3 months.[171].. in Japan,National International Medical Research CenterFollowed 2020 patients who were discharged from the center in February-June 2 and found that 6% had some sequelae 63 months after onset and 2% had some sequelae 48 months after onset.[172]..One study found that 19% of people were unable to return to work 14-21 days after becoming COVID-35 positive.[170]..ChineseCapital Medical UniversityBy "LancetIn the report to the countryWuhanOf the approximately 2020 people who were discharged from the hospital in January-May 1, 5% had some symptoms even one year after the onset.[173].

Severe inflammatory reaction due to illness, thrombotic microangiopathy,静脈It is thought that long-term damage to many organs and organ systems such as the lungs, heart, brain, kidneys, and vascular system may be caused as a sequelae of thromboembolism and the associated oxygen deficiency.[174]..Although the entire mechanism of sequelae is under study[22]In addition to the hypothesis that it is due to the virus remaining in the body because the genetic substance of the virus has been detected in the intestines of patients with sequelae, it was formed by infection.antibodyIs hypothesized to resemble an autoimmune disease that attacks the human body[175].

Treatment methods have not been established, and some hospitals have specialized outpatient clinics in Japan, but some people are forced to take leave or retire due to long-lasting sequelae that interfere with their studies and work.[22].

COVID-19 vaccineIt has been suggested that if it is a so-called breakthrough infection after two inoculations, it may be possible to suppress the occurrence of sequelae and the period of feeling subjective symptoms.[173].

Virus positive conversion phenomenon after recovery

PCR and blood for COVID-19 patients diagnosed by PCR at a hospital in Wuhan, ChinaserumThere was a study investigating the details of the diagnosis. Fifteen of the 39 patients had the virus in their intestines and blood after treatment.Also, in a study of 15 cases at the hospital, even if the oral sample was negative on the 16th day, it was on the 0th day.anusThere were 4 cases in which the sample collected in 5 was positive, and in the serum test, it was negative immediately after the treatment, but when it was tested XNUMX days after the treatment, many of them turned positive.[176].

On the other hand, the patient was hospitalized with a positive PCR test, and was discharged because the subsequent test became negative and the symptoms subsided. However, in some cases, the PCR test became positive again more than 2 weeks after the first onset. It has been pointed out that there is a possibility of reactivation of the latent virus or reinfection of the mutant virus.[177][178][179][180].

After that, according to research by vaccine clinical trials, there are problems with the method and accuracy of the PCR test alone, and if other detection methods are not used in combination, it may become re-positive, and depending on the screening, it may become negative or positive. If that is,False positiveIt has become clear that there are cases where[181][182]..Conversely,Suspicious negativeIt is believed that this is causing re-positiveness.[183].Mutant strainRegarding re-infection due to, there can be no infection in the hospital, which is a controlled environment.[Note 7][184], Believed to be an infection in the city[185].

Case fatality rate / severity rate

Earlier reports had a high severity rate of 32% and a high mortality rate of 15%.[93]However, due to the accumulation of cases, it is now known that both the rate of severe disease and mortality are lower than that. The WHO reports that mild to moderate cases account for approximately 80%, severe cases 13.8%, and severe cases 6.1%.[89].. Many of the dead areHigh blood pressure-Diabetes mellitus-Immune systemSpoilCardiovascular diseaseHad other diseases such as[186].. It is also an overreaction of the immune system.Cytokine stormThere are cases where it becomes serious due to[187].. According to the early cases leading to death, the median time from illness to death was 14 days, ranging from 6 to 41 days.[188].

LethalityOf October 2020Systematic reviewMeta-analysisAccording toFrance- Netherlands·new zealand·Portugal0.5 - 1% in Australia, etc.England-リトアニア・1 - 2% in Spain,ItalyWas over 2%[189]。 さらにこの研究では、致死率の違いは、集団の年齢構成および年齢別の感染率に起因することが発見されている。致死率についてのメタ回帰推定値は、子供と若い成人では非常に低い(10歳では0.002%、25歳では0.01%)が、55歳では0.4%、65歳では1.4%、 75歳、85歳では15%となり[189]These results were also highlighted in the December 2020 report published by WHO.[190].

Difference in aggravation risk

Whether or not a person is infected with the causative virus and becomes severe depends on the individual."Clinical Guide" prepared by the Ministry of Health, Labor and Welfare of JapanKeio UniversityIn research in both Japan and the United States,age,ABO blood type,RaceRelated togene,Chronic obstructive pulmonary disease(COPD),cancer, Type 2 diabetes, chronic diseases such as hypertension,obesity,smokingLifestyle, access to medical care (residential area and income,medical insuranceType) is influencing[191][192].

It has been reported that type O tends to act more protectively than other blood types regarding the severity of the new coronavirus.[193].

Major celebrities affected

Infection of animals

  • After infecting humans, dozens of animals have been infected and tested.[194][195][196].
  • In laboratory research,ferret-Cat-Golden hamsterMay spread the same species after infection,dogHas not been confirmed to infect other breeds after infection.Dream Pork-chicken-duckNo infection in[194].A mouseWas initially said to be free of infection[194], Confirmed to be infected by mutation[197].
  • PetDogs and cats are transmitted from humans such as their owners.Dogs do not infect each other, but cats infect each other, and kittens are particularly vulnerable and at risk of death.Infected cats had virus growth in the nose and trachea and no lung growth, but remained asymptomatic and inflamed after 4 weeks in the lungs.[198].
  • Lion,DoraEtc. are in the United StatesNew York City内 のZooInfected with.He showed symptoms such as dry cough, wheezing, and loss of appetite, but recovered after a few days.
  • gorillaTwo were announced to be infected2021January, U.S.A.California OfSan Diego ZooIt was confirmed in.largeApeThis is the first infection to the disease, and infection from asymptomatic staff has been pointed out.Symptoms of stuffy nose and cough were confirmed[199].
  • United States between April 2020 and January 4IowaIn the wild that was run over on the road or killed by a hunterDeerIt was confirmed that about 80% were infected.[200].
  • minkof infections in the NetherlandsDenmark・It was confirmed in leather factories in Spain and the United States.Infected minks become dramatically ill and die as early as the next day.About 1 have died as a result.

Infection from animals to humans

  • SARS-CoV-2BatIt is believed to be the origin of the coronavirus[196].
  • Confirmed transmission of mink, hamsters, deer, and cats to humans[201].
  • There have been reports of veterinarians being infected by cat sneezing without protective equipment such as face shields and eyeglasses to protect the mucous membranes of the eyes.[201].
  • There have been cases of infection from mink to humans.During reinfection of this humanMutant strain Cluster 5Has been reported.It has been suggested that this mutant strain is difficult to react with the antibody that humans have against coronavirus and may be less effective with the coronavirus countermeasure vaccine under development (Cluster 5 has been wiped out and an epidemic has occurred. Is not believed to be).
  • It is thought that transmission from animals such as pets to humans rarely occurs under normal breeding environments.It is said that the reason is that there is no amount of virus carried by pets and no route of transmission to humans.On the other hand, since human infections have been reported on mink farms that are bred in large numbers, human infections may be possible depending on conditions such as multi-headed breeding.[202].

Research case

Effectiveness of infectious disease control

Even if individual infection prevention measures such as staggered commuting hours, teleworking, class closures, reducing the contact rate, and staying at home after fever are used alone or partially combined, no significant effect can be obtained, but when combined measures are used, the number of deaths and the maximum number of severely ill hospitalizations per day can be greatly reduced[203].Regarding measures against the new coronavirus infectious disease in Japan, measures against infectious diseases such as isolation and movement restrictions are highly effective, but public health measures have not shown a great effect.[204]..Economic support measures are statistically effective in controlling the epidemic of infectious diseases.[204].

Study of preventive behavior

Gender and age influence the occurrence of new coronavirus infection prevention behavior, and irrational behavior[Note 8]Was affected by anxiety about infection and social threats, and the lack of preventive action was associated with acceptance of infection and the benefit of not taking preventive action.[205].

Research on infection anxiety and mental health

Infection anxiety, cognition and behavior differed between men and women, but regional differences were not so large.[206]..Infectious anxiety was also associated with aversion to others and promoted infectious disease prevention behavior such as new lifestyles.[206]. How COVID-19 affects college studentsmental healthThere were many reports that it had an adverse effect on people's lives, and few documents showed that it had a positive effect.[207].

Awareness of vaccination

Regarding risk recognition in the concept of vaccination, various other risk events[Note 9]It was confirmed that the risk recognition was low and the profit recognition tended to be highly estimated.[208]..In particular, it was confirmed that the risk recognition of vaccination is positive among the elderly (60s) and vaccination applicants.[208].Pregnant women in the corona crisis were worried about infection, wanted to understand the status of their own antibodies, and hoped to acquire immunity.[209].

Research on therapeutic agents

Super computer"Fuyue"UsingMolecular dynamics calculationBy doing this, the target protein related to the growth of the new coronavirus (Main protease) Searching for therapeutic drug candidates showing high affinity,IdentificationWas made[210].

Study of elderly cases

During hospitalization for new coronavirus infections in the elderlyリ ハ ビ リ テ ー シ ョ ンEtcActivities of daily livingThe challenge is to build a comprehensive approach in the local community, such as not dropping the patient and promptly making adjustments until discharge.[211].

footnote

[How to use footnotes]

注 釈

  1. ^ The causative virus name bears "SARS", but it became epidemic from 2002 to 2003.Severe acute respiratory syndrome It is not a virus that causes (SARS).This name is simplySARS coronavirus It is derived from the phylogenetic relationship with (SARS-CoV).
  2. ^ For the origin of the new coronavirus,BatIt is said that it was transmitted from wild animals, and it is close to the early endemic area.Wuhan Institute of VaseIt is said that the former is highly likely, but the latter is not denied and the exact origin is unknown.[28].
  3. ^ A site that binds to a receptor on the virus side[65].
  4. ^ SARSThe onset interval is estimated to be 5.3 to 19 days[92].
  5. ^ In particular,Senior citizensIn the case of, the aggravation of the underlying disease is observed, and in the case of the younger generation, severe fever symptoms are observed due to a decrease in physical strength due to malnutrition or the like.
  6. ^ Of course, there are some patients who cannot use acetaminophen due to side effects.
  7. ^ As a matter of course, it is possible that the hospital hygiene standards are not observed.
  8. ^ Behaviors such as refraining from going to the hospital excessively necessary for treatment of pre-existing diseases and thinking of moving if an infected person appears in the neighborhood[205].
  9. ^ Risks of nuclear power, food additives, bicycles, alcoholic beverages[208].

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