概述

冠状病毒是一大类病毒家族的总称,可引起包括普通感冒、严重急性呼吸道综合征(SARS)和中东呼吸综合征(MERS)在内的多种疾病。2019 年发现了一种新型冠状病毒,这种病毒是导致中国暴发疫情的罪魁祸首。

它被命名为严重急性呼吸道综合征冠状病毒 2 型(SARS-CoV-2)。这种病毒导致的疾病被称为 2019 冠状病毒病(COVID-19)。世界卫生组织(WHO)于 2020 年 3 月宣布 COVID-19 疫情为大流行。

包括美国疾病控制与预防中心(CDC)和 WHO 在内的公共卫生组织正在监测 COVID-19 疫情,并在各自的网站上发布最新消息。这些组织还就如何预防和治疗 COVID-19 致病病毒发布了相关建议。

症状

2019 冠状病毒病(COVID-19)的体征和症状可能会在接触病毒后的 2 到 14 天出现。接触病毒后到出现症状前的这段时间称为潜伏期。感染者在出现症状之前,仍可以传播 COVID-19(症状前传播)。常见体征和症状可能包括:

  • 发热
  • 咳嗽
  • 疲倦

COVID-19 的早期症状可能包括味觉或嗅觉丧失。

其他症状可能包括:

  • 气短或呼吸困难
  • 肌肉疼
  • 寒战
  • 咽喉疼痛
  • 流鼻涕
  • 头痛
  • 胸部疼痛
  • 红眼病(结膜炎)
  • 恶心
  • 呕吐
  • 腹泻
  • 皮疹

本列表并不详尽。儿童的症状与成人相似,一般病情轻微。

COVID-19 症状的严重程度从极轻度到重度不等。有些人可能只会出现少许症状。有些人可能根本没有症状,但仍能传播该疾病(无症状传播)。症状开始一周后,有些人的症状可能加重,例如气短和感染性肺炎加重。

部分患者的 COVID-19 症状会在确诊后持续四周以上。这些健康问题有时被称为 COVID-19 后医疗状况。一些儿童会在感染 COVID-19 数周后患上多系统炎症综合征(一种可能影响部分器官和组织的综合征)。在极少数情况下,一些成人也会患该综合征。

年长者出现严重 COVID-19 病症的风险更高,而且风险随年龄的增长而增加。身患其他医学状况的人出现严重病症的可能性也更高。可能增加 COVID-19 重症风险的医学状况包括:

  • 心力衰竭、冠状动脉疾病或心肌病等严重心脏病
  • 癌症
  • 慢性阻塞性肺疾病(COPD)
  • 1 型或 2 型糖尿病
  • 超重、肥胖症或严重肥胖症
  • 高血压
  • 抽烟
  • 慢性肾病
  • 镰状细胞病或地中海贫血
  • 实体器官移植或骨髓移植导致的免疫功能低下
  • 怀孕
  • 哮喘
  • 囊性纤维化或肺动脉高压等慢性肺病
  • 肝病
  • 失智
  • 唐氏综合征
  • 骨髓移植、HIV 或一些药物导致的免疫功能低下
  • 卒中等脑和神经系统状况
  • 物质使用障碍

此表并非完整列表。其他医学状况可能会增加 COVID-19 重症风险。

什么时候应该去看医生

如果您出现 COVID-19 的体征或症状,或者接触过 COVID-19 确诊患者,请立即联系医疗服务提供者获取医疗建议。医务人员可能会建议您进行 COVID-19 检测。如果您出现紧急的 COVID-19 症状,如呼吸困难,请立即就医。如果您需要去医院,请提前致电,这样医疗服务提供者就可以采取措施以确保其他人不受感染。

如果您出现紧急的 COVID-19 体征和症状,请立即就医。紧急体征和症状可能包括:

  • 呼吸困难
  • 持续的胸部疼痛或压迫感
  • 无法保持清醒
  • 新出现的意识模糊
  • 皮肤、嘴唇或甲床变白、变灰或变青(取决于肤色)

本列表并不详尽。如果您年龄较大或有慢性医疗状况,如心脏病或肺病,请告知您的医疗服务提供者,因为您可能有较高的 COVID-19 重症风险。

病因

感染严重急性呼吸道综合征冠状病毒 2(简称 SARS-CoV-2)会导致 2019 冠状病毒病(COVID-19)。

导致 COVID-19 的病毒很容易在人群中传播。数据显示,COVID-19 病毒主要在密切接触者之间进行人际传播。该病毒通过携带者咳嗽、打喷嚏、呼吸、唱歌或说话时释放的呼吸道飞沫传播。这些飞沫可能会被吸入或落在附近人的口腔、鼻或眼睛中。

有时,当一个人接触到在空气中停留数分钟或数小时的小飞沫或气溶胶时,COVID-19 病毒就会传播,称为空气传播。

如果您触摸带有病毒的表面,然后触碰自己的口腔、鼻或眼睛,病毒也可能传播。但是风险较低。

COVID-19 病毒可以通过无症状感染者传播。这称为无症状传播。COVID-19 病毒还可以通过受到感染但尚未出现症状的人传播。这称为症状前传播。

有可能感染 COVID-19 一次以上。

风险因素

COVID-19 的风险因素可能包括:

  • COVID-19 患者(特别是有症状者)有过密切接触
  • 感染者对着您咳嗽或打喷嚏
  • 与感染者同在通风不良的室内

并发症

虽然大多数 COVID-19 患者只有轻度至中度症状,但某些患者有可能会出现严重并发症并因此死亡。老年人或有基础疾病的人感染 COVID-19 后转为重症的风险更高。

并发症可能包括:

  • 感染性肺炎和呼吸困难
  • 多个器官衰竭
  • 心脏问题
  • 严重的肺部疾病,导致流经全身的血液含氧量降低,造成机体供氧不足(急性呼吸窘迫综合征)
  • 血凝块
  • 急性肾损伤
  • 其他病毒和细菌感染

预防

美国食品药品管理局(FDA)已紧急授权部分 COVID-19 疫苗在美国使用。FDA 已批准辉瑞-生物科技 COVID-19 疫苗(现称为复必泰,Comirnaty)用于 12 岁及以上人群预防 COVID-19FDA 已向辉瑞-生物科技 COVID-19 疫苗授予紧急使用许可,可用于 6 个月至 11 岁儿童。

FDA 已批准莫德纳疫苗(现称为 Spikevax)用于 18 岁及以上人群预防 COVID-19FDA 也已授权莫德纳 COVID-19 疫苗用于 6 个月至 17 岁儿童。FDA 还授权诺瓦瓦克斯 COVID-19 佐剂疫苗用于 12 岁及以上人群预防 COVID-19

由于可能出现危及生命的凝血问题,FDA 限制部分 18 岁及以上人群接种杨森/强生疫苗。例如在接种 mRNACOVID-19 疫苗后出现严重过敏反应的人群,以及由于资源有限、个人或宗教问题而无法接种 mRNACOVID-19 疫苗的人群。如果您要接种此疫苗,请务必了解出现凝血问题的风险和症状。

疫苗可以防止您感染 COVID-19 病毒,或在您已感染 COVID-19 病毒的情况下,防止出现严重病情。此外,相比感染 COVID-19,接种 COVID-19 疫苗或许能够提供更好的保护力。最近的一项研究表明,感染过 COVID-19 但未接种疫苗的人群再次感染 COVID-19 的可能性是完全接种人群的两倍以上。

接种后,您就可以更安全地重新开始许多之前因疫情而无法进行的活动。但是,如果您所在地区有大量 COVID-19 住院病例和新发 COVID-19 病例,CDC 建议在室内公共场所佩戴口罩。接种第二剂 mRNACOVID-19 疫苗后两周,接种两剂诺瓦瓦克斯疫苗,或接种单剂型杨森/强生 COVID-19 疫苗后两周,即视为已完成全程疫苗接种。如果您在符合条件的情况下接种了所有建议接种的 COVID-19 疫苗,包括加强针剂,即视为您已接种最新疫苗。

对于已接种疫苗但免疫应答可能不够强的人群,建议额外接种一剂 COVID-19 疫苗基础针。

与之相比,对于已经接种但免疫应答因时间推移而在减弱的人群,建议接种加强针。研究表明,接种加强针可以降低感染 COVID-19 和因感染而患重症的风险。

中度或重度免疫系统低下的人群应额外接种基础针和加强针。

CDC 建议在特定的情况下接种 COVID-19 疫苗的额外基础针和加强针:

  • 额外基础针。CDC 建议免疫系统低下的人群,例如接受过器官移植者,额外接种一剂 mRNA COVID-19 基础针。免疫功能低下的人群在接种两剂 mRNACOVID-19 疫苗或一剂杨森/强生 COVID-19 疫苗后可能无法产生足够的免疫力。使用 mRNACOVID-19 疫苗作为额外针剂或许能增强其对 COVID-19 的抵抗能力。建议 6 个月及以上人群接种 mRNACOVID-19 的额外针剂。

    应在接种第二剂 mRNACOVID-19 疫苗或接种一剂杨森/强生 COVID-19 疫苗至少四周后接种额外基础针剂。额外基础针剂的品牌应与您接种的其他两剂 mRNACOVID-19 疫苗的品牌相同。如果所接种疫苗的品牌未知,则任一 mRNACOVID-19 疫苗均可作为第三剂接种。

  • 加强针。这些建议因年龄、所接种的疫苗和免疫系统状况而异。但总体而言,可以在此前最后一次疫苗接种后至少两个月打加强针。近期 COVID-19 检测呈阳性的人群可以考虑在症状开始后等待 3 个月再打加强针。

    已接种莫德纳 COVID-19 疫苗的 6 个月至 4 岁儿童可以接种新出的二价莫德纳 COVID-19 疫苗加强针。该加强针基于原始病毒株和两株奥密克戎株。

    已接种辉瑞-生物科技 COVID-19 疫苗的 6 个月至 5 岁儿童只能接种新出的辉瑞-生物科技加强针。该加强针基于原始病毒株和两株奥密克戎株。

    5 岁及以上已接种莫德纳 COVID-19 疫苗的人群,以及 6 岁及以上已接种任一疫苗的人群,可以接种新出的辉瑞-生物科技或新出的莫德纳 COVID-19 二价疫苗加强针剂。

    12 岁及以上已接种诺瓦瓦克斯 COVID-19 疫苗的人群,可以接种新出的辉瑞-生物科技或新出的莫德纳 COVID-19 二价疫苗加强针剂。

    18 岁及以上已接种杨森 COVID-19 疫苗的人群,在疫苗接种后至少两个月可以接种任一 mRNA 疫苗二价加强针。18 岁及以上人群也可以在上一次疫苗接种后至少六个月,接种诺瓦瓦克斯加强针作为第一针加强针,该加强针基于原始病毒株。

    孕妇也能接种 COVID-19 加强针。

您可以采取许多措施来降低感染 COVID-19 病毒或将该病毒传染给他人的风险。WHOCDC 建议采取以下预防措施:

  • 接种疫苗。COVID-19 疫苗可降低感染和传播 COVID-19 的风险。
  • 避免与生病或出现症状的任何人密切接触。
  • 在室内公共场所与他人保持距离。如果您患重症的风险较高,这一点尤为重要。需要记住,有些 COVID-19 患者即使没有症状或不知道自己患 COVID-19,也可能将病毒传播给他人。
  • 避开人群密集处,并避免待在空气流通(通风)不畅的室内场所。
  • 经常用肥皂和水洗手至少 20 秒,或者使用酒精含量至少 60% 的免洗洗手液。
  • 如果您所在地区有许多 COVID-19 住院病例和新发 COVID-19 病例,则无论您是否已接种疫苗,均应在室内公共场所佩戴口罩。CDC 建议在您可以经常佩戴、大小合适且舒适的口罩中选择最具防护性的一款。
  • 改善室内的空气流动。开窗。打开风扇,将空气吹到窗外。如果无法开窗,考虑使用空气过滤器。打开浴室和厨房的排气扇。还可以考虑使用便携式空气净化器。
  • 咳嗽或打喷嚏时,用手肘或纸巾遮住口鼻。扔掉用过的纸巾。立即洗手。
  • 避免触摸眼、鼻和口。
  • 患病期间避免与他人共用餐具、水杯、毛巾、床上用品和其他日常用品。
  • 定期清洁和消毒频繁接触的表面,例如门把手、灯开关、电子产品和台面。
  • 患者请勿上班、上学或前往公共场所,除非是去看病,其余时间请留在家中自行隔离。患病期间避免乘坐公共交通工具、计程车和网约车。

如果您患有慢性病并且可能有较高风险发生重症,请咨询医生以了解其他的自我防护方法。

旅行

如果您计划外出旅行,请先查看 CDCWHO 网站,了解最新情况和相关建议。CDC 建议在往返美国或美国境内的飞机、公共汽车、火车和其他室内公共交通工具上,以及在机场和火车站等地,都要佩戴口罩。在公共场所保持良好的手部卫生习惯。如果您的健康状况让您更容易发生呼吸道感染和并发症,还建议您咨询医务人员。

July 14, 2023
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