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
  • 肌肉酸痛
  • 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

该列表并非详尽列表。儿童的症状与成人相似,一般病情轻微。

COVID-19 症状的严重程度从非常轻度到重度不等。有些人可能只有少许症状。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 后病症。一些儿童会在患 COVID-19 数周后患多系统炎症综合征(一种可能影响部分器官和组织的综合征)。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,而且风险随年龄增加。身患其他医学疾病的人患严重疾病的风险也更高。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
  • 吸烟
  • 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
  • 痴呆
  • 唐氏综合征
  • 骨髓移植、HIV 或一些药物导致的免疫功能低下
  • 卒中等大脑和神经系统疾病
  • 物质使用障碍

此表并非完整列表。其他疾病可能会增加您因 COVID-19 患严重疾病的风险。

COVID-19 自查工具

使用 CDC 的冠状病毒自查工具评估您的症状,确认您是否需要接受 COVID-19 检测。

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

严重急性呼吸道综合征冠状病毒 2(SARS-CoV-2)感染可引起 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(约 6 英尺或 2 米内)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、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、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进行传播。这称为无症状传播。COVID-19 病毒还可以通过受感染但尚未出现症状的人进行传播。这称为症状前传播。

有可能感染 COVID-19 两次或两次以上,但这并不常见。

如果病毒出现一种或多种新突变,这些突变病毒就称为原始病毒的变异株。目前,美国疾病控制与预防中心(CDC)已将引起 COVID-19 的两个病毒变异株确定为关切变异株。这包括德尔塔(B.1.617.2)变异株和奥密克戎(B.1.1.529)变异株。德尔塔变异株的传染性高于早期变异株,并且可能会导致更严重的疾病。奥密克戎变异株比包括德尔塔在内的其他变异株更容易传播。但目前还不清楚奥密克戎是否会导致更严重的疾病。

风险因素

2019 冠状病毒病 (COVID-19) 的风险因素可能包括:

  • COVID-19 患者发生密切接触(6 英尺或 2 米以内)
  • 感染者朝您咳嗽或打喷嚏

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

美国食品药品监督管理局 (FDA) 已授予美国部分 COVID-19 疫苗紧急使用许可。FDA 已批准辉瑞-BioNTech 的 COVID-19 疫苗(现称为复必泰,Comirnaty)用于 16 岁及以上人群预防 COVID-19FDA 已授予辉瑞-BioNTech COVID-19 疫苗用于 5 至 15 岁人群的紧急使用许可。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-19

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,防止您的病情加重。此外,相比感染 COVID-19,接种 COVID-19 疫苗可提供更好的保护力。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。

此外,如果您已完全接种,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,如果您所在的地区有大量的新增 COVID-19 病例,美国疾病控制与预防中心(CDC)建议,无论是在室内公共场所还是在户外拥挤的地方,或者与没有完全接种疫苗的人近距离接触时,都要戴上口罩。CDC 建议佩戴您经常佩戴且大小合适的最具防护性的口罩。

建议已接种疫苗但可能未产生足够强的免疫反应的人群接种额外的 COVID-19 基础免疫疫苗。

相比之下,对于完全接种且免疫反应随时间的推移而减弱的人群,建议进行加强免疫接种。研究表明,完成加强免疫接种可以降低感染 COVID-19 和因感染而患严重疾病的风险。

中度或重度免疫系统低下的人群应接种额外的基础针和加强针。

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:

  • 额外剂量。美国疾病控制与预防中心建议免疫功能低下的人群,例如接受过器官移植的人群,接种第三剂 mRNA COVID-19 疫苗。免疫功能低下的人群在接种两剂 mRNA COVID-19 疫苗后可能无法产生足够的免疫力。额外的剂量可能会增强他们对 COVID-19 的抵御能力。

    应在第二剂 mRNA COVID-19 疫苗接种后至少 28 天后再接种第三剂疫苗。额外剂量的品牌应与您接种的其他两剂 mRNA COVID-19 疫苗的品牌相同。如果所接种疫苗的品牌未知,则任一 mRNA COVID-19 疫苗均可作为第三剂接种。

  • 加强针剂。如果您年满 12 岁,已接种过两剂辉瑞-BioNTech COVID-19 疫苗且距离第二剂疫苗接种已有至少 5 个月,那么您应该接种一剂加强针。12 至 17 岁的青少年仅应接种辉瑞-BioNTech COVID-19 疫苗加强针。对于年满 18 岁者,在大多数情况下,首选辉瑞-生物科技或莫德纳 COVID-19 疫苗加强针。

    如果您年满 18 岁,已接种过两剂莫德纳 COVID-19 疫苗且距离第二剂疫苗接种已有至少 5 个月,那么您应该接种一剂加强针。在大多数情况下,首选辉瑞-BioNTech 或莫德纳 COVID-19 疫苗加强针。

    如果您年满 18 岁,已接种过一剂杨森/强生 COVID-19 疫苗,且距离上次接种已有至少两个月,那么您应该接种一剂加强针。在大多数情况下,首选辉瑞-BioNTech 或莫德纳 COVID-19 疫苗加强针。

    孕妇也可以接种 COVID-19 加强针。

美国食品药品管理局还授权单克隆抗体 tixagevimab 和 cilgavimab(Evusheld)用于一些免疫功能低下或对 COVID-19 疫苗有严重反应的人群,以预防 COVID-19

美国食品药品管理局还授权,使用卡西瑞单抗和伊德维单抗混合药物以及巴尼韦单抗和埃特司韦单抗混合药物,治疗罹患重症风险较高、最近已暴露于 COVID-19 病毒或具有高暴露风险的人群。例如,一旦护理院或监狱中有人最近感染了 COVID-19 病毒,那么住在此处的人就成了暴露风险高的人群。这种治疗方式适用于未完全接种或已完全接种但免疫功能低下的人群。

您可以采取许多措施来降低您感染 COVID-19 病毒或将该病毒传染给他人的风险。世界卫生组织 (WHO)美国疾病控制与预防中心 (CDC) 建议采取以下预防措施:

  • 免疫接种。COVID-19 疫苗可降低感染和传播 COVID-19 的风险。
  • 避免与任何生病或有症状的人密切接触(约 2 米或 6 英尺以内)。
  • 如果您未完全接种疫苗,当您位于室内公共场所时,请与其他人保持距离(约 6 英尺或 2 米以上)。如果您患重病的风险较高,这一点尤为重要。需要记住,有些 2019 冠状病毒病患者即使无症状或不知道自己患 2019 冠状病毒病,也可能将病毒传播给他人。
  • 避开人群,并避免前往空气流通(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为 60% 的免洗洗手液。
  • 在室内公共场所时佩戴口罩。CDC 建议您经常佩戴大小合适的最具防护性的口罩。如果您所在的地区有大量的新增 COVID-19 病例,在存在 COVID-19 高传播风险(例如人员密集的活动或大型聚会)的室内和室外,请佩戴口罩。
  • 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。
  • 避免触摸眼睛、鼻子和嘴巴。
  • 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、电灯开关、电子产品和柜台。
  • 患病期间请留在家中进行隔离,请勿上班、上学和前往公共场所,除非前往看病。患病期间避免乘坐公共交通工具、计程车和网约车。

如果您患有慢性疾病并且有发生重症的高危因素,请咨询医生以了解其他自我防护方法。

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。准备好佩戴口罩并在公共场合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。

Aug. 27, 2022
  1. Coronavirus disease 2019 (COVID-2019). Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/index.html. Accessed Aug. 22, 2022.
  2. Coronavirus disease (COVID-19) outbreak. World Health Organization. https://www.who.int/emergencies/diseases/novel-coronavirus-2019. Accessed Oct. 22, 2021.
  3. AskMayoExpert. COVID-19: Inpatient management (adult). Mayo Clinic; 2021.
  4. AskMayoExpert. Upper respiratory tract infection. Mayo Clinic; 2020.
  5. Tosh PK (expert opinion). Mayo Clinic. March 16, 2020.
  6. What you should know about coronavirus disease 2019 (COVID-19). American Academy of Otolaryngology – Head and Neck Surgery. https://www.enthealth.org/be_ent_smart/what-you-should-know-about-coronavirus-disease-2019-covid-19/. Accessed Nov. 9, 2021.
  7. McIntosh K. Coronavirus disease 2019 (COVID-19): Epidemiology, virology, clinical features, diagnosis, and prevention. https://www.uptodate.com/contents/search. Accessed Nov. 9, 2021.
  8. Coronavirus disease 2019 (COVID-19) treatment guidelines. National Institutes of Health. https://covid19treatmentguidelines.nih.gov/introduction/. Accessed Feb. 18, 2022.
  9. Emergency use authorization. U.S. Food & Drug Administration. https://www.fda.gov/emergency-preparedness-and-response/mcm-legal-regulatory-and-policy-framework/emergency-use-authorization. Accessed Feb. 18, 2022.
  10. Coronavirus (COVID-19) update: FDA authorizes first standalone at-home sample collection kit that can be used with certain authorized tests. U.S. Food & Drug Administration. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-first-standalone-home-sample-collection-kit-can-be-used. Accessed May 20, 2020.
  11. Coronavirus (COVID-19) update: FDA authorizes first diagnostic test using at-home collection of saliva specimens. U.S. Food & Drug Administration. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-first-diagnostic-test-using-home-collection-saliva. Accessed May 20, 2020.
  12. Interim guidelines for collecting, handling, and testing clinical specimens for COVID-19. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-nCoV/lab/guidelines-clinical-specimens.html. Accessed June 29, 2020.
  13. Speth MM, et al. Olfactory dysfunction and sinonasal symptomatology in COVID-19: Prevalence, severity, timing, and associated characteristics. Otolaryngology-Head and Neck Surgery. 2020; doi:10.1177/0194599820929185.
  14. Marshall WF (expert opinion). Mayo Clinic. Nov. 23, 2020.
  15. Vaccines and related biological products advisory committee meeting. U.S. Food and Drug Administration. https://www.fda.gov/media/144245/download. Accessed Dec. 9, 2020.
  16. AskMayoExpert. COVID-19: Vaccination. Mayo Clinic; 2021.
  17. Science Brief: SARS-CoV-2 and surface (fomite) transmission for indoor community environments. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/more/science-and-research/surface-transmission.html. Accessed April 13, 2021.
  18. Interim public health recommendations for fully vaccinated people. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated-guidance.html. Accessed Dec. 15, 2021.
  19. Coronavirus (COVID-19) update: FDA authorizes additional vaccine dose for certain immunocompromised individuals. U.S. Food and Drug Administration. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-additional-vaccine-dose-certain-immunocompromised. Accessed Aug. 13, 2021.
  20. Talking with patients who are immunocompromised. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/immunocompromised-patients.html. Accessed Aug. 16, 2021.
  21. COVID-19 vaccines for moderately to severely immunocompromised people. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/immuno.html. Accessed Aug. 16, 2021.
  22. Joint CDC and FDA statements on vaccine booster. U.S. Food and Drug Administration. https://www.fda.gov/news-events/press-announcements/joint-cdc-and-fda-statement-vaccine-boosters. Accessed Aug. 16, 2021.
  23. Comirnaty and Pfizer-BioNTech COVID-19 vaccine frequently asked questions. U.S. Food and Drug Administration. https://www.fda.gov/emergency-preparedness-and-response/mcm-legal-regulatory-and-policy-framework/comirnaty-and-pfizer-biontech-covid-19-vaccine-frequently-asked-questions. Accessed Aug. 23, 2021.
  24. CDC statement on ACIP booster recommendations. Centers for Disease Control and Prevention. https://www.cdc.gov/media/releases/2021/p0924-booster-recommendations-.html. Accessed Sept. 24, 2021.
  25. Frequently asked questions about COVID-19 vaccination. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html. Accessed Oct. 1, 2021.
  26. CDC expands eligibility for COVID-19 booster shots. Centers for Disease Control and Prevention. https://www.cdc.gov/media/releases/2021/p1021-covid-booster.html. Accessed Oct. 22, 2021.
  27. Pfizer-BioNTech COVID-19 frequently asked questions. U.S. Food and Drug Administration. https://www.fda.gov/emergency-preparedness-and-response/mcm-legal-regulatory-and-policy-framework/pfizer-biontech-covid-19-vaccine-frequently-asked-questions. Accessed Nov. 3, 2021.
  28. FDA authorizes Pfizer-BioNTech COVID-19 vaccine for emergency use in children 5 through 11 years of age. U.S. Food and Drug Administration. https://www.fda.gov/news-events/press-announcements/fda-authorizes-pfizer-biontech-covid-19-vaccine-emergency-use-children-5-through-11-years-age. Accessed Nov. 3, 2021.
  29. Coronavirus (COVID-19) update: FDA expands eligibility for COVID-19 vaccine boosters. U.S. Food and Drug Administration. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-expands-eligibility-covid-19-vaccine-boosters. Accessed Nov. 19, 2021.
  30. COVID-19 vaccine booster shots. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-shot.html. Accessed Jan. 6, 2022.
  31. Coronavirus (COVID-19) update: FDA expands eligibility for Pfizer-BioNTech COVID-19 booster dose to 16- and 17-year-olds. U.S. Food and Drug Administration. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-expands-eligibility-pfizer-biontech-covid-19-booster-dose-16-and-17. Accessed Dec. 9, 2021.
  32. Coronavirus (COVID-19) update: FDA authorizes new long-acting monoclonal antibodies for pre-exposure prevention of COVID-19 in certain individuals. U.S. Food and Drug Administration. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-new-long-acting-monoclonal-antibodies-pre-exposure. Accessed Dec. 9, 2021.
  33. CDC endorses ACIP’s updated COVID-19 vaccine recommendations. Centers for Disease Control and Prevention. https://www.cdc.gov/media/releases/2021/s1216-covid-19-vaccines.html. Accessed Dec. 17, 2021.
  34. Stay up to date with your vaccines. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html. Accessed Aug. 22, 2022.
  35. Types of masks and respirators. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/types-of-masks.html. Accessed Jan. 17, 2021.
  36. Spikevax and Moderna COVID-19 vaccine. U.S. Food and Drug Administration. https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/spikevax-and-moderna-covid-19-vaccine. Accessed Jan. 31, 2022.
  37. Coronavirus (COVID-19) update: FDA authorizes new monoclonal antibody for treatment of COVID-19 that retains activity against omicron variant. U.S. Food & Drug Administration. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-new-monoclonal-antibody-treatment-covid-19-retains. Accessed Feb. 17, 2022.
  38. Use and care of masks. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html. Accessed Feb. 28, 2022.
  39. COVID-19 community levels. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/science/community-levels.html. Accessed Aug. 11, 2022.
  40. Interim clinical considerations for use of COVID-19 vaccines currently approved or authorized in the United States. Centers for Disease Control and Prevention. https://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html#CoV-19-vaccination. Accessed March 30, 2022.
  41. Coronavirus (COVID-19) update: FDA authorizes second booster dose of two COVID-19 vaccines for older and immunocompromised individuals. U.S. Food and Drug Administration. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-second-booster-dose-two-covid-19-vaccines-older-and. Accessed March 30, 2022.
  42. Coronavirus (COVID-19) update: FDA limits use of Janssen COVID-19 vaccine to certain individuals. U.S. Food and Drug Administration. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-limits-use-janssen-covid-19-vaccine-certain-individuals. Accessed May 9, 2022.
  43. Novavax COVID-19 vaccine, adjuvanted. Food and Drug Administration. https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/novavax-covid-19-vaccine-adjuvanted. Accessed Aug. 22, 2022.
  44. Improving ventilation in your home. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/Improving-Ventilation-Home.html. Accessed Aug. 16, 2022.
  45. Understanding exposure risks. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/your-health/risks-exposure.html. Accessed Aug. 23, 2022.
  46. Variants and genomic surveillance. Centers for Disease Control and Prevention. https://covid.cdc.gov/covid-data-tracker/#variant-proportions. Accessed Aug. 23, 2022.

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