概述

COVID-19(也称为 2019 冠状病毒病)是一种由严重急性呼吸道综合征冠状病毒 2(SARS-CoV-2)病毒引起的疾病。该病毒是一种冠状病毒。

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。

许多 COVID-19 患者有轻度至中度症状,并且可以自愈。但对于某些人群,COVID-19 可能会发展为重症并导致死亡。高风险人群包括老年人,并且风险会随着年龄的增长而增加。存在基础医疗状况的人出现重症的风险也更高。

接种 COVID-19 疫苗有助于预防重症、避免因 COVID-19 而需要住院治疗以及预防 COVID-19 导致的死亡。

症状

2019 冠状病毒病(COVID-19)的症状会在接触病毒后 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。出现症状前仍可能会将 COVID-19 传染给他人。这就是症状前传播。常见症状包括:

  • 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。

此表并非完整列表。儿童的症状与成人相似,但病情一般较轻。

COVID-19 的症状从非常轻微到严重不等。有些人可能只有一些症状。有些人可能没有任何症状,但仍有转染性。这就是无症状传播。

有些人的症状可能会在出现一周后加重,如气短和肺炎加重。有些人的 COVID-19 症状在确诊后的持续时间会超过四周。这些健康问题有时称为后 COVID-19 症状。

有些儿童在感染 COVID-19 几周后会出现多系统炎症综合征,这种综合征可影响某些器官和组织。极少数情况下,一些成人也会出现这种综合征。

什么时候应该去看医生

如果您出现 COVID-19 的症状,或者接触过 COVID-19 确诊患者,请立即联系您医疗护理团队获取医疗建议。

医疗护理专业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,请立即就医。紧急症状可能包括:

  • 呼吸困难。
  • 持续性胸部疼痛或压迫感。
  • 难以保持清醒
  • 新发意识模糊。
  • 皮肤、嘴唇或甲床苍白、发灰或发青(取决于肤色)。

本列表并不详尽。如果您年龄较大或存在慢性医疗状况(如心脏病或肺病),请告知您的医疗护理团队,因为您患上 COVID-19 重症的可能性更大。

病因

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

引起 COVID-19 的病毒易在人群中传播。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、鼻或眼中。

有时,当人接触到在空气中停留数分钟或数小时的极小飞沫或气溶胶时,COVID-19 病毒就会传播(也就是空气传播)。

如果接触了带有病毒的表面,然后又接触了口腔、鼻或眼睛,病毒也会传播。但这种风险较低。

无症状感染人群也可以传播 COVID-19 病毒。这就是无症状传播。尚未出现症状的感染人群也可以传播 COVID-19 病毒。这就是症状前传播。

可能会不止一次感染 COVID-19

风险因素

COVID-19 的风险因素似乎包括:

  • 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。

感染 COVID-19 而导致重症的风险因素

一些人感染 COVID-19 而导致重症的风险较其他人更高。其中包括老年人,且风险随年龄增长而提高。

有既往病史的人患重症的风险也可能更高。其中包括患以下疾病的人群:

  • 镰状细胞病或地中海贫血。
  • 严重的心脏病,如心力衰竭、冠状动脉疾病或心肌病,还可能包括高血压。
  • 慢性肾脏、肝脏或肺部疾病。

失智症或阿尔茨海默病患者也有较高风险,患脑部和神经系统疾病(例如卒中)的人群也是如此。抽烟会增加感染 COVID-19 进而导致重症的风险。体重指数属于超重或肥胖的人群,患病风险也会增加。

其他可能增加感染 COVID-19 进而导致重症的疾病包括:

  • 癌症。
  • 1 型或 2 型糖尿病。
  • 因实体器官移植或骨髓移植、某些药物或 HIV 而导致免疫系统衰弱。
  • 妊娠。
  • 唐氏综合征。
  • 物质服用病症。

上述仅为举例,并非全部。其他疾病可能增加您感染 COVID-19 进而导致重症的风险。

并发症

虽然大多数 COVID-19 患者的症状为轻度至中度,但这种疾病会引起严重的医疗并发症,有些人甚至会死亡。

老年人或已有其他健康问题的人患 COVID-19 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。
  • 急性呼吸窘迫综合征是一种严重的肺部疾病,会导致通过血液到达器官的氧气量减少。
  • 血凝块。
  • 急性肾损伤。
  • 其他病毒和细菌感染。

预防

美国疾病控制与预防中心(CDC)建议,6 个月及以上的人群均应接种 COVID-19 疫苗。COVID-19 疫苗可以降低由 COVID-19 引起的死亡或重症的风险。疫苗不仅有助于降低自身的感染风险,也可降低传播给周边人群的风险。

接种 COVID-19 疫苗尤其重要,因为流感和 COVID-19 可能会同时传播,并引起类似症状。接种 COVID-19 疫苗和流感疫苗是预防这两种疾病的最佳手段。

在美国境内可接种以下 COVID-19 疫苗:

  • 2023-2024 年度辉瑞-生物科技 COVID-19 疫苗。该疫苗已获批用于 6 月龄及以上人群。

    在具有典型免疫系统的人群中:

    • 6 月龄至 4 岁的儿童在接种了三剂辉瑞-生物科技 COVID-19 疫苗后即视为已接种最新疫苗。
    • 5 岁及以上人群在接种了一剂辉瑞-生物科技 COVID-19 疫苗后即视为已接种最新疫苗。
    • 对于未接种 2023-2024 年度 COVID-19 疫苗的人群,CDC 建议额外接种一剂更新版的疫苗。
  • 2023-2024 年度莫德纳 COVID-19 疫苗。该疫苗已获批用于 6 月龄及以上人群。

    在具有典型免疫系统的人群中:

    • 6 月龄至 4 岁的儿童在接种了两剂莫德纳 COVID-19 疫苗后即视为已接种最新疫苗。
    • 5 岁及以上人群在接种了一剂莫德纳 COVID-19 疫苗后即视为已接种最新疫苗。
    • 对于未接种 2023-2024 年度 COVID-19 疫苗的人群,CDC 建议额外接种一剂更新版的疫苗。
  • 2023-2024 年度诺瓦瓦克斯 COVID-19 疫苗。该疫苗已获批用于 12 岁及以上人群。

    在具有典型免疫系统的人群中:

    • 12 岁及以上的儿童在接种了两剂诺瓦瓦克斯 COVID-19 疫苗后即视为已接种最新疫苗。
    • 对于未接种 2023-2024 年度 COVID-19 疫苗的人群,CDC 建议额外接种一剂更新版的疫苗。

通常而言,具有典型免疫系统的 5 岁及以上人群可以接种适用其年龄段的任何经批准或许可的疫苗,而且通常不需要每次都接种同一款疫苗。

有些人群则应该在所有疫苗剂次接种同一疫苗制造商生产的疫苗,包括:

  • 6 月龄至 4 岁儿童。
  • 免疫系统功能低下的 5 岁及以上人群。
  • 已接种过一剂诺瓦瓦克斯疫苗的 12 岁及以上人群应在两剂次中接种第二剂诺瓦瓦克斯疫苗。

如果您对自己或孩子接种的疫苗有任何疑问,请咨询医疗护理专业人员。如果出现以下情况,医疗护理团队可以为您提供帮助:

  • 您或您孩子之前接种的疫苗已断货。
  • 您不知道自己或孩子接种了哪种疫苗。
  • 您或您的孩子开始接种多剂次疫苗,但由于副作用而无法完成全程接种。

免疫系统功能低下的人群

如果您属于中度或重度免疫系统功能低下的人群,医疗护理团队可能会建议增加 COVID-19 疫苗的剂次。

疫苗接种和其他行动

您可以采取多种措施,来降低感染 COVID-19 病毒或将该病毒传染给他人的风险。世卫组织(WHO)和 CDC 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。
  • 避免与患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,不前往空气流通(也称为通风)不畅的室内场所。
  • 经常用肥皂和清水洗手,至少搓洗 20 秒。或者用酒精含量至少 60% 的免洗洗手液清洁双手。
  • 如果您所在地区有大量 COVID-19 住院病例,应在室内公共场所佩戴口罩。CDC 建议佩戴您经常佩戴的贴合度良好、舒适且最具防护性的口罩。
  • 改善室内的空气流动状况。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。
  • 遮挡口鼻。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。
  • 对频繁接触的表面进行清洁和消毒。例如,定期清洁门把手、电灯开关、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。

如果您存在慢性医疗状况并且可能患重症的风险较高,请咨询医疗护理专业人员,了解其他自我防护措施。

旅行

如果您计划外出旅行,请先查看 CDC世卫组织网站,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、火车和其他公共交通上,以及在机场和火车站等地,都佩戴口罩。

在公共场所保持良好的手部卫生习惯。

如果您的健康状况使您更容易受到呼吸道感染和并发症的影响,您可能还需要与您的医疗护理团队进行沟通。

Nov. 01, 2023
  1. Coronavirus disease 2019 (COVID-2019). Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/index.html. Accessed June 19, 2023.
  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 Oct. 17, 2022.
  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 June 19, 2023.
  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 June 19, 2023.
  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. U.S. Food and Drug Administration. https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/novavax-covid-19-vaccine-adjuvanted. Accessed Oct. 20, 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 June 19, 2023.
  46. Variants and genomic surveillance. Centers for Disease Control and Prevention. https://covid.cdc.gov/covid-data-tracker/#variant-proportions. Accessed April 12, 2023.
  47. COVID-19 bivalent vaccine boosters. U.S. Food and Drug Administration. https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/covid-19-bivalent-vaccine-boosters. Accessed Oct. 17, 2022.
  48. Reinfections and COVID-19. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/your-health/reinfection.html. Accessed Sept. 13, 2022.
  49. COVID-19 Therapeutics. U.S. Food and Drug Administration. https://www.fda.gov/health-professionals/covid-19-health-care-professional-resources#Therapeutics. Accessed June 19, 2023.
  50. Benefits of getting a COVID-19 vaccine. U.S. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/vaccine-benefits.html. Accessed Oct. 22, 2023.
  51. Masking during travel. Centers for Disease Control and Prevention. https://wwwnc.cdc.gov/travel/page/masks. Accessed Oct. 6, 2023.

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