corona virus disease 2019 (COVID-19)

2019 年冠状病毒病 (CoViD - 19)
  • 文章类型: Journal Article
    由于严重急性呼吸道综合症冠状病毒2(SARS-CoV-2)感染,2019年冠状病毒病(COVID-19)影响了整个世界。已经报道了获得性血栓性血小板减少性紫癜(TTP)在施用基于mRNA或腺病毒载体的COVID-19疫苗后,包括Ad26。COV2-S,BNT162b2、mRNA-1273和ChAdOx1nCov-19。然而,无论是灭活疫苗,比如CoronaVac,可能导致TTP以及灭活疫苗引起的TTP症状是否与以前报道的病例不同尚不清楚。在这项研究中,报告了两例。这两个病例在第二次注射CoronaVac疫苗后出现TTP,但不是第一个。他们表现出发烧的症状,神经异常,肾功能不全,血小板减少症,和溶血。两名患者通过几次血浆置换和免疫抑制均达到完全缓解。分析南京地区TTP的发病情况。2019年TTP患者人数为12人,2020年为6人,2021年为16人,2022年为19人。就作者所知,本报告是与灭活COVID-19疫苗(CoronaVac)相关的TTP的第一份报告。稀有和延迟发作可能是由于灭活疫苗引起的免疫反应比基于mRNA的疫苗相对温和。及时血浆置换是CoronaVac相关TTP的重要治疗方法,与活疫苗相关的TTP相似。
    Corona virus disease 2019 (COVID-19) due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has affected the whole world. Acquired thrombotic thrombocytopenic purpura (TTP) has been reported after administration of mRNA- or adenoviral vector-based COVID-19 vaccines, including Ad26.COV2-S, BNT162b2, mRNA-1273, and ChAdOx1 nCov-19. However, whether inactivated vaccines, such as CoronaVac, could cause TTP and whether the symptoms in TTPs caused by inactivated vaccines are different from previously reported cases are unknown. In this study, two cases were reported. Both cases developed TTP after the second CoronaVac vaccination shot, but not the first. They demonstrated symptoms of fever, neurological abnormalities, renal dysfunction, thrombocytopenia, and hemolysis. Both patients achieved complete remission through several sessions of plasma exchanges and immune suppression. The incidence of TTP in Nanjing area was analyzed. The number of patients with TTP was 12 in 2019, 6 in 2020, 16 in 2021, and 19 in 2022. To the authors\' knowledge, this report is the first report of TTP associated with inactivated COVID-19 vaccine (CoronaVac). The rarity and delayed onset may be due to the relatively milder immune response caused by the inactivated vaccines than mRNA-based ones. Timely plasma exchange is a vital treatment for CoronaVac-related TTP, similar to activated vaccine-related TTP.
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  • 文章类型: Journal Article
    目的:本研究旨在探讨COVID-19感染对冷冻胚胎移植(FET)女性胚胎着床和早期发育的潜在影响,特别关注FET周围不同时期发生的感染。
    方法:对上海地区在COVID-19感染显著激增的期间行FET的女性进行回顾性分析。所有登记的女性在FET发生时经历了他们第一次记录的COVID-19感染,确保在取卵前不发生感染.根据感染时间将参与者分为六组:未感染,≥60天,FET前<60天,0-14天,15-28天,和FET后29-70天。比较了这些组的临床结果。
    结果:709例患者中感染率为78.28%。受感染的个体表现出无症状或轻度症状。前四组的持续妊娠率为40.7%,44.4%,40.5%,和34.2%(P=0.709),生化妊娠率(59.1%vs.61.1%vs.67.6%与55.7%,P=0.471)和临床妊娠率(49.6%vs.55.6%与55.4%vs.48.1%,P=0.749),均无显著差异。所有六组的早期自然流产率为18.3%,20.0%,25.0%,28.9%,5.4%,和19.0%,差异无统计学意义(P=0.113)。多变量逻辑分析显示感染与持续妊娠之间没有显着相关性。
    结论:FET周围发生的无症状或轻度COVID-19感染似乎不会对早期妊娠结局产生重大不利影响。
    OBJECTIVE: The study aimed to investigate the potential influence of COVID-19 infection on embryo implantation and early development in women undergoing frozen embryo transfer (FET), with a specific focus on infections occurring at different periods around FET.
    METHODS: A retrospective analysis was performed on women who had undergone FET during a period marked by a significant surge in COVID-19 infection in Shanghai. All enrolled women experienced their first documented COVID-19 infection around the time of FET, ensuring that infections did not occur prior to oocyte retrieval. Participants were categorized into six groups based on the timing of infection: uninfected, ≥ 60 days, < 60 days before FET, 0-14 days, 15-28 days, and 29-70 days after FET. Clinical outcomes were compared across these groups.
    RESULTS: The infection rate among the total of 709 cases was 78.28%. Infected individuals exhibited either asymptomatic or mild symptoms. The ongoing pregnancy rates for the first four groups were 40.7%, 44.4%, 40.5%, and 34.2% (P = 0.709) respectively, biochemical pregnancy rates (59.1% vs. 61.1% vs. 67.6% vs. 55.7%, P = 0.471) and clinical pregnancy rates (49.6% vs. 55.6% vs. 55.4% vs. 48.1%, P = 0.749), all showed no significant differences. Early spontaneous abortion rates across all six groups were 18.3%, 20.0%, 25.0%, 28.9%, 5.4%, and 19.0% respectively, with no significant differences (P = 0.113). Multivariable logistic analysis revealed no significant correlation between the infection and ongoing pregnancy.
    CONCLUSIONS: Asymptomatic or mild COVID-19 infections occurring around FET do not appear to have a significant adverse impact on early pregnancy outcomes.
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  • 文章类型: Journal Article
    2019年冠状病毒病(COVID-19)是由严重急性呼吸道综合症冠状病毒2型(SARS-CoV-2)引起的全球大流行,这对全世界的人类健康构成了严重威胁,并造成了巨大的经济损失。随着新病毒株的不断涌现,小分子药物仍然是COVID-19最有效的治疗方法。传统的药物开发过程通常需要几年的时间;然而,计算机辅助药物设计(CADD)的发展为快速有效地开发创新药物提供了机会。文献综述描述了CADD的一般过程,在SARS-CoV-2的生命周期中发挥重要作用并可以作为治疗靶标的病毒蛋白,以及应用CADD方法对病毒靶蛋白进行药物筛选的实例。最后,CADD在COVID-19治疗中的潜力,的不足,并探讨了未来可能的发展方向。
    Corona Virus Disease 2019 (COVID-19) is a global pandemic epidemic caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which poses a serious threat to human health worldwide and results in significant economic losses. With the continuous emergence of new virus strains, small molecule drugs remain the most effective treatment for COVID-19. The traditional drug development process usually requires several years; however, the development of computer-aided drug design (CADD) offers the opportunity to develop innovative drugs quickly and efficiently. The literature review describes the general process of CADD, the viral proteins that play essential roles in the life cycle of SARS-CoV-2 and can serve as therapeutic targets, and examples of drug screening of viral target proteins by applying CADD methods. Finally, the potential of CADD in COVID-19 therapy, the deficiency, and the possible future development direction are discussed.
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  • 文章类型: Journal Article
    在2019年冠状病毒病(COVID-19)时代,戴口罩可以有效保护人们免受感染风险,并大大减少公共场所的传播,比如医院和机场。这带来了对检测戴口罩的人所需的监测仪器的需求。然而,这不是现有人脸检测算法的目标。在这篇文章中,我们提出了一个两阶段的方法来检测戴口罩使用混合机器学习技术。第一阶段旨在检测尽可能多的候选佩戴掩模区域,它基于Faster_RCNN和InceptionV2结构的传输模型,而第二阶段旨在使用广泛的学习系统来验证真实的面膜。它是通过训练两类模型来实现的。此外,本文提出了一个数据集佩戴面罩检测(WMD),包括7804真实的图像。数据集有26403戴口罩,覆盖多个场景,可在\"https://github.com/BingshuCV/WMD获得。“对数据集进行的实验表明,该方法对简单场景的总体精度为97.32%,对复杂场景的总体精度为91.13%,性能优于所比较的方法。
    In the era of Corona Virus Disease 2019 (COVID-19), wearing a mask can effectively protect people from infection risk and largely decrease the spread in public places, such as hospitals and airports. This brings a demand for the monitoring instruments that are required to detect people who are wearing masks. However, this is not the objective of existing face detection algorithms. In this article, we propose a two-stage approach to detect wearing masks using hybrid machine learning techniques. The first stage is designed to detect candidate wearing mask regions as many as possible, which is based on the transfer model of Faster_RCNN and InceptionV2 structure, while the second stage is designed to verify the real facial masks using a broad learning system. It is implemented by training a two-class model. Moreover, this article proposes a data set for wearing mask detection (WMD) that includes 7804 realistic images. The data set has 26403 wearing masks and covers multiple scenes, which is available at \"https://github.com/BingshuCV/WMD.\" Experiments conducted on the data set demonstrate that the proposed approach achieves an overall accuracy of 97.32% for simple scene and an overall accuracy of 91.13% for the complex scene, outperforming the compared methods.
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  • 文章类型: Journal Article
    从SARS-CoV-2的首次报道,2019年底到现在,根据世界卫生组织(WHO)的报告,与COVID-19相关的全球死亡率已达到6,952,522例死亡。早期插管和机械通气可提高危重患者的生存率。这项前瞻性研究是在穆雷县临床医院ICU的885名患者中进行的,罗马尼亚。在应用纳入和排除标准后,共纳入54例患者.在住院期间和6个月随访时对患者进行监测。我们分析了有创机械通气(IMV)和无创机械通气(NIMV)与6个月随访时胸部CT扫描的放射学变化之间的关系,发现没有显着关联。关于临床分析,入院第1天按IMV和铁蛋白水平分组的患者之间存在统计学上的显着关联(p=0.034),以及按PaO2/FiO2比值与代谢综合征(p=0.03)和降钙素原水平(p=0.01)分组的患者之间。在6个月的评估中观察到,入住ICU的COVID-19患者中有很大一部分发生了肺纤维化。补充氧气或机械通气的患者需要动态监测和放射学检查,因为存在长期肺纤维化的可能性,需要药物干预和寻找新的治疗替代方案。
    From the first reports of SARS-CoV-2, at the end of 2019 to the present, the global mortality associated with COVID-19 has reached 6,952,522 deaths as reported by the World Health Organization (WHO). Early intubation and mechanical ventilation can increase the survival rate of critically ill patients. This prospective study was carried out on 885 patients in the ICU of Mureș County Clinical Hospital, Romania. After applying inclusion and exclusion criteria, a total of 54 patients were included. Patients were monitored during hospitalization and at 6-month follow-up. We analyzed the relationship between invasive mechanical ventilation (IMV) and non-invasive mechanical ventilation (NIMV) and radiological changes on thoracic CT scans performed at 6-month follow-up and found no significant association. Regarding paraclinical analysis, there was a statistically significant association between patients grouped by IMV and ferritin level on day 1 of admission (p = 0.034), and between patients grouped by PaO2/FiO2 ratio with metabolic syndrome (p = 0.03) and the level of procalcitonin (p = 0.01). A significant proportion of patients with COVID-19 admitted to the ICU developed pulmonary fibrosis as observed at a 6-month evaluation. Patients with oxygen supplementation or mechanical ventilation require dynamic monitoring and radiological investigations, as there is a possibility of long-term pulmonary fibrosis that requires pharmacological interventions and finding new therapeutic alternatives.
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  • 文章类型: Editorial
    呼吸道合胞病毒(RSV)的病例,猴痘病毒(MPXV),在我们目前长期的冠状病毒病2019(CoViD-19)大流行期间,禽流感病毒(IAV)有所增加。这些病毒感染性疾病的上升可能与急性,系统性急性呼吸系统综合症冠状病毒-2(SARS-CoV2)的潜伏性或复发性感染。暂时引入了无意义的新词“三分法”来描述这些趋势的融合性质(流行病来自两个希腊语:epi=on,关于,演示=人;大流行也源于古希腊语:pan=全部,演示=人;但是“三分法”将来自拉丁语三分法=三,希腊演示=人,充其量代表三个国家,三个民族,但肯定不是目前三者融合的威胁,或者更多的流行病)。新出现的证据表明,在其他几种病毒性疾病中,猴痘和CoViD-19,在口腔中产生显著的可观察的表现。从临床的角度来看,牙医和牙科人员可能是第一批遇到和诊断合并感染的临床迹象的卫生专业人员。从免疫监视的角度来看,必须检查这些传染病之间的病毒重组和病毒干扰,以确定这些碰撞大流行的潜在威胁。
    Cases of the respiratory syncytial virus (RSV), monkeypox virus (MPXV), and avian influenza A Virus (IAV) have increased during our current prolonged Corona Virus Disease 2019 (CoViD-19) pandemic. The rise of these viral infectious diseases may be associated or even inter-dependent with acute, latent or recurrent infection with Systemic Acute Respiratory Syndrome Corona virus-2 (SARS-CoV2). The nonsensical neologism \'tripledemic\' was tentatively introduced to describe the confluent nature of these trends (epidemic comes from two Greek words: epi=on, about, demos=people; pandemic is also derived from Ancient Greek: pan=all, demos=people; but \'tripledemic\' would derive from Latin triplus=three, Greek demos=people, and would at best signify \'three countries, three peoples\', but certainly not the current threat of confluence of three, or perhaps more pandemics). Emerging evidence suggests that monkey pox and CoViD-19, among several other viral diseases, produce significant observable manifestations in the oral cavity. From a clinical standpoint, dentists and dental personnel may be among the first health professionals to encounter and diagnose clinical signs of converging infections. From the immune surveillance viewpoint, viral recombination and viral interference among these infectious diseases must be examined to determine the potential threat of these colliding pandemics.
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  • DOI:
    文章类型: English Abstract
    目的:探讨2019年冠状病毒病(COVID-19)大流行对泌尿系结石术后患者生活质量(QoL)和心理健康的影响。
    方法:收集2019年12月至2020年6月在泌尿外科内镜碎石术后行输尿管支架置入术患者的人口学和临床资料。收集输尿管支架症状问卷(USSQ)评分和结果20项焦虑自评量表(SAS)和抑郁自评量表(SDS),以评估QoL和精神状态。USSQ由6个领域的44个问题组成(包括泌尿症状,身体疼痛,一般健康,工作表现,性功能,和输尿管支架相关感染)。对于每个领域的大多数问题,其评分为1~5分的Likert型5分量表,小部分问题用1~4或1~7量表量化.SAS和SDS均包含20个问题,用于评估患者的焦虑和抑郁水平。每个项目的评分均为1至4的4分Likert型评分。总分(20至80分)是主要统计指标。通过使用标准分数(总分乘以1.25以产生整数)来量化临床焦虑和抑郁的水平。并通过矩结构分析(AMOS)分析构建了多组结构方程模型。
    结果:总体而言,71例患者被纳入分析。结果发现,对照组和延迟组的输尿管支架时间中位数差异显着,分别为32(30,33)d和94.5(88,103)d,分别。延迟组导致USSQ多维分数更高,其中包括泌尿症状,一般健康,工作表现和输尿管支架相关感染。延迟组的焦虑和抑郁也明显比对照组严重。输尿管支架留置时间越长,尿路症状和躯体疼痛对工作表现的影响越严重(P=0.029<0.05)。其中,尿路症状严重导致工作表现不佳的患者受输尿管支架持续时间延长的影响最大(CR=2.619>1.96).
    结论:因COVID-19导致输尿管支架拔除延迟的患者导致QoL和精神状态恶化。在COVID-19期间,焦虑和抑郁程度较高的患者支架相关症状更严重。为改善COVID-19期间泌尿系结石术后患者的生活质量和心理健康状况,仍不建议延长支架持续时间或采取相应干预措施。
    OBJECTIVE: To explore the impacts of delayed ureteral stent removal on the quality of life (QoL) and mental health of urinary calculi postoperative patients due to the corona virus disease 2019(COVID-19) pandemic.
    METHODS: The demographic and clinical data of patients with ureteral stent placement after urinary endoscopic lithotripsy and returned to Peking University People\'s Hospital for stent removal from December 2019 to June 2020 were collected. Ureteral stent symptoms questionnaire (USSQ) score and the outcome 20-item self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were collected to estimate the QoL and mental status. The USSQ consisted of 44 questions in 6 domains (including urinary symptom, physical pain, general health, work performance, sexual function, and ureteral stent related infection). For most questions in each domain, its score was a five-point Likert-type scale from 1 to 5, and a small proportion of questions was quantified by 1 to 4 or 1 to 7 scale. SAS and SDS both contained 20 questions used to assess a patient\'s level of anxiety and depression. Its scoring for each item was on a four-point Likert-type scale from 1 to 4. A total score (ranging from 20 to 80) was the main statistical indicator. The level of clinical anxiety and depression was quantified by using standard scores (total score multiplied by 1.25 to produce integers). And the multi-group structural equation model was constructed by analysis of moment structure (AMOS) analysis.
    RESULTS: Overall, 71 patients were enrolled for analysis. It was found that the median duration of ureteral stent time differed significantly between the control and delayed groups for 32 (30, 33) d and 94.5 (88, 103) d, respectively. The delayed group resulted in higher scores in the USSQ multidimensional, which included urinary symptoms, general health, work performance and ureteral stent related infections. Anxiety and depression were also significantly serious in the delayed group than in the control group. A longer indwelling time of a ureteral stent could exacerbate the effects of urinary symptoms and physical pain on work performance (P=0.029 < 0.05). Among them, the patients with severe urinary symptoms leading to poor work performance were most significantly affected by prolonged ureteral stent duration time (CR=2.619>1.96).
    CONCLUSIONS: Patients with delayed ureteral stent removal due to the COVID-19 had resulted in worse QoL and mental status. Stents related symptoms are more severe in patients with higher anxiety and depression degree during COVID-19. To improve the QoL and mental health of patients after urinary calculi surgery during COVID-19, it is still not recommended to prolong the stent duration time or corresponding intervention measures should be taken.
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  • 文章类型: Journal Article
    由严重急性呼吸道综合症冠状病毒2(SARS-CoV-2)引起的COVID-19大流行在全球范围内导致了大量病例和死亡。接种疫苗是预防这种疾病最有效的措施。这项研究旨在评估美国COVID-19患者的死亡率和辉瑞(辉瑞,NY,美国),Moderna(Moderna,MA,美国),和詹森(约翰逊和约翰逊,NJ,美国)预防死亡的疫苗。根据系统评价和荟萃分析的首选报告项目(PRISMA-2020)指南进行系统评价和荟萃分析。纳入了报告COVID-19疫苗对患者预后有效性的合格研究。搜索是在PubMed中进行的,科克伦,和谷歌学者数据库。数据被提取出来,并计算死亡结局的风险比(RR).使用ReviewManager软件进行分析,使用乔安娜·布里格斯研究所(JBI)的荟萃分析工具进行偏倚评估。共有7项研究纳入荟萃分析,其中21,618,297例COVID-19患者。与未接种疫苗的患者相比,未接种疫苗的患者死亡率的比值比(OR)为2.46(95%CI:1.71-3.53),表明未接种疫苗的患者死于COVID-19的可能性是其2.46倍。这项研究的结果支持了COVID-19疫苗接种在降低感染者死亡率方面的有效性。与接种疫苗的患者相比,未接种疫苗的患者死亡风险明显更高。疫苗接种仍然是减轻疾病严重程度和降低死亡率的关键策略。应努力解决疫苗犹豫的问题,并确保广泛的疫苗覆盖率。
    The COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in a significant number of cases and deaths worldwide. Vaccination is the most effective preventive measure against the disease. This study aimed to assess the mortality rates of COVID-19 patients in the United States and the effectiveness of Pfizer (Pfizer, NY, USA), Moderna (Moderna, MA, USA), and Janssen (Johnson & Johnson, NJ, USA) vaccines in preventing mortality. A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA-2020) guidelines. Eligible studies reporting on the effectiveness of COVID-19 vaccines on patient outcomes were included. The search was performed in PubMed, Cochrane, and Google Scholar databases. The data were extracted, and risk ratios (RR) were calculated for mortality outcomes. The analysis was performed using Review Manager software, and bias assessments were conducted using the Joanna Briggs Institute (JBI) Meta-Analysis tools. A total of seven studies with 21,618,297 COVID-19 patients were included in the meta-analysis. The odds ratio (OR) for mortality among unvaccinated patients compared to vaccinated patients was 2.46 (95% CI: 1.71-3.53), indicating that unvaccinated patients were 2.46 times more likely to die from COVID-19. The findings of this study support the effectiveness of COVID-19 vaccination in reducing mortality among infected individuals. Unvaccinated patients had a significantly higher risk of mortality compared to vaccinated patients. Vaccination remains a crucial strategy to mitigate the severity of the disease and reduce mortality rates. Efforts should be made to address vaccine hesitancy and ensure widespread vaccine coverage.
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  • 文章类型: Editorial
    对系统性急性呼吸系统综合症冠状病毒2(SARS-CoV2)病毒呈血清阳性的患者发展为冠状病毒病2019(CoViD-19)。CoViD-19在某些个体中可能无症状,在其他患者中出现轻微症状,在一个亚组的人群中可能是一种严重甚至致命的疾病。确定CoViD-19严重程度的变量尚未完全表征。清楚的是,在CoViD-19中存活的患者通常在3-5周内恢复到SARS-CoV2的血清阴性状态。然而,报告了几例反复感染的病例,在恢复SARS-CoV2的血清阴性数周后,大部分CoViD-19恢复的患者出现多系统和多器官症状性病变。这种新的病理状况,最初被称为LongCovid,现在被认为是急性后CoViD-19综合征(PACS)。PACS最初的主要体征和症状:复发和再感染的可能性,身体疲劳和认知能力下降,实际上可能会扩大到包括免疫失调,心血管疾病和凝血异常。开发和评估新的和改进的PACS临床干预措施是关键和及时的。
    Patients sero-positive for the Systemic Acute Respiratory Syndrome Corona virus2 (SARS-CoV2) virus develop the Corona Virus Disease 2019 (CoViD-19). CoViD-19 may be asymptomatic in some individuals, proffer mild symptoms in other patients, and can be a serious and even lethal disease in a sub-group of the population. The variables that determine the severity of CoViD-19 have not been fully characterized. What is clear is that the patients who survive CoViD-19 return to a state of sero-negativity for SARS-CoV2 generally within 3-5 weeks. However, several cases of repeated infection have been reported, and a large proportion of CoViD-19-recovered patients manifest multi-system and multi-organ symptomatic pathologies several weeks-to-months after resuming sero-negativity for SARS-CoV2. This new pathological condition, originally termed Long Covid, is now recognized as the Post Acute CoViD-19 Syndrome (PACS). The original principal clusters of signs and symptoms of PACS: likelihood of relapse and reinfection, physical fatigue and cognitive slowdown, may actually be broadened to include immune deregulation, cardiovascular disease and coagulation abnormalities. The development and evaluation of new and improved clinical interventions for PACS are critical and timely.
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  • 文章类型: Editorial
    病毒干扰是免疫学中最古老的概念之一。最近的研究结果表明,它可能取决于宿主的抗病毒细胞免疫监视过程,以及双链RNA指导的序列特异性基因沉默机制。其他生物活动,至少在某种程度上与免疫依赖性IFN或RNA依赖性病毒干扰无关。我们在负责冠状病毒病2019(CoViD-19)的系统性急性呼吸综合征冠状病毒2(SARS-CoV2)病毒的背景下讨论了这些生物学机制。
    Virus interference is one of the oldest concepts in immunology. Recent findings indicate that it may depend on the host\'s anti-viral cellular immune surveillance processes, as well as on sequence-specific gene silencing mechanism guided by double-stranded RNA. Other biological events, unrelated to some degree at least from immune-dependent IFN or RNA-dependent viral interference may be at play as well. We discuss these biological mechanisms in the context of of the Systemic Acute Respiratory Syndrome Corona virus2 (SARS-CoV2) virus responsible for Corona Virus Disease 2019 (CoViD-19).
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