Objective

To review the virology, immunology, epidemiology, clinical manifestations, and treatment of the following 3 major zoonotic coronavirus epidemics: severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and coronavirus disease 2019 (COVID-19).

Data Sources

Published literature obtained through PubMed database searches and reports from national and international public health agencies.

Study Selections

Studies relevant to the basic science, epidemiology, clinical characteristics, and treatment of SARS, MERS, and COVID-19, with a focus on patients with asthma, allergy, and primary immunodeficiency.

Results

Although SARS and MERS each caused less than a thousand deaths, COVID-19 has caused a worldwide pandemic with nearly 1 million deaths. Diagnosing COVID-19 relies on nucleic acid amplification tests, and infection has broad clinical manifestations that can affect almost every organ system. Asthma and atopy do not seem to predispose patients to COVID-19 infection, but their effects on COVID-19 clinical outcomes remain mixed and inconclusive. It is recommended that effective therapies, including inhaled corticosteroids and biologic therapy, be continued to maintain disease control. There are no reports of COVID-19 among patients with primary innate and T-cell deficiencies. The presentation of COVID-19 among patients with primary antibody deficiencies is variable, with some experiencing mild clinical courses, whereas others experiencing a fatal disease. The landscape of treatment for COVID-19 is rapidly evolving, with both antivirals and immunomodulators demonstrating efficacy.

Conclusion

Further data are needed to better understand the role of asthma, allergy, and primary immunodeficiency on COVID-19 infection and outcomes.

中文翻译：

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人畜共患冠状病毒流行

客观的

综述以下 3 种主要人畜共患冠状病毒流行病的病毒学、免疫学、流行病学、临床表现和治疗：严重急性呼吸综合征（SARS）、中东呼吸综合征（MERS）和 2019 年冠状病毒病（COVID-19）。

数据源

通过 PubMed 数据库检索以及国家和国际公共卫生机构的报告获得的已发表文献。

研究选择

与 SARS、MERS 和 COVID-19 的基础科学、流行病学、临床特征和治疗相关的研究，重点关注哮喘、过敏和原发性免疫缺陷患者。

结果

尽管 SARS 和 MERS 各自造成的死亡人数不到千人，但 COVID-19 却引发了全球大流行，造成近 100 万人死亡。诊断 COVID-19 依赖于核酸扩增测试，感染具有广泛的临床表现，几乎可以影响每个器官系统。哮喘和特应性似乎不会使患者容易感染 COVID-19，但它们对 COVID-19 临床结果的影响仍然是复杂且不确定的。建议继续有效的治疗，包括吸入皮质类固醇和生物治疗，以维持疾病控制。目前尚无原发性先天细胞和 T 细胞缺陷患者中出现 COVID-19 的报道。一抗缺陷患者中的 COVID-19 表现各不相同，有些患者经历轻微的临床病程，而另一些则经历致命的疾病。COVID-19 的治疗格局正在迅速发展，抗病毒药物和免疫调节剂均显示出疗效。

结论

需要更多数据来更好地了解哮喘、过敏和原发性免疫缺陷对 COVID-19 感染和结果的作用。