By April 19, 2021, the ongoing coronavirus disease 2019 (COVID-2019), which is caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) has infected more than one hundred and fourty million individuals across more than 200 countries or territories and killed more than three million twenty-six thousand individuals worldwide. There are currently no specific drugs available for patients with COVID-19 infection, but a number of potential drug targets have been identified with the further understanding of the virological characteristics and pathogenesis of SARS-CoV-2. Some candidate drugs have shown good antiviral activity against SARS-CoV-2 in preclinical or clinical trials. This paper summarizes the current status of potential therapeutic drugs for COVID-19 in order to provide references for future COVID-19 therapy. DOI: 10.11855/j.issn.0577-7402.2021.06.16

[Abstract] The outbreak of coronavirus disease 2019 (COVID-19) has become a global pandemic. The pathogen responsible for this disease is a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It belongs to coronavirus family, a pathogen similar to SARS and Middle East respiratory syndrome (MERS), and manifests strong infectivity and pathogenicity to progress into severe pneumonia. Till now, there is no specific therapeutic drug targeting against this virus. With the rapid spread and deterioration of the epidemic situation, vaccination has become an urgent need. This review introduces the immune defense mechanism of human body against coronavirus briefly, set forth the key viral spike protein for coronavirus vaccine development, and then summarize the recent advances/progresses and potential challenges in safety and efficacy of vaccine development for SARS-CoV-2.

Since December 2019, a novel type of coronavirus disease (COVID-19) in Wuhan led to an outbreak throughout the world. To date, there have been more than 1,260,000 COVID-19 patients, with a mortality rate of approximately 5.44%. Studies have shown that coagulation dysfunction is a major cause of death in patients with severe COVID-19. Therefore, the People's Liberation Army Professional Committee of Critical Care Medicine and Chinese Thrombosis and Hemostasis Committee grouped experts from the frontline of the Wuhan epidemic to come together and develop an expert consensus on diagnosis and treatment of coagulation dysfunction associated with severe COVID-19 infection. This consensus includes an overview of COVID-19-related coagulation dysfunction, tests for coagulation, anticoagulation therapy, replacement therapy, supportive therapy and prevention. The consensus produced 18 recommendations which are being used to guide clinical work. DOI: 10.11855/j.issn.0577-7402.2020.04.01

From December 2019, the outbreak of corona virus disease 2019 (COVID-19) hits Hubei Province of China. It causes severe acute respiratory syndrome in some patients and notable number of cases died of multiple organ failures. SARS-CoV-2 mainly spread by respiratory droplets and close contact. It is highly infectious and has been found in many countries and regions around the world. So far, no specific vaccine and specific drugs against SARS-CoV-2 have been developed for clinical use. This article reviews the virological characteristics, clinical symptoms, infection mechanism, epidemiology, research progress and clinical effect of COVID-19. It could provide new insights for clinical prevention of COVID-19. DOI: 10.11855/j.issn.0577-7402.2020.03.06

A coronavirus disease 2019 (COVID-19) outbreak has occurred in Wuhan, Hubei province since Dec. 2019. As of Feb. 10, 2020, more than 40,000 cases had been confirmed, nearly 30,000 cases in Hubei alone, and no inflection point in epidemiology appeared. Severe trauma may still occur during the outbreak of the COVID-19. In order to protect the medical personnel involved in emergency treatment and ensuring the timeliness of treatment for trauma patients, The Trauma Surgery Branch of Chinese Medical Doctors' Association (CMDA) organized the drafting of the present expert consensus. This paper interprets the main views of the expert consensus, emphasizes that the safety of health care staff and patients are equally important, and that the treatment strategies and procedures for severe trauma need to be adjusted during the COVID-19 outbreak. The consensus also recommends the use of CT scan, which plays both the role of screening COVID-19 and accurate assessment of trauma, and strengthening the protection of medical staff. The consensus states that medical personnel can be exempted from isolation if they wear standard three-level protective equipment and are not accidentally exposed during the operation. This expert consensus is the first one to systematically review, summarize and analyze the progress of COVID-19 from a surgeon's perspective. It may be used as a reference for medical institutions at all levels to treat patients with severe trauma and perform other kinds of operations during the COVID-19 outbreak. DOI: 10.11855/j.issn.0577-7402.2020.02.02

Objective To investigate the clinical features of 13 fatal cases of corona virus disease 2019 (COVID-19). Methods The clinical data of 13 patients who died of COVID-19 in Central Theater General Hospital, China, between January 4, 2020, and February 24, 2020, were analyzed retrospectively. The data reviewed included clinical manifestations, laboratory test results, radiographic features and dinical treatment plan. The cellular immune function, the expression of inflammatory factors, and lactate level in deceased patients at different stages of the disease were analyzed. Results Of those who died, the patients consisted of 10 men and 3 women. The age of those who died was (74±19) years, and 10(76.9%) patients were over 70 years old. For the patients who died, 9 presented with underlying diseases, 6(46.2%) of whom had more than 2 diseases. On admission, the chest computed tomography (CT) for 8 patients (61.5%) mainly showed multiple patchy ground-glass opacities. When the disease progressed, the ground-glass opacities rapidly developed into diffuse lesions in both lungs. The lymphocyte and CD3+, CD4+, and CD8+ T lymphocyte counts in the peripheral blood of 13 patients were significantly lower than normal levels and decreased more substantially during the disease course based on the levels when admitted (P<0.01). Additionally, the interleukin (IL)-6, D-dimer, C-reactive protein (CRP), lactic acid levels gradually increased, and most peaked before death. The cause of death for most patients was acute respiratory distress syndrome (ARDS) with type I respiratory failure. Three patients eventually developed multiorgan deficiency syndrome (MODS). Conclusions The risk factors of death for COVID-19 patients included older men, more underlying diseases, poor cellular immune function and over-expression of inflammatory factors. The main cause of death in patients with COVID-19 was ARDS, which led to respiratory failure and MODS. DOI: 10.11855/j.issn.0577-7402.2020.05.03

Objective To summarize the main characteristics of clinical studies regarding coronavirus disease 2019 (COVID-19) registered on the Chinese and US NIH Official Clinical Trial Registration Websites. Methods To search all the clinical studies about COVID-19 which were registered on the Chinese and U.S. NIH official clinical trial registration websites until March 9, 2020. The search terms were new coronavirus pneumonia (COVID-19), 2019-nCoV, novel coronavirus pneumonia. Results Overall, 360 studies with a total sample size of 268,773 participants are registered on Chinese clinical trial registration website, and 74 studies with a total sample size of 73,723 participants in the U.S. NIH clinical trial registration website. According to the information provided by the Chinese Clinical Trial Registration Website, there are 237 interventional studies, 108 observational studies, and 15 diagnostic test studies; and the most commonly studied interventions were Traditional Chinese Medicine in 80 studies, antiviral therapy in 58 studies, stem cells in 19 studies, plasma of recovered patients in 13 studies, glucocorticoid in 7 studies, molecular targeted therapy in 4 studies, and vaccine in 2 studies. According to the information provided by the U.S. NIH Clinical Trial Registration Website, there were 54 interventional studies, 17 observational studies, and 3 diagnostic test studies; and the most commonly studied interventions were antiviral therapy in 16 studies, stem cells in 7 studies, Traditional Chinese Medicine in 6 studies, molecular targeted therapy in 3 studies, and vaccine in 3 studies. Conclusions Numerous clinical studies related to COVID-19 have been registered during a very short period. Among them, Traditional Chinese Medicine is the most commonly studied intervention, which suggests the Chinese characteristics in medical care. However, considering such a large sample size needed for these clinical studies, it is very important to ensure the enrollment of participants effectively and orderly in future. DOI: 10.11855/j.issn.0577-7402.2020.04.04

Objective To investigate the influence of chemotherapy combined with autophagy inhibitor on apoptosis and calreticulin (CRT) expression on colonic cancer cells. Methods The colon cancer cells HCT116 were taken as the target in the present study. The inhibition rates (IC50) of chemotherapeutics oxaliplatin, 5-Fu and SN-38 were assessed by MTT assay. The changes in CRT expression on the membrane of HCT116 and apoptosis were determined with flow cytometry before and after treatment with chemotherapeutics. CRT location in HCT116 was detected by fluorescent immunoassay before and after treatment with chemotherapeutic agents. The influence on HCT116 autophagy was determined by Western blotting after treatment with these chemotherapeutic agents. The changes in CRT expression on HCT116 membrane and apoptosis were determined with flow cytometry before and after treatment with the chemotherapeutics combined with autophagy inhibitor chloroquine (CQ). Results The ratio of apoptosis and membrane expression of CRT were elevated 12 hours after treatment with Oxaliplatin, 5-Fu and SN38, but without statistical significance. Fluorescent immunoassay showed a transposition of CRT from cytoplasm to the membrane after oxaliplatin treatment. Western blotting revealed that oxaliplatin, 5Fu and SN38 induced autophagy of HCT116 cells, and the autophagy was inhibited by the addition of CQ. Flow cytometric analysis indicated that the percentages of annexin V+ cells and membrane expression of CRT were higher after treatment with the chemotherapy agents combined with CQ. The upregulation of CRT expression on membrane was obviously higher after treatment with oxaliplatin combined with CQ than that before the treatment with these agents (P=0.027). Conclusion Oxaliplatin combined with CQ may increase the apoptosis rate of HCT116 cells and upregulate CRT expression in the membrane. DOI: 10.11855/j.issn.0577-7402.2016.04.03