Новый коронавирус SARSCoV-2 в аспекте глобальной эпидемиологии коронавирусных инфекций

Новый коронавирус SARSCoV-2 в аспекте глобальной эпидемиологии коронавирусных инфекций Кажущееся неожиданным появление в КНР и затем глобальное распространение SARSCoV-2 заставляет задуматься о коронавирусной угрозе, исходящей из природных очагов, на территории нашей страны. Цель работы – рассмотреть SARS-CoV-2 в аспекте глобальной эпидемиологии коронавирусных инфекций. При подготовке статьи в основном использовались данные китайских ученых, опубликованные в англоязычных научных журналах. Их анализ показал широкое распространение вирусов данного таксона среди летучих мышей и ежей, в том числе в природных экосистемах Европы. До настоящего времени промежуточный между летучими мышами и человеком вид-хозяин SARS-CoV-2 и промежуточный вид коронавируса – прямой предшественник SARS-CoV-2, не обнаружены. Основная часть генома коронавирусов консервативна, однако он легко поддается генетическим рекомбинациям в естественных условиях, так что вирус может быть перенацелен как в естественных, так и в искусственных условиях с диких животных на человека путем изменения структуры белка S1. Патогенез коронавирусных инфекций у человека, вызывающих тяжелый острый респираторный синдром (SARS), складывается из этапов специфического узнавания вирусом рецепторов на клетках-мишенях в нижних отделах легких, проникновения в клетку-мишень, размножения, генерирования сначала цитокинового шторма, разрушающего нижние отделы легких, затем – феномена антитело-зависимого усиления инфекции, приводящего к изменению тропности вируса и его генерализации в организме человека. Вирулентность для человека у SARS-CoV-2 значительно ниже, чем у коронавирусов, вызвавших SARS в 2002–2003 гг. в Китае и ближневосточный респираторный синдром на Ближнем Востоке в 2012 г. Однако благодаря более высокой устойчивости при проникновении в эндосомы клетки и эффективной работе репликационно-транскрипционного комплекса, обеспечивается его размножение до количеств, позволяющих ему передаваться от больных людей здоровым. Разные этнические группы могут иметь разную чувствительность к SARS-CoV-2 и отличия в клинической симптоматике, что связано с количеством рецепторов ACE2 на поверхности пневмоцитов II типа, энтероцитов кишечника и сосудистого эндотелия других органов. В статье также приведены клинические наблюдения, сделанные китайскими исследователями во время вспышки коронавирусной инфекции, вызванной SARS-CoV-2. Ими высказано мнение, что эффективная и своевременная диагностика COVID-19 возможна при сочетании молекулярно-диагностических методов обнаружения SARS-CoV-2 с обнаружением характерных пневмонических очагов компьютерной томографией. Несмотря на все трудности борьбы с новой пандемией, она стала той встряской, которая сделала Россию более сильной в противоэпидемическом отношении.

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