关于冠状病毒的一些知识。COVID-19
冠状病毒平常也会见到，但是一般就是小感冒，呼吸道症状或者拉肚子。SARS 病毒和这些一般的冠状病毒的区别是存活力超强：可以在干燥的表面存活9天，一般的冠状病毒3天之内就完全失活了。这解释了为什么一个人可以把许多同住一个酒店的人给传染了。
除了已知的通过咳嗽（唾液）传染，SARS病毒也可以通过大小便传染。在痰中可以存活4-5天。普通人的粪便和尿液呈酸性，一般只能存活一天。但是拉肚子的时候粪便呈弱碱性，可以存活到四天。
冠状病毒的通性：酸性环境（PH6-6.5）和碱性环境（PH8）比，酸性稳定些。但是前面作者又说 弱 碱性的粪便病毒存活时间长于弱酸性的粪便。前后有点矛盾。
小知识： PH 是液体酸碱度的尺度。越低越酸。参考：
白醋的PH 2.4.
8克小苏打溶于1000毫升水中，PH8.4.
28克碱溶于1000 毫升水，PH大约11.
所以家里熏醋，应该是可以有帮助的。用白醋和小苏打水交替洗手和处理病人用过的器具，应该有消毒作用。
一般的洗手液可能对这个病毒没有效。尤其是含有有机成分的。因为病毒可能遇到有机物后抱团取暖而逃过。引用的文章试验了四种病毒，但是没有包括SARS。结论是以下溶液对所有的四种病毒都起到了灭活的作用：A。 2%戊二醛的；B。 0.5%邻苄基对氯膦酸钠和0.6%月桂基硫酸钠的；C。7%盐酸的0.04%季铵盐；D。每升氯胺含有至少3克氯的液体； E。每升水中至少5克盐的水。 70%酒精或含有70%酒精的溶液对有包膜的病毒（比如，SARS） 有效。
文章来源：Geller C, Varbanov M, Duval RE. Human coronaviruses: insights into environmental resistance and its influence on the development of new antiseptic strategies. Viruses. 2012;4(11):3044–3068. Published 2012 Nov 12. doi:10.3390/v4113044
Claims: the information is for your reference only. Please follow the advice from the doctors if you experience COVID-19 symptoms.
Proven to be no effect: hydroxychloroquine 羟氯喹 (ref 1), azithromycin 阿奇霉素 (ref 2).
Remdesivir (GS-5734), an inhibitor of the viral RNA polymerase, proven to be effective for hospitalized patients who only required supplemental oxygen. There was no observed benefit of remdesivir in those who were on high-flow oxygen, noninvasive ventilation, neigther for patients with mild to moderate conditions (ref 3). However, WHO recommends against the use of remdesivir in COVID-19 patients on 20 November 2020, no reason is given which is weird (ref 4a). FDA still approves its use based on 3 Nov. notice (ref 4b).
baricitinib plus remdesivir is better than remdesivir alone for Patients receiving high-flow oxygen or noninvasive ventilation (ref6). Nov. 19, 2020 FDA authorizes to use this combination for COVID-19 treatment (ref7)
Antibody treatments target the spike protein, which the virus utilizes to enter host cells. Eli Lilly’s monoclonal antibody regimen, bamlanivimab (also known as LY-CoV555), consists of two antibodies directed against the SARS-CoV-2 spike protein and its receptor binding domain; Regeneron’s products, casirivimab (REGN10933) and imdevimab (REGN10987), consists of two antibodies that bind to different regions of the SARS-CoV-2 spike protein receptor binding domain (ref 5). However, the supporting evidences based on the clinical trial results for both are not very strong.
Fever reducing for COVID-19: Acetaminophen (Tylenol, DayQuil etc). 服用维生素C要早 + 不宜用 ibuprofen 退烧。
NIH guideline: https://www.covid19treatmentguidelines.nih.gov/
Ref 1: Effect of Hydroxychloroquine in Hospitalized Patients with Covid-19. Nov. 19, 2020. New England Journal of Medicine 383:2030-2040.
Ref 2: Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19. Nov. 19, 2020. New England Journal of Medicine 383:2041-2052
Ref 3: Remdesivir for the Treatment of Covid-19 — Final Report. Nov 5, 2020. New England Journal of Medicine 383:1813-1826.
Ref 4a: https://www.who.int/news-room/feature-stories/detail/who-recommends-against-the-use-of-remdesivir-in-covid-19-patients#:~:text=WHO%20recommends%20against%20the%20use%20of%20remdesivir%20in%20COVID%2D19%20patients,-20%20November%202020&text=WHO%20has%20issued%20a%20conditional,other%20outcomes%20in%20these%20patients.
Ref 4b: https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/remdesivir/
Ref 5: https://www.idsociety.org/covid-19-real-time-learning-network/therapeutics-and-interventions/monoclonal-antibodies/
Ref 6: https://www-nejm-org.eu1.proxy.openathens.net/doi/10.1056/NEJMoa2031994 Ref 7: https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-drug-combination-treatment-covid-19
除了已知的通过咳嗽（唾液）传染，SARS病毒也可以通过大小便传染。在痰中可以存活4-5天。普通人的粪便和尿液呈酸性，一般只能存活一天。但是拉肚子的时候粪便呈弱碱性，可以存活到四天。
冠状病毒的通性：酸性环境（PH6-6.5）和碱性环境（PH8）比，酸性稳定些。但是前面作者又说 弱 碱性的粪便病毒存活时间长于弱酸性的粪便。前后有点矛盾。
小知识： PH 是液体酸碱度的尺度。越低越酸。参考：
白醋的PH 2.4.
8克小苏打溶于1000毫升水中，PH8.4.
28克碱溶于1000 毫升水，PH大约11.
所以家里熏醋，应该是可以有帮助的。用白醋和小苏打水交替洗手和处理病人用过的器具，应该有消毒作用。
一般的洗手液可能对这个病毒没有效。尤其是含有有机成分的。因为病毒可能遇到有机物后抱团取暖而逃过。引用的文章试验了四种病毒，但是没有包括SARS。结论是以下溶液对所有的四种病毒都起到了灭活的作用：A。 2%戊二醛的；B。 0.5%邻苄基对氯膦酸钠和0.6%月桂基硫酸钠的；C。7%盐酸的0.04%季铵盐；D。每升氯胺含有至少3克氯的液体； E。每升水中至少5克盐的水。 70%酒精或含有70%酒精的溶液对有包膜的病毒（比如，SARS） 有效。
文章来源：Geller C, Varbanov M, Duval RE. Human coronaviruses: insights into environmental resistance and its influence on the development of new antiseptic strategies. Viruses. 2012;4(11):3044–3068. Published 2012 Nov 12. doi:10.3390/v4113044
Claims: the information is for your reference only. Please follow the advice from the doctors if you experience COVID-19 symptoms.
Treatment for COVID-19:
Proven to be no effect: hydroxychloroquine 羟氯喹 (ref 1), azithromycin 阿奇霉素 (ref 2).
Remdesivir (GS-5734), an inhibitor of the viral RNA polymerase, proven to be effective for hospitalized patients who only required supplemental oxygen. There was no observed benefit of remdesivir in those who were on high-flow oxygen, noninvasive ventilation, neigther for patients with mild to moderate conditions (ref 3). However, WHO recommends against the use of remdesivir in COVID-19 patients on 20 November 2020, no reason is given which is weird (ref 4a). FDA still approves its use based on 3 Nov. notice (ref 4b).
baricitinib plus remdesivir is better than remdesivir alone for Patients receiving high-flow oxygen or noninvasive ventilation (ref6). Nov. 19, 2020 FDA authorizes to use this combination for COVID-19 treatment (ref7)
Antibody treatments target the spike protein, which the virus utilizes to enter host cells. Eli Lilly’s monoclonal antibody regimen, bamlanivimab (also known as LY-CoV555), consists of two antibodies directed against the SARS-CoV-2 spike protein and its receptor binding domain; Regeneron’s products, casirivimab (REGN10933) and imdevimab (REGN10987), consists of two antibodies that bind to different regions of the SARS-CoV-2 spike protein receptor binding domain (ref 5). However, the supporting evidences based on the clinical trial results for both are not very strong.
Fever reducing for COVID-19: Acetaminophen (Tylenol, DayQuil etc). 服用维生素C要早 + 不宜用 ibuprofen 退烧。
NIH guideline: https://www.covid19treatmentguidelines.nih.gov/
Ref 1: Effect of Hydroxychloroquine in Hospitalized Patients with Covid-19. Nov. 19, 2020. New England Journal of Medicine 383:2030-2040.
Ref 2: Hydroxychloroquine with or without Azithromycin in Mild-to-Moderate Covid-19. Nov. 19, 2020. New England Journal of Medicine 383:2041-2052
Ref 3: Remdesivir for the Treatment of Covid-19 — Final Report. Nov 5, 2020. New England Journal of Medicine 383:1813-1826.
Ref 4a: https://www.who.int/news-room/feature-stories/detail/who-recommends-against-the-use-of-remdesivir-in-covid-19-patients#:~:text=WHO%20recommends%20against%20the%20use%20of%20remdesivir%20in%20COVID%2D19%20patients,-20%20November%202020&text=WHO%20has%20issued%20a%20conditional,other%20outcomes%20in%20these%20patients.
Ref 4b: https://www.covid19treatmentguidelines.nih.gov/antiviral-therapy/remdesivir/
Ref 5: https://www.idsociety.org/covid-19-real-time-learning-network/therapeutics-and-interventions/monoclonal-antibodies/
Ref 6: https://www-nejm-org.eu1.proxy.openathens.net/doi/10.1056/NEJMoa2031994 Ref 7: https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-authorizes-drug-combination-treatment-covid-19
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