Past, present, and future of COVID-19: a review

SARS-CoV-2 has recently emerged, becoming a global threat, affecting directly all human beings owing to its morbidity and mortality and indirectly, due to the enormous economic and psychological impact produced by social isolation, the most effective measure so far, but unsustainable for a long period. The scientific effort to understand and control SARS-CoV-2 transmission and clinical impact has been huge, and important achievements are highlighted in this review. Diagnosis is central and is the first step in recognizing and fighting any infectious agent. Instrumental to that is the quality of the data, relying on serological and molecular surveys in addition to trustworthy clinical records. However, the fast spread of a virus adapted for human-to-human respiratory transmission raised a demand for millions of molecular tests that are simply not available. Several candidate drugs are under evaluation in clinical trials. Those with an already recognized safety profile are more auspicious, since, if proven effective, can cut several steps of production and phase 2 and 3 trials. More than one hundred vaccine prototypes are in different stages of development, however, safety and efficacy evaluations cannot be obviated, implicating, most optimistically, in at least months for us to have an effective immunization, the definite measure to allow a safe return to the pre-pandemic lifestyle. Science has never been more necessary and present in daily life. Relying on the best of human wit is the only way out to this pandemic, saving as many lives as possible.

严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）近期突发，已成为全球性公共卫生威胁。其引发的发病率与死亡率直接威胁全人类健康；而作为目前最有效但长期难以持续的防控措施，社交隔离所带来的巨大经济与心理负担，又造成了间接的社会冲击。为理解并控制SARS-CoV-2的传播与临床影响，全球科研界投入了巨大精力，本综述重点阐述该领域取得的重要进展。诊断是防控的核心环节，亦是识别与对抗任何病原体的首要步骤，诊断质量有赖于血清学检测、分子检测以及可靠的临床记录作为支撑。然而，这种具备人际呼吸道传播能力的病毒快速扩散，催生了对数百万份分子检测的庞大需求，却无法得到充分满足。目前已有多款候选药物处于临床试验评估阶段，其中安全性已获公认的药物更具发展前景——若能证实其有效性，即可省去多个生产环节与II期、III期临床试验步骤。全球已有超100种疫苗原型处于不同开发阶段，但安全性与有效性评估环节绝不可省略。即便以最乐观的情境估算，我们也至少需要数月时间才能获得有效的免疫接种方案，而这正是让人类安全恢复大流行前生活方式的确定性措施。科学从未像如今这般必要且深入融入日常生活，依靠人类智慧的最优解是应对这场大流行的唯一出路，旨在尽可能挽救更多生命。