{"id":26524,"date":"2023-04-27T15:47:56","date_gmt":"2023-04-27T08:47:56","guid":{"rendered":"http:\/\/noithathoaphat.in\/ctv\/?p=26524"},"modified":"2023-05-07T09:59:52","modified_gmt":"2023-05-07T02:59:52","slug":"tre-em","status":"publish","type":"post","link":"http:\/\/noithathoaphat.in\/ctv\/index.php\/2023\/04\/27\/tre-em\/","title":{"rendered":"Q\u00faa tr\u00ecnh x\u00e2m nh\u1eadp v\u00e0 l\u00e2y truy\u1ec1n COVID 19 \u1edf tr\u1ebb em"},"content":{"rendered":"

Vi\u1ec7c x\u00e2m nh\u1eadp t\u1ebf b\u00e0o v\u00e0 l\u00e2y nhi\u1ec5m virus SARS-CoV-2 – nguy\u00ean nh\u00e2n g\u00e2y ra b\u1ec7nh COVID-19 – \u1edf tr\u1ebb em t\u01b0\u01a1ng t\u1ef1 nh\u01b0 \u1edf ng\u01b0\u1eddi l\u1edbn. Virus c\u00f3 th\u1ec3 l\u00e2y lan th\u00f4ng qua ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp v\u1edbi m\u1ed9t ng\u01b0\u1eddi nhi\u1ec5m b\u1ec7nh ho\u1eb7c qua c\u00e1c gi\u1ecdt b\u1eafn khi ng\u01b0\u1eddi nhi\u1ec5m ho ho\u1eb7c h\u1eaft h\u01a1i. Tuy nhi\u00ean, tr\u1ebb em \u1edf nh\u1eefng nh\u00f3m tu\u1ed5i kh\u00e1c nhau \u0111\u00f4i khi qu\u00e1 tr\u00ecnh l\u00e2y truy\u1ec1n kh\u00f4ng gi\u1ed1ng nhau. Do \u0111\u00f3, trong b\u00e0i n\u00e0y s\u1ebd th\u1ea3o lu\u1eadn v\u1ec1 s\u1ef1 l\u00e2y truy\u1ec1n c\u1ee7a virus v\u00e0 qu\u00e1 tr\u00ecnh x\u00e2m nh\u1eadp t\u1ebf b\u00e0o \u1edf tr\u1ebb em.<\/strong><\/p>\n

1. T\u1ed5ng quan<\/strong><\/h1>\n

COVID 19 hi\u1ec7n l\u00e0 m\u1ed1i \u0111e d\u1ecda nghi\u00eam tr\u1ecdng \u0111\u1ed1i v\u1edbi con ng\u01b0\u1eddi v\u00ec n\u00f3 g\u00e2y ra b\u1ec7nh h\u00f4 h\u1ea5p nghi\u00eam tr\u1ecdng, bi\u1ebfn ch\u1ee9ng th\u1ea7n kinh v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 li\u00ean quan kh\u00e1c. M\u1eb7c d\u00f9 COVID-19 th\u01b0\u1eddng g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng nh\u1eb9 v\u00e0 c\u00f3 th\u1ec3 ph\u1ee5c h\u1ed3i \u1edf tr\u1ebb em, nh\u01b0ng n\u00f3 c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c tri\u1ec7u ch\u1ee9ng nghi\u00eam tr\u1ecdng nghi\u00eam tr\u1ecdng v\u00e0 g\u00e2y ra c\u00e1c bi\u1ebfn ch\u1ee9ng d\u1eabn \u0111\u1ebfn t\u1eed vong. Quan tr\u1ecdng nh\u1ea5t, SARS-CoV-2 c\u00f3 th\u1ec3 g\u00e2y ra c\u00e1c bi\u1ebfn ch\u1ee9ng th\u1ea7n kinh \u1edf tr\u1ebb em, ch\u1eb3ng h\u1ea1n nh\u01b0 kh\u00f3 th\u1edf, \u0111au c\u01a1, \u0111\u1ed9t qu\u1ef5 v\u00e0 b\u1ec7nh n\u00e3o. Nh\u1eefng v\u1ea5n \u0111\u1ec1 n\u00e0y c\u00f3 m\u1ed1i li\u00ean h\u1ec7 ch\u1eb7t ch\u1ebd v\u1edbi c\u01a1n b\u00e3o cytokine v\u00e0 c\u00e1c ph\u1ea3n \u1ee9ng ti\u1ec1n vi\u00eam, c\u00f3 th\u1ec3 l\u00e0m thay \u0111\u1ed5i sinh l\u00fd h\u1ecdc c\u1ee7a h\u00e0ng r\u00e0o m\u00e1u n\u00e3o v\u00e0 cho ph\u00e9p virus x\u00e2m nh\u1eadp v\u00e0o n\u00e3o.<\/p>\n

2. Qu\u00e1 tr\u00ecnh x\u00e2m nh\u1eadp t\u1ebf b\u00e0o v\u00e0 l\u00e2y truy\u1ec1n c\u1ee7a virus \u1edf tr\u1ebb em<\/strong><\/h2>\n

Ngu\u1ed3n g\u1ed1c c\u1ee7a s\u1ef1 xu\u1ea5t hi\u1ec7n v\u00e0 l\u00e2y truy\u1ec1n t\u1eeb \u0111\u1ed9ng v\u1eadt sang ng\u01b0\u1eddi \u00a0c\u1ee7a COVID 19 v\u1eabn c\u00f2n \u0111ang g\u00e2y tranh c\u00e3i; tuy nhi\u00ean, s\u1ef1 l\u00e2y truy\u1ec1n t\u1eeb ng\u01b0\u1eddi sang ng\u01b0\u1eddi \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e1c nh\u1eadn r\u1ed9ng r\u00e3i. R\u00f5 r\u00e0ng l\u00e0 tr\u1ebb em c\u00f3 th\u1ec3 d\u1ec5 d\u00e0ng nhi\u1ec5m SARS-CoV-2 t\u1eeb ng\u01b0\u1eddi l\u1edbn th\u00f4ng qua ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp. Tuy nhi\u00ean, t\u1ef7 l\u1ec7 l\u00e2y truy\u1ec1n t\u1eeb tr\u1ebb em t\u01b0\u01a1ng \u0111\u1ed1i th\u1ea5p.<\/p>\n

M\u1eb7c d\u00f9 RNA c\u1ee7a SARS-CoV-2 \u0111\u00e3 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n trong c\u00e1c m\u1eabu ph\u00e2n c\u1ee7a b\u1ec7nh nhi, nh\u01b0ng kh\u00f4ng c\u00f3 b\u1eb1ng ch\u1ee9ng thuy\u1ebft ph\u1ee5c n\u00e0o cho th\u1ea5y virus l\u00e2y truy\u1ec1n qua \u0111\u01b0\u1eddng ph\u00e2n-mi\u1ec7ng. Trong s\u1ed1 c\u00e1c c\u00e1ch th\u1ee9c l\u00e2y truy\u1ec1n \u00a0kh\u00e1c nhau, c\u00e1c gi\u1ecdt b\u1eafn \u0111\u01b0\u1ee3c coi l\u00e0 c\u00e1ch th\u1ee9c l\u00e2y truy\u1ec1n quan tr\u1ecdng nh\u1ea5t \u1edf tr\u1ebb em.<\/p>\n

Qu\u00e1 tr\u00ecnh x\u00e2m nh\u1eadp c\u1ee7a SARS-CoV-2 v\u00e0o t\u1ebf b\u00e0o c\u1ea7n glycoprotein t\u0103ng \u0111\u1ed9t bi\u1ebfn (S), t\u1ea1o \u0111i\u1ec1u ki\u1ec7n thu\u1eadn l\u1ee3i cho vi\u1ec7c li\u00ean k\u1ebft v\u1edbi th\u1ee5 th\u1ec3 (ACE2). Protein S n\u00e0y \u0111\u01b0\u1ee3c hi\u1ec3n th\u1ecb d\u01b0\u1edbi d\u1ea1ng c\u00e1c Trimers Protein l\u00e0m t\u0103ng s\u1ef1 xu\u1ea5t hi\u1ec7n c\u1ee7a virus.<\/p>\n

Protein S bao g\u1ed3m c\u00e1c ti\u1ec3u \u0111\u01a1n v\u1ecb S1 v\u00e0 S2, trong \u0111\u00f3 S1 ch\u1ecbu tr\u00e1ch nhi\u1ec7m li\u00ean k\u1ebft v\u1edbi ACE-2, trong khi ti\u1ec3u \u0111\u01a1n v\u1ecb th\u1ee9 hai c\u1ea7n thi\u1ebft cho s\u1ef1 dung h\u1ee3p t\u1ebf b\u00e0o. Qu\u00e1 tr\u00ecnh x\u00e2m nh\u1eadp b\u1eaft \u0111\u1ea7u v\u1edbi s\u1ef1 t\u01b0\u01a1ng t\u00e1c gi\u1eefa ACE2 v\u00e0 mi\u1ec1n li\u00ean k\u1ebft v\u1edbi th\u1ee5 th\u1ec3 (RBD) trong S1, ti\u1ebfp theo l\u00e0 qu\u00e1 tr\u00ecnh ph\u00e2n c\u1eaft qua trung gian Protease.<\/p>\n

\"\"
Ngu\u1ed3n: Cody B. Jackson, Michael Farzan, Bing Chen & Hyeryun Choe, \u201cMechanisms of SARS-CoV-2 entry into cells\u201d<\/strong>, Nature Reviews Molecular Cell Biology<\/em>, 2022.<\/figcaption><\/figure>\n

C\u00e1c nghi\u00ean c\u1ee9u tr\u01b0\u1edbc \u0111\u00e2y \u0111\u00e3 b\u00e1o c\u00e1o r\u1eb1ng Protein S l\u00e0 nh\u00e2n t\u1ed1 ch\u00ednh trong qu\u00e1 tr\u00ecnh x\u00e2m nh\u1eadp t\u1ebf b\u00e0o v\u00e0 do \u0111\u00f3 c\u00f3 th\u1ec3 \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn qu\u00e1 tr\u00ecnh truy\u1ec1n b\u1ec7nh. Qu\u00e1 tr\u00ecnh x\u00e2m nh\u1eadp b\u1ecb \u1ea3nh h\u01b0\u1edfng nhi\u1ec1u b\u1edfi m\u1ed9t s\u1ed1 \u0111\u1ed9t bi\u1ebfn trong Protein S, ch\u1eb3ng h\u1ea1n nh\u01b0 s\u1ef1 thay th\u1ebf axit Aspartic th\u00e0nh Glycine \u1edf v\u1ecb tr\u00ed axit amin 614 (D614G). C\u00e1c b\u00e1o c\u00e1o tr\u01b0\u1edbc \u0111\u00f3 \u0111\u00e3 ch\u1ee9ng minh s\u1ef1 v\u01b0\u1ee3t tr\u1ed9i v\u1ec1 ki\u1ec3u h\u00ecnh do D614 mang l\u1ea1i, tuy nhi\u00ean, c\u01a1 ch\u1ebf l\u00e0m c\u01a1 s\u1edf cho s\u1ef1 v\u01b0\u1ee3t tr\u1ed9i n\u00e0y v\u1eabn ch\u01b0a \u0111\u01b0\u1ee3c nghi\u00ean c\u1ee9u.<\/p>\n

Vai tr\u00f2 quan tr\u1ecdng n\u00e0y c\u1ee7a Protein S c\u00f3 th\u1ec3 \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng \u0111\u1ec3 ph\u00e1t tri\u1ec3n vaccine, ch\u1eb3ng h\u1ea1n nh\u01b0 Protein S t\u00e1i t\u1ed5 h\u1ee3p c\u00f3 th\u1ec3 k\u00edch ho\u1ea1t c\u00e1c ph\u1ea3n \u1ee9ng mi\u1ec5n d\u1ecbch, c\u00f3 th\u1ec3 gi\u00fap \u0111i\u1ec1u tr\u1ecb v\u00e0 ng\u0103n ng\u1eeba COVID-19.<\/p>\n

Patra v\u00e0 c\u1ed9ng s\u1ef1 \u0111\u00e3 b\u00e1o c\u00e1o r\u1eb1ng Protein S t\u1ea1o \u0111i\u1ec1u ki\u1ec7n thu\u1eadn l\u1ee3i cho angiotensin II – t\u00edn hi\u1ec7u h\u00f3a h\u1ecdc trung gian \u1ea3nh h\u01b0\u1edfng \u0111\u1ebfn c\u00e1c ph\u00e2n t\u1eed \u0111i\u1ec1u h\u00f2a phi\u00ean m\u00e3 th\u00f4ng qua k\u00edch ho\u1ea1t MAPK v\u00e0 t\u0103ng gi\u1ea3i ph\u00f3ng IL-6.<\/p>\n

H\u01a1n n\u1eefa, qu\u00e1 tr\u00ecnh phosphoryl h\u00f3a STAT3 \u1edf g\u1ed1c Tyr705 \u0111\u01b0\u1ee3c ph\u00e1t hi\u1ec7n \u0111\u00f3ng vai tr\u00f2 quan tr\u1ecdng nh\u01b0 m\u1ed9t ch\u1ea5t c\u1ea3m \u1ee9ng phi\u00ean m\u00e3 cho s\u1ef1 bi\u1ec3u hi\u1ec7n c\u1ee7a MCP-1 v\u00e0 SOCS3.<\/p>\n

Nh\u00ecn chung, s\u1ef1 hi\u1ec7n di\u1ec7n c\u1ee7a Protein S th\u00fac \u0111\u1ea9y truy\u1ec1n t\u00edn hi\u1ec7u IL-6 b\u1eb1ng c\u00e1ch k\u00edch ho\u1ea1t tr\u1ee5c AT1 \u0111\u1ec3 b\u1eaft \u0111\u1ea7u t\u0103ng c\u00e1c ph\u1ea3n \u1ee9ng vi\u00eam.<\/p>\n

Xem x\u00e9t t\u00ecnh tr\u1ea1ng l\u00e2y nhi\u1ec5m \u1edf tr\u1ebb s\u01a1 sinh, m\u1ed9t s\u1ed1 b\u00e1o c\u00e1o \u0111\u00e3 n\u00eau ra nh\u1eefng h\u1eadu qu\u1ea3 x\u1ea5u c\u1ee7a COVID-19 trong th\u1eddi k\u1ef3 mang thai, tuy nhi\u00ean, kh\u00f4ng c\u00f3 b\u00e1o c\u00e1o n\u00e0o x\u00e1c nh\u1eadn s\u1ef1 l\u00e2y truy\u1ec1n theo chi\u1ec1u d\u1ecdc. Tr\u01b0\u1edbc \u0111\u00e2y c\u00e1c nghi\u00ean c\u1ee9u \u0111\u00e3 b\u00e1o c\u00e1o r\u1eb1ng nhi\u1ec5m SARS-CoV-2 c\u00f3 th\u1ec3 l\u00e0m t\u0103ng nguy c\u01a1 vi\u00eam ph\u1ed5i \u1edf tr\u1ebb s\u01a1 sinh v\u00e0 sinh non. C\u00e1c nghi\u00ean c\u1ee9u m\u1edbi nh\u1eadn th\u1ea5y r\u1eb1ng t\u1ea5t c\u1ea3 tr\u1ebb s\u01a1 sinh ngo\u1ea1i tr\u1eeb 2 tr\u01b0\u1eddng h\u1ee3p nghi ng\u1edd do s\u1ea3n ph\u1ee5 b\u1ecb nhi\u1ec5m COVID-19 sinh ra \u0111\u1ec1u kh\u1ecfe m\u1ea1nh. Nh\u1eefng k\u1ebft qu\u1ea3 n\u00e0y cho th\u1ea5y r\u1eb1ng s\u1ef1 l\u00e2y truy\u1ec1n d\u1ecdc trong t\u1eed cung c\u00f3 th\u1ec3 kh\u00f4ng x\u1ea3y ra, tuy nhi\u00ean, SARS-CoV-2 c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn k\u1ebft qu\u1ea3 b\u1ea5t l\u1ee3i cho thai k\u1ef3. Trong tr\u01b0\u1eddng h\u1ee3p sinh t\u1ef1 nhi\u00ean, c\u00e1c nghi\u00ean c\u1ee9u nh\u1eadn th\u1ea5y k\u1ebft qu\u1ea3 t\u01b0\u01a1ng t\u1ef1 nh\u01b0 trong sinh m\u1ed5.<\/p>\n

Nh\u00ecn chung, c\u00e1c b\u00e1o c\u00e1o n\u00e0y kh\u00f4ng t\u00ecm th\u1ea5y b\u1eb1ng ch\u1ee9ng thuy\u1ebft ph\u1ee5c v\u1ec1 vi\u1ec7c l\u00e2y truy\u1ec1n COVID-19 theo chi\u1ec1u d\u1ecdc ho\u1eb7c l\u00e2y truy\u1ec1n t\u1eeb m\u1eb9 sang tr\u1ebb s\u01a1 sinh trong khi sinh.<\/p>\n

Ng\u01b0\u1ee3c l\u1ea1i, Peng et al. \u0111\u00e3 b\u00e1o c\u00e1o kh\u1ea3 n\u0103ng l\u00e2y truy\u1ec1n d\u1ecdc sang tr\u1ebb s\u01a1 sinh sinh \u0111\u00f4i non th\u00e1ng t\u1eeb ng\u01b0\u1eddi m\u1eb9 b\u1ecb nhi\u1ec5m b\u1ec7nh. Trong b\u00e1o c\u00e1o n\u00e0y, tr\u1ebb s\u01a1 sinh sinh \u0111\u00f4i \u0111\u00e3 \u0111\u01b0\u1ee3c x\u00e9t nghi\u1ec7m d\u01b0\u01a1ng t\u00ednh v\u1edbi nhi\u1ec5m COVID-19 ngay sau khi ch\u00e0o \u0111\u1eddi v\u00e0 nhi\u1ec5m tr\u00f9ng n\u00e0y \u0111\u01b0\u1ee3c cho l\u00e0 do l\u00e2y truy\u1ec1n d\u1ecdc trong t\u1eed cung. Tuy nhi\u00ean, nghi\u00ean c\u1ee9u n\u00e0y c\u00f3 m\u1ed9t s\u1ed1 h\u1ea1n ch\u1ebf quan tr\u1ecdng nh\u01b0 n\u01b0\u1edbc \u1ed1i v\u00e0 m\u00e1u cu\u1ed1ng r\u1ed1n kh\u00f4ng \u0111\u01b0\u1ee3c x\u00e9t nghi\u1ec7m, c\u1ee1 m\u1eabu nh\u1ecf v\u00e0 kh\u00f4ng c\u00f3 x\u00e9t nghi\u1ec7m chi ti\u1ebft trong ph\u00f2ng th\u00ed nghi\u1ec7m.<\/p>\n

Theo c\u00e1c nghi\u00ean c\u1ee9u hi\u1ec7n t\u1ea1i, kh\u00f4ng c\u00f3 nghi\u00ean c\u1ee9u n\u00e0o b\u00e1o c\u00e1o cho th\u1ea5y b\u1eb1ng ch\u1ee9ng thuy\u1ebft ph\u1ee5c. Do \u0111\u00f3 , c\u00f3 th\u1ec3 k\u1ebft lu\u1eadn r\u1eb1ng c\u00f3 r\u1ea5t \u00edt kh\u1ea3 n\u0103ng l\u00e2y truy\u1ec1n SARS-CoV-2 theo chi\u1ec1u d\u1ecdc t\u1eeb ng\u01b0\u1eddi m\u1eb9 b\u1ecb nhi\u1ec5m b\u1ec7nh sang tr\u1ebb s\u01a1 sinh. D\u1ef1a tr\u00ean nh\u1eefng d\u1ea5u hi\u1ec7u n\u00e0y, c\u00e1c b\u00e0 m\u1eb9 n\u00ean ti\u1ebfp t\u1ee5c nu\u00f4i con b\u1eb1ng s\u1eefa m\u1eb9 v\u1edbi s\u1ef1 ch\u0103m s\u00f3c th\u00edch h\u1ee3p v\u00e0 tu\u00e2n theo c\u00e1c bi\u1ec7n ph\u00e1p v\u1ec7 sinh.<\/p>\n

Ngu\u1ed3n tham kh\u1ea3o<\/strong><\/p>\n

Suliman Khan, Rabeea Siddique, Xiao Hao, Yueting Lin, Yuxin Liu, Xiaoyan Wang, Linlin Hua, and Ghulam Nabi, “The COVID-19 infection in children and its association with the immune system, prenatal stress, and neurological complications”, International Journal of Biological Sciences,<\/em> 2022.<\/p>\n","protected":false},"excerpt":{"rendered":"

Vi\u1ec7c x\u00e2m nh\u1eadp t\u1ebf b\u00e0o v\u00e0 l\u00e2y nhi\u1ec5m virus SARS-CoV-2 – nguy\u00ean nh\u00e2n g\u00e2y ra b\u1ec7nh COVID-19 – \u1edf tr\u1ebb em t\u01b0\u01a1ng t\u1ef1 nh\u01b0 \u1edf ng\u01b0\u1eddi l\u1edbn. Virus c\u00f3 th\u1ec3 l\u00e2y lan th\u00f4ng qua ti\u1ebfp x\u00fac tr\u1ef1c ti\u1ebfp v\u1edbi m\u1ed9t ng\u01b0\u1eddi nhi\u1ec5m b\u1ec7nh ho\u1eb7c qua c\u00e1c gi\u1ecdt b\u1eafn khi ng\u01b0\u1eddi nhi\u1ec5m ho ho\u1eb7c h\u1eaft h\u01a1i. […]<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[15,33],"tags":[],"yoast_head":"\nQ\u00faa tr\u00ecnh x\u00e2m nh\u1eadp v\u00e0 l\u00e2y truy\u1ec1n COVID 19 \u1edf tr\u1ebb em<\/title>\n<meta name=\"description\" content=\"Tr\u1ebb em \u1edf nh\u1eefng nh\u00f3m tu\u1ed5i kh\u00e1c nhau \u0111\u00f4i khi qu\u00e1 tr\u00ecnh l\u00e2y truy\u1ec1n kh\u00f4ng gi\u1ed1ng nhau. Do \u0111\u00f3, trong b\u00e0i n\u00e0y s\u1ebd th\u1ea3o lu\u1eadn v\u1ec1 s\u1ef1 l\u00e2y truy\u1ec1n c\u1ee7a\" \/>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Q\u00faa tr\u00ecnh x\u00e2m nh\u1eadp v\u00e0 l\u00e2y truy\u1ec1n COVID 19 \u1edf tr\u1ebb em\" \/>\n<meta property=\"og:description\" content=\"Tr\u1ebb em \u1edf nh\u1eefng nh\u00f3m tu\u1ed5i kh\u00e1c nhau \u0111\u00f4i khi qu\u00e1 tr\u00ecnh l\u00e2y truy\u1ec1n kh\u00f4ng gi\u1ed1ng nhau. 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