208.2 📚 國考版

208.2.0.1 必背 — Virology

• ssRNA β-coronavirus
• ACE2 + TMPRSS2 receptors
• Spike protein = vaccine target

208.2.0.2 必背 — Variants

• Pre-Omicron: Alpha, Beta, Gamma, Delta
• Omicron lineages: BA.5 → XBB → JN.1 → KP.3 → ongoing 2024-2025

208.2.0.3 必背 — Clinical Spectrum

• Mild URI to severe ARDS + multi-organ
• Thromboembolism prominent
• MIS-C / MIS-A post-COVID
• Long COVID (PASC) 1-3% prevalence

208.2.0.4 必背 — High Risk

• ≥ 65, comorbidities, immunocompromise, pregnancy, unvaccinated

208.2.0.5 必背 — Treatment

Setting	Tx
Outpatient high-risk < 5d	Paxlovid (drug interactions!) or remdesivir 3d or molnupiravir
Immunocompromise pre-exposure	Pemivibart mAb
Hospitalized oxygen	Remdesivir + dexamethasone
Severe cytokine	Tocilizumab or baricitinib
All hospitalized	Prophylactic anticoagulation
Severe non-ICU	Therapeutic anticoagulation

208.2.0.6 必背 — Paxlovid Drug Interactions

• Major: tacrolimus, cyclosporine, simvastatin, amiodarone, midazolam, lurasidone, oral OC
• Review with pharmacist / Liverpool COVID tool
• Some require hold / dose adjustment

208.2.0.7 必背 — Vaccines 2024-2025

• Monovalent mRNA KP.2 / current variant
• Annual recommendation universal ≥ 6 mo
• Co-administration OK

208.2.0.8 必背 — MIS-C / MIS-A

• 2-6 wk post-COVID
• Multi-organ + cardiac + GI + rash + LAP
• IVIG + steroid + biologic if refractory

208.2.0.9 必背 — Long COVID

• Post-acute sequelae of COVID-19
• 1-3% prevalence (varies)
• Multi-organ
• Multidisciplinary management

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