International Journal of Biomedicine. 2020;10(4):303-311.
Originally published December 10, 2020
The first human case of COVID-19, caused by the novel coronavirus, was reported by health officials in the city of Wuhan, China, in December of 2019. The virus was identified as a novel coronavirus in early January 2020, and its genetic sequence was shared publicly on January 11, 2020. The novel virus, previously called 2019-novel coronavirus (2019-nCoV), is currently designated as the severe respiratory syndrome coronavirus-2 (SARS-CoV-2). On January 23, Wuhan was locked down, and the World Health Organization (WHO) declared a “public health emergency of international concern.” The viral genome of SARS-CoV-2 is around 29.8 kilobase, containing six major open reading frames. The most common clinical symptoms were fever, cough, fatigue, shortness of breath, dyspnea, muscle ache, headache, chest pain, vomiting, sore throat, and sputum production. The main mode of transmission is through respiratory particles. The incubation period is 3 to 7 days. Both asymptomatic and symptomatic patients seem to be infectious. Spike (S) proteins of SARS-CoV-2 seem to have a 10- to 20-fold higher affinity to the human angiotensin enzyme 2 (ACE2) receptor than that of SARS-CoV. The high affinity of S protein to theACE2 receptor, and the additional advantages offered by the transfection facilitators Furin and Neutropilin-1, likely, contributes to the rapid spreading of this novel virus. Since these receptors are highly expressed on a variety of cells, including vascular endothelial cells and adipose tissue, individuals with compromised function of these tissues drive greater infection and severity in patients with COVID-19. Global health experts estimate that one in five individuals worldwide could be at risk for severe COVID-19, due to underlying health conditions. There is a great need for a rapid, specific, cost-effective test for monitoring the infected individuals. Even though a 15- minute, antigen test was made available by Abbott recently, it seems that the schools, colleges, and business establishments lack the ability to use these tests effectively to keep their businesses open safely. Management of the infected individuals seems to be based on clinical symptoms that manifest as the disease progresses. The US Food & Drug Administration (FDA), has created a special emergency program for possible therapies, the Coronavirus Treatment Acceleration Program (CTAP). The program uses every available method to move new and emerging treatments as quickly as possible, keeping in mind the safety and efficacy of such therapies. According to the WHO report, there are currently more than 150 COVID-19 vaccine candidates under development. Several vaccines are in Phase 3 clinical trials. In an unprecedented effort, one of the experimental monoclonal antibody cocktails of Regeneron was used for therapeutic purposes when the US president was tested positive for COVID-19. There are no drugs or other therapeutics approved by the US FDA to prevent or treat COVID-19. The National Institutes of Health (NIH) have published interim guidelines for the medical management of COVID-19. In the absence of a cure, the only choice we all have is to follow the best practices recommended by the public health experts—use of face masks (coverings), frequent hand washing with soap, contact tracing of infected individuals, and quarantining COVID-19 positive individuals, till they are free of the highly infectious virus.
1. Singer M, Bulled N, Ostrach B, Mendenhall E. Syndemics and the biosocial conception of health. Lancet. 2017 Mar 4;389(10072):941-950. doi: 10.1016/S0140-6736(17)30003-X.
2. Rao GHR. Coronavirus Disease Pandemic: A Public Health Perspective. J Med and Healthcare. 2020; 2(4):1-7.
3. Rao GHR. COVID-19 and Cardiometabolic Disease. EC Cardiol. 2020;7.6:08-12.
4. Rao GHR. Coronavirus Disease and Acute Vascular Events. Clin Appl Thromb Hemost. 2020 Jan-Dec;26:1076029620929091. doi: 10.1177/1076029620929091.
5. Rao GHR. Coronavirus Disease, Comorbidities, and Clinical Manifestations. Acta Sci Pharmacology. 2020;1.8
6. Rao GHR. Coronavirus Disease (Covid-19): A Disease of the Vascular Endothelium. Ser Cardiol Res. 2020;2(1):23-27
7. Rao GHR: Coronavirus Disease Transmission, Vascular Dysfunction and Pathology J Cardiol Res Rev & Rep. 2020;1(3):1-4
8. Rao GHR. Excess Weight, Obesity, Diabetes and Coronavirus Disease. Arch Diab & Obesity 3(1)-2020. MS ID.000152. doi: 10.32474/ADO.2020.03.000152.
9. Taubenberger JK, Morens DM. 1918 Influenza: the mother of all pandemics. Emerg Infect Dis. 2006 Jan;12(1):15-22. doi: 10.3201/eid1201.050979.
10. Cutler DM, Summers LH. The COVID-19 Pandemic and the $16 Trillion Virus. JAMA. 2020 Oct 20;324(15):1495-1496. doi: 10.1001/jama.2020.19759.
11. Brandsma E, Verhagen HJMP, van de Laar TJW, Claas ECJ, Cornelissen M, van den Akker E. Rapid, sensitive and specific SARS coronavirus-2 detection: a multi-center comparison between standard qRT-PCR and CRISPR based DETECTR. J Infect Dis. 2020 Oct 10:jiaa641. doi: 10.1093/infdis/jiaa641.
12. Slavitt A. Science is Needed to Rescue the Nation from Covid-19, but Not Just Traditional Biomedical Science. JAMA Forum|COVID-19. Available at: https://jamanetwork.com/channels/health-forum/fullarticle/2771804
13.Burki T. The origin of SARS-CoV-2. Lancet Infect Dis. 2020 Sep;20(9):1018-1019. doi: 10.1016/S1473-3099(20)30641-1.
14. Cohen J. Chinese researchers reveal draft genome of virus implicated in Wuhan pneumonia outbreak. Science. 2020. doi:10.1126/science.aba8829.
15. Wang H, Li X, Li T, Zhang S, Wang L, Wu X, Liu J. The genetic sequence, origin, and diagnosis of SARS-CoV-2. Eur J Clin Microbiol Infect Dis. 2020 Sep;39(9):1629-1635. doi: 10.1007/s10096-020-03899-4.
16. Koyama T, Platt D, Parida L. Variant analysis of SARS-CoV-2 genomes. Bull WHO. 2020; 98:495-504.
17. Brainard J. Researchers face hurdles to evaluate, synthesize COVID-19 evidence at top speed. Health, Scientific Community: Coronavirus; Science. 2020 doi:10.1126/science.abf1761.
18. Wu F, Zhao S, Yu B, Chen YM, Wang W, Song ZG, Hu Y, Tao ZW, Tian JH, Pei YY, Yuan ML, Zhang YL, Dai FH, Liu Y, Wang QM, Zheng JJ, Xu L, Holmes EC, Zhang YZ. A new coronavirus associated with human respiratory disease in China. Nature. 2020 Mar;579(7798):265-269. doi: 10.1038/s41586-020-2008-3.
19. Lu J, du Plessis L, Liu Z, Hill V, Kang M, Lin H, et al. Genomic Epidemiology of SARS-CoV-2 in Guangdong Province, China. Cell. 2020 May 28;181(5):997-1003.e9. doi: 10.1016/j.cell.2020.04.023.
20. Lam TT. Tracking the Genomic Footprints of SARS-CoV-2 Transmission. Trends Genet. 2020 Aug;36(8):544-546. doi: 10.1016/j.tig.2020.05.009.
21. Gussow AB, Auslander N, Faure G, Wolf YI, Zhang F, Koonin EV. Genomic determinants of pathogenicity in SARS-CoV-2 and other human coronaviruses. Proc Natl Acad Sci U S A. 2020 Jun 30;117(26):15193-15199. doi: 10.1073/pnas.2008176117.
22. Severe Covid-19 GWAS Group, Ellinghaus D, Degenhardt F, Bujanda L, Buti M, Albillos A, Invernizzi P, et al. Genomewide Association Study of Severe Covid-19 with Respiratory Failure. N Engl J Med. 2020 Oct 15;383(16):1522-1534. doi: 10.1056/NEJMoa2020283.
23. Abdullahi IN, Emeribe AU, Ajayi OA, Oderinde BS, Amadu DO, Osuji AI. Implications of SARS-CoV-2 genetic diversity and mutations on pathogenicity of the COVID-19 and biomedical interventions. J Taibah Univ Med Sci. 2020 Aug;15(4):258-264. doi: 10.1016/j.jtumed.2020.06.005.
24. Tortorici MA, Veesler D. Structural insights into coronavirus entry. Adv Virus Res. 2019;105:93-116. doi: 10.1016/bs.aivir.2019.08.002.
25. Walls AC, Park YJ, Tortorici MA, Wall A, McGuire AT, Veesler D. Structure, Function, and Antigenicity of the SARS-CoV-2 Spike Glycoprotein. Cell. 2020 Apr 16;181(2):281-292.e6. doi: 10.1016/j.cell.2020.02.058.
26. Xu W, Wang M, Yu D, Zhang X. Variations in SARS-CoV-2 Spike Protein Cell Epitopes and Glycosylation Profiles During Global Transmission Course of COVID-19. Front Immunol. 2020 Sep 4;11:565278. doi: 10.3389/fimmu.2020.565278.
27. Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, Schiergens TS, Herrler G, Wu NH, Nitsche A, Müller MA, Drosten C, Pöhlmann S. SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor. Cell. 2020 Apr 16;181(2):271-280.e8. doi: 10.1016/j.cell.2020.02.052.
28. Morse JS, Lalonde T, Xu S, Liu WR. Learning from the Past: Possible Urgent Prevention and Treatment Options for Severe Acute Respiratory Infections Caused by 2019-nCoV. Chembiochem. 2020 Mar 2;21(5):730-738. doi: 10.1002/cbic.202000047.
29. Shang J, Wan Y, Luo C, Ye G, Geng Q, Auerbach A, Li F. Cell entry mechanisms of SARS-CoV-2. Proc Natl Acad Sci U S A. 2020 May 26;117(21):11727-11734. doi: 10.1073/pnas.2003138117.
30. Noor FM, Islam M. Prevalence of Clinical Manifestations and Comorbidities of Coronavirus (COVID-19) Infection: A Meta-Analysis. Fortune J Health Sci. 2020;3(1):55-97.
31. Rao GHR. Coronavirus Disease and Acute Vascular Events. Clin Appl Thromb Hemost. 2020 Jan-Dec;26:1076029620929091. doi: 10.1177/1076029620929091. doi: 10.1177/1076029620929091
32. Rao GHR. COVID-19 and Cardiometabolic Diseases: Guest Editorial. EC Cardiol. 2020;7(6):08-12.
33. Rao GHR. Coronavirus (COVID-19), Comorbidities, and Acute Vascular Events: Guest Editorial. EC Clinical Case Reports. 2020;3(6):87-91.
34. Rao GHR. Coronavirus Disease 2019 (COVID-19), Comorbidities, and Clinical Manifestations: Guest Editorial. EC Diab Met Res. 2020;4(8):27-33.
35. Rao GHR: Coronavirus Disease (COVID-19): A Disease of the Vascular Endothelium. Series Cardiology Res. 2020;2(1):23-27.
36. Hall MW, Joshi I, Leal L, Ooi EE. Immune modulation in COVID-19: Strategic considerations for personalized therapeutic intervention. Clin Infect Dis. 2020 Jul 1:ciaa904. doi: 10.1093/cid/ciaa904.
37. Kavianpour M, Saleh M, Verdi J. The role of mesenchymal stromal cells in immune modulation of COVID-19: focus on cytokine storm. Stem Cell Res Ther. 2020 Sep 18;11(1):404. doi: 10.1186/s13287-020-01849-7.
38. Editors. Dying in a Leadership Vacuum. N Engl J Med. 2020 Oct 8;383(15):1479-1480. doi: 10.1056/NEJMe2029812.
39. Seymour CW, McCreary EK, Stegenga J. Sensible Medicine-Balancing Intervention and Inaction During the COVID-19 Pandemic. JAMA. 2020 Oct 15. doi: 10.1001/jama.2020.20271.
40. Cohen J. Designer antibodies could battle COVID-19 before vaccines arrive. Science. 2020. doi: 10.1126/science. abe1740
41. Krause PR, Gruber MF. Emergency Use Authorization of Covid Vaccines - Safety and Efficacy Follow-up Considerations. N Engl J Med. 2020 Nov 5;383(19):e107. doi: 10.1056/NEJMp2031373.
42. Schwartz JL. Evaluating and Deploying Covid-19 Vaccines - The Importance of Transparency, Scientific Integrity, and Public Trust. N Engl J Med. 2020 Oct 29;383(18):1703-1705. doi: 10.1056/NEJMp2026393.
43. Lee EC, Wada NI, Grabowski MK, Gurley ES, Lessler J. The engines of SARS-CoV-2 spread. Science. 2020 Oct 23;370(6515):406-407. doi: 10.1126/science.abd8755.
44. Beck DB, Aksentijevich I. Susceptibility to severe COVID-19. Science. 2020 Oct 23;370(6515):404-405. doi: 10.1126/science.abe7591.
45. Daly JL, Simonetti B, Klein K, Chen KE, Williamson MK, Antón-Plágaro C, Shoemark DK, Simón-Gracia L, Bauer M, Hollandi R, Greber UF, Horvath P, Sessions RB, Helenius A, Hiscox JA, Teesalu T, Matthews DA, Davidson AD, Collins BM, Cullen PJ, Yamauchi Y. Neuropilin-1 is a host factor for SARS-CoV-2 infection. Science. 2020 Nov 13;370(6518):861-865. doi: 10.1126/science.abd3072.
46. Cantuti-Castelvetri L, Ojha R, Pedro LD, Djannatian M, Franz J, Kuivanen S, et al. Neuropilin-1 facilitates SARS-CoV-2 cell entry and infectivity. Science. 2020 Nov 13;370(6518):856-860. doi: 10.1126/science.abd2985.
47. Toelzer C, Gupta K, Yadav SKN, Borucu U, Davidson AD, Kavanagh Williamson M, et al. C. Free fatty acid binding pocket in the locked structure of SARS-CoV-2 spike protein. Science. 2020 Nov 6;370(6517):725-730. doi: 10.1126/science.abd3255.
48. Matheson NJ, Lehner PJ. How does SARS-CoV-2 cause COVID-19? Science. 2020 Jul 31;369(6503):510-511. doi: 10.1126/science.abc6156.
49. V'kovski P, Kratzel A, Steiner S, Stalder H, Thiel V. Coronavirus biology and replication: implications for SARS-CoV-2. Nat Rev Microbiol. 2020 Oct 28:1–16. doi: 10.1038/s41579-020-00468-6.
50. Masters PS. The molecular biology of coronaviruses. Adv Virus Res. 2006;66:193-292. doi: 10.1016/S0065-3527(06)66005-3.
51. Shang J, Wan Y, Luo C, Ye G, Geng Q, Auerbach A, Li F. Cell entry mechanisms of SARS-CoV-2. Proc Natl Acad Sci U S A. 2020 May 26;117(21):11727-11734. doi: 10.1073/pnas.2003138117.
52. Kondo T, Iwatani Y, Matsuoka K, Fujino T, Umemoto S, Yokomaku Y, et al. Antibody-like proteins that capture and neutralize SARS-CoV-2. Sci Adv. 2020 Oct 14;6(42):eabd3916. doi: 10.1126/sciadv.abd3916.
53. Kamps BS, Hoffman. COVID Reference. 2020.4 Available at: https://amedeo.com/CovidReference04.pdf
Received November 3, 2020.
Accepted December 4, 2020.
©2020 International Medical Research and Development Corporation.