Understanding Viral Infection Mechanisms and Patient Symptoms for the Development of COVID-19 Therapeutics

Abstract

Coronavirus disease 2019 (COVID-19), caused by the SARS-CoV-2 virus, has become a worldwide pandemic. Symptoms range from mild fever to cough, fatigue, severe pneumonia, acute respiratory distress syndrome (ARDS), and organ failure, with a mortality rate of 2.2%. However, there are no licensed drugs or definitive treatment strategies for patients with severe COVID-19. Only antiviral or anti-inflammatory drugs are used as symptomatic treatments based on clinician experience. Basic medical researchers are also trying to develop COVID-19 therapeutics. However, there is limited systematic information about the pathogenesis of COVID-19 symptoms that cause tissue damage or death and the mechanisms by which the virus infects and replicates in cells. Here, we introduce recent knowledge of time course changes in viral titers, delayed virus clearance, and persistent systemic inflammation in patients with severe COVID-19. Based on the concept of drug reposition, we review which antiviral or anti-inflammatory drugs can effectively treat COVID-19 patients based on progressive symptoms and the mechanisms inhibiting virus infection and replication.

Repositioning Ivermectin for Covid-19 treatment: Molecular mechanisms of action against SARS-CoV-2 replication

“…Much like the previous SARS-CoV, SARS-CoV-2 also requires the binding of spike (S) protein to the host angiotensin-converting enzyme 2 (ACE2) receptors to infiltrate the host cells [69] . There are two regions in the receptor-binding motif on the S protein that forms an interface between S protein and ACE2.…”

Exacerbation of COVID 19 in Hypertensive Patients ( A review)

“…The Renin-Angiotensin II-Aldosterone axis was recognized as a key regulator of blood pressure in the hypertensive patient, with Angiotensin II regulated through ACE (57) . Thus, due to imbalance between ACE1 and ACE2 result from viral infection, the hypertensive patients tend to appear more serious organs injury (58) . In hypertensive COVID 19 patients more sever clinical types of mortality were observed, leading to a suggestion that COVID 19 associated the clinical outcome of COVID 19 (59) .…”

Anticoagulant Treatment of COVID-19 as Early as Possible—Sulodexide and Perspectives

“…2 However, patients may remain asymptomatic following infection or develop symptoms suspicious for COVID-19 approximately 5 days after infection with SARS-CoV-2. 3 Upon deterioration of symptoms, patients are hospitalized and anticoagulation with low-molecular weight heparin (LMWH) is now regarded as cornerstone therapy for admitted patients with COVID-19. 4,5 For asymptomatic patients with laboratory-confirmed COVID-19, it is uncertain whether hydroxychloroquine reduces hospitalization.…”