Microstructure, pathophysiology, and potential therapeutics of COVID‐19: A comprehensive review

Abstract

There have been over 7 million cases and almost 413,372 deaths globally due to the novel coronavirus (2019‐nCoV) associated disease COVID‐19, as of June 11, 2020. Phylogenetic analysis suggests that there is a common source for these infections. The overall sequence similarities between the spike protein of 2019‐nCoV and that of SARS‐CoV are known to be around 76‐78% and 73‐76% for whole protein and receptor‐binding domain (RBD), respectively. Thus, they have the potential to serve as drug and/ or vaccine candidate. However, the individual response against 2019‐nCoV differs due to genetic variations in the human population. Understanding the variations in Angiotensin‐converting enzyme 2 (ACE2) and human leukocyte antigen (HLA) that may affect the severity of 2019‐nCoV infection could help in identifying individuals at higher risk from the COVID‐19. A number of potential drugs/vaccines as well as antibody/cytokine‐based therapeutics are running in various developmental stages of preclinical/clinical trials against SARS‐CoV, MERS‐CoV and 2019‐nCoV with substantial cross‐reactivity, which may be used against COVID‐19. For diagnosis, reverse transcription polymerase chain reaction (RT‐PCR) is the gold standard test for initial diagnosis of COVID‐19. Kit based on serological tests are also recommended for investigating the spread of COVID‐19 but it is challenging due to antibodies cross‐reactivity. This review comprehensively summarizes the recent reports available regarding the host‐pathogen interaction, morphological and genomic structure of the virus, and the diagnostic techniques as well as available and potential therapeutics against COVID‐19. This article is protected by copyright. All rights reserved.

Pathological Findings in COVID-19 as a Tool to Define SARS-CoV-2 Pathogenesis. A Systematic Review

“…Evidence highlights that the individual response against SARS-CoV-2 differs due to genetic variations in the human population that may affect the severity of the infection and a better understanding of such variations could help identify the subjects who are most at risk ( Singh et al, 2020 ).…”

When Frequent (Pandemic) Occurs in a Non-Frequent Disease: COVID-19 and Fabry Disease: Report of Two Cases

“…The disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), called coronavirus disease 2019 (COVID- 19), mainly affects the lungs, and can produce diverse clinical manifestations, ranging from asymptomatic forms to severe lung involvement, even multi-organ dysfunction (3)(4)(5), resulting in a fatality ratio case of 13-30% (6 -8), highest mortality cases in Peru (8). Risk factors for severe disease as previously reported (9)(10)(11) are: advanced age, diabetes, hypertension, obesity and chronic kidney disease.…”

Ischemic stroke leading to bilateral vision loss in COVID‐19 patient—A rare case report

“…is the main causative agent of coronavirus disease 2019 (COVID-19). 1 Besides, progressive atypical respiratory system involvement, other organ systems including the central nervous system have also been affected due to the discernable affinity of the virus towards the angiotensin-converting enzyme 2 (ACE2) receptors 2,3 that may result in meningitis, encephalitis or stroke. This unique feature of infection is due to the activation of imbalance clotting factors which blocks the vessel and gives rise to ischemia of the brain, even in the young infected patient.…”

“…6 It is a neurotropic virus 7,8 and is genetically similar to SARS-CoV-1. 3 It has been reported that SARS-CoV-2 uses the same receptor as SARS-CoV, i.e. membrane-bound ACE II (ACE2), making it the major entry point 9,10 to the central nervous system.…”

“…membrane-bound ACE II (ACE2), making it the major entry point 9,10 to the central nervous system. 3 Irfan Ullah MBBS 2,3,4 Kiran Shafiq Khan MBBS 5 1 Department of Internal Medicine,…”