Molecular mechanism, diagnosis, and potential treatment for novel coronavirus (COVID-19): a current literature review and perspective

Abstract

Novel coronavirus disease 2019 (COVID-19) is a positive-sense single-stranded RNA virus which belongs to the Coronaviridae family. COVID-19 outbreak became evident after the severe acute respiratory syndrome coronavirus and the Middle East respiratory syndrome coronavirus in the twenty-first century as the start of the third deadly coronavirus. Currently, research is at an early stage, and the exact etiological dimensions of COVID-19 are unknown. Several candidate drugs and plasma therapy have been considered and evaluated for the treatment of severe COVID-19 patients. These include clinically available drugs such as chloroquine, hydroxychloroquine, and lopinavir/ritonavir. However, understanding the pathogenic mechanisms of this virus is critical for predicting interaction with humans. Based on recent evidence, we have summarized the current virus biology in terms of the possible understanding of the various pathophysiologies, molecular mechanisms, recent efficient diagnostics, and therapeutic approaches to control the disease. In addition, we briefly reviewed the biochemistry of leading candidates for novel therapies and their current status in clinical trials. As information from COVID-19 is evolving rapidly, this review will help the researcher to consider new insights and potential therapeutic approaches based on up-to-date knowledge. Finally, this review illustrates a list of alternative therapeutic solutions for a viral infection.

Elements and COVID-19: A Comprehensive Overview of Studies on Their Blood/Urinary Levels and Supplementation with an Update on Clinical Trials

“…The pharmacological approach includes empirical, targeted, and adjuvant therapies with antiviral/antimalarial medications, antibiotics, and chelators, respectively. As for antiviral drugs, favipiravir, ribavirin, darunavir, and lopinavir in conjunction with ritonavir or oseltamivir as well as the ribavirin-pegylated interferon combination and remdesivir, for which a conditional recommendation against its use for the treatment of COVID-19 patients has been issued in the updated guidelines from WHO [ 52 ], are taken into account as candidate medicines [ 42 , 50 ]. It has also been reported that quinoline-containing antimalarial derivatives—i.e., chloroquine (CQ) and hydroxychloroquine (HCQ)—may exhibit potential in fighting SARS-CoV-2 infection [ 53 , 54 ].…”

“…Monoclonal antibodies (mAbs) and interferons (IFNs) should also be mentioned as specific forms of therapy against COVID-19 [ 32 , 50 ]. mAbs are considered a promising approach in treatment of high-risk mild-to-moderate non-hospitalized patients.…”

“…For example, Jovic et al [ 74 ] reviewed the current evidence base and critically appraised the potential immunomodulatory and antioxidant roles of vitamins A to E in the context of respiratory disease and their roles in the fight against COVID-19. The data on the doses of recommended vitamins for COVID-19 were summarized as well [ 50 ]. Some minerals such as Mg, Zn, Se, Cu, and Fe may also be helpful in the fight against coronavirus disease, as they can modulate the immune system [ 44 , 51 , 73 , 75 , 76 , 77 , 78 , 79 , 80 ].…”

Are Host Defense Peptides and Their Derivatives Ready to be Part of the Treatment of the Next Coronavirus Pandemic?

“…Several studies have suggested the use of interferon (IFN)-α, ribavirin combined with IFN-α or lopinavir/ritonavir, chloroquine phosphate, nelfinavir, and arbidol (Wolfel et al 2020 ). Other antiviral drugs have been tested during this pandemic (reviewed comprehensively elsewhere) (Peng et al 2021 ; Ratre et al 2021 ), as well as the use of immunotherapy such as convalescent plasma from recovered patients, intravenous injection of an anti-SARS-CoV-2 human immunoglobulin, and tocilizumab, all of them accompanied by the use of glucocorticoids such as methylprednisolone to damper inflammation, thus allowing better oxygenation. Preventing complications and providing organ function support are also key therapeutic approaches; nevertheless, no specific antiviral treatment of COVID-19 still exists.…”

Impact of glycosylation on a broad-spectrum vaccine against SARS-CoV-2

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Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in more than 167 million confirmed cases and over 3 million deaths so far [1][2][3][4] . This global pandemic has led to great efforts directed toward the study of this virus and its infection mechanism as well as development of effective means to control this devastating infectious disease [5][6][7][8] . Like many other viral surface proteins, the trimeric SARS-CoV-2 spike (S) protein is heavily glycosylated with 22 N-and 2 O-glycosites per monomer which are likely to influence S protein folding and evade host immune response 9 .

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