New Insights of Emerging SARS-CoV-2: Epidemiology, Etiology, Clinical Features, Clinical Treatment, and Prevention

Guo, Gangqiang; Ye, Lele; Pan, Kan; Chen, Yu; Xing, Dong; Yan, Kejing; Chen, Zhiyuan; Ding, Ning; Li, Wenshu; Huang, Hong; Zhang, Lifang; Li, Xiaokun; Xue, Xiangyang

doi:10.3389/fcell.2020.00410

Cited by 116 publications

(157 citation statements)

References 208 publications

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“…Genetic drift almost inevitably leads, during time, to amino acid mutations in proteins critical for virus replication and spreading, mostly generating an attenuated viral progeny [ 8 ]. Indeed, different epidemiological and clinical features of COVID-19 were found to be related to genetic changes of SARS-CoV-2 [ 9 ]. The novel coronavirus has been found to evolve into two subtypes, L and S [ 10 ], with the former being more aggressive and spreading more rapidly than the latter [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, different epidemiological and clinical features of COVID-19 were found to be related to genetic changes of SARS-CoV-2 [ 9 ]. The novel coronavirus has been found to evolve into two subtypes, L and S [ 10 ], with the former being more aggressive and spreading more rapidly than the latter [ 9 ]. Jin et al [ 3 ] compared the complete genome of 52 strains of SARS-CoV-2 and described a continuous evolution of the potential furin cleavage site of the S protein of SARS-CoV-2 till the latest isolate (ZJ01) derived from a patient with mild COVID-19.…”

Section: Introductionmentioning

confidence: 99%

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A persistently replicating SARS-CoV-2 variant derived from an asymptomatic individual

et al. 2020

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Background Since the first outbreak of SARS-CoV-2, the clinical characteristics of the Coronavirus Disease 2019 (COVID-19) have been progressively changed. Data reporting a viral intra-host and inter-host evolution favouring the appearance of mild SARS-CoV-2 strains are since being accumulating. To better understand the evolution of SARS-CoV-2 pathogenicity and its adaptation to the host, it is therefore crucial to investigate the genetic and phenotypic characteristics of SARS-CoV-2 strains circulating lately in the epidemic. Methods Nasopharyngeal swabs have been analyzed for viral load in the early (March 2020) and late (May 2020) phases of epidemic in Brescia, Italy. Isolation of SARS-CoV-2 from 2 high viral load specimens identified on March 9 (AP66) and on May 8 (GZ69) was performed on Vero E6 cells. Amount of virus released was assessed by quantitative PCR. Genotypic characterization of AP66 and GZ69 was performed by next generation sequencing followed by an in-depth in silico analysis of nucleotide mutations. Results The SARS-CoV-2 GZ69 strain, isolated in May from an asymptomatic healthcare worker, showed an unprecedented capability of replication in Vero E6 cells in the absence of any evident cytopathic effect. Vero E6 subculturing, up to passage 4, showed that SARS-CoV-2 GZ69 infection was as productive as the one sustained by the cytopathic strain AP66. Whole genome sequencing of the persistently replicating SARS-CoV-2 GZ69 has shown that this strain differs from the early AP66 variant in 9 nucleotide positions (C2939T; C3828T; G21784T; T21846C; T24631C; G28881A; G28882A; G28883C; G29810T) which lead to 6 non-synonymous substitutions spanning on ORF1ab (P892S; S1188L), S (K74N; I95T) and N (R203K, G204R) proteins. Conclusions Identification of the peculiar SARS-CoV-2 GZ69 strain in the late Italian epidemic highlights the need to better characterize viral variants circulating among asymptomatic or paucisymptomatic individuals. The current approach could unravel the ways for future studies aimed at analyzing the selection process which favours viral mutations in the human host.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A persistently replicating SARS-CoV-2 variant derived from an asymptomatic individual

et al. 2020

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“…Another 60% (range 40-80%) will have a range of mild symptoms (Chen et al 2020a), but even so might be incurring serious organ damage that will haunt them later in life (Mitrani et al 2020). Another roughtly 10-25% of cases will have severe to critical symptoms resulting in pneumonia leading to acute respiratory distress (ARDS), coagulopathies, and a form of hyperactive immune response termed a cytokine storm (Ragab et al 2020;Mangalmurti and Hunter 2020;Guan et al 2020;Guo et al 2020). Finally, roughly 3-5% of confirmed symptomatic cases of Covid-19 will die from multiple organ failures or other sequelae.…”

Section: Introductionmentioning

confidence: 99%

BCG vaccination early in life does not improve COVID‐19 outcome of elderly populations, based on nationally reported data

Wassenaar

Buzard²,

Newman³

2020

Lett. Appl. Microbiol.

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Significance and Impact of the Study: It has been suggested in the recent literature that some countries have lower case rates or death rates of Covid-19 as a result of large-scale BCG vaccination programs. This has resulted in the initiation of clinical trials to assess if the vaccine can act as a prophylactic or ameliorate the disease. However, by comparing countries that are well into the epidemic and have different (current or past) BCG vaccination practices, we conclude that there is currently no compelling evidence of any such protective effect.

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“…Homology modelling revealed that a SARS-CoV-2 protease, known as endopeptidase C30 (CEP_C30), binds efficiently with protease inhibitors, i.e., lopinavir and ritonavir, suggesting anti-SARS-CoV-2 activity of drugs probably due to their inhibitory action on C30 (CEP_C30). Lopinavir/ritonavir showed antiviral activity against SARS-CoVs in cell culture, but results against MERS CoVs were conflicting [ 51 , 52 ]. Cao et al revealed that the condition of SARS-CoV-2-infected individuals did not improve by using these protease inhibitors [ 53 ].…”

Section: Pharmacologic Treatmentsmentioning

confidence: 99%

COVID-19: Current Developments and Further Opportunities in Drug Delivery and Therapeutics

et al. 2020

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SARS-CoV-2 has affected people from all age groups, races and ethnicities. Given that many infected individuals are asymptomatic, they transmit the disease to others unknowingly, which has resulted in the spread of infection at an alarming rate. This review aims to provide an overview of the pathophysiology, preventive measures to reduce the disease spread, therapies currently in use, an update on vaccine development and opportunities for vaccine delivery. The World Health Organization has advised several precautions including social distancing, hand washing and the use of PPE including gloves and face masks for minimizing the spread of SARS-CoV-2 infection. At present, several antiviral therapies previously approved for other infections are being repositioned to study their efficacy against SARS-CoV-2. In addition, some medicines (i.e., remdesivir, chloroquine, hydroxychloroquine) have received emergency use authorisation from the FDA. Plasma therapy has also been authorised for emergency use for the treatment of COVID-19 on a smaller scale. However, no vaccine has been approved so far against this virus. Nevertheless, several potential vaccine targets have been reported, and development of different types of vaccines including DNA, mRNA, viral vector, inactivated, subunit and vaccine-like particles is in process. It is concluded that a suitable candidate delivered through an advanced drug delivery approach would effectively boost the immune system against this coronavirus.

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New Insights of Emerging SARS-CoV-2: Epidemiology, Etiology, Clinical Features, Clinical Treatment, and Prevention

Cited by 116 publications

References 208 publications

A persistently replicating SARS-CoV-2 variant derived from an asymptomatic individual

A persistently replicating SARS-CoV-2 variant derived from an asymptomatic individual

BCG vaccination early in life does not improve COVID‐19 outcome of elderly populations, based on nationally reported data

COVID-19: Current Developments and Further Opportunities in Drug Delivery and Therapeutics

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