Recent review of COVID-19 management: diagnosis, treatment and vaccination

Abstract

The idiopathic Coronavirus disease 2019 (COVID-19) pandemic outbreak caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has reached global proportions; the World Health Organization (WHO) declared it as a public health emergency during the month of January 30, 2020. The major causes of the rise of new variants of SARS-CoV-2 are genetic mutations and recombination. Some of the variants with high infection and transmission rates are termed as variants of concern (VOCs) like currently Omicron variants. Pregnant women, aged people, and immunosuppressed and compromised patients constitute the most susceptible human population to the SARS-CoV-2 infection, especially to the new evolving VOCs. To effectively manage the pathological condition of infection, the focus should be directed towards prevention and prophylactic approach. In this narrative review, we aimed to analyze the current scenario of COVID-19 management and discuss the treatment and prevention strategies. We also focused on the complications prevalent during the COVID-19 and post-COVID period and to discuss the novel approaches developed for mitigation of the global pandemic. We have also emphasized on the COVID-19 management approaches for the special population including children, pregnant women, aged groups, and immunocompromised patients. We conclude that the advancements in therapeutic and pharmacological domains have provided opportunities to develop and design novel diagnosis, treatment, and prevention strategies. New advanced techniques such as RT-LAMP, RT-qPCR, High-Resolution Computed Tomography, etc., efficiently diagnose patients with SARS-CoV-2 infection. In the case of treatment options, new drugs like paxlovid, combinations of β-lactum drugs and molnupiravir are found to be effective against even the new emerging variants. In addition, vaccination is an essential approach to prevent the infection or to reduce its severity. Vaccines for against COVID-19 from Comirnaty by Pfizer-BioNTech, SpikeVax by Moderna, and Vaxzevria by Oxford-AstraZeneca are approved and used widely. Similarly, numerous vaccines have been developed with different percentages of effectiveness against VOCs. New developments like nanotechnology and AI can be beneficial in providing an efficient and reliable solution for the suppression of SARS-CoV-2. Public health concerns can be efficiently treated by a unified scientific approach, public engagement, and better diagnosis.

mRNA-Based Vaccine for COVID-19: They Are New but Not Unknown!

“…Recent technologies such as mRNA-based vaccines or vector-based vaccines make the most of it for the safety and efficacy of COVID-19 vaccines [ 33 ]. The vector-based vaccines are also known as heterologous prime-boost vaccination, which helps in inducing both cellular and humoral immune responses, whereas the live sub-unit vaccines provoke a humoral response only [ 34 , 35 , 36 , 37 , 38 , 39 ]. According to a study, a 5–10 times increase in T cell-mediated immune response in case of a heterologous vector-based vaccine in comparison to the same formulation, prepared using a homologous approach [ 40 ].…”

Immunological Studies to Understand Hybrid/Recombinant Variants of SARS-CoV-2

“…The changes in the genetic code of the virus happen either by random point mutations (Alpha, Beta, Gamma, Mu, Delta, and Omicron) or recombination (coronaviruses including novel hybrid variants, influenza virus, HIV, etc.,) during viral replication. The variants are classified into lineages based on their evolution from a common ancestor [ 13 , 14 ]. The investigations on the viral genomes focus on tracking the global transmission of the virus, analyzing the local outbreaks, and promoting public health policies.…”

“…Hybrid variants are a growing cause of concern in the current scenario because they have the potential to again increase positive cases globally by gaining enhanced virulence and transmission rates on recombination between two variants of distinct lineages [ 14 ].…”

“…Due to its high potential for future outbreaks, Deltacron is categorized in the list of Variants being Monitored (VBMs) [ 21 ]. XD was created by recombination between the Delta and BA.1 variant of Omicron, whereas recombination of BA.1 and UK Delta variants created the XF variant [ 14 , 24 ]. On the other hand, the XE subvariant was created by recombination between BA.1 and BA.2 variants of Omicron [ 27 ].…”

Molnupiravir: A Versatile Prodrug against SARS-CoV-2 Variants

“…These changes affect the spread ability and susceptibility of a virus to infection, disease severity, performance of therapeutic agents, diagnostic methods, and ultimately public health [ 10 , 11 , 12 ]. Since the outbreak of COVID-19, approximately 4000 different genetic changes have been detected in the virus responsible for the disease, known as SARS-CoV-2 [ 13 , 14 ]. Variants of concern (VOCs) are types of SARS-CoV-2 that have undergone changes in the proteins on their surface, specifically the spike glycoprotein and the receptor binding domain (RBD) to human angiotensin converting enzyme 2 ( h ACE2); consequently, the binding affinity of RBD with h ACE2 will be increased, and thus, viral transmission and virulence will also be increased.…”