The coronavirus pandemic in five powerful charts

Highlights-Severe acute respiratory virus-2 (SARS-CoV2), the infection responsible for coronavirus disease-2019 (COVID-19), has spread globally leading to a devastating loss of life. In a few short months, the clinical and scientific communities have rallied to rapidly evolve our understanding of the mechanism(s) of disease and potential therapeutics. -This review discusses the current understanding of the basis virology of SARS-CoV2 and the epidemiology, clinical manifestations, including cardiovascular, and mortality of COVID-19. A detailed review of the viral life cycle and putative mechanism(s) of injury frames the discussion of possible preventative and therapeutic strategies. -The ongoing, unprecedented collective effort will, without a doubt, advance our ability to prevent the spread and optimally care for patients suffering from COVID-19. SummaryThe coronavirus disease-2019 (COVID-19), a contagious disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV2), has reached pandemic status. As it spreads across the world, it has overwhelmed healthcare systems, strangled the global economy and led to a devastating loss of life. Widespread efforts from regulators, clinicians and scientists are driving a rapid expansion of knowledge of the SARS-CoV2 virus and the COVID-19 disease.We review the most current data with a focus on our basic understanding of the mechanism(s) of disease and translation to the clinical syndrome and potential therapeutics. We discuss the basic virology, epidemiology, clinical manifestation, multi-organ consequences, and outcomes. With a focus on cardiovascular complications, we propose several mechanisms of injury. The virology and potential mechanism of injury form the basis for a discussion of potential disease-modifying therapies.

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“…An outbreak will continue to increase in size if the R o >1. For context, seasonal influenza has an R o of 1.5 (43).…”

Section: Transmissionmentioning

confidence: 99%

COVID-19 for the Cardiologist

Atri

Siddiqi

Lang

et al. 2020

JACC: Basic to Translational Science

265

137

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“…In an article published in Nature, the infection rate of SARS-CoV-2 was shown to be higher than the seasonal flu based on current estimates. 4 The question of when to return to work for health care professionals who have tested positive will impact care. The Centers for Disease Control and Prevention (CDC) offers guidelines, which separate decision making into testingbased and non-testing-based options.…”

Section: Infection and Mortalitymentioning

confidence: 99%

Urologic Surgery and COVID-19: How the Pandemic Is Changing the Way We Operate

Steward

Kitley

Schmidt

et al. 2020

Journal of Endourology

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The coronavirus disease 2019 (COVID-19) pandemic has had a global impact on all aspects of health care, including surgical procedures. For urologists, it has affected and will continue to influence how we approach the care of patients preoperatively, intraoperatively, and postoperatively. A risk-benefit assessment of each patient undergoing surgery should be performed during the COVID-19 pandemic based on the urgency of the surgery and the risk of viral illness and transmission. Patients with advanced age and comorbidities have a higher incidence of mortality. Routine preoperative testing and symptom screening is recommended to identify those with COVID-19. Adequate personal protective equipment (PPE) for the surgical team is essential to protect health care workers and ensure an adequate workforce. For COVID-19 positive or suspected patients, the use of N95 respirators is recommended if available. The anesthesia method chosen should attempt to minimize aerosolization of the virus. Negative pressure rooms are strongly preferred for intubation/extubation and other aerosolizing procedures for COVID-19 positive patients or when COVID status is unknown. Although transmission has not yet been shown during laparoscopic and robotic procedures, efforts should be made to minimize the risk of aerosolization. Ultra-low particulate air filters are recommended for use during minimally invasive procedures to decrease the risk of viral transmission. Thorough cleaning and sterilization should be performed postoperatively with adequate time allowed for the operating room air to be cycled after procedures. COVID-19 patients should be separated from noninfected patients at all levels of care, including recovery, to decrease the risk of infection. Future directions will be guided by outcomes and infection rates as social distancing guidelines are relaxed and more surgical procedures are reintroduced. Recommendations should be adapted to the local environment and will continue to evolve as more data become available, the shortage of testing and PPE is resolved, and a vaccine and therapeutics for COVID-19 are developed.

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“…Accordingly, the availability of efficient antiviral drugs would be of utmost interest for the treatment of infected patients and possibly for preventive or preemptive use. Regrettably, the current and unprecedented outbreak of SARS-CoV-2 occurs in an unprepared world, with no firmly established identification of active molecules against beta-coronaviruses (Callaway et al, 2020). There is thus an urgent necessity to provide hic et nunc therapeutic solutions to limit viral infection.…”

Section: Introductionmentioning

confidence: 99%

In vitroscreening of a FDA approved chemical library reveals potential inhibitors of SARS-CoV-2 replication

Touret

Gilles

Barral

et al. 2020

Preprint

148

184

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17 18 A novel coronavirus, named SARS-CoV-2, emerged in 2019 from Hubei region in China and rapidly 19 spread worldwide. As no approved therapeutics exists to treat Covid-19, the disease associated to Cov-2, there is an urgent need to propose molecules that could quickly enter into clinics. Repurposing 21 of approved drugs is a strategy that can bypass the time consuming stages of drug development. In this 22 study, we screened the Prestwick Chemical Library® composed of 1,520 approved drugs in an infected 23 cell-based assay. 90 compounds were identified. The robustness of the screen was assessed by the 24 identification of drugs, such as Chloroquine derivatives and protease inhibitors, already in clinical trials. 25The hits were sorted according to their chemical composition and their known therapeutic effect, then 26 EC50 and CC50 were determined for a subset of compounds. Several drugs, such as Azithromycine, 27 Opipramol, Quinidine or Omeprazol present antiviral potency with 2

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The coronavirus pandemic in five powerful charts

Cited by 228 publications

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COVID-19 for the Cardiologist

COVID-19 for the Cardiologist

Urologic Surgery and COVID-19: How the Pandemic Is Changing the Way We Operate

In vitroscreening of a FDA approved chemical library reveals potential inhibitors of SARS-CoV-2 replication

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