Overview of the Pathogenesis and Treatment of SARS-CoV-2 for Clinicians: A Comprehensive Literature Review

Voto, Christian; Berkner, Paul D.; Brenner, Carol A.

doi:10.7759/cureus.10357

Cited by 15 publications

(18 citation statements)

References 51 publications

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“…The virus uses the protein spike, which is important for assessing tropism and virus transmissibility. Additionally, SARS‐CoV‐2 even targets human respiratory epithelial cells with ACE2 receptors, indicating a structure of RBD similar to SARS‐CoV 38 . After attachment of the S1‐RBD to the ACE2 receptor, host cell‐surface proteases such as TMPRSS2 (transmembrane serine protease 2) act on a critical cleavage site on S2 38 .…”

Section: Genomics Structure and Biological Features Of Sars‐cov‐2mentioning

confidence: 99%

“…38 After attachment of the S1-RBD to the ACE2 receptor, host cell-surface proteases such as TMPRSS2 (transmembrane serine protease 2) act on a critical cleavage site on S2. 38 This results in membrane fusion and viral infection. Inside the host cells, survival of SARS CoVs is maintained by multiple strategies to evade the host immune mechanism, which can also be generalized to SARS-CoV-2.…”

Section: Pathogenesis Of Sars-cov-2mentioning

confidence: 99%

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COVID‐19: Virology, biology and novel laboratory diagnosis

Mohamadian

Chiti

Shoghli

et al. 2021

The Journal of Gene Medicine

282

225

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Background: At the end of December 2019, a novel coronavirus tentatively named SARS-CoV-2 in Wuhan, a central city in China, was announced by the World Health Organization. SARS-CoV-2 is an RNA virus that has become a major public health concern after the outbreak of the Middle East Respiratory Syndrome-CoV (MERS-CoV) and Severe Acute Respiratory Syndrome-CoV (SARS-CoV) in 2002 and 2012, respectively. As of 29 October 2020, the total number of COVID-19 cases had reached over 44 million worldwide, with more than 1.17 million confirmed deaths. Discussion: SARS-CoV-2 infected patients usually present with severe viral pneumonia. Similar to SARS-CoV, the virus enters respiratory tract cells via the angiotensinconverting enzyme receptor 2. The structural proteins play an essential role in budding the virus particles released from different host cells. To date, an approved vaccine or treatment option of a preventive character to avoid severe courses of COVID-19 is still not available. Conclusions: In the present study, we provide a brief review of the general biological features of CoVs and explain the pathogenesis, clinical symptoms and diagnostic approaches regarding monitoring future infectivity and prevent emerging COVID-19 infections.

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Section: Genomics Structure and Biological Features Of Sars‐cov‐2mentioning

confidence: 99%

Section: Pathogenesis Of Sars-cov-2mentioning

confidence: 99%

COVID‐19: Virology, biology and novel laboratory diagnosis

Mohamadian

Chiti

Shoghli

et al. 2021

The Journal of Gene Medicine

282

225

View full text Add to dashboard Cite

show abstract

“…They harbor single stranded RNA as their genetic material that has positive polarity. Some studies published during the recent pandemic of COVID-19 have provided insight into parameters pertaining to the transmission, susceptibility, clinical presentation, and laboratory findings of this potential pathogen[ 44 , 45 ]. Although respiratory droplets and contact are the prime route of transmission for SARS-CoV2, there have been some instances where prolonged exposure to aerosols with high concentrations of the virus may facilitate transmission.…”

Section: Pathophysiological Mechanisms For Gi Symtoms In Covid-19mentioning

confidence: 99%

Pathophysiological mechanisms underlying gastrointestinal symptoms in patients with COVID-19

Jin

Singh

et al. 2021

WJG

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Gastrointestinal (GI) symptoms, such as diarrhea, abdominal pain, vomiting, and anorexia, are frequently observed in patients with coronavirus disease 2019 (COVID-19). However, the pathophysiological mechanisms connecting these GI symptoms to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections remain elusive. Previous studies indicate that the entry of SARS-CoV-2 into intestinal cells leads to downregulation of angiotensin converting enzyme 2 (ACE2) receptors resulting in impaired barrier function. While intestinal ACE2 functions as a chaperone for the amino acid transporter B0AT1, the B0AT1/ACE2 complex within the intestinal epithelium acts as a regulator of gut microbiota composition and function. Alternations to the B0AT1/ACE2 complex lead to microbial dysbiosis through increased local and systemic immune responses. Previous studies have also suggested that altered serotonin metabolism may be the underlying cause of GI disorders involving diarrhea. The findings of elevated plasma serotonin levels and high fecal calprotectin in COVID-19 patients with diarrhea indicate that the viral infection evokes a systemic inflammatory response that specifically involves the GI. Interestingly, the elevated proinflammatory cytokines correlate with elevated serotonin and fecal calprotectin levels further supporting the evidence of GI inflammation, a hallmark of functional GI disorders. Moreover, the finding that rectal swabs of COVID-19 patients remain positive for SARS-CoV-2 even after the nasopharynx clears the virus, suggests that viral replication and shedding from the GI tract may be more robust than that of the respiratory tract, further indicating fecal-oral transmission as another important route of viral spread. This review summarized the evidence for pathophysiological mechanisms (impaired barrier function, gut inflammation, altered serotonin metabolism and gut microbiota dysbiosis) underlying the GI symptoms in patients with COVID-19.

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“…For further background on this novel pathogen's significant characteristics, we refer the reader to the extensive basic science literature that is readily accessible [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Incidence, Presentation, Characteristics and Short Term Outcomes of Hospitalized Pregnant Women Confirmed SARS-COV-2 Positive

Irshad¹,

Nasry²,

Ahmed³

et al. 2021

JGO

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To report the incidence, presentation, characteristics and outcomes of a cohort of hospitalized pregnant women who had tested positive for SARS-2, whether or not they had demonstrated signs of Coronavirus Disease-19 (2019-nCov, or Covid-19, ICD-10 U07.1). Material and Methods. The study includes pregnant women, 18 years old and older, who were hospitalized for evaluation or delivery and who had tested positive for SARS-CoV-2 via NP sampling. All were followed by RT PCR and NAA determination between March and December of 2020. Universal testing for SARS-CoV-2 was used throughout the study period. Maternal history and physical screening were conducted upon admission to detect any of the known variables of Covid-19, such as: fatigue, fever (38 C), shortness of breath, and cough. Chest imaging was obtained when indicated. The screening process included domestic or international travel. Additional information collected on 100% of the patients included: maternal ethnicity, body mass index, and 5-digit zip code of maternal residence. Neonates (NN) from SARS-2 positive mothers at delivery admission were tested following the Neonatology service protocol, at age 24 and 48 hours. Additional testing was performed prior to NN discharge when indicated. Results. Of the 3,109 pregnant women who were hospitalized and tested during the study period, 4.3% were reported SARS-2 positive. Of these patients, 13.6% were symptomatic for Covid-19 upon admission; 54% showed a comorbidity; 61% were obese; and one patient needed mechanical ventilation. Table 1 summarizes the cohort characteristics. Table 2 shows the characteristics of the symptomatic women and their clinical course. Conclusion. Our report describes a pregnant patient cohort that had experienced mild to moderate Covid-19 disease. Conflicting studies postulated that pregnant women exposed to SARS-CoV-2 may suffer more serious adverse effects than their non-pregnant counterparts. In view of the wide spectrum of clinical events and the variable severity reported in association with Covid-19 in pregnancy, we believe that quality big data would be beneficial. We therefore recommend strict identification of maternal ethnicity, comorbidities, timing, acuity and severity of the disease. Moreover, health care culture with accurate harmonization of clinical findings and treatments via widespread collaborative efforts, with timely reporting, may assist in understanding the variable pathophysiology of the novel SARS-CoV-2, including its variants, and their conflicting effects on pregnancy.

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Overview of the Pathogenesis and Treatment of SARS-CoV-2 for Clinicians: A Comprehensive Literature Review

Cited by 15 publications

References 51 publications

COVID‐19: Virology, biology and novel laboratory diagnosis

COVID‐19: Virology, biology and novel laboratory diagnosis

Pathophysiological mechanisms underlying gastrointestinal symptoms in patients with COVID-19

Incidence, Presentation, Characteristics and Short Term Outcomes of Hospitalized Pregnant Women Confirmed SARS-COV-2 Positive

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