COVID-19 AND SARS-COV-2: WHAT WE KNOW SO FAR

Main Article Content

Beenish Khurshid
Saira Farman
Zahida Parveen
Mohammad Assad
Umia Shams
Nosheen Faiz

Keywords

COVID-19, SARS-CoV-2, Pandemic, Vaccines, Virus

Abstract

Currently, more than 500 million individuals have been infected with SARS-CoV-2 and more than 6 million have died from this deadly virus in 222 countries. This mini-review sheds light on some of the important aspects of COVID-19 disease and the information that the researchers have gathered so far regarding epidemiology, virology, pathogenesis, diagnosis, treatment, variants of concerns, and vaccine development. We also summarize the timeline for the development of the disease and milestones achieved so far so that the readers can grasp the timing of some of these critical events. Notables are the rapid development and regulatory approval of diagnostics, antiviral medicines, and vaccines within a year of the virus's discovery. Because the development of understanding the mechanism of this viral infection and drug design occurred concurrently, we provide a chronology to help readers understand the progression of research findings as well as their interpretation. Scientists from across the globe are collaborating to combat this pandemic. This analysis also identifies future directions for research and development in these areas.

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References

1. WHO. Novel Coronavirus (2019-nCoV) SITUATION REPORT - 1. (2020).
2. Petrosillo, N., Viceconte, G., Ergonul, O., Ippolito, G. & Petersen, E. COVID-19, SARS and MERS: are they closely related? Clin. Microbiol. Infect. 26, 729 (2020).
3. WHO Coronavirus (COVID-19) Dashboard | WHO Coronavirus (COVID-19) Dashboard With Vaccination Data. Available at: https://covid19.who.int/. (Accessed: 19th April 2022)
4. Pakistan: WHO Coronavirus Disease (COVID-19) Dashboard With Vaccination Data | WHO Coronavirus (COVID-19) Dashboard With Vaccination Data. Available at: https://covid19.who.int/region/emro/country/pk. (Accessed: 04th September 2022)
5. UNICEF. Children and COVID-19 | UNICEF South Asia. (2021). Available at: https://www.unicef.org/rosa/stories/children-and-covid-19. (Accessed: 13th November 2021)
6. Dong, E., Du, H. & Gardner, L. An interactive web-based dashboard to track COVID-19 in real time. Lancet Infect. Dis. 20, 533–534 (2020).
7. Gorbalenya, A. E. et al. The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat. Microbiol. 5, 536 (2020).
8. Guimarães, P. O. et al. Features, Evaluation, and Treatment of Coronavirus (COVID-19). N. Engl. J. Med. 385, 406–415 (2021).
9. Li, F. Structure, Function, and Evolution of Coronavirus Spike Proteins.
http://dx.doi.org/10.1146/annurev-virology-110615-042301 3, 237–261 (2016).
10. Huang, Y., Yang, C., Xu, X. feng, Xu, W. & Liu, S. wen. Structural and functional properties of SARS-CoV-2 spike protein: potential antivirus drug development for COVID-19. Acta Pharmacol. Sin. 2020 419 41, 1141–1149 (2020).
11. Biorender. Untitled. (2021). Available at: https://app.biorender.com/biorender-templates. (Accessed: 24th November 2021)
12. Hu, B., Ge, X., Wang, L. F. & Shi, Z. Bat origin of human coronaviruses Coronaviruses: Emerging and re-emerging pathogens in humans and animals Susanna Lau Positive-strand RNA viruses. Virol. J. 12, 1–10 (2015).
13. Czubak, J., Stolarczyk, K., Orzel, A., Frączek, M. & Zatoński, T. Comparison of the clinical differences between COVID-19, SARS, influenza, and the common cold: A systematic literature review. Adv. Clin. Exp. Med. 30, 109–114 (2021).
14. Huang, C. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 395, 497–506 (2020).
15. Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected. Interim guidance. Pediatria i Medycyna Rodzinna (2020).
doi:10.15557/PiMR.2020.0003
16. World Health Organization Europe (WHO Europe). Transmission of SARS-CoV-2: implications for infection prevention precautions. Scientific brief, 09 July 2020. Who (2020).
17. Lee, S. et al. Clinical Course and Molecular Viral Shedding among Asymptomatic and Symptomatic Patients with SARS-CoV-2 Infection in a Community Treatment Center in the Republic of Korea. JAMA Intern. Med. (2020). doi:10.1001/jamainternmed.2020.3862
18. van Doremalen, N. et al. Aerosol and surface stability of HCoV-19 (SARS-CoV-2) compared to SARS-CoV-1. medRxiv Prepr. Serv. Heal. Sci. (2020). doi:10.1101/2020.03.09.20033217
19. Vivanti, A. J. et al. Transplacental transmission of SARS-CoV-2 infection. Nat. Commun. (2020). doi:10.1038/s41467-020-17436-6
20. Makarov, V., Riabova, O., Ekins, S., Pluzhnikov, N. & Chepur, S. Similarities and Differences Between Flu and COVID-19. Pathogens and Disease (2020).
21. Cai, Y. et al. Distinct conformational states of SARS-CoV-2 spike protein. Science (80-. ). (2020). doi:10.1126/science.abd4251
22. Yan, R. et al. Structural basis for the recognition of SARS-CoV-2 by full-length human ACE2. Science (80-. ). (2020). doi:10.1126/science.abb2762
23. Xu, X. et al. Evolution of the novel coronavirus from the ongoing Wuhan outbreak and modeling of its spike protein for risk of human transmission. Science China Life Sciences (2020). doi:10.1007/s11427-020-1637-5
24. Padhan, K., Parvez, M. K. & Al-Dosari, M. S. Comparative sequence analysis of SARS-CoV-2 suggests its high transmissibility and pathogenicity. Future Virol. (2021). doi:10.2217/fvl-2020-0204
25. Zhou, P. et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature (2020). doi:10.1038/s41586-020-2012-7
26. Wrapp, D. et al. Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation. Science (80-. ). (2020). doi:10.1126/science.aax0902
27. Bertram, S. et al. Influenza and SARS-coronavirus activating proteases TMPRSS2 and HAT are expressed at multiple sites in human respiratory and gastrointestinal tracts. PLoS One (2012). doi:10.1371/journal.pone.0035876
28. Breining, P. et al. Camostat mesylate against SARS-CoV-2 and COVID-19—Rationale, dosing and safety. Basic Clin. Pharmacol. Toxicol. (2021). doi:10.1111/bcpt.13533
29. Islam, M. A. et al. Prevalence and characteristics of fever in adult and paediatric patients with coronavirus disease 2019 (COVID-19): A systematic review and meta-analysis of 17515 patients. PLoS One (2021). doi:10.1371/journal.pone.0249788
30. Saniasiaya, J., Islam, M. A. & Abdullah, B. Prevalence and Characteristics of Taste Disorders in Cases of COVID-19: A Meta-analysis of 29,349 Patients. Otolaryngology - Head and Neck Surgery (United States) (2021). doi:10.1177/0194599820981018
31. Shoer, S. et al. Who should we test for COVID-19? A triage model built from national symptom surveys. medRxiv (2020). doi:10.1101/2020.05.18.20105569
32. Menni, C. et al. Real-time tracking of self-reported symptoms to predict potential COVID-19. Nat. Med. (2020). doi:10.1038/s41591-020-0916-2
33. Bajema, K. L. et al. Persons Evaluated for 2019 Novel Coronavirus — United States, January 2020. MMWR. Morb. Mortal. Wkly. Rep. (2020). doi:10.15585/mmwr.mm6906e1
34. Alqahtani, J. S. et al. Prevalence, severity and mortality associated with COPD and smoking in patients with COVID-19: A rapid systematic review and meta-analysis. PLoS ONE (2020). doi:10.1371/journal.pone.0233147
35. Fang, L., Karakiulakis, G. & Roth, M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? The Lancet Respiratory Medicine (2020). doi:10.1016/S2213-2600(20)30116-8
36. Shah, S. et al. Elevated D-dimer levels are associated with increased risk of mortality in COVID-19: A systematic review and meta-analysis. medRxiv (2020). doi:10.1101/2020.04.29.20085407
37. Russell, B. et al. Risk of COVID-19 death in cancer patients: an analysis from Guy’s Cancer Centre and King’s College Hospital in London. Br. J. Cancer (2021). doi:10.1038/s41416-021-01500-z
38. Cecconi, M. et al. Early predictors of clinical deterioration in a cohort of 239 patients hospitalized for Covid-19 infection in Lombardy, Italy. J. Clin. Med. (2020). doi:10.3390/jcm9051548
39. Imam, Z. et al. Older age and comorbidity are independent mortality predictors in a large cohort of 1305 COVID-19 patients in Michigan, United States. J. Intern. Med. (2020). doi:10.1111/joim.13119
40. CDC. COVID-19 Provisional Counts - Weekly Updates by Select Demographic and Geographic Characteristics. (2021). Available at:
https://www.cdc.gov/nchs/nvss/vsrr/covid_weekly/index.htm. (Accessed: 26th November 2021)
41. Peckham, H. et al. Male sex identified by global COVID-19 meta-analysis as a risk factor for death and ITU admission. Nat. Commun. (2020). doi:10.1038/s41467-020-19741-6
42. Duarte-Salles, T. et al. Thirty-day outcomes of children and adolescents with COVID-19: An international experience. Pediatrics (2021). doi:10.1542/peds.2020-042929
43. Shane, A. L. et al. A pediatric infectious diseases perspective of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and novel coronavirus disease 2019 (COVID-19) in children. Journal of the Pediatric Infectious Diseases Society (2020).
doi:10.1093/JPIDS/PIAA099
44. Bialek, S. et al. Coronavirus Disease 2019 in Children — United States, February 12–April 2, 2020. MMWR. Morb. Mortal. Wkly. Rep. (2020). doi:10.15585/mmwr.mm6914e4
45. Hasan, M. R. et al. Nasopharyngeal Expression of Angiotensin-Converting Enzyme 2 and Transmembrane Serine Protease 2 in Children within SARS-CoV-2-Infected Family Clusters. Microbiol. Spectr. (2021). doi:10.1128/spectrum.00783-21
46. Allotey, J. et al. Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: Living systematic review and meta-analysis. BMJ (2020). doi:10.1136/bmj.m3320
47. WHO. Increasing understanding of the impact of COVID-19 for pregnant women and their babies. (2020). Available at: https://www.who.int/news/item/01-09-2020-increasing-understanding-of-the-impact-of-covid-19-for-pregnant-women-and-their-babies. (Accessed: 26th November 2021)
48. Van Der Meer, A. J. et al. Association between sustained virological response and all-cause mortality among patients with chronic hepatitis C and advanced hepatic fibrosis. JAMA - J. Am. Med. Assoc. (2012). doi:10.1001/jama.2012.144878
49. Zhang, C. H. et al. Potent Noncovalent Inhibitors of the Main Protease of SARS-CoV-2 from Molecular Sculpting of the Drug Perampanel Guided by Free Energy Perturbation Calculations. ACS Cent. Sci. (2021). doi:10.1021/acscentsci.1c00039
50. More Than 11.4 Billion Shots Given: Covid-19 Vaccine Tracker. Available at:
https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/. (Accessed: 18th April 2022)
51. Pakistan – COVID19 Vaccine Tracker. Available at:
https://covid19.trackvaccines.org/country/pakistan/. (Accessed: 18th April 2022)
52. The COVID-19 vaccine race | Gavi, the Vaccine Alliance. Available at:
https://www.gavi.org/vaccineswork/covid-19-vaccine-race. (Accessed: 18th April 2022)
53. Pfizer-BioNTech COVID-19 Vaccine COMIRNATY® Receives Full U.S. FDA Approval for Individuals 16 Years and Older | Business Wire. Available at:
https://www.businesswire.com/news/home/20210823005499/en/. (Accessed: 18th April 2022)
54. FDA. Moderna COVID-19 Vaccine | FDA. (2021). Available at:
https://www.fda.gov/emergency-preparedness-and-response/coronavirus-disease-2019-covid-19/moderna-covid-19-vaccine. (Accessed: 23rd November 2021)
55. AstraZeneca Vaccine Is Safe, Europe’s Drug Regulator Says - The New York Times. Available at: https://www.nytimes.com/2021/03/18/world/europe/astrazeneca-vaccine-europe.html. (Accessed: 26th November 2021)
56. Logunov, D. Y. et al. Safety and efficacy of an rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine: an interim analysis of a randomised controlled phase 3 trial in Russia. Lancet (2021). doi:10.1016/S0140-6736(21)00234-8
57. RDIF. Combination of the first component of Sputnik V vaccine (Sputnik Light vaccine) with vaccines by AstraZeneca, Sinopharm and Moderna demonstrates high safety profile during the study in Argentina’s Buenos-Aires province | Russian Direct Investment Fund. (2021). Available at: https://rdif.ru/Eng_fullNews/7035/. (Accessed: 26th November 2021)
58. Janssen Pharmaceutical Companies. COVID-19 Vaccine Janssen. Agencia Española Medicam. y Prod. Sanit. 10 (2021).
59. World Health Organization Europe (WHO Europe). WHO approves Sinovac coronavirus vaccine for emergency use, second Chinese treatment to win designation | South China Morning Post. (2021). Available at:
https://www.scmp.com/news/china/science/article/3135677/who-approves-sinovac-biotechs-covid-19-vaccine-emergency-use. (Accessed: 2nd December 2021)
60. Ryzhikov, A. B. et al. Immunogenicity and protectivity of the peptide vaccine against SARS-CoV-2. Vestn. Ross. Akad. Meditsinskikh Nauk (2021). doi:10.15690/vramn1528
61. Zhu, F. C. et al. Immunogenicity and safety of a recombinant adenovirus type-5-vectored COVID-19 vaccine in healthy adults aged 18 years or older: a randomised, double-blind, placebo-controlled, phase 2 trial. Lancet (2020). doi:10.1016/S0140-6736(20)31605-6
62. BIONTECH. Pfizer and BioNTech Conclude Phase 3 Study of COVID-19 Vaccine Candidate, Meeting All Primary Efficacy Endpoints | BioNTech. Available at:
https://investors.biontech.de/news-releases/news-release-details/pfizer-and-biontech-conclude-phase-3-study-covid-19-vaccine/. (Accessed: 23rd November 2021)
63. FDA. FDA Takes Key Action in Fight Against COVID-19 By Issuing Emergency Use Authorization for First COVID-19 Vaccine | FDA. (2020). Available at:
https://www.fda.gov/news-events/press-announcements/fda-takes-key-action-fight-against-covid-19-issuing-emergency-use-authorization-first-covid-19. (Accessed: 23rd November 2021)
64. Pfizer. Pfizer and BioNTech Announce Positive Topline Results From Pivotal Trial of COVID-19 Vaccine in Children 5 to 11 Years | Pfizer. Available at: https://www.pfizer.com/news/press-release/press-release-detail/pfizer-and-biontech-announce-positive-topline-results. (Accessed: 23rd November 2021)
65. BioNTech. Pfizer and BioNTech Provide Update on Booster Program in Light of the Delta-Variant | BioNTech. (2021). Available at: https://investors.biontech.de/news-releases/news-release-details/pfizer-and-biontech-provide-update-booster-program-light-delta. (Accessed: 23rd November 2021)
66. El Sahly, H. M. et al. Efficacy of the mRNA-1273 SARS-CoV-2 Vaccine at Completion of Blinded Phase. N. Engl. J. Med. (2021). doi:10.1056/nejmoa2113017
67. Kozlov, M. What COVID vaccines for young kids could mean for the pandemic. Nature 599, 18–19 (2021).
68. The New york times. Coronavirus Vaccine Tracker. (2021). Available at:
https://www.nytimes.com/interactive/2020/science/coronavirus-vaccine-tracker.html. (Accessed: 15th November 2021)
69. WHO. Interim Recommendations For Use Of The Moderna Mrna-1273 Vaccine Against COVID-19. World Heal. Organ. (2021).
70. Tukhvatulin, A. I. et al. An Open, Non-Randomised, 1/2 Phase Study on the Safety, Tolerability, and Immunogenicity of Single Dose ‘Sputnik Light’ Vaccine for Prevention of Coronavirus Infection in Healthy Adults. SSRN Electron. J. (2021). doi:10.2139/ssrn.3886430
71. RDIF. The world’s first study of a combination between the AstraZeneca vaccine and the first component of the Sputnik V vaccine (Sputnik Light) in Azerbaijan shows no serious adverse events or COVID infection cases following the vaccination | Russian Direct Inv. (2021).
72. Dolzhikova, I. V et al. One-shot immunization with Sputnik Light (the first component of Sputnik V vaccine) is effective against SARS-CoV-2 Delta variant: efficacy data on the use of the vaccine in civil circulation in Moscow. medRxiv 2021.10.08.21264715 (2021).
doi:10.1101/2021.10.08.21264715
73. University of Oxford. Oxford vaccine reaches one billion doses released | University of Oxford. (2021). Available at: https://www.ox.ac.uk/news/2021-07-29-oxford-vaccine-reaches-one-billion-doses-released. (Accessed: 26th November 2021)
74. University of Oxford. Oxford University extends COVID-19 vaccine study to children University of Oxford. (2021). Available at: https://www.ox.ac.uk/news/2021-02-12-oxford-university-extends-covid-19-vaccine-study-children. (Accessed: 26th November 2021)
75. RDIF. A clinical study of the combination of AstraZeneca and Sputnik Light vaccines in Azerbaijan shows strong neutralizing antibodies growth in the majority of participants | Russian Direct Investment Fund. (2021). Available at: https://rdif.ru/Eng_fullNews/7111/. (Accessed: 26th November 2021)
76. Mendonça, S. A., Lorincz, R., Boucher, P. & Curiel, D. T. Adenoviral vector vaccine platforms in the SARS-CoV-2 pandemic. npj Vaccines (2021). doi:10.1038/s41541-021-00356-x
77. Dania Nadeem, C. O. Novavax vaccine 96% effective against original coronavirus, 86% vs British variant in UK trial | Reuters. (2021). Available at: https://www.reuters.com/article/us-health-coronavirus-vaccines-novavax/novavax-vaccine-96-effective-against-original-coronavirus-86-vs-british-variant-in-uk-trial-idUSKBN2B32ZO. (Accessed: 2nd December 2021)
78. Zhang, Y. et al. Safety, tolerability, and immunogenicity of an inactivated SARS-CoV-2 vaccine in healthy adults aged 18–59 years: a randomised, double-blind, placebo-controlled, phase 1/2 clinical trial. Lancet Infect. Dis. 21, 181–192 (2021).
79. Lakner, Christoph & Mahler, Daniel & Negre, Mario & Prydz, E. How Much Does Reducing Inequality Matter for Global Poverty? (2020). doi:10.1596/33902
80. Steinman, J. B., Lum, F. M., Ho, P. P. K., Kaminski, N. & Steinman, L. Reduced development of COVID-19 in children reveals molecular checkpoints gating pathogenesis illuminating potential therapeutics. Proceedings of the National Academy of Sciences of the United States of America (2020). doi:10.1073/pnas.2012358117

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