ABSTRACT
The COVID-19 pandemic, caused by SARS-CoV-2 - a novel and highly infectious coronavirus, has been spreading around the world for over a year, and poses a serious threat to the public health. Numerous studies have revealed the genome, structure and replication cycle of the SARS-CoV-2 virus as well as the immune response to infection. Data from these studies provide a firm basis for the development of strategies to prevent the further spread of COVID-19, as well as to synthesize effective and safe vaccines and drugs. First and foremost, vaccines are needed to control the COVID-19 pandemic. According to data released by WHO, at the beginning of 2021 there were 63 potential vaccines under clinical examinations, and over 172 in preclinical trials. The most promising vaccines are mRNA-based: Comirnaty (Pfizer- BioNTech), COVID-19 Vaccine (Moderna/NIAID) and CVnCoV (CureVac);vector vaccines: COVID-19 Vaccine (AstraZeneca/Oxford University), Gam-COVIDVac (Gamaleja Institute, Russia) and JNJ-78436735/Ad.26.COV2.S. (Johnson & Johnson), and NVX-CoV2373 recombinant subunit vaccine (Novavax). The following groups of drugs potentially may be used in the COVID-19 therapy: Antiviral drugs with different mechanisms of action - blocking the binding of SARS-CoV-2 to its specific receptor on cell membrane (angiotensin coverting enzyme 2;ACE2) and inhibiting viral entry into host cells (umifenovir, chloroquine, hydroxychloroquine, camostat mesylate and nafamostat);drugs that inhibit viral replication (inhibitors of RNA-dependent RNA polymerase, e.g. remdesivir, favipiravir, ribovirin and molnupiravir;protease inhibitors, e.g. Kaletra);immunomodulating drugs (humanized monoclonal anticytokine antibodies, e.g. adalimumab, infliximab, tocilizumab and anakinra;JAK kinase inhibitors - ruxolitinib and baricitinib), anti-inflammatory drugs (glucocorticosteroids), and neutralizing monoclonal antibodies targeting the SARS-CoV-2 spike protein (S). Moreover, low molecular weight heparin is used for prophylactic and therapeutic purposes. © 2021 Polish Pharmaceutical Society. All rights reserved.
ABSTRACT
Coronaviruses have been known to the mankind for decades. In the past, they were thought to cause mild infections of the upper respiratory tract. The emergence at the beginning of the 21st century of two highly transmissible and pathogenic β-coronaviruses, i.e. Severe Acute Respiratory Syndrome Coronavirus (SARS- CoV) and Middle East Respiratory Syndrome Coronavirus (MERS-CoV), causing respiratory failure leading to the death of a large number of patients, highlighted a significant threat to the entire world. The 21st century has brought events at a catastrophic scale - the COVID-19 pandemic. SARS-CoV-2 virus from the Coronaviridae family responsible for the disease, appeared at the end of 2019 in Wuhan, China, and in a short time has lead to the devastation of lives of millions of people around the world. A comparison of the SARS-CoV-2 genome sequence and other available β-coronavirus genomes indicates the closest association of SARS-CoV-2 with the BatCov RaTG13 bat coronavirus strain (96% similarity). Therefore, it is suggested that SARS-CoV-2 virus may have evolved naturally from the RaTG13 virus strain transmitted by bats. The consequences of the COVID-19 pandemic include, among others, a significant number of illnesses and fatalities, inefficiency of health care systems, mental disorders and unprecedented methods of fighting the pandemic requiring closure of large sectors of the economy and a drastic reduction of interpersonal contacts. This survey presents basic information about β-coronaviruses. It also describes the course of COVID-19, taking into account a wide range of clinical symptoms from the respiratory, cardiovascular, digestive, reproductive and nervous systems, kidneys and skin. In addition, problems of mental disorders related to the current situation, both in patients and medical personnel as well as in general population, are discussed. The most common symptoms of COVID- 19 in children are presented. The article also describes methods used for a diagnosis of the SARS-CoV-2 infection, and disturbances in hematological, biochemical, hemostatic and inflammatory parameters found in COVID-19 patients, emphasizing their role as prognostic factors for the severity of the disease. © 2021 Polish Pharmaceutical Society. All rights reserved.