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1.
Biomed Pharmacother ; 150: 113041, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1821148

ABSTRACT

BACKGROUND: Lung diseases including chronic obstructive pulmonary disease (COPD), infections like influenza, acute respiratory distress syndrome (ARDS), asthma and pneumonia lung cancer (LC) are common causes of sickness and death worldwide due to their remoteness, cold and harsh climatic conditions, and inaccessible health care facilities. PURPOSE: Many drugs have already been proposed for the treatment of lung diseases. Few of them are in clinical trials and have the potential to cure infectious diseases. Plant extracts or herbal products have been extensively used as Traditional Chinese Medicine (TCM) and Indian Ayurveda. Moreover, it has been involved in the inhibition of certain genes/protiens effects to promote regulation of signaling pathways. Natural remedies have been scientifically proven with remarkable bioactivities and are considered a cheap and safe source for lung disease. METHODS: This comprehensive review highlighted the literature about traditional plants and their metabolites with their applications for the treatment of lung diseases through experimental models in humans. Natural drugs information and mode of mechanism have been studied through the literature retrieved by Google Scholar, ScienceDirect, SciFinder, Scopus and Medline PubMed resources against lung diseases. RESULTS: In vitro, in vivo and computational studies have been explained for natural metabolites derived from plants (like flavonoids, alkaloids, and terpenoids) against different types of lung diseases. Probiotics have also been biologically active therapeutics against cancer, anti-inflammation, antiplatelet, antiviral, and antioxidants associated with lung diseases. CONCLUSION: The results of the mentioned natural metabolites repurposed for different lung diseases especially for SARS-CoV-2 should be evaluated more by advance computational applications, experimental models in the biological system, also need to be validated by clinical trials so that we may be able to retrieve potential drugs for most challenging lung diseases especially SARS-CoV-2.


Subject(s)
COVID-19 , Lung Diseases , COVID-19/drug therapy , Dietary Supplements , Humans , Lung Diseases/drug therapy , Medicine, Chinese Traditional , Phytochemicals/pharmacology , Phytochemicals/therapeutic use , Phytotherapy , Plant Extracts/pharmacology , SARS-CoV-2
2.
Biomed Pharmacother ; 147: 112700, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1664683

ABSTRACT

Coronavirus disease 2019 (COVID-19) represents an unmet clinical need, due to a high mortality rate, rapid mutation rate in the virus, increased chances of reinfection, lack of effectiveness of repurposed drugs and economic damage. COVID-19 pandemic has created an urgent need for effective molecules. Clinically proven efficacy and safety profiles have made favipiravir (FVP) and remdesivir (RDV) promising therapeutic options for use against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Even though both are prodrug molecules with an antiviral role based on a similar mechanism of action, differences in pharmacological, pharmacokinetic and pharmacotoxicological mechanisms have been identified. The present study aims to provide a comprehensive comparative assessment of FVP and RDV against SARS-CoV-2 infections, by centralizing medical data provided by significant literature and authorized clinical trials, focusing on the importance of a better understanding of the interactions between drug molecules and infectious agents in order to improve the global management of COVID-19 patients and to reduce the risk of antiviral resistance.


Subject(s)
Adenosine Monophosphate/analogs & derivatives , Alanine/analogs & derivatives , Amides/therapeutic use , Antiviral Agents/therapeutic use , COVID-19/drug therapy , Pyrazines/therapeutic use , Adenosine Monophosphate/therapeutic use , Alanine/therapeutic use , Humans , SARS-CoV-2
3.
Front Pharmacol ; 12: 652335, 2021.
Article in English | MEDLINE | ID: covidwho-1526785

ABSTRACT

COVID-19 is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has a disastrous effect on mankind due to the contagious and rapid nature of its spread. Although vaccines for SARS-CoV-2 have been successfully developed, the proven, effective, and specific therapeutic molecules are yet to be identified for the treatment. The repurposing of existing drugs and recognition of new medicines are continuously in progress. Efforts are being made to single out plant-based novel therapeutic compounds. As a result, some of these biomolecules are in their testing phase. During these efforts, the whole-genome sequencing of SARS-CoV-2 has given the direction to explore the omics systems and approaches to overcome this unprecedented health challenge globally. Genome, proteome, and metagenome sequence analyses have helped identify virus nature, thereby assisting in understanding the molecular mechanism, structural understanding, and disease propagation. The multi-omics approaches offer various tools and strategies for identifying potential therapeutic biomolecules for COVID-19 and exploring the plants producing biomolecules that can be used as biopharmaceutical products. This review explores the available multi-omics approaches and their scope to investigate the therapeutic promises of plant-based biomolecules in treating SARS-CoV-2 infection.

4.
Environ Sci Pollut Res Int ; 29(8): 12336-12346, 2022 Feb.
Article in English | MEDLINE | ID: covidwho-1437316

ABSTRACT

Coronavirus disease (COVID-19) is an emerging pandemic that threatens the world since the early days of 2020. Development of vaccines or new drugs against COVID-19 comprises several stages of investigation including efficacy, safety, and approval studies. A shortcut to this delicate pathway is computational-based analysis of FDA-approved drugs against assigned molecular targets of the coronavirus. In this study, we virtually screened a library of FDA-approved drugs prescribed for different therapeutic purposes against versatile COVID-19 specific proteins which are crucial for the virus life cycle. Three antibiotics in our screening polymyxin B, bafilomycin A, and rifampicin show motivating binding stability with more than one target of the virus. Another category of tested drugs is oral antiseptics of mouth rinsing solutions that unexpectedly exhibited significant affinity to the target proteins employed by the virus for attachment and cell internalization. Other OTC drugs widely used and tested in our study are heartburn drugs and they show no significant binding. We tested also some other drugs falling under the scope of investigation regarding interference with a degree of severity of COVID-19 like angiotensin II blockers used as antihypertensive, and our study suggests a therapeutic rather than predisposing effect of these drugs against COVID-19.


Subject(s)
COVID-19 , Pharmaceutical Preparations , Antiviral Agents/pharmacology , Drug Repositioning , Humans , Molecular Docking Simulation , SARS-CoV-2
5.
Biomedicines ; 9(9)2021 Sep 18.
Article in English | MEDLINE | ID: covidwho-1430776

ABSTRACT

The worldwide transmission of acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as a deadly or devastating disease is known to affect thousands of people every day, many of them dying all over the planet. The main reason for the massive effect of COVID-19 on society is its unpredictable spread, which does not allow for proper planning or management of this disease. Antibiotics, antivirals, and other prescription drugs, necessary and used in therapy, obviously have side effects (minor or significant) on the affected person, there are still not clear enough studies to elucidate their combined effect in this specific treatment, and existing protocols are sometimes unclear and uncertain. In contrast, it has been found that nutraceuticals, supplements, and various herbs can be effective in reducing the chances of SARS-CoV-2 infection, but also in alleviating COVID-19 symptoms. However, not enough specific details are yet available, and precise scientific studies to validate the approved benefits of natural food additives, probiotics, herbs, and nutraceuticals will need to be standardized according to current regulations. These alternative treatments may not have a direct effect on the virus or reduce the risk of infection with it, but these products certainly stimulate the human immune system so that the body is better prepared to fight the disease. This paper aims at a specialized literary foray precisely in the field of these "cures" that can provide real revelations in the therapy of coronavirus infection.

6.
Environ Sci Pollut Res Int ; 28(38): 52599-52609, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1408891
7.
Inflammopharmacology ; 29(5): 1331-1346, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1333093

ABSTRACT

The pandemic coronavirus disease 2019 (COVID-19) is instigated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that is mainly transmitted via the inhalation route and characterized by fever, coughing and shortness of breath. COVID-19 affects all age groups with no single cure. The drug discovery, manufacturing, and safety studies require extensive time and sources and, therefore, struggled to match the exponential spread of COVID-19. Yet, various repurposed drugs (antivirals, immune-modulators, nucleotide analogues), and convalescent plasma therapy have been authorized for emergency use against COVID-19 by Food and Drug Administration under certain limits and conditions. The discovery of vaccine is the biggest milestone achieved during the current pandemic era. About nine vaccines were developed for human use with varying claims of efficacy. The rapid emergence of mutations in SARS-CoV-2, suspected adverse drug reactions of current therapies in special population groups and limited availability of drugs in developing countries necessitate the development of more efficacious, safe and cheap drugs/vaccines for treatment and prevention of COVID-19. Keeping in view these limitations, the current review provides an update on the efficacy and safety of the repurposed, and natural drugs to treat COVID-19 as well as the vaccines used for its prophylaxis.


Subject(s)
COVID-19 Vaccines/immunology , COVID-19 Vaccines/therapeutic use , COVID-19/immunology , COVID-19/therapy , Drug Repositioning/trends , Angiotensin-Converting Enzyme 2/antagonists & inhibitors , Angiotensin-Converting Enzyme 2/immunology , Animals , Antiviral Agents/immunology , Antiviral Agents/therapeutic use , Biological Products/immunology , Biological Products/therapeutic use , COVID-19/epidemiology , Drug Repositioning/methods , Humans , Immunization, Passive , Immunologic Factors/immunology , Immunologic Factors/therapeutic use
8.
Environ Sci Pollut Res Int ; 28(33): 44812-44817, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1303355

ABSTRACT

The infectiousness of COVID-19 is high among the susceptible population, making the calculation of the reproduction number (R) an essential step to implement preventive measures. We aim to estimate COVID-19 transmission to determine if the disease is successfully controlled or extra measured should be adopted to attain this goal. The daily incidence data of COVID-19 in Saudi Arabia from March 2nd, 2020, to April 4th, 2021, were obtained from the continuously updated Saudi Ministry of Health COVID-19 repository. To get accurate estimation of the situation over the last 4 months (from December 1st, 2020, to April 4th, 2021), we calculated the weekly (every 7 days) R starting from March 2nd, 2020, and till the last week of the available data. The calculated values of R were represented as median, first quantile (Q1), and third quantile (Q3). As early as the first week of December 2020, the median R was 0.81 (0.80-0.83) which means that each existing infected case would transmit infection to only one person. This was followed by fluctuations over the next few weeks around R value of 1, reaching its highest level of 1.45 (1.42-1.47) between December 31st, 2020, and January 6th, 2021. This was followed by a relatively steady decline over the following weeks, with some till mid-March where the R values started to slightly rise again. Social distancing, protective precautions, avoiding abuse of the partial lifting, expanding the screening process, and other Saudi measures sound to be successful and should be replicated in similar communities. This measure should be continued till the vaccination process is completed, to reduce the number of contacts and to avoid uncontrolled transmission of the disease.


Subject(s)
COVID-19 , Humans , Reproduction , SARS-CoV-2 , Saudi Arabia
9.
Environ Sci Pollut Res Int ; 28(44): 62266-62273, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1286177

ABSTRACT

We conducted the current analysis to determine the potential role of measles vaccination in the context of the spread of COVID-19. Data were extracted from the World Health Organization's (WHO) Global Health Observatory data repository about the measles immunization coverage estimates and correlated to overall morbidity and mortality for COVID-19 among different countries. Data were statistically analyzed to calculate the Spearman rank correlation coefficient (rho). There was a significant positive correlation between the vaccine coverage (%) and new cases per one million populations (rho = 0.24; p-value = 0.025); however, this correlation was absent in deaths per one million populations (rho = 0.17; p-value = 0.124). On further analysis of the effect of first reported year of vaccination policy, there was no significant correlation with both of total cases per one million populations (rho = 0.11; p-value = 0.327) and deaths per one million populations (rho = -0.02; p-value = 0.829). Claims regarding the possible protective effect of measles vaccination seem to be doubtful.


Subject(s)
COVID-19 , Measles , Epidemiologic Studies , Humans , Infant , Measles/epidemiology , Measles/prevention & control , Morbidity , SARS-CoV-2 , Vaccination , Vaccination Coverage
11.
Mar Drugs ; 19(5)2021 Apr 24.
Article in English | MEDLINE | ID: covidwho-1244064

ABSTRACT

Cyanobacteria are photosynthetic prokaryotic organisms which represent a significant source of novel, bioactive, secondary metabolites, and they are also considered an abundant source of bioactive compounds/drugs, such as dolastatin, cryptophycin 1, curacin toyocamycin, phytoalexin, cyanovirin-N and phycocyanin. Some of these compounds have displayed promising results in successful Phase I, II, III and IV clinical trials. Additionally, the cyanobacterial compounds applied to medical research have demonstrated an exciting future with great potential to be developed into new medicines. Most of these compounds have exhibited strong pharmacological activities, including neurotoxicity, cytotoxicity and antiviral activity against HCMV, HSV-1, HHV-6 and HIV-1, so these metabolites could be promising candidates for COVID-19 treatment. Therefore, the effective large-scale production of natural marine products through synthesis is important for resolving the existing issues associated with chemical isolation, including small yields, and may be necessary to better investigate their biological activities. Herein, we highlight the total synthesized and stereochemical determinations of the cyanobacterial bioactive compounds. Furthermore, this review primarily focuses on the biotechnological applications of cyanobacteria, including applications as cosmetics, food supplements, and the nanobiotechnological applications of cyanobacterial bioactive compounds in potential medicinal applications for various human diseases are discussed.


Subject(s)
Antiviral Agents/pharmacology , COVID-19/drug therapy , COVID-19/virology , Cyanobacteria/chemistry , Cyanobacteria/physiology , SARS-CoV-2 , Antiviral Agents/chemistry , Aquatic Organisms , Humans
12.
Int J Environ Res Public Health ; 18(11)2021 05 25.
Article in English | MEDLINE | ID: covidwho-1244014

ABSTRACT

The COVID-19 pandemic is a serious challenge for societies around the globe as entire populations have fallen victim to the infectious spread and have taken up social distancing. In many countries, people have had to self-isolate and to be confined to their homes for several weeks to months to prevent the spread of the virus. Social distancing measures have had both negative and positive impacts on various aspects of economies, lifestyles, education, transportation, food supply, health, social life, and mental wellbeing. On other hands, due to reduced population movements and the decline in human activities, gas emissions decreased and the ozone layer improved; this had a positive impact on Earth's weather and environment. Overall, the COVID-19 pandemic has negative effects on human activities and positive impacts on nature. This study discusses the impact of the COVID-19 pandemic on different life aspects including the economy, social life, health, education, and the environment.


Subject(s)
COVID-19 , Pandemics , Humans , Physical Distancing , SARS-CoV-2
13.
Environ Sci Pollut Res Int ; 28(23): 28825-28830, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1217461
14.
Environ Sci Pollut Res Int ; 28(30): 40507-40514, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1209354

ABSTRACT

After the early advent of the Coronavirus Disease 2019 (COVID-19) pandemic, myriads of FDA-approved drugs have been massively repurposed for COVID-19 treatment based on molecular docking against selected protein targets that play fundamental roles in the replication cycle of the novel coronavirus. Honeybee products are well known of their nutritional values and medicinal effects. Bee products contain bioactive compounds in the form of a collection of phenolic acids, flavonoids, and terpenes of natural origin that display wide spectrum antiviral effects. We revealed by molecular docking the profound binding affinity of 14 selected phenolics and terpenes present in honey and propolis (bees glue) against the main protease (Mpro) and RNA-dependent RNA polymerase (RdRp) enzymes of the novel SARS-CoV-2 virus (the causative agent of COVID-19) using AutoDock Vina software. Of these compounds, p-coumaric acid, ellagic acid, kaempferol, and quercetin have the strongest interaction with the SARS-CoV-2 target enzymes, and it may be considered an effective COVID-19 inhibitor.


Subject(s)
COVID-19 , Coronavirus Infections , Animals , Antiviral Agents/pharmacology , Bees , COVID-19/drug therapy , Coronavirus Infections/drug therapy , Humans , Molecular Docking Simulation , SARS-CoV-2
15.
Environ Sci Pollut Res Int ; 28(30): 40496-40506, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1173977

ABSTRACT

COVID-19 was first discovered in Wuhan, China in December 2019. It is one of the worst pandemics in human history. Recent studies reported that COVID-19 is transmitted among humans by droplet infection or direct contact. COVID-19 pandemic has invaded more than 210 countries around the world and as of February 18th, 2021, just after a year has passed, a total of 110,533,973 confirmed cases of COVID-19 were reported and its death toll reached about 2,443,091. COVID-19 is a new member of the family of corona viruses, its nature, behaviour, transmission, spread, prevention, and treatment are to be investigated. Generally, a huge amount of data is accumulating regarding the COVID-19 pandemic, which makes hot research topics for machine learning researchers. However, the panicked world's population is asking when the COVID-19 will be over? This study considered machine learning approaches to predict the spread of the COVID-19 in many countries. The experimental results of the proposed model showed that the overall R2 is 0.99 from the perspective of confirmed cases. A machine learning model has been developed to predict the estimation of the spread of the COVID-19 infection in many countries and the expected period after which the virus can be stopped. Globally, our results forecasted that the COVID-19 infections will greatly decline during the first week of September 2021 when it will be going to an end shortly afterward.


Subject(s)
COVID-19 , Pandemics , Forecasting , Humans , Machine Learning , SARS-CoV-2
16.
BMJ Open ; 11(2): e043971, 2021 02 23.
Article in English | MEDLINE | ID: covidwho-1150232

ABSTRACT

OBJECTIVE: The adherence to public health recommendations to control COVID-19 spread is influenced by public knowledge, attitudes and practices (KAP). We performed this cross-sectional study to assess the levels and determinants of public KAP towards COVID-19 in a large, multinational sample. DESIGN: Cross-sectional study (survey). SETTING: The questionnaire was distributed to potential respondents via online platforms. PARTICIPANTS: 71 890 individuals from 22 countries. METHODS: We formulated a four-section questionnaire in English, followed by validation and translation into seven languages. The questionnaire was distributed (May to June 2020) and each participant received a score for each KAP section. RESULTS: Overall, the participants had fair knowledge (mean score: 19.24±3.59) and attitudes (3.72±2.31) and good practices (12.12±1.83) regarding COVID-19. About 92% reported moderate to high compliance with national lockdown. However, significant gaps were observed: only 68.2% knew that infected individuals may be asymptomatic; 45.4% believed that antibiotics are an effective treatment; and 55.4% stated that a vaccine has been developed (at the time of data collection). 71.9% believed or were uncertain that COVID-19 is a global conspiracy; 36.8% and 51% were afraid of contacting doctors and Chinese people, respectively. Further, 66.4% reported the pandemic had moderate to high negative effects on their mental health. Female gender, higher education and urban residents had significantly (p≤0.001) higher knowledge and practice scores. Further, we observed significant correlations between all KAP scores. CONCLUSIONS: Although the public have fair/good knowledge and practices regarding COVID-19, significant gaps should be addressed. Future awareness efforts should target less advantaged groups and future studies should develop new strategies to tackle COVID-19 negative mental health effects.


Subject(s)
COVID-19 , Adult , Communicable Disease Control , Cross-Sectional Studies , Female , Health Knowledge, Attitudes, Practice , Humans , Male , Middle Aged , SARS-CoV-2 , Surveys and Questionnaires
17.
Environ Sci Pollut Res Int ; 28(26): 34611-34618, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1111322

ABSTRACT

We conducted the current analysis to determine the potential role of polio vaccination in the context of the spread of COVID-19. Data were extracted from the World Health Organization's (WHO) Global Health Observatory data repository regarding the polio immunization coverage estimates and correlated to the overall morbidity and mortality for COVID-19 among different countries. Data were analyzed using R software version 4.0.2. Mean and standard deviation were used to represent continuous variables while we used frequencies and percentages to represent categorical variables. The Kruskal-Wallis H test was used for continuous variables since they were not normally distributed. Moreover, the Spearman rank correlation coefficient (rho) was used to determine the relationship between different variables. There was a significantly positive correlation between the vaccine coverage (%) and both of total cases per one million populations (rho = 0.37; p-value < 0.001) and deaths per one million populations (rho = 0.30; p-value < 0.001). Moreover, there was a significant correlation between different income groups and each of vaccine coverage (%) (rho = 0.71; p-value < 0.001), total cases per one million populations (rho = 0.50; p-value < 0.001), and deaths per one million populations (rho = 0.39; p-value < 0.001). All claims regarding the possible protective effect of Polio vaccination do not have any support when analyzing the related data. Polio vaccination efforts should be limited to eradicate the disease from endemic countries; however, there is no evidence to support the immunization with live-attenuated vaccines for the protection against COVID-19.


Subject(s)
COVID-19 , Poliomyelitis , Humans , Morbidity , Poliomyelitis/epidemiology , Poliomyelitis/prevention & control , SARS-CoV-2 , Vaccination , Vaccination Coverage
18.
Mol Neurobiol ; 58(5): 1917-1931, 2021 May.
Article in English | MEDLINE | ID: covidwho-1009203

ABSTRACT

The new coronavirus (CoV), called novel coronavirus disease 2019 (COVID-19), belongs to the Coronaviridae family which was originated from the sea market in Wuhan city in China, at the end of the year 2019. COVID-19 and severe acute respiratory syndrome (SARS) are belonging to the same family (Coronaviridae). The current outbreak of COVID-19 creates public concern and threats all over the world and now it spreads out to more than 250 countries and territories. The researchers and scientists from all over the world are trying to find out the therapeutic strategies to abate the morbidity and mortality rate of the COVID-19 pandemic. The replication, spreading, and severity of SARS-CoV2 depend on environmental settings. Noteworthy, meteorological parameters are considered as crucial factors that affect respiratory infectious disorders, although the controversial effect of the meteorological parameter is exposed against COVID-19. Besides, COVID-19 accelerates the pathogenesis of the neurological disorders. However, the pathogenic mechanisms between COVID-19 and neurological disorders are still unclear. Hence, this review is focused on the genomics and ecology of SARS-CoV2 and elucidated the effects of climatic factors on the progression of COVID-19. This review also critically finds out the vulnerability between COVID-19 and neurological disorders based on the latest research data.


Subject(s)
COVID-19/epidemiology , Genetic Variation , Nervous System Diseases/epidemiology , SARS-CoV-2/genetics , COVID-19/genetics , Comorbidity , Humans , Nervous System Diseases/genetics , Pandemics
19.
Saudi J Biol Sci ; 28(3): 1519-1527, 2021 Mar.
Article in English | MEDLINE | ID: covidwho-989225

ABSTRACT

Coronavirus Disease (COVID-19) has infected people in 210 nations and has been declared a pandemic on March 12, 2020 by the World Health Organization (WHO). In the absence of effective treatment and/or vaccines for COVID-19, natural products of known therapeutic and antiviral activity could offer an inexpensive, effective option for managing the disease. Benefits of products of honey bees such as honey, propolis, and bee venom, against various types of diseases have been observed. Honey bees products are well known for their nutritional and medicinal values, they have been employed for ages for various therapeutic purposes. In this review, promising effects of various bee products against the emerging pandemic COVID-19 are discussed. Products of honey bees that contain mixtures of potentially active chemicals, possess unique properties that might help to protect, fight, and alleviate symptoms of COVID-19 infection.

20.
Front Pharmacol ; 11: 563478, 2020.
Article in English | MEDLINE | ID: covidwho-909021

ABSTRACT

At the end of 2019, a novel coronavirus (CoV) was found at the seafood market of Hubei province in Wuhan, China, and this virus was officially named coronavirus diseases 2019 (COVID-19) by World Health Organization (WHO). COVID-19 is mainly characterized by severe acute respiratory syndrome coronavirus-2 (SARS-CoV2) and creates public health concerns as well as significant threats to the economy around the world. Unfortunately, the pathogenesis of COVID-19 is unclear and there is no effective treatment of this newly life-threatening and devastating virus. Therefore, it is crucial to search for alternative methods that alleviate or inhibit the spread of COVID-19. In this review, we try to find out the etiology, epidemiology, symptoms as well as transmissions of this novel virus. We also summarize therapeutic interventions and suggest antiviral treatments, immune-enhancing candidates, general supplements, and CoV specific treatments that control replication and reproduction of SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV).

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