Novel Coronavirus Disease 2019 (COVID-19) Current Update: Perspective on Epidemiology, Diagnosis, Drug Targets and Vaccines

Background: A novel coronavirus disease, 2019-nCoV (COVID-19), was reported first in Wuhan, the capital of Hubei, China, in late December 2019 and subsequently reached pandemic level affecting around 213 countries. As of 24th May 2020, the total number of positive cases confirmed is 5,446,514 and 344,754 death reports worldwide. COVID-19 infection causes pneumonia-like severe respiratory infection and acute lung failure. Severe acute respiratory syndrome coron-avirus 2 (SARS-CoV-2) is a positive-sense single-stranded RNA beta coronavirus that is a confirmed causative agent of COVID-19. SARS-CoV-2 may use angiotensin-converting enzyme 2 (ACE2), unlike the receptor utilized by SARS-CoV (emerged in 2002) to infect humans. People with a history of hypertension, chronic obstructive pulmonary disease, diabetes, cardiovascular disease are more susceptible to SARS-CoV-2. Objective(s): The purpose of this review was to help the society to distinguish and deal with SARS-CoV-2, and make available a reference for forthcoming studies. Method(s): Recently, diagnostic primer sets on the SARS-CoV-2 genome have been identified. The receptor-binding domain of SARS-COV-2 highlighted the mode by which beta-CoV recognizes ACE2. Various diagnostic tools are available to differentiate and identify SARS-CoV-2 infection as RT-PCR, antigen detection assay, and antibody detection assay. Different strategies have been employed to control the SARS-CoV-2, considering various drug targets like the main protease (3-CLPro), papain-like protease (PLpro), helicase (NSP13), RNA dependent RNA polymerase (RdR-p), and viral envelope (E) protein. Conclusion(s): In the present review, we have updated details of transmission, pathogenesis, genome structure, diagnostic criteria, clinical characteristics, therapeutics, and vaccine development of the SARS-CoV-2 infection, which may be significant in the control and response to the COVID-19 out-break.Copyright © 2021 Bentham Science Publishers.

Imaging features of COVID-19: a series of 56 cases.

Objective: To evaluate the imaging features of CT scan in patients with COVID-19. Method(s): Clinical data of 56 patients with COVID-19 from January 17 to 19, 2020 admitted to Wenzhou Central Hospital and the Second Affiliated Hospital of Wenzhou Medical University were retrospectively reviewed. The clinical manifestations, lung imaging characteristics and treatment outcomes of patients with different severity were analyzed with SAS software. Result(s): Fever (92.8%, 52/56), dry cough (75.0%, 42/56) and asthenia (58.9%, 33/56) were the first symptoms in most of the patients;some patients also had shortness of breath (25.0%, 14/56) and pharyngeal pain (10.7%, 6/56). Chest high-resolution CT scan showed that in 42 moderate patients, ground glass-like high-density shadows in the lung were observed in 30 cases (71.4%);localized plaque consolidation shadows and bronchial inflation signs were observed in 10 cases (23.8%). In 12 severe patients, 11 had high-density patches involving multiple lung lobes (>=3). In 2 critically ill patients the patches and stripes involving the entire lung were observed;and cord-like high-density shadow, local consolidation and fibrosis were also shown. Conclusion(s): The multiple ground-glass changes outside the lungs are early imaging manifestations of COVID-19 patients. The increase in pulmonary lobe consolidation and fibrosis may indicate the disease progression, and the degree of lung consolidation and fibrosis is closely related to the disease severity.Copyright © 2020 by the Chinese Medical Association.

Nonthyroidal Illness Syndrome: To Treat or Not to Treat? Have We Answered the Question? A Review of Metanalyses.

Background and Objective: Nonthyroidal Illness Syndrome (NTIS) occurs in approximately 70% of patients admitted to Intensive Care Units (ICU)s and has been associated with increased risk of death. Whether patients with NTIS should receive treatment with thyroid hormones (TH)s is still debated. Since many interventional randomized clinical trials (IRCT)s were not conclusive, current guidelines do not recommend treatment for these patients. In this review, we analyze the reasons why TH treatment did not furnish convincing results regarding possible beneficial effects in reported IRCTs. Methods: We performed a review of the metanalyses focused on NTIS in critically ill patients. After a careful selection, we extracted data from four metanalyses, performed in different clinical conditions and diseases. In particular, we analyzed the type of TH supplementation, the route of administration, the dosages and duration of treatment and the outcomes chosen to evaluate the results. Results: We observed a marked heterogeneity among the IRCTs, in terms of type of TH supplementation, route of administration, dosages and duration of treatment. We also found great variability in the primary outcomes, such as prevention of neurological alterations, reduction of oxygen requirements, restoration of endocrinological and clinical parameters and reduction of mortality. Conclusions: NTIS is a frequent finding in critical ill patients. Despite several available IRCTs, it is still unclear whether NTIS should be treated or not. New primary endpoints should be identified to adequately validate the efficacy of TH treatment and to obtain a clear answer to the question raised some years ago.

Integrated Bioinformatics Analysis for the Screening of Associated Pathways and Therapeutic Drugs in Coronavirus Disease 2019.

BACKGROUND: COVID-19 caused by a novel coronavirus, a severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), has recently broken out worldwide. Up to now, the development of vaccine is still in the stage of clinical research, and there is no clinically approved specific antiviral drug for human coronavirus infection. The purpose of this study is to investigate the key molecules involved in response during SARS-CoV-2 infection and provide references for the treatment of SARS-CoV-2. METHODS: We conducted in-depth and comprehensive bioinformatics analysis of human proteins identified with SARS-CoV-2, including functional enrichment analysis, protein interaction network analysis, screening of hub genes, and evaluation of their potential as therapeutic targets. In addition, we used the gene-drug database to search for inhibitors of related biological targets. RESULTS: Several significant pathways, such as PKA, centrosome and transcriptional regulation, may greatly contribute to the development and progression of COVID-2019 disease. Taken together 15 drugs and 18 herb ingredients were screened as potential drugs for viral treatment. Specially, the trans-resveratrol can significantly reduce the expression of N protein of MERS-CoV and inhibit MERS-CoV. In addition, trans-resveratrol, Epigallocatechin-3-gallate (EGCG) and BX795 all show good anti multiple virus effects. CONCLUSION: Some drugs selected through our methods have been proven to have antiviral effects in previous studies. We aim to use global bioinformatics analysis to provide insights to assist in the design of new drugs and provide new choices for clinical treatment.

Computers and viral diseases. Preliminary bioinformatics studies on the design of a synthetic vaccine and a preventative peptidomimetic antagonist against the SARS-CoV-2 (2019-nCoV, COVID-19) coronavirus.

This paper concerns study of the genome of the Wuhan Seafood Market isolate believed to represent the causative agent of the disease COVID-19. This is to find a short section or sections of viral protein sequence suitable for preliminary design proposal for a peptide synthetic vaccine and a peptidomimetic therapeutic, and to explore some design possibilities. The project was originally directed towards a use case for the Q-UEL language and its implementation in a knowledge management and automated inference system for medicine called the BioIngine, but focus here remains mostly on the virus itself. However, using Q-UEL systems to access relevant and emerging literature, and to interact with standard publically available bioinformatics tools on the Internet, did help quickly identify sequences of amino acids that are well conserved across many coronaviruses including 2019-nCoV. KRSFIEDLLFNKV was found to be particularly well conserved in this study and corresponds to the region around one of the known cleavage sites of the SARS virus that are believed to be required for virus activation for cell entry. This sequence motif and surrounding variations formed the basis for proposing a specific synthetic vaccine epitope and peptidomimetic agent. The work can, nonetheless, be described in traditional bioinformatics terms, and readily reproduced by others, albeit with the caveat that new data and research into 2019-nCoV is emerging and evolving at an explosive pace. Preliminary studies using molecular modeling and docking, and in that context the potential value of certain known herbal extracts, are also described.