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Abstract
We know more and more about this deadly enemy of the Betacoronavirus family, initially called 19- nCoV that causes COVID-19 (Coronavirus infectous disease), today classified SARS-CoV-2, because it is responsible for producing SARS (severe acute respiratory syndrome), It shares a strong sequence homology with SARS-CoV, its cousin that caused the 2003 SARS epidemic, both capable of spreading rapidly, particularly this one and causing great global chaos as has happened with this pandemic. Based on previous studies targeting SARS-CoV, and also on the virus that causes MERS (Middle East Respiratory Syndrome); and with the current knowledge about SARS-CoV-2, we will explore some therapeutic options for the management of infection by this complex and lethal virus, mentioning some aspects of pathogenic relevance. Possible management alternatives from the pathophysiology and pathogenesis to the evidence currently available were emphasized. We will explore the probable use of ECA2 recombinate, some experimental molecules, we will review some of the antimalarials (chloroquine and hydroxychloroquine), steroids, azithromycin, specific antivirals such as remdesivir, lopinavir / ritonavir, biologics such as tocilizumab, monoclonal antiviral antibodies, and we will emphasize transfusion of convalescent plasma from the passive immunization principle, very useful.
References
Wu F, Zhao S, Yu B, et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020;579(7798):265-69.
Zhu N, Zhang D, Wang W, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382(8):727-33.
Guan W, Ni Z, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382(18):1708-20.
Harcourt J, Tamin A, Lu X, et al. Severe Acute Respiratory Syndrome Coronavirus 2 from Patient with Coronavirus Disease, United States. Centers Dis Control Prev. 2020;26(6).
Li Q, Guan X, Wu P, et al. Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia. N Engl J Med. 2020;382(13):1199-207.
Jiang X, Rayner S, Luo MH. Does SARS-CoV-2 has a longer incubation period than SARS and MERS? J Med Virol. 2020;92(5):476-478.
Tang B, Wang X, Li Q, et al. Estimation of the Transmission Risk of the 2019-nCoV and Its Implication for Public Health Interventions. J Clin Med. 2020;9(462).
Zhao S, Lin Q, Ran J, Musa SS, Yang G. Preliminary estimation of the basic reproduction number of novel coronavirus (2019-nCoV) in China, from 2019 to 2020: A data-driven analysis in the early phase of the outbreak. Int J Infect Dis. 2020;92.
A C-CL, Shihb T-P, Koc W-C, D H-JT, Po-Ren Hsueh. Severe acute respiratory syndrome coronavirus 2 (SARS- oV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents. 2020;55.
Li F. Receptor Recognition Mechanisms of Coronaviruses: a Decade of Structural Studies. J Virol. 2015;89(4):1954-64.
Lu R, Zhao X, Li J, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet. 2020;395(10224):565-74.
Spaan W, Cavanagh D, Horzinek MC. Coronaviruses: Structure and genome expression. J Gen Virol. 1988;69(12):2939-52.
Zhong NS, Zeng GQ. Pandemic planning in China: Applying lessons from severe acute respiratory syndrome. Respirology. 2008;13(SUPPL. 1):33-5.
Xia S, Zhu Y, Liu M, et al. Fusion mechanism of 2019-nCoV and fusion inhibitors targeting HR1 domain in spike protein. Cell Mol Immunol. 2020;(February):2019-21.
Zhang H, Penninger JM, Li Y, Zhong N, Slutsky AS. Angiotensin-converting enzyme 2 (ACE2) as a SARS-zoV-2 receptor: molecular mechanisms and potential therapeutic target. Intensive Care Med. 2020;46(4):586-90.
Morse JS, Lalonde T, Xu S, Liu WR. Learning from the Past: Possible Urgent Prevention and Treatment Options for Severe Acute Respiratory Infections Caused by 2019-nCoV. ChemBioChem. 2020;21(5):730-38.
Kruse R. herapeutic strategies in an outbreak scenario to treat the novel coronavirus originating in Wuhan, China. F1000research. 2020;9(72).
National Health Commission of the People’s Republic of China. Notice on printing and distributing the convalescent plasma treatment for novel coronavirus pneumonia (trial version 2). Available from: ttp://www.nhc.gov.cn/yzygj/s7658/202003/61d608a7e8bf49fca418a6074c2bf5a2.shtml (accessed March 4, 2020). 2020
Lu S. Timely development of vaccines against SARS-CoV-2. Emerg Microbes Infect. 2020;9:542-44.
Tian X, Li C, Huang A, et al. Potent binding of 2019 novel coronavirus spike protein by a SARS coronavirus-specific human monoclonal antibody. Emerg Microbes Infect. 2020;9(1):382-85.
Zhao Y, Zhao Z, Wang Y, Zhou Y, Ma Y, Zuo W. Single-cell RNA expression profiling of ACE2, the putative receptor of Wuhan 2019- nCov. bioRxiv. 2020:2020.01.26.919985.
Zheng M, Song L. Novel antibody epitopes dominate the antigenicity of spike glycoprotein in SARS-CoV-2 compared to SARS-CoV. Cell Mol Immunol. 2020;17(5):536-38.
Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor. Cell. 2020;181(2):271-80.e8.
Chan KS, Lai ST, Chu CM, et al. Treatment of severe acute respiratory syndrome with lopinavir/ritonavir: A multicentre retrospective matched cohort study. Hong Kong Med J. 2003;9(6):399-406.
Yao TT, Qian JD, Zhu WY, Wang Y, Wang GQ. A systematic review of lopinavir therapy for SARS coronavirus and MERS coronavirus— A possible reference for coronavirus disease-19 treatment option. J Med Virol. 020;92(6):556-63.
Sheahan TP, Sims AC, Graham RL, et al. Broad-spectrum antiviral GS-5734 inhibits both epidemic and zoonotic coronaviruses. Sci Transl Med. 2017;9(396).
Sheahan TP, Sims AC, Leist SR, et al. Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV. Nat Commun. 2020;11(1).
Falzarano D, De Wit E, Rasmussen AL, et al. Treatment with interferon-a2b and ribavirin improves outcome in MERS-CoV-infected rhesus macaques. Nat Med. 2013;19(10):1313-317.
EP T, JY F, DP P, M G. Mechanism of inhibition of Ebola virus RNA-dependent RNA Polymerase by remdesivir. Viruses. 2019;11(4).
Wit E de, Feldmann F, Cronin J, et al. Prophylactic and therapeutic remdesivir (GS-5734) treatment in the rhesus macaque model of MERS-CoV infection. Proc Natl Acad Sci U S A. 2020;117(12):6771-776.
Gordon CJ, Tchesnokov EP, Feng JY, Porter DP, Götte M. The antiviral compound remdesivir potently inhibits RNAdependent RNA polymerase from Middle East respiratory syndrome coronavirus. J Biol Chem. 2020;295(15):4773-779.
Wang M, Cao R, Zhang L, et al. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res. 2020;30(3):269-71.
Bosseboeuf E, Aubry M, Nhan T, et al. Azithromycin Inhibits the Replication of Zika Virus. J Antivir Antiretrovir. 2018;10(1):6-11.
Bacharier LB, Guilbert TW, Mauger DT, et al. Early Administration of Azithromycin and Prevention of Severe Lower Respiratory Tract Illnesses in Preschool Children With a History of Such Illnesses: A Randomized Clinical Trial. JAMA - J Am Med Assoc. 2015;314(19):2034-44.
Retallack H, Di Lullo E, Arias C, et al. Zika virus cell tropism in the developing human brain and inhibition by azithromycin. Proc Natl Acad Sci U S A. 2016;113(50):14408-13.
Madrid PB, Panchal RG, Warren TK, et al. Evaluation of Ebola Virus Inhibitors for Drug Repurposing. ACS Infect Dis. 2015;1(7).
Savarino A, Trani L Di, Donatelli I, Cauda R, Cassone A. New insights into the antiviral effects of chloroquine. Lancet Infect Dis. 2006;6(2):67-9.
Zhi Z jie he he hu xi za. [Expert consensus on chloroquine phosphate for the treatment of novel coronavirus pneumonia]. Chinese J Tuberc Respir Dis. 2020;43(3):185-88.
Yan Y, Zou Z, Sun Y, et al. Anti-malaria drug chloroquine is highly effective in treating avian influenza A H5N1 virus infection in an animal model. Cell Res. 2013;23(2):300-02.
Colson P, Rolain J-M, Raoult D. Chloroquine for the 2019 novel coronavirus SARS-CoV-2. Int J Antimicrob Agents. 2020;55(3).
Colson P, Rolain J-M, Lagier J-C, Brouqui P, Raoult D. Chloroquine and hydroxychloroquine as available weapons to fight COVID-19. Int J Antimicrob Agents. 2020:105932. doi:10.1016/j.ijantimicag.2020.105932
Gao J, Tian Z, Yang X. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends. 2020;14(1):72-3.
Biot C, Daher W, Chavain N, et al. Design and Synthesis of Hydroxyferroquine Derivatives with Antimalarial and Antiviral Activities. J Med Chem. 2006;49(9):2845-49.
Yao X, Ye F, Zhang M, et al. In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Main point: Hydroxychloroquine was found to be more potent than chloroquine at inhibiting SARS-CoV-2 in vit. Clin Infect Dis. 2020;2:1-25.
Cortegiani A, Ingoglia G, Ippolito M, Giarratano A, Einav S. A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19. J Crit Care. 2020;57:279-83.
Xu X, Han P, Li T, et al. Effective treatment of severe COVID-19 patients with tocilizumab. Proc Natl Acad Sci U S A. 2020;117(20):10970-75.
Zhou Y, Fu B, Zheng X, et al. Aberrant pathogenic GM-CSF+ T cells and inflammatory CD14+CD16+ monocytes in severe pulmonary syndrome patients of a new coronavirus. bioRxiv. 2020.
Russell CD, Millar JE, Baillie JK. Clinical evidence does not support corticosteroid treatment for 2019-nCoV lung injury. Lancet. 2020;395(10223):473-5.
Zhou W, Liu Y, Tian D, et al. Potential benefits of precise corticosteroids therapy for severe 2019-nCoV pneumonia. Signal Transduct Target Ther. 2020;5(18).
Walls AC, Park YJ, Tortorici MA, Wall A, McGuire AT, Veesler D. Structure, Function, and Antigenicity of the SARS-CoV-2 Spike Glycoprotein. Cell. 2020;181(2):281-92.e6.
Li G, Clercq E De. Therapeutic options for the 2019 novel coronavirus (2019-nCoV). Nat Rev Drug Discov. 2020;19(3):149-50.
Mulangu S, Dodd LE, Davey RT, et al. A randomized, controlled trial of Ebola virus disease therapeutics. N Engl J Med. 2019;381(24):2293-303.
Chen L, Xiong J, Bao L, Shi Y. Convalescent plasma as a potential therapy for COVID-19. Lancet Infect Dis. 2020;20(4):398-400.
Garraud O, Heshmati F, Pozzetto B, et al. Plasma therapy against infectious pathogens, as of yesterday, today and tomorrow. Transfus Clin Biol. 2016;23(1):39-44.
Marano G, Vaglio S, Pupella S, et al. Convalescent plasma: New evidence for an old therapeutic tool? Blood Transfus. 2016;14(2):152-57.
China. NHC of the PR of. Notice on printing and distributing the convalescent plasma treatment for novel coronavirus pneumonia (trial version 2). Available from: http://www.nhc.gov.cn/yzygj/s7658/202003/61d608a7e8bf49fca418a6074c2bf5a2.shtml (accessed March 4, 2020). 2020.
Lu S. Timely development of vaccines against SARS-CoV-2. Emerg Microbes Infect. 2020;9(6):542-44. 58. Wrapp D, Wang N, Corbett KS, et al. Cryo-EM structure of the 2019-nCoV spike in the prefusion conformation. Science (80). 2020;367(6483):1260-63.
Lucchese G. Epitopes for a 2019-nCoV vaccine. Cell Mol Immunol. 2020;17(5):539-40. 60. Ahmed SF, Quadeer AA, McKay MR. Preliminary identification of potential vaccine targets for the COVID-19 Coronavirus (SARS- CoV-2) Based on SARS-CoV Immunological Studies. Viruses. 2020;12(3).
Pang J, Wang MX, Ang IYH, et al. Potential Rapid Diagnostics, Vaccine and Therapeutics for 2019 Novel Coronavirus (2019-nCoV): A Systematic Review. J Clin Med. 2020;9(3):623.