The Natural History, Pathobiology, and Clinical Manifestations of SARS-CoV-2 Infections
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INVITED REVIEW
The Natural History, Pathobiology, and Clinical Manifestations of SARS-CoV-2 Infections Jatin Machhi 1 & Jonathan Herskovitz 1,2 & Ahmed M. Senan 3 & Debashis Dutta 4 & Barnali Nath 5 & Maxim D. Oleynikov 1 & Wilson R. Blomberg 1 & Douglas D. Meigs 1 & Mahmudul Hasan 6 & Milankumar Patel 1 & Peter Kline 7 & Raymond Chuen-Chung Chang 8 & Linda Chang 9 & Howard E. Gendelman 1,2,6 & Bhavesh D. Kevadiya 1,10 Received: 1 July 2020 / Accepted: 8 July 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the etiological agent of coronavirus disease 2019 (COVID-19). SARS-CoV-2, is a positive-sense single-stranded RNA virus with epithelial cell and respiratory system proclivity. Like its predecessor, SARS-CoV, COVID-19 can lead to life-threatening disease. Due to wide geographic impact affecting an extremely high proportion of the world population it was defined by the World Health Organization as a global public health pandemic. The infection is known to readily spread from person-to-person. This occurs through liquid droplets by cough, sneeze, hand-to-mouth-to-eye contact and through contaminated hard surfaces. Close human proximity accelerates SARS-CoV-2 spread. COVID-19 is a systemic disease that can move beyond the lungs by bloodbased dissemination to affect multiple organs. These organs include the kidney, liver, muscles, nervous system, and spleen. The primary cause of SARS-CoV-2 mortality is acute respiratory distress syndrome initiated by epithelial infection and alveolar macrophage activation in the lungs. The early cell-based portal for viral entry is through the angiotensin-converting enzyme 2 receptor. Viral origins are zoonotic with genomic linkages to the bat coronaviruses but without an identifiable intermediate animal reservoir. There are currently few therapeutic options, and while many are being tested, although none are effective in curtailing the death rates. There is no available vaccine yet. Intense global efforts have targeted research into a better understanding of the epidemiology, molecular biology, pharmacology, and pathobiology of SARS-CoV-2. These fields of study will provide the insights directed to curtailing this disease outbreak with intense international impact.
Keywords Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) . Coronavirus disease 2019 (COVID-19) . Acute respiratory distress syndrome (ARDS) . Angiotensin-converting enzyme 2 (ACE-2)
* Howard E. Gendelman [email protected]
5
Viral Immunology Lab, Indian Institute of Technology Guwahati, Guwahati, Assam 781039, India
* Bhavesh D. Kevadiya [email protected]
6
Department of Pharmaceutical Sciences, College of Pharmacy, University of Nebraska Medical Center, Omaha, NE 68198, USA
7
SARS-CoV-2 Patient Survivor, Chicago, IL 60204, USA
8
Laboratory of Neurodegenerative Diseases, School of Biomedical Sciences, LKS Faculty of Medicine, and State Key Laboratory of Brain and Cognitive Sciences, The University
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