A review on SARS-CoV-2: virology aspects, therapy and vaccine development

Document Type : Analytic Review

Authors
P. Safarzadeh Kozani 1
F. rahbarizadeh 2
ص. ک. Safarzadeh Kozani 3
Z. Sadeghi 1
E. Darzi Eslam 1
1 Department of Medical Biotechnology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
2 Department of Medical Biotechnology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, IranResearch and Development Center for Biotechnology (RDCB), Tarbiat Modares University, Tehran, Iran
3 Department of Medical Biotechnology, Faculty of Paramedicine, Guilan University of Medical Sciences, Rasht, Iran
Abstract
Coronavirus disease 2019 (COVID-19) is a virally-induced pneumonia caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This is the third disease-causing coronavirus after severe acute respiratory syndrome coronavirus (SARS-CoV) and the middle east respiratory syndrome coronavirus (MERS-CoV) which has been known in the human population in the 21st century. To this date (20th of Mehr, 1399), more than thirty-four million people have been infected by this virus and more than a million have lost their lives because of it which further signifies the importance of COVID-19 prevention and treatment. In this review article, we first take a look at the history of the famous coronaviruses and then introduce the genetic and pathophysiology of SARS-CoV-2 in a detailed manner. After discussing the related clinical manifestations, we shed a light on the treatments that have been assessed to this date. In the end, we will briefly discuss the vaccines that are currency being developed and highlight their success rate, so far. It is delightful to assert that out own research team is currently developing an oral and/or respiratory vaccine against SARS-CoV-2 which is composed of spike-surface decorated chitosan nanoparticles.

Keywords

Subjects

1. Paraskevis, D., et al., Full-genome evolutionary analysis of the novel corona virus (2019-nCoV) rejects the hypothesis of emergence as a result of a recent recombination event. Infection, Genetics and Evolution, 2020. 79: p. 104212.
2. Schoeman, D. and B.C. Fielding, Coronavirus envelope protein: current knowledge. Virology journal, 2019. 16(1): p. 1-22.
3. Cui, J., F. Li, and Z.-L. Shi, Origin and evolution of pathogenic coronaviruses. Nature Reviews Microbiology, 2019. 17(3): p. 181-192.
4. Andersen, K.G., et al., The proximal origin of SARS-CoV-2. Nature medicine, 2020. 26(4): p. 450-452.
5. Zhu, N., et al., A novel coronavirus from patients with pneumonia in China, 2019. New England Journal of Medicine, 2020.
6. Ceraolo, C. and F.M. Giorgi, Genomic variance of the 2019‐nCoV coronavirus. Journal of medical virology, 2020. 92(5): p. 522-528.
7. Liu, P., W. Chen, and J.-P. Chen, Viral metagenomics revealed Sendai virus and coronavirus infection of Malayan pangolins (Manis javanica). Viruses, 2019. 11(11): p. 979.
8. Uddin, M., et al., SARS-CoV-2/COVID-19: Viral Genomics, Epidemiology, Vaccines, and Therapeutic Interventions. Viruses, 2020. 12(5).
9. Xiaolu, T., et al., On the origin and continuing evolution of SARS-CoV-2. Natl Sci Rev, 2020.
10. Pachetti, M., et al., Emerging SARS-CoV-2 mutation hot spots include a novel RNA-dependent-RNA polymerase variant. Journal of Translational Medicine, 2020. 18: p. 1-9.
11. Forster, P., et al., Phylogenetic network analysis of SARS-CoV-2 genomes. Proceedings of the National Academy of Sciences, 2020. 117(17): p. 9241-9243.
12. Gandhi, S., et al., Covid-19 immune mechanisms: A systematic review. Indian Journal of Allergy, Asthma and Immunology, 2020. 34(1): p. 23.
13. Millet, J.K. and G.R. Whittaker, Host cell entry of Middle East respiratory syndrome coronavirus after two-step, furin-mediated activation of the spike protein. Proceedings of the National Academy of Sciences, 2014. 111(42): p. 15214-15219.
14. De Wit, E., et al., SARS and MERS: recent insights into emerging coronaviruses. Nature Reviews Microbiology, 2016. 14(8): p. 523.
15. Wang, S.-F., et al., Human-leukocyte antigen class I Cw 1502 and class II DR 0301 genotypes are associated with resistance to severe acute respiratory syndrome (SARS) infection. Viral immunology, 2011. 24(5): p. 421-426.
16. Tu, X., et al., Functional polymorphisms of the CCL2 and MBL genes cumulatively increase susceptibility to severe acute respiratory syndrome coronavirus infection. Journal of Infection, 2015. 71(1): p. 101-109.
17. Li, G., X. Chen, and A. Xu, Profile of specific antibodies to the SARS-associated coronavirus. New England Journal of Medicine, 2003. 349(5): p. 508-509.
18. Zhao, J., et al., Rapid generation of a mouse model for Middle East respiratory syndrome. Proceedings of the National Academy of Sciences, 2014. 111(13): p. 4970-4975.
19. Huang, C., et al., Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The lancet, 2020. 395(10223): p. 497-506.
20. Xu, Z., et al., Pathological findings of COVID-19 associated with acute respiratory distress syndrome. The Lancet respiratory medicine, 2020. 8(4): p. 420-422.
21. Menachery, V.D., et al., MERS-CoV and H5N1 influenza virus antagonize antigen presentation by altering the epigenetic landscape. Proceedings of the National Academy of Sciences, 2018. 115(5): p. E1012-E1021.
22. Huang, C., et al., Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet, 2020. 395(10223): p. 497-506.
23. Xu, Y., et al., Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding. Nature medicine, 2020. 26(4): p. 502-505.
24. Xu, Y., et al., Characteristics of pediatric SARS-CoV-2 infection and potential evidence for persistent fecal viral shedding. Nat Med, 2020. 26(4): p. 502-505.
25. Mao, L., et al., Neurological manifestations of hospitalized patients with COVID-19 in Wuhan, China: a retrospective case series study. 2020.
26. Tu, Y.F., et al., A Review of SARS-CoV-2 and the Ongoing Clinical Trials. Int J Mol Sci, 2020. 21(7).
27. Corman, V.M., et al., Detection of 2019 novel coronavirus (2019-nCoV) by real-time RT-PCR. Euro Surveill, 2020. 25(3).
28. Chu, D.K.W., et al., Molecular Diagnosis of a Novel Coronavirus (2019-nCoV) Causing an Outbreak of Pneumonia. Clin Chem, 2020. 66(4): p. 549-555.
29. Xie, X., et al., Chest CT for Typical Coronavirus Disease 2019 (COVID-19) Pneumonia: Relationship to Negative RT-PCR Testing. Radiology, 2020. 296(2): p. E41-e45.
30. Pan, Y., et al., Initial CT findings and temporal changes in patients with the novel coronavirus pneumonia (2019-nCoV): a study of 63 patients in Wuhan, China. Eur Radiol, 2020. 30(6): p. 3306-3309.
31. Ajlan, A.M., et al., Middle East respiratory syndrome coronavirus (MERS-CoV) infection: chest CT findings. AJR Am J Roentgenol, 2014. 203(4): p. 782-7.
32. Woo, P.C., et al., Differential sensitivities of severe acute respiratory syndrome (SARS) coronavirus spike polypeptide enzyme-linked immunosorbent assay (ELISA) and SARS coronavirus nucleocapsid protein ELISA for serodiagnosis of SARS coronavirus pneumonia. J Clin Microbiol, 2005. 43(7): p. 3054-8.
33. de Wilde, A.H., et al., Screening of an FDA-approved compound library identifies four small-molecule inhibitors of Middle East respiratory syndrome coronavirus replication in cell culture. Antimicrob Agents Chemother, 2014. 58(8): p. 4875-84.
34. Yan, D., et al., Factors associated with prolonged viral shedding and impact of Lopinavir/Ritonavir treatment in hospitalised non-critically ill patients with SARS-CoV-2 infection. European Respiratory Journal, 2020.
35. Cao, B., et al., A trial of lopinavir–ritonavir in adults hospitalized with severe Covid-19. New England Journal of Medicine, 2020.
36. Cai, Q., et al., Experimental treatment with favipiravir for COVID-19: an open-label control study. Engineering, 2020.
37. Tu, Y.-F., et al., A review of SARS-CoV-2 and the ongoing clinical trials. International journal of molecular sciences, 2020. 21(7): p. 2657.
38. Li, C., et al., Chloroquine, a FDA-approved drug, prevents Zika virus infection and its associated congenital microcephaly in mice. EBioMedicine, 2017. 24: p. 189-194.
39. Oh, S., et al., Anti-inflammatory activity of chloroquine and amodiaquine through p21-mediated suppression of T cell proliferation and Th1 cell differentiation. Biochemical and biophysical research communications, 2016. 474(2): p. 345-350.
40. Gao, J., Z. Tian, and X. Yang, Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Bioscience trends, 2020.
41. Gautret, P., et al., Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. International journal of antimicrobial agents, 2020: p. 105949.
42. Molina, J.M., et al., No evidence of rapid antiviral clearance or clinical benefit with the combination of hydroxychloroquine and azithromycin in patients with severe COVID-19 infection. Med Mal Infect, 2020. 50(384): p. 30085-8.
43. Shittu, M.O. and O.I. Afolami, Improving the efficacy of chloroquine and hydroxychloroquine against SARS-CoV-2 may require zinc additives-A better synergy for future COVID-19 clinical trials. Infez Med, 2020. 28(2): p. 192-197.
44. Sheahan, T.P., et al., Broad-spectrum antiviral GS-5734 inhibits both epidemic and zoonotic coronaviruses. Science translational medicine, 2017. 9(396).
45. Grein, J., et al., Compassionate use of remdesivir for patients with severe Covid-19. New England Journal of Medicine, 2020. 382(24): p. 2327-2336.
46. Wang, Y., et al., Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial. The Lancet, 2020.
47. Caly, L., et al., The FDA-approved drug ivermectin inhibits the replication of SARS-CoV-2 in vitro. Antiviral research, 2020: p. 104787.
48. Schmith, V.D., J. Zhou, and L.R. Lohmer, The Approved Dose of Ivermectin Alone is not the Ideal Dose for the Treatment of COVID‐19. Clinical Pharmacology & Therapeutics, 2020.
49. Ko, J.-H., et al., Challenges of convalescent plasma infusion therapy in Middle East respiratory coronavirus infection: a single centre experience. Antivir Ther, 2018. 23(7): p. 617-22.
50. Duan, K., et al., Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Proceedings of the National Academy of Sciences, 2020. 117(17): p. 9490-9496.
51. Zhang, H., et al., Angiotensin-converting enzyme 2 (ACE2) as a SARS-CoV-2 receptor: molecular mechanisms and potential therapeutic target. Intensive care medicine, 2020. 46(4): p. 586-590.
52. Monteil, V., et al., Inhibition of SARS-CoV-2 infections in engineered human tissues using clinical-grade soluble human ACE2. Cell, 2020.
53. Zhang, S., et al., Rational use of tocilizumab in the treatment of novel coronavirus pneumonia. Clinical Drug Investigation, 2020. 40(6): p. 511-518.
54. Ortiz-Martínez, Y., Tocilizumab: A new opportunity in the possible therapeutic arsenal against COVID-19. Travel medicine and infectious disease, 2020. 101678.
55. Zhang, C., et al., The cytokine release syndrome (CRS) of severe COVID-19 and Interleukin-6 receptor (IL-6R) antagonist Tocilizumab may be the key to reduce the mortality. International journal of antimicrobial agents, 2020: p. 105954.
56. Cellina, M., et al., Favorable changes of CT findings in a patient with COVID-19 pneumonia after treatment with tocilizumab. Diagnostic and Interventional Imaging, 2020. 101(5): p. 323.
57. Ulrich, H. and M.M. Pillat, CD147 as a target for COVID-19 treatment: suggested effects of azithromycin and stem cell engagement. Stem Cell Reviews and Reports, 2020: p. 1-7.
58. Bian, H., et al., Meplazumab treats COVID-19 pneumonia: an open-labelled, concurrent controlled add-on clinical trial. MedRxiv, 2020.
59. Burkard, C., et al., Coronavirus cell entry occurs through the endo-/lysosomal pathway in a proteolysis-dependent manner. PLoS Pathog, 2014. 10(11): p. e1004502.
60. Nguyen, B.C.Q., et al., 1, 2, 3-Triazolyl ester of Ketorolac: A “Click Chemistry”-based highly potent PAK1-blocking cancer-killer. European Journal of Medicinal Chemistry, 2017. 126: p. 270-276.
61. Riggioni, C., et al., A compendium answering 150 questions on COVID-19 and SARS-CoV-2. Allergy, 2020.
62. Lurie, N., et al., Developing Covid-19 Vaccines at Pandemic Speed. New England Journal of Medicine, 2020. 382(21): p. 1969-1973.
63. van Riel, D. and E. de Wit, Next-generation vaccine platforms for COVID-19. Nature Materials, 2020. 19(8): p. 810-812.
64. Begum, J., et al., Challenges and prospects of COVID-19 vaccine development based on the progress made in SARS and MERS vaccine development. Transboundary and Emerging Diseases, 2020. n/a(n/a).
65. Bandyopadhyay, A.S., et al., Polio vaccination: past, present and future. Future microbiology, 2015. 10(5): p. 791-808.
66. Mukherjee, R., Global efforts on vaccines for COVID-19: Since, sooner or later, we all will catch the coronavirus. Journal of Biosciences, 2020. 45: p. 1-10.
67. Zuniga, A., et al., Attenuated measles virus as a vaccine vector. Vaccine, 2007. 25(16): p. 2974-2983.
68. Syomin, B. and Y. Ilyin, Virus-like particles as an instrument of vaccine production. Molecular Biology, 2019. 53(3): p. 323-334.
69. Robert-Guroff, M., Replicating and non-replicating viral vectors for vaccine development. Current opinion in biotechnology, 2007. 18(6): p. 546-556.
70. López-Camacho, C., et al., Rational Zika vaccine design via the modulation of antigen membrane anchors in chimpanzee adenoviral vectors. Nature communications, 2018. 9(1): p. 1-11.
71. Funk, C.D., C. Laferrière, and A. Ardakani, A Snapshot of the Global Race for Vaccines Targeting SARS-CoV-2 and the COVID-19 Pandemic. Frontiers in Pharmacology, 2020. 11(937).
72. world health organization. list-of-candidate-vaccines-developed-against-mers. 2020; Available from: https://www.who.int/blueprint/priority-diseases/key-action/list-of-candidate-vaccines-developed-against-mers.pdf?ua=1.
73. organization, W.h. list-of-candidate-vaccines-developed-against-sars. 2020; Available from: https://www.who.int/blueprint/priority-diseases/key-action/list-of-candidate-vaccines-developed-against-sars.pdf.
74. Padron-Regalado, E., Vaccines for SARS-CoV-2: Lessons from Other Coronavirus Strains. Infectious Diseases and Therapy, 2020. 9(2): p. 255-274.
75. Zhang, J., et al., Progress and Prospects on Vaccine Development against SARS-CoV-2. Vaccines, 2020. 8(2).
76. Zhou, Y., S. Jiang, and L. Du, Prospects for a MERS-CoV spike vaccine. Expert Review of Vaccines, 2018. 17(8): p. 677-686.
77. Li, F., Structure, Function, and Evolution of Coronavirus Spike Proteins. Annual Review of Virology, 2016. 3(1): p. 237-261.
78. Leung, D.T.M., et al., Antibody Response of Patients with Severe Acute Respiratory Syndrome (SARS) Targets the Viral Nucleocapsid. The Journal of Infectious Diseases, 2004. 190(2): p. 379-386.
79. Neuman, B.W., et al., A structural analysis of M protein in coronavirus assembly and morphology. Journal of Structural Biology, 2011. 174(1): p. 11-22.
80. Nieto-Torres, J.L., et al., Severe Acute Respiratory Syndrome Coronavirus Envelope Protein Ion Channel Activity Promotes Virus Fitness and Pathogenesis. PLOS Pathogens, 2014. 10(5): p. e1004077.
81. Wang, N., et al., Subunit Vaccines Against Emerging Pathogenic Human Coronaviruses. Frontiers in Microbiology, 2020. 11(298).
82. world health organization. draft-landscape-of-covid-19-candidate-vaccines. 2020 [cited 2020 28 sep]; Available from: https://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-vaccines.
83. Hu, H., et al., Enhancing immune responses against SARS-CoV nucleocapsid DNA vaccine by co-inoculating interleukin-2 expressing vector in mice. Biotechnology letters, 2009. 31(11): p. 1685.
84. Smith, T.R., et al., Immunogenicity of a DNA vaccine candidate for COVID-19. Nature communications, 2020. 11(1): p. 1-13.
85. Yi, C., Y. Yi, and J. Li, mRNA Vaccines: Possible Tools to Combat SARS-CoV-2. Virologica Sinica, 2020: p. 1-4.
86. Pardi, N. and D. Weissman, Nucleoside modified mRNA vaccines for infectious diseases, in RNA Vaccines. 2017, Springer. p. 109-121.
87. Zarghampoor, F., et al., Improved translation efficiency of therapeutic mRNA. Gene, 2019. 707: p. 231-238.
88. Wang, F., R.M. Kream, and G.B. Stefano, An evidence based perspective on mRNA-SARS-CoV-2 vaccine development. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 2020. 26: p. e924700-1.
89. Vigerust, D.J. and V.L. Shepherd, Virus glycosylation: role in virulence and immune interactions. Trends in microbiology, 2007. 15(5): p. 211-218.
90. Vankadari, N. and J.A. Wilce, Emerging COVID-19 coronavirus: glycan shield and structure prediction of spike glycoprotein and its interaction with human CD26. Emerging microbes & infections, 2020. 9(1): p. 601-604.
91. Watanabe, Y., et al., Site-specific analysis of the SARS-CoV-2 glycan shield. BioRxiv, 2020.
92. Wassenaar, T.M., G.S. Buzard, and D.J. Newman, BCG vaccination early in life does not improve COVID‐19 outcome of elderly populations, based on nationally reported data. Letters in applied microbiology, 2020.
93. Kamat, S. and M. Kumari, BCG Against SARS-CoV-2: Second Youth of an Old Age Vaccine? Frontiers in pharmacology, 2020. 11: p. 1050.
94. Roth, A., et al., BCG vaccination scar associated with better childhood survival in Guinea-Bissau. International journal of epidemiology, 2005. 34(3): p. 540-547.
95. Stensballe, L.G., et al., Acute lower respiratory tract infections and respiratory syncytial virus in infants in Guinea-Bissau: a beneficial effect of BCG vaccination for girls: community based case–control study. Vaccine, 2005. 23(10): p. 1251-1257.
96. Ohrui, T., et al., Prevention of elderly pneumonia by pneumococcal, influenza and BCG vaccinations. Nihon Ronen Igakkai zasshi. Japanese journal of geriatrics, 2005. 42(1): p. 34-36.
97. Kleinnijenhuis, J., et al., BCG-induced trained immunity in NK cells: role for non-specific protection to infection. Clinical immunology, 2014. 155(2): p. 213-219.
98. Covián, C., et al., Could BCG vaccination induce protective trained immunity for SARS-CoV-2? Frontiers in Immunology, 2020. 11: p. 970.
99. Dayal, D. and S. Gupta, Connecting BCG vaccination and COVID-19: additional data. Medrxiv, 2020.
Pathobiology Reserach
Volume 23, Issue 0
March 2021
Pages 1-29