Recent insights for the emerging COVID-19: Drug discovery, therapeutic options and vaccine development

SARS-CoV-2 has been marked as a highly pathogenic coronavirus of COVID-19 disease into the human population, causing over 5.5 million confirmed cases worldwide. As COVID-19 has posed a global threat with significant human casualties and severe economic losses, there is a pressing demand to further understand the current situation and develop rational strategies to contain the drastic spread of the virus. Although there are no specific antiviral therapies that have proven effective in randomized clinical trials, currently, the rapid detection technology along with several promising therapeutics for COVID-19 have mitigated its drastic transmission. Besides, global institutions and corporations have commenced to parse out effective vaccines for the prevention of COVID-19.

This century has witnessed the worldwide spread of several hitherto unknown coronaviruses. The rapid alteration of ecology and urbanization along with vulnerable public health systems have facilitated more frequent emerging of epidemics, which have become more and more intractable for us to prevent and contain. In December 2019, a new coronavirus (CoV) correlated with human respiratory disease was firstly reported causing pneumonia and death. Soon afterward, the disease cases continued to expand and soared dramatically worldwide. The causative virus, named as severe acute respiratory syndrome CoV-2 (SARS-CoV-2), was identified as the pathogen leading to the CoV disease COVID-19. Infections with SARS-CoV-2 are now swift and violent, and as of 28 May 2020, over 5.5 million cases have been confirmed in more than 215 countries, with over 353, 334 deaths. To date, SARS-CoV-2 has most closest relation to SARS and relevant viruses that circulate in bats, as evidenced by viral genome analysis as well as the research probing into the proximal origin of such virus.

In general, CoVs, subfamily coronavirinae, are a cluster of highly diversified, enveloped, positive-sense and single-stranded viruses ((+)ssRNA virus) that can induce enteric, respiratory, hepatic as well as neurological disorders of discrepant severity in a wide range of animal species, encompassing humans. As the largest RNA viruses ever discovered, CoVs can be categorized into α-, β-, δ- and γ-CoVs. Among these genera, the β group can be subdivided into A, B, C and D lineages. In the past 17 years, three neoteric β-CoVs, SARS-CoV, Middle East respiratory syndrome CoV (MERS-CoV), along with SARS-CoV-2 have emerged, engendering severe human diseases. Although the origin of SARS-CoV-2 outbreak is not yet clear, recent studies have deduced that it might be transmitted through bats because it is highly similar to the bat SARS-CoV-like coronaviruses. Later on, genomic and evolutionary proofs of the occurrence of Pangolin-CoV indicated that pangolin species might be the potential intermediate host for SARS-CoV-2. Unlike human CoVs, zoonotic viruses hold the capacity of infecting both animals and humans, leading to severe respiratory diseases (i.e., acute respiratory distress syndrome (ARDS) and pneumonia). Clinical data revealed that the COVID-19 symptoms are far more severe among the elders with comorbidities, while asthma, allergic illnesses, as well as chronic obstructive pulmonary disease are also risk factors. Despite the continuous improvement of the prevention strategy and the disease surveillance system, the lack of efficacious drug treatment and correlated high morbidity cases of the SARS-CoV-2 along with its potentiality to induce pandemics, highlighting the urgent demand for neoteric drug discovery.

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