Advances in COVID-19: the virus, the pathogenesis, and evidence-based control and therapeutic strategies
Guangbiao Zhou1(), Saijuan Chen2, Zhu Chen2()
1. State Key Laboratory of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China 2. State Key Laboratory of Medical Genomics, Shanghai Institute of Hematology, National Research Center for Translational Medicine (Shanghai), Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
Since the outbreak of the COVID-19 pandemic in early December 2019, 81 174 confirmed cases and 3242 deaths have been reported in China as of March 19, 2020. The Chinese people and government have contributed huge efforts to combat this disease, resulting in significant improvement of the situation, with 58 new cases (34 were imported cases) and 11 new deaths reported on March 19, 2020. However, as of March 19, 2020, the COVID-19 pandemic continues to develop in 167 countries/territories outside of China, and 128 665 confirmed cases and 5536 deaths have been reported, with 16 498 new cases and 817 new deaths occurring in last 24 hours. Therefore, the world should work together to fight against this pandemic. Here, we review the recent advances in COVID-19, including the insights in the virus, the responses of the host cells, the cytokine release syndrome, and the therapeutic approaches to inhibit the virus and alleviate the cytokine storm. By sharing knowledge and deepening our understanding of the virus and the disease pathogenesis, we believe that the community can efficiently develop effective vaccines and drugs, and the mankind will eventually win this battle against this pandemic.
. [J]. Frontiers of Medicine, 2020, 14(2): 117-125.
Guangbiao Zhou, Saijuan Chen, Zhu Chen. Advances in COVID-19: the virus, the pathogenesis, and evidence-based control and therapeutic strategies. Front. Med., 2020, 14(2): 117-125.
R Yan, Y Zhang, Y Li, L Xia, Y Guo, Q Zhou. Structural basis for the recognition of the SARS-CoV-2 by full-length human ACE2. Science 2020 Mar 4. [Epub ahead of print] doi: 10.1126/science.abb2762 https://doi.org/10.1126/science.abb2762
2
World Health Organization. Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). 2020.
3
World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report — 59. March 19, 2020.
4
World Health Organization. Coronavirus disease 2019 (COVID-19) Situation Report — 37. February 26, 2020.
5
Y Zhang, D Cao. Wuhan to close its largest makeshift hospital. China Daily. March 7, 2020.
6
World Health Organization. WHO Director-General’s opening remarks at the media briefing on COVID-19 — 11 March 2020. March 11, 2020.
7
S Kannan, P Shaik Syed Ali, A Sheeza, K Hemalatha. COVID-19 (novel coronavirus 2019) — recent trends. Eur Rev Med Pharmacol Sci 2020; 24(4): 2006–2011 https://doi.org/10.26355/eurrev_202002_20378
pmid: 32141569
8
M Wang, R Cao, L Zhang, X Yang, J Liu, M Xu, Z Shi, Z Hu, W Zhong, G Xiao. Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res 2020; 30(3): 269–271 https://doi.org/10.1038/s41422-020-0282-0
pmid: 32020029
9
X Tang, C Wu, X Li, Y Song, X Yao, X Wu, Y Duan, H Zhang, Y Wang, Z Qian, J Cui, J Lu. On the origin and continuing evolution of SARS-CoV-2. Natl Sci Rev 2020 Mar 3. [Epub ahead of print] doi:10.1093/nsr/nwaa036 https://doi.org/10.1093/nsr/nwaa036
10
OA Maclean, R Orton, J Singer, DL Robertson. Response to “On the origin and continuing evolution of SARS-CoV-2”. 2020.
11
L Zhang, J-R Yang, Z Zhang, Z Lin. Genomic variations of SARS-CoV-2 suggest multiple outbreak sources of transmission. medRxiv 2020; doi: 10.1101/2020.02.25.20027953 https://doi.org/10.1101/2020.02.25.20027953
12
C Ceraolo, FM Giorgi. Genomic variance of the 2019-nCoV coronavirus. J Med Virol 2020; 92: 522–528 https://doi.org/10.1002/jmv.25700
13
A Wu, P Niu, L Wang, H Zhou, X Zhao, W Wang, et al.. Mutations, recombination and insertion in the evolution of 2019-nCoV. bioRxiv 2020; doi: 10.1101/2020.02.29.971101 https://doi.org/10.1101/2020.02.29.971101
14
WB Yu, GD Tang, L Zhang, RT Corlett. Decoding evolution and transmissions of novel pneumonia coronavirus using the whole genomic data. ChinaXiv 2020.
15
KG Andersen, A Rambaut, WI Lipkin, EC Holmes, RF Garry. The proximal origin of SARS-CoV-2. Nat Med 2020. [Epub ahead of print] doi: 10.1038/s41591-020-0820-9 https://doi.org/10.1038/s41591-020-0820-9
16
H Liu, C Wu, Y Yang, Y Liu, P Zhang, Y Wang, Q Wang, et al.. Furin, a potential therapeutic target for COVID-19. ChinaXiv 2020.
17
M Hoffmann, H Kleine-Weber, S Schroeder, N Krüger, T Herrler, S Erichsen, TS Schiergens, G Herrler, NH Wu, A Nitsche, MA Müller, C Drosten, S Pöhlmann. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 2020 Mar 4. [Epub ahead of print] doi: 10.1016/j.cell.2020.02.052 https://doi.org/10.1016/j.cell.2020.02.052
pmid: 32142651
18
X Zou, K Chen, J Zou, P Han, J Hao, Z Han. The single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Front Med 2020 Mar 12. [Epub ahead of print] doi: 10.1007/s11684-020-0754-0 https://doi.org/10.1007/s11684-020-0754-0
19
L Du, Y He, Y Zhou, S Liu, BJ Zheng, S Jiang. The spike protein of SARS-CoV—a target for vaccine and therapeutic development. Nat Rev Microbiol 2009; 7(3): 226–236 https://doi.org/10.1038/nrmicro2090
pmid: 19198616
20
R Lu, X Zhao, J Li, P Niu, B Yang, H Wu, W Wang, H Song, B Huang, N Zhu, Y Bi, X Ma, F Zhan, L Wang, T Hu, H Zhou, Z Hu, W Zhou, L Zhao, J Chen, Y Meng, J Wang, Y Lin, J Yuan, Z Xie, J Ma, WJ Liu, D Wang, W Xu, EC Holmes, GF Gao, G Wu, W Chen, W Shi, W Tan. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. Lancet 2020; 395(10224): 565–574 https://doi.org/10.1016/S0140-6736(20)30251-8
pmid: 32007145
21
N Chen, M Zhou, X Dong, J Qu, F Gong, Y Han, Y Qiu, J Wang, Y Liu, Y Wei, J Xia, T Yu, X Zhang, L Zhang. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020; 395(10223): 507–513 https://doi.org/10.1016/S0140-6736(20)30211-7
pmid: 32007143
22
D Wang, B Hu, C Hu, F Zhu, X Liu, J Zhang, B Wang, H Xiang, Z Cheng, Y Xiong, Y Zhao, Y Li, X Wang, Z Peng. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020; 323(11): 1061 https://doi.org/10.1001/jama.2020.1585
pmid: 32031570
23
WJ Guan, ZY Ni, Y Hu, WH Liang, CQ Ou, JX He, L Liu, H Shan, CL Lei, DSC Hui, B Du, LJ Li, G Zeng, KY Yuen, RC Chen, CL Tang, T Wang, PY Chen, J Xiang, SY Li, JL Wang, ZJ Liang, YX Peng, L Wei, Y Liu, YH Hu, P Peng, JM Wang, JY Liu, Z Chen, G Li, ZJ Zheng, SQ Qiu, J Luo, CJ Ye, SY Zhu, NS Zhong; China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020 Feb 28. [Epub ahead of print] doi: 10.1056/NEJMoa2002032 https://doi.org/10.1056/NEJMoa2002032
pmid: 32109013
24
J Liu, S Li, J Liu, B Liang, X Wang, H Wang, et al.. Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood of SARS-CoV-2 infected patients. medRxiv 2020; doi: 10.1101/2020.02.16.20023671 https://doi.org/10.1101/2020.02.16.20023671
25
B Diao, C Wang, Y Tan, X Chen, Y Liu, L Ning, et al.. Reduction and functional exhaustion of T cells in patients with coronavirus disease 2019 (COVID-19). medRxiv 2020; doi: 10.1101/2020.02.18.20024364 https://doi.org/10.1101/2020.02.18.20024364
26
Z Zhang, X Li, W Zhang, ZL Shi, Z Zheng, T Wang. Clinical features and treatment of 2019-nCov pneumonia patients in Wuhan: report of a couple cases. Virol Sin 2020 Feb 7. [Epub ahead of print] doi: 10.1007/s12250-020-00203-8 https://doi.org/10.1007/s12250-020-00203-8
pmid: 32034637
27
W Wang, J He, P Lie, L Huang, S Wu, Y Lin, et al.. The definition and risks of cytokine release syndrome-like in 11 COVID-19-infected pneumonia critically ill patients: disease characteristics and retrospective analysis. medRxiv 2020; doi: 10.1101/2020.02.26. 20026989 https://doi.org/10.1101/2020.02.26.20026989
L Chatenoud, C Ferran, A Reuter, C Legendre, Y Gevaert, H Kreis, P Franchimont, JF Bach. Systemic reaction to the anti-T-cell monoclonal antibody OKT3 in relation to serum levels of tumor necrosis factor and interferon-γ [corrected]. N Engl J Med 1989; 320(21): 1420–1421 https://doi.org/10.1056/NEJM198905253202117
pmid: 2785642
30
EM Behrens. Cytokines in cytokine storm syndrome. In: Cron RQ, Behrens EM. Cytokine Storm Syndrome. Cham: Springer International Publishing, 2019. 197–207
31
T Okabayashi, H Kariwa, S Yokota, S Iki, T Indoh, N Yokosawa, I Takashima, H Tsutsumi, N Fujii. Cytokine regulation in SARS coronavirus infection compared to other respiratory virus infections. J Med Virol 2006; 78(4): 417–424 https://doi.org/10.1002/jmv.20556
pmid: 16482545
32
JR Teijaro, KB Walsh, S Cahalan, DM Fremgen, E Roberts, F Scott, E Martinborough, R Peach, MB Oldstone, H Rosen. Endothelial cells are central orchestrators of cytokine amplification during influenza virus infection. Cell 2011; 146(6): 980–991 https://doi.org/10.1016/j.cell.2011.08.015
pmid: 21925319
33
R Channappanavar, S Perlman. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. Semin Immunopathol 2017; 39(5): 529–539 https://doi.org/10.1007/s00281-017-0629-x
pmid: 28466096
34
T Liu, J Zhang, Y Yang, H Ma, Z Li, J Zhang, et al.. The potential role of IL-6 in monitoring severe case of coronavirus disease 2019. medRxiv 2020; doi: 10.1101/2020.03.01.20029769 https://doi.org/10.1101/2020.03.01.20029769
35
L Yu, Y Tong, G Shen, A Fu, Y Lai, X Zhou, et al.. Immunodepletion with hypoxemia: a potential high risk subtype of coronavirus disease 2019. medRxiv 2020; doi: 10.1101/2020. 03.03.20030650 https://doi.org/10.1101/2020.03.03.20030650
36
Z Xu, L Shi, Y Wang, J Zhang, L Huang, C Zhang, S Liu, P Zhao, H Liu, L Zhu, Y Tai, C Bai, T Gao, J Song, P Xia, J Dong, J Zhao, FS Wang. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med 2020 Feb 18. [Epub ahead of print] doi: 10.1016/S2213-2600(20)30076-X https://doi.org/10.1016/S2213-2600(20)30076-X
pmid: 32085846
37
Y Zhou, B Fu, X Zheng, D Wang, C Zhao, Y Qi, et al.. Aberrant pathogenic GM-CSF+ T cells and inflammatory CD14+CD16+ monocytes in severe pulmonary syndrome patients of a new coronavirus. bioRxiv 2020; doi: 10.1101/2020.02.12.945576 https://doi.org/10.1101/2020.02.12.945576
38
KJ Huang, IJ Su, M Theron, YC Wu, SK Lai, CC Liu, HY Lei. An interferon-g-related cytokine storm in SARS patients. J Med Virol 2005; 75(2): 185–194 https://doi.org/10.1002/jmv.20255
pmid: 15602737
39
W Luo, H Yu, J Gou, X Li, Y Sun, J Li, L Liu. Clinical pathology of critical patient with novel coronavirus pneumonia (COVID-19). Preprints 2020; 2020020407
40
P Zhou, XL Yang, XG Wang, B Hu, L Zhang, W Zhang, HR Si, Y Zhu, B Li, CL Huang, HD Chen, J Chen, Y Luo, H Guo, RD Jiang, MQ Liu, Y Chen, XR Shen, X Wang, XS Zheng, K Zhao, QJ Chen, F Deng, LL Liu, B Yan, FX Zhan, YY Wang, GF Xiao, ZL Shi. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020; 579(7798): 270–273 https://doi.org/10.1038/s41586-020-2012-7
pmid: 32015507
41
C Anastassopoulou, L Russo, A Tsakris, C. Siettos Data-based analysis, modelling and forecasting of the novel coronavirus (2019-nCoV) outbreak. medRxiv 2020; doi: 10.1101/2020.02.11. 20022186 https://doi.org/10.1101/2020.02.11.20022186
42
Q Li, X Guan, P Wu, X Wang, L Zhou, Y Tong, R Ren, KSM Leung, EHY Lau, JY Wong, X Xing, N Xiang, Y Wu, C Li, Q Chen, D Li, T Liu, J Zhao, M Liu, W Tu, C Chen, L Jin, R Yang, Q Wang, S Zhou, R Wang, H Liu, Y Luo, Y Liu, G Shao, H Li, Z Tao, Y Yang, Z Deng, B Liu, Z Ma, Y Zhang, G Shi, TTY Lam, JTK Wu, GF Gao, BJ Cowling, B Yang, GM Leung, Z Feng. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med 2020 Jan 29. [Epub ahead of print] doi: 10.1056/NEJMoa2001316 https://doi.org/10.1056/NEJMoa2001316
pmid: 31995857
43
Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China. Chin J Epidemiol (Zhonghua Liu Xing Bing Xue Za Zhi) 2020; 41(2): 145–151 (in Chinese)
pmid: 32064853
44
K Duan, B Liu, C Li, H Zhang, T Yu, J Qu, et al.. The feasibility of convalescent plasma therapy in severe COVID-19 patients: a pilot study. Proc Natl Acad Sci USA 2020; doi: 10.1073/pnas.2004168117 https://doi.org/10.1016/S1473-3099(20)30141-9
pmid: 32113510
45
L Chen, J Xiong, L Bao, Y Shi. Convalescent plasma as a potential therapy for COVID-19. Lancet Infect Dis 2020 Feb 27. [Epub ahead of print] doi: 10.1016/S1473-3099(20)30141-9 https://doi.org/10.1016/S1473-3099(20)30141-9
pmid: 32113510
46
ML Holshue, C DeBolt, S Lindquist, KH Lofy, J Wiesman, H Bruce, C Spitters, K Ericson, S Wilkerson, A Tural, G Diaz, A Cohn, L Fox, A Patel, SI Gerber, L Kim, S Tong, X Lu, S Lindstrom, MA Pallansch, WC Weldon, HM Biggs, TM Uyeki, SK Pillai; Washington State 2019-nCoV Case Investigation Team. First case of 2019 novel coronavirus in the United States. N Engl J Med 2020; 382(10): 929–936 https://doi.org/10.1056/NEJMoa2001191
pmid: 32004427
47
N Zhu, D Zhang, W Wang, X Li, B Yang, J Song, X Zhao, B Huang, W Shi, R Lu, P Niu, F Zhan, X Ma, D Wang, W Xu, G Wu, GF Gao, W Tan; China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020; 382(8): 727–733 https://doi.org/10.1056/NEJMoa2001017
pmid: 31978945
48
V Staedtke, RY Bai, K Kim, M Darvas, ML Davila, GJ Riggins, PB Rothman, N Papadopoulos, KW Kinzler, B Vogelstein, S Zhou. Disruption of a self-amplifying catecholamine loop reduces cytokine release syndrome. Nature 2018; 564(7735): 273–277 https://doi.org/10.1038/s41586-018-0774-y
pmid: 30542164
49
NR London, W Zhu, FA Bozza, MCP Smith, DM Greif, LK Sorensen, et al.. Targeting Robo4-dependent Slit signaling to survive the cytokine storm in sepsis and influenza. Sci Transl Med 2010; 2(23): 23ra19 https://doi.org/10.1126/scitranslmed.3000678
50
X Liu, Z Li, S Liu, Z Chen, Z Zhao, YY Huang, et al.. Therapeutic effects of dipyridamole on COVID-19 patients with coagulation dysfunction. medRxiv 2020; doi: 10.1101/2020.02.27.20027557 https://doi.org/10.1101/2020.02.27.20027557
51
S Pfaender, KB Mar, E Michailidis, A Kratzel, D Hirt, P V’kovski, et al.. LY6E impairs coronavirus fusion and confers immune control of viral disease. bioRxiv 2020; doi: 10.1101/2020.03.05.979260 https://doi.org/10.1101/2020.03.05.979260
52
C Wu, Y Liu, Y Yang, P Zhang, W Zhong, Y Wang, Q Wang, Y Xu, M Li, X Li, M Zheng, L Chen, H Li. Analysis of therapeutic targets for SARS-CoV-2 and discovery of potential drugs by computational methods. Acta Pharm Sin B 2020 Feb 27. [Epub ahead of print] doi:10.1016/j.apsb.2020.02.008 https://doi.org/10.1016/j.apsb.2020.02.008
53
A Rimanshee, D Amit, P Vishal, K Mukesh. Potential inhibitors against papain-like protease of novel coronavirus (SARS-CoV-2) from FDA approved drugs. ChemRxiv 2020; doi: 10.26434/chemrxiv.11860011.v2 https://doi.org/10.26434/chemrxiv.11860011.v2
54
ul Tahir M Qamar, S Alqahtani, M Alamri, L Chen. Structural basis of SARS-CoV-2 3CLpro and anti-COVID-19 drug discovery from medicinal plants. Preprints 2020; 2020020193
55
B Cao, Y Wang, D Wen, W Liu, J Wang, G Fan, L Ruan, B Song, Y Cai, M Wei, X Li, J Xia, N Chen, J Xiang, T Yu, T Bai, X Xie, L Zhang, C Li, Y Yuan, H Chen, H Li, H Huang, S Tu, F Gong, Y Liu, Y Wei, C Dong, F Zhou, X Gu, J Xu, Z Liu, Y Zhang, H Li, L Shang, K Wang, K Li, X Zhou, X Dong, Z Qu, S Lu, X Hu, S Ruan, S Luo, J Wu, L Peng, F Cheng, L Pan, J Zou, C Jia, J Wang, X Liu, S Wang, X Wu, Q Ge, J He, H Zhan, F Qiu, L Guo, C Huang, T Jaki, FG Hayden, PW Horby, D Zhang, C Wang. A trial of lopinavir-ritonavir in adults hospitalized with severe COVID-19. N Engl J Med 2020 Mar 18. [Epub ahead of print] doi: 10.1056/NEJMoa2001282 https://doi.org/10.1056/NEJMoa2001282
pmid: 32187464