Human Coronaviruses: Counteracting the Damage by Storm
Abstract
:1. Introduction
2. Clinical Presentation of Highly Pathogenic hCoV Infections
2.1. SARS
2.2. MERS
2.3. COVID-19
3. Lung Pathology of Highly Pathogenic hCoV Infections
3.1. Viral Tropism and Pulmonary Histopathological Features of SARS
3.2. Viral Tropism and Pulmonary Histopathological Features of MERS
3.3. Viral Tropism and Pulmonary Histopathological Features of COVID-19
4. Cytokine and Chemokine Responses of Highly Pathogenic hCoV Infections
4.1. Cytokine and Chemokine Response to SARS-CoV Infection
4.2. Cytokine and Chemokine Response to MERS-CoV Infection
4.3. Cytokine and Chemokine Response to SARS-CoV-2 Infection
5. A Dysregulated Immune Response in Highly Pathogenic hCoV Infections
6. Treatments of Highly Pathogenic hCoV Infections
6.1. SARS-CoV and MERS-CoV: A Historical Perspective
6.2. SARS-CoV-2
6.3. Other Prospective Treatments
6.3.1. T-Cell Based Vaccines: The Importance of Cell-Mediated Immunity
6.3.2. Rapamycin: Improving Vaccine Responses and Modulating the Cytokine Storm
6.3.3. Stapled Peptides
7. Conclusions
Author Contributions
Funding
Informed Consent Statement
Acknowledgments
Conflicts of Interest
References
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SARS | MERS | COVID-19 | |
---|---|---|---|
Date of first case report (place) | November 2002 (China) | April 2012 (Jordan) June 2012 (first KSA case) | December 2019 (Wuhan, China) |
Incubation period | Mean: 4.6 days (95% CI: 3.8–5.8) | Mean: 5.2 days (95% CI: 1.7–14.7) | Mean: 5.6–6.7 days (95% CI: 5.2–7.4) |
Age (years) | Range: 2–14 days | Range: 2–13 days | Range: 1–14 days |
Range, Median | Range: 1–91 Mean: 39.9 | Range: 1–94 Median: 50 | Range: 16–89 Median: 50 |
Mortality | |||
Overall case fatality rate (CFR) | 9.6% | 41.8% | 3.8% |
CFR in patients with comorbidities | 46% | 60% | 11% |
Gender (M, F) | M: 43%, F: 57% | M: 64.5%, F: 35.5% | M: 50.7–56%, F: 44–49.3% |
Presenting Symptoms | |||
Fever (>38 °C) | 99–100% | 98–100% | 20–98% |
Chills/Rigors | 15–73% | 87% | 11.4–18% |
Cough | 62–100% | 83–100% | 28.6–79% |
Dry | 29–75% | 56% | 67.7% |
Productive | 4–29% | 44% | 23–33.4% |
Haemoptysis | 0–1% | 17% | 0.9% |
Headache | 20–56% | 11% | 8–15% |
Myalgia | 45–61% | 32% | 11–44% |
Malaise | 31–45% | 38% | 23.6–34.2% |
Shortness of breath | 40–42% | 72% | 4–55% |
Nausea | 20–35% | 21% | 2.2–4.5% |
Vomiting | 20–35% | 21% | 2.2–4.5% |
Diarrhoea | 20–25% | 26% | 5–28.6% |
Sore throat | 13–25% | 14% | 11–15% |
Rhinorrhoea | 2–24% | 6% | 5.6% |
Olfactory/Gustatory dysfunction | N.R. 1 | N.R. 1 | 64–80% |
Disease Progression | |||
Time from onset to ventilatory support | Mean: 11 days | Mean: 7 days | Median: 5 days (IQR: 1–10 days) |
Time from onset to death | 23.7 days | Median: 11.5 days | Mean: 15.93 days |
Comorbidities | 10–30% | 76% | 24–48% |
Diabetes | 24% | 10% | 2.7–58% |
Chronic renal disease | 2–6% | 13% | 3–13% |
Chronic heart disease | 10% | 7.5% | 16.2% |
Malignancy | 3% | 2% | 6–8% |
Hypertension | 19% | 34% | 4.5–63% |
Obesity | N/A | 17% | 46–47.6% |
Smoking | 17% | 23% | 23% |
Viral hepatitis | 27% | Not known | ≤0.1–12.2% |
Imaging and Laboratory Results | |||
CXR abnormalities | 94–100% | 100% | 0–63% |
Leukopenia (<4.0 × 109/L) | 25–35% | 14% | 31–33.7% |
Lymphopenia (<1.5 × 109/L) | 68–85% | 32% | 42–83.2% |
Thrombocytopenia (<140 × 109/L) | 40–45% | 36% | 36.2% |
Elevated LDH | 50–71% | 48% | 41–75% |
Elevated ALT | 20–30% | 11% | 21.3–28% |
Elevated AST | 20–30% | 14% | 22.2–35% |
Ventilatory support required | 14–20% | 80% | 8–91% |
Risk factors associated with poor outcome (severe disease or death) | Advanced age, male gender, high initial or peak LDH, high neutrophil count on presentation, diabetes mellitus or other comorbid conditions, low CD4 and CD8 lymphocyte counts at presentation. | Any immunocompromised state, comorbid illness, concomitant infections, low albumin, age ≥ 65 years. | Advanced age, male gender, comorbidities, immunocompromised state. |
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Schoeman, D.; Fielding, B.C. Human Coronaviruses: Counteracting the Damage by Storm. Viruses 2021, 13, 1457. https://doi.org/10.3390/v13081457
Schoeman D, Fielding BC. Human Coronaviruses: Counteracting the Damage by Storm. Viruses. 2021; 13(8):1457. https://doi.org/10.3390/v13081457
Chicago/Turabian StyleSchoeman, Dewald, and Burtram C. Fielding. 2021. "Human Coronaviruses: Counteracting the Damage by Storm" Viruses 13, no. 8: 1457. https://doi.org/10.3390/v13081457
APA StyleSchoeman, D., & Fielding, B. C. (2021). Human Coronaviruses: Counteracting the Damage by Storm. Viruses, 13(8), 1457. https://doi.org/10.3390/v13081457