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Review
. 2020 Apr 6;12(4):e7560.
doi: 10.7759/cureus.7560.

A Comprehensive Literature Review on the Clinical Presentation, and Management of the Pandemic Coronavirus Disease 2019 (COVID-19)

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Free PMC article
Review

A Comprehensive Literature Review on the Clinical Presentation, and Management of the Pandemic Coronavirus Disease 2019 (COVID-19)

Pramath Kakodkar et al. Cureus. .
Free PMC article

Abstract

Coronavirus disease 2019 (COVID-19) is a declared global pandemic. There are multiple parameters of the clinical course and management of the COVID-19 that need optimization. A hindrance to this development is the vast amount of misinformation present due to scarcely sourced manuscript preprints and social media. This literature review aims to presents accredited and the most current studies pertaining to the basic sciences of SARS-CoV-2, clinical presentation and disease course of COVID-19, public health interventions, and current epidemiological developments. The review on basic sciences aims to clarify the jargon in virology, describe the virion structure of SARS-CoV-2 and present pertinent details relevant to clinical practice. Another component discussed is the brief history on the series of experiments used to explore the origins and evolution of the phylogeny of the viral genome of SARS-CoV-2. Additionally, the clinical and epidemiological differences between COVID-19 and other infections causing outbreaks (SARS, MERS, H1N1) are elucidated. Emphasis is placed on evidence-based medicine to evaluate the frequency of presentation of various symptoms to create a stratification system of the most important epidemiological risk factors for COVID-19. These can be used to triage and expedite risk assessment. Furthermore, the limitations and statistical strength of the diagnostic tools currently in clinical practice are evaluated. Criteria on rapid screening, discharge from hospital and discontinuation of self-quarantine are clarified. Epidemiological factors influencing the rapid rate of spread of the SARS-CoV-2 virus are described. Accurate information pertinent to improving prevention strategies is also discussed. The penultimate portion of the review aims to explain the involvement of micronutrients such as vitamin C and vitamin D in COVID19 treatment and prophylaxis. Furthermore, the biochemistry of the major candidates for novel therapies is briefly reviewed and a summary of their current status in the clinical trials is presented. Lastly, the current scientific data and status of governing bodies such as the Center of Disease Control (CDC) and the WHO on the usage of controversial therapies such as angiotensin-converting enzyme (ACE) inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs) (Ibuprofen), and corticosteroids usage in COVID-19 are discussed. The composite collection of accredited studies on each of these subtopics of COVID-19 within this review will enable clarification and focus on the current status and direction in the planning of the management of this global pandemic.

Keywords: ace2; ards; chloroquine; covid-19; lopinavir and ritonavir; mrna-1273 vaccine; pandemic; remdesivir (gs-5734); sars-cov-2; severe acute respiratory infection.

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. 3-D model of the SARS-CoV-2 virion and a schematic diagram of its structural proteins and genome.
Image component modified from CDC Public Health Image Library (ID 23312: Alissa Eckert and Dan Higgins)
Figure 2
Figure 2. Summary of the natural reservoir, intermediate host and target in major coronaviruses.
Figure 3
Figure 3. Summary of the clinical course of COVID-19 patients. The solid colors and cross-hatched patterns indicate the survivors (n = 137) and non-survivors (n = 54), respectively.
Figure 4
Figure 4. Illustration of the geographical spread of active COVID-19.
This data is accurate as of 22nd March 2020. The image is modified from the source [30].

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