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. 2020 Apr;53(4):191-205.
doi: 10.5483/BMBRep.2020.53.4.080.

COVID-19: An Update on Diagnostic and Therapeutic Approaches

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Free PMC article

COVID-19: An Update on Diagnostic and Therapeutic Approaches

Mahalaxmi Iyer et al. BMB Rep. .
Free PMC article

Abstract

The unexpected pandemic set off by the novel coronavirus 2019 (COVID-19) has caused severe panic among people worldwide. COVID-19 has created havoc, and scientists and physicians are urged to test the efficiency and safety of drugs used to treat this disease. In such a pandemic situation, various steps have been taken by the government to control and prevent the Severe Acute Respiratory Syndrome coronavirus 2 (SARSCoV- 2). This pandemic situation has forced scientists to rework strategies to combat infectious diseases through drugs, treatment, and control measures. COVID-19 treatment requires both limiting viral multiplication and neutralizing tissue damage induced by an inappropriate immune reaction. Currently, various diagnostic kits to test for COVID-19 are available, and repurposing therapeutics for COVID-19 has shown to be clinically effective. As the global demand for diagnostics and therapeutics continues to rise, it is essential to rapidly develop various algorithms to successfully identify and contain the virus. This review discusses the updates on specimens/samples, recent efficient diagnostics, and therapeutic approaches to control the disease and repurposed drugs mainly focusing on chloroquine/hydroxychloroquine and convalescent plasma (CP). More research is required for further understanding of the influence of diagnostics and therapeutic approaches to develop vaccines and drugs for COVID-19. [BMB Reports 2020; 53(4): 191-205].

Conflict of interest statement

CONFLICTS OF INTEREST

The authors have no conflicting interests.

Figures

Fig. 1
Fig. 1
Collection of Specimens/samples and diagnostics methods for COVID-19: Depiction of various diagnostic methods for COVID-19 infection. CT scans can be utilized to find lung abnormalities in patients with infection, this can be a serious tool to determine severity and track progress. The NP swab taken from the patient is collected and transported to a laboratory. Here, RT-PCR analysis is conducted using specific viral gene probes targeting viral specific genes. If the viral nucleic acid is present in the specimens, the patients is diagnosed with COVID-19. Similar RT-PCR techniques are utilized to detect presence of the virus in tissue samples after autopsy and stool samples of patients exhibiting symptoms. The plasma and blood collected by venipuncture is used to detect virus specific antibodies in the blood using ELISA method using a reporter antibody. As antibodies will be present in the blood after infection, this can be utilized as a tool to detect exposure to virus. The rapid detection kits use blood from a finger prick to detect 1gG and IgM antibodies. These tests are easily accessible and do not need a laboratory for further processing.
Fig. 2
Fig. 2
Probable mechanism of hydroxychloroquine (HC) against SARS-CoV-2: The figure depicts the mechanism of action of hydroxychloroquine targeting the SARS-CoV-2 through many ways. (1) The hydroxychloroquine has the ability to constrain the quinone reductase-2 which is an essential agent required for the biosynthesis of sialic acid (SA) which is generally used as the receptor moieties by the SARS-CoV-2. (2) The hydroxychloroquine could change the pH of lysosomes that leads to inhibition of the cathepsins which is mandatory for the formation of autophagosomes to cleave the SARS-CoV-2 spike (S1 and S2) protein and blocks the viral attachment to the human host receptors. (3) The drug also targets the virus through increasing the endosomal pH and hinders the glycosylation process of the cellular receptors of SARS-CoV-2, which eventually blocks the viral attachment to the ACE2 receptors and inhibits the viral infection. (4) Moreover, the hydroxychloroquine obstructs the MAP-kinase pathway which results to SARS-CoV-2 virus molecular crosstalk resulting into alteration of viral assembly and also intrude the proteolytic process of the M protein of the virus.
Fig. 3
Fig. 3
Convalescent plasma (CP) therapy: The figure illustrates the process and importance of CP therapy to treat COVID-19 disease. CP therapy is an immunotherapy where the humoral antibody (Ab) from the recovered patients to the severely affected diseased patients. In CP therapy, as the SARS-CoV-2 affected is infected the Ab spans out and marks the virus as an intruding agent into the human system. This in future triggers the White blood cells to identify the SARS-CoV-2 virus which deactivates the viral function in the human body. In this procedure almost 1ltr of blood will be collected from the recovered patients and approximately 250 ml of plasma will be injected to the COVID-19 diseased patients. This might reduce the COVID-19 disease symptoms, give relief to the patients and would get recovered from this dreadful infection.

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