SARS-CoV-2/COVID-19: a primer for cardiologists

Abstract

In the late autumn of 2019, a new potentially lethal human coronavirus designated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China. The pandemic spread of this zoonotic virus has created a global health emergency and an unprecedented socioeconomic crisis. The severity of coronavirus disease 2019 (COVID-19), the illness caused by SARS-CoV‑2, is highly variable. Most patients (~85%) develop no or mild symptoms, while others become seriously ill, some succumbing to disease-related complications. In this review, the SARS-CoV‑2 life cycle, its transmission and the clinical and immunological features of COVID-19 are described. In addition, an overview is presented of the virological assays for detecting ongoing SARS-CoV‑2 infections and the serological tests for SARS-CoV-2-specific antibody detection. Also discussed are the different approaches to developing a COVID-19 vaccine and the perspectives of treating COVID-19 with antiviral drugs, immunomodulatory agents and anticoagulants/antithrombotics. Finally, the cardiovascular manifestations of COVID-19 are briefly touched upon. While there is still much to learn about SARS-CoV‑2, the tremendous recent advances in biomedical technology and knowledge and the huge amount of research into COVID-19 raise the hope that a remedy for this disease will soon be found. COVID-19 will nonetheless have a lasting impact on human society.

Keywords: Acute respiratory distress syndrome; Antiviral drug; Coronavirus disease 2019; Pandemic; Severe acute respiratory syndrome coronavirus 2; Vaccine.

Fig. 1

Schematic representations of SARS-CoV‑2 genome organisation, gene expression strategy and virion structure. See running text for explanation

Fig. 2

Schematic drawing of SARS-CoV‑2 life/infectious cycle. See running text for explanation. ACE2 angiotensin I converting enzyme 2, TMPRSS2 transmembrane serine protease 2

Fig. 3

a, b Antigen detection methods. a Sandwich ELISA. b Immunochromatography test

Fig. 4

Overview of the different approaches to developing a vaccine for SARS-CoV‑2

Fig. 5

Overview of potential targets for the development of antiviral drugs for COVID-19. ACE2 angiotensin I converting enzyme 2, TMPRSS2 transmembrane serine protease 2