SARS-CoV-2 multifaceted interaction with human host. Part I: What we have learnt and done so far, and the still unknown realities

IUBMB Life. 2020 Nov;72(11):2313-2330. doi: 10.1002/iub.2380. Epub 2020 Sep 12.


SARS-CoV-2, the causing agent of the ongoing COVID-19 pandemic, is a beta-coronavirus which has 80% genetic homology with SARS-CoV, but displays increased virulence and transmissibility. Initially, SARS-CoV-2 was considered a respiratory virus generally causing a mild disease, only severe and fatal in the elderly and individuals with underlying conditions. Severe illnesses and fatalities were attributed to a cytokine storm, an excessive response from the host immune system. However, with the number of infections over 10 millions and still soaring, the insidious and stealthy nature of the virus has emerged, as it causes a vast array of diverse unexpected symptoms among infected individuals, including the young and healthy. It has become evident that besides infecting the respiratory tract, SARS-CoV-2 can affect many organs, possibly through the infection of the endothelium. This review presents an overview of our learning curve with the novel virus emergence, transmission, pathology, biological properties and host-interactions. It also briefly describes remedial measures taken until an effective vaccine is available, that is non-pharmaceutical interventions to reduce the viral spread and the repurposing of existing drugs, approved or in development for other conditions to eliminate the virus or mitigate the cytokine storm.

Keywords: ACE2; COVID-19; SARS-CoV-2; coronavirus; host-virus interaction; pandemic.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Anticoagulants / therapeutic use
  • Antiviral Agents / therapeutic use
  • COVID-19 / immunology*
  • COVID-19 / virology
  • COVID-19 Drug Treatment
  • Cytokine Release Syndrome / drug therapy
  • Cytokine Release Syndrome / immunology*
  • Cytokine Release Syndrome / virology
  • Drug Repositioning / methods
  • Genome, Viral*
  • Host-Pathogen Interactions / drug effects
  • Host-Pathogen Interactions / genetics
  • Host-Pathogen Interactions / immunology*
  • Humans
  • Immunologic Factors / therapeutic use
  • Inflammation
  • Masks
  • Physical Distancing
  • SARS-CoV-2 / drug effects
  • SARS-CoV-2 / immunology
  • SARS-CoV-2 / pathogenicity*
  • Severe Acute Respiratory Syndrome
  • Severe acute respiratory syndrome-related coronavirus / drug effects
  • Severe acute respiratory syndrome-related coronavirus / immunology
  • Severe acute respiratory syndrome-related coronavirus / pathogenicity


  • Anti-Inflammatory Agents
  • Anticoagulants
  • Antiviral Agents
  • Immunologic Factors