Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is a novel coronavirus that is responsible for the 2019–2020 pandemic. In this comprehensive review, we discuss the current published literature surrounding the SARS-CoV-2 virus. We examine the fundamental concepts including the origin, virology, pathogenesis, clinical manifestations, diagnosis, laboratory, radiology, and histopathologic findings, complications, and treatment. Given that much of the information has been extrapolated from what we know about other coronaviruses including severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), we identify and provide insight into controversies and research gaps for the current pandemic to assist with future research ideas. Finally, we discuss the global response to the coronavirus disease-2019 (COVID-19) pandemic and provide thoughts regarding lessons for future pandemics.
Highlights
The world has witnessed numerous epidemics and pandemics that have affected thousands to millions of lives
There have been cases reported of patients presenting with classic computed tomography (CT) chest findings combined with high clinical suspicion for SARS-CoV-2 infection who test negative on reverse-transcription polymerase chain reaction (RT-PCR) [67]
A study done by Zhou et al showed that elevated levels of lactate dehydrogenase (LDH), serum ferritin, IL-6, and high sensitivity cardiac troponin I were all associated with worsening illness and higher mortality [73]
Summary
The world has witnessed numerous epidemics and pandemics that have affected thousands to millions of lives. Acute lung injury, including its severe form ARDS, is a common consequence of cytokine storm syndrome This has been shown to occur in patients with SARS-CoV-2 infection with the development of diffuse lung injury, inflammation, and fluid buildup, which can lead to death. The results of a retrospective Chinese study in Wuhan involving 1,178 patients hospitalized with COVID-19 showed that the frequency of severe disease, ARDS, and mortality did not differ in those using ACE-Is or ARBs compared to those not using these medications [43]. There have been cases reported of patients presenting with classic computed tomography (CT) chest findings (bilateral peripheral distribution with multifocal lower lung involvement) combined with high clinical suspicion for SARS-CoV-2 infection who test negative on RT-PCR [67]. Blood and stool specimens could be tested to aid with the diagnosis [66]
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