Abstract
Coronaviruses (CoVs) have formerly been regarded as relatively harmless respiratory pathogens to humans. However, two outbreaks of severe respiratory tract infection, caused by the severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV), as a result of zoonotic CoVs crossing the species barrier, caused high pathogenicity and mortality rates in human populations. This brought CoVs global attention and highlighted the importance of controlling infectious pathogens at international borders. In this review, we focus on our current understanding of the epidemiology, pathogenesis, prevention, and treatment of SARS-CoV and MERS-CoV, as well as provides details on the pivotal structure and function of the spike proteins (S proteins) on the surface of each of these viruses. For building up more suitable animal models, we compare the current animal models recapitulating pathogenesis and summarize the potential role of host receptors contributing to diverse host affinity in various species. We outline the research still needed to fully elucidate the pathogenic mechanism of these viruses, to construct reproducible animal models, and ultimately develop countermeasures to conquer not only SARS-CoV and MERS-CoV, but also these emerging coronaviral diseases.
Highlights
Before the first outbreak of severe acute respiratory syndrome (SARS), a limited number of coronaviruses were known to be circulating in humans, causing only mild illnesses, such as the common cold [1]
A decade later in June 2012, another highly pathogenic and novel coronavirus, MERS-CoV, was isolated from the sputum of a male patient who died from acute pneumonia and renal failure in Saudi Arabia [9]
MERS-CoV was transmitted from dromedary camels directly to humans, principally in the Arabian Peninsula, and this is considered to be the main route of transmission from animals to humans, causing significant morbidity and mortality [16,17]
Summary
Before the first outbreak of severe acute respiratory syndrome (SARS), a limited number of coronaviruses were known to be circulating in humans, causing only mild illnesses, such as the common cold [1]. The 21st century has seen the worldwide spread of two previously unrecognized coronaviruses, the severe acute respiratory syndrome coronavirus (SARS-CoV) [4] and Middle East respiratory syndrome coronavirus (MERS-CoV), both of which are highly pathogenic. A decade later in June 2012, another highly pathogenic and novel coronavirus, MERS-CoV, was isolated from the sputum of a male patient who died from acute pneumonia and renal failure in Saudi Arabia [9]. Nosocomial infections were reported, and international travel led to the transmission of MERS-CoV to countries outside of the Arabian Peninsula, causing it to become a global pathophoresis. Scientific advancements have allowed for rapid and systemic progress in our understanding of the epidemiology and pathogenesis of MERS-CoV. This review highlights the epidemiology and pathogenesis of these viruses, including our current understanding of their biological characteristics, their transmission, and their replication in the host. Several potential therapies have been identified with SARS and MERS in animal and in vitro models, human clinical trials remain lacking, hindering the advancement of these potential countermeasures
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