Abstract

While repurposed drugs came in handy earlier in the wake of the coronavirus disease 2019 (COVID-19) pandemic, vaccination has been considered a more sustainable approach. The recent spikes have been linked to “double,” “triple,” and even multi-mutant variants, thus renewing calls for deeper structural and functional insights of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as a lead to rationale design of therapeutics, vaccines, and point-of-care diagnostics. There is a repertoire of findings from the earliest SARS-CoV-2 molecular mimicry to evade host immunity cum host immune responses to the role of the viral glycocalyx in modulating the susceptibility and severity of infection through attraction and repulsive interactions. Recently, molecular studies of some viral components that aid infection in the face of vaccination seem unending. In addition, the wave of infections and the attendant case fatality ratios have necessitated the need for emergency use authorizations for COVID-19 vaccines and in vitro diagnostics. This review provides key updates of SARS-CoV-2, current antigenic and formulation strategies, with emergency use authorizations considerations for future vaccine candidates and diagnostics. We also premise that despite the difficulty in modeling and analyzing glycans, understanding and exploiting their roles in the SARS-CoV-2 architecture is fundamental to glycan-based COVID-19 vaccines devoid of inconsistent clinical outcomes.

Highlights

  • The beginning of the decade ushered in the outbreak of the novel coronavirus disease 2019 (COVID-19)1 – a public health concern of global significance that transitioned quickly from an epidemic to a global pandemic within a few weeks

  • In context, emerging results from host immune responses to severe acute respiratory syndrome (SARS)-CoV-2 are certain to enhance our understanding of the variations in disease susceptibility and clinical outcomes and how to deal with potential variants or other zoonotic pathogens best

  • It is established that clinical outcomes correlate with host immunity

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Summary

Introduction

The beginning of the decade ushered in the outbreak of the novel coronavirus disease 2019 (COVID-19)1 – a public health concern of global significance that transitioned quickly from an epidemic to a global pandemic within a few weeks. The socio-economic and geopolitical impacts of the pandemic are notable, the public health concerns remain at the core. By June 2021, over 180 million confirmed cases with an approximate 2.2% mortality rate have been reported according to a World Health Organization report (https://covid19.who.int/). This report depicted the Western Pacific and Americas to bear the least and highest burden of COVID-19, respectively. The clinical manifestations of the disease are fever, cough, dyspnea, malaise, fatigue and sputum/secretion,[2] albeit prolonged pulmonary, neurological, and cardiological conse-

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