MERS Epidemics Research Articles

Hydroxychloroquine as ‘Potential Treatment Option’ for Persistent Immune Dysregulation in Long COVID: Revisiting Its New Use as a ‘Versatile’ Molecule!

COVID-19 pandemic is over now and we are in great peace of relief after three years of first case reported in China. This pandemic has observed a significant impact on quality of life globally and this puts unforgettable imprints on the history of mankind. Reason for more havoc in this pandemic was less studied virus before this ‘unpredicted or surprise pandemic’ by medical scientists regarding its pathophysiology, available treatment options and lack of effective vaccine to tackle this dragon. Rationale would be COVID-19 is the first observed and reported pandemic of corona virus related global disease apart from its previously occurring SARS and MERS Epidemics. Fast track developments in medical treatment options with use of ultrafast digital and artificial intelligence techniques have curtailed mortality on a large scale globally. Although mortality is significantly reduced, morbidity is documented in significant number of cases worldwide after this Dragon related pandemic. Morbidity due to COVID-19 now called as ‘Long COVID’, which is underreported & half-heartedly evaluated globally. Long COVID is related to persistent immune dysregulation which occurred during evolution of COVID-19 as a natural trend of disease & documented during the course of active viremia, during recovery of viral illness and after the post viral phase. Immune dysregulation occurs in a ‘selected group’ of cases irrespective of disease severity and vaccination status, and observed in cases irrespective of severity of illness as with negligible illness resulted into brainstorming effect on medical scientists and researchers as of today to advanced and mandates further global research. Globally, one third of recovered or affected cases of COVID-19 are facing long covid and need prompt treatment options to tackle this dragon related long term effect on body. ‘Immunomodulatory’ or immunity modifying agents are the primary targets to curtail immune dysregulation and long covid. Some experts recommend ‘disease modifying agents’ to treat long covid cases. Still, many miles to go to reach effective treatment options for long covid and we don’t have effective options as of now for this ‘health issue of global concern’ related to Dragon. Hydroxychloroquine is initially used as an antimalarial and as an anti-inflammatory molecule for decades in various rheumatic conditions with satisfactory results. Despite decades of dependable use and predictable results in the treatment of rheumatic disease, HCQ remains a drug with an ever-expanding number of underlying mechanisms. HCQ was tried initially for prophylaxis treatment of COVID-19 due to its anti-inflammatory properties but has not shown any dramatic results. WHO has removed HCQ from the treatment plan after many trial results with disappointing outcomes. HCQ is a drug with multiple beneficial pleiotropic effects such as immunomodulatory effects which regulates immunological responses that inhibit dysregulated immune system. These Immunomodulatory and or diseases modifying effects of HCQ makes it the future candidate with ‘game changer’ role for management of Long covid resulting from immune dysregulation as a core pathophysiologic pathway of this Dragon Pandemic. Revisiting this old drug with ‘versatile effects’ can be used as treatment option for short time as frontline molecule for Long covid when no definitive options are available after consideration of risk benefit ratio which is a cost-effective treatment option.

ICTV Virus Taxonomy Profile: Coronaviridae 2023.

The family Coronaviridae includes viruses with positive-sense RNA genomes of 22-36 kb that are expressed through a nested set of 3' co-terminal subgenomic mRNAs. Members of the subfamily Orthocoronavirinae are characterized by 80-160 nm diameter, enveloped virions with spike projections. The orthocoronaviruses, severe acute respiratory syndrome coronavirus and Middle East respiratory syndrome-related coronavirus are extremely pathogenic for humans and in the last two decades have been responsible for the SARS and MERS epidemics. Another orthocoronavirus, severe acute respiratory syndrome coronavirus 2, was responsible for the recent global COVID-19 pandemic. This is a summary of the International Committee on Taxonomy of Viruses (ICTV) Report on the family Coronaviridae which is available at www.ictv.global/report/coronaviridae.

Gain-of-function and origin of Covid19

In nature, wild viruses adapted for transmission circulate in many animal species (bats, birds, primates...). Contamination of other animals, including humans, may occur by crossing of the species barrier. Genetic manipulations have been carried out on wild viruses to favor the species jumping and to increase of viral virulence. The aim was to identify the critical genes for pathogenicity. This has been mainly performed on potentially epidemic pathogens, as Myxovirus influenzae of avian flu and coronaviruses of SARS and MERS epidemics. These dangerous experiments were subject to a moratorium in the United States (2014-2017). Three years after the emergence of Covid-19, the origin of du SARS-CoV2 remains a mystery. Covid19 appeared in Wuhan, officially in December 2019, but probably during the autumn 2019. The virus was identified in January 2020. It belongs to the genus Betacoronavirus (subgenus Sarbecovirus). It was at once highly contagious. In addition, the primary isolates were genetically very homogeneous, differing only by two nucleotides without evidence for adaptive mutations. In addition, the Spike protein, a major virulence factor, has a furin site, not found in any other known sarbecovirus. Unlike the SARS and MERS epidemics, no intermediate host has been detected so far. Finally, no other outbreaks were reported at the beginning of the pandemic outside of Wuhan, contrary to what happened with the emergence of SARS (2002) and H7N9 avian influenza (2013). Today, there are two scenarios to explain the emergence of SARS-CoV2. Proponents of the natural origin argue that the bat virus might have directly infected humans, spreading silently at a low level in humans for years, without eliminating the existence of undetected intermediate hosts. This does not explain the origin in Wuhan, far away from the natural virus reservoirs. The furin site would have arisen spontaneously from other coronaviruses. The alternative scenario is that of a laboratory accident after gain-of-function manipulations from a SARS-like virus, or even the occurrence of a human contamination by a natural CoV virus grown on cells in Wuhan.

Plasma exchange and COVID 19

Plasma exchange and COVID 19

Using Non-Pharmaceutical Interventions and High Isolation of Asymptomatic Carriers to Contain the Spread of SARS-CoV-2 in Nursing Homes.

More than 40% of the deaths recorded in the first wave of the SARS-CoV-2 pandemic were linked to nursing homes. Not only are the residents of long-term care facilities (LTCFs) typically older and more susceptible to endemic infections, the facilities’ high degree of connection to wider communities makes them especially vulnerable to local COVID-19 outbreaks. In 2008, in the wake of the SARS-CoV-1 and MERS epidemics and anticipating an influenza pandemic, we created a stochastic compartmental model to evaluate the deployment of non-pharmaceutical interventions (NPIs) in LTCFs during influenza epidemics. In that model, the most effective NPI by far was a staff schedule consisting of 5-day duty periods with onsite residence, followed by an 4-to-5 day off-duty period with a 3-day quarantine period just prior to the return to work. Unlike influenza, COVID-19 appears to have significant rates of pre-symptomatic transmission. In this study, we modified our prior modeling framework to include new parameters and a set of NPIs to identify and control the degree of pre-symptomatic transmission. We found that infections, deaths, hospitalizations, and ICU utilization were projected to be high and largely irreducible, even with rigorous application of all defined NPIs, unless pre-symptomatic carriers can be identified and isolated at high rates. We found that increasingly rigorous application of NPIs is likely to significantly decrease the peak of infections; but even with complete isolation of symptomatic persons, and a 50% reduction in silent transmission, the attack rate is projected to be nearly 95%.

Telehealth and Telemedicine in response to selected critical coronavirus: A systematic review

Background & Objectives: Due to the outbreak of COVID-19, applying telehealth and telemedicine to prevent the spread of disease is inevitable. Therefore, this study aimed to investigate the application of telehealth and telemedicine in the human coronavirus epidemic. Materials and Methods: The systematic search was conducted in Medline (through PubMed), Scopus, and ISI Web of Science to identify relevant studies published until June 10, 2020. Inclusion criteria included studies in which telemedicine and telehealth were utilized as healthcare services in COVID-19, SARS, or MERS epidemics. This review was performed according to PRISMA guidelines. Results: A total of 598 articles were identified after removing duplicates. After the systematic screening, 18 studies were met our criteria. The analysis showed that only one study was related to SARS, and the rest were on COVID-19 disease. Teleconsultation and televisit had a high percentage (55.6%) among other types of telemedicine services. The most mentioned obstacles were access to suitable technologies and lack of assessment or follow-up to achieve outcomes. Conclusion: The results showed that telehealth and telemedicine could have advantages such as preventing the spread of COVID-19, reducing the healthcare burden, and maintaining appropriate patient care. In addition to these benefits, several limitations and obstacles, including organizational, technological, and patient-related barriers, may be encountered, so it is better to consider the necessary arrangements before implementing telemedicine.

Immunological Approaches to the Treatment of New Coronavirus Infection (Review).

The pandemic of the new coronavirus infection (COVID-19) caused by the SARS-CoV-2 virus has spread all over the world. The large amount of information that appears every day requires comprehension and systematization. The immunological aspects of the virus-host interaction are the core issues in the effective treatment and prevention of COVID-19’ development.The review analyzes the known pathways of the viral invasion and evasion, the mechanisms of the cytokine storm, endothelial damage, and hypercoagulability associated with SARS-CoV-2 infection. Clinical data from previous SARS and MERS epidemics is discussed here. We also address the therapeutic approaches based on the basic knowledge of immune response and the blood cells’ immune functions, as well as the ways to reduce their hyperactivation. The use of interferon therapy, anti-inflammatory therapy, anti-cytokine therapy, neutralizing antibodies, convalescent plasma, and mesenchymal stem cells, as well as prophylactic vaccines, is discussed.

SARS-Cov2 S Protein Features Potential Estrogen Binding Site.

SUMMARYResearch backgroundDuring the current SARS-CoV2 pandemic, as well as earlier SARS and MERS epidemics, it has been observed that COVID19-positive women on average tend to have milder symptoms and lower fatality rates than men. There is a number of differences between the sexes known to contribute to different immune responses and severity of the disease, one being the effect of estrogen via estrogen receptor signalling. We wondered if estrogen might also affect the SARS-CoV2 more directly, perhaps by binding to the surface glycoprotein (S protein), thus possibly reducing its infectivity.Experimental approachTo assess whether there is a possibility for estrogen binding on the SARS-CoV2 S protein, we used BLAST and HHpred to compare protein sequences of S protein and human estrogen receptor β, while 3D structures of a potential estrogen binding site and an active site of estrogen receptor β were visualized and compared using PyMOL.Results and conclusionsBy comparing the sequence of SARS-CoV2 S protein with the human estrogen receptor β, we identified a potential estrogen binding site on S protein and further determined that it also shares notable similarities with the active site of ER β when observed in 3D structure of their respective proteins. As a control, SARS-CoV2 S protein was compared with the human androgen receptor, and no such similarities were found. The potential estrogen binding site is part of coronavirus S2 superfamily domain, which is involved in host-virus membrane fusion during infection and appears to be conserved throughout the Coronaviridae family.Novelty and scientific contributionThis preliminary communication shows that SARS-CoV2 S protein features a potential estrogen binding site. Hopefully, this will prompt a more comprehensive study on the possibilities of estrogen binding on the S protein and the effect this might confer on the virus infectivity.

Health-related Quality of Life (HRQoL) of Individuals from Pune city after 6 weeks of Mild and Moderate grade COVID-19 infection

Background: Coronavirus disease (COVID-19) caused by SARS-CoV-2 virus was declared as a global pandemic by the WHO in March 2020. India is the second worst hit by the pandemic in which Maharashtra records highest number of infected cases in the country with Pune topping the count. Prevalence of Mild and Moderate grade of COVID-19 infection is high among the population. HRQoL was found to be curtailed in adults who suffered from Upper respiratory tract infection and also in survivors of H1N1 pandemic, SARS and MERS epidemics. Purpose of study: Alteration in individual’s HRQoL can affect his daily activities and community participation. There is a dearth of studies about the impact of COVID-19 infection on the quality of life of patients in Indian Population. Hence, the following study was undertaken and HRQoL was assessed using components of Short Form-12 questionnaire. Results and main findings: This cross-sectional study was carried out on 121 individuals across Pune city, after a mean of 45 days after suffering from Mild (73%) or Moderate (27%) grade of COVID-19 infection. Out of the study population, 29% had one or more co-morbidities present such as type 2 diabetes mellitus, systemic hypertension, hypothyroidism. Results of the components of the SF-12 questionnaire of these individuals are as follows. 61.15% of the study population have no limitations in physical functioning, 65% have no limitation in role physical activities, 72.7% have no pain interference in their daily activities, 92.6% have positive general health perception, 90% have good amount of energy in their daily life, 89.2% have no significant interference in their social activities, 74% have no limitations in their daily activities due to their emotional health, 72.7% have felt peaceful for significant amount of the time and 64.9% individuals have not felt depressed or sad since the infection. Conclusion: Health-related Quality of Life is not impaired in 61.15% of the population of Pune city who suffered from mild and moderate grade COVID-19 infection. Clinical implication: This study can be helpful in planning a multidisciplinary treatment after 6 weeks of the infection for individuals who were mildly or moderately infected by COVID-19. KEY WORDS: Covid-19, Health related quality of life, SF-12, persistent symptoms.

The global challenges of controlling coronavirus disease 2019: A review study

Background: The COVID-19 pandemic is a challenging health problem around the world. At time of this study, the pandemic is still underway, so prevention and control are of great importance. This review provides a comprehensive examination and analysis of the literature related to the challenges of controlling COVID-19. Methods: In this narrative review study, the search was performed on international databases including PubMed, Scopus and Embase, using relevant keywords. The resulting articles and texts were reviewed and screened, and then the relevant information was extracted. Results: The number of patients who are thought to have contracted COVID-19 is much higher than that in the SARS and MERS epidemics. Despite a lower mortality rate, COVID-19 has caused more deaths. One of the challenges that have made the control of the disease more difficult include the emergence of multiple viral mutations. In this review, it was found that the best course of action comprises continuous monitoring of disease-related indicators as part of a series of measures taken together to ensure their effectiveness. Conclusion: It is recommended that governments should form international partnerships in their efforts to overcome the pandemic, and that preventive and control measures should be taken simultaneously. © 2021 Shriaz University of Medical Sciences. All rights reserved.

Testing the identification effectiveness of an unknown outbreak of the Infectious Diseases Seeker (IDS) using and comparing the novel coronavirus disease (COVID-19) outbreak with the past SARS and MERS epidemics

BackgroundThe aim of this research is to assess the predictive accuracy of the Infectious Diseases Seeker (IDS) – an innovative tool for prompt identification of the causative agent of infectious diseases during outbreaks – when field epidemiological data collected from a novel outbreak of unknown origin are analysed by the tool. For this reason, it has been taken into account the novel coronavirus disease (COVID-19) outbreak, which began in China at the end of December 2019, has rapidly spread around the globe, and it has led to a public health emergency of international concern (PHEIC), declared to the 30th of January 2020 by the World Health Organization (WHO). MethodsThe IDS takes advantage of an off-line database, built before the COVID-19 pandemic, which represents a pivotal characteristic for working without an internet connection. The software has been tested using the epidemiological data available in different and progressive stages of the COVID-19 outbreak. As a comparison, the results of the tests performed using the epidemiological data from the Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) epidemic in 2002 and Middle East Respiratory Syndrome coronavirus (MERS-CoV) epidemic in 2012, are shown. ResultsThe overall outcomes provided by the software are comforting, as a matter of the fact that IDS has identified with a good accuracy the SARS and MERS epidemics (over 90%), while, as expected, it has not provided erroneous and equivocal readings after the elaboration COVID-19 epidemic data. ConclusionsEven though IDS has not recognized the COVID-19 epidemic, it has not given to the end user a false result and wrong interpretation, as expected by the developers. For this reason, IDS reveals itself as useful software to identify a possible epidemic or outbreak. Thus, the intention of developers is to plan, once the software will be released, dedicated updates and upgrades of the database (e.g., SARS-CoV-2) in order to keep this tool increasingly useful and applicable to reality.

Immune Response to COVID-19: Can We Benefit from the SARS-CoV and MERS-CoV Pandemic Experience?

The global range and high fatality rate of the newest human coronavirus (HCoV) pandemic has made SARS-CoV-2 the focus of the scientific world. Next-generation sequencing of the viral genome and a phylogenetic analysis have shown the high homology of SARS-CoV-2 to other HCoVs that have led to local epidemics in the past. The experience acquired in SARS and MERS epidemics may prove useful in understanding the SARS-CoV-2 pathomechanism and lead to effective treatment and potential vaccine development. This study summarizes the immune response to SARS-CoV, MERS-CoV, and SARS-CoV-2 and focuses on T cell response, humoral immunity, and complement system activation in different stages of HCoVs infections. The study also presents the quantity and frequency of T cell responses, particularly CD4+ and CD8+; the profile of cytokine production and secretion; and its relation to T cell type, disease severity, and utility in prognostics of the course of SARS, MERS, and COVID-19 outbreaks. The role of interferons in the therapy of these infections is also discussed. Moreover, the kinetics of specific antibody production, the correlation between humoral and cellular immune response and the immunogenicity of the structural HCoVs proteins and their utility in the development of a vaccine against SARS, MERS, and COVID-19 has been updated.

Maternal and fetal outcomes of COVID-19, SARS, and MERS: a narrative review on the current knowledge.

Coronavirus infections, including SARS, MERS and COVID-19 have significant impact on global health as well as on pregnancies. The aim of this review was to enlighten and summarize the cumulative knowledge regarding the relationship between Coronavirus outbreaks and pregnancy. Literature search was commenced in order to analyze the maternofetal effects of Coronavirus outbreaks. Fever and cough are the most common presenting symptoms of COVID-19 which mostly affects pregnant women in their 3rd trimester with a maternal mortality rate of 0-77% and fetal and neonatal mortality rates of 1.2%. Fetal demise is common in critically ill pregnant. Pregnancy seems as a worsening factor for SARS and MERS epidemics and both infections affect prominently 3rd trimester pregnancies, although abortion (57%) is a significant risk for cases of early pregnancy. Clinical course of COVID-19, SARS and MERS may be rapid and worse in pregnant women than non-pregnant individuals. Cesarean section is the choice of delivery in most reported women due to mostly obstetrical reasons, although vaginal delivery seems not a worsening factor for the disease. COVID-19, SARS and MERS have significant detrimental effect on pregnancy. Rapid intervention, treatment, and intensive care support are essential for infected pregnant. Timely delivery is important in order to avoid intrauterine fetal death.

Unraveling the Epidemiology, Geographical Distribution, and Genomic Evolution of Potentially Lethal Coronaviruses (SARS, MERS, and SARS CoV-2).

SARS CoV appeared in 2003 in China, transmitted from bats to humans via eating infected animals. It affected 8,096 humans with a death rate of 11% affecting 21 countries. The receptor binding domain (RBD) in S protein of this virus gets attached with the ACE2 receptors present on human cells. MERS CoV was first reported in 2012 in Middle East, originated from bat and transmitted to humans through camels. MERS CoV has a fatality rate of 35% and last case reported was in 2017 making a total of 1,879 cases worldwide. DPP4 expressed on human cells is the main attaching site for RBD in S protein of MERS CoV. Folding of RBD plays a crucial role in its pathogenesis. Virus causing COVID-19 was named as SARS CoV-2 due its homology with SARS CoV that emerged in 2003. It has become a pandemic affecting nearly 200 countries in just 3 months' time with a death rate of 2–3% currently. The new virus is fast spreading, but it utilizes the same RBD and ACE2 receptors along with furin present in human cells. The lessons learned from the SARS and MERS epidemics are the best social weapons to face and fight against this novel global threat.

CORTICOSTEROIDS IN THE TREATMENT OF SEVERE COVID-19 LUNG DISEASE: THE PULMONOLOGY PERSPECTIVE FROM THE FIRST UNITED STATES EPICENTER

The SARS-CoV-2 pandemic has introduced the medical community to a lung disease heretofore unknown to most clinicians. In much of the discourse about COVID-19 lung disease, the more familiar clinical entity of ARDS has been used as the guiding paradigm. Reflecting on studies in ARDS, particularly that due to influenza, and on data from the SARS-CoV and MERS epidemics, many authorities, including within the discipline of infectious diseases, were initially passionate in their opposition to the use of corticosteroids for lung involvement in COVID-19. The voice of the pulmonology community—the community of lung experts—has continued to be among the quietest in this conversation. Herein we offer our perspective as academic pulmonologists who encountered COVID-19 in its first United States epicenter of New York City. We encourage a conceptual separation between early COVID-19 lung involvement and ARDS. We draw on history with other immune cell-mediated lung diseases, on insights from the SARS-CoV experience, and on frontline observations in an attempt to allay the skepticism towards corticosteroids in COVID-19 lung disease that is likely to persist even as favorable study results emerge.

The use of viral RNA polymerase inhibitors in combination with a fusion inhibitor in the treatment of patients with COVID-19: hypothesis

This review article considers the possibilities of combined antiviral therapy in the treatment of patients with COVID-19, based on the analysis of the mechanism of action of known antiviral drugs in the framework of the medical hypothesis. The potential effectiveness of the joint use of viral RNA polymerase inhibitors and a fusion inhibitor in this pathology is discussed. The review discusses the main representatives of these groups of drugs - ribavirin, riamilovir, umifenovir, favipiravir. The efficacy and safety profile of these drugs was analyzed, including the experience of their use in clinical trials conducted during the COVID-19 pandemic, as well as earlier work performed during the SARS and MERS epidemics.

Preliminary evidence for seasonality of Covid-19 due to ultraviolet radiation

The Covid-19 pandemic has spread across the world during early 2020, with unforeseen consequences. Beyond social measures and biomedical research, it is important to assess the seasonality of the epidemic to inform strategies, with limited available data in the short period of time between the March equinox and the June solstice. While the effect of multiple factors is being investigated, little attention has been paid to ultraviolet (UV) radiation, a key parameter of seasonal forcing. We review the effects of UV radiation, proposing it as a potential element of seasonality, and provide evidence from the current literature and scant, yet revealing, observations. Explicit consideration should be given to UV radiation for the seasonality of Covid-19 at high latitudes and altitudes, based on the SARS and MERS epidemics and coronavirus diseases, and not just the ‘warmer days’ of summer.

Metastatic melanoma treatment with checkpoint inhibitors in the COVID-19 era: experience from an Italian Skin Cancer Unit.

Linked articles: COVID‐19 SPECIAL FORUM. J Eur Acad Dermatol Venereol 2020; 34: e291–e310 .

The cytokine storm in COVID-19: An overview of the involvement of the chemokine/chemokine-receptor system

In 2019–2020 a new coronavirus named SARS-CoV-2 was identified as the causative agent of a several acute respiratory infection named COVID-19, which is causing a worldwide pandemic. There are still many unresolved questions regarding the pathogenesis of this disease and especially the reasons underlying the extremely different clinical course, ranging from asymptomatic forms to severe manifestations, including the Acute Respiratory Distress Syndrome (ARDS). SARS-CoV-2 showed phylogenetic similarities to both SARS-CoV and MERS-CoV viruses, and some of the clinical features are shared between COVID-19 and previously identified beta-coronavirus infections. Available evidence indicate that the so called “cytokine storm” an uncontrolled over-production of soluble markers of inflammation which, in turn, sustain an aberrant systemic inflammatory response, is a major responsible for the occurrence of ARDS. Chemokines are low molecular weight proteins with powerful chemoattractant activity which play a role in the immune cell recruitment during inflammation. This review will be aimed at providing an overview of the current knowledge on the involvement of the chemokine/chemokine-receptor system in the cytokine storm related to SARS-CoV-2 infection. Basic and clinical evidences obtained from previous SARS and MERS epidemics and available data from COVID-19 will be taken into account.

Research progress of new coronavirus (COVID-19): Theoretical study

الأهداف: توفير منظور شمولي عن فيروس كورونا الجديد (كوفيد-19) لمساعدة الباحثين وتحسين مجالات خطط الاستجابة المستقبلية للتعامل مع هذا الوباء، وتقديم ملخص للعوامل التي تساعد على إيقاف تطوره. الطرق والوسائل: هذه دراسة نظرية تم إجراؤها من خلال مراجعة شاملة للأدبيات والبحوث في المحركات البحثية (PubMed) و(Read) و( ELSEVIER) والدراسات الجديدة الأخرى المنشورة باللغة الصينية، حيث تم الحصول على معلومات حول التشخيص والعلاج والوقاية وطرق العدوى، ومن أجل تحديد الخصائص للفيروس (كوفيد-19) التي تتشابه مع الفيروسات الأخرى تم الرجوع إلى بعض الأبحاث المتعلقة بالفيروسات من نفس العائلة مثل متلازمة الشرق الأوسط التنفسية (MERS) والمتلازمة التنفسية الحادة الوخيمة (SARS). النتائج: حتى الآن لم يتم العثور على دواء فعال لعلاج الالتهاب الرئوي التاجي الناجم عن فيروس كورونا الجديد (كوفيد-19) ، وتطوير اللقاحات لا يزال قيد التجريب على الحيوانات ولا تزال التوصيات والإجراءات الوقائية للسيطرة على انتشار العدوى هي الطريقة الوحيدة لمنع انتشار فيروس كوفيد-19. ومع ذلك، فقد ثبت أن بعض الأدوية تخفف بشكل فعال من الالتهابات المصاحبة لفيروس (كوفيد-19) كما ثبت أيضًا أن استخدام بعض الأدوية التي كان لها أثر أثناء وباء فيروسات (MERS) و(SARS) على سبيل المثال: لوبينافير (LPV) هو دواء فعال لتثبيط نشاط البروتياز من للفيروس الجديد. تم إحراز تقدم في التشخيص، حيث وجدت بعض الدراسات أن الأشعة المقطعية قد تظهر بعض التشوهات في الصدر حتى قبل ظهور الأعراض. أهم التوصيات: لا يزال فيروس كوفيد -19 مصدر قلق عالمي وهناك حاجة إلى مزيد من البحث للسيطرة عليه، وهناك حاجة إلى البحث عن جميع مصادر العدوى خاصة تلك التي لا تزال غامضة، ولا تزال هناك حاجة إلى تطوير الاحتياطات وإجراءات الوقاية، خاصة لموظفي المستشفيات وأولئك الذين يحتاجون إلى اتصال مباشر مع المرضى.