Novel coronavirus disease (COVID-19) update on epidemiology, pathogenicity, clinical course and treatments

Abstract

During the December of 2019, a series of patients with pneumonia caused by novel coronavirus; the severe acute respiratory syndrome (SARS) corona (COV-2), that is, COVID-19. Since the first cluster of cases was reported in China on 31 December 2019 until the 28 April 2020, there were internationally reported 3'000'000 cases, in over 185 countries, and 207'265 deaths. To date, it is still not unanimously clear which effects parameters of virus and host are important for the development of severe disease course. According to the most updated internationally available online cases register, COVID-19 disease has mild symptoms in around 85% of cases, there are 3%-10% of critical cases, and mortality is around 5%-7%. Since currently there is no available vaccine and no well-established specific antiviral therapy, numerous agents are being tested in clinical scenarios. The most common regimens include remdesivir, convalescent plasma. Widely used chloroquine, hydroxychloroquine and azithromycin combinations, as well as lopinavir-ritonavir were shown to have less efficient treatment effects. More severe cases of pneumonia and dyspnoea, or uncontrollable fever are treated as inpatients, and nearly 10% in intensive care units. Oxygen supplementation is indicated to maintain peripheral blood oxygenation over 90%-96%. Advanced support systems include mechanical ventilation and extracorporeal membranous support; however, those without targeted antiviral therapy represent only temporary bridge for scarce potential restitution in patient themselves. The aim of review is to present current state of the art in epidemiology, pathogenesis, clinical course and treatment of COVID-19 patients.

Keywords: ARDS-acute respiratory distress syndrome; COVID-19-coronavirus disease 2019; CoV-coronavirus; ECMO- extracorporeal membranous oxygenation; SARS-severe acute respiratory syndrome.