Understanding COVID-19 Pandemic: Molecular Mechanisms and Potential Therapeutic Strategies. An Evidence-Based Review

Abstract

Initially, the SARS-CoV-2 virus was considered as a pneumonia virus; however, a series of peer reviewed medical papers published in the last eight months suggest that this virus attacks the brain, heart, intestine, nervous and vascular systems, as well the blood stream. Although many facts remain unknown, an objective appraisal of the current scientific literature addressing the latest progress on COVID-19 is required. The aim of the present study was to conduct a critical review of the literature, focusing on the current molecular structure of SARS-CoV-2 and prospective treatment modalities of COVID-19. The main objectives were to collect, scrutinize and objectively evaluate the current scientific evidence-based information, as well to provide an updated overview of the topic that is ongoing. The authors underlined potential prospective therapies, including vaccine and phototherapy, as a monotherapy or combined with current treatment modalities. The authors concluded that this review has produced high quality evidence, which can be utilized by the clinical scientific community for future reference, as the knowledge and understanding of the SARS-CoV-2 virus are evolving, in terms of its epidemiological, pathogenicity, and clinical manifestations, which ultimately map the strategic path, towards an effective and safe treatment and production of a reliable and potent vaccine.

Keywords: COVID-19; PBMT; PDT; SARS-CoV-2; antiviral; clinical trials; cytokines storm; diagnostic methods; immunotherapy; photobiomodulation therapy; photodynamic therapy; vaccine; virus pathogenicity.

Figure 1

Modified schematic diagram illustrates COVID-19 clinical presentation, diagnostic investigations, assessment of disease severity and consideration of care settings accordingly.,,–

Figure 2

Modified schematic diagram illustrates the etiopathogenesis and pathophysiology of COVID-19. Data from Wiersinga et al.

Figure 3

Modified schematic diagram illustrates the cellular and molecular cascade of PBMT that reserve SARS-CoV-2 cellular and molecular activities to prevent ARDS. Notes: Adapted with permission from Mokmeli S, Vetrici M. Low level laser therapy as a modality to attenuate cytokine storm at multiple levels, enhance recovery, and reduce the use of ventilators in COVID–19. Can J Respir Ther. 2020;56:1–7.