New threatening of SARS-CoV-2 coinfection and strategies to fight the current pandemic

Abstract

Coronavirus disease (COVID-19) is a global pandemic. The COVID-19 outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has overloaded healthcare systems that need medication to be rapidly established, at least to minimize the incidence of COVID-19. The coinfection with other microorganisms has drastically affected human health. Due to the utmost necessity to treat the patient infected with COVID-19 earliest, poor diagnosis and misuse of antibiotics may lead the world where no more drugs are available even to treat mild infections. Besides, sanitizers and disinfectants used to help minimize widespread coronavirus infection risk also contribute to an increased risk of antimicrobial resistance. To ease the situation, zinc supplements' potentiality has been explored and found to be an effective element to boost the immune system. Zinc also prevents the entry of the virus by increasing the ciliary beat frequency. Furthermore, the limitations of current antiviral agents such as a narrow range and low bioavailability can be resolved using nanomaterials, which are considered an important therapeutic alternative for the next generation. Thus, the development of new antiviral nanoagents will significantly help tackle many potential challenges and knowledge gaps. This review paper provides profound insight into how COVID-19 and antimicrobial resistance (AMR) are interrelated and the possible implications and current strategies to fight the ongoing pandemic.

Keywords: COVID-19; antimicrobial resistance; antiviral agents; immune system; nanomaterials.

Graphical abstract

Fig. 1

Schematic diagram of SARS-CoV-2 virus structure, component, and its role in virus propogation.

Fig. 2

The relationship between SARS-CoV-2 in coinfections, bacteria, and the host. (A) The virulence factors of SARS-CoV-2 interact with the lungs and elicit an immune response. These interactions can compromise innate immunity at several levels, leading to increased bacterial attachment, growth, and dissemination. Bacterial receptors mediating bacterial attachment can be discovered by a viral infection. An exuberant inflammatory response can result from coinfection. It is also possible that the form of SARS-CoV-2-induced immune response can allow bacteria to thrive in the lungs. On the other hand, SARS-CoV-2 infection may be predisposed to bacterial colonization because the innate immune host defenses can be downregulated, allowing survival, development, and pathology of the virus. (B) Coinfection may aggravate tissue damage, and exuberant inflammatory response may further aggravate SARS-CoV-2-induced lung damage. Reproduced with permission from ref. [15]. Copyright 2020 Published under the terms of the CC BY 4.0 license.

Fig. 3

Schematic diagram of the current scenario of COVID-19.