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Review
. 2025 Oct 24;11(1):75.
doi: 10.1038/s41572-025-00662-x.

Acute SARS-CoV-2 infection

Amy C Sherman  1 , Glenda E Gray  2 , Bin Cao  3 , Kelvin K W To  4 , Nadine Rouphael  5 , Ana Maria Henao-Restrepo  6 , Anthony C Gordon  7 , Lindsey R Baden  8
Affiliations
Review

Acute SARS-CoV-2 infection

Amy C Sherman et al. Nat Rev Dis Primers. .

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a respiratory pathogen that emerged in December 2019 and caused a global pandemic by March 2020, with >7 million deaths due to coronavirus disease 2019 (COVID-19) globally as of September 2025. The clinical syndrome of COVID-19 ranges from asymptomatic infection to severe disease with pneumonia and death. SARS-CoV-2 variant type, inoculum, previous exposure and host factors influence the clinical trajectory. Identification of key structural proteins of SARS-CoV-2 and insights into the pathophysiology of the immune response to infection led to the development of effective preventive (vaccines and monoclonal antibodies) and therapeutic (antivirals and immunomodulatory agents) agents. Antiviral agents, such as remdesivir and nirmatrelvir-ritonavir, inhibit viral replication and immunomodulatory agents, such as tocilizumab and baricitinib, act to reduce a dysregulated immune response to SARS-CoV-2. The pandemic had economic and socio-cultural consequences that affected the quality of life and overall life expectancy of individuals. As the emergency phase of the pandemic concludes, robust monitoring and surveillance systems must be sustained and research to improve vaccines and therapeutics must continue to maintain control of SARS-CoV-2 in the population and be prepared for emerging pathogens with pandemic potential.

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Conflict of interest statement

Competing interests: A.C.S. is involved in human immunodeficiency virus (HIV), coronavirus (COVID) and other vaccine clinical trials conducted in collaboration with the National Institutes of Health (NIH), HIV Vaccine Trials Network, COVID Vaccine Prevention Network, International AIDS Vaccine Initiative, Crucell/Janssen and Moderna. K.K.W.T. has received free admission to London Calling 2024, a conference organized by Oxford Nanopore Technologies. Emory receives funds for N.R. to conduct research from Sanofi, Lilly, Merck, Quidel, Immorna, Vaccine Company and Pfizer. N.R. served on selected advisory boards for Sanofi, Seqirus, Pfizer and Moderna and is a paid clinical trials safety consultant for ICON, CyanVac, Imunon and EMMES. She also receives payments for co-authoring the COVID-19 vaccines chapter in Up to Date. A.C.G. has consulted for AstraZeneca and for Partner Therapeutics, with fees paid to his institution. L.R.B. reports research support from the NIH (including National Institute of Allergy and Infectious Diseases and the National Center for Advancing Translational Sciences), Wellcome Trust, and the Bill & Melinda Gates Foundation, outside of the submitted work; has served on a Data and Safety Monitoring Board, SMC, and advisory committee for NIH and the Food and Drug Administration; and is involved in HIV, COVID and other vaccine clinical trials conducted in collaboration with the NIH, HIV Vaccine Trials Network, COVID Vaccine Prevention Network, International AIDS Vaccine Initiative, Crucell/Janssen, Moderna, Military HIV Research Program, the Bill & Melinda Gates Foundation, and the Ragon Institute. G.E.G., B.C. and A.M.H.-R. declare no competing interests.

References

    1. Chan, J. F.-W. et al. A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. Lancet 395, 514–523 (2020). An early report of the epidemiological, clinical and microbiological features of patients in a family cluster who became ill with an unexplained pneumonia, demonstrating person-to-person spread of a novel coronavirus. - PubMed - PMC - DOI
    1. Zhu, N. et al. A novel coronavirus from patients with pneumonia in China, 2019. N. Engl. J. Med. 382, 727–733 (2020). One of the first reports of SARS-CoV-2 identified in Wuhan, China, among hospitalized patients, with whole-genome sequencing, direct PCR and culture from bronchoalveolar lavage fluid confirming a novel type of coronavirus. - PubMed - PMC - DOI
    1. Huang, C. et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 395, 497–506 (2020). - PMC - DOI
    1. World Health Organization. Coronavirus Disease (COVID-19) Pandemic. WHO https://www.who.int/europe/emergencies/situations/covid-19 (2025).
    1. Centers for Disease Control and Prevention. CDC Museum COVID-19 Timeline. CDC https://www.cdc.gov/museum/timeline/covid19.html (2023).