Covid-19 Treatments Based on pathogenicity

Covid-19 Treatments Based on pathogenicity
Ali salimi asl,¹ Sobhan Montazerghaem,² Faezeh Malekzadeh ,³ Amin Reza Nikpoor ,⁴ Shaghayegh KermaniNezhad,^5,* Soroush Bahrami,⁶
1. Student Research Committee, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
2. Student Research Committee, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
3. Student Research Committee, Faculty of Para-Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
4. Department of Immunology, Faculty of Medicine, Hormozgan University of Medical Science, Bandar Abbas, Iran.
5. Student Research Committee, Faculty of Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
6. Student Research Committee, Faculty of Para-Medicine, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
Introduction: It is important to know the mechanism by which the coronavirus enters the host cell and consequently causes infection in the host. the virus first binds to Angiotensin-converting enzyme 2 (ACE2) receptors on the surface of host cells and then enters the cell, then the virus starts proliferation, membrane fusion, assembly, and subsequent infection and cytokine secretion. By Understanding the pathogenesis stage of the virus, as well as identifying the drugs that prevent the virus from spreading in each of these stages, Controlling the disease and the recovery of patients is possible.
Methods: Article selection were conducted through advanced search in web of science, Pubmed database and without time limit, using two keywords derived from MeSH (SARS-CoV-2 and treatment) and limiting the search to keywords in the abstract. From the 40 available articles, based on the content of the abstracts, 19 articles related to treatment of SARS-CoV-2 were selected. The articles were studied and key points of each were identified.
Results: The virus is likely to infect epithelial cells in the nasal cavity even with a low load and begins to multiply.The virus travels in the respiratory tract along the airways, triggering a strong innate immune response and the disease becomes clinically apparent. about 20% of infected patients progress to stage 3 of disease and develop an infection in the alveolar cells and lung gas exchange units.Coronavirus has a number of proteins including Protein spike. Protein S contains RBD, which is the basic Ag for binding to ACE2. Overexpression of ACE2 may facilitate virus replication in lung tissue.There are various drugs for the treatment of this disease with different methods. methods such as: inhibition of some cellular receptors, prevention of virus entry, inhibition of some intracellular proteases, etc. The primary strategies involved are to prevent the binding of the SARS-CoV2 virus to ACE2 and ACE2 may be a drug target to limit the entry of the virus. SARS-CoV-2 has been shown that The process of binding of protein S to the ACE2 receptor is facilitated by host cell-derived serine protease (TMPRSS2). Kamvastat mesylate prevent SARS-CoV-2 infection and commostat mesylate reduces its infection. SARS-CoV-2 has recently been shown to be a receptor for the ACE2 to enter the host cell from the S protein. Therefore, the ACE2 forms a molecular target to prevent SARS-CoV-2 from entering host cell. Upon entering the host cell, viral single-stranded RNA is released to amplify the RNA virus and translate the virus polyproteins. Lopinavir, Ritanovir and some are candidates for treatment. Due to anti-inflammatory activity, corticosteroids (CS) are an adjunct therapy for acute respiratory distress syndrome and cytokine storm. One of the first defense lines against RNA viruses such as SARS-CoV-2 is the release of type I and III IFNs. Recently, there has been great interest in the therapeutic effect of modulating the IFN response to inactivate the pathogenesis of COVID-19 . Excessive inflammatory responses and high levels of inflammatory cytokines including interleukins -6, 8, and 10 have been shown to be associated with the severity of COVID-19. the anti-IL-6 and other cytokine/chemokine-related elements are potential block targets for the management of COVID-19 cytokine secretion syndrome. there is interest in using selective nAb transmission as a treatment. identifying nAbs produced during natural infections such as patients recovering from SARS-CoV-2 infection or SARS-CoV-1 due to the similarities between SARS-CoV-1 and 2 or through animal vaccination methods are important. transferring plasma (CP) from people previously infected with SARS-CoV-2 have evaluated the safety and potential efficacy of plasma therapy in patients with severe disease. However, there is no specific treatment for COVID-19 disease but there are candidates with positive effect. Some candidates prevent the virus entry into the host cell while some other candidates prevent the proliferation of it and etcetera. So it is important to identify virus pathogenesis and also treatment candidates.
Conclusion: In this study, the mechanism of virus pathogenesis and effective drugs in blocking each stage of virus spread were investigated due to the necessity of Choosing the right medicine for people with Covid-19.
Keywords: SARS-CoV-2,COVID-19,treatment