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Roberto Alfonso Accinelli1,2,3, Cristian Mingxiong Zhang Xu3, Jia-Der Ju Wang3

  • 1Servicio de Neumología, Hospital Cayetano Heredia, Lima, Perú.

Revista Peruana De Medicina Experimental Y Salud Publica
|September 3, 2020
PubMed
Summary
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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19, characterized by fever, cough, and dyspnea. Severe cases exhibit diffuse alveolar damage and cytokine storms, necessitating treatments like methylprednisolone.

Area of Science:

  • Virology
  • Immunology
  • Radiology

Background:

  • The emergence of SARS-CoV-2 in early 2020 led to a global pandemic.
  • SARS-CoV-2 is a positive single-stranded RNA virus with structural proteins, including the S protein crucial for host cell entry via the ECA2 receptor.
  • COVID-19 presentation varies, with 81% mild, 14% severe, and 5% critical cases.

Purpose of the Study:

  • To describe the clinical, pathological, and radiological characteristics of SARS-CoV-2 infection.
  • To identify potential therapeutic targets and management strategies for COVID-19.

Main Methods:

  • Analysis of clinical symptoms, including fever, cough, and dyspnea.
  • Review of laboratory findings such as lymphopenia.
  • Examination of lung biopsy findings (diffuse alveolar damage) and radiological patterns (ground glass, alveolar opacities).

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Main Results:

  • Fever, cough, and dyspnea are the most common symptoms.
  • Lymphopenia is observed in patients, with no other pathogens typically found in sputum.
  • Lung biopsies show diffuse alveolar damage, and radiological imaging reveals characteristic patterns, predominantly in the lower lobes.
  • Severe inflammation and cytokine storms are noted in critical cases.

Conclusions:

  • The S protein-ECA2 interaction is a key target for antiviral therapies.
  • Management of severe COVID-19 may involve anti-inflammatory treatments like methylprednisolone pulse therapy.
  • Chloroquine/hydroxychloroquine, with or without azithromycin, has been authorized for potential anti-SARS-CoV-2 and anti-inflammatory effects, despite limited large-scale studies.