Kakodkar Pramath, Kaka Nagham, Baig M N
Medicine, National University of Ireland Galway, Galway, IRL.
Orthopaedics, University Hospital Galway, Galway, IRL.
Cureus. 2020 Apr 6;12(4):e7560. doi: 10.7759/cureus.7560.
Coronavirus disease 2019 (COVID-19) is a declared global pandemic. There are multiple parameters of the clinical course and management of the COVID-19 that need optimization. A hindrance to this development is the vast amount of misinformation present due to scarcely sourced manuscript preprints and social media. This literature review aims to presents accredited and the most current studies pertaining to the basic sciences of SARS-CoV-2, clinical presentation and disease course of COVID-19, public health interventions, and current epidemiological developments. The review on basic sciences aims to clarify the jargon in virology, describe the virion structure of SARS-CoV-2 and present pertinent details relevant to clinical practice. Another component discussed is the brief history on the series of experiments used to explore the origins and evolution of the phylogeny of the viral genome of SARS-CoV-2. Additionally, the clinical and epidemiological differences between COVID-19 and other infections causing outbreaks (SARS, MERS, H1N1) are elucidated. Emphasis is placed on evidence-based medicine to evaluate the frequency of presentation of various symptoms to create a stratification system of the most important epidemiological risk factors for COVID-19. These can be used to triage and expedite risk assessment. Furthermore, the limitations and statistical strength of the diagnostic tools currently in clinical practice are evaluated. Criteria on rapid screening, discharge from hospital and discontinuation of self-quarantine are clarified. Epidemiological factors influencing the rapid rate of spread of the SARS-CoV-2 virus are described. Accurate information pertinent to improving prevention strategies is also discussed. The penultimate portion of the review aims to explain the involvement of micronutrients such as vitamin C and vitamin D in COVID19 treatment and prophylaxis. Furthermore, the biochemistry of the major candidates for novel therapies is briefly reviewed and a summary of their current status in the clinical trials is presented. Lastly, the current scientific data and status of governing bodies such as the Center of Disease Control (CDC) and the WHO on the usage of controversial therapies such as angiotensin-converting enzyme (ACE) inhibitors, nonsteroidal anti-inflammatory drugs (NSAIDs) (Ibuprofen), and corticosteroids usage in COVID-19 are discussed. The composite collection of accredited studies on each of these subtopics of COVID-19 within this review will enable clarification and focus on the current status and direction in the planning of the management of this global pandemic.
2019冠状病毒病（COVID-19）已被宣布为全球大流行病。COVID-19临床病程和管理的多个参数需要优化。由于来源稀少的手稿预印本和社交媒体的存在，大量错误信息成为了这一进展的障碍。本综述旨在介绍与严重急性呼吸综合征冠状病毒2（SARS-CoV-2）基础科学、COVID-19临床表现和病程、公共卫生干预措施以及当前流行病学进展相关的权威且最新的研究。基础科学部分的综述旨在阐明病毒学术语，描述SARS-CoV-2病毒粒子结构，并呈现与临床实践相关的详细信息。讨论的另一个内容是用于探索SARS-CoV-2病毒基因组系统发育起源和进化的一系列实验的简要历史。此外，还阐明了COVID-19与其他引起疫情爆发的感染（SARS、中东呼吸综合征、H1N1）之间的临床和流行病学差异。重点是循证医学，以评估各种症状出现的频率，从而创建一个针对COVID-19最重要流行病学风险因素的分层系统。这些可用于分流和加快风险评估。此外，还评估了目前临床实践中诊断工具的局限性和统计学强度。明确了快速筛查、出院和解除自我隔离的标准。描述了影响SARS-CoV-病毒快速传播速度的流行病学因素。还讨论了与改进预防策略相关的准确信息。综述的倒数第二部分旨在解释维生素C和维生素D等微量营养素在COVID-19治疗和预防中的作用。此外，简要回顾了新型疗法主要候选药物的生物化学，并介绍了它们在临床试验中的现状。最后，讨论了疾病控制中心（CDC）和世界卫生组织（WHO）等管理机构关于血管紧张素转换酶（ACE）抑制剂、非甾体抗炎药（NSAIDs）（布洛芬）等有争议疗法在COVID-19中的使用以及皮质类固醇使用的当前科学数据和现状。本综述中关于COVID-19这些子主题的经认可研究的综合汇集将有助于明确并聚焦于这一全球大流行病管理规划的当前状况和方向。
