Posted on Authorea 11 Sep 2020 | The copyright holder is the author/funder. All rights reserved. No reuse without permission. | https://doi.org/10.22541/au.159986344.43500232 | This a preprint and has not been peer reviewed. Data may be preliminary. pnil fteCVD1 lns,i savrsta eog oteCrnvrsfml,i stetidvrsin virus third the is it family, re- Coronavirus the (SARS-CoV-2) to 2 belongs coronavirus that virus syndrome a respiratory is acute it illness, severe COVID-19 named the been of sponsible has coronavirus new The Abstracs [email protected] Guti´errez. Email: Cabello Carlos [email protected] Cort´es. Email: Palma Gabriel 5123 Ext: Co-Autors 00. 17 87 54 55 Phone: CDMX. [email protected] Cos´ıo Villegas, Email: Ismael Diseases, Respiratory of Institute Mycology National and Virology in Research of Olvera Department Rosete Patricia Dora C en M M´exico CDMX. 14080, Tlalpan Secci´on Cos´ıo XVI. Ismael Colonia Diseases. 4502, Correspondence Respiratory No. of Tlalpan Institute de National Calzada Mycology, (INER), and Villegas Virology in Research of Department Cabello-Guti´errez. Palma-Cort´es, Carlos Gabriel (SARS- Rosete-Olvera, coronavirus Patricia new Dora the illness. and COVID-19 (HCoVs) produces Coronavirus that Human CoV-2) the of the characteristics described General illness. we COVID-19 SARS-CoV-2 review, combat of this to characteristics only In for clinical It person development the and valued. more infected prevention epidemic. affects vaccines transmission, illness, being an mainly and the COVID-19 are causes treatments of that against vaccines research some that vaccines transmissible and latest and family or and and drugs this drug HCoVs pathogenic antiviral in of antiviral highly characteristics some virus not is general Recently, third is It the There treatments. is world. death. supportive it cause have the family, can throughout Coronavirus and spread the tract has to respiratory and belongs COVID- that China the of virus in responsible a (SARS-CoV-2) originated 2 is coronavirus it syndrome respiratory illness, acute severe 19 named been has coronavirus new The Abstract 2020 11, September 2 1 Rosete Dora COVID-19 produces illness. that (SARS-CoV-2) and coronavirus (HCoVs) new Coronavirus the Human the of characteristics General ffiito o available not Diseases Affiliation Respiratory of Institute National 1 are Cortez Gabriel , 1 n alsGuti´errez Carlos and , 1 2 Posted on Authorea 11 Sep 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159986344.43500232 — This a preprint and has not been peer reviewed. 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All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159986344.43500232 — This a preprint and has not been peer reviewed. Data may be preliminary. iessta a edt et.Svnsrtpsifc h ua:29,N6 ( NL63 229E, human: the infect serotypes respiratory Seven severe and death. mild, to asymptomatic, lead ( cause can can CoV-B that infections, diseases respiratory symptomatic genera: mild 4 and in divided are δ- they serotype the family on the to belong CoVs CORONAVIRUS OF CLASSIFICATION 3 epidemic. the of peak highest the ( ae ihpemnao nnw tooywr dnie.Ms ae eeascae ihafo market food habitants, a of with million associated 11 were with cases China Most of province identified. Hubei were capital etiology by the unknown cell Wuhan, of infected of pneumonia city the with the from cases 2019, released 30 be December COVID-19 In to OF interaction particles SPREAD subsequent viral surface. 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(Figure Furthermore, Coronaviridae β- o,lnaeB;MR ( MERS B); lineage CoV, 12 1 1,20,28 1hscl eetrbnigdmis(Bs,teestsaehighly are sites these (RBDs), domains binding receptor cell has S1 β- subfamily , oshv iegs(,B ,D.CVAcueasymptomatic cause CoV-A D). C, B, (A, lineages 4 have CoVs ,β γ β, α, 21,22 tas nue h rdcino etaiigantibodies neutralizing of production the induces also It 3 Coronarivinae and 1,20,21 β- o,lnaeC n h otrcn SARS-CoV-2 recent most the and C) lineage CoV, δ- 25,26 CoVs. loi epnil o sebyvrscompo- virus assembly for responsible is Also 27 1,19,20 α n order and , 2,23 and 20,21,24 Fgr )Tesrcua proteins structural The 2) (Figure β- osifc ua and human infect CoVs 16 rti sivle nthe in involved is protein N Nidovirales rti eit cell-cell mediate S Protein 20,21,23 α- os;O4,HKU1 OC43, CoVs); n depending and γ and Posted on Authorea 11 Sep 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159986344.43500232 — This a preprint and has not been peer reviewed. Data may be preliminary. rc asn nuoi.Ptet ihsvr ies fe n ekpeetwt ype,hypoxemia, dyspnea, with present week respiratory lower one the after moderate clinical infects disease subsequently with typical severe patients and no with and tract have Patients symptoms respiratory patients flu-like upper pneumonia. asymptomatic mild the symp- have causing in The to patients tract begins asymptomatic Other disease from cases. the SARS-CoV-2 detected. critical with symptoms is and patients virus severe in but seen moderate, symptoms, is mild, manifestations clinical tomatic: of range wide A disease moderate the disease. MANIFESTATIONS or transfer severe medium CLINICAL can with with 7 they patients samples and from than Samples negative period 2-7 become latency symptoms. between developing rapidly the disease before more throughout the people develop contagious patients low. other remains most extremely to virus however is virus days, The mortality 14 the infection. of prognosis, after is good days SARS-CoV-2 a from been has time has baby incubation SARS-CoV-2 the The and with shorted deaths age. is maternal of time of shedding years reports viral 15 recovery, and below COVID-19 children for hypertension, in population as confirmed. cases vulnerable such few a comorbidities mortality also are more higher are there a or have However, they one and that men. had disorders the cardiovascular principally when indicating and that disease severe patients, found pulmonary more obstructive research chronic symptomatic manifest recent diabetes, clinic in A has that transmission. elderly others. for similar Patients to potential were virus high a patients the the be have asymptomatic transmit may infections to in asymptomatic system able detected hours, digestive are the load 72 the they with that viral than but associated suggesting more symptoms is receptor, clinical for and ACE2 not SARS-CoV-2 steel the with stainless route. infected hours. express transmission and patients 24 that potential plastic in for enterocytes as reported cardboard of such been remain in expression have surfaces can and vomiting on SARS-CoV-2 hours and and that 4 nausea reported hours for al 3 copper et for in Doremalen from aerosols Van nose. distance in and short and conditions. mouth viable surfaces the atmospheric eyes, virus-contaminated in favorable through the staying occurs in of it and membranes surfaces are common, mucous sneezing very that with is or droplets contact contact talking respiratory indirect subsequent the coughing, the Also through while person person. person to another infected person an from by contact direct produced for transmits is SARS-CoV-2 SARS-COV-2. OF ROUTE TRANSMISSION authorities 6 to stations, Chinese cooperating train all The SARS-CoV-2. airports, public, of general death. (closing spread and SARS-CoV reported outbreaks. 2873 measures government, the workers, the containment WHO with prevent health in initiated confirmed to the for than and try were measures 9, sanitary deaths seriously cases February and very of 79,968 highways) On breath, number threat and of of the global total 2%. shortness surpassing the a of cough, deaths, took 2020, was dry 812 to fever, March rate the disease and high fatality the time, of China epidemic. exhibit transmit the this provinces in SARS-CoV-2 could At pneumonia, other confirmed with patient USA. presented in patients one 37,251cases and infected that spread cases Taiwan, indicating The infection severe Korea, 3.5, the and people. 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All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159986344.43500232 — This a preprint and has not been peer reviewed. Data may be preliminary. ira alr.Teptet a ihpam yoie n hmknslvl I-,I-,I-,I1,GCSF, IL10, IL-7, IL-6, (IL-2, levels chemokines mul- and and (ARDS) cytokines syndrome plasma distress high respiratory has IFN- production acute patients uncontrolled of by The cause characterized trigger- is main failure. storm the response, tiorgan cytokine immune is The and strong cytokines a damage. pro-inflammatory show lung of COVID-19 severe and for storm disease cytokine severe a with ing patients of thrombosis. results and laboratory parameters The coagulation abnormal presents can COVID-19 with eetetdwt ,ciia mrvmn a bevdi 6o 3(8)o h ains anyi oxygen in mainly patients, the of (68%) 53 of 36 no in and observed improved was improvement symptoms clinical and clinical R, patient’s SARS-CoV-2 with the of body. treated were observed. of R, replication organs were administered the different effects was inhibits in adverse SARS-CoV-2 R efficiently with that penetrated infected shown R patient have primates non-human studies the vitro in In termination. pre-mature (R) Remdesivir below: supportive described as as Antivirals: used results 9 are promising adjunc- corticosteroids and with and antivirals patients azithromycin with COVID-19 treatment tocilizumab, for some plasma, care however convalescent COVID-19, as against therapies drugs antiviral tive and specific infections. deterioration not organic opportunistic is hyper- any acquire There for mellitus, not monitored diabetes do carefully with patients be breath Patients that should of ventilation. care problems shortness have mechanical kidney with or or Patients in diseases supply management. chronic oxygen fever home tension, for and at while cough hospitalized tissue remain serum, be and with must should hydration masks cases mouth. face are: or exposure. confirmed care 70% wear eyes travel,Supportive patients/individuals virus with or nose, avoiding infected sanitizer face, the suspected with places, touching, or from m, contact avoid public 2s in away and 1 avoid than sneezing/coughing are stay approximately spaces, more who of to common People for distance disinfecting is soap quarantine. spaces, social and protection water home a of with or maintain means hands work and washing best ventilate management The alcohol, are: prevention, measure SARS-CoV-2, preventive against crucial. vaccines The are or healhcare treatment antiviral support not is absorbed. are gradually GGO dense there is with Recently, Progressive: consolidation diffuse is the TREATMENT bilaterally. 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All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159986344.43500232 — This a preprint and has not been peer reviewed. Data may be preliminary. pae3 n hyaetemi addtsfrt ns ihti admc ntdSae(cetssof (Scientists State United pandemic. this with finish immunogenicity to and for their safety candidates verified in main and still the trials are are clinic trials they their these and BioNtech, finished However, 3) include, for (phase companies time others. These more many vaccine. require of and SARS-CoV-2. and coronavirus Johnson, develop- stages novel & the early the on Johnson for working GlaxoSmithKline, vaccines been have 200 Pfizer, worldwide nearly groups of research ment and institutions companies, Development several Vaccine Recently, COVID-19 of cases. severe Status severe with Current patients for COVID-19 10 recommended among is mortality it reduces Only dexamethasone that complications. showed respiratory been has Studies in improvement ties. COVID-19. an for mortality observed (D). and is Dexamethasone reduction azithromycin load recog- with viral pattern combined and induce anti-inflammatory hydroxychloroquine cases to of the that ability shows production the patients has the Also, with attenuating IFNs. immunoglobulins. and response, of receptors inflammatory production nition the the promoting regulate and AZ cytokines properties. in ral role patients COVID-19, (AZ). important with patients an Azythromycinm critical plays improvement. for drug of IL-6 immunotherapy signs an the as response. showed TCZ inflammatory recommends China, the gression. reducing thereby storm. IL-6, cytokine of pathway reported duction have COVID-19 (TCZ). severe Tocilizumab and critical effects. use. with their side diagnosed approved serious has patients without with and improvement studies clinical Two COVID-19. from (CP). COVID-19 plasma Convalescent of Treatment and Diagnosis Agents the Supporting for 10 course. 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Chloroquine March, in China in COVID-19 umifenovir of with its treated and that form than rate phosphoribosylated active replication. an replication. viral in SARSCoV-2 during into of process transformed incorporation then nucleotide is the and interrupts endocytosis L through with cells treatment infected received COVID19 (Avigan). severe Favipiravir with observed, patients no decreased. was hospitalized load benefit adult effect viral and 99 the and /R with symptoms cytochrome, study clinical CYP450 another and of L/R China, inhibition administered was through symptoms L respiratory replication. of viral half-life block and is activity pharmacokinetic the activity. boost promising very shown (L/R). intubated. has Lopinavir/ritonavir drug be this to and need COVID-19 of not treatment did they support, 66,67 80 he onre r rdcn acns hyaei h otavne tgso development of stages advanced most the in are they vaccines, producing are countries Three 70,71 rcs nue o ASCV2ifcinadta a edn orpddsaepro- disease rapid to leading can that and infection SARS-CoV-2 for induced Process Qbok ia neto yicesn nooa Hrqie o iu/elfusion, virus/cell for required pH endosomal increasing by infection viral blocks CQ 15 samncoa nioytree gis L6rcpos tbok h inltrans- signal the blocks it receptors, IL-6 against targeted antibody monoclonal a Is sasnhtcguootci ihat-namtr n muoupesv proper- immunosuppressive and anti-inflammatory with glucocorticoid synthetic a Is 57 73,74 sagaieaaou htihbt h ia N oyeae rtetr the enters first polymerase, RNA viral the inhibits that analogue guanine a Is 63 sabodsetu arld niitcwt muoouainadantivi- and immunomodulation with antibiotic macrolide broad-spectrum a Is nKra ain f5 er l er netdwt ASCV2hdmild had SARS-CoV-2 with infected years old years 54 of patient a Korea, In OI-9ptet rae ihfvprvrsoe hthv ueirrecovery superior have that showed favipiravir with treated patients COVID-19 nvitro In sa muohrp fnurlzn nioyo ainswohv recovered have who patients of antibody neutralizing of immunotherapy an Is sa satcai rtaeihbtradi sc-omltdwt to R with co-formulated is it and inhibitor protease acid aspartic an is L 59 71,72 te tde aesmlrresults. similar have studies other 64 57 tde hw htA a ciiyaantSR-o- n studies and SARS-CoV-2 against activity has AZ that shows studies rlopinavir/ritonavir. or 56 nvitro in edsvr(S53)i npae3ciia rasfrthe for trials clinical 3 phase in is (GS-5734) Remdesivir 6 8 69 68, 8 65 18, ie h lncleetvns fC,teFDA the CP, of effectiveness clinical the Given n lncltil ofimdta Qi effica- is CQ that confirmed trials clinical and 53 75,76 aiiai a prvdfrtetreatment the for approved was Favipiravir 77-79 60,61 13,62 57 nvtosuissosinhibition shows studies vitro In α n L6 tde demon- Studies IL-6. and 58 oee,in However, Posted on Authorea 11 Sep 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159986344.43500232 — This a preprint and has not been peer reviewed. Data may be preliminary. REFERENCES https://orcid.org/0000-0001-6021-9950 Olvera Rosete Patricia Dora traduction the supervision. in ORCID contributed final also the DPRO in paper. the CCG writing-review editing. the and in contributed CCG and GPC DPRO, disclose. to CONTRIBUTIONS interest AUTHOR of “Ismael conflict Diseases no declare Respiratory authors of The Institute National review. INTEREST from this OF with support CONFLICT assisted financial who the colleagues in those thank normality including M´exico new to Cos´ıo and Villegas, a like soon authors very The pass to and of virus deadly The use purchase this the ACKNOWLEDGEMENTS hygiene, hope infection. combat distancing, great to the with social months control see a the coming world or world. moment become the the this prevent all the will in results, for For vaccine it encouraging basic the with and it. stages are of advanced remain with consciousness in live will already social is to virus vaccine principally learn This and to quarantine differently. should have case The professionals behaves masks, we healthcare are confirmed. patient and the be each investigations virus treated, to is of shows have because seasonal their difficult results pandemic agents caution, and and because complex this sizes great several is is sample take stop illness small Although, this severe with for of trials controversial, manifestations Measures clinical treatment. clinical from remains effective data others worldwide. preliminary identifying or safety, respiratory mortality reports and severe and and discovering originate efficacy morbidity has or significant of disease vaccine degree COVID-19 the causes high through that a virus with SARSCoV-2 diseases novel the with can and Infection safety is vaccine the that vector report CONCLUSION adenoviral both an response. and used immune SARS-CoV-2 groups robust of a glycoprotein both S produce Biologics), the (CanSino expressing China responses. that nanoparticles, and immune (Ad5) lipid an Company) potent in used a AstraZeneca encapsulated They and and SARS-CoV-2 antibodies versity of Moderna). neutralizing protein Company specific S Biotechnology produce the and to encodes Disease that Infectious mRNA-1273 vaccine, and mRNA Allergy of Institute National CiJ iFadSiZ.Oii n vlto fptoei ooaiue.NtRvMicrobiol. Rev Nat coronaviruses. pathogenic of evolution and Origin Novel a ZL. of Shi Isolation and RA. Fouchier F and Li AD, J, Osterhaus TM, Cui Bestebroer 7. S, Boheemen van AM, Zaki 6. Coro- Coronaviruses. old of G the Pathogenesis C, with and Recombination, Drosten New Genetic, What’s Epidemiology, 5. al. JA. et Englund W and Shi G, CH, Wong Chiu S, Su HJ, Huh 4. MT, 12:587-593. Martin 2012; YJ, Edition. Mol Kim Eighteenth Methods Microbiology. C, pathogenesis. Medical Ogimi and Coronaviruses. 3. 2012. replication JSM. their Peiris of overview 2. an Coronaviruses: S. Perlman AR, Fehr 1. ooaiu rmaMnwt nuoi nSuiAai.NEg e 02 367:1814-1820. 2012; Med J Engl N Arabia. 2019:17:181-192. Saudi in Pneumonia with Man a from Coronavirus 2003;348:1967-1976. Med. J Engl N Syndrome. Respiratory Acute 2016;24:490-502. Microbiol. Trends 2020:1-8. Soc. Dis Infec Pediatr J naviruses? 2015;1282:1-23. Biol. nhrS rie ta.Ietfiaino oe ooaiu nPtet ihSevere with Patients in Coronavirus Novel a of Identification al. et W Preiser S, unther ¨ 80,82,84 7 14,81-83 xod K(xodUni- (Oxford UK Oxford, Posted on Authorea 11 Sep 2020 — The copyright holder is the author/funder. All rights reserved. No reuse without permission. — https://doi.org/10.22541/au.159986344.43500232 — This a preprint and has not been peer reviewed. Data may be preliminary. L ,LuS,Y H agS,Tn K ooaiu ies 09(COVID- 2019 disease Coronavirus CK. Tang SL, Tang XH, Yu Has SM, 24. Liu 2019;16:69. J. H, Virol knowledge. current 3-11. protein: Li 42(1): envelope 2020; 23. Coronavirus Novel Pathol. on BC. J 2019 Fielding Malaysian Recent and SARS-CoV-2. therapies and the D Coronavirus Schoeman Microbiol. into clinical of 22. Insights Properties Rev YA. HA. and Malik Annu Elshabrawy 21. and transmission Interaction. M Host-Pathogen origin, Rahman Coronavirus: WF, The Elkhatib Human HM, DX. al. Ashour Liu 20. et and ZS TS Fung Hong 19. 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