What is Emerging Variants of SARS-CoV-2 and Novel Therapeutics Against Coronavirus (COVID-19)?
COVID-19, the disease caused by the virus SARS-CoV-2, has had a devastating impact, leading to over 6 million deaths globally and becoming the greatest global health crisis since the 1918 flu pandemic. Despite worldwide efforts, the virus continues to spread, causing wave after wave of outbreaks.
The virus evolves over time, producing small changes in its genetic code that can sometimes make it more dangerous or harder to fight off. For example, even one single change in the virus’s genetic makeup has the potential to help the virus evade the immune system and make creating vaccines against it more difficult. Tracking these changes and understanding their impact on the virus’s behaviour is vital in managing the pandemic.
New versions of the virus, known as ‘variants’, have emerged that may behave differently from the original virus. For instance, the D614G variant spread widely but did not make people sicker than the original virus. There have also been variants linked to animals, such as a variant from infected farmed mink in Denmark, which did not spread more readily among humans.
However, some variants have been identified as ‘variants of concern’ (VOCs) due to their potential impact on human health. These variants may spread more easily, cause more severe disease, evade the immune response, or reduce the effectiveness of treatments or vaccines. The World Health Organization (WHO) has identified five such variants:
- Alpha (B.1.1.7): identified in the United Kingdom in late 2020.
- Beta (B.1.351): first reported in South Africa in December 2020.
- Gamma(P.1): first identified in Brazil in early 2021.
- Delta (B.1.617.2): first detected in India in December 2020.
- Omicron (B.1.1.529): first reported in South Africa in November 2021.
In addition to these VOCs, other variants known as ‘variants of interest’ (VOIs) have been identified. These are variants that could impact human health but aren’t yet known to have caused widespread disease. The WHO has identified eight such VOIs, including Epsilon (B.1.427 and B.1.429), Zeta (P.2), Eta (B.1.525), Theta (P.3), Iota (B.1.526), Kappa (B.1.617.1), Lambda (C.37), and Mu (B.1.621).
Understanding these variants is crucial in managing the COVID-19 pandemic and developing effective treatments and vaccines. Efforts continue to monitor the virus’s evolution and respond to the challenges it presents.
What Causes Emerging Variants of SARS-CoV-2 and Novel Therapeutics Against Coronavirus (COVID-19)?
Coronaviruses are a type of virus that has a distinctive ‘crown’ shape, hence the name, which comes from the Latin word for crown, ‘corona’. These viruses have a single strand of RNA – a key part of the genetic material of a living organism – at their core.
There are four main categories of coronaviruses, known as Alphacoronavirus, Betacoronavirus, Gammacoronavirus and Deltacoronavirus. Coronaviruses are commonly found in birds and mammals. However, only the Alpha and Beta types have been associated with human diseases.
The Alphacoronavirus has two strains that can infect humans called HCoV-229E and HCoV-NL63, and the Betacoronavirus also has five strains that can infect humans, namely HCoV-OC43, HCoV-HKU1, MERS-CoV, SARS-CoV, and SARS-CoV-2. Most of these viruses affect the respiratory system and can cause symptoms similar to the common cold.
The 2019 novel coronavirus, also known as SARS-CoV-2 is closely related to a coronavirus found in bats and shares about 82% of its genetic material with the previous SARS virus. SARS-CoV-2 is a sub-type of Betacoronavirus, which also includes the viruses that caused the SARS and MERS epidemics. These had death rates as high as 10% and 35% respectively.
Risk Factors and Frequency for Emerging Variants of SARS-CoV-2 and Novel Therapeutics Against Coronavirus (COVID-19)
COVID-19 first emerged in China in December 2019, and has since swept across 223 countries, making it a global pandemic. Worldwide, we’ve seen over 643 million cases and over 6 million deaths. The World Health Organization has noted that more than 200 countries reported cases of the SARS-CoV-2 variants, with the Omicron variant being the most dominant lately. The United States has the highest number of COVID-19 cases and deaths, with India and Brazil coming next.
While everyone is at risk, people over 60 or those with certain medical conditions like obesity, heart disease, kidney disease, diabetes, lung disease, cancer, or those who have undergone organ or stem cell transplants are at a higher risk of severe COVID-19. A study found that COVID-19 patients with pre-existing medical conditions were six times more likely to require hospitalization and 12 times more likely to die compared to those without.
- COVID-19 has spread to 223 countries.
- Over 643 million cases and more than 6 million deaths have been reported globally.
- The US, India, and Brazil have the highest numbers of COVID-19 cases and deaths.
- People over 60 or those with pre-existing medical conditions are more likely to get severe COVID-19.
Data shows that men have a higher risk of severe illness and death from COVID-19 than women. Also, certain ethnic groups such as Black, Hispanic, and Asian people have an increased risk of getting and dying from the virus.
- Men are more likely than women to have severe COVID-19 symptoms and die from the virus.
- Black, Hispanic, and Asian people are at a higher risk of COVID-19 than other ethnic groups.
Signs and Symptoms of Emerging Variants of SARS-CoV-2 and Novel Therapeutics Against Coronavirus (COVID-19)
COVID-19, caused by the SARS-CoV-2 virus, primarily attacks the respiratory system and spreads mostly through particles from activities like coughing and sneezing. Transmission also happens through close contact with individuals who show no symptoms, have mild symptoms, or are severely ill. In some cases, COVID-19 can also spread through surfaces contaminated with the virus or via aerosol-generating procedures. Research also suggests that it could potentially spread through fecal matter, and in a small number of cases, from a mother to her newborn.
The virus typically takes around 5.1 days to show symptoms, with most patients exhibiting symptoms within 11.5 days. Estimates show that a significant percentage of infected individuals may not exhibit any symptoms. The severity of symptoms can vary widely, ranging from no symptoms to severe illness that can cause respiratory failure, septic shock, and failure of multiple organs.
Common symptoms of COVID-19 include fever, cough, and shortness of breath. Other symptoms can include sore throat, loss of smell or taste, nausea, tiredness, muscle pain, and diarrhea. Studies show that about 70% of confirmed COVID-19 cases experience fever, cough, and shortness of breath, while over 30% report muscle ache and headaches.
Lab tests have shown abnormalities in numerous patients, which include decreased number of white blood cells (lymphopenia), elevated inflammation markers (C-reactive protein), increased cardiac enzymes, and abnormal liver function tests. Radiographic findings typically involve opacity in chest X-rays and ground-glass opacities with or without consolidation areas in chest CT scans.
The National Institutes of Health (NIH) classifies COVID-19 severity based on the following categories:
- Asymptomatic or Presymptomatic Infection: Testing positive for the virus but without any symptoms of COVID-19.
- Mild illness: Having any symptoms of COVID-19 without shortness of breath or abnormal chest imaging.
- Moderate illness: Having symptoms or evidence of lower respiratory tract disease with oxygen saturation (SpO2) of 94% or more.
- Severe illness: Having SpO2 of 94% or less; severe breathlessness with respiratory frequency above 30 breaths/min or lung infiltration greater than 50%.
- Critical illness: Developing acute respiratory failure, septic shock, and/or dysfunction of multiple organs.
Patients with severe disease can progress to a critical status and develop acute respiratory distress syndrome (ARDS), usually around a week after symptom onset. It is reported that about 81% of patients experience mild disease, 14% experience severe disease, and 5% develop critical disease.
COVID-19 can also affect other parts of the body with symptoms such as:
- Neurological symptoms like headache, stroke, seizures, and impaired consciousness. Some patients develop Guillain-Barré syndrome, a neurological disorder.
- Cardiac issues like myocardial injury, arrhythmias, cardiomyopathy, and cardiogenic shock.
- Abnormalities in blood cell counts, and coagulation disorders that can present as venous or arterial clot formation.
- Kidney-related issues, the most common being acute kidney injury, potentially due to a variety of factors including fluid overload, medication injury, and direct virus toxicity.
- GI symptoms such as diarrhoea, nausea, vomiting, and abdominal pain. Cases of acute mesenteric ischemia and portal vein thrombosis have also been reported.
- Changes in liver function, more frequently in severe cases.
- Endocrine issues with higher risk noted in patients with pre-existing conditions like diabetes.
Testing for Emerging Variants of SARS-CoV-2 and Novel Therapeutics Against Coronavirus (COVID-19)
If you show typical signs of COVID-19, such as fever, cough, sore throat, loss of taste or smell, tiredness, and muscle aches, your doctor will likely order a test. This also applies if you’ve been in close contact with someone confirmed to have the virus, even if you’re not showing symptoms.
The regular way to test for the virus involves taking a sample from the back of your nose and throat (a nasopharyngeal swab) and checking it for the genetic material of the virus, SARS-CoV-2. This is done through a method called a real-time PCR assay. Such tests have been approved by the US Food and Drug Administration (FDA) in emergency situations. Samples can also be obtained from other places including the throat, the middle part of the nose, aspirates from the back of the nose, lavage (washing) from the windpipe and lungs, as well as saliva.
The reliability of this PCR testing process depends on several factors including how well the sample was obtained, how it was collected, how long it’s been since exposure to the virus, and where the sample came from. Most commercially available FDA-approved SARS-CoV-2 PCR tests have a near 100% accuracy, as long as there was no contamination during the sample processing.
There are also SARS-CoV-2 antigen tests, which are less sensitive but provide faster results than the PCR tests. In appropriate situations, tests for other respiratory illnesses should also be considered.
If you’re hospitalized, you may undergo other laboratory tests. These include a complete blood count (CBC), a comprehensive metabolic panel (CMP) checking for kidney and liver function, as well as a coagulation panel looking at how your blood clots.
If your doctors think it’s necessary, particularly if you’re either showing symptoms of chest tightness or difficulty in breathing, they may perform an EKG and check your troponin levels – two tests to assess if there’s any damage to your heart.
Additional tests could involve checking for inflammation markers, like ESR, C-reactive protein (CRP), ferritin, lactate dehydrogenase, D-dimer, and procalcitonin in your blood. However, their relevance in predicting the course of COVID-19 is uncertain.
Regarding imaging, you might need a chest X-ray, lung ultrasound, or a computed tomography (CT) scan, which is a specialized X-ray generating detailed pictures of your lungs. However, the American College of Radiology does not recommend using a CT scan as a routine first imaging study or screening. There are currently no guidelines about when and what type of lung imaging should be done in patients with COVID-19. Doctors decide based on each patient’s specific condition.
Treatment Options for Emerging Variants of SARS-CoV-2 and Novel Therapeutics Against Coronavirus (COVID-19)
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What else can Emerging Variants of SARS-CoV-2 and Novel Therapeutics Against Coronavirus (COVID-19) be?
The following is a list of different viruses that can affect the respiratory system:
- Influenza A and B
- Parainfluenza virus
- Respiratory syncytial virus
- Adenovirus
- Cytomegalovirus
- Rhinovirus
What to expect with Emerging Variants of SARS-CoV-2 and Novel Therapeutics Against Coronavirus (COVID-19)
The course and outcome of COVID-19 vary widely and depend on several factors, including a patient’s age, the severity of their symptoms when they first get sick, any existing health conditions they have, how quickly they receive treatment, and how well they respond to that treatment. It’s been noted in a report by the Chinese Center for Disease Control and Prevention that about 81% of COVID-19 patients experience mild symptoms, about 14% have severe symptoms like breathlessness, low oxygen levels, or abnormal medical imaging results, and about 5% have critical symptoms like respiratory failure, shock, or multiple organ failure. The overall death rate was 2.3%.
In a large-scale analysis of 212 studies involving 281,461 individuals from 11 different countries or regions, it was reported that the disease became severe in roughly 23% of COVID-19 cases, with a mortality rate of about 6% among infected patients.
Possible Complications When Diagnosed with Emerging Variants of SARS-CoV-2 and Novel Therapeutics Against Coronavirus (COVID-19)
COVID-19 is viewed as a disease that affects major body systems, not just one part.
People who are older or have other health issues like obesity, diabetes, lung disease, heart disease, kidney disease, liver disease, and cancer are more likely to get seriously ill from COVID-19. This severe form of the disease can rapidly get worse, leading to serious breathing problems, a condition known as Acute Respiratory Distress Syndrome (ARDS), or failure of multiple organs. These complications can even result in death.
People with COVID-19 are also more likely to develop blood clot issues, like pulmonary embolism (a clot in the lungs), deep vein thrombosis (a clot in a deep vein), heart attacks, ischemic strokes (strokes caused by clots), and arterial thrombosis (clots in arteries).
Involvement of the heart can bring about dangerous heart rhythms, cardiomyopathy (heart muscle disease), and cardiogenic shock (a condition where the heart can’t pump enough blood to meet the body’s needs).
Kidney failure has been the most reported issue affecting a part of the body outside the lungs in COVID-19 patients, and it’s linked with a higher chance of death.
New information shows that some patients continue to have symptoms long after recovering from the COVID-19 infection. This condition is referred to as “post-acute COVID-19 syndrome.” A study followed up with 1773 patients six months after they were hospitalized with COVID-19 found that most of them experienced at least one long-lasting symptom: tiredness, muscle weakness, problems sleeping, or anxiety. Those who had been very sick with the virus were also more likely to have long-term lung problems.
Common Long-Term Symptoms:
- Tiredness
- Muscle weakness
- Sleep difficulties
- Anxiety
- Long-term lung problems
Preventing Emerging Variants of SARS-CoV-2 and Novel Therapeutics Against Coronavirus (COVID-19)
Doctors should encourage patients to follow social distancing rules and the use of masks, both of which have been recommended by the Centers for Disease Control and Prevention (CDC), as well as state and local officials. These measures can help prevent the spread of diseases.
Patients should also be reminded to wash their hands thoroughly for at least 20 seconds with soap and water. This is especially crucial after touching surfaces that might be contaminated.
It’s important that, even during these stressful times, patients do not hesitate to seek emergency medical care when needed.
One safe and convenient option is using telehealth services, where patients can have healthcare appointments over the phone or via video, instead of going to a doctor’s office. Physicians should let patients know if this service is available to them.
Patient education regarding the effectiveness and benefits of available vaccines is crucial as well. This can help patients make informed decisions about vaccination.
Physicians should ensure patients understand the importance of seeking treatment quickly if they feel unwell. They should also keep them updated about any new treatments, like monoclonal antibodies, which are laboratory-made proteins that mimic the immune system’s ability to fight off harmful viruses and diseases.
