Immunologic aspect in diagnosis and treatment of SARS-COV-2 patients
Recent worldwide outbreak of novel coronavirus disease (CoVID-19) has affected massive human population including Pakistan, and has caused a huge number of mortalities in few months. CoVID-19 is an infectious disease caused by a virus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) which is single stranded RNA enveloped beta coronavirus and affects lower respiratory tract. It transmits from human to human through respiratory droplets. It uses its S-protein to recognize ACE2 (Angiotensin Converting Enzyme-2) receptors in lung epithelial cells where it attaches and causes infection. The incubation period is 2-14 days. In pre-symptomatic phase, body’s immune system starts antibodies production. Significant antibodies are IgM and IgG that produces within 03-06 days and 8-12 days respectively. This review provides the available information about immunological aspects in terms of diagnosis and screening of CoVID-19 and potential therapeutic targets for combating SARS-CoV-2 infection. Immunologic techniques to detect these antibodies are ELISA (Enzyme-linked Immunosorbent Assay), CMIA (Chemiluminescent Micro particle Immunoassay) and ICT (Immunochromatographic Test). Among these, ELISA and CMIA are found to be highly specific and sensitive in convalescent phase of infection. While the fundamental confirmatory test for SARS-CoV-2 infection is RT-PCR (Reverse Transcription Polymerase Chain Reaction) which detects the viral RNA in respiratory samples preferably nasopharyngeal swab. Serological assays are essential to find out rate of infection, and most importantly antibody titers in recovered patients to be used for therapeutic purpose. After some successful studies Convalescent Plasma is considered as a good therapeutic option in the absence of specific antiviral therapy.
Wang LS, Wang YR, Ye DW, Liu QQ. A review of the 2019 Novel Coronavirus (COVID-19) based on current evidence. Int. J. Antimicrob. Agents. 2020; 19:105948.
Sahin AR, Erdogan A, Agaoglu PM, Dineri Y, Cakirci AY, Senel ME, at. al. 2019 novel coronavirus (COVID-19) outbreak: a review of the current literature. EJMO. 2020; 4(1):1-7.
Li X, Song Y, Wong G, Cui J. Bat origin of a new human coronavirus: there and back again. Sci China Life Sci. 2020 Mar; 63(3):461-2.
Tang X, Wu C, Li X, Song Y, Yao X, Wu X, et al. On the origin and continuing evolution of SARS-CoV-2. Natl Sci Rev. 2020; 7(6):1012-1023
Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus: implications for virus origins and receptor binding. The Lancet. 2020; 395(10224):565-74.
World health organization. Coronavirus disease (COVID-19) pandemic. Aug 2020 (cited 10 June 2020). Available from: URL: https://www.who.int/emergencies/diseases/novel-coronavirus-2019.
International Committee on Taxonomy of Viruses ICTV. (cited 10 June 2020). Available from: URL: https://talk.ictvonline.org
COVID-19 live dashboard. (cited 10 June 2020). Available from: URL: https://www.worldometers.info/coronavirus/country/pakistan
Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020; 579(7798):270-3.
Fehr AR, Perlman S. Coronaviruses: an overview of their replication and pathogenesis in Coronaviruses. Humana Press, New York, NY. 2015. 1-23.
Sohrabi C, Alsafi Z, O’Neill N, Khan M, Kerwan A, Al-Jabir A, et al. World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19). Int J Sur. 2020; 76(4):71-76.
Li X, Geng M, Peng Y, Meng L, Lu S. Molecular immune pathogenesis and diagnosis of COVID-19. J Pharm Anal. 2020; 10(2):102-8.
Li Z, Yi Y, Luo X, Xiong N, Liu Y, Li S, et al. Development and clinical application of a rapid IgM/IgG combined antibody test for SARS-CoV-2 infection diagnosis. Journal of medical virology. 2020; 92(9):1518-24.
Sun X, Wang T, Cai D, Hu Z, Liao H, Zhi L, et al. Cytokine storm intervention in the early stages of COVID-19 pneumonia. Cytokine & Growth Factor Rev. 2020; 53(4):38-42.
Abdin SM, Elgendy SM, Alyammahi SK, Alhamad DW, Omar HA. Tackling the cytokine storm in COVID-19, challenges, and hopes. Life Sci. 2020; 257(9).
Lin HY. The severe COVID-19: a sepsis induced by viral infection? And its immunomodulatory therapy. Chinese J Traumatol. 2020; 23(4):190-95.
Haveri A, Smura T, Kuivanen S, Österlund P, Hepojoki J, Ikonen N, et. al. Serological and molecular findings during SARS-CoV-2 infection: the first case study in Finland, January to February 2020. Eurosurveillance. 2020; 25(11).
Udugama B, Kadhiresan P, Kozlowski HN, Malekjahani A, Osborne M, Li VY, et. al. Diagnosing COVID-19: the disease and tools for detection. ACS nano. 2020; 14(4):3822-35.
Tang YW, Schmitz JE, Persing DH, Stratton CW. Laboratory Diagnosis of COVID-19: Current Issues and Challenges. J Cli Microbiol. 2020; 58(6).
Emery SL, Erdman DD, Bowen MD, Newton BR, Winchell JM, Meyer RF, et. al. Real-time reverse transcription–polymerase chain reaction assay for SARS-associated coronavirus. Emerg Infect Dis. 2004; 10(2):311-16.
Wu HS, Chiu SC, Tseng TC, Lin SF, Lin JH, Hsu YF, et al. Serologic and molecular biologic methods for SARS-associated coronavirus infection, Taiwan. Emerg Infect Dis. 2004; 10(2):305-10.
Winter AK, Hegde ST. The important role of serology for COVID-19 control. The Lancet Infect Dis. 2020; 20(7):758-9.
DOI: https://doi.org/10.1016/ S1473-3099(20)30322-4
Guo L, Ren L, Yang S, Xiao M, Chang D, Yang F, et al. Profiling early humoral response to diagnose novel coronavirus disease (COVID-19). Clin Infect Dis. 2020; 71(15):778-85.
Advance Diagnostic of Covid 19. (cited 10 June 2020). Available from:URL:https://www.corelaboratory.abbott/us/en/offerings/segments/infectious-disease/sars-cov-2
Mathur G, Mathur S. Antibody Testing For COVID-19: Can It Be Used As A Screening Tool In Areas With Low Prevalence? Am J Clin Patho. 2020; 154(1):1-3.
Shen B, Zheng Y, Zhang X, Zhang W, Wang D, Jin J, et al. Clinical evaluation of a rapid colloidal gold immunochromatography assay for SARS-Cov-2 IgM/IgG. Am J Transl Res. 2020; 12(4):1348-54.
Duan K, Liu B, Li C, Zhang H, Yu T, Qu J, et al. Effectiveness of convalescent plasma therapy in severe COVID-19 patients. Pro Natl Acad Sci. 2020; 117(17):9490-6.
Shen C, Wang Z, Zhao F, Yang Y, Li J, Yuan J, et al. Treatment of 5 critically ill patients with COVID-19 with convalescent plasma. JAMA. 2020; 323(16):1582-9.
Ye M, Fu D, Ren Y, Wang F, Wang D, Zhang F, et al. Treatment with convalescent plasma for COVID‐19 patients in Wuhan, China. J Med Virol. 2020.
Copyright (c) 2020 Journal of Shifa Tameer-e-Millat University
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Journal of Shifa Tameer-e-Millat University (JSTMU) is the owner of all copyright to any work published in the journal. Any material printed in JSTMU may not be reproduced without the permission of the editors or publisher. The Journal accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing and/or decision in this journal. The Editorial Board makes every effort to ensure the accuracy and authenticity of material printed in the journal. However, conclusions and statements expressed are views of the authors and do not necessarily reflect the opinions of the Editorial Board or JSTMU.
Content of this journal is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.