An Explication of Pandemic Public Health Emergency, Coronavirus Disease 2019 (COVID-19)
In December 2019 a series of acute atypical respiratory disease occurred in Wuhan, China. The first clusters of cases were identified in association with the South China Seafood Market. In subsequent investigations it was found to be a novel coronavirus. It is suggested to have zoonotic origin. On December 31st 2019, China notified the outbreak to the World Health Organization. During the New Year, the massive migration of Chinese fuelled the epidemic. Cases in other provinces of China and other countries (South Korea, Thailand and Japan in quick succession) were reported in people who were returning from Wuhan. On 11 February, on the basis of existing rules on taxonomy the virus was names as SARS-CoV-2. SARS-CoV-2 belongs to the family of coronaviruses. It is a positive-sense single-stranded RNA (+ssRNA) virus. It has a single linear RNA segment. On the same day WHO announced the new name for the disease i.e. Coronavirus disease 2019 (COVID-19). The WHO and the US Centers for Disease Control and Prevention (CDC) say it is primarily spread directly due to close contact between people through small droplets produced during coughing, sneezing or talking within a range of about 1-3 meters. It may even transmit through indirect contact via fomites. While there are concerns it may spread by feces, this risk is believed to be low. Soon, the number of cases started increasing exponentially and on March 12, 2020 WHO announced COVID-19 a pandemic. COVID-19 has been impacting a large number of people worldwide, being reported in approximately 200 countries and territories. It was identified that Angiotensin converting enzyme 2 (ACE2) act as a functional receptor for SARS-CoV-2. The pathophysiology of COVID-19 follows sex differences, age differences, race differences in as well as underlying disease conditions i.e. comorbidities aggravated the severity of this disease. The most common symptoms being reported are fever, dry cough or chest tightness, and dyspnoea. It is now widely recognized that respiratory symptoms of COVID-19 are extremely heterogeneous, ranging from minimal symptoms to significant hypoxia with ARDS. Diagnosis is done with the help of history, clinical signs and serological testing. Real-time reverse transcription polymerase chain reaction (rRT-PCR) is considered the standard method of testing. Several have been tested in clinical trials but none of them have been proven to be a definite therapy yet. The evolution of the current outbreak has seen extraordinary measures put in place to control transmission, including the ‘shut-down’ and ‘quarantine’. Researchers are trying to develop a vaccine against SARS-CoV-2 but at present, no vaccine is available. One should strictly follow all the preventive measures as directed by WHO and CDC and along with this, one should boost up its natural immunity to lessen the chances of getting infection.
Keywords:SARS-CoV-2, COVID-19, ACE2
Adams ML, Katz DL and Grandpre J (2020). Population-Based Estimates of Chronic Conditions Affecting Risk for Complications from Coronavirus Disease, United States. Emerging Infectious Diseases 26(8).
Belouzard S, Chu VC and Whittaker GR (2009). Activation of the SARS coronavirus spike protein via sequential proteolytic cleavage at two distinct sites. Proceedings of the National Academy of Sciences 106(14): 5871-5876.
Belouzard S, Millet JK, Licitra B N and Whittaker GR (2012). Mechanisms of coronavirus cell entry mediated by the viral spike protein Viruses 4(6): 1011-1033.
Benvenuto D, Giovanetti M, Ciccozzi A, Spoto S, Angeletti S and Ciccozzi M (2020). The 2019?new coronavirus epidemic: evidence for virus evolution. Journal of medical virology 92(4): 455-459.
Berghöfer B, Frommer T, Haley G, Fink L, Bein G and Hackstein H (2006). TLR7 ligands induce higher IFN-? production in females. The Journal of Immunology 177(4): 2088-2096.
Brown NJ, Gainer JV, Stein CM, et al. (1999). Bradykinin stimulates tissue plasminogen activator release in human vasculature. Hypertension.33:1431–1435.
Brown, N. J. Gainer, J. V. Murphey, L. J. and Vaughan, D. E. (2020). Bradykinin Stimulates Tissue Plasminogen Activator Release From Human Forearm Vasculature Through B2 Receptor–Dependent, NO Synthase–Independent, and Cyclooxygenase-Independent Pathway. Am Heart Assoc. Jour.51: 2190-2196.
Cao B, Wang Y, Wen D, Liu W, Wang J, Fan G, Ruan L, Song B, Cai Y, Wei M and Li X (2020). A trial of lopinavir–ritonavir in adults hospitalized with severe Covid-19. New England Journal of Medicine.
Cao Q, Chen YC, Chen CL and Chiu CH (2020). SARS-CoV-2 infection in children: Transmission dynamics and clinical characteristics. Journal of the Formosan Medical Association 119(3): 670.
Chan JFW, Yuan S, Kok KH, To KKW, Chu H, Yang J, Xing F, Liu J, Yip CCY, Poon RWS and Tsoi HW (2020). A familial cluster of pneumonia associated with the 2019 novel coronavirus indicating person-to-person transmission: a study of a family cluster. The Lancet 395(10223): 514-523.
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, Wang J, Liu Y, Wei Y and Yu T (2020). Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. The Lancet 395(10223): 507-513.
Chen Y, Guo Y, Pan Y and Zhao ZJ (2020). Structure analysis of the receptor binding of 2019-nCoV. Biochemical and biophysical research communications.
Connors TJ, Ravindranath TM, Bickham KL, Gordon CL, Zhang F, Levin B, Baird JS and Farber DL (2016). Airway CD8+ T cells are associated with lung injury during infant viral respiratory tract infection. American journal of respiratory cell and molecular biology 54(6): 822-830.
Coutard B, Valle C, de Lamballerie X, Canard B, Seidah NG and Decroly E (2020). The spike glycoprotein of the new coronavirus 2019-nCoV contains a furin-like cleavage site absent in CoV of the same clade. Antiviral research 176: 104742.
Cyranoski D (2020). Mystery deepens over animal source of coronavirus. Nature 579 (7797): 18-19.
Cyranoski, D et al. (2020). Did pangolins spread the China coronavirus to people? Nature 10.
Fernandez-Nieto D, Jimenez-Cauhe J, Suarez-Valle A, Moreno-Arrones OM, Saceda-Corralo D, Arana-Raja A and Ortega-Quijano, D (2020). Characterization of acute acro-ischemic lesions in non-hospitalized patients: a case series of 132 patients during the COVID-19 outbreak. Journal of the American Academy of Dermatology.
Frantzeskaki F, Armaganidis A and Orfanos SE (2017). Immunothrombosis in acute respiratory distress syndrome: cross talks between inflammation and coagulation. Respiration 93(3): 212-225.
Gautret P, Lagier JC, Parola P, Meddeb L, Mailhe M, Doudier B, Courjon J, Giordanengo V, Vieira VE, Dupont HT and Honoré S (2020). Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial. International journal of antimicrobial agents 105949.
Giani M, Seminati D, Lucchini A, Foti G and Pagni F (2020). Exuberant plasmocytosis in bronchoalveolar lavage specimen of the first patient requiring extracorporeal membrane oxygenation for SARS-CoV-2 in Europe. Journal of Thoracic Oncology.
Giannis D, Ziogas IA and Gianni P (2020). Coagulation disorders in coronavirus infected patients: COVID-19, SARS-CoV-1, MERS-CoV and lessons from the past. Journal of Clinical Virology 104362.
Glas GJ, Van Der Sluijs KF, Schultz MJ, HOFSTRA JJ, Van Der Poll T and Levi M (2013). Bronchoalveolar hemostasis in lung injury and acute respiratory distress syndrome. Journal of Thrombosis and Haemostasis 11(1): 17-25.
Goldstein, Joseph (6 April 2020). "Bronx Zoo Tiger Is Sick With the Coronavirus". The New York Times
Gorbalenya AE, Baker SC, Baric RS, de Groot RJ, Drosten C and Gulyaeva AA (2020). The species severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2, National Microbiology.
Gu J, Han B and Wang J (2020). COVID-19: gastrointestinal manifestations and potential fecal–oral transmission. Gastroenterology.
Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, Liu L, Shan H, Lei CL, Hui DS and Du B (2020). Clinical characteristics of coronavirus disease 2019 in China. New England journal of medicine 382(18): 1708-1720.
Hamming I, Timens W, Bulthuis MLC, Lely AT, Navis GJ and van Goor H (2004). Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. The Journal of Pathology: A Journal of the Pathological Society of Great Britain and Ireland 203(2): 631-637.
Henry BM, de Oliveira MHS, Benoit S, Plebani M and Lippi G (2020). Hematologic, biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 (COVID-19): a meta-analysis. Clinical Chemistry and Laboratory Medicine (CCLM), 1(ahead-of-print).
Henry BM, Vikse J, Benoit S, Favaloro EJ and Lippi G (2020). Hyperinflammation and Derangement of Renin-Angiotensin-Aldosterone System in COVID-19: a novel hypothesis for clinically suspected hypercoagulopathy and microvascular immunothrombosis. Clinica Chimica Acta.
Hoffmann M, Kleine-Weber H, Schroeder S, Krüger N, Herrler T, Erichsen S, Schiergens TS, Herrler G, Wu NH, Nitsche A and Müller MA (2020). SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell.
Holshue ML, DeBolt C, Lindquist S, Lofy KH, Wiesman J, Bruce H, Spitters C, Ericson K, Wilkerson S, Tural A and Diaz G (2020). First case of 2019 novel coronavirus in the United States. New England Journal of Medicine.
Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, Zhang L, Fan G, Xu J, Gu X and Cheng Z (2020). Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. The lancet 395(10223): 497-506.
Huang P, Liu T, Huang L, Liu H, Lei M, Xu W, Hu X, Chen J and Liu B (2020). Use of chest CT in combination with negative RT-PCR assay for the 2019 novel coronavirus but high clinical suspicion. Radiology 295(1): 22-23.
Hui DS, I Azhar E and Madani TA (2020). The continuing 2019-nCoV epidemic threat of novel coronaviruses to global health-the latest 2019 novel coronavirus outbreak in Wuhan. China 91: 264-266.
Jin YH, Cai L, Cheng ZS, Cheng H, Deng T, Fan YP, Fang C, Huang D, Huang LQ, Huang Q and Han Y (2020). A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Military Medical Research 7(1): 4.
Kolivras A, Dehavay F, Delplace D, Feoli F, Meiers I, Milone L, Olemans C, Sass U, Theunis A, Thompson CT and Van De Borne L (2020). Coronavirus (COVID-19) infection-induced chilblains: a case report with histopathological findings. JAAD Case Reports.
Kupferschmidt K (2020). Study claiming new coronavirus can be transmitted by people without symptoms was flawed. Science 3.
Lake MA (2020). What we know so far: COVID-19 current clinical knowledge and research. Clinical Medicine 20(2): 124.
Landa N, Mendieta?Eckert M, Fonda?Pascual P and Aguirre T (2020). Chilblain?like lesions on feet and hands during the COVID?19 Pandemic. International Journal of Dermatology.
Letko M, Marzi A and Munster V (2020). Functional assessment of cell entry and receptor usage for SARS-CoV-2 and other lineage B betacoronaviruses. Nature microbiology 5(4): 562-569.
Letko MC and Munster V (2020). Functional assessment of cell entry and receptor usage for lineage B ?-coronaviruses, including 2019-nCoV. bioRxiv.
Li M, Yao D, Zeng X, Kasakovski D, Zhang Y, Chen S, Zha X, Li Y and Xu L (2019). Age related human T cell subset evolution and senescence. Immunity & Ageing 16(1): 24.
Li Q, Guan X, Wu P, Wang X, Zhou L, Tong Y, Ren R, Leung K, Lau EH, Wong JY and Xing X (2020). Early transmission dynamics in Wuhan, China, of novel coronavirus–infected pneumonia. New England Journal of Medicine.
Li R, Pei S, Chen B, Song Y, Zhang T, Yang W and Shaman J (2020). Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2). Science 368(6490: 489-493.
Li W, Moore MJ, Vasilieva N, Sui J, Wong SK, Berne MA, Somasundaran M, Sullivan JL, Luzuriaga K, Greenough TC and Choe H (2003). Angiotensin-converting enzyme 2 is a functional receptor for the SARS coronavirus. Nature 426(6965):450-454.
Lillicrap D (2020). Disseminated intravascular coagulation in patients with 2019?nCoV pneumonia. Journal of Thrombosis and Haemostasis 18(4): 786.
Lippi, G. and Plebani, M. (2020). Laboratory abnormalities in patients with COVID-2019 infection. Clinical Chemistry and Laboratory Medicine (CCLM) DOI: https://doi.org/10.1515/cclm-2020-0198
Liu P, Chen W and Chen JP (2019). Viral Metagenomics Revealed Sendai Virus and Coronavirus Infection of Malayan Pangolins (Mani’s javanica). Viruses 11(11): 979.
Liu Y, Yan LM, Wan L, Xiang TX, Le A, Liu JM, Peiris M, Poon LL and Zhang W (2020). Viral dynamics in mild and severe cases of COVID-19. The Lancet Infectious Diseases.
Mazzotta F and Troccoli T (2020). Acute acro-ischemia in the child at the time of COVID-19. European Journal of pediatric dermatology.
Meyer MA, Ostrowski SR, Overgaard A, Ganio MS, Secher NH, Crandall, CG and Johansson PI (2013). Hypercoagulability in response to elevated body temperature and central hypovolemia. journal of surgical research 185(2): e93-e100.
Mitra A, Dwyre DM, Schivo M, Thompson GR, Cohen SH, Ku N and Graff JP (2020). Leukoerythroblastic reaction in a patient with COVID?19 infection. American Journal of Hematology.
Nakamura S, Nakamura I, Ma L, Vaughan DE and Fogo AB (2000). Plasminogen activator inhibitor-1 expression is regulated by the angiotensin type 1 receptor in vivo. Kidney international 58(1): 251-259.
Nicin L, Abplanalp WT, Mellentin H, Kattih B, Tombor L, John D, Schmitto JD, Heineke J, Emrich F, Arsalan M and Holubec T (2020). Cell type-specific expression of the putative SARS-CoV-2 receptor ACE2 in human hearts. European Heart Journal.
Nickbakhsh S, Mair C, Matthews L, Reeve R, Johnson PC, Thorburn F, von Wissmann B, Reynolds A, McMenamin J, Gunson RN and Murcia PR (2019). Virus–virus interactions impact the population dynamics of influenza and the common cold. Proceedings of the National Academy of Sciences 116(52): 27142-27150.
OIE (2020). Report on coronavirus
Ou X, Liu Y, Lei X, Li P, Mi D, Ren L, Guo L, Guo R, Chen T, Hu J and Xiang Z (2020). Characterization of spike glycoprotein of SARS-CoV-2 on virus entry and its immune cross-reactivity with SARS-CoV. Nature communications 11(1): 1-12.
Ozolina A, Sarkele M, Sabelnikovs O, Skesters A, Jaunalksne I, Serova J, Ievins T, Bjertnaes LJ and Vanags I (2016). Activation of coagulation and fibrinolysis in acute respiratory distress syndrome: a prospective pilot study. Frontiers in medicine 3: 64.
Paraskevis D, Kostaki EG, Magiorkinis G, Panayiotakopoulos G, Sourvinos G and Tsiodras S (2020). Full-genome evolutionary analysis of the novel corona virus (2019-nCoV) rejects the hypothesis of emergence as a result of a recent recombination event. Infection, Genetics and Evolution 79: 104212.
Piccolo V, Neri I, Filippeschi C, Oranges T, Argenziano G, Battarra VC, Berti S, Manunza F, Belloni Fortina A, Di Lernia V and Boccaletti V (2020). Chilblain?like lesions during COVID?19 epidemic: a preliminary study on 63 patients. Journal of the European Academy of Dermatology and Venereology.
Recalcati, S (2020). Cutaneous manifestations in COVID?19: a first perspective. Journal of the European Academy of Dermatology and Venereology.
Roberts A, Deming D, Paddock CD, Cheng A, Yount B, Vogel L, Herman BD, Sheahan T, Heise M, Genrich GL and Zaki SR (2007). A mouse-adapted SARS-coronavirus causes disease and mortality in BALB/c mice. PLoS pathogens 3(1).
Rodríguez-Morales AJ, MacGregor K, Kanagarajah S, Patel D and Schlagenhauf P (2020). Going global–Travel and the 2019 novel coronavirus. Travel medicine and infectious disease 33: 101578.
Russell CD, Millar JE and Baillie JK (2020). Clinical evidence does not support corticosteroid treatment for 2019-nCoV lung injury. The Lancet 395(10223): 473-475.
Sanchis-Gomar F, Lavie CJ, Perez-Quilis C, Henry BM and Lippi G (2020). Angiotensin-Converting Enzyme 2 and antihypertensives (angiotensin receptor blockers and angiotensin-converting enzyme inhibitors) in Coronavirus Disease 2019. In Mayo Clinic Proceedings. Elsevier.
Saule P, Trauet J, Dutriez V, Lekeux V, Dessaint JP and Labalette M (2006). Accumulation of memory T cells from childhood to old age: central and effector memory cells in CD4+ versus effector memory and terminally differentiated memory cells in CD8+ compartment. Mechanisms of ageing and development 127(3): 274-281.
Seillet C, Laffont S, Trémollières F, Rouquié N, Ribot C, Arnal JF, Douin-Echinard V, Gourdy P and Guéry JC (2012). The TLR-mediated response of plasmacytoid dendritic cells is positively regulated by estradiol in vivo through cell-intrinsic estrogen receptor ? signaling. Blood, The Journal of the American Society of Hematology 119(2): 454-464.
Smits SL, de Lang A, van den Brand JM, Leijten LM, van IJcken WF, Eijkemans MJ, van Amerongen G, Kuiken T, Andeweg AC, Osterhaus AD and Haagmans BL (2010). Exacerbated innate host response to SARS-CoV in aged non-human primates. PLoS pathogens 6(2).
Souyris M, Cenac C, Azar P, Daviaud D, Canivet A, Grunenwald S, Pienkowski C, Chaumeil J, Mejía JE and Guéry JC (2018). TLR7 escapes X chromosome inactivation in immune cells. Science immunology 3(19).
Stoll V (2020). The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19)—China, 2020. China CDC Weekly 2(8): 113-122.
Tan L, Wang Q, Zhang D, Ding J, Huang Q, Tang YQ, Wang Q and Miao H (2020). Lymphopenia predicts disease severity of COVID-19: a descriptive and predictive study. Signal transduction and targeted therapy 5(1): 1-3.
Tikellis C and Thomas MC (2012). Angiotensin-converting enzyme 2 (ACE2) is a key modulator of the renin angiotensin system in health and disease. International journal of peptides.
van Doremalen N, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, Tamin, A, Harcourt JL, Thornburg NJ, Gerber SI and Lloyd-Smith JO (2020). Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. New England Journal of Medicine 382(16): 1564-1567.
van Dorn A, Cooney RE and Sabin ML(2020). COVID-19 exacerbating inequalities in the US. The Lancet 395(10232): 1243-1244.
Varga Z, Flammer, AJ, Steiger P, Haberecker M, Andermatt R, Zinkernagel AS, Mehra MR, Schuepbach RA, Ruschitzka F and Moch H (2020). Endothelial cell infection and endotheliitis in COVID-19. The Lancet 395(10234): 1417-1418.
Vaughan DE, Lazos SA and Tong K (1995). Angiotensin II regulates the expression of plasminogen activator inhibitor-1 in cultured endothelial cells. A potential link between the renin-angiotensin system and thrombosis. The Journal of clinical investigation 95(3): 995-1001.
Vrigkou E, Tsangaris I, Bonovas S, Tsantes A and Kopterides P (2017). The evolving role of the renin–angiotensin system in ARDS. Critical Care 21(1): 329.
Walls AC, Park YJ, Tortorici MA, Wall A, McGuire AT and Veesler D (2020). Structure, function, and antigenicity of the SARS-CoV-2 spike glycoprotein. Cell.
Wang X, Xu W, Hu G, Xia S, Sun Z, Liu Z, Xie Y, Zhang R, Jiang S and Lu L (2020). SARS-CoV-2 infects T lymphocytes through its spike protein-mediated membrane fusion. Cellular & Molecular Immunology 1-3.
Wenham C, Smith J and Morgan R (2020). COVID-19: the gendered impacts of the outbreak. The Lancet 395(10227): 846-848.
Wölfel R, Corman VM, Guggemos W, Seilmaier M, Zange S, Müller MA, Niemeyer D, Jones, TC, Vollmar P, Rothe C and Hoelscher M (2020). Virological assessment of hospitalized patients with COVID-2019. Nature 1-10.
Wong M C, Cregeen SJJ, Ajami NJ and Petrosino JF (2020). Evidence of recombination in coronaviruses implicating pangolin origins of nCoV-2019. Biorxiv.
World Health Organization (1 February 2020). Novel Coronavirus (2019-nCoV): situation report, 12 (Report)
Wu C, Liu Y, Yang Y, Zhang P, Zhong W, Wang Y, Wang Q, Xu Y, Li M, Li X and Zheng M (2020). Analysis of therapeutic targets for SARS-CoV-2 and discovery of potential drugs by computational methods. Acta Pharmaceutica Sinica B.
Xiao K, Zhai J, Feng Y, Zhou N, Zhang X, Zou JJ, Li N, Guo Y, Li X, Shen X and Zhang Z (2020). Isolation and characterization of 2019-nCoV-like coronavirus from Malayan pangolins. BioRxiv.
Xu X, Chen P, Wang J, Feng J, Zhou H, Li X, Zhong W and Hao P (2020). Evolution of the novel coronavirus from the ongoing Wuhan outbreak and modeling of its spike protein for risk of human transmission. Science China Life Sciences 63(3): 457-460.
Yuki, K Fujiogi, M. and Koutsogiannaki, S. (2020). COVID-19 pathophysiology: A review. Clin Immunol. 2020 Jun; 215: 108427. doi: 10.1016/j.clim.2020.108427
Yao, X, Fei Ye, and Zhang, et al.,(2020). In Vitro Antiviral Activity and Projection of Optimized Dosing Design of Hydroxychloroquine for the Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Clinical Infectious Diseases. Springer. doi/10.1093/cid/ciaa237/5801998
Zhang J, Litvinova M, Wang W, Wang Y, Deng X, Chen X, Li M, Zheng W, Yi L, Chen X and Wu Q (2020). Evolving epidemiology and transmission dynamics of coronavirus disease 2019 outside Hubei province, China: a descriptive and modelling study. The Lancet Infectious Diseases.
Zhang T, Wu Q and Zhang Z (2020). Probable pangolin origin of SARS-CoV-2 associated with the COVID-19 outbreak. Current Biology.
Zhang Y, Cao W, Xiao M, Li YJ, Yang Y, Zhao J, Zhou X, Jiang W, Zhao YQ, Zhang SY and Li TS (2020). Clinical and coagulation characteristics of 7 patients with critical COVID-2019 pneumonia and acro-ischemia. Zhonghua xue ye xue za zhi= Zhonghua Xueyexue Zazhi 41: E006-E006.
Zhao JP, Hu Y, Du RH, Chen ZS, Jin Y, Zhou M, Zhang J, Qu JM and Cao B (2020). Expert consensus on the use of corticosteroid in patients with 2019-nCoV pneumonia. Zhonghua jie he he hu xi za zhi= Zhonghua jiehe he huxi zazhi= Chinese journal of tuberculosis and respiratory diseases 43(3): 183-184.
Zheng M, Gao Y, Wang G, Song G, Liu S, Sun D, Xu Y and Tian Z (2020). Functional exhaustion of antiviral lymphocytes in COVID-19 patients. Cellular & molecular immunology 1-3.
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, Xiang J, Wang Y, Song B, Gu X and Guan L (2020). Clinical course and risk factors for mortality of adult in patients with COVID-19 in Wuhan, China: a retrospective cohort study. The lancet.
Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, Si HR, Zhu Y, Li B, Huang CL and Chen HD (2020). A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 579(7798): 270-273.
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, Zhao X, Huang B, Shi W, Lu R and Niu P (2020). A novel coronavirus from patients with pneumonia in China, 2019. New England Journal of Medicine.
Zou X, Chen K, Zou J, Han P, Hao J and Han Z (2020). Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Frontiers of medicine 1-8.
Copyright (c) 2020 Neha Pant, Ajay Kumar Upadhyay
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Any non-commercial use, distribution, adaptation, and reproduction in any medium is permitted as long as the original work is properly cited. However, caution and responsibility are required when reusing as the articles on the preprint server are not peer-reviewed. Readers are advised to check for the availability of any updated or peer-reviewed version.