SARS-CoV-2/COVID-19: Evolving Reality, Global Response, Knowledge Gaps, and Opportunities

Shock. 2020 Oct;54(4):416-437. doi: 10.1097/SHK.0000000000001565.

Abstract

Approximately 3 billion people around the world have gone into some form of social separation to mitigate the current severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. The uncontrolled influx of patients in need of emergency care has rapidly brought several national health systems to near-collapse with deadly consequences to those afflicted by Coronavirus Disease 2019 (COVID-19) and other critical diseases associated with COVID-19. Solid scientific evidence regarding SARS-CoV-2/COVID-19 remains scarce; there is an urgent need to expand our understanding of the SARS-CoV-2 pathophysiology to facilitate precise and targeted treatments. The capacity for rapid information dissemination has emerged as a double-edged sword; the existing gap of high-quality data is frequently filled by anecdotal reports, contradictory statements, and misinformation. This review addresses several important aspects unique to the SARS-CoV-2/COVID-19 pandemic highlighting the most relevant knowledge gaps and existing windows-of-opportunity. Specifically, focus is given on SARS-CoV-2 immunopathogenesis in the context of experimental therapies and preclinical evidence and their applicability in supporting efficacious clinical trial planning. The review discusses the existing challenges of SARS-CoV-2 diagnostics and the potential application of translational technology for epidemiological predictions, patient monitoring, and treatment decision-making in COVID-19. Furthermore, solutions for enhancing international strategies in translational research, cooperative networks, and regulatory partnerships are contemplated.

Publication types

  • Review

MeSH terms

  • Betacoronavirus*
  • COVID-19
  • COVID-19 Drug Treatment
  • COVID-19 Testing
  • Clinical Laboratory Techniques*
  • Clinical Trials as Topic
  • Coronavirus Infections / diagnosis*
  • Coronavirus Infections / drug therapy
  • Coronavirus Infections / therapy*
  • Coronavirus Infections / transmission
  • Humans
  • Pandemics
  • Pneumonia, Viral / diagnosis*
  • Pneumonia, Viral / therapy*
  • Pneumonia, Viral / transmission
  • SARS-CoV-2