COVID-19: Pathophysiology, diagnosis, complications and Investigational therapeutics

Abstract

The novel coronavirus (COVID-19) outbreak started early in December 2019 in the Hubei province and its capital Wuhan of the People’s Republic of China and caused a global pandemic. The number of patients confined to this disease has exceeded nine million in more than 215 countries, and the number who died is over 480,600 (up to 25 June 2020). Coronaviruses were identified in the 1960s and recently identified to cause the Middle East Respiratory Syndrome (MERS-CoV) in 2012 and severe acute respiratory syndrome (SARS) in 2003. The current severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the most recently identified. Patients with COVID-19 may be asymptomatic. Typical symptoms including fever, dry cough, and shortness of breath. Gastrointestinal symptoms such as nausea, vomiting, abdominal pain and diarrhea, have been reported— neurologically related symptoms, particularly anosmia, hyposmia, and dysgeusia, have also been reported. Physical examination may reveal a fever in over 44% of patients (and could be documented in over 88% of patients after admission), increased respiratory rate, acute respiratory disease, and maybe decreased consciousness, agitation, and confusion. This article aims at presenting an up-to-date review on the pathogenesis, diagnosis and complications of COVID-19 infection. Currently, no therapeutics have been found to be effective. Investigational therapeutics are briefly discussed.