PREVENTION AND TREATMENT OF SARS-CoV-2: AN UPDATE Taras Nebeluk, DO and Meredith E. Clement, MD Affiliation: Section of Infectious Diseases, Louisiana State University Health Sciences Center-New Orleans Corresponding author: Meredith Clement, MD 1542 Tulane Ave, Suite 331C New Orleans, LA 70112 Phone: 504-568-5204 Email: mclem5@lsuhsc.edu MEC reports the following disclosures: grants to institution (Janssen), Scientific Advisory Board (Roche)
ABSTRACT
Introduction: As the SARS-CoV-2 virus continues to spread globally, effective prevention and treatment strategies are critical to controlling the virus and halting its destructive impact worldwide.
Material Content: This article highlights evidence behind prevention modalities including non-pharmaceutical and pharmaceutical interventions and, in the context of vaccines, discusses prevention of both asymptomatic infection and progressive disease. Recent developments are discussed, including the safety and efficacy of multiple vaccines. Various treatment modalities are also discussed under the framework of COVID-19 staged progression from early viral response to hyperinflammation. Discussion: Rigorous studies have demonstrated efficacy of various prevention and treatment strategies and led to dissemination and uptake. A number of vaccines have remarkable efficacy in preventing symptomatic disease, with early data demonstrating protection against viral replication as well. Repurposed and novel treatments have been found to have real impact on hospitalization and mortality rates. Science has prepared us to face the challenge of COVID-19, and current and future interventions are promising to halt the pandemic and its global impact.
INTRODUCTION The outbreak of severe acute respiratory syndrome coronavirus-2 (SAR-CoV-2), the virus that causes COVID-19, began in Wuhan, China in December 2019 and by March 2020 had been declared a global pandemic by the World Health Organization. 1 As of February 2021 there have been more than 100 million diagnosed cases worldwide. 2 In Louisiana, more than 400,000 have been diagnosed and almost 10,000 have died. 3 As the virus continues to spread globally, effective prevention and treatment strategies are critically needed to control the virus and halt its destructive
replicating), and disease (i.e., when cellular damage ensues and symptoms appear in the host). Most studies have focused on prevention of disease and/or progression to severe illness, since evaluation of this outcome does not require frequent SARS-CoV-2 viral testing. Here we highlight evidence behind prevention modalities including non- pharmaceutical and pharmaceutical interventions and, in the context of vaccines, discuss prevention of both infection and disease.
NON-PHARMACEUTICAL INTERVENTIONS
impact worldwide. PREVENTION
Masking is an important component of infection prevention that has been shown to have efficacy in preventing SARS- CoV-2 transmission. 4–7 Both commercially available and surgical masks offer a degree of protection, 8 althoughN95 or similar respirators are likely to have the most benefit. 9 There is concern regarding emergence of new, more transmissible variants of the virus, with prominent examples being B.1.1.7 from the United Kingdom and B.1.351 from South Africa. 10,11 16
Multiple methods have been studied to prevent both person-to-person transmission and disease progression. When considering these methods, it is important to understand the difference between prevention of infection (i.e., when the virus invades the host and begins
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