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      Novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) Infection: Microbiologic perspectives and Anatomic considerations for Sanctuary Sites

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          Abstract

          Introduction

          A significant chunk of global life - the economy, sports, aviation, academic, and entertainment activities- has significantly been affected by the ravaging outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) with devastating consequences on morbidity and mortality in many countries of the world.

          Methods

          This review utilized search engines such as google scholar, PubMed, ResearchGate, and web of science to retrieve articles and information using keywords like “Coronavirus”, “SARS-CoV-2”, “COVID-19”, “Origin of coronavirus and SARS-CoV-2”, “microbiology of coronavirus”, “microbiology of SARS-CoV-2”, COVID-19”, “Coronavirus reservoir sites”, “Anatomic sanctuary sites and SARS-CoV-2”, biological barriers and coronavirus”, biological barrier and SARS-CoV-2”.

          Results

          While this pandemic has caught the global scientific community at its lowest level of preparedness, it has inadvertently created a unified and wholesome approach towards developing potential vaccine (s) candidates by escalating clinical trial protocols in many countries of Europe, China and the United States. Interestingly, viral pathobiology continues to be an evolving aspect that potentially shows that the management of the current outbreak may largely depend on the discovery of a vaccine as the administration of known antiviral drugs are proving to offer some respite. Unfortunately, discontinuation and longtime administration of these drugs have been implicated in endocrine, reproductive and neurological disorders owing to the development of pathological lesions at anatomical sanctuary sites such as the brain and testis, as well as the presence of complex biological barriers that permit the entry of viruses but selective to the entrance of chemical substances and drugs.

          Conclusion

          This review focuses on the microbiologic perspectives and importance of anatomical sanctuary sites in the possible viral rebound or reinfection into the system and their implications in viral re-entry and development of reproductive and neurological disorders in COVID-19 patients.

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          Most cited references133

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          SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor

          Summary The recent emergence of the novel, pathogenic SARS-coronavirus 2 (SARS-CoV-2) in China and its rapid national and international spread pose a global health emergency. Cell entry of coronaviruses depends on binding of the viral spike (S) proteins to cellular receptors and on S protein priming by host cell proteases. Unravelling which cellular factors are used by SARS-CoV-2 for entry might provide insights into viral transmission and reveal therapeutic targets. Here, we demonstrate that SARS-CoV-2 uses the SARS-CoV receptor ACE2 for entry and the serine protease TMPRSS2 for S protein priming. A TMPRSS2 inhibitor approved for clinical use blocked entry and might constitute a treatment option. Finally, we show that the sera from convalescent SARS patients cross-neutralized SARS-2-S-driven entry. Our results reveal important commonalities between SARS-CoV-2 and SARS-CoV infection and identify a potential target for antiviral intervention.
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            Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis

            Abstract Severe acute respiratory syndrome (SARS) is an acute infectious disease that spreads mainly via the respiratory route. A distinct coronavirus (SARS‐CoV) has been identified as the aetiological agent of SARS. Recently, a metallopeptidase named angiotensin‐converting enzyme 2 (ACE2) has been identified as the functional receptor for SARS‐CoV. Although ACE2 mRNA is known to be present in virtually all organs, its protein expression is largely unknown. Since identifying the possible route of infection has major implications for understanding the pathogenesis and future treatment strategies for SARS, the present study investigated the localization of ACE2 protein in various human organs (oral and nasal mucosa, nasopharynx, lung, stomach, small intestine, colon, skin, lymph nodes, thymus, bone marrow, spleen, liver, kidney, and brain). The most remarkable finding was the surface expression of ACE2 protein on lung alveolar epithelial cells and enterocytes of the small intestine. Furthermore, ACE2 was present in arterial and venous endothelial cells and arterial smooth muscle cells in all organs studied. In conclusion, ACE2 is abundantly present in humans in the epithelia of the lung and small intestine, which might provide possible routes of entry for the SARS‐CoV. This epithelial expression, together with the presence of ACE2 in vascular endothelium, also provides a first step in understanding the pathogenesis of the main SARS disease manifestations. Copyright © 2004 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
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              Case-Fatality Rate and Characteristics of Patients Dying in Relation to COVID-19 in Italy

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                Author and article information

                Journal
                J Infect Public Health
                J Infect Public Health
                Journal of Infection and Public Health
                Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences.
                1876-0341
                1876-035X
                20 August 2021
                20 August 2021
                Affiliations
                [a ]Department of Anatomy School of Medicine, University of Namibia, Windhoek, Private bag 13301, Namibia
                [b ]Discipline of Clinical Anatomy, School of Laboratory Medicine & Medical Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, 719 Umbilo Road, Durban, South Africa
                [c ]Department of Biological Sciences, Florida Atlantic University, Davie, FL 33314, USA
                [d ]Department of Pre-Clinical Sciences, University of Limpopo, South Africa
                Author notes
                [* ]Corresponding author at: Department of Anatomy, School of Medicine, University of Namibia, Windhoek, Private bag 13301, Namibia.
                Article
                S1876-0341(21)00234-3
                10.1016/j.jiph.2021.08.015
                8378066
                d830eb12-8e2b-4f03-a147-653ff36e8f96
                © 2021 Published by Elsevier Ltd on behalf of King Saud Bin Abdulaziz University for Health Sciences.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 17 June 2021
                : 31 July 2021
                : 15 August 2021
                Categories
                Review

                sars-cov-2,anatomical sanctuary sites,testis,brain,microbiology,viral reinfection

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