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Combatting COVID-19: Research, Treatment...

Combatting COVID-19: Research, Treatment, and Prevention

Journal of Covid Research and Treatment

With the emergence of a novel coronavirus (2019-nCoV) spreading quickly in China, researchers are racing to better understand its etiology, pathophysiology, and clinical features.

Several biopharmaceutical companies are developing vaccines to prevent or treat long COVID. However, effective therapies remain elusive. Repurposed medicines such as the antiparasitic drug ivermectin may help to bridge this gap.

Pathophysiology

The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has created a global health crisis. COVID-19 infection is associated with pneumonia and multiorgan failure. The rapid rise in mortality during the initial weeks of the outbreak has highlighted a critical need for effective therapies.

Inflammation-related pulmonary injury is the major cause of death. High circulating levels of inflammatory mediators result in dysfunction of pulmonary macrophages, as evidenced by increased permeability and elevated cytokine production. Correlations between granulocyte-macrophage colony stimulating factor (GM-CSF) and adverse outcomes have led to trials of anti-GM-CSF therapy with limited clinical impact so far.

Despite the understandable rush to publish results during this time, much of the current literature represents little more than little pieces of a big jigsaw puzzle that have not yet yielded a coherent picture. DML reports grants from the UK Medical Research Council and GlaxoSmithKline, personal fees or honoraria from Biotest UK, Gilead, and Bristol Myers Squibb, and conference support from Octapharma.

Diagnosis

Long COVID is a debilitating illness with many symptoms that affect multiple organ systems. It is a post-infectious disorder and has similarities to other viral-onset illnesses, such as ME/CFS and dysautonomia17,38,39. Research on these conditions shows multilineage cellular inflammation, blood vessel damage with endothelial dysfunction and hypoperfusion in brain and brainstem regions, cognitive decline and multi-systemic deregulation of autonomic functions42,43,45.

As a result, it can be difficult to diagnose and requires careful history taking, symptom monitoring and adherence to the current treatment guidelines. In addition, it is recommended that patients discuss their care goals, review their advanced directives and identify surrogate medical decision-makers. Patients should be kept on anticoagulation therapy, as COVID-19 infection is associated with a prothrombotic state. Blood pressure and renal function should be monitored closely, as well as for electrolyte abnormalities and signs of respiratory failure. In a subset of patients with severe illness, intensive supportive care with inhaled oxygen, intravenous fluids and ECMO may be necessary to support renal and cardiovascular function.

Treatment

Journal of covid research and treatment offers the most comprehensive coverage of current research on coronavirus infection, including its post-covid effects. The journal welcomes submission of original articles, review articles, case reports and short communications. As an open access publisher well known for its fast publication times, journal of covid is able to publish research as it happens, helping to guide public health responses and save lives.

Remdesivir (GS-5734) is an inhibitor of the viral RNA-dependent RNA polymerase that targets SARS-CoV and MERS-CoV in vitro, and in nonhuman primate studies reduced virus levels and lung damage. It is currently being tested in a phase 2/3 trial of oral remdesivir for the treatment of symptomatic nonhospitalized people with mild to moderate COVID-19 disease.

Prevention

COVID-19 is spreading rapidly around the world, and urgent research is required to limit the impact. Submissions are welcome from field teams, laboratories, technology developers and providers of apps, telework/telemedicine platforms, protocols, models and studies on isolation, suppression, treatment, and post-covid effects. As a fast-turnaround publisher, JMIR Publications is proud to support the global effort to combat this pandemic by publishing research as it is being developed. The journal is free to read, with article processing charges (APC) paid by the authors or their institutions.

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