Pathogenesis and Possible Drug Targets for Covid-19

Abstract

Coronavirus (CoVs) is a large family of enveloped, single-stranded, positive-sense RNA viruses that infect a wide range of vertebrates. They are extensively found in bats and also in many other birds and mammals including humans. SARS-CoV-2 is a global pandemic and originated from Wuhan States of China. The SARS-CoV-2 is more genetically similar to zoonotic SARS-CoV and less similar to MERS-CoV.  The viral surface spike protein of SARS-CoV-2 binds to the human angiotensin-converting enzyme-2 (ACE-2) receptor of Type II alveolar cells of the lungs and it appears to be the major portal of entry by this virus.  The subsequent activation of the spike protein by transmembrane protease-2 and in addition to lung, ACE-2 is highly expressed in heart followed by kidney and intestinal epithelium. SARS-CoV-2 infects more men than women due to ACE-2 receptor on the cells increased with age and generally it was higher in men than in women. The incubation period for this virus varies from place to place and asystematic symptoms are also commonly seen in infected patients. There are a number of pharmaceuticals already being tried and are in different phase levels of testing, but a better understanding of the underlying pathobiology is required. In this circumstance, this article will briefly review the underlying principle for ACE-2 receptor as a specific target. Despite ACE-2 serving as the portal for infection, the role of ACE inhibitors or angiotensin receptor blockers requires further investigation.