![]() There has also been interest in elucidating the effects of infection on pregnancy and fetal development, however, knowledge gaps remain. Recent emergence of SARS-CoV-2 variants pose ongoing concerns in relation to vaccine and treatment efficacy. As of yet, there is no cure or prophylactic treatment to prevent infection, however, multiple vaccines have been produced and disseminated world-wide that reduce rates of severe illness and death. Since then, clinical manifestations have expanded to include immune dysregulation, gastrointestinal illness, and long-term post COVID-19 syndromes. Samples collected from the patients were submitted for isolation in cell culture followed by RT-qPCR and next-generation sequencing (NGS), which revealed the causative agent to be a coronavirus (CoV). The patients presented with a fever, cough, chest discomfort, and pneumonia, requiring hospitalization and placement on ventilators for support, and with some progressing to death. The first cases of COVID-19 were reported in December 2019 in Wuhan, Hubei Province, China, with most people who were infected having an association with a seafood and animal wholesale market. ![]() Over 5.18 million deaths and 259.5 million confirmed cases have resulted from the ongoing pandemic of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Future research will establish stronger connections between the above processes to develop diagnostic and therapeutic solutions towards COVID-19 and similar viral outbreaks. ![]() In this direction, this review focuses on SARS-CoV-2 virology, its in utero transmission from infected pregnant mothers to fetuses, SARS-CoV-2 and exosomal cellular trafficking, transcriptomic impacts, and RNA-mediated therapeutics against COVID-19. Consequently, a major outcome of COVID-19 is an elevated immune response and the detection of viral RNA transcripts in host tissue. As the infection spreads, the transcriptome of cells is drastically perturbed, e.g., through the severe upregulation of several immune-related genes. Although a connection has not yet been established between exosomal trafficking and the placental transmission of COVID-19, reports indicate that SARS-CoV-2 components may be trafficked between cells through exosomes. Hence, a deeper understanding of the pathophysiology of COVID-19 during various developmental stages and placental transmission is essential. COVID-19-related complications have been reported in neonates whose mothers were infected with SARS-CoV-2 during pregnancy, and in children who get infected. The infection now shows devastating impacts on the younger population, who were not previously predicted to be vulnerable, such as in the older population. With over 4.8 million deaths within 2 years, time is of the essence in combating COVID-19.
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