Three critical clinicobiological phases of the human SARS-associated coronavirus infections
Date
2020Author
Turk, C. and Turk, S. and Malkan, U. Y. and Haznedaroglu, I. C.
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OBJECTIVE: COVID-19 immune syndrome is a multi-systemic disorder induced
by the COVID-19 infection. Pathobiological transitions and clinical
stages of the COVID-19 syndrome following the attack of SARS-CoV-2 on
the human body have not been fully explored. The aim of this review is
to outline the three critical prominent phase regarding the
clinicogenomics course of the COVID-19 immune syndrome.
MATERIALS AND METHODS: In the clinical setting, the COVID-19 process
presents as ``asymptomatic/pre-symptomatic phase. ``respiratory phase
with mild/moderate/severe symptoms{''} and ``multi-systemic clinical
syndrome with impaired/disproportionate and/or defective immunity{''}.
The corresponding three genomic phases include the ``ACE2. ANPEP
transcripts in the initial phase{''}, ``EGFR and IGF2R transcripts in
the propagating phase{''} and the ``immune system related critical gene
involvements of the complicating phase{''}.
RESULTS: The separation of the phases is important since the genomic
features of each phase are different from each other and these different
mechanisms lead to distinct clinical multi-systemic features.
Comprehensive genomic profiling with next generation sequencing may play
an important role in defining and clarifying these three unique separate
phases for COVID-19. From our point of view. it is important to
understand these unique phases of the syndrome in order to approach a
COVID-19 patient bedside.
CONCLUSIONS: This three-phase approach may be useful for future studies
which will focus on the clinical management and development of the
vaccines and/or specific drugs targeting the COVID-19 processes. ANPEP
gene pathway may have a potential for the vaccine development. Regarding
the specific disease treatments, MAS agonists, TXA127, Angiotensin (1-7)
and soluble ACE2 could have therapeutic potential for the COVID-19
course. Moreover, future CRISPR technology can be utilized for the
genomic editing and future management of the clinical course of the
syndrome.
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