POTENTIAL THERAPIES FOR TREATMENT OF COVID-19

Since discovery of the novel coronavirus (SARS-CoV-2) in December of 2019, this viral pneumonia originated in Wuhan, China quickly spread around the world. This new disease, called COVID-19 can cause Acute Respiratory Distress Syndrome (ARDS) due to an uncontrolled inflammatory response like sepsis, that leads to multiple organ failure and even death. Several pharmacotherapeutics alternatives are being tested over the world, looking for most diverse drugs that might be able to fight the infection. The objective of this paper is to review the main pharmacotherapeutics techniques development, as remdesivir, chloroquine/hydroxychloroquine, lopinavir plus ritonavir, interferon-β, ivermectin, anticoagulants, convalescent plasma and vaccine, currently undergoing clinical trials in order to evaluate its effectiveness and safety to combat the COVID-19, presenting their characteristics, possible adverse effects and main scientific findings of its potential action. In conclusion, some therapies presented promising in-vitro results or in the treatment of some patients, nonetheless, multicentric blinded placebo controlled clinical trials are necessary to determine their effectiveness, safety, dosage, and best time point of treatment.

TOPICS ON MOLECULAR CHARACTERIZATION OF THE NOVEL CORONAVIRUS SPECIES SARS-CoV-2

Since December 2019, a new coronavirus species named SARS-CoV-2 has been related to thousands of cases of severe respiratory disease worldwide, been considered a public health issue. Molecular comparisons between isolates from SARS-CoV-2 and other coronavirus species showed identity levels around 79% with the human strain SARS-CoV. However, sequence homology analysis showed that the most closely related known viruses with SARS-CoV-2 are two bat SL-CoVs (~89%), revealing similar evolutionary relationships and evidences that bats can act as reservoirs of SARS-CoV-2. Despite this, viral RNA has been detected in two dogs and two cats belonging to SARS-CoV-2 infected owners, in Hong Kong and Belgium, and in one tiger maintained at the Bronx Zoo in New York City. Additionally, ferrets and cats are found to be highly susceptible to SARS-CoV-2 in an experiment carried out in a controlled environment. However, there is no evidence of these animals acting as reservoirs of the virus. Despite the high genetic identity found among SARS-CoV-2 strains, mutations have been identified, mostly in the structural protein S gene, but until now, there is no enough evidence to relate specific mutation in the viral genome to a higher number of infected patients or death.

MACROSCOPIC AND MICROSCOPIC INJURIES OF PATIENTS AFFECT-ED BY COVID-19

After the first report of an outbreak of acute respiratory syndrome in China in December 2019, a new coronavirus, severe acute respiratory syndrome - coronavirus 2 (SARS-CoV-2) was identified. Despite to the high number of cases and deaths, limited information is available regarding the pathogenesis and injuries caused by the new coronavirus. This study aims to carry out a literature review concerning the macroscopic and microscopic aspects of the disease, since the progression of the disease is closely related to the viral action and the cellular and tissue response in the lesions caused by it. In conclusion COVID-19 is a disease that can affect all types of body tissues. The lesions affect mainly the pulmonary parenchyma and are usually macroscopically observed as consolidation areas, and histologically as plasmacytic lymphoid interstitial pneumonia and with neutrophil infiltration, already observed lesions outside the lung are mainly due to the inflammatory action of lymphocytes and histiocytes, and to the intense production of cytokines with systemic action

CHALLENGES OF THE MEDICAL TEAM DURING HOSPITAL TREATMENT OF PATIENTS WITH SUSPECTED COVID-19

In December 2019, a new disease was identified in China. From the investigation of cases of pneumonia of undefined origin, researchers came to the identification of a new coronavirus, named SARS-CoV-2. The health sector in Brazil is facing a huge load from the disease pandemic. Since February 26, 2020, when the first case of COVID-19 was registered in São Paulo, the Unified Health System, which offers universal access to health services, and the private sector face a growing pressure and overload on the system, with 241 thousand cases, 16 thousand deaths and 8 million of tests performed. In the most affected regions, health systems are near to the collapse - the result of years of fragmentation and decades of financial cuts, and deprivations of human and technical resources. This scenario never before faced in most of western countries, but already seen in eastern countries, is a major challenge for health teams and health managers in Brazil. This review aims to elucidate the main challenges of the hospital team in the management of patients suspected of COVID-19 during the 2020 pandemic in Brazil.

COVID-19 IN PETS, WHAT DO WE KNOW?

The COVID-19 caused by the coronavirus 2 severe acute respiratory syndrome (SARS-CoV-2), was first reported in Wuhan, China, starting an outbreak that affected countries around the whole world. The disease leads to simple clinical signs, such as colds common to more serious conditions as pneumonia and severe respiratory insufficiency. It is assumed that the agent was originated from bats in China, considering its as natural reservoirs, however, this relationship is still being investigated, as well as the possible intermediate hosts. Little is known about the relationship of animals with the disease epidemiological cycle, however, until now, the human transmission to companion animals and vice versa, is not yet evidenced. Nevertheless, some care must be considered if the tutors are infected by the disease.

EPIDEMIOLOGY OF SARS-COV-2 IN BRAZIL – A NEW CHALLENGE FOR PUBLIC HEALTH

In December 2019, a new disease was identified in China. From the investigation of cases of pneumonia of indefinite origin, researchers came to the identification of a new coronavirus, called SARS-CoV-2. Causing more than 3.5 million cases and nearly 250.000 deaths between December 2019 and May 2020, COVID-19 was declared a Pandemic by the WHO in March 2020 and since then major consequences and changes in the daily lives of the world population have been occurring. Elucidating its epidemiology, knowing its associated risk factors are fundamental points to combat COVID-19.

THE VETERINARIAN IN PANDEMY SARS-CoV-2 (COVID-19): BACKGROUND AND ATTRIBUTIONS

In December 2019, the world watched in disbelief as a viral epidemic, originating in Wuhan, Hubei Province, China, took on frightening proportions. On January 30, 2020, the World Health Organization (WHO) declared the outbreak of the disease caused by the new coronavirus (SARS-CoV-2) to be a public health emergency of international importance, the highest level of alert of the Organization, as provided in the International Health Regulations (IHR, 2016). On March 11, 2020, the epidemic was declared a pandemic by the WHO. Despite the rapid distribution of the new virus, many countries were reluctant or slow to comply strictly with the prophylactic methods suggested by those who had already experienced the whole situation of threat to the health of their populations.

FOOD SAFETY IN PANDEMIC TIMES: COVID-19

Food directly influences consumers' life quality. Therefore, in order to guarantee food quality and safety, it is necessary to develop better control methods for raw material, processing, transport, marketing and preparation of food. Once contaminated by microorganisms, food can promote the occurrence of diseases, generating an impact on public health. Since the emergence of COVID-19, the role of food in its transmission and dissemination among humans has been questioned. Despite the possible correlation of the disease with an animal source, there is still no precise information on the origin and transmission of the pathogen. Most infections are respiratory and can cause mild conditions up to acute severe respiratory syndrome, the main symptoms being fever, cough and difficulty to breath. There are no evidences that SARS-CoV-2 is carried by food or packaging. Thus, probably, or the virus is transmitted between people by secretions or indirectly by contaminated surfaces. Despite the lack of information on the potential risk of food consumed, avoid the consumption of uninspected, raw or undercooked food and food-related services must prioritize hygiene standards, a risk of avoiding cross-contamination.

PHYSIOPATOLOGICAL ASPECTS OF COVID-19 IN HUMANS

In December 2019, the largest epidemic associated with a Coronavirus began, SARS-CoV-2 (better known as COVID-19, or Coronavirus Disease / 2019). The first focus was in Hubei province, China, and since then it has spread throughout the world, reaching, until April 2020, almost 2.8 million people and approximately 193 thousand deaths worldwide. The agent causes respiratory, hemodynamic, digestive and inflammatory disorders, which can lead to death in any individual, although the lethality rate is higher in individuals over 60 years and with some comorbidity, such as diabetes or previous cardiac problems. The present study describes the pathogenesis of the agent and the anatomopathological lesions induced by COVID-19 in humans.

EMERGING CORONAVIRUSES IN NEOTROPICAL PRIMATES: A NEW THREAT?

Anthropogenic activities are the main reason for the current alarming conservation status of non-human primates (NHP) worldwide, and also lead to habitat-sharing, facilitating human-NHP (interspecific) viral transmission. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the ongoing COVID-19 pandemic, is well-known for its large genome plasticity and spike proteins (S proteins) highly adaptable to human receptor angiotensin-converting enzyme-2 (ACE2). NHP have been used as models for clinical, diagnostic, and therapeutic studies on SARS-CoV-2 and their correlates. However, the lack of systematic sanitary surveillance in NHP in the Neotropics, as well as the limited capacity to detect infections in their populations, challenge the implementation of consistent epidemiological connections regarding the potential interspecific transmission in the natural environment. Although the natural cross-transmission of SARS-CoV-2 between humans and NHP has not been demonstrated, the global spread of the virus represents a potential threat. Thus, establishing preventive, surveillance, and control measures for viruses of the family Coronaviridae in Neotropical NHP populations is crucial for their conservation.