The Current Status and Challenges in the Development of Vaccines and Drugs against Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2)

Emerging role of microRNAs and long non-coding RNAs in COVID-19 with implications to therapeutics

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection which is commonly known as COVID-19 (COronaVIrus Disease 2019) has creeped into the human population taking tolls of life and causing tremendous economic crisis. It is indeed crucial to gain knowledge about their characteristics and interactions with human host cells. It has been shown that the majority of our genome consists of non-coding RNAs. Non-coding RNAs including micro RNAs (miRNAs) and long non-coding RNAs (lncRNAs) display significant roles in regulating gene expression in almost all cancers and viral diseases. It is intriguing that miRNAs and lncRNAs remarkably regulate the function and expression of major immune components of SARS-CoV-2. MiRNAs act via RNA interference mechanism in which they bind to the complementary sequences of the viral RNA strand, inducing the formation of silencing complex that eventually degrades or inhibits the viral RNA and viral protein expression. LncRNAs have been extensively shown to regulate gene expression in cytokine storm and thus emerges as a critical target for COVID-19 treatment. These lncRNAs also act as competing endogenous RNAs (ceRNAs) by sponging miRNAs and thus affecting the expression of downstream targets during SARS-CoV-2 infection. In this review, we extensively discuss the role of miRNAs and lncRNAs, describe their mechanism of action and their different interacting human targets cells during SARS-CoV-2 infection. Finally, we discuss possible ways how an interference with their molecular function could be exploited for new therapies against SARS-CoV-2.

Sertraline Is an Effective SARS-CoV-2 Entry Inhibitor Targeting the Spike Protein

The global spread of the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the continuously emerging new variants underscore an urgent need for effective therapeutics for the treatment of coronavirus disease 2019 (COVID-19). Here, we screened several FDA-approved amphiphilic drugs and determined that sertraline (SRT) exhibits potent antiviral activity against infection of SARS-CoV-2 pseudovirus (PsV) and authentic virus in vitro. It effectively inhibits SARS-CoV-2 spike (S)-mediated cell-cell fusion. SRT targets the early stage of viral entry. It can bind to the S1 subunit of the S protein, especially the receptor binding domain (RBD), thus blocking S-hACE2 interaction and interfering with the proteolysis process of S protein. SRT is also effective against infection with SARS-CoV-2 PsV variants, including the newly emerging Omicron. The combination of SRT and other antivirals exhibits a strong synergistic effect against infection of SARS-CoV-2 PsV. The antiviral activity of SRT is independent of serotonin transporter expression. Moreover, SRT effectively inhibits infection of SARS-CoV-2 PsV and alleviates the inflammation process and lung pathological alterations in transduced mice in vivo. Therefore, SRT shows promise as a treatment option for COVID-19. IMPORTANCE The study shows SRT is an effective entry inhibitor against infection of SARS-CoV-2, which is currently prevalent globally. SRT targets the S protein of SARS-CoV-2 and is effective against a panel of SARS-CoV-2 variants. It also could be used in combination to prevent SARS-CoV-2 infection. More importantly, with long history of clinical use and proven safety, SRT might be particularly suitable to treat infection of SARS-CoV-2 in the central nervous system and optimized for treatment in older people, pregnant women, and COVID-19 patients with heart complications, which are associated with severity and mortality of COVID-19.

Theoretical Explanation for the Rarity of Antibody-Dependent Enhancement of Infection (ADE) in COVID-19

Global vaccination against the SARS-CoV-2 virus has proved to be highly effective. However, the possibility of antibody-dependent enhancement of infection (ADE) upon vaccination remains underinvestigated. Here, we aimed to theoretically determine conditions for the occurrence of ADE in COVID-19. We developed a series of mathematical models of antibody response: model Ab—a model of antibody formation; model Cv—a model of infection spread in the body; and a complete model, which combines the two others. The models describe experimental data on SARS-CoV and SARS-CoV-2 infections in humans and cell cultures, including viral load dynamics, seroconversion times and antibody concentration kinetics. The modelling revealed that a significant proportion of macrophages can become infected only if they bind antibodies with high probability. Thus, a high probability of macrophage infection and a sufficient amount of pre-existing antibodies are necessary for the development of ADE in SARS-CoV-2 infection. However, from the point of view of the dynamics of pneumocyte infection, the two cases where the body has a high concentration of preexisting antibodies and a high probability of macrophage infection and where there is a low concentration of antibodies in the body and no macrophage infection are indistinguishable. This conclusion could explain the lack of confirmed ADE cases for COVID-19.

An Effective Platform for SARS-CoV-2 Prevention by Combining Neutralization and RNAi Technology

At present, the coronavirus disease 2019 (COVID-19) pandemic is a global health crisis. Scientists all over the globe are urgently looking forward to an effective solution to prevent the spread of the epidemic and avoid more casualties at an early date. In this study, we establish an effective platform for the prevention of SARS-CoV-2 by combining the neutralization strategy and RNAi technology. To protect normal cells from infection, the customized cells are constructed to stably express viral antigenic receptor ACE2 on the cell membrane. These modified cells are used as bait for inducing the viral entry. The transcription and replication activities of viral genome are intercepted subsequently by the intracellular shRNAs, which are complementary to the viral gene fragments. A pseudotyped virus reconstructed from the HIV lentivirus is utilized as a virus model, by which we validate the feasibility and effectiveness of our strategy in vitro. Our work establishes an initial model and lays the foundation for future prevention and treatment of various RNA viruses.

Development of antibody resistance in emerging mutant strains of SARS CoV-2: Impediment for COVID-19 vaccines

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a highly infectious agent associated with unprecedented morbidity and mortality. A failure to stop growth of COVID-19-linked morbidity rates is caused by SARS-CoV-2 mutations and the emergence of new highly virulent SARS-CoV-2 strains. Several acquired SARS-CoV-2 mutations reflect viral adaptations to host immune defence. Mutations in the virus Spike-protein were associated with the lowered effectiveness of current preventive therapies, including vaccines. Recent in vitro studies detected diminished neutralisation capacity of vaccine-induced antibodies, which are targeted to bind Spike receptor-binding and N-terminal domains in the emerging strains. Lower than expected inhibitory activity of antibodies was reported against viruses with E484K Spike mutation, including B.1.1.7 (UK), P.1 (Brazil), B.1.351 (South African), and new Omicron variant (B.1.1.529) with E484A mutation. The vaccine effectiveness is yet to be examined against new mutant strains of SARS-CoV-2 originating in Europe, Nigeria, Brazil, South Africa, and India. To prevent the loss of anti-viral protection in vivo, often defined as antibody resistance, it is required to target highly conserved viral sequences (including Spike protein) and enhance the potency of antibody cocktails. In this review, we assess the reported mutation-acquiring potential of coronaviruses and compare efficacies of current COVID-19 vaccines against 'parent' and 'mutant' strains of SARS-CoV-2 (Kappa (B.1.617.1), Delta (B.1.617.2), and Omicron (B.1.1.529)).

Antibody responses and CNS pathophysiology of Mucormycosis in Chronic SARS CoV-2 infection: Current Therapies against Mucormycosis

The incidence rate of opportunistic secondary infections through invasive fungi has been observed to be 14.5% to 27% in the SARS CoV pandemic during the year 2003. But, the incidence of SARS CoV-2 is accompanied by the substantial rise in secondary opportunistic infections like mucormycosis (black fungus) mainly in the immunocompromised individuals, and diabetic patients taking steroids. Substantial rates of COVID-19 cases with mucormycosis were reported in India and other parts of the world. Previous research reports delineated the ability of Mucorales in invading the various tissues like lungs, brain, sinus through the GRP78 and subsequently this infection could invoke crusting, edema, and necrosis of brain parenchyma, ptosis, proptosis, and vision loss due to intraorbital & intracranial complications. Similarities of these pathophysiological complications with already existing diseases are causing clinicians to face several challenges in order to diagnose and treat this disease effectively at the early stage. This minireview depicts the mucormycosis-induced immune, and pathophysiological alterations in COVID-19 patients comorbid with diabetes, immunosuppression, and also reported the various clinical manifestations, and the therapeutic modalities and the failures of anti-fungal vaccines. Therefore, the emerging mucormycosis in COVID-19 patients need a rapid investigation and selective optimization of the effective therapeutic modalities including antifungal vaccines to minimize mortality rate.

Herd immunity to SARS-COV-2 in the population of the Southern regions of the Far East of Russia

The aim: to study the structure and dynamics of population immunity to SARSCoV-2 of the population of the Southern Regions of the Far East (SRFE): Khabarovsk, Primorsky Krai and Amur Region during the COVID-19 epidemic in 2020.

Materials and methods. The work was carried out according to the program for assessing population immunity to SARS -CoV-2 of the population of the Russian Federation according to the methodology developed by the Rospotrebnadzor with the  participation of the St.  Petersburg Pasteur Institute. The study was approved by  the  ethical committee of the St.  Petersburg Pasteur Institute. The selection of participants was carried out by a questionnaire method using cloud technologies. The  volunteers were randomized by age by stratification into 7  age groups: 1–17, 18–29, 30–39, 40–49, 50–59, 60–69, 70+ years old. Territorial randomization consisted in limiting the engaging of volunteers – no more than 30 people from one enterprise. After the initial cross-sectional study, a 3-stage seromonitoring was carried out, in which the same volunteers participated. Antibodies to the SARS-CoV-2 nucleocapsid were determined in peripheral blood serum by the enzyme immunoassay using an appropriate set of reagents produced by the State Scientific Center for Medical and Biological Sciences of the Rospotrebnadzor (Obolensk). Statistical analysis was performed using the Excel package. The confidence interval for the proportion was calculated using the A. Wald, J. Wolfowitz method with A. Agresti, B.A. Coull’s correction. The statistical significance of the differences was calculated online using a specialized calculator. The statistical significance of the differences was assessed with a probability of p˂ 0.05, unless otherwise indicated.

Results. In a comparative analysis, the highest morbidity was observed in the Khabarovsk Territory, the lowest – in the Primorsky Territory. The level of seroprevalence among the population of the region was 19.6 % (95 % CI: 18.2–21.1) in  the  Khabarovsk Territory, 19.6  % (95  %  CI: 18.1–21.2) in the Primorsky Territory19,6 % and 45,5 % (95 % CI: 43.7–47.3) in the Amur region. The highest seroprevalence was noted among 1–17 years old children, mainly due to the subgroup of 14–17-years-olds. The smallest proportion of seropositive was found among 40–49-year-olds in the Khabarovsk Territory (14.7 %, 95 % CI: 11.2–18.6), 18–28-yearolds in the Primorsky Territory (13.3 %, 95 % CI: 10.0–17.1) and 30–39-year-olds in the Amur Region (36.3  %, 95%  CI:  31.7–41.6). No statistically significant dependence of  seroprevalence on territorial and occupational factors has been established, with the exception of an increase in the proportion of seropositive medical workers in Primorsky Territory. In the process of 3-stage seromonitoring, a regular increase in the proportion of seropositive people was revealed in all SRFE. The resulting tendency is correctly described by a second-order polynomial. A relationship was revealed between the number of convalescents and persons in contact with them, which made it possible to calculate the base reproductive number (R0) in the range from 1.4 (Primorsky Territory) to 2.4 (Amur Region). Analysis of seroprevalent volunteers showed that the number of asymptomatic individuals varied from 94.1 % (95 % CI: 92.8–95.3) to 98.3 % (95 % CI: 98.8–99.2). This indicates that most of the volunteers had COVID-19 asymptomatically.

Conclusions. A comparative study showed the prevalence of seroprevalence in the Amur Region compared with the Khabarovsk and Primorsky Territories. The relationship between the number of convalescents and persons in contact with them was noted. The value of the base R0 is calculated. It has been shown that more than 90 % of seropositive individuals in the COVID-10 SRFE were asymptomatic.

A Biological Insight into the Susceptibility to Influenza Infection in Junior Rats by Comprehensive Analysis of lncRNA Profiles

Long noncoding RNAs (lncRNAs) have been reported to participate in regulating many biological processes, including immune response to influenza A virus (IAV). However, the association between lncRNA expression profiles and influenza infection susceptibility has not been well elucidated. Here, we analyzed the expression profiles of lncRNAs, miRNAs, and mRNAs among IAV-infected adult rat (IAR), normal adult rat (AR), IAV-infected junior rat (IJR), and normal junior rat (JR) by RNA sequencing. Compared with differently expressed lncRNAs (DElncRNAs) between AR and IAR, 24 specific DElncRNAs were found between IJR and JR. Then, based on the fold changes and P value, the top 5 DElncRNAs, including 3 upregulated and 2 downregulated lncRNAs, were chosen to establish a ceRNA network for further disclosing their regulatory mechanisms. To visualize the differentially expressed genes in the ceRNA network, GO and KEGG pathway analysis was performed to further explore their roles in influenza infection of junior rats. The results showed that the downregulated DElncRNA-target genes were mostly enriched in the IL-17 signaling pathway. It indicated that the downregulated lncRNAs conferred the susceptibility of junior rats to IAV via mediating the IL-17 signaling pathway.