Asthe Covid-19 cases surge globally, especially in India, leaving many of uswonder why it is so hard to treat, a review published in the prestigiousjournal The Lancet has revealed that the increase in caseloads is owing to aunique infectious profile.
Accordingto the review, there is growing evidence that the virus infects both the upperand lower respiratory tracts.
Thereview suggests that it is unlike "low pathogenic" human coronavirussub-species, which typically settle in the upper respiratory tract and causecold-like symptoms or "high pathogenic" viruses such as those thatcause SARS and ARDS, which typically settle in the lower respiratory tract.
Additionally,more frequent multi-organ impacts, blood clots and an unusualimmune-inflammatory response not commonly associated with other, similarviruses, mean that Covid-19 has evolved a uniquely challenging set ofcharacteristics.
"Theemergence of severe acute respiratory syndrome coronavirus two (SARS-CoV-2),which causes Covid-19, has resulted in a health crisis not witnessed since the1918 Spanish flu pandemic. Tragically, millions around the world have diedalready," said co-author Ignacio Martin-Loeches, Clinical Professor inTrinity College Dublin.
Whileanimal and experimental models imply an overly aggressive immune-inflammationresponse is a key driver, it seems things work differently in humans --although inflammation is a factor it is a unique dysregulation of the immuneresponse that causes our bodies to mismanage the way they fight the virus.
"Despiteinternational focus on the virus, we are only just beginning to understand itsintricacies," Martin-Loeches said.
"Basedon growing evidence we propose that Covid-19 should be perceived as a new entitywith a previously unknown infectious profile. It has its own characteristicsand distinct pathophysiology and we need to be aware of this when treatingpeople," Martin-Loeches added.
However,the co-author also said that it doesn't mean we should abandon existingbest-practice treatments that are based on our knowledge of other humancoronaviruses.
Butan unbiased, gradual assembly of the key Covid-19 puzzle pieces for differentpatient cohorts -- based on sex, age, ethnicity, pre-existing comorbidities --is what is needed to modify the existing treatment guidelines, subsequentlyproviding the most adequate care to Covid-19 patients.