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Viruses
Special Issues
Medical Interventions for Treatment and Prevention of SARS-CoV-2 Infections
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Medical Interventions for Treatment and Prevention of SARS-CoV-2 Infections

A special issue of Viruses (ISSN 1999-4915). This special issue belongs to the section "SARS-CoV-2 and COVID-19".

Deadline for manuscript submissions: closed (30 September 2021) | Viewed by 38590

Special Issue Editors

Dr. Jeroen van Kampen

E-Mail Website
Guest Editor
Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
Interests: clinical virology; diagnosis & treatment of viral infections; antivirals
Dr. Pieter L.A. Fraaij

E-Mail
Guest Editor
Department of Viroscience, Erasmus MC, Rotterdam, The Netherlands
Interests: immunology; microbiology

Special Issue Information

Dear Colleagues,

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections continue to have devastating effects on societies worldwide. Control measures such as social distancing, lockdowns, the widespread use of personnel protective equipment, and test and trace policies have been put in place to reduce SARS-CoV-2-related morbidity and mortality and to prevent the collapse of national healthcare services from overwhelming numbers of coronavirus disease 2019 (COVID-19) patients. Although most agree that these sometimes-harsh measures help to reduce the number of infections, they are not sufficient to quell the global SARS-CoV-2 pandemic, while the collateral social and economic damage is becoming increasingly clear. Further medical interventions are clearly warranted.

Fortunately, within a year after the start of the pandemic, medical interventions have been developed at “warp speed”. Most notable are the safe and effective SARS-CoV-2 vaccines, which are now employed in mass vaccination campaigns with ever increasing volumes. In addition, significant progress has been made in the treatment of patients with COVID-19. Especially, the use of immune modulatory therapies has proven to be a game changer. In the pre-COVID-19 era, the treatment of individuals affected by severe acute respiratory viral infections with immunomodulatory agents was filled with controversy and heavily debated. This debate is now likely to be rekindled, as it is not likely that immunomodulation would only work for severe acute respiratory viral infections caused by SARS-CoV-2. Despite these good results, additional data are needed including knowledge on the use of different immunomodulatory regimens, their PK/PD and the timing of interventions. The efficacy of antiviral compounds and passive immunization is less clear, but new compounds and existing drugs are being tested in vitro and in vivo. The results are eagerly anticipated.

Indeed, there is now a phase in the pandemic in which knowledge is rapidly accumulating on the use of passive immunizations, immunomodulation and antiviral compounds for the treatment and prevention of SARS-CoV-2 infections and their sequelae. We therefore feel that it is now due time to devote a Special Issue of Viruses to these topics. Herewith, we invite you to submit your valuable manuscripts to this Special Issue of Viruses on medical interventions for the treatment and prevention of SARS-CoV-2 infections.

Dr. Jeroen van Kampen
Dr. Pieter L.A. Fraaij
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Viruses is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • SARS-CoV-2
  • COVID-19
  • treatment
  • prevention
  • antiviral
  • antibody
  • immunomodulation

Published Papers (5 papers)

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Research

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23 pages, 34686 KiB  
Article
ZRC3308 Monoclonal Antibody Cocktail Shows Protective Efficacy in Syrian Hamsters against SARS-CoV-2 Infection
by Pragya D. Yadav, Sanjeev Kumar Mendiratta, Sreelekshmy Mohandas, Arun K. Singh, Priya Abraham, Anita Shete, Sanjay Bandyopadhyay, Sanjay Kumar, Aashini Parikh, Pankaj Kalita, Vibhuti Sharma, Hardik Pandya, Chirag G. Patel, Mihir Patel, Swagat Soni, Suresh Giri and Mukul Jain
Viruses 2021, 13(12), 2424; https://0-doi-org.brum.beds.ac.uk/10.3390/v13122424 - 03 Dec 2021
Cited by 5 | Viewed by 2022
Abstract
We have developed a monoclonal antibody (mAb) cocktail (ZRC-3308) comprising of ZRC3308-A7 and ZRC3308-B10 in the ratio 1:1 for COVID-19 treatment. The mAbs were designed to have reduced immune effector functions and increased circulation half-life. mAbs showed good binding affinities to non-competing epitopes [...] Read more.
We have developed a monoclonal antibody (mAb) cocktail (ZRC-3308) comprising of ZRC3308-A7 and ZRC3308-B10 in the ratio 1:1 for COVID-19 treatment. The mAbs were designed to have reduced immune effector functions and increased circulation half-life. mAbs showed good binding affinities to non-competing epitopes on RBD of SARS-CoV-2 spike protein and were found neutralizing SARS-CoV-2 variants B.1, B.1.1.7, B.1.351, B.1.617.2, and B.1.617.2 AY.1 in vitro. The mAb cocktail demonstrated effective prophylactic and therapeutic activity against SARS-CoV-2 infection in Syrian hamsters. The antibody cocktail appears to be a promising candidate for prophylactic use and for therapy in early COVID-19 cases that have not progressed to severe disease. Full article
(This article belongs to the Special Issue Medical Interventions for Treatment and Prevention of SARS-CoV-2 Infections)
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14 pages, 606 KiB  
Article
Unique Severe COVID-19 Placental Signature Independent of Severity of Clinical Maternal Symptoms
by Marjolein F. Husen, Lotte E. van der Meeren, Robert M. Verdijk, Pieter L. A. Fraaij, Annemiek A. van der Eijk, Marion P. G. Koopmans, Liv Freeman, Hein Bogers, Marjolijn D. Trietsch, Irwin K. M. Reiss, Philip L. J. DeKoninck and Sam Schoenmakers
Viruses 2021, 13(8), 1670; https://0-doi-org.brum.beds.ac.uk/10.3390/v13081670 - 23 Aug 2021
Cited by 32 | Viewed by 16163
Abstract
Background: Although the risk for transplacental transmission of SARS-CoV-2 is rare, placental infections with adverse functional consequences have been reported. This study aims to analyse histological placental findings in pregnancies complicated by SARS-CoV-2 infection and investigate its correlation with clinical symptoms and perinatal [...] Read more.
Background: Although the risk for transplacental transmission of SARS-CoV-2 is rare, placental infections with adverse functional consequences have been reported. This study aims to analyse histological placental findings in pregnancies complicated by SARS-CoV-2 infection and investigate its correlation with clinical symptoms and perinatal outcomes. We want to determine which pregnancies are at-risk to prevent adverse pregnancy outcomes related to COVID-19 in the future. Methods: A prospective, longitudinal, multicentre, cohort study. All pregnant women presenting between April 2020 and March 2021 with a nasopharyngeal RT-PCR-confirmed SARS-CoV-2 infection were included. Around delivery, maternal, foetal and placental PCR samples were collected. Placental pathology was correlated with clinical maternal characteristics of COVID-19. Results: Thirty-six patients were included, 33 singleton pregnancies (n = 33, 92%) and three twin pregnancies (n = 3, 8%). Twenty-four (62%) placentas showed at least one abnormality. Four placentas (4/39, 10%) showed placental staining positive for the presence of SARS-CoV-2 accompanied by a unique combination of diffuse, severe inflammatory placental changes with massive perivillous fibrin depositions, necrosis of syncytiotrophoblast, diffuse chronic intervillositis, and a specific, unprecedented CD20+ B-cell infiltration. This SARS-CoV-2 placental signature seems to correlate with foetal distress (75% vs. 15.6%, p = 0.007) but not with the severity of maternal COVID-19 disease. Conclusion: We describe a unique placental signature in pregnant patients with COVID-19, which has not been reported in a historical cohort. We show that the foetal environment can be seriously compromised by disruption of placental function due to local, devastating SARS-CoV-2 infection. Maternal clinical symptoms did not predict the severity of the SARS-CoV-2-related placental signature, resulting in a lack of adequate identification of maternal criteria for pregnancies at risk. Close foetal monitoring and pregnancy termination in case of foetal distress can prevent adverse pregnancy outcomes due to COVID-19 related placental disease. Full article
(This article belongs to the Special Issue Medical Interventions for Treatment and Prevention of SARS-CoV-2 Infections)
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15 pages, 2290 KiB  
Article
Protective Effects of Astodrimer Sodium 1% Nasal Spray Formulation against SARS-CoV-2 Nasal Challenge in K18-hACE2 Mice
by Jeremy R. A. Paull, Carolyn A. Luscombe, Alex Castellarnau, Graham P. Heery, Michael D. Bobardt and Philippe A. Gallay
Viruses 2021, 13(8), 1656; https://0-doi-org.brum.beds.ac.uk/10.3390/v13081656 - 20 Aug 2021
Cited by 14 | Viewed by 10772
Abstract
Strategies to combat COVID-19 require multiple ways to protect vulnerable people from infection. SARS-CoV-2 is an airborne pathogen and the nasal cavity is a primary target of infection. The K18-hACE2 mouse model was used to investigate the anti-SARS-CoV-2 efficacy of astodrimer sodium formulated [...] Read more.
Strategies to combat COVID-19 require multiple ways to protect vulnerable people from infection. SARS-CoV-2 is an airborne pathogen and the nasal cavity is a primary target of infection. The K18-hACE2 mouse model was used to investigate the anti-SARS-CoV-2 efficacy of astodrimer sodium formulated in a mucoadhesive nasal spray. Animals received astodrimer sodium 1% nasal spray or PBS intranasally, or intranasally and intratracheally, for 7 days, and they were infected intranasally with SARS-CoV-2 after the first product administration on Day 0. Another group was infected intranasally with SARS-CoV-2 that had been pre-incubated with astodrimer sodium 1% nasal spray or PBS for 60 min before the neutralisation of test product activity. Astodrimer sodium 1% significantly reduced the viral genome copies (>99.9%) and the infectious virus (~95%) in the lung and trachea vs. PBS. The pre-incubation of SARS-CoV-2 with astodrimer sodium 1% resulted in a significant reduction in the viral genome copies (>99.9%) and the infectious virus (>99%) in the lung and trachea, and the infectious virus was not detected in the brain or liver. Astodrimer sodium 1% resulted in a significant reduction of viral genome copies in nasal secretions vs. PBS on Day 7 post-infection. A reduction in the viral shedding from the nasal cavity may result in lower virus transmission rates. Viraemia was low or undetectable in animals treated with astodrimer sodium 1% or infected with treated virus, correlating with the lack of detectable viral replication in the liver. Similarly, low virus replication in the nasal cavity after treatment with astodrimer sodium 1% potentially protected the brain from infection. Astodrimer sodium 1% significantly reduced the pro-inflammatory cytokines IL-6, IL-1α, IL-1β, TNFα and TGFβ and the chemokine MCP-1 in the serum, lung and trachea vs. PBS. Astodrimer sodium 1% nasal spray blocked or reduced SARS-CoV-2 replication and its sequelae in K18-hACE2 mice. These data indicate a potential role for the product in preventing SARS-CoV-2 infection or for reducing the severity of COVID-19. Full article
(This article belongs to the Special Issue Medical Interventions for Treatment and Prevention of SARS-CoV-2 Infections)
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11 pages, 479 KiB  
Systematic Review
What Is the Role of Therapeutic Plasma Exchange as an Adjunctive Treatment in Severe COVID-19: A Systematic Review
by Łukasz J. Krzych, Zbigniew Putowski, Marcelina Czok and Mariusz Hofman
Viruses 2021, 13(8), 1484; https://0-doi-org.brum.beds.ac.uk/10.3390/v13081484 - 28 Jul 2021
Cited by 11 | Viewed by 2940
Abstract
Introduction: Since the COVID-19 pandemic outbreak, multiple promising treatment modalities have been tested, however, only several of them were proven to be effective. Therapeutic plasma exchange (TPE) has been recently discussed as a possible supportive treatment for severe cases. Methods: To investigate a [...] Read more.
Introduction: Since the COVID-19 pandemic outbreak, multiple promising treatment modalities have been tested, however, only several of them were proven to be effective. Therapeutic plasma exchange (TPE) has been recently discussed as a possible supportive treatment for severe cases. Methods: To investigate a possible role of TPE in severe COVID-19 we used a structured systematic search strategy to retrieve all relevant publications in the field. We screened in PubMed, EMBASE, Web of Science, Cochrane Library and clinicaltrials.gov for data published until the 4 June 2021. Results: We identified 18 papers, enrolling 384 patients, 220 of whom received TPE. The number of TPE sessions ranged from 1 to 9 and the type of replacement fluid varied markedly between studies (fresh frozen plasma or 5% albumin solution, or convalescent plasma). Biochemical improvement was observed in majority of studies as far as C-reactive protein (CRP), interleukin-6 (IL-6), ferritin, lactate dehydrogenase (LDH), D-dimer concentrations and lymphocyte count are concerned. The improvement at a laboratory level was associated with enhancement of respiratory function. Adverse effects were limited to five episodes of transient hypotension and one femoral artery puncture and thrombophlebitis. Conclusions: Although the effect of therapeutic plasma exchange on mortality remains unclarified, the procedure seems to improve various secondary end-points such as PaO2/FiO2 ratio or biomarkers of inflammation. Therapeutic plasma exchange appears to be a safe treatment modality in COVID-19 patients in terms of side effects. Full article
(This article belongs to the Special Issue Medical Interventions for Treatment and Prevention of SARS-CoV-2 Infections)
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12 pages, 1234 KiB  
Opinion
Compelling Evidence for the Activity of Antiviral Peptides against SARS-CoV-2
by Miray Tonk, Daniel Růžek and Andreas Vilcinskas
Viruses 2021, 13(5), 912; https://0-doi-org.brum.beds.ac.uk/10.3390/v13050912 - 14 May 2021
Cited by 17 | Viewed by 5665
Abstract
Multiple outbreaks of epidemic and pandemic viral diseases have occurred in the last 20 years, including those caused by Ebola virus, Zika virus, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The emergence or re-emergence of such diseases has revealed the deficiency in [...] Read more.
Multiple outbreaks of epidemic and pandemic viral diseases have occurred in the last 20 years, including those caused by Ebola virus, Zika virus, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The emergence or re-emergence of such diseases has revealed the deficiency in our pipeline for the discovery and development of antiviral drugs. One promising solution is the extensive library of antimicrobial peptides (AMPs) produced by all eukaryotic organisms. AMPs are widely known for their activity against bacteria, but many possess additional antifungal, antiparasitic, insecticidal, anticancer, or antiviral activities. AMPs could therefore be suitable as leads for the development of new peptide-based antiviral drugs. Sixty therapeutic peptides had been approved by the end of 2018, with at least another 150 in preclinical or clinical development. Peptides undergoing clinical trials include analogs, mimetics, and natural AMPs. The advantages of AMPs include novel mechanisms of action that hinder the evolution of resistance, low molecular weight, low toxicity toward human cells but high specificity and efficacy, the latter enhanced by the optimization of AMP sequences. In this opinion article, we summarize the evidence supporting the efficacy of antiviral AMPs and discuss their potential to treat emerging viral diseases including COVID-19. Full article
(This article belongs to the Special Issue Medical Interventions for Treatment and Prevention of SARS-CoV-2 Infections)
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