2020 has been a challenging year across the globe. SARS-CoV-2, the virus that causes COVID-19 and is believed to originate from bats, quickly spread into a global pandemic. During this outbreak of COVID-19, the world is frightened with an unpredictable and hasty impact of the infection, and the data is changing day by day. As of December 29, 2020, almost a year later, the coronavirus COVID-19 is affecting 218 countries and territories around the world with over 79,931,215 confirmed cases, including 1,765,265 deaths, according to WHO. (1)
The most common clinical features of COVID-19 infection are fever (more than 80% cases), cough (more than 60% cases), fatigue (more than 35% cases), sputum production (more than 30% cases), and shortness of breath (more than 15% cases). Respiratory distress syndrome, septic shock, metabolic acidosis, coagulation dysfunction, and multiple organ failure are noted as the main complications of COVID-19. (2)
COVID-19 took the world by storm, requiring an unprecedented response from governments and healthcare institutions from across the world. It became an international threat, leading many pharmaceutical companies, organizations, and laboratories to begin studying it to understand this virus and treat it successfully. With both good and bad developments, the pandemic has prompted the development of fast diagnostic tools and treatment options.
R/D Progress for COVID-19 in 2020
2020 saw major pharmaceutical companies, like Pfizer, direct their efforts at understanding the virus and creating the tools to manage it. Specifically, research has addressed diagnostics, treatments, drug repurposing, vaccination, and protection measures against the disease. The progress and the rate of said progress have been amazing, much faster than expected, especially in regards to the vaccine. Usually, successful development of a new vaccine requires years of research and testing before reaching the clinic, but in this pandemic crisis of COVID-19, scientists embarked on a race to produce safe and effective coronavirus vaccines in record time. As per the available data, scientists are currently testing 64 vaccines in clinical trials on humans, and 19 have reached the final stages of testing. At least 85 preclinical vaccines are under active investigation in animals. (3)
COVID-19 Diagnostic Progress in 2020
In order to control COVID-19, various emerging technologies have been implemented to confirm its presence by the pharmaceutical and biotech industries and organizations.
One of the first issues was developing a quick diagnostic tool for the COVID-19. Currently, the most common diagnostic tools were the real-time reverse transcription-polymerase chain reaction (RT-PCR). RT-PCR method was based on detection of genes that are unique to SARS- CoV-2. (4) This was managed rather quickly for the diagnosis of COVID-19.
In addition, infrared (IR) sensors and thermal scanning have been used as diagnostic auxiliaries. Thermal cameras allow detection of increase temperature and can monitor individuals and crowds or large gatherings who may present symptoms.
Another diagnostic option is the Nucleic Acid Amplification test or NAAT, which can confirm COVID-19 through a nasal swab or a blood sample in real-time. However, it can be associated with false negatives due to limited sensitivity. (5)
Now, tests have become more available, and across the world individuals with symptoms can access one with a good general degree of accuracy. Testing has been an important part of the strategy for containing the virus, however, the problem with false negatives has not been fully resolved. (6)
COVID-19 Treatment Progress in 2020
Medical science has progressed very quickly, even faster than expected during the COVID-19 pandemic. Effective therapeutics include antiviral drugs (Remdesivir and Favilavir), the protease inhibitors (Lopinavir/ritonavir (LPV/RTV), cytokine inhibitors (IL-6 inhibitors, such as Tocilizumab), monoclonal antibodies (Leronlimab, the CCR5/chemokine receptor 5 inhibitor), convalescent plasma and corticosteroids (corticosteroids should only be used in COVID-19 induced lung injury in the setting of a clinical trial). (7) These medications have shown promising results. (8) In particular, the most promising development has been in the field of vaccines. By December 2020, vaccinations already started across the world, and vaccine candidates reported high rates of success after only a few months of development. Vaccines appear as the most promising strategy as well, however, other than this, there also appears to be some positive news for antibody treatments. Eli Lilly and Regeneron have received limited approval for their COVID-19 treatments. (9)
Medical interventions have helped reduce deaths almost in half. China reported some measure of success using drugs like interferon.(10) Dexamethasone is the first drug to be shown to improve survival in COVID-19. (11)
Currently, there are over 300 potential treatments, and over 200 potential vaccines being developed and researched.(12) Three vaccines are approved, and another 80 are being studied at the moment. (3)
At the moment, there are viable vaccines that are already being used. However, there are some concerns and problems still to be addressed. Firstly, the vaccinations will likely take time to reach everyone and to have a complete effect on global health. This appears to be the best long-term strategy and there is a low risk of anaphylaxis after receiving the vaccine. However, a bigger issue is the concerns people might have and their unwillingness to accept a vaccine that is perceived to be dangerous, in particular, those who believe in conspiracy theories surrounding the virus and the treatment as well. (13)
Furthermore, distribution, production, and storage all present their own issues, as, for instance, some of the vaccines require specific conditions, like temperature, to stay viable, that could influence on-time delivery and vaccination for COVID-19. The logistics associated with a massive vaccination present challenges for vaccine manufacturers, distributors, and local governments. As the process is only just beginning, it remains to be seen how it will continue, but early results seem promising.
COVID-19 is not going to magically end with the end of 2020. It is likely to remain a problem throughout 2021 as well, while the vaccine is being distributed and applied, as contagions keep happening. However, there is also good reason to be more optimistic, as there are more solutions and a better understanding of the virus and how it should be treated. Still, it will remain a challenge for some time.
The COVID-19 pandemic highlighted the incredible speed of scientific responses, as the vaccine appeared within just a year of the virus being discovered. However, the pandemic also showed that a more serious threat, a virus that is deadlier, could have a huge impact on humanity, and there is a need to be prepared for such a situation.
The research focused on COVID-19 continues and will likely remain a priority. This especially concerns possibilities for treatment and improvement of the vaccines. A better understanding of the treatment options could help save the lives of people who are already infected with the disease.
COVID-19 has been a real challenge, and it has put to the test many aspects of modern society, from healthcare, pharmaceutical research, and diagnostics to policies and public health approaches. It has forced the world to work harder and faster and has also made everyone pay more attention to health. The long-term impacts are not yet fully clear, but they will definitely be significant.
2 Wang, Y., Wang, Y., Chen, Y., Qin, Q., 2020b. Unique epidemiological and clinical features of the emerging 2019 novel coronavirus pneumonia (COVID-19) implicate special control measures. J. Med. Virol. 92 (6), 568–576. https://doi.org/10.1002/ jmv.25748.
Lin Zhang, Ph.D., senior director of a health care industry company in the United States. With the experience in clinical medicine, biotechnology, health industry and other fields, he is responsible for the research and development of plant medicine, functional food and health products. He was a clinician and worked for the National Cancer Institute, FDA and the National Cancer Center of Japan for many years.