By Bincy M Biju (M.Sc. Biotechnology) and Dr. Chiradeep Sarkar (Assistant Professor, Department of Biotechnology) at G.N.Khalsa College (Autonomous), Mumbai, India.
[Note: Numbers mentioned in parenthesis relate to References that are mentioned at the end of this article]
Zoonotic disease or zoonosis is a type of disease that is transmitted from animals or birds to humans. Zoonotic outbreak tends to occur due to the destruction of animal habitats and increased interaction of humans & animals. Such outbreaks spread worldwide due to increased traveling & globalization of markets.
By the end of 2019, an unidentified cluster of pneumonia emerged in Wuhan, Hubei Province, China  and a global outbreak occurred, affecting 12,286,264 individuals worldwide (updated as on 11th July 2020) . International Committee on Taxonomy of Viruses (ICTV) named novel coronavirus as SARS-CoV-2 , followed by WHO naming this disease as COVID-19. In COVID-19 patients, SARS-CoV-2 was isolated from bronchoalveolar lavage fluid (BALF) , and after analysis was considered as a member of β-CoV’s family [4,5]. Coronavirus is an enveloped, positive sense single-stranded RNA virus which is divided into 4 subfamilies: α, β, γ, δ- CoV’s and causing respiratory, enteric, hepatic and neurological diseases [6,7]. This virus enters into the cell by interacting with human angiotensin, converting enzyme 2 (ACE2) receptor which is expressed in kidney, lungs, heart and intestine [8,9,10].
Coronavirus or COVID-19 show 5 different types of outcomes: mild to medium case (80.9%), severe case (13.8%), critical case (4.7%), asymptomatic case (1.2%), death (2.3%) . Most common symptoms are fever, cough and fatigue while less common symptoms are sputum production, headache, hemoptysis and diarrhea. Patients also show normal or decreased white blood cell count and consolidation in bilateral multiple lobular and subsegmental areas [1,10,11]. The main transmission route is respiratory droplets and contact transmission . Children below 10-years-old, obese people, smokers, people with asthma, diabetes, cancer, cardiovascular disease are more susceptible to infection [13-17].
Anti-viral compounds such as Ribavirin, Lopinavir/ritonavir, Remdesivir, Nelfinavir, Arbidol, chloroquine can be used for the treatment of COVID-19 [18-23]. Vaccines could be the best option to control COVID-19 as vaccines stimulate Helper T-cells to produce cytokines which in turn triggers Killer T-cells and other natural killer cells to recognize and mount immune response against the virus-infected cells and thus helping in an increased immune response against a particular pathogen. Vaccine candidate(s) for COVID-19 though will be available only after exhaustive clinical trials for safety and efficacy and probably enter the market by mid-2021 according to many experts.
There is, however, a growing evidence, that live attenuated vaccines given during childhood also confer beneficial Non-Specific Effects (NSE) and can reduce both morbidity and mortality due to unrelated infections [24,25]. A paper by Fidel Jr. and Noverr proposes, based on various empirical studies, that live attenuated vaccines like MMR (Measles, Mumps, Rubella) can induce “trained” non-specific innate immune cells for improved host responses and reduce COVID-19 associated lung inflammation and sepsis. Moreover, in immunocompetent individuals, MMR does not show any contraindications .
According to Salman and Salem, combined vaccination with varicella, Hepatitis B, MMR, Poliomyelitis and Rotavirus can be used to reduce the fatality and recover quickly against COVID-19. MMR vaccine has been used before to develop enhanced immunity against other virus strains like HPV (Human Papilloma Virus) .
In another recent preprint paper by Young et.al, sequence homology was identified in fusion proteins of SARS-CoV-2 with measles and mumps viruses. Moreover, the macro domain (ADP-ribose-1-phosphatase) of the SARS-CoV-2 and Rubella virus showed 29% Amino acid sequence homology. As an initial test of the hypothesis, the study concluded that age-groups that lacked MMR- induced immunity had the poorest outcome in COVID-19 and COVID-19 disease burden correlates with Rubella antibody titres potentially induced by SARS-CoV-2 sequence homology. Hence, the emerging hypothesis indicates that MMR vaccine can provide protection by reducing its adverse effects .
Thus, vaccination strategies with attenuated vaccines like MMR warrants more detailed clinical studies/trials as a safe and time-appropriate therapeutic intervention in reducing the worst aspects of COVID-19.
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