VASILIOS TZILAS and DEMOSTHENES BOUROS
Abstract. Severe acute respiratory syndrome coronavirus 2
(SARS‑CoV‑2) is transmitted to humans mainly via contact
and droplet transmission and its entry into cells is mediated
by the efficient binding of the spike (S) viral protein with
the angiotensin converting enzyme‑2 (ACE2) receptors.
Although acute respiratory distress syndrome (ARDS) caused
by SARS‑CoV‑2 fulfills the criteria of the Berlin definition,
in a considerable proportion of patients with COVID‑19,
there is a dissociation between their relatively well‑preserved
lung mechanics and the severity of hypoxaemia. The extent
of pneumococcal related morbidity and mortality is largely
unknown. Respiratory comorbidities that increase the risk
of severe disease and mortality due to SARS‑CoV‑2 include
chronic obstructive pulmonary disease, asthma, bronchiectasis
and fibrotic interstitial lung diseases, regardless of aetiology.
Pneumococcal and seasonal influenza vaccinations are useful
in preventing a substantial burden of mortality in high‑risk
populations, while general quarantine and social distancing
can reduce the infiltration of the virus within the community.
To date, several therapeutic agents have been studied or are
currently examined, such as hydroxychloroquine, chloroquine,
ritonavir/lopinavir, remdesivir, colchicines and interleukin‑6
inhibitors. However, the usage of most of these into clinical
practice was not based on randomised clinical trials and their
results should be viewed with extreme caution; remdesivir
seems to be the more promising option. Rigorous efforts are
under way for the development of a safe and successful vaccine
against SARS‑CoV‑2.
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