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      An overview on tumor treating fields (TTFields) technology as a new potential subsidiary biophysical treatment for COVID-19

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          COVID-19 pandemic situation has affected millions of people with tens of thousands of deaths worldwide. Despite all efforts for finding drugs or vaccines, the key role for the survival of patients is still related to the immune system. Therefore, improving the efficacy and the functionality of the immune system of COVID-19 patients is very crucial. The potential new, non-invasive, FDA-approved biophysical technology that could be considered in this regard is tumor treating fields (TTFields) based on an alternating electric field has great biological effects. TTFields have significant effects in improving the functionality of dendritic cell, and cytotoxic T-cells, and these cells have a major role in defense against viral infection. Hence, applying TTFields could help COVID-19 patients against infection. Additionally, TTFields can reduce viral genomic replication, by reducing the expressions of some of the vital members of DNA replication complex genes from the minichromosome maintenance family (MCMs). These genes not only are involved in DNA replication but it has also been proven that they have a crucial role in viral replication. Also, TTFields suppress the formation of the network of tunneling nanotubes (TNTs) which is knows as filamentous (F)-actin-rich tubular structures. TNTs have a critical role in promoting the spread of viruses through improving viral entry and acting as a protective agent for viral components from immune cells and even pharmaceuticals. Moreover, TTFields enhance autophagy which leads to apoptosis of virally infected cells. Thus, it can be speculated that using TTFields may prove to be a promising approach as a subsidiary treatment of COVID-19.

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          COVID-19 infection: Origin, transmission, and characteristics of human coronaviruses

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            Virology, Epidemiology, Pathogenesis, and Control of COVID-19

            The outbreak of emerging severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) in China has been brought to global attention and declared a pandemic by the World Health Organization (WHO) on March 11, 2020. Scientific advancements since the pandemic of severe acute respiratory syndrome (SARS) in 2002~2003 and Middle East respiratory syndrome (MERS) in 2012 have accelerated our understanding of the epidemiology and pathogenesis of SARS-CoV-2 and the development of therapeutics to treat viral infection. As no specific therapeutics and vaccines are available for disease control, the epidemic of COVID-19 is posing a great threat for global public health. To provide a comprehensive summary to public health authorities and potential readers worldwide, we detail the present understanding of COVID-19 and introduce the current state of development of measures in this review.
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              The cytokine storm and COVID‐19

              Abstract Coronavirus disease 2019 (COVID‐19), which began in Wuhan, China in December 2019 has caused a large global pandemic and poses a serious threat to public health. More than four million cases of COVID‐19, which is caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), have been confirmed as of May 11, 2020. SARS‐CoV‐2 is a highly pathogenic and transmissible coronavirus that primarily spreads through respiratory droplets and close contact. A growing body of clinical data suggests that a cytokine storm is associated with COVID‐19 severity and is also a crucial cause of death from COVID‐19. In the absence of antivirals and vaccines for COVID‐19, there is an urgent need to understand the cytokine storm in COVID‐19. Here, we have reviewed the current understanding of the features of SARS‐CoV‐2 and the pathological features, pathophysiological mechanisms, and treatments of the cytokine storm induced by COVID‐19. Additionally, we suggest that the identification and treatment of the cytokine storm are important components for rescuing patients with severe COVID‐19. This article is protected by copyright. All rights reserved.
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                Author and article information

                Contributors
                ahmadrezafarmani66@gmail.com
                mahdaviforough@gmail.com
                carolina.scagnolari@uniroma1.it
                mahsa.bah.k@gmail.com
                s.mohammadi.ippi@gmail.com
                jafar_ai@tums.ac.ir
                mhshoormeij@gmail.com
                rezaei_nima@tums.ac.ir
                Journal
                Drug Deliv Transl Res
                Drug Deliv Transl Res
                Drug Delivery and Translational Research
                Springer US (New York )
                2190-393X
                2190-3948
                20 September 2021
                : 1-11
                Affiliations
                [1 ]GRID grid.411705.6, ISNI 0000 0001 0166 0922, Tissue Engineering and Applied Cell Sciences Department, School of Advanced Technologies in Medicine, , Tehran University of Medical Sciences, ; Tehran, Iran
                [2 ]GRID grid.411135.3, ISNI 0000 0004 0415 3047, Tissue Engineering Department-School of Advanced Technologies in Medicine, , Fasa University of Medical Sciences, ; Fasa, Iran
                [3 ]GRID grid.411705.6, ISNI 0000 0001 0166 0922, Students’ Scientific Research Center, , Tehran University of Medical Sciences, ; Tehran, Iran
                [4 ]GRID grid.411705.6, ISNI 0000 0001 0166 0922, Anatomy Department-School of Medicine, , Tehran University of Medical Sciences, ; Tehran, Iran
                [5 ]GRID grid.7841.a, Laboratory of Virology, Department of Molecular Medicine, Sapienza University, Affiliated to Istituto Pasteur Italia, ; Viale Di Porta Tiburtina, 28, 00185 Rome, Italy
                [6 ]GRID grid.419412.b, ISNI 0000 0001 1016 0356, Department of Plastic Engineering, Faculty of Polymer Processing, , Iran Polymer and Petrochemical Institute, ; Tehran, Iran
                [7 ]GRID grid.415646.4, ISNI 0000 0004 0612 6034, Emergency Medicine Department, , Shariati Hospital, Tehran University of Medical Sciences, ; Tehran, Iran
                [8 ]GRID grid.411705.6, ISNI 0000 0001 0166 0922, Research Center for Immunodeficiencies, Children’s Medical Center, , Tehran University of Medical Sciences, ; Tehran, Iran
                [9 ]GRID grid.411705.6, ISNI 0000 0001 0166 0922, Department of Immunology, School of Medicine, , Tehran University of Medical Sciences, ; Tehran, Iran
                [10 ]GRID grid.510410.1, ISNI 0000 0004 8010 4431, Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), , Universal Scientific Education and Research Network (USERN), ; Tehran, Iran
                Author information
                http://orcid.org/0000-0002-3836-1827
                Article
                1067
                10.1007/s13346-021-01067-5
                8451390
                34542840
                a9b487ab-e391-4bde-a85a-e3583ccee25f
                © Controlled Release Society 2021

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                : 10 September 2021
                Categories
                Review Article

                Pharmacology & Pharmaceutical medicine
                bioelectricity,biophysical treatment,covid-19,ttfields,immunity system

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