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      Intranasal Antiviral Drug Delivery and Coronavirus Disease 2019 (COVID-19): A State of the Art Review

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          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objective

          To provide a state of the art review of intranasal antiviral drug delivery and to discuss current applications, adverse reactions, and future considerations in the management of coronavirus disease 2019 (COVID-19).

          Data Sources

          PubMed, Embase, and Clinicaltrials.gov search engines.

          Review Methods

          A structured search of the current literature was performed of dates up to and including April 2020. Search terms were queried as related to topics of antiviral agents and intranasal applications. A series of video conferences was convened among experts in otolaryngology, infectious diseases, public health, pharmacology, and virology to review the literature and discuss relevant findings.

          Conclusions

          Intranasal drug delivery for antiviral agents has been studied for many years. Several agents have broad-spectrum antiviral activity, but they still require human safety and efficacy trials prior to implementation. Intranasal drug delivery has potential relevance for future clinical trials in the settings of disease spread prevention and treatment of SARS-CoV-2 and other viral diseases.

          Implications for Practice

          Intranasal drug delivery represents an important area of research for COVID-19 and other viral diseases. The consideration of any potential adverse reactions is paramount.

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          Most cited references77

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          Temporal dynamics in viral shedding and transmissibility of COVID-19

          Xi. He, Eric Lau, Peng Wu … (2020)
          We report temporal patterns of viral shedding in 94 patients with laboratory-confirmed COVID-19 and modeled COVID-19 infectiousness profiles from a separate sample of 77 infector-infectee transmission pairs. We observed the highest viral load in throat swabs at the time of symptom onset, and inferred that infectiousness peaked on or before symptom onset. We estimated that 44% (95% confidence interval, 25-69%) of secondary cases were infected during the index cases' presymptomatic stage, in settings with substantial household clustering, active case finding and quarantine outside the home. Disease control measures should be adjusted to account for probable substantial presymptomatic transmission.
          Article 0 comments Cited 2184 times – based on 0 reviews     Review now
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            Structural basis of receptor recognition by SARS-CoV-2

            Jian Ku Shang, Gang Ye, Ke Chuang Shi … (2020)
            Summary A novel SARS-like coronavirus (SARS-CoV-2) recently emerged and is rapidly spreading in humans 1,2 . A key to tackling this epidemic is to understand the virus’s receptor recognition mechanism, which regulates its infectivity, pathogenesis and host range. SARS-CoV-2 and SARS-CoV recognize the same receptor - human ACE2 (hACE2) 3,4 . Here we determined the crystal structure of SARS-CoV-2 receptor-binding domain (RBD) (engineered to facilitate crystallization) in complex of hACE2. Compared with SARS-CoV RBD, a hACE2-binding ridge in SARS-CoV-2 RBD takes a more compact conformation; moreover, several residue changes in SARS-CoV-2 RBD stabilize two virus-binding hotspots at the RBD/hACE2 interface. These structural features of SARS-CoV-2 RBD enhance its hACE2-binding affinity. Additionally, we showed that RaTG13, a bat coronavirus closely related to SARS-CoV-2, also uses hACE2 as its receptor. The differences among SARS-CoV-2, SARS-CoV and RaTG13 in hACE2 recognition shed light on potential animal-to-human transmission of SARS-CoV-2. This study provides guidance for intervention strategies targeting receptor recognition by SARS-CoV-2.
            Article 0 comments Cited 1924 times – based on 0 reviews     Review now
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              Persistence of coronaviruses on inanimate surfaces and their inactivation with biocidal agents

              G Kampf, D Todt, S. Pfaender … (2020)
              Summary Currently, the emergence of a novel human coronavirus, SARS-CoV-2, has become a global health concern causing severe respiratory tract infections in humans. Human-to-human transmissions have been described with incubation times between 2-10 days, facilitating its spread via droplets, contaminated hands or surfaces. We therefore reviewed the literature on all available information about the persistence of human and veterinary coronaviruses on inanimate surfaces as well as inactivation strategies with biocidal agents used for chemical disinfection, e.g. in healthcare facilities. The analysis of 22 studies reveals that human coronaviruses such as Severe Acute Respiratory Syndrome (SARS) coronavirus, Middle East Respiratory Syndrome (MERS) coronavirus or endemic human coronaviruses (HCoV) can persist on inanimate surfaces like metal, glass or plastic for up to 9 days, but can be efficiently inactivated by surface disinfection procedures with 62–71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite within 1 minute. Other biocidal agents such as 0.05–0.2% benzalkonium chloride or 0.02% chlorhexidine digluconate are less effective. As no specific therapies are available for SARS-CoV-2, early containment and prevention of further spread will be crucial to stop the ongoing outbreak and to control this novel infectious thread.
              Article 0 comments Cited 1494 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Title: Otolaryngology–Head and Neck Surgery
                Abbreviated Title: Otolaryngol Head Neck Surg
                Publisher: SAGE Publications
                ISSN (Print): 0194-5998
                ISSN (Electronic): 1097-6817
                Publication date Created: October 2020
                Publication date (Electronic): July 14 2020
                Publication date (Print): October 2020
                Volume: 163
                Issue: 4
                Pages: 682-694
                Affiliations
                [1 ]Department of Otolaryngology–Head and Neck Surgery and Communica-tive Disorders, University of Louisville, Louisville, Kentucky, USA
                [2 ]Rhinology, Sinus, and Skull Base, Kentuckiana Ear, Nose, and Throat, Louisville, Kentucky, USA
                [3 ]Department of Otolaryngology–Head and Neck Surgery, Cedars Sinai, Los Angeles, California, USA
                [4 ]Department of Otolaryngology–Head and Neck Surgery, Indiana University, Indianapolis, Indiana, USA
                [5 ]Department of Microbiology and Immunology, University of Louisville, Louisville, Kentucky, USA
                [6 ]Center for Predictive Medicine and Emerging Infectious Diseases, University of Louisville, Louisville Kentucky, USA
                [7 ]Division of Infectious Diseases, Departments of Internal Medicine and Pediatrics, School of Medicine, Indiana University, Indianapolis, Indiana, USA
                [8 ]Pharmacy Operations, Kindred Healthcare Support Center, Louisville, Kentucky, USA
                Article
                DOI: 10.1177/0194599820933170
                PubMed ID: 32660339
                SO-VID: a5ec015c-0a89-40fa-bd8b-9c58c85a0c86
                Copyright © © 2020
                License:

                http://journals.sagepub.com/page/policies/text-and-data-mining-license

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