Insights into the Viral Evolution and Microbial Interactions In COVID-19
Microbial Interactions In COVID-19
DOI:
https://doi.org/10.63939/z1qkax02Keywords:
COVID-19, Microbial interaction, Viral Evolution, Co-infection, Microbiome, Gut-Lung AxisAbstract
The ongoing COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, has been largely described in terms of virology and immunology. However, to understand the disease process, it is important to "digest" the microbial content of the disease. In this review, we will try to synthesize the known information on COVID-19 from a microbiological perspective that considers the interaction between the virus and the host, and existing microbes. We will first review the molecular virology and evolutionary biology of SARS-CoV-2, including viral entry, replication, and immune evasion mechanisms, as well as the factors that drive the development of variants of concern. Next, we will review the interplay between the host and the pathogen, considering the lens of viral-induced changes in the host's cellular networks and the mismanaged immune response. An entire core focuses on Infection ecology and covers the prevalence, effect, and mechanisms of bacterial and viral co-infection/secondary infection outcomes. Expanding the lens on the host-virus interaction to the host-microbiome interaction, we will review the gut-lung axis, considering evidence that the gut microbiome influences the severity of the disease and the risk of Post-Acute Sequelae of COVID-19 (PASC, or Long COVID), and the mechanisms by which this might occur. We will also review changes in the lung and oropharyngeal microbiomes during COVID-19 infection. Lastly, we will review the clinical and therapeutic implications of the host-microbiome interaction in COVID-19, considering the role of the microbiome in disease, the effect of antimicrobials, and new therapeutic approaches to the host microbiome. In this review, we will argue that COVID-19 is not a viral disease but a systemic microbiological disorder that must be taken into account in the development of new approaches to the disease, including personalized medicine approaches to the treatment and prevention of COVID-19 and future pandemics.
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