Page 50 - GHES-3-1

Global Health Economics and
Sustainability
COVID-19 changed our world

3. Results the virus (Figure 4B) (Li, 2016; Graham & Baric, 2010).
The spike protein binds to acetyl-CoA dehydrogenase 2;
After completing our systematic literature survey, we thus, it initiates the COVID-19 infection and permits it to
identified and evaluated a comprehensive array of studies penetrate cells and cause the contagion. Figure 5 presents
relevant to the impact of COVID-19. Initially, we identified the detailed life cycle of the virus. However, an intriguing
1,130 articles; however, this number was honed to 185 question arises: was the possibility of susceptibility to
articles after excluding irrelevant studies. The PRISMA flow infection caused by a risk factor, or did it result merely
diagram (Figure 3) illustrates the stream of information from exposure?
through the different phases of the review including the
identification, screening, and inclusion of studies. 3.2. Susceptibility to COVID-19 infection
The literature highlighted that the COVID-19 pandemic Varied risk factors influence one’s susceptibility to
critically disrupted life worldwide, affecting nearly every COVID-19 and can be broadly categorized as genetic and
aspect of human life and resources (Hiscott et al., 2020). environmental features (Singh et al., 2022). Environmental
A key question consequently emerged: was this virus factors and lifestyle choices function significantly
novel or related to earlier viruses? Coronaviruses have in modifying vulnerabilities determined by genetic
infected humans since the 1960s, and typically cause mild pre-dispositions. For instance, severe or pre-existing
respiratory symptoms or the common cold. However, the conditions such as renal disease or anemia are linked to
recent SARS-CoV-2 outbreak represented the third major a higher risk of severe COVID-19 outcomes (Tao et al.,
occurrence of respiratory illnesses triggered by this virus 2021). Hospitalization-related factors such as the need for
family in the last 20 years and significantly disrupted the supplemental oxygen and severe vitamin D deficiency are
global socioeconomic system. associated with an increased risk of mortality (Bhargava
The first known case of pneumonia caused by SARS- et al., 2020; Carpagnano et al., 2021). Nutritional
CoV was reported in Foshan, China, in November 2002 deficiencies have been observed in a substantial proportion
(Zhong et al., 2003). More than 8,000 cases had been of COVID-19 patients, particularly zinc insufficiency. Such
recorded by July 2003, resulting in 774 deaths. A small deficits generate greater complications, increase the risk of
outbreak in 2004 added four more cases that generated death, and mandate prolonged hospital stays (Jothimani
symptoms such as fever, headaches, coughing, and et al., 2020). In addition, hormonal changes have been
shortness of breath (Zhao, 2007). MERS-CoV emerged noted in males who have recovered from the infection: Low
in Saudi Arabia in 2012, affecting more than 2,494 people levels of luteinizing hormone, 17β-estradiol/estrogen, and
and causing 858 deaths. MERS-CoV was less contagious testosterone indicative of hypogonadism were observed at
than SARS-CoV but was more lethal: it resulted in a 7-month follow-up (Salonia et al., 2022).
kidney failure in patients (Baharoon & Memish, 2019; COVID-19 impacts more than just the lungs; it affects
Chakraborty & Maity, 2020). A new coronavirus, SARS- several vital organs and can induce varied comorbid
CoV-2, was identified in Wuhan, China, in December conditions. For instance, Khoo et al.’s (2021) observational
2019. This coronavirus instigated a pandemic that resulted study found that COVID-19 patients exhibited lower
in millions of reported fatalities by early March 2021.
levels of thyroid-stimulating hormone and free thyroxine
3.1. Structure and genome of COVID-19 (FT4) compared to uninfected individuals. Diabetes is
another major concern: Diabetic patients with COVID-19
Structurally, the COVID-19 virus is spherical and were at higher risk of intensive care unit admission but
features single-stranded (positive-sense) RNA linked no significant increase was noted in their mortality rates
to a nucleoprotein in a matrix protein-encased capsid (Al-Salameh et al., 2021). Metz et al. reported a higher risk
(Figure 4A). The viral genome contains distinguishing of cesarean delivery, premature births, and hypertensive
traits such as a different N-terminal portion inside the disorders in pregnant patients with severe COVID-19 (Metz
spike proteins; the genes for the key structural proteins et al., 2021). Neurological issues were also observed, for
are arranged in the 5′-3′ order as S, E, M, and N5. instance, stroke, neuromuscular problems, altered mental
Several minor ORFs can be identified downstream of
the nucleocapsid gene and between the conserved genes status, anosmia, headaches, seizures, encephalopathy,
(envelope, ORF1ab, membrane, spike, and nucleocapsid) and encephalitis. Some patients also experienced mild to
(Figure 4A) (Mousavizadeh & Ghasemi, 2021). The moderate confusion (García-Azorín et al., 2021; Abildúa
et al., 2021).
virus’s ability to adapt to a new environment/host tropism
through mutations in the spike protein creates unwanted Mortality rates from COVID-19 were notably higher
situations for researchers who try to cope immediately with for individuals with specific health conditions: for instance,

Volume 3 Issue 1 (2025) 42 https://doi.org/10.36922/ghes.3992