Page 52 - GHES-3-1

Global Health Economics and
Sustainability
COVID-19 changed our world

Figure 5. Schematic representation of the life cycle of COVID-19: (1) Membrane fusion at the plasma membrane following endocytosis; (2) This fusion
is mediated by conformational changes in the glycoprotein induced by angiotensin-converting enzyme 2 (ACE2) binding; (3) After entering the host
cell, COVID-19 releases its genomic ssRNA into the cytoplasm; (4) Here, the genome RNA is first translated into viral replicase polyprotein; (5) These
polyproteins are later on are further cleaved by viral proteases into a total of 16 non-structural proteins (NSP) that form a replication-transcription complex
(RTC); (6) The negative-sense (- sense) genomic RNA is generated and used as a template to produce positive-sense (+ sense) by RTC; (7) S protein
membrane (M) protein and envelope (E) protein are transcribed, subsequently translated in the rough endoplasmic reticulum (RER), and transported
to the Golgi complex; (8) The nucleocapsid (N) structural protein and viral RNA are replicated, transcribed, and synthesized in the cytoplasm; (9) In the
RER and Golgi complex, the COVID-19 glycoprotein is subjected to cotranslational and post-translational processing including signal peptide removal,
trimerization, extensive glycosylation and subunit cleavage; (10) The N protein is subsequently associated with the positive-sense genomic RNA to become
a nucleo-protein complex (nucleocapsid),which is further assembled together with S, M, and E proteins as well as other viral proteins and followed by
budding into the lumen of the ER-Golgi intermediate compartment to form mature virions; (11 – 13) The mature virions then reach the plasma membrane
where they become fused with plasma membranes and exit the cell through exocytosis. Image created by the authors.

homes except to accomplish essential tasks such as obesity, cardiovascular issues, muscle atrophy, bone loss,
visiting medical facilities and buying provisions (Park and decreased aerobic capacity (Kang et al., 2020; Qiu
et al., 2022). Such restrictions increase stress, confusion, et al., 2020; Maugeri et al., 2020). Financial difficulties,
and anxiety in individuals (Brooks et al., 2020; Lima et al., job losses, and separation from family members
2020). Notably, these issues were often more severely because of the mandated restraints also heightened
experienced by people without pre-existing mental health depression and anxiety in people (Jean-Baptiste et al.,
conditions than people who already suffered from mental 2020). The impact was particularly profoundly sensed
health problems (Kang et al., 2020; Qiu et al., 2020; Singh by children and adolescents who sensed increased
et al., 2023). anxiety and uncertainty because of school closures that
Studies linked increased social media use during disrupted their daily routines, social interactions, and
lockdowns to reduced physical activity, which was access to educational resources (Imran et al., 2020; Guan
associated with health problems such as early aging, et al., 2020).

Volume 3 Issue 1 (2025) 44 https://doi.org/10.36922/ghes.3992