What is COVID-19?

COVID-19 is an acute respiratory illness borne from infection with SARS-CoV-2 – a positive single-stranded RNA virus. The SARS-CoV-2 virus shares structural similarities to SARS and MERS, which cause acute severe respiratory infections. The incubation period for the development of clinical COVID-19 symptoms from the time of initial SARS-CoV-2 viral infection is highly variable, ranging from 2 to 14 days.

While more than 80% of infected patients spontaneously resolve the infection, up to 20% of COVID-19 patients have clinically severe complications which require hospitalization. Progression of the disease to respiratory failure has been common in severely ill patients and is associated with a high risk of death.

Clinical Signs and Symptoms

Stage 1

Early Infection:

  • Mild symptoms including a fever, dry cough, fatigue, myalgias, headache, dyspnea, and (in about 50% of patients) GI symptoms (nausea, vomiting, or diarrhea)
  • Laboratory signs (variable) of lymphopenia, increased prothrombin time, increased D-Dimer and mild LDH elevation

Stage 2

Pulmonary Phase:

  • Shortness of breath (dyspnea) with hypoxia
  • Abnormal chest imaging, transaminitis, low-normal procalcitonin

Stage 3

Hyperinflammation Phase:

  • Acute respiratory distress syndrome (ARDS), systemic inflammatory responsesyndrome (SIRS), and multi-organ dysfunction due to thromboembolic phenomena (kidneys, heart, liver, CNS)
  • Elevated inflammatory markers, troponin, NT-proBNP elevation
A chart of the severity of illness for COVID-19 over its time course, divided into three different stages.

Siddiqi et al The Journal of Heart and Lung Transplantation. DOI: 10.1016/j.healun.2020.03.012

About AT-527

The next steps in our global response to COVID-19.

A doctor in a protective mask is checking the temperature of a patient via an infrared thermometer.

What can we expect?

Due to its very high transmission rate, including from asymptomatic persons spreading the SARS-CoV-2 virus in respiratory droplets, COVID-19 poses a serious public health risk in the U.S. and globally. Currently, there are no vaccines to prevent SARS-CoV-2 infection. Just one therapeutic, intravenous remdesivir, is available and only under an FDA Emergency Use Authorization for treatment of patients with clinically severe COVID-19.

Social distancing and self-quarantining measures have been partially effective at slowing the spread of the virus in populations. However, as mandated stay-at-home orders become less restrictive, an urgent need is arising for oral, potent and safe therapeutics administered at or near the time of symptom onset. These therapies will be paramount in preventing disease progression and viral spreading in community settings.

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