Multisystem inflammatory syndrome in children (MIS-C) during the COVID-19 pandemic raised a global alert from the Centers for Disease Control and Prevention’s Health Alert Network. The main manifestations of MIS-C in the setting of a severe inflammatory state include fever, diarrhea, shock, and variable presence of rash, conjunctivitis, extremity edema, and mucous membrane changes, and in some cases it progressed to multi-organ failure. The low percentage of children with asymptomatic cases compared with mild illness and moderate illness could be correlated with the rare cases of MIS-C. One potential explanation for the progression to severe MIS-C disease despite the presence of readily detectable anti-SARS-CoV-2 antibodies could be due to potential role of antibody-dependent enhancement (ADE). We reason that the incidence of the ADE phenomenon whereby the pathogen-specific antibodies can promote pathology should be considered in vaccine development against SARS-COV-2.

The SARS-CoV-2 infection has been considered a global pandemic due to its widespread transmission and high rate of fatality. As of April 11, 2020, globally, there are 1.76 million confirmed cases of COVID-19, of which 108,281 people succumbed to the disease. In the absence of therapeutic intervention and a possible vaccine candidate, the spread of the disease and associated fatalities are on the rise. The epidemiological data indicate age and country-specific bias in the spread and severity of COVID-19. In this review, we discussed the recent update on the pathogenesis of SARS-CoV-2 among men and women, including children. Further, we also discuss the role of the cellular receptors and co-receptors used by the virus to enter host cells in the virus pathogenesis on differential infection among men and women. Further, highlighted the co-morbidity of COVID-19 with cardio-metabolic disease, and the potential treatments to control SARS-CoV-2 infection. Finally, we summarize the prospective treatment options that have been evaluated or are in the pipeline at different stages of clinical trials to fight against COVID-19.