Extracellular vesicles in COVID-19 prognosis, treatment, and vaccination: an update

The lethality of the COVID 19 pandemic became the trigger for one of the most meteoric races on record in the search for strategies of disease control. Those include development of rapid and sensitive diagnostic methods, therapies to treat severe cases, and development of anti-SARS-CoV-2 vaccines, the latter responsible for the current relative control of the disease. However, the commercially available vaccines are still far from conferring protection against acquiring the infection, so the development of more efficient vaccines that can cut the transmission of the variants of concerns that currently predominate and those that will emerge is a prevailing need. On the other hand, considering that COVID 19 is here to stay, the development of new diagnosis and treatment strategies is also desirable. In this sense, there has recently been a great interest in taking advantage of the benefits offered by extracellular vesicles (EVs), membrane structures of nanoscale size that carry information between cells participating in this manner in many physiological homeostatic and pathological processes. The interest has been focused on the fact that EVs are relatively easy to obtain and manipulate, allowing the design of natural nanocarriers that deliver molecules of interest, as well as the information about the pathogens, which can be exploited for the aforementioned purposes. Studies have shown that infection with SARS-CoV-2 induces the release of EVs from different sources, including platelets, and that their increase in blood, as well as some of their markers, could be used as a prognosis of disease severity. Likewise, EVs from different sources are being used as the ideal carriers for delivering active molecules and drugs to treat the disease, as well as vaccine antigens. In this review, we describe the progress that has been made in these three years of pandemic regarding the use of EVs for diagnosis, treatment, and vaccination against SARS-CoV-2 infection.

Automated summary

The COVID-19 pandemic has sparked a rapid race to develop control strategies, including diagnostic methods, therapies, and vaccines. However, existing vaccines do not provide sufficient protection against infection, highlighting the need for more effective vaccines to combat current and future variants. Additionally, the development of new diagnosis and treatment strategies is desirable to address the persistent presence of COVID-19. Recently, there has been interest in utilizing extracellular vesicles (EVs) as natural nanocarriers for delivering molecules and pathogen information. Studies have shown that SARS-CoV-2 infection induces the release of EVs, which can be used for disease prognosis and as carriers for active molecules and drugs. This review summarizes the progress made in using EVs for diagnosis, treatment, and vaccination against SARS-CoV-2 infection over the past three years.