AUTHORS :
*Tinku Kumar Singh1, Satish Kumar1, Purna Tiwari2
1 Indchemie health Specialities Pvt. Ltd
2 Alkem health science Ltd
tinku20190@gmail.com
ABSTRACT : The World Health Organization (WHO) has declared the corona virus disease 2019 (COVID-19) a pandemic. In January 2020, a previously unknown new virus was identified subsequently named the 2019 novel corona virus, and samples obtained from cases and analysis of the virus’ genetics indicated that this was the cause of the outbreak. Corona viruses are a group of related viruses that cause diseases in mammals and birds. The COVID-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes. Corona viruses are large pleomorphic spherical particles with bulbous surface projections. Isolation remains the most effective measure for containment of COVID-19. Moreover unnecessary administration of antibiotics should also be avoided. Critically ill patients require high flow oxygen, extracorporeal membrane oxygenation (ECMO), glucocorticoid therapy, and convalescent plasma. Therapeutically, aerosol administration of alpha-interferon (5 million units twice daily), chloroquine phosphate, and lopinavir/ritonavir have been suggested.
INTRODUCTION :
The World Health Organization (WHO) has declared the corona virus disease 2019 (COVID-19) a pandemic [1]. On 31 December 2019, a cluster of cases of pneumonia of unknown cause, in the city of Wuhan, Hubei province in China, was reported to the World Health Organization. In January 2020, a previously unknown new virus was identified [2], subsequently named the 2019 novel corona virus, and samples obtained from cases and analysis of the virus’ genetics indicated that this was the cause of the outbreak. This novel corona virus was named Corona virus Disease 2019 (COVID-19) by WHO in February 2020. Corona virus disease (COVID-19) is an infectious disease caused by a newly discovered corona virus. Most people infected with the COVID-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment. Older people and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness. The best way to prevent and slow down transmission is be well informed about the COVID-19 virus, the disease it causes and how it spreads. Protect yourself and others from infection by washing your hands or using an alcohol based rub frequently and not touching your face. The COVID-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes, so it’s important that you also practice respiratory etiquette (for example, by coughing into a flexed elbow).At this time, there are no specific vaccines or treatments for COVID-19. However, there are many ongoing clinical trials evaluating potential treatments [3].
Corona virus
Corona viruses were first discovered in the 1930s when an acute respiratory infection of domesticated chickens was shown to be caused by infectious bronchitis virus (IBV). Corona viruses are a group of related viruses that cause diseases in mammals and birds. Human corona viruses were discovered in the 1960s. The earliest ones studied were from human patients with the common cold, which were later named human corona virus 229E and human corona virus OC43. They were first imaged by Scottish virologist June Almeida at St. Thomas Hospital in London. Other human corona viruses have since been identified, including SARS-CoV in 2003, HCoV NL63 in 2004, HKU1 in 2005, MERS-CoV in 2012, and SARS-CoV-2 in 2019. Most of these have involved serious respiratory tract infections [4].
Structure of corona virus
Coronaviruses are large pleomorphic spherical particles with bulbous surface projections [5]. The average diameter of the virus particles is around 120 nm (.12 μm). The diameter of the envelope is ~80 nm (.08 μm) and the spikes are ~20 nm (.02 μm) long. The envelope of the virus in electron micrographs appears as a distinct pair of electron dense shells [6].
The viral envelope consists of a lipid bilayer where the membrane (M), envelope (E) and spike (S) structural proteins are anchored [7]. A subset of corona viruses (specifically the members of betacoronavirus subgroup A) also have a shorter spike-like surface protein called hemagglutinin esterase (HE) [8].
Inside the envelope, there is the nucleocapsid, which is formed from multiple copies of the nucleocapsid (N) protein, which are bound to the positive-sense single-stranded RNA genome in a continuous beads-on-a-string type conformation. The lipid bilayer envelope, membrane proteins, and nucleocapsid protect the virus when it is outside the host cell [6].
[Fig 1: Cross-sectional model of a corona virus]
Life cycle[9]:
[Fig 2: The life cycle of a corona virus]
Signs and Symptoms of COVID-19[10]:
[Fig3 : Symptoms of COVID-19]
Transmission(COVID-19):
Fig 4. An illustration of various possible transmission routes of respiratory infection between an infected and a susceptible individual. Both close range (i.e. conversational) airborne transmission and longer range (over several meters) transmission routes are illustrated here. The orange head colour represents a source and the white head colour a potential recipient (with the bottom right panel indicating that both heads are potential recipients via self-inoculation from contaminated surface fomite sources). Here ‘Expiration’ also includes normal breathing exhalation, as well as coughing and/or sneezing airflows. Airborne droplets can then settle on surfaces (fomites) from where they can be touched and carried on hands leading to further self-inoculation routes of transmission [11].
Prevention and control(COVID-19) :
Management : Isolation remains the most effective measure for containment of COVID-19. No specific anti-viral medication or vaccine is currently available. Therefore, the treatment of COVID-19 includes symptomatic care and oxygen therapy. Patients with mild infections require early supportive management. This can be achieved with the use of acetaminophen, external cooling, oxygen therapy, nutritional supplements, and anti-bacterial therapy. Critically ill patients require high flow oxygen, extracorporeal membrane oxygenation (ECMO), glucocorticoid therapy, and convalescent plasma. The administration of systemic corticosteroids is not recommended to treat ARDS. Moreover, unnecessary administration of antibiotics should also be avoided. ECMO should be considered in patients with refractory hypoxemia despite undergoing protective ventilation. Patients with respiratory failure may require intubation, mechanical ventilation, high-flow nasal oxygen, or non-invasive ventilation. Treatment of septic shock requires hemodynamic support with the administration of vasopressors. Organ function support is necessary for patients with multiple organ dysfunctions.
Therapeutically, aerosol administration of alpha-interferon (5 million units twice daily), chloroquine phosphate, and lopinavir/ritonavir have been suggested. Other suggested anti-virals include ribavirin and abidor. The use of three or more anti-viral drugs simultaneously is not recommended. Ongoing clinical studies suggest that remdesivir (GS5734) can be used for prophylaxis and therapy. Furthermore, a fusion inhibitor targeting the HR1 domain of spike protein is reported to have the potential to treat COVID-19 [12].
CONCLUSION : According to above discussion COVID-19 is pandemic due to no any specific vaccine or medicine to control spread over population (tillApr.2020). Hence maintain social distancing and hand sanitization to control spreading. Older people and those with underlying medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to develop serious illness.
REFERENCES:
1. World Health Organization. WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020
2. World Health Organisation. Novel Coronavirus – China.Disease outbreak news: Update 12 January 2020.
3. World Health Organization. Director-General's remarks at the media briefing on 2019-nCoV on 11 February 2020. 2020/2/18)[2020-02-21]. https://www. who. int/dg/speeches/detail/who-director-generals-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020. 2020.
4. http://en.wikipedia.org/wiki/corona virus.
5. Goldsmith CS, Tatti KM, Ksiazek TG, Rollin PE, Comer JA, Lee WW, et al. (February 2004). "Ultrastructural characterization of SARS coronavirus". Emerging Infectious Diseases. 10 (2):32026. doi:10.3201/eid1002.030913. PMC 3322934. PMID 15030705. Virions acquired an envelope by budding into the cisternae and formed mostly spherical, sometimes pleomorphic, particles that averaged 78 nm in diameter (Figure 1A).
6. International Committee on Taxonomy of Viruses (2010-08-24). "ICTV Master Species List 2009—v10" (xls).
7. Neuman BW, Adair BD, Yoshioka C, Quispe JD, Orca G, Kuhn P, et al. (August 2006). "Supramolecular architecture of severe acute respiratory syndrome coronavirus revealed by electron cryomicroscopy". Journal of Virology. 80 (16): 7918–28. doi:10.1128/JVI.00645-06. PMC 1563832. PMID 16873249. Particle diameters ranged from 50 to 150 nm, excluding the spikes, with mean particle diameters of 82 to 94 nm; Also See Figure 1 for double shell.
8. de Groot RJ, Baker SC, Baric R, Enjuanes L, Gorbalenya AE, Holmes KV, Perlman S, Poon L, Rottier PJ, Talbot PJ, Woo PC, Ziebuhr J (2011). "Family Coronaviridae". In King AM, Lefkowitz E, Adams MJ, Carstens EB, International Committee on Taxonomy of Viruses, International Union of Microbiological Societies. Virology Division (eds.). Ninth Report of the International Committee on Taxonomy of Viruses. Oxford: Elsevier. pp. 806–28. ISBN 978-0-12-384684-6.
9. Wikimedia Commons, the free media repository File: Corona virus replication.png
10. References for diagram are located at: Commons:File:Symptoms of coronavirus disease 2019 3.0.svg#References.
11. Tellier et al. BMC Infectious Diseases (2019) 19:101
12. Hassan S, Sheikh F N, Jamal S, et al. (March 21, 2020) Coronavirus (COVID-19): A Review of Clinical Features, Diagnosis, and Treatment. Cureus 12(3): e7355. doi:10.7759/cureus.7355
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