Coronaviruses - Volume 2, Issue 1, 2021

Coronavirus Disease 2019 (COVID-19) infection, the pandemics, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has no known effective radical pharmacotherapy and just supportive approach at present. Amantadine is a drug used in Parkinson’s disease and other parkinsonisms; and is known to increase indirectly dopamine by antagonistic effects at the N-methyl-Daspartate (NMDA) receptor by increasing the release and blocking the reuptake of dopamine. Initially, amantadine was approved as an antiviral drug. We hypothesize that if amantadine is considered its antiviral, immunological and neurostimulant effects might be useful in the supportive treatment of SARSCoV- 2 cases, especially those who developed acute respiratory failure with decreased vigilance and are being monitored in the intensive care unit. Further phase III clinical trials are needed.

COVID-19 has led to morbidity in millions of patients, ranging from mild flu-like symptoms to severe respiratory failure, necessitating oxygen supplementation and mechanical ventilation, and ultimately death. The SARS-CoV-2 virus reacts with angiotensin-converting enzyme 2 (ACE2) molecules that are especially found in alveolar epithelial type 2 cells in the lungs and thereby causes a loss in lung surfactant, a protein-lipid mixture that is crucial for both native immunity and reduction of surface tension in the lung alveoli. Lung surfactant insufficiency results in atelectasis and loss of functional lung tissue amid an inflammatory storm and may be countered by treating COVID-19 pneumonia patients with exogenous lung surfactant, preferably by aerosol delivery of a novel dry powder synthetic lung surfactant. More research on timing, dosing, and delivery of synthetic lung surfactant in patients with COVID-19 pneumonia is of crucial importance to implement this approach in clinical practice.

In Lebanon, with COVID-19 cases escalating and national efforts exhausted in the containment of the pandemic, calls were made for increased awareness, scientific literacy, and the debunking of false information. This article sheds light on the positive role that a private University can play in spreading scientifically-authenticated, health-related, awareness through the community. The Lebanese International University (LIU) has 9 campuses distributed across all Lebanese Governorates with an extensive communications platform that takes advantage of LIU’s website, University Management System, several Facebook pages with thousands of followers, and many WhatsApp groups. LIU has over 34,000 undergraduate and graduate students, in addition to a little over a thousand faculty and staff members. The University capitalized on this extensive network to play a positive role in delivering authenticated health-related information to the University’s greater community. A health committee comprised of multidisciplinary educators, mostly from the fields of medicine and health sciences, was established to act as a health advisory panel to the University Council and to raise awareness among the University’s larger community. An extensive health awareness campaign was launched through activities and the sharing of the material of different formats aimed at providing accurate information on infection prevention, and disseminating authentic and accurate health-related guidelines and recommendations during the pandemic. This compendium aims to summarize the role of the health committee in meeting the various challenges created by the emergence of COVID-19 in our community, and highlights its influence and future perspectives.

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), sometimes referred to as the novel coronavirus (2019-nCoV), is currently a worldwide threat to public health. According to the Johns Hopkins University monitor (available at, coronavirus.jhu.edu/map), there have been more than 10 million reported cases of coronavirus 2019 disease (COVID-19) and 500,000 deaths as of June 29, 2020, deeming urgent the identification of a drug candidate and treatment regimen. Objective: This work aims to compile the current knowledge available on this drug, including its background, approved uses, some synthetic methods, the primary pharmacological aspects, the results against COVID-19 reported so far, and ongoing clinical trials against COVID-19. Methods: We reviewed relevant press releases, scientific articles, and official documents to compile information about Favipiravir. Results: We highlight, in a clear and concise form, not only the published and ongoing clinical trials on the use of Favipiravir against COVID-19 but also compile some relevant synthetic and pharmacological information available about this drug. Conclusion: The Antiviral Favipiravir has shown interesting preliminary results, but it seems too early to recommend a treatment protocol for COVID-19 based on this drug. Robust clinical trials that will provide less biased data on its efficacy and safety are being pushed forward by FUJIFILM Corporation and by research groups around the globe.

Italy was the first western nation affected by the pandemic and was observed as a pilot case in the management of the new coronavirus epidemic. The outbreak of COVID-19 disease has been challenging in Italy. On June 25, 2020 there were 239,821 total cases, of which 33,592 were deaths nationwide. Three lessons emerged from this experience that can serve as a blueprint to improve future plans for the outbreak of viruses. First, early reports on the spread of COVID-19 can help inform public health officials and medical practitioners in effort to combat its progression; second, inadequate risk assessment related to the urgency of the situation and limited reporting to the virus has led the rapid spread of COVID-19; third, an effective response to the virus had to be undertaken with coherent system of actions simultaneously.

Background: Novel coronavirus (2019-nCov) imposed deadly health calamity with unexpected disastrous situation alarming the globe for urgent treatment regimes. World Health Organization (WHO) termed the coronavirus disease as COVID-2019 on February 11, 2020 and announced its outbreak as pandemic on 11 March 2020. The first infection was noticed in Wuhan, Hubei province, China, in December 2019, and it is believed that the corona-virus is transmitted to humans through bats as a reservoir involving human to human transfer. However, the proper intermediary transmission channel is yet to be unestablished. Methods: Elderly populations and patients with concomitant symptoms are more at risk as compared to middle-aged patients as it may progress to pneumonia followed by severe acute respiratory syndrome (SARS) and multi-organ failure. Morbidity rates estimated in patients are less, i.e., 2-3%, but the dearth of a specific treatment strategy to prevent coronavirus infection is a major concern. Results: Currently, anti-viral and anti-malarial drugs are in practice for the management of COVID-19 disease along with plasma therapy in the absence of a potent vaccine. Besides, home isolation and social distancing are the precautionary measures adopted by many countries to minimize the spread of infection. Various studies have been conducted, and numerous are still going on to establish specific treatment for COVID-19. Conclusion: In this review, we summarized information on the structural components of COVID19 virus with special emphasis on the virus genome, life cycle, the importance of protease enzyme, the role of spike proteins in viral replication, validated drug targets, ongoing effective treatments for COVID-19 management and the latest research on drug design to develop anti-CoV drugs.

Coronavirus disease 2019 (COVID-19) is an acute respiratory tract infection causing a pandemic that emerged in 2019 initially in China involving 13.8% cases with severe, and 6.1% with critical course and later throughout the globe. Vaccines or antiviral medications are yet to be used to prevent or treat infections of Human Coronavirus (HCoV). The much-discovered HCoV found in 2003, SARSCOVID- 19, which caused respiratory syndrome, has special pathogenesis as it causes respiratory tract infection. The coronavirus spike protein's association with its host cell receptor complement is crucial in deciding the virus infectivity, tissue tropism and species variety. SARS, COVID-19, infects human cells by binding to angiotensin-converting enzyme 2 (ACE2) receptor and uses the TMPRSS2 cell protease to activate it. Lungs are most affected by COVID-19 as host cells are accessed by the virus through ACE2, which is most abundant in alveolar cells of the lungs. Special attention and efforts should be given in reducing transmission in vulnerable populations, including infants, health care providers and the elderly. COVID 19, is the main causative agent of potentially lethal disease and is of significant concern for global public health and in pandemics which was highlighted in this review.

Background: COVID-19 is an infectious disease caused by SARS-CoV-2. The disease has hit hard around the globe and is now a pandemic. As of April 01, 2020, a total of 875,560 cases have been reported and the figures are increasing day by day. Currently, there is no treatment or vaccine available for curing COVID-19 and pharmaceutical companies are racing toward the common goal of achieving the cure. Methods: Scientific databases, including Science direct, Pub med, Elsevier, Scopus, and Nature, were explored. Data has also been accessed from case reports, newspaper reports, internet data, World Health Organisation (WHO) reports, and Centre of Disease Control (CDCs) reports. The US National Library of Medicine, Clinicaltrials.gov, were accessed to get information about the ongoing clinical trials. The literature survey started in the first week of February 2020 and was completed in the first week of April 2020. Additional literature survey was done in the second week of June 2020. Results: The epicentre of COVID-19 is Wuhan City, Hubei Province, China. Coronavirus belongs to Order Nidovirale and is subdivided into four groups alpha, beta, gamma, and delta. Coronavirus 229E, NL63, HKU1, MERS-CoV and SARS-CoV are known to infect humans. It is an enveloped, nonsegmented positive-sense RNA virus of size 30-32 kb with several structural and accessory proteins. The pathogenesis of COVID-19 involves attachment of Spike (S) protein of SARS-CoV-2 to the angiotensin- converting enzyme 2(ACE2) receptor present on the host cell membrane. Clinical manifestation of COVID-19 include fever, cough, complicated dyspnoea, pneumonia, etc. Real-time -PCR is a sensitive test for the detection of SARS-CoV. Remdesivir, Bevacizumab, Darunavir and cobicistat, lopinavirritonavir, Oseltamavir, hydroxychloroquine, Sarilumab, mRNA -1273, Ad5-nCoV are some of the drugs under the clinical phase of the trial. People with A-positive blood group, with comorbidities like diabetes, hypertension, chronic pulmonary obstructive disease, substance abuse disorders, immunocompromised individuals, health care workers, and older adults are at high risk of getting infected with SARS-CoV-2. Conclusion: This article gives insight into the occurrence of COVID-19, classification and structure of SARS-CoV-2, pathogenesis, pathological findings, clinical manifestation, diagnosis, potential treatment options and prevention, and people at risk of COVID-19.

Background: The rampant spread of SARS-CoV-2 worldwide increases the likelihood that dental health care professionals will treat this subset of the patient population. Due to the characteristics of the profession and the virus, two situations deserve attention: the disinfection of surfaces that can be contaminated during dental treatment and the presence of the virus in the oral cavity and the countless possibilities of microbial interaction with microorganisms in the oral cavity. Objective: The objective of this review was to point out the current stage of the discussion on dental biosafety involving professionals, the work team and patients. Methods: The following databases were consulted: MEDLINE (National Library of Medicine, USA - NLM), Lilacs, Scielo, Embase, Web of Science and Google Academic with the keywords COVID-19 and dental practice, dentistry, oral conditions, mouthrinses. Results: Disinfection of surfaces has always been paramount and the protocol to prevent the spread of SARS-CoV-2 seems to be established. SARS-CoV-2 is vulnerable to oxidation, it is recommended to use a mouth rinse containing oxidizing agents. Conclusion: Dentists are among the professionals who are most at risk of COVID-19 infection, and they must have extra attention during this period, biosafety measures must be reinforced and patients must be motivated to maintain a strict oral hygiene routine so that there is no accumulation of biofilm and this may somehow interfere with their systemic condition.

Background: Since Coronavirus (COVID-19) is increasing its influence from China and spreading its reservoir to neighboring areas and other nations, expanded national and foreign efforts are being made to control this epidemic. Methods: This review incorporated the information depicting the effect of COVID-19 on different industrial sectors. Results: According to the World Health Organization, the outbreak was first identified in the Chinese city of Wuhan in December 2019 and has affected more than 17660523 people (confirmed cases) worldwide, and more than 680894 people have died. In addition to its alarming impact on human health, the novel strain of COVID-19 has dramatically slowed down not just the Chinese economy but also the world economy. The increased uncertainty has led to financial market volatility. Conclusion: Some firm decisions and policies must be framed out to stabilize the world economy so that threatening socio-economic impact cannot be sustained for a longer period of time for the welfare of humankind.

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected around 13 million people and has caused more than 5.7 lakh deaths worldwide since December 2019. In the absence of FDA approved drugs for its treatment, only symptomatic management is done. Methods: We attempted to uncover potential therapeutic targets of spike, helicase, and RNA dependent RNA polymerase (RdRp) proteins of the SARS-CoV-2 employing a computational approach. The PDB structure of spike and RdRp and predicted structure of helicase proteins were docked with 100 approved anti-viral drugs, natural compounds, and some other chemical compounds. Results: The anti-SARS ligands EK1 and CID 23631927, and NCGC00029283 are potential entry inhibitors as they showed affinity with immunogenic Receptor Binding Domain (RBD) of the spike protein. This RBD interacts with Angiotensin Converting Enzyme (ACE2) receptor, facilitating the entry of virion in the host cells. The FDA approved drugs, including Nelfinavir, Saquinavir, Tipranavir, Setrobuvir, Indinavir, and Atazanavir, showed potential inhibitory activity against targeted domains and thus, may act as entry or replication inhibitor or both. Furthermore, several anti-HCoV natural compounds, including Amentoflavone, Rutin, and Tannin, are also potential entry and replication inhibitors as they showed affinity with RBD, P-loop containing nucleoside triphosphate hydrolase, and the catalytic domain of the respective protein. Dithymoquinone showed significant inhibitory potential against the fusion peptide of S2 domain. Importantly, Tannin, Dithymoquinone, and Rutin can be extracted from Nigella sativa seeds and thus, may prove to be one of the most potential anti-SARS-CoV-2 inhibitors. Conclusion: Several potential ligands were identified with already known anti-HCoVs activities. Furthermore, as this study showed that some of the ligands acted as both entry and replication inhibitors against SARS-CoV-2, it is envisaged that a combination of either inhibitor with a dual mode of action would prove to be a much desired therapeutic option against this viral infection.

Background: For the first time in December 2019, as reported in the Wuhan city of China, COVID-19 deadly virus spread rapidly around the world and the first cases were seen in Turkey on March 11, 2020. On the same day, a pandemic was declared by the World Health Organization due to the rapid spread of the disease throughout the world. Methods: In this study, a multilayered perception feed-forward back propagation neural network has been designed for predicting the spread and mortality rate of the COVID-19 virus in Turkey. COVID-19 data from six different countries were used in the design of the artificial neural network, which has 15 neurons in its hidden layer. 70% of these optimized data were used for training, 20% for validation, and 10% for testing. Results: The simulation results showed that the COVID-19 virus in Turkey, between day 20 and 37, was the fastest to rise. The number of cases for the 20th day was predicted to be 13.845. Conclusion: As for the death rate, it was predicted that a rapid rise would start on the 20th day and a slowdown around the 43rd day and progress towards the zero case point. The death rate for the 20th day was predicted to be 170 and for the 43rd day it was 1,960s.

Background: Coronavirus, called as, “the worst public health crisis for a generation,” is a malevolent silent killer. Objective: One of the main concerns is containing the disease and avoiding the second wave of the pandemic, likely to arise because of the symptomatic patients, while ensuring the safe execution of day to day tasks. Methods: The indirect transmission of coronavirus from asymptomatic individuals during incubation time and the identification of the people who have accidentally and unknowingly come in contact with infected but asymptomatic patients pose a significant challenge to the health care providers. Results: Herein, for the first time, we have introduced a quantitative index; asymptomatic growth, to indicate whether the COVID-19 community spread is under control and if economic activities can be resumed. Conclusion: More importantly, our system provides a feasible mechanism for improving the index to a level <1, a safety level at which normal economic activities can be conducted.

Background: Some vitamins play a beneficial role in the immune system and certain diseases may be associated with an increase in the number of COVID-19 cases and mortality. Objectives: In this work, we aim to verify a possible relationship between vitamin A, vitamin D, sunlight, and COVID-19 cases and mortality. We also aim to study the relationship between chronic diseases and COVID-19 in the world. Methods: We consulted online databases (Johns Hopkins, World Life Expectancy, NASA, and World Health Organization) and used SPSS (v23) for statistical analysis. Results: We found that countries with the highest number of cases and deaths by COVID-19 are the countries with the highest death rates from different types of cancer and multiple sclerosis. Besides, the relationship between cancer death rate and COVID-19 is not biased by the life expectancy. We also found that the low solar incidence and low vitamins A and D levels can be related to the number of cases and deaths by COVID-19. Conclusion: Our findings suggest a relationship between different cancer types and multiple sclerosis death rates and COVID-19. We also recommend that vitamins D and A may play a protective role in COVID-19 infection.