Coronaviruses - Volume 2, Issue 4, 2021

Background: Current COVID-19 pandemic poses a significant health crisis caused by SARSCoV- 2 coronavirus around the globe, including India. Patients with cancer, especially those who underwent treatment, may have a higher risk of getting sicker with COVID-19 disease. Medical care facilities aim to provide proper treatment to cancer patients while minimizing the possibilities of COVID-19 transmission. Objective: The perspective article summarizes practical recommendations and perspective answers to all difficulties so that we can better treat and care for cancer patients. Methods: The literature search includes recent publications and guidelines/recommendations of the central institutes of India. Results: Social distancing, guidelines, rescheduling the treatment of stable patients, nutritional care and telecommunication are some of the containment measures that can be applied in clinical practice in cancer management in COVID-19 pandemic. Conclusion: With these interventions discussed above, we can reduce the impact of this pandemic and deliver the best care to cancer patients.

Background: COVID-19 caused by the novel SARS Coronavirus-2 (SARS-CoV-2) is causing serious problems in the global public health sphere. In the absence of a powerful antiviral treatment, the exploration of plant-based products with antiviral potential has gained interest. Scope and Approach: This commentary presents the prospects of utilizing coconut oil directly or its derivatives such as monolaurin in treating COVID-19 with a special emphasis on their biochemical characteristics features. The potential pitfalls therein and way forward are also highlighted. Key findings and conclusions: There are enough research-backed evidences to demonstrate the antiviral capabilities of coconut oil and monolaurin. The possibility of developing a medium-chain fatty acidbased nasal spray as a prophylactic or therapeutic is also discussed. Nevertheless, the potential impediments in devising suitable therapeutic models to treat SARS-CoV-2, are presented.

Background: An outbreak of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection or COVID 19 has caused serious threats to all around the world. Until an effective and safe vaccine for novel coronavirus is developed by scientists, current drug therapy should be optimized for the control and treatment of COVID 19. Objective: In this manuscript, we present a perspective on possible benefits of reformulating antiviral drug dosage form with nanoemulsion system against novel coronavirus infection. Methods: Literature review has been done on COVID 19, treatment strategies, novel drug delivery systems and the role of pulmonary surfactant in lung protection. Results: Nanoemulsion system and its components have certain biophysical properties which could increase the efficacy of drug therapy. Antiviral drugs, delivered through a nanoemulsion system containing P-gp inhibitor (surfactant and co-solvent), can minimize the cellular resistance to drugs and would potentiate the antiviral action of drugs. Pulmonary Surfactant (PS) assisted antiviral drug delivery by nanoemulsion system could be another effective approach for the treatment of COVID 19. The use of functional excipients like Pulmonary Surfactant (PS) and Surfactant Proteins (SPs) in the formulation of the antiviral drug-loaded nanoemulsion system can improve the treatment of coronavirus infection. Conclusion: In our opinion, for synergizing antiviral action, lipid and protein portion of PS and their commercial analogs should be explored by pharmaceutical scientists to use them as a functional excipient in the formulation of antiviral drug-loaded nanoemulsion system.

Background: COVID-19 has been declared as a pandemic recently and has caused many deaths worldwide. Till date, no effective drug or vaccine is available against SARS-CoV-2. There is an urgent need to find effective alternative preventive and treatment strategies to deal with the SARS-CoV- 2 outbreak. Objective: This communication proposes a new potential drug combination (repurposed) for prophylaxis and treatment of SARS-CoV-2. Methods and Materials: We performed a brief review of literature on a combination of Hydroxychloroquine, Melatonin and Mercaptopurine for prophylaxis and treatment of Novel COVID-19 infection and also assessed their possible mechanism of action against SARS-CoV-2. Observation: Proposed combination seems to be safe, and the target is unlikely to develop resistance to this combination. Conclusion: This scientific review proposes potential candidate repurposed drugs and potential drug combinations targeting 2019-nCoV/SARS-CoV-2.

In the context of the novel Coronavirus pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the management of patients with cancer constitutes a real challenge. These patients are more likely to be immunocompromised due to the underlying malignancy or anticancer treatments. As a consequence, they are more at risk of contracting this virus and tend to show a higher rate of fatal cases. In order to reduce the risk of this pandemic among patients and health care professionals, oncologists are currently proposing hypofractionated radiotherapy regimens using higher doses per fraction, thus shortening treatment courses and saving treatment visits. Since higher doses of radiation may also increase the ACE/ACE2 activity, which has been identified as a key SARS-CoV-2 receptor, this paper raises the question of whether hypofractionated radiotherapy regimens further increase the infectivity of these already vulnerable patients.

The current decade started on an unexpected note, with almost the entire world grappling with a newly arisen pandemic. A novel coronavirus, tracing its first human host to a Chinese province, has spread to all geographical areas with human populations. The virus, named SARS-CoV-2, infects the lower respiratory tract, much like other coronaviruses, that caused the 2002 epidemic, to which it is eponymous . The severity of infection is seen in individuals with comorbidities like diabetes, cardiovascular disorders, chronic respiratory problems, hypertension, cancer, etc. This virus represents another incidence of zoonosis to humans and has infected over eighteen million people since December 2019, of its first human transmission. All the currently employed therapies are either aimed at alleviating the severity of the symptoms or being administered on a trial basis. This review attempts to summarize brief aetiology of the virus, epidemiology of the outbreak, clinical symptoms of the disease with a postulated mechanism of pathogenesis and several existing and approved drugs and therapeutics along with plasma therapy, which are being clinically reviewed for their activity, as well as safety, against the disease; none of which are approved yet. A few promising vaccine candidates, as per in vivo studies, are also underway, but their evaluation might take a year at least. Meanwhile, experts have come up with the concept of “social distancing” to stem the viral spread, as the medical research fraternity of the world strives hard to find a safe, successful and effective cure for it.

Background: Coronavirus Disease 2019 (COVID-19) is a widely infectious and pathogenic viral infection. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) was reported in Wuhan, China, and spread throughout the world. Coronavirus is indeed an enveloped RNA virus of the genus Betacoronavirus, which is transmitted to birds, humans as well as other mammals. The fastest human to human transition has been generally established. On July 19, 2020, the WHO has reported total confirmed cases: 1,40, 43,176, total confirmed new cases: 1,66,735, total deaths: 5,97,583, and total new deaths: 4,496 globally. Material & Methods: In this review, the Clinical trial database is analyzed and systematically summarized drugs which are in the recruiting phase and the completion phase of the clinical trial. Results: Total 383 clinical trials are listed, involving more than 350 medicines such as Deferoxamine, Favipiravir, DAS181, Tocilizumab Injection, Sarilumab, Placebo, Sildenafil citrate tablets, Sargramostim, Lopinavir/ritonavir, Remdesivir, Bevacizumab, Tetrandrine, Fingolimod, Methylprednisolone, Plaquenil, Tocilizumab, Hydroxychloroquine, Abidol hydrochloride, Bevacizumab Injection, Methylprednisolone, Amoxicillin-clavulanate, Moxifloxacin, Sarilumab, Darunavir, Cobicistat, etc. Conclusion: There is no commercially authorized antiviral treatment or vaccine suitable for use against COVID-19. However, clinical trials represent an effective approach because they facilitate the development of new types of pharmaceutical drugs.

Nanotechnology is a multidisciplinary field of science which deals with physics, chemistry, material science, and engineering sciences. The applications of Nanotechnology cover almost all the branches of science and technology. In late 2019, SARS-CoV-2 virus became the cause of infection for coronavirus infectious disease (COVID-19). The outbreak of 2019 coronavirus disease (COVID-19) becomes a challenge for Hospitals and laboratories due to the large number of samples testing the presence of the causative pathogen. Many Scientists and researchers are devotedly working on finding out rapid immunodiagnostic methods to find positive cases. Nano based drugs offer a new therapeutic scheme against the wide range of bacterial pathogens. In this review article, the role of nanomaterial is focused on the fight against COVID-19.

This review summarizes the outbreak of viruses causing the fatal disease, which is highly pathogenic and efficiently transmitted from human to human. This first began in Wuhan, China, and now turned into an epidemic situation worldwide. A novel coronavirus (2019-nCoV) or severe acute respiratory syndrome coronavirus(SARS-CoV)-2 belongs to β-coronavirus genera originated in bats due to highly identical genome which leads to bat coronavirus. This review highlights the study of Indian Council of Medical Research, India, which determined the detection of pathogenic coronavirus in two different species of Indian bats. Indian Council of Medical Research, India, has successfully isolated the COVID-19 virus strain which was the first step towards diagnosis and the development of vaccines in the country. The outbreaks of coronavirus received worldwide attention for overcoming the challenges faced during this current pandemic as there is no clinically approved antiviral drug or vaccine available yet. However, preventive measures and different treatments were taken to cope with this viral outbreak. In response to this global outbreak, this review tries to explain the Virology, Epidemiology and pathogenesis, and discusses the diagnosis and treatment strategies of COVID-19. This review emphasizes the current update of COVID-19.

Background: The world is presently experiencing the devastating pandemic by a coronavirus that compelled the whole research communities to relook the epidemiology of these viruses, particularly their evolution and transmission in the milieu of the human-animal interface. Methods: The data from various databases like Science Direct, PubMed, Elsevier, Scopus, and Nature has been referred to classify the virus, its epidemiology, zoonotic potential, and its host determinants. The literature survey started when COVID-19 was declared as a pandemic by the WHO. Results and Conclusion: In this review article, we discuss the paradigm of coronaviruses as a new emerging zoonotic disease. We also examine the zoonotic concerns of these viruses in the setting of interspecies transmission and their consequences. These critical findings might be helpful for researchers to understand the mechanism of these viruses and the diseases they caused.

Coronavirus disease 2019 named COVID-19 caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been reported in Wuhan city of Hubei Province of China become a global pandemic. Genomic sequencing of SARS-CoV-2 unveils which showed multiple mutations relative to SARS-CoV. SARS-CoV-2 showed a very high receptor-binding domain (RBD) affinity towards the ACE-2 receptor in host cells, similar to SARS. Lack of immediate supervision and diagnostic measures hurdles prevention and treatment strategies against COVID-19. However, from SARS and MERS epidemics, WHO launched SOLIDARITY, a strategic and technical advisory group for infection hazards (STAG-IH) for the regular supervision and alert, which identified the estimated risk of COVID-19 and recommended the health emergence program to respond COVID-19. This article will briefly review the rationale history, structural genome with mutation, pathogenesis, preventive measure, and targeted treatment strategy to handle this pandemic COVID-19.

Coronavirus disease 2019 (COVID-19) is defined as an illness caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2). COVID-19 was first reported in the Wuhan, China, in late December, 2019. The World Health Organization (WHO) declared COVID-19 a global emergency on March 11, 2020. COVID-19 was rapidly transmitted and caused infection in 21,294,845 people and 761,779 deaths in more than 213 countries worldwide till August 16, 2020. United States of America (USA), Brazil, India, Russia Federation, Peru, Mexico, Colombia, Spain, France, Italy, Germany, and United Kingdom (UK) stand top COVID-19 affected countries in the world. The high transmission rate of COVID-19 might be due to large viral incubation time (2-14 days) and some modifications in the spike glycoprotein. Currently, effective drugs or vaccines are not developed for the treatment of novel coronavirus. However, few antibiotics like hydroxychloroquine and remdesivir have been currently used for the treatment of COVID-19 infection. Several collaboratives are working together for developing an effective and safe vaccine against COVID-19 and few vaccines are under clinical trial. Scientists are also working on plasma therapy and monoclonal antibodies. Nowadays, plasma therapy is considered the most effective treatment against COVID-19 and some promising results have been achieved. This review focuses on several therapeutic options for COVID-19, such as anti-viral drugs, vaccines, plasma therapy, and monoclonal antibodies. This review also covers the current situations of COVID-19 in the world. This review is about COVID-19, which will be beneficial to researchers for the development of potential treatment against it.

The explanations behind the wide spreadability of coronavirus sickness (COVID-19) are not known properly in this world. Several clinical investigations have indicated that the BCG antibody impacts on the immune system and human sicknesses which take part in the host system to such an extent that numerous types of viral diseases are extensively diminished or reduced. Subsequently, it was also observed in different studies that the recurrence and seriousness of numerous microbial or viral diseases, including COVID-19, will be lower in few countries where BCG Immunization programs are carried out. Few clinical investigations proposed by the epidemiological data have shown that the BCG antibody has a valuable impact in the treatment of COVID-19. So the BCG immunization may be found valuable in the coming months, particularly in the countries, where mass BCG immunization is done. Further thorough BCG immunization clinical trial is required to establish the above findings and its clinical significance. In future, this investigation will concentrate on the BCG vaccine and it may forestall the event of SARS-CoV-2 contamination and its succession in the large population.

Background: Severe viral pneumonia cases were observed in the people of Wuhan, China in December 2019. It has already affected almost every country around the globe and was declared a pandemic by the World Health Organization. We aim to evaluate the therapeutics and safety of various off label COVID-19 drugs. Methods: PubMed, Research Gate, Science Direct, Google Scholar, Centre for Disease control and prevention (CDC) portal, Chinese Centre for Disease Control and prevention (CCDC) portal, World Health Organization (WHO) portal were searched for obtaining reliable data. Result: COVID-19 is creating a storm of deaths and active cases globally, which is forcing the pharmaceutical companies and scientists to work day and night to find an effective and safer anti-COVID-19 medication. Various in vitro and clinical trials had been performed as well as are currently ongoing to analyze the mechanisms and therapeutics of off label medications like Chloroquine, Hydroxychloroquine, Amodiaquine, Azithromycin, Remdesivir, Favipiravir, Ritonavir/Lopinavir, Umifenovir, Oseltamivir, Ribavirin, Nafamostat, Camostat, Tocilizumab, Ivermectin, Nitazoxanide, Famotidine, Vitamin D, Corticosteroids and Dexamethasone. In vitro studies were performed by utilizing Vero E6 cells and hSLAM cells while open/closed, randomized/non-randomized, single-centered/multi-centered and retrospective clinical trials and case studies were organized to determine their safety and efficacy. Conclusion: Although these drugs have shown promising results against COVID-19 patients, it cannot be concluded that these drugs are truly safe and effective because there are no conclusive evidence to support the facts since only limited researches and studies had been investigated.

Aims: The research work aims to apply the current virtual screening approaches for rapid screening of available compounds as inhibitors of the novel coronavirus (COVID-19). Background: The worldwide pandemic, uncontrolled spread, and lack of effective therapeutics demand novel SARS-CoV-2 inhibitory anti-viral agents. Objective: The major objectives of the present work are – i) effective utilization of open-source computer- aided drug design (CADD) tools; ii) to prepare a database according to chemical structure similarity to the reported anti-viral drug, Favipiravir; and iii) to investigate potential inhibitors of the novel coronavirus. Methods: The dataset was prepared based on the chemical structure similarity feature of ChemSpider. The virtual screening was carried out using molecular docking and ADMET properties. For performing molecular docking studies, the standard docking protocol of iGEMDOCK was used. Results: Based on chemical structure similarity search to Favipiravir, a small library of 40 compounds was designed. The docking score and ADMET properties were analyzed to prioritize the compounds. Conclusion: The virtual screening resulted in the identification of potential anti-viral compounds. Among the designed library of compounds based on structural similarity to Favipiravir, 70% of compounds were found to possess docking scores more than that of Favipiravir. The amino acid residues involved in binding at the RNA dependent RNA polymerase (RdRp) were identified. The compounds have shown acceptable ADME properties and are potentially non-toxic. Other: The study has successfully applied the open-source CADD tools to investigate the novel SARSCoV- 2 polymerase inhibitors.

Background: India is facing a pandemic of ‘Coronavirus disease -2019’ (COVID-19). In the absence of proper medicine and vaccine for the treatment of COVID-19, the Government of India has imposed the country lockdown from 25 March 2020 to avoid chain/community transmission of coronavirus in humans. Consequently, the educational institutes were also closed during the lockdown period and traditional classroom teaching switched to online teaching in India to compensate for the educational losses. Aims: This article aims to measure the impact of online teaching on education as well as the health of the students. Methodology: The online survey was conducted on the students to measure the impact of online teaching on their education and health. There are 792 valid responses obtained from the survey. Results: According to the survey, online teaching was equally important in all segments of education during the period of a pandemic, but about 30 % of students are not satisfied with the delivery of content through online teaching. The students below 14 years were getting addicted to mobiles and laptops and consequently, they suffered from mental sickness and eye problems due to the screen effect. Conclusion: Online teaching has played a vital role during the pandemic, but its consequences can not be ignored. The online classes can not be accessed by each student due to the unavailability of smartphones, laptops and mobiles network to especially poor families and remote areas. This creates discrimination among the students of poor and rich or urban and rural. The students below 14 years are not aware of the screen effect and get addicted to mobile that causes mental and eye problems. Thus, online teaching can not take the position of traditional classroom teaching for a long time and we will need to get back to traditional teaching after a pandemic ends.

Background: In the current pandemic of COVID-19, hydroxychloroquine (HCQ) is recommended as an experimental drug for prophylaxis and treatment of the illness. Although it is a safe drug, it can rarely produce a severe drug reaction ‘drug rash with eosinophilia and systemic symptoms syndrome (DRESS)’, and to differentiate it from systemic viral infections is challenging. Case Presentation: A 45-year old male nurse working in a COVID-19 ward consumed HCQ weekly for two weeks for prevention of SARS-COV-2 illness. He presented with fever, pruritic maculopapular palmar rash, cervical lymphadenopathy for 12 hours and was quarantined as a suspected COVID-19 case. His laboratory tests revealed lymphopenia, eosinophilia, atypical lymphocytes, raised liver enzymes along with IgM negative, IgG positive rapid antibody test of SARS-COV-2. However, his throat swabs for SARS-COV-2 by real-time PCR were negative on day 1 and 7. He was finally diagnosed as definite DRESS based on the RegiSCAR score of six. He responded to levocetirizine 5 mg OD and oral prednisolone 60 mg daily tapered over 7 days. Conclusion: DRESS due to HCQ is ‘probable’, ‘of moderate severity’, and ‘not preventable’ adverse effect mimicking SARS-COV-2 illness.