COVID-19 Current Challenges and Future Perspectives

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in China, affecting millions of peoples worldwide, and was declared as a global health emergency by the World Health Organization (WHO). This infection is extremely transmittable from humans to humans due to its long incubation period (as compared to other viruses of the same category), which results in asymptomatic carriers. The complete knowledge regarding this virus is still unclear and various studies are being conducted worldwide. Till now, no vaccines or specific drugs are available for its prevention and treatment. However, various classes of drugs are repurposed for their treatment and many new drugs and vaccines are under development. This chapter provides brief information related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) along with its diagnosis, prevention, and treatment strategies.

Researchers identified human coronaviruses (HCoV), for the first time in the year 1960s, to be responsible for cold. However, later that decade, it was observed that these viruses also affect the upper and lower respiratory tract and are probable common human pathogens. The last few eras witnessed the emergence of novel zoonotic viruses, including recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV- 2 or COVID-19). The COVID-19 disease is extremely infectious and transmittable, which results in severe acute respiratory syndrome. This virus emerged in China’s Wuhan city wet market and spread globally within a few months. Molecular data analysis of genome revealed similarity of SARS-CoV-2 with severe acute respiratory syndrome-like (SARS-like) bat viruses. The evidence for zoonotic virus spillover is not known, whereas the virus passes from human to human rapidly. This chapter discusses the origin of human coronaviruses and their distribution. Further, the global epidemiology of COVID- 19 is also discussed.

The pathogenesis of coronavirus 2019 (COVID-19) disease is unclear so far. However, emerging reports have revealed how this virus enters the body and affects various organs and finally results in the death of the patients. This chapter mainly compiled the information related to the pathogenesis of COVID-19 infection.

Currently, reverse transcription-Polymerase chain reaction (RT-PCR) and real-time reverse transcription-polymerase chain reaction (rRT-PCR) are used for the diagnosis of COVID-19 patients. COVID-19 antibodies can be reliably detected only around 15 days after disease onset, whereas; rRT-PCR allows the detection of virus within the first week of illness. The various diagnostic tests are under development. The treatment of the patient depends upon the individual case. Currently, no specific drug or vaccine is available for its treatment. Symptomatic treatment is the only option. This chapter brings into notice the diagnosis, management, and treatment methods used so far for COVID-19.

In the beginning of the 21st century, many viral infections were reported with a significant impact on the socio-economic growth of many nations globally. Many new strains of viruses were reported in the recent past. Passive antibody therapy involves antibody administration against various viruses. Though vaccines are available for many diseases, however, a longer duration is required for the development of a vaccine for novel viruses like the COVID-19 outbreak. In such cases, passive antibody therapy plays a major role in providing instantaneous immunity to susceptible persons. Proofs predicted that patients receiving convalescent plasma recovered from the disease and utilized it as a treatment without any serious antagonistic occasions. In this manner, it may be beneficial to test the safety and adequacy of convalescent plasma transfusion in SARS-CoV-2 contaminated patients. In this chapter, the authors conducted a brief literature review on treatment options against novel coronavirus. This chapter emphasized on the use of plasma therapy against novel Coronavirus and its future perspectives.

Recently, the World Health Organization (WHO) has declared COVID-19 as a worldwide public health emergency. The mode of transmission of COVID-19 appears to be from humans to humans. There is no vaccine or specific drug available for its treatment. To reduce the spread of this disease, reduction of the human to human contact is required. Therefore, the concept of social distancing and community lockdown prevails as one of the preventive measures. Some of the countries followed early community lockdown, while some adopted it at a later stage. The community lockdown could be effective in reducing the spread of COVID-19. However, management of the same still remains a matter of concern.

In the present study, we have extracted data from WHO daily situation reports and have compared the disease progression per week from the first identified confirmed case of USA, Italy and India. Our observation indicates that the number of cases in India is significantly lesser as compared to the USA and Italy. This might have happened due to the early lockdown in India.

Many COVID-19 patients die not just because of the virus but also due to the patient’s own immune system responding in an exaggerated manner called “Cytokine Storm”. This stormy strong immune response not only just kills the virus but also kills the patients. The interaction of COVID-19 with the immune system is poorly understood. Recently, some studies have indicated the alteration of innate and adaptive immune signalling pathways after COVID-19 infection. Thus, in this chapter, we have compared the normal immune signalling pathways with COVID-19 altered immune signalling pathways, which will help the researchers in the designing and development of specific drugs or vaccines against this virus.

Coronavirus, an infectious disease known as COVID-19, has become a pandemic affecting the respiratory system of humans and leads to fatal outcomes. It has been originated from Wuhan, China, and has spread all over the world. This virus shares similar clinical symptoms with the earlier viral infections, such as Severe acute respiratory syndrome (SARS-Cove) and the Middle East respiratory syndrome (MERS-CoV) infection; therefore, COVID-19 is also known as SARS-CoV-2. As of SARS-CoV, SARS-CoV-2 also utilizes the ACE-2 receptor to enter the host cell. These receptors are reported to present in the brain and cerebrospinal fluid. Moreover, various COVID-19 patients reported symptoms related to neuro, such as nausea, headache, tremor, etc. This finding shows that the virus is not only restricted to the respiratory system, but it also invades the CNS, which raises the interest to find its mechanism to enter the human brain cell and alteration of various brain Signalling pathways such as interferon, MAPK, JAK-STAT, and ACE-2/ANG-(1-7)/MAS caused by the novel coronavirus. Here, in this chapter, the recent updates regarding COVID-19 brain alterations and the possible brain targets to treat the SARS-CoV-2 disease have been discussed.

The global pandemic situation of COVID-19 has drawn the attention of various health care professionals. Several preclinical or clinical investigations have been explored; however, effective management of COVID-19 has not been found yet. The infection to death ratio related to COVID-19 varies in different countries, yet endangering human survival. Therefore, at present, prevention from SARS-CoV-2 infection appears promising in limiting the spread of the disease. The susceptibility of different individuals varies extensively in a demographic distribution. It has been found that patients with cardiovascular or metabolic disorders, smoking habits, and health care professionals have a higher susceptibility towards SARS-COV-2 infection. Therefore, it becomes mandatory to spread awareness to the people who are at higher risk. After COVID-19 infection, the occurrence of several complications may be lifethreatening.

Thus, this review has summarized the information regarding the susceptibility of people towards COVID-19 disease and disabling/life-threatening conditions after getting infected from COVID-19 disease.

The novel coronavirus disease 2019 (COVID-19) is an acute infectious disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). After severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS), COVID-19 is the third acute infectious disease caused by the coronavirus in humans. According to WHO, as of 3rd March 2020, the mortality rate of COVID-19 cases was reported globally as approximately 3.4% and it was observed particularly in patients who were suffering from comorbid conditions. The exact mechanism of death is unclear so far, however, emerging reports have indicated that less oxygen supply, excessive release of cytokines, and inflammatory mediators could be one of the reasons. Thus, in this chapter, we have provided classification of death cases occurring due to COVID-19. The possible mechanism of death is also discussed. The last section of the chapter discusses the role of concomitant medication in the death of COVID-19 patients.

Recently, the World health organization (WHO) has declared COVID-19 as a global health emergency as it is spreading almost all over the world. The number of infections to death ratio related to COVID-19 is varying in different countries, yet endangering human survival. Currently, no specific treatment is available, thus, there is a need for specific drugs against SARS-CoV-2. To develop specific drugs, specific targets should be identified. Thus, this chapter summarizes potential targets in SARSCoV- 2.

In December 2019, the sudden emergence of severe respiratory disease caused by novel coronavirus-2019 in Wuhan City, Hubei Province, China has become a public health emergency. As of June 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected more than 9,000,000 and mortality of more than 450,000 individuals, leading to devastating consequences worldwide. The persistent human-to-human transmission of nCoV-19 has prompted scientists to develop the treatment for coronavirus disease 2019 (COVID-19). Moreover, it has been declared as a pandemic and there is an urgent need for the development of treatment. However, there is no specific and effective treatment approved against COVID-19 to date. Developing a new drug is a time-consuming process, which is impractical to face the immediate global challenge. Thus, drug repurposing or drug repositioning is a strategy that allows the use of existing molecules against new indications. This chapter summarized various drugs repurposed against coronavirus disease 2019 along with the current challenges and future perspectives of drug repurposing against COVID-19.

Herbals are used from ancient times for the treatment of various body ailments. These are also used in the treatment of various infectious diseases, including viral infection. Recently, COVID-19 viral infection has emerged and spread across the globe. Currently, no specific drugs are available in the treatment of this infection. Thus, there is a need for specific drugs or herbal molecules against this infection. This chapter summarized potential antiviral herbals that could be effective in the treatment of COVID-19 infection. Further, the proposed mechanism of action of these herbals against COVID-19 has also been discussed. Finally, this chapter concludes with current challenges and the future perspectives of using herbals against COVID-19 infections.

The novel epidemic of zoonotic origin coronavirus disease (COVID-19) outbreak from wet market Wuhan, Hubei province of China became one of the massive eruptions toward humanity in 2020. In the present scenario, the World Health Organization declared the coronavirus outbreak as a public health pandemic. Researchers have been trying to develop vaccines and drugs against SARS since its outbreak, but no licensed treatments and vaccines are available. So, in the epidemic situation, consequently precautions measures are the only solution to prevent the spread of this virus. Scientists are struggling for vaccine development against COVID-19 that mainly targets the surface protein (S), the major inducer for neutralizing antibodies. Although few aspirants are also working for in vitro studies and many clinical trials are going on throughout the world. This chapter summarised the on-going challenges in the development of vaccines and specific drugs against SARS 2 along with future prospects.