key: cord-0902019-ymimvoq9
authors: Ameen, Fuad; Amna, Touseef; AA Alghamdi, Abdullah; Almansob, Abobakr
title: Covid-19 pandemic outburst in Saudi Arabia: A Glimpse
date: 2020-07-30
journal: Saudi J Biol Sci
DOI: 10.1016/j.sjbs.2020.07.026
sha: be50ee37999c6bd29502da00b3dad6b45d9ef574
doc_id: 902019
cord_uid: ymimvoq9

Abstract Synopsis Severe Acute Respiratory Syndrome Coronavirus2(SARS-CoV2) provoked alertness globally. Existing pandemic eruption of infections with SARS-CoV2 has been phrased as coronavirus disease 2019(covid-19). Worldwide pneumonia outburst attributable to new SARS-CoV2 alleged to be originated in Wuhan city of China and has affectation of enormous danger regarding civic wellbeing. As of 11 March 2020, international death toll owing to outburst of new coronavirus was approximately 3,800, and about 110,000 have been declared as confirmed cases. The novel SARS-CoV2 demonstrated competence with respect to human to human communication; therefore depicted exponential intensification of cases. As of March 23, there are 374,513 collective cases of global infections; more than 16,350 deaths and number of recovered cases is 101,554. Now Europe has turn out into new epicenter of lethal coronavirus. More than one third of the covid 19 cases are currently outside China. Presently Italy is one of worst hit countries followed by Spain. The rapid global widespread of novel covid-19 viruses lead to World Health Organization (WHO) to declare outbreak as pandemic. Given to seriousness of present scenario an accurate and rapid classification of noxious pathogenic virus is important which will lend a hand in opting for best fitting drugs. The screening program will aid saving people’s lives and help to put off the pandemic situation. The scientists and researchers should collaborate nationally and internationally to win the battle against novel covid-19. We aimed to represent covid 19 outburst scenario in general and Saudi Arabia in particular. This short review report very briefly highlights covid-19 syndromes; propagation; Middle East outburst, natural products as cure for viral diseases, probable psychosomatic effects, protective measures and Islamic wisdom. SARS-CoV2 is subsequent coronavirus outburst that perturbs Middle East, after SARS-CoV and MERS-CoV which has been originated in kingdom of Saudi Arabia in year 2002 and 2012 respectively. The report covers information and developments till 23rd of March 2020 on basis of current published data and studies published on different scientific web-pages.

Severe Acute Respiratory Syndrome Coronavirus2 (SARS-CoV2) provoked alertness globally. Existing pandemic eruption of infections with SARS-CoV2 has been phrased as coronavirus disease 2019 (covid-19) . Worldwide pneumonia outburst attributable to new SARS-CoV2 alleged to be originated in Wuhan city of China and has affectation of enormous danger regarding civic wellbeing. As of 11 March 2020, international death toll owing to outburst of new coronavirus was approximately 3,800, and about 110,000 have been declared as confirmed cases. The novel SARS-CoV2 demonstrated competence with respect to human to human communication; therefore depicted exponential intensification of cases. As of March 23, there are 374,513 collective cases of global infections; more than 16,350 deaths and number of recovered cases is 101,554. Now Europe has turn out into new epicenter of lethal coronavirus.

More than one third of the covid 19 cases are currently outside China. Presently Italy is one of worst hit countries followed by Spain. The rapid global widespread of novel covid-19 viruses lead to World Health Organization (WHO) to declare outbreak as pandemic. Given to seriousness of present scenario an accurate and rapid classification of noxious pathogenic virus is important which will lend a hand in opting for best fitting drugs. The screening program will aid saving people's lives and help to put off the pandemic situation. The scientists and researchers should collaborate nationally and internationally to win the battle against novel covid-19. We aimed to represent covid 19 outburst scenario in general and Saudi Arabia in particular. This short review report very briefly highlights covid-19 syndromes; propagation; Middle Astonishingly, Europe has been turned out as recent focal point of covid-19. In less than a month; covid-19 deaths exceeded 6,000.More to the point, in one single day 793 deaths have been recorded. Interestingly till date no death information has been reported by Kingdom of Saudi Arabia. Given to seriousness of infections as a result of novel covid-19; it is imperative to set up quick standard diagnostic test for uncovering infectious covid-19 in order to avoid successive secondary outbreak. Additionally there is an immediate need of vaccine which should be safe and effective with least/or no side effects.

Extensive and continuous studies going on covid-19 infections have specified initial and later disease syndromes (Fig. 2) . In broader sense the warning signs of covid-19 infection normally emerge out following an incubation time of roughly two to fourteen days ). However; commencement of covid-19 warning signs to death varied as of 6 to 41 days, mean of 14 days (Wang et al. 2020b ). However; this syndrome may vary with age and condition of patient's immune system. Wang et al. have suggested shorter duration in cases with age above seventy and may take longer time in patients below seventy years (Wang et al. 2020b ). Fever, cough, and fatigue, sputum production, headache, haemoptysis, diarrhoea, dyspnoea, and lymphopenia have been listed as frequent signs after inception of covid-19 disease (Carlos et al. 2020; Huang et al. 2020; Wang et al. 2020b) . A very recent (23 rd March) investigation by The American Academy of Otolaryngology has reported that loss of smell (Anosmia) and altered taste (Dysgeusia) could be significant warning signs of covid-19 ( Fig. 2) irrespective of signs of respiratory disease.

(https://www.today.com/health/coronavirus-covid-19-symptoms-may-include-losssmell-or-taste-t176597) During an alternative scientific research it has been stated that covid-19 infection is not transmittable from infected pregnant mothers to unborn/or newborn babies; however covid-19 infection can pass at time of birth (Chen et al. 2020a) . To restrict propagation of lethal covid-19 WHO and other scientific societies have issued specific guidelines which are shown in the below given figure (Fig. 3) . figure (Fig. 4) recoveries. The cases are geographically divided and distribution is highlighted in map (Fig. 5) .

(https://english.alarabiya.net/en/News/gulf/2020/03/20/Saudi-Arabia-confirms-70new-coronavirus-cases-total-at-344.html)

Primary outburst case of covid-19 has been announced in Saudi Arabia on 2 March, a Saudi native way back to country from Iran via Bahrain. After that, number of cases increased rapidly. It is famous proverb that extraordinary times require extraordinary measures. Therefore as a preventive step; for time being, Saudi government has restricted tourists and visitors from covid-19 affected countries. The Great Mosque

(Masjid al-Nabawi), has been closed for safety and sterilization purposes. Mecca is one of the busiest cities in world as this city never sleeps. But due to covid-19 pandemic all congregational prayers have been suspended (Fig.6 ). The first public decision was issued (04 th of March 2020) to prevent Umrah pilgrims and tourists from entering to limit the spread of covid-19 in Kingdom. Accordingly there are some precautionary measures including that Saudi Ministry of Sports halted fans from attending all sports competition. Moreover; Saudi authorities imposed a temporary ban on citizens and residents from nine countries (UAE, Kuwait, Bahrain, Lebanon, Syria, South Korea, Egypt, Italy, and Iraq). Saudi airline clogged all international flights temporarily and also closed malls and recreational places excluding medicine cabinet and supermarkets.

As of 17 March 2020, The Saudi Ministry of Islamic Affairs, Dawah and Guidance announced that daily five congregational prayers and weekly Friday prayer have been suspended across the Kingdom's mosques. As of 20 March, General Presidency of Grand mosque and prophet's (peace be upon him) mosque halted presence of people and prayers even in outer courtyards. As of 23 rd of March public quarantine has been applied from 7 pm to 6 am for 21 days.

Isolation and quarantine practices have been recommended in Islamic scriptures for the comfort of sick individuals and protection of healthy community ages back. It has been narrated by prophet Mohammed (peace be upon him) to his companions that in case of plague or any other communicable disease; if you listen to rigorous eruption of contagion in specific territory, never visit there; but if it outbreaks into your place also, do not leave that place (Sayili 1980) . The establishment of present quarantine system has now become basis of modern preventative medicine after discovery of communicable diseases. However; in Islamic history, the first hospital was built in 706 under kind instructions of Umayyad caliph AL-Walid in Damascus to isolate leprosy patients from other patients in hospital (Sayili 1980) . In addition to that; it is also mentioned in holy Quran that one shouldn't cause harm to oneself and others as well (Source: Al-baqarah, chapter 2: verse 195). Furthermore; Islamic protocol encouraged suspension of congregational prayers during adverse circumstances; which has been implemented during the covid-19 pandemic in almost all the Middle East countries.

Conclusively the Islamic wisdom leads a way to deal with frightening and panic situations such as pandemic covid-19.

Worldwide catastrophe due to viral diseases is massive. Recently, it has been reported that internationally half a million causalities are exclusively due to influenza conventional medicine based on local medicinal plants will serve as a substitute.

Nonetheless hitherto there isn't any authorized medication for covid-19.

Commonly applied medicines for virus are protease inhibitors, lopinavir and ritonavir or virus replication inhibitor, redemsivir etc. Medical research with aforementioned drugs is in progress. Taking into consideration cycle of SARS-CoV2 WHO has recommended focal points for medication formulation; such as targeting virus with monoclonal antibodies, suppression of viral endocytosis via antimalaria drugs, e.g., chloroquine or hydroxychloroquine. A couple of very recent investigations have also indicated that chloroquine exhibits inhibitory effect towards SARS-CoV2 under in vitro conditions. Its antiviral action pre-and post-infection against SARS and other coronavirus has been demonstrated in in vitro studies (Herraiz 2020) . Alternatively a few professionals have suggested antimalarial drug to covid-19 patients (Chen et al. 2020b; Kumar et al. 2020) . Chloroquine and hydroxychloroquine possess wide range antiviral potential towards HIV, hepatitis B, Herpex simplex virus type 1, Ebola and also SARS and MERS respectively by hampering stages of replication of different viruses. Moreover; theoretically chloroquine/hydroxychloroquine may possibly interlock hemoglobin distressing cysteine proteases essential for viral propagation (Herraiz 2020) . The high hopes regarding treatment of covid-19 patients with hydroxychloroquine was due to outcome of limited clinical trials in France. The treated patients depicted noteworthy reduction in viral count. On the other hand some patients did not react to hydroxychloroquine and accounted rationale was considered as metabolism. Therefore advance clinical investigations and trials are necessary as well as are in progress.

Due to covid-19 pandemic, earth planet has been shut down; taking a siesta. It is given to understand that infected as well as healthy folks may suffer depression due to quarantine, travel ban, fear of infection, and recurrence of disease as well as side effects of treatment itself. To overcome abovementioned worries, National Health Commission of China released a national guideline for psychological problems intervention on 27 January 2020 (Duan and Zhu 2020) . Nevertheless, psychological counseling of persons (who are suffering and had gone through covid-19 infections) will extremely be helpful to come back to normal life again.

Conclusively, scientists, researchers, health care practitioners as well as pharmaceutical agencies around the world are trying hard to discover cure for fatal covid-19 virus. Enormous measures such as complete shutdown, quarantine and lockdowns have already been taken worldwide to prevent fatal covid-19 virus spread.

However; immediate development of new vaccine is the need of hour. It has been anticipated that existing antiviral drugs akin to Nucleoside analogues, also HIVprotease inhibitors may reduce covid-19 infection (Lu 2020) . Additionally existing antivirals like ribavirin, 5-Fluorouracil, 5-Azacytidine, Remdesivir etc were also thought to be effective (Rothan and Byrareddy 2020) as these nucleoside analogues operate by enhancing mutations in RNA viruses and ultimately extinction (lethal mutagenesis). However; till date no success has been obtained against robust covid-19 outbursts. Besides; taking aforementioned measures The Saudi Health Ministry reaffirmed to control further spread of covid-19 viruses. Proper screening on airports is being done to screen passengers for covid-19 in order to avoid any untoward incident.

In all cities quarantine rooms have been created in hospitals to properly treat patients.

Nevertheless; funds have also been dedicated to research with Global bodies for thorough understanding of covid-19 mechanisms of infection, establishment of diagnostics systems and fast track development of vaccines.

In summary; till date (As of 31 march) WHO has not proposed any therapy for covid-19. The entire world is eagerly looking forward for a vaccine which can fight with covid-19 and can save millions of lives. There are twenty vaccines which are being in developmental stage. We expect broad-spectrum anti-covid-19 vaccine which possesses potential to combat the deadly covid-19 virus effectively and with maximum safety. 

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