key: cord-0906705-fn5p9ne0 authors: Sharma, Prerna; Gupta, Sumeet; Goel, Nitin; Gupta, Aikan; Saini, Vipin; Sharma, Neha title: A review: novel coronavirus (COVID-19): an evidence-based approach date: 2021-06-11 journal: Biomedical Engineering Tools for Management for Patients with COVID-19 DOI: 10.1016/b978-0-12-824473-9.00007-0 sha: 42caaa3e3bd89808c46722683328bc9a616d1186 doc_id: 906705 cord_uid: fn5p9ne0 The World Health Organization in China was informed about the cases of pneumonia of unknown antecedent ailments. Since then, there have been over 141 million cases globally of 2019 novel coronavirus (Covid-19), 3.01 million deaths, and over 80.4 million recovered. Clinical research of novel agents represent opportunities to inform real-time public health action. In 2018 there was a systematic review to identify priority research questions for Severe Acute Respiratory Syndrome-related coronavirus and Middle East Respiratory Syndrome-related coronavirus. Here, we review information available on COVID-19 and provide evidenced-based approaches in clinical research for the current COVID-19 outbreak. A new coronavirus named 2019-nCoV appeared in late 2019 in Wuhan, China. As of January 30, 2020, only 98 cases were reported in china and outside china, only four countries (Japan, Unites states, Vietman, and Germany) showed eight cases by human to human transmission. Although many details of the virus' development are still unknown, such as its origin and the ability to spread among humans, the increasing number of cases has been caused by person-to-person transmission. Following the outbreak of the severe acute respiratory syndrome coronavirus (SARS-CoV) in 2002 and the outbreak of the Middle East respiratory syndrome coronavirus (MERS-CoV) in 2012, 2019-nCoV is the third coronavirus to occur in the human population in the last two decades (Rota et al., 2003) , an appearance that has alerted global public health institutions (Donnelly et al., 2003) . China responded quickly by informing the World Health Organization (WHO) of the epidemic and sharing its consistency information with the international community after identifying the cause. WHO responded quickly by coordinating the development of diagnoses; issuing guidelines for monitoring, sampling, and treating patients; and providing up-to-date information on the epidemic. In several countries in the region, as well as in the United States, Wuhan travelers undergo a fever test to detect 2019-nCoV cases before the virus spreads . Updates from China, Thailand, Korea, and Japan show that the 2019-nCoV-related disease appears to be relatively mild compared to SARS and MERS (Li et al., 2005 ; J.S.M. . There is currently no evidence from randomized clinical trials in which potential therapy improves the outcome of abnormal patients suspected or confirmed COVID-19. There is no clinical trial that supports prophylactic therapy. More than 300 active clinics treatment trials are ongoing. This narrative review summarizes current evidence for the proposed main treatments, redesigned or experimental, for Coronaviruses belong to the Coronavirinae subfamily of the Coronaviridae family. Different types of human coronaviruses cause varying severity of the resulting disease and how far they can spread also varies. Doctors currently recognize seven types of coronaviruses that infect humans (Zaki et al., 2012) . • 229E (alpha coronavirus) • NL63 (alpha coronavirus) • OC43 (beta coronavirus) • HKU1 (beta coronavirus) Coughing and sneezing without covering your mouth can disperse the drops in the air. Touching or shaking hands with a person with a virus can transmit the virus to the person (Holmes, 1999) . Making contact with a surface or object that has a virus and then touching the nose, eyes, or mouth can aid its dispersal. Some animal coronaviruses, such as feline coronavirus (FCoV), are spreading through fecal. However, it is unclear whether this also applies to human coronaviruses. According to the National Institutes of Health, several groups of people are at the highest risk of developing complications from COVID-19 (Muniyappa & Gubbi, 2020) . These groups include: • Young children • People aged 65 years or older • Women who are pregnant • People with diabetes mellitus In 2019 the Centers for Disease Control and Prevention (CDC) began monitoring the outbreak of a new coronavirus, SARS-CoV-2, which causes a respiratory disease known today as COVID-19 (Tang et al., 2020) . Authorities first discovered the virus in Wuhan, China (Boldog et al., 2020) . More than 74,000 people have contracted the virus in China. Health authorities around the world have identified many other people with COVID-19, including many in the United States. On January 31, 2020, the virus was recorded as spreading from person to person in the United States (Imai, Dorigatti, Cori, Riley, & Ferguson, 2020) . The WHO has declared a public health emergency for COVID-19. The symptoms of COVID-19 can vary from person to person. It can cause few or no symptoms or it can lead to serious illness and be fatal (Lu et al., 2021 ). • Fever • Breathlessness • Cough • It may take 2À14 days for a person to notice symptoms after infection According to a report published on January 24, 2020, patients infected with coronavirus have several characteristics in common: fever, cough, and fatigue, while diarrhea and shortness of breath are found to be rare. Many patients reported bilateral abnormalities. First Infectious virus was confirmed through RTPCR of nine active cases which was isolated from throat samples. Until now, there have been no coronaviruses confirmed in urine samples in patients Zhu, 2020 (Weiss & Navas-Martin, 2005a) • Replicase protein expression • Replication and transcription • Assembly and release ( Fig. 1.1 ) Figure 1 .1 Coronavirus replication model. After receptor interaction and fusion of viral and plasma membranes, virus-specific RNA and proteins are synthesized, probably entirely in the cytoplasm. Coronavirus expression begins with the translation of two poly proteins (Weiss & Navas-Martin, 2005a) , pp1a andpp1ab, which undergo cotranslational proteolytic processing to proteins that form the replicase complex (Lee et al., 1991) . This complex is used for transcription. Embedded subgenomic mRNAs and a 3-cytothermic set of genomic RNAs with a common 5 "leader" sequence derived from the 5 ends the genome. Proteins were translated from the 5 ends of each mRNA. The new virions are collected by incorporation into intracellular membranes and the secretory mechanisms of cells are released through the vesicles. RER, thick endoplasmic reticulum; ER/GIC, endoplasmic reticulum/Golgi intermediate compartment (Weiss & Navas-Martin, 2005b ). In December 2019, several cases of pneumonia were reported, grouped together in Wuhan City, and the source was based on the Huanan Seafood Market. The first case of COVID-19 was discovered with unexplained pneumonia on December 12, 2019, and 27 cases of viral pneumonia, seven of which were severe, were officially reported on December 31, 2019. Etiological studies were performed in hospitalized patients due to their similar medical history, confirming the probability of infection from animals to humans. On January 22, 2020, it was announced that the new CoV had come from nature. Bats and coronavirus beta 2, which contains coronavirus (SARS-CoV), are associated with severe acute respiratory syndrome . Since December 31, 2019 and as of April 18, 2020, 2,197,593 cases of COVID-19 (in accordance with the applied case definitions and testing strategies in the affected countries) have been reported, including 153,090 deaths. Cases have been reported from: (11) 1.6.1.1 Antiviral Nucleoside analog Ribavirin, a nucleoside analog, has antiviral activity against a CoVs animal and against SARS-CoV. Due to the epidemic, many patients were treated with ribavirin along with corticosteroids and it has become a standard SARS-CoV treatment regimen. However, the lack of a control group prevented a real estimate effect size and in vitro tests did not show efficacy of any amount of ribavirin against SARS-CoV. Ribavirin has known side effects (hemolytic anemia, hypocalcemia, and hypomagnesemia). Many subsequent studies have questioned ribavirin's efficacy. With a lot of ribavirin and the combination of corticosteroids showed an increased viral load after treatment. Therefore its use decreased for a time (Battegay et al., 2020) . Other important nucleoside analogs are favipiravir and galidesivir, but these have not been evaluated so far in 2019-nCoV. Neuraminidase inhibitors are used for flu treatment. In a study of the MERS-CoV case in Paris between 2013 and 2016, a total of 35 patients received oseltamivir (37.6%). Of the patients positive for influenza virus (n 5 25), 52% (n 5 13) received oseltamivir. Oseltamivir can be started on the assumption of the empirical evidence of the MERS-CoV cases (Zumla, Chan, Azhar, Hui, & Yuen, 2016) . Oseltamivir has been evaluated in several other studies on MERS-CoV (Li & De Clercq, 2020) . However, strong evidence of its efficiency against COVID-19 is inadequate because there are inadequate control groups in the studies . Host-directed therapies are fundamentally developmentally oriented: improving host status, improving host immunity response, or addressing factors related to the host viral replication (World Health Organization, 2003b) . In addition to immunomodulators, metformin, atorvastatin, nutrients, and fibrils supplements can help treat acute respiratory distress syndrome by improving immunity. Till date, there is no 100% effective therapy available for SARS-CoV or SARS and other viral diseases. (Tai, 2007) . Zinc appears to have antiviral activity and inhibitory effects on CoV RNA polymerase activity and therefore inhibits it replication in cell culture experiments (Al-Abdely et al., 2019; Centers for Disease Control and Prevention, 1999 ). The cytokine storm shows pathognomonic property in the case of COVID-19 that can be caused by inhibition of these proinflammatory cytokines (e.g., inhibition of IL-6 by tocilizumab) (Tai, 2007) . Corticosteroids have been widely used in SERS-CoV and MERS-CoV and to manage the current 2019-nCoV epidemic. However, the WHO interim guidelines prohibit the routine use of corticosteroids unless indicated for other clinical reasons. The use of corticosteroids is associated with delayed virus removal RNA (for both SERS-CoV and MERS-CoV) and other steroid-related complications like psychosis (Zumla, Hui, Azhar, Memish, & Maeurer, 2020) . Interferons (IFN) are broad-spectrum antiviral agents that are mainly used in the treatment of hepatitis B. SARS-CoV patients were compared for ribavirin or interferon (IFN) alone, and a benefit was observed at high doses of IFN-α 1 group of corticosteroids (Te Velthuis et al., 2010) . Other observational studies support these findings, and the combined use of IFN-α and corticosteroids (corticosteroid arm n 5 13; corticosteroid 1 IFN-α arm n 5 9) showed less disease-related impairment of oxygen saturation. For the treatment of 2019-nCoV (7), IFN-α (5 million U bid inh) is recommended in combination with lopinavir 1 ritonavir combination (Russell, Millar, & Baillie, 2020 For distaster epidemic management, guidelines can help to eradicate this type of diseases; WHO and Eruopean Centre for Disease Prevention and Control posted regularly. Basically, these guidelines apply to health. Human studies have provided a lot of evidence for human coronavirus transfer from Wuhan, China. Another study reported the spread of the virus in the air. Due to a lack of evidence of transmission health professionals were not able to present prevention guidelines (Wang & Peng, 2006; Yu, Cao, & Xiong, 2015) . WHO has published some general guidelines, for example separate the infected patient from the rest of the family in an individual room, prevent contact, air precautions etc. ECDC also published information for people: avoid contact with patients, and especially coughing; avoid visiting markets and live or dead animal handling places; wash hands with soap and water or use an alcoholic disinfectant solution before and after meals, after using the bathroom and any contact with animals; and avoid contact with animals and feces (Li & Peng, 2013; Tong, 2010) . Ephedrae Herba 10 g, Paeoniae Radix Alba 10 g, Asari Herba 3 g, Zingiberis Rhizoma 10 g, Glycyrrhizae Radix et Rhizoma 5 g, Cinnamomi Ramulus 10 g, Schisandrae Fructus 5 g, Pinelliae Rhizoma Praeparatum10g, Lepidii seu Descurainiae Semen 10 g, Citri Reticulatae Pericarpium 10 g, Atractylodis Rhizoma 10 g, Magnoliae Cortex 10 g, Codonopsis Pilosulae Radix 10g Zhao et al. (2003) 7. Qingfei Paidu Tang Ephedrae Herba 9 g, Glycyrrhizae Radix et Rhizoma 6 g, Armeniacae Semen Amarum 9 g, Gypsum Fibrosum 15B30 g, Cinnamomi Ramulus 9 g, Alismatis Rhizoma 9 g, Polyporus 9 g, Atractylodis Macrocephalae Rhizoma 9 g, Poria Sclerotium 15 g, Bupleuri Radix16 g, Scutellariae Radix 6g, Pinelliae Rhizoma 9 g, Zingiberis Rhizoma Recens 9 g, Asteris Radix 9 g, Farfare Flos 9 g, Belamcandae Rhizoma 9 g, Asari Herba 6 g, Dioscoreae Rhizoma 12 g, Aurantii Fructus 6 g, Citri Unshius Pericarpium 6 g, Agastachis Herba 9 g Xi and Gong (2017) Over the past 50 years, a series of coronaviruses have developed that cause a wide variety of human and veterinary diseases. These viruses are likely to continue to emerge and develop and cause both human and veterinary outbreaks as they can recombine, mutate, and infect multiple species and cell types. The COVID-19 pandemic represents the largest global public health crisis of this generation, and probably since the pandemic influenza outbreak in 1918. Both the speed and volume of clinical trials launched to explore possible therapies for COVID-19 highlight the high-quality evidence that can be produced even in the midst of an epidemic. To date, no therapeutic method has been shown to be effective. All authors consent to publication in the journal. All relevant data are within the paper and its supporting information files. No human participants were involved in this paper and no new data were collected; thus ethical approval was not required. 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The authors received no financial support for the research, authorship, and/or publication of this article.