key: cord-1025139-rfo5rkcr
authors: Mohapatra, Sradhanjali; Ayash Kumar, P.; Farooq, Uzma; Jain, Pooja; khan, Rahmuddin; Hasan, Nazia; Shamim, Ather; Javed Ansari, Mohammad; Alalaiwe, Ahmed S.; Aldawsari, Mohammed F.; Aamir Mirza, Mohd; Iqbal, Zeenat
title: COVID 19 pandemic challenges and their management: A review of medicines, vaccines, patents and clinical trials with emphasis on psychological health issues
date: 2022-05-24
journal: Saudi Pharm J
DOI: 10.1016/j.jsps.2022.05.004
sha: b151083d9d8195d9cc1c15383b8770b235eab36b
doc_id: 1025139
cord_uid: rfo5rkcr

The SARS‐CoV‐2 (COVID 19) paroxysm is a dominant health exigency that caused significant distress, affecting physical and mental health. Increased mortality, a stressed healthcare system, financial crisis, isolation, and new living and working styles enhanced societal commiseration leading to poor health outcomes. Though people try to maintain good physical health but unfortunately the mental affliction is still ignored. Poor psychological health has emerged as a burgeoning social issue and demands attention. Henceforth, the fundamental objective of this review article is to collate information about COVID-linked physical and psychological agony in diverse population groups with related symptoms and accessible diagnosis techniques. Recent studies have unraveled the fragile mental states of people who have either contracted COVID 19 or had near and dear ones falling prey to it. The impact of the epidemic on the human mind both in short and long-term, with possible risk and preventive factors together with suggested solutions for maintaining good health have also been discussed here. It also enlists the available medications, vaccines and investigational research in the form of patents and clinical trials. This article can be taken as an updated information sheet for COVID 19, accompanied by its management techniques with special emphasis on coping strategies for mental health. Further, it may also assist the policymakers to devise approaches that could enable the public to overcome the pandemic-driven adversity not only in the given situation but also futuristically.

The COVID 19 pandemic is a major health exigency that has caused significant distress and deteriorated the quality of life (QoL) of individuals. While causing numerous fatalities across the globe and leaving many impacted by long covid effects, this pandemic has affected society in myriad ways. Although most recuperated well, its fierce emergence has left the healthcare system in shambles and ushered the world economy into the doldrums. The shutting down of small-time businesses and activities related to infrastructure has added to the rising rates of unemployment and financial insecurities posing unprecedented challenges for the entire population. One thing which is severely depreciated by this pandemic is the health of the individual which entails both physical as well as mental health. "WHO" defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. It simply means good health can be achieved by maintaining both physical as well as mental health (WHO, n.d.) . Additionally, emotional, spiritual, and financial well-being also contribute to the individual's general health status as these are linked to stress levels. It is apparent that this deadly virus disturbs our physical health which manifests as diverse symptoms in an infected individual whereas mental health is not outwardly noticeable, demanding special attention (Salari et al., 2020) .

Good physical health is prerequisite for optimum functioning of individuals, is directly related to their overall productivity, and is the index of 'one's well-being. Any compromises thereof would reduce the 'body's inherent capacity to fight infections and may invariably lead to poor mental health. Henceforth, consuming a nutritious diet, following a healthy lifestyle, with regular physical exercise and proper sleep remains the key to and uphold good physical health. Unfortunately, the forced isolation and physico-social disconnect due to the current COVID 19 pandemic has disrupted our daily routine with adverse physical health outcomes. The Pan Global nationwide lockdowns have become the mainstay governmental tool to restrict and slow down the spread of the virus, leaving no means to cater to personal health and consequently waning off public health.

The unforeseen societal changes have resulted in an emergence of "fear of unknown" which is collectively perceived by the populace and expectably so. The primary contributors to these negative connotations include the birth of newer life realities like facing the temporary unemployment, working indoor, home-education for children, exploitation of virtual platforms, social distancing and lack of physical contact with friends and colleagues. The conjoined effect of the "pandemic stress" and "poor physical health" is causing an imbalance to the mental well-being. The situation could be scarier for those who previously suffer from mental debilitation of any kind. It has been noted that the impact on the mental health has been felt throughout the affected countries although it is much accentuated in developing countries. Therefore, it is essential to enumerate the effect of COVID 19 on stress to better deal with this situation.

COVID 19 is causing disaster worldwide, but people of developing countries are getting more frightened, unsecured emotionally, depressed, and in a stage of confusion. Most of them are unaware about symptoms of COVID 19, its preventive measures and management techniques. Sometimes they consider the infection as social stigma primarily due to lack of knowledge, which deteriorates social stigma primarily due to lack of knowledge, which deteriorates the condition. Even if the government has taken necessary steps and strict measures, people's awareness of infection remains the most significant factor in restricting the prevalence of diseases. General knowledge and understanding about the corona virus, causes of infection, symptoms, diagnostic techniques, accessible mode of treatment, and vaccines are essential to fight against the infection. Simultaneously it is important to track the investigational research such as patent and clinical trials to have an upgraded knowledge about the ongoing investigation (Alahdal et al., 2020) (Mohapatra et al., 2021) .

"Good mental health is absolutely fundamental to overall health and well-being". In this context, the current review is an attempt to explore and update the physical and mental health status of various populaces such as healthcare professionals, elderly, children, adolescents and pregnant women, etc. for such rapidly spreading contagious illness and their management procedures. It compiles various symptoms related to physical health and enlists several risk factors for mental health issues amid COVID 19 pandemic. Further, it tries to collate the different patent, clinical trials related to COVID 19 and enlists available medications and vaccines to fight against this virus. This article discusses many challenges and suggested solutions, together with the authors' views. Lastly, it may act as a platform to understand the psychiatric aspects of the COVID 19 and advocates a case for the serious intervention of psychiatrists who may propose using effective medications and other techniques for this unattended health issue.

Physical health may be defined as "the ability to perform daily tasks and live comfortably, free from disease or disability. A healthy body is a reflection of a healthy mind and vice versa that leads to an improved QoL. Regular exercise, balanced diet, and adequate rest contribute to good health. Following a healthful lifestyle is an absolute necessity to maintain good physical health. It decreases the risk of disease by maintaining body composition, activeness, muscular strength and resilience of the individual. The current corona epoch restricts the lives of the people within their home by disturbing their lifestyle and physical health.

Coronavirus disease is a pernicious disease caused owing to the SARS -CoV-2, a diverse family of viruses affecting humans and animals equally. Several types of corona viruses that produce mild to moderate respirational sickness in humans and recover without demanding special treatment. Others, such as SARS-CoV and MERS-CoV, can cause more acute respiratory ailments. A SARS-CoV-2 (COVID 19) is a novel strain of coronaviruses, which can have potentially major complications, such as trouble breathing and pneumonia. Patients infected with SARS-CoV-2 show a wide range of symptoms from asymptomatic cases to acute respiratory distress syndrome and many others as summarized in the Table 1 . Although, many have rescued without needing special therapy but older individuals and people having other medical complications (such as chronic respiratory disease, diabetes, cardiovascular disorder and cancer) are more prone to develop critical illness even lose their life (Gasmi et al., 2021) . Literature has been well established that patients having co-morbidities are seen to have a high mortality rate after COVID 19 )(R. )(D. Wang et al., 2020) (Yang et al., 2019) . Further, researches have shown the connotation of reduced physical activity and lengthy sedentary behavior with poor health outcomes (Korczak et al., 2017) (Haapala et al., 2017) (Archer and Garcia, 2014 (Hueso et al., 2020) (Fung et al., 2021) # No more in use, amid serious concerns about the drug's safety. ## No more recommended due to lower efficacy on Covid 19. WHO: World health Organisation FDA: U.S. Food and Drug Administration DCGI: Drugs Controller General of India Additionally, timely diagnosis and earliest therapy of COVID 19 are the key steps for superior management of the infection and is essential to reduce the fatality ratio in COVID 19 patients. Ignoring the symptoms at the initial stage and deviating the public health protocol are found to be the vital reason for spread of infection and depreciating public health; as reinforcing immunity at the initial period are easy rather than severe stages of infection. So it is essential to overcome ignorance with adequate knowledge and awareness which will be valuable to boost the febrile patients with cough to seek immediate doctor's consultation (G. , , . Figure 1 illustrates various diagnostic tests for COVID 19. 

Mental health describes the emotional and psychological well-being that helps to lead a relatively happy and healthy life. When we go through a difficult time and facing challenges it is obvious to receive negative emotions. Even though all the individuals are different from each other, there are certain factors that will affect our mental health. Different life experiences, upbringing conditions, environment and genetic factors can influence our thinking and response to challenges and opportunities. There's no single "right way" to react, so everyone may react differently to different events. The coronavirus (COVID 19) outbreak may cause a diverse negative impact (summarized in Table 3 ) that might have different contributing factors summarized in the following Figure 2 . As a consequence of the emergence of corona virus disease public health actions, such as quarantine, social distancing, lockdown are taken into contemplation to reduce the spread, but at the same time, it also imposed persons to feel isolated and lonely and leads to the intensification of stress, anxiety and depression (Rogers et al., 2020) (Wang et al., 2021a )(M. L. . Several studies have been carried out to find the consequence of quarantine on the individual's psychological status, and the results show a much greater occurrence of psychological distress amongst the quarantined population than those who did not. So this period seems to have important and dysfunctional psychological stress on the individual's mental health, causing anxiety, depression, anger, and stress-related disorders both in the short-term and long-term period which further worsening their overall health status (Henssler et al., 2021) (Bai et al., 2004) (Reynolds et al., 2008) (Sprang and Silman, 2013) (Hawryluck et al., 2004 (Hawryluck et al., )(R. et al., 2003 (Hull et al., 2005) . Table 4 conscripts some of the potential risk and protective factors underlying mental distress in response to the COVID 19 lockdown. The risk factors help to better recognize the reason why certain people are more predisposed to severe illness, whereas the protective factors give methods to deal with the situation with necessary precautions. One of the recent investigations indicates that lack of social connection is linked with a variety of deprived physical and mental health consequences, even early mortality. Therefore it is an undeniable fact that physical distancing carried out to limit the spread of the corona virus has a potential negative impact on these health outcomes affecting life severely (Morina et al., 2021) According to other studies, the COVID 19 contagion increases the psychological health problems in COVID 19 patients and quarantined persons but also in health care workers and patients with non-infectious chronic disease, demanding urgent interventions of mental health management measures (Pappa et al., 2020) (Nochaiwong et al., 2020) (Kumar, 2019) (Kumar et al., 2020) . Another study carried out in the Indian population concluded that students and health professionals shows higher psychological distress than others and necessitate special attention as they are the main stakeholders in society (Rehman et al., 2021) . A further investigation conducted to check the mental health condition of pregnant females during the COVID 19 plague and concluded that pregnant ladies are more prevalent to anxiety and depression during this period, particularly younger pregnant women (Fan et al., 2021) .

Evidence has been found that people having mental illness are at higher affliction of getting infected with COVID-19 (Mazereel et al., 2021) . If they had any previous history of mental disorder then the relative risk of having infection is little more (Taquet et al., 2021) . Hence, taking into account the higher risk for COVID 19, it has been advised that persons with mental illness should be vaccinated on a priority basis. Yet, the patients with mental diseases are reluctant to get vaccines for COVID-19. However, there is limited literature on the rates of vaccine reluctancy among people having mental illness. Further, in case of depression and schizophrenia the immune response to vaccines get reduced leading to inadequate production of antibodies, which may not give enough protection to the patient even after vaccination. Additionally, there are rising fears for hesitancy in the general public because of associated side effects and doubt about the efficiency (Khubchandani et al., 2021; Razai et al., 2021; Shacham et al., 2021) . All these above experiences are factual in the face of this significant challenge of the COVID 19 pandemic. Concern for one's own and one's loved ones, rapid modifications in one's way of life (e.g., education, employment, social get-togethers), interrupted plans caused by travel restrictions, social isolation, and quarantine are some of the population's new-fangled challenges. Thus it's essential to recognize the seriousness of the situation. At this point, the authors want to highlight that the emergence of psychiatric conditions and mental health were identified as the 10th most frequently investigated subject in the course of the COVID 19 pandemic (Tran et al., 2020) . Thus to understand and accept the fact we have to first analyze the mental status of the individual population with their mindset for such pandemic, which is imperative to meet the global crisis. A startling observation in regard with the covid impact is its potential to exacerbate health issues amongst vulnerable groups like mental health sufferers, geriatric population, pregnant women and even less privileged unemployed members of the community (Holmes et al., 2020) (Power et al., 2020 )(OECD, 2020 . This emergence warrants attention and indicates the collation and discussion of the COVID -19 data related to psychological stress in the various population (enlisted in the Table 5 ). Furthermore, concerted efforts towards accumulation of real world evidence (RWE) with a focus on their possible management procedures, is highly desirable. This repository of information will act as a resource for the patients, clinicians, regulators, and policymakers who would be better equipped to deal with the present scenario of crisis and any future pandemics. 

Healthcare workers 1 Police personnel (Specially in countries like India) 2

Children and adolescents 3

Older persons 4

Pregnant women 5

Patients suffering from COVID 19 6

Persons at domestic abuse risk 7

Individuals who have had previous history of mental sickness 8

Women, in particular, if they have to juggle home-schooling, working from home, and do the household tasks 9

Individuals struggling financially or in lower socioeconomic

The following section elucidates the psychological agony in diverse population groups along with suggested solutions.

The COVID 19 outbreak 2019 evolved to be one of the central health crises affecting people of all continents, realms, races, and socioeconomic groups and posed an increasing challenge for healthcare professionals who are designated as the front-line workers (Q. Chen et al., 2020) . Understandably, in this pandemic, health professionals are experiencing the same situations as other individuals but are burdened with insurmountable mental and physical stress (Petzold et al., 2020) . In the perspective of any epidemic, health workers are expected to have long working hours without availing any leave. Massive workload, an growing figure of infected cases, rise in the death rate, risk of being infected while treating patients, lack of any specific medication, extensive social media reporting, shortage of personal protective equipment, lack of preparedness and every day's new challenges can contribute to various psychological and mental illnesses (NCT04497415, 2020) (Lai et al., 2020) . Further morals and medical ethics that emphasize self-sacrifice as a vital principle of this noble profession, may add to job pressure. According to past reports, health care workers having a high risk of contamination have persistent stress and higher degrees of anxiety and depression (McAlonan et al., 2007) . The study carried out to investigate stress reactions among staff members in a hospital involved in the outbreak of severe acute respiratory syndrome (SARS) located in east Taiwan concluded that 5% of this group suffered from an acute stress disorder, 20 % felt stigmatized and debarred in their neighborhood since they involved in hospital job and 9% reported reluctance to work (Bai et al., 2004) . Research on the occurrence of anxiety, depression, stress and restlessness during the COVID 19 eruption among healthcare workers suggested that a significant percentage of them experienced mood and sleep problems in this situation. Additionally, female healthcare staff, nurses, younger medical staff, and workers in this area have shown higher rates of emotional symptoms than, than males and other counterparts (Pappa et al., 2020) (Vizheh et al., 2020) . Another investigation on health care staff in hospitals in Wuhan and other parts in China described the mental problem, mainly in nurses, females, and front-line healthcare workers who are involved directly in the diagnosis, management, and patients care during COVID 19 situation (Lai et al., 2020) .

Appreciation by the supervisors, public and patients is one of the powerful motivational tools for reducing stress in health care workers. It helps to boost the kindness and sacrifices of health workers who risk their lives to serve the infected patients. Such gestures may support overcoming empathetic distress and fear to provide care under challenging clinical conditions of the COVID 19 pandemic. Various stress management methods such as training and educational programs may be beneficial for this outbreak (Chua et al., 2004) . Personal coping methods such as positive thinking, problem-solving, seeking social support, along with institutional measures such as self-care, infection control, safety, staff support and gratitude, and clear communication are helpful measures for managing stress (Chew et al., 2020) . It is advisable to the head, managers, and policymakers to implement supportive, protective, encouraging & motivational, training, and educational interventions, at a regular interval to reduce the psychological stress in front-line workers (Vizheh et al., 2020) .

Similar to health care personnel, police are also listed as the "corona warriors" and acted as front-line workers in this pandemic. During this epidemic outburst in populous countries like India, the primary responsibility of the police personnel is to implement the national lockdown and safeguard physical distancing by enforcing laws (Epidemic Disease Act, 1987, and the Disaster Management Act, 2005) along with other social responsibility apart of their regular work profile. This can result in a greater possibility of developing a range of psychological, emotional and perturbation amidst this group. There is adequate prove to document the intensification of depression, anxiety, drug abuse, and suicide among this population )(Di Nota et al., 2020) (Edwards and Kotera, 2020) . It is evident from the past research that organizational culture and workload are the main issues for boosting stress in police personnel. Stress concerning to job among the police personnel may be attributed to nearly similar factors as discussed above, the reason being participation as front-line workers in the COVID 19 outbreak. Further, susceptibility in female officers is comparatively more than their male counterpart (Collins and Gibbs, 2003 ) .

Spreading awareness among the staff about mental health complications, conducting training and motivational sessions to develop constructive coping skills, and building resilience can alleviate mental distress. Teaching relaxation practices such as yoga or meditation can also help them to cope with stress positively. Regular physical exercise can also solve the purpose along with special appreciation and support. Regular communication (online medium) with the family members is an effective way to strengthen their support system, especially those who work away from their homes or undergo quarantine. Additionally, persons with a previous history of mental disorder should pay special attention to timely and reasonable consultation (Khadse et al., 2020) .

COVID 19 contagion is causing interruptions in the universal social structure leading to socioemotional complications. Many countries maintain social distancing and observe the quarantine with government-imposed mandatory restrictions on many outside activities. As a result of which children and adolescents have had their schools closed, and outdoor home activity and social interactions abridged many fold. These restrictions limit this group's physical movement, which further leads to irritability, lethargy, anxiety, depression, stress, and inattention and fear of infection in them (Nearchou et al., 2020) (Meherali et al., 2021) . Such public restrictions promote stress in this youth population and in their parents and can become a barrier in the normal growth and development of children (Araújo et al., 2020) and may intensify as this isolation continues. Additionally, poor diet, confinement to a place, and increased screen time may cause cases of obesity, eyesight complications, stroke, heart attack and many other ailments (Spitzer, 2021) . The declining QoL of young children cannot be ignored and demands special attention as they are the main stakeholders of any country. There is sufficient evidence of the correlation between physical activity and psychological status in the literature (Saxena et al., 2005) (Sagatun et al., 2007) (Ahn and Fedewa, 2011) (Okuyama et al., 2021) . Study outcomes concluded that the COVID 19 pandemic is responsible for the new onset of psychological problems among children. The current scenario has taken a heavy toll on differently-abled children. Autstics and ADHD sufferers have emerged as a highly vulnerable group whose mental health deterioration could be detrimental for their future .

This epidemic outbreak demands immediate action by preparing novel strategies for early psychological interventions to decrease its influence on the mental health of the youth. There is an utmost emergency for establishing an on demand clinical support facility for better amelioration of these problems. The distress quotient among these populations can be reduced by maintaining social networking with friends and relatives, positive thinking, physical exercise and avoiding false social media information. Online resources such as information about psychological health and preventive measures, video counselling, tele-psychiatry and telemedicine services, can be useful to lessen the imaginary fears and ultimately psychosocial stress (Deolmi and Pisani, 2020 ) (Loades et al., 2020) (Prisco et al., 2020) . It is advisable to the psychologist, doctors, and policymakers to develop new and innovative policies that help them compete with this corona epidemic-driven adversity and ensure normal physical and mental development in children and adolescents (Araújo et al., 2020) .

Although people of all eons are affected by the rage of corona, geriatrics are more prone to the negative consequences, which results in decreased QoL and poor mental health. The rapid rate of geriatric mortality in the COVID 19 outbreak may be attributed to compromised immunity, pre-existing ailments such as diabetes, hypertension, thyroid, cardiovascular, menopause, and other chronic conditions that make them more susceptible to viral infections (Sepúlveda-Loyola et al., 2020)(Nanomedicinal Approaches Towards Cardiovascular Disease, 2021). Usually, older adults suffer from age-related mental stress; a condition which further worsens in this corona age due to restrictions in movement, limited social participation and reduced autonomy. Rapidly growing risk of social isolation, worry and loneliness induced by the pandemic is resulting in various severe short and long-term negative mental health impacts (Bansod et al., 2021) . Additionally, QoL has deteriorated and often ends with mortality in this populace. The condition worsens for menopausal females and individuals with a history of psychological illness as they have already strived with poor QoL (Mohapatra et al., 2020)(Sradhanjali Mohapatra, 2022) .It is reported elsewhere that there is a strong positive relation with social participation and geriatric health (Douglas et al., 2017) (Carver et al., 2018 )(Sepúlveda-Loyola et al., 2020) (Perez et al., 2021) . Deprivation of social participations of different forms leads to augmented depression, anxiety and cognitive dysfunctions. Nonetheless it is heartening to know that a study conducted on 1,000 U.S. adults claim that though the older population faces stress, anxiety, and depression, but they exhibit bettercoping capability with COVID 19 stress in comparison to young adults and have reported to have comparatively less depression and anxiety("The Older You Are, the Better You May Cope With Pandemic Stress," n.d.) .

Even though there are several recommendations for the elderly to deal with this emerging COVID 19 pandemic, the major management method is to offer adequate emotional support that boosts them to cope with this situation. Family members and caregivers need to be actively and emotionally involved in elderly care focusing more on mental health. Connecting with family and friends over the internet and phone is a better way to ventilate thoughts and helps to deal with isolation. But at the same time, the digital screen time for the news media should be reduced to avoid misinformation and dread statistics. Descriptive news or information with illustrations from authentic sources may help. Maintaining a proper routine, healthy nutrition habits and daily physical activity may improve resilience in older people. Avoidance of self-medication, virtual consultations and telemedicine, tele-psychiatry, proper health education, and psychological counseling could also be beneficial, particularly for individuals having a previous track record of mental ailments(Ahn and Fedewa, 2011) (Lebrasseur et al., 2021) (Prisco et al., 2020 )(Gillman-Wells et al., 2021 . Further implementing homedelivered settings that enhance mental security may be advantageous in this population (Tegeler et al., 2020) . Additionally, stakeholders and policymakers need to take collective action to deal with this challenge ensuring better psychological well-being.

Pregnancy is believed to be a triumphant phase in women's life but a few are predisposed to negative emotions that lead to psychological distress. Women consecrated with pregnancy are more prone to face psychological agony during their prenatal period. It may increase up to 25% more than the prevailing mental disorder at their reproductive age where the problem is found to be common (Brooks et al., 2020) (Howard et al., 2018) (Kendig et al., 2017) . Perinatal depression is especially dangerous for women who are carrying a medically high-risk pregnancy (Fairbrother et al. 2017 ). The pregnancy-induced physiological changes greatly affect the various body system including the immune system of the females. The present COVID -19 era further adds trauma to the condition by exaggerating the damaging effect on this vulnerable population. Although pregnant women have a greater predilection to psychological problems, the COVID 19 outbreak and associated factors further accelerate the condition. Moreover, reduced access to reproductive health services, increased socioeconomic scarcity and social cut-off may worsen the situation. It is well established that expectant females have always been regarded a highly susceptible community. Various findings have been described the vulnerability of expecting females to their emotional insecurity and routine trauma (Loomans et al., 2013) . It was observed that the pregnancy period during the past pandemic was related with additional adverse clinical outcomes and a higher rate of death (Chui et al., 2004 ) (Mosby et al., 2011) . Some investigations conclude that maternal mental health is adversely influenced by the social distancing and impacts of infectious outbreaks. There is an influx of studies stating that the SARS quarantine has led to significant upsurges in levels of anxiety (Dodgson et al., 2010) , depression (Linde and Siqueira, 2018) and stress (Davis et al., 2014) . Evidences of deteriorating mental health of expectant women and their off springs due to extreme stress conditions, natural disasters or emergencies, have also been reported well (King et al., 2009) (Laplante et al., 2004 ) (Cao-Lei et al., 2015) . Some of the current studies depict that this pandemic and related factors have negatively affected pregnant women with depression and anxiety and lower quality of mental life and reasonable psychological impact due to isolation (Saccone et al., 2020) (Berthelot et al., 2020) .

Reliable and up-to-date information about the current situation; support, guidance and advice from physician particularly with regards to the prophylaxis and treatment; support and care provided by the family and health care professionals, proper counseling about the potential for severe disease and virtual support; social connectivity; personal hygiene, walking, yoga or exercise are effective methods to deal with this problem. It is imperative to brainstorm and then reach clinical decisions for using approved COVID 19 medicines in expectant mother as the safety of both mother and the foetus is of paramount importance and should ideally be a combined decision between the patient and the clinical team (Gynecologists, n.d 

COVID 19 being a highly infectious and contagious ailment with increased incidence of death rate and absence of appropriate treatment gives sufficient reasons to affect patients' mental health. Additionally, socio-emotional and socio-economic factors accentuate the condition. Mental issues in patients may be the sum of both pandemic stress and the physical effects of the disease. Anxiety and depression are the most prevalent symptoms in this population. Furthermore, post-traumatic stress symptoms were surprisingly common after discharge from the hospital (Muruganandam et al., 2020) . Nearly 20 % of patients developed a mental health issue while suffering from COVID 19 (Ries, n.d.) . There are few studies found in the literature relating to the psychological experience of COVID 19 affected individuals during their hospital stay. According to a survey, anxiety and depression were found to be prevalent in 34.72 percent and 28.47 percent in hospitalized covid patients, respectively (Kong et al., 2020) . Another study demonstrated that COVID 19 patients suffer from both physical and mental distress. Further, COVID 19 patients with general pneumonia commonly showed anxiety and depression . Other investigations conclude that posttraumatic stress symptoms associated with the COVID 19 were observed in the maximum number of clinically stable COVID 19 patients before and after discharge (Bo et al., 2020) (Mazza et al., 2020) . One meta-analysis report specified that the collective prevalence of post-traumatic stress symptoms linked with COVID 19 was found to be 23.88% (Cooke et al., 2020) . Further, incidences of confusion and agitation are also reported in ICUs admitted patients having severe COVID 19 infection (N. Chen et al., 2020) (Helms et al., 2020) .

The process of disease treatment for such infection should combine medical therapy along with psychological support. So, medical staff should be trained accordingly. Mental support from medical workers along with physical backing, and regular interaction would keep them motivated to remain positive during the hospital stay (Kong et al., 2020) . Traditional counseling may help to mitigate the condition. Mental resources and related amenities must be assigned to support the psychological health problem of the patients. Familiar and adaptive coping skills such as interactions with family and friends, spending time on spiritual things and interaction with mental health professionals in the perspective of this COVID 19 isolation has to be developed (Werner et al., 2020) . Quarantine policies and shut-down procedures adapted to avoid the transmission of COVID 19 have obstructed social behaviors in these isolated individuals, so there should be a rethinking for future implementation. It is advisable to initiate cognitive processing therapy for post-traumatic stress disorder and also explicitly use telemedicine, tele-psychiatry during the COVID 19 (Moring et al., 2020) . Currently, online psychotherapy such as internet cognitive behavior therapy (ICBT) is proved to be more relevant for dealing mental health particularly during COVID 19 pandemics (Aminoff et al., 2021) . It is a modern tool which is emerged with recent technology evolutions and is effective across almost all the geographical area involving several cultures and languages. This is a promising approach to reduce the psychological stress with increased access and better outcomes, in cost effective manner. It has been scientifically proven to be effective in children and adolescents to treat symptoms of depression and anxiety and can be useful for all the above populations to deal with the COVID 19 related psychological agony. 

The COVID 19 outbreak has brought about a wide-reaching unprecedented investigation across all countries.

Research during a pandemic helps to collect important information that can help to improve outbreak control measures, and catalyses the concerted research efforts in both the clinical settings as well as vaccine development and its trials. Additionally, research into optimizing tools for evaluating health and disease through innovative approaches and technologies could finally lead to improved access to care. It shall also forge ties with the public and pour, benefits to health and disease management organizations. Table 6 enlists several vaccines that are being investigated as well as approved for vaccination against this illness that help to obtain information and comparison among diverse vaccines. Further, it includes some recent patents (collected out of approximately 2,014 published patents) coupled with the prevention and treatment of COVID 19 ("Patent," n.d.) in Table 7 . Additionally, this section enlists (Table 8 ) some clinical trials from all across the world highlighting the on-going investigations relating to the health (both physical and mental) in relation to COVID 19. A recce of the repository reveals the impetus with which such research endeavors are initiated and executed. It is worth noting that research organizations in developed and developing nations are equally keen to utilize this colossal calamity as an opportunity to unravel their research understanding, which could come in handy in these testing times. It is also evident from the efforts taken by the scientists that they are working towards generating an affordable, accessible and sustainable remedy for this devastating disease. 

In the extant global panorama of COVID 19, it is imperative to identify the seriousness of our community's public health challenges and preparedness. Natural descent of such diseases and a poor response by the health systems is a recipe enough for insurmountable societal destruction leading to stunted evolution of a healthy and happy society. Therefore, the need of the hour is to pay attention to the health and well-being of different populations with suggested solutions through particular emphasis on psychological health. The current review compiles the overall physical and mental health-related issues, including the symptoms, risk and protecting factors, available medications, vaccines, and some recent patents and clinical trials in this area. Looking after our well-being in time like this can help to reduce stress and enable us to stay calm and joyful. In this context, the present topic provides a resource for the management of stress and anxiety in several communities and may act as a clinical update on health during COVID 19. The authors draw a categorical conclusion that the youth and health professionals need special care amidst this pandemic as they have comparatively higher psychological sufferings. Students should take special care as they are the main stakeholders in society. The authors emphasize the fortification of positive coping skill of the individual, which can help transform the negative experiences of getting diseased into positive upshots. Additionally, they suggest inclusion of physical exercise, yoga and counselling as an indispensable part of therapy. Most definitely an awareness about the disease, its early diagnosis and treatment will help to overcome this COVID 19 pandemic challenge smoothly. Further, unchecked chronic conditions and a massive backlog of surgeries due to social isolation and loss of jobs may be waiting to unfold another potential disaster in the society. It is imminent that the political willingness along with a commitment of health leaders and policymakers to devise innovative policies that would enable the public to overcome this pandemic-driven adversity is the need of the hour. These cogent steps would not only bail us out in the present situation but would also enhance the public preparedness for any similar prospective disasters.

pediatric HIV Infection

Fact sheet for healthcare providers: emergency use authorization (EUA) of bamlanivimab and etesevimab

Dexamethasone for the Treatment of Coronavirus Disease (COVID-19): a Review. SN Comprehensive Clinical Medicine

Knowledge, awareness and practice of health care professionals amid sars-cov-2, corona virus disease outbreak

A meta-analysis of the relationship between children's physical activity and mental health

Mental health status and risk factors during Covid-19 pandemic in the Croatia's adult population

An analytical study on the awareness, attitude and practice during the COVID-19 pandemic in Riyadh, Saudi Arabia

Maternal mental health amidst the COVID-19 pandemic

Internet-Based Cognitive Behavioral Therapy for Psychological Distress Associated With the COVID-19 Pandemic: A Pilot Randomized Controlled Trial

The potential impact of the COVID-19 pandemic on child growth and development: a systematic review

Physical Exercise Influences Academic Performance and Well-being in Children and Adolescents

Efficacy and Safety of the mRNA-1273 SARS-CoV-2 Vaccine

Survey of stress reactions among health care workers involved with the SARS outbreak

COVID-19 and geriatric population: From pathophysiology to clinical perspectives

A cross-national study of factors associated with women's perinatal mental health and wellbeing during the COVID-19 pandemic

Sinopharm COVID-19 vaccine

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We thank Jamia Hamdard for providing support.

This research did not receive any specific grant from funding agencies in the public, commercial, or not-forprofit sectors. Abrams, E., Ammann, A., Anderson, M., Bernstein, L., Baker, C., 2000. Guidelines for the use of antiretroviral