corona is culprit of ridiculous offensive nonsense air

www.wjpr.net Vol 9, Issue 4, 2020.

Sen et al. World Journal of Pharmaceutical Research

503

CORONA IS CULPRIT OF RIDICULOUS OFFENSIVE NONSENSE AIR

1*Dr. Dhrubo Jyoti Sen,

2Dr. Sudip Kumar Mandal,

1Arpita Biswas,

3Dipra Dastider and

1Dr. Beduin Mahanti

1Department of Pharmaceutical Chemistry, School of Pharmacy, Techno India University,

Salt Lake City, Sector-V, EM-4, Kolkata-700091, West Bengal, India.

2Dr. B. C. Roy College of Pharmacy and A.H.S, Dr. Meghnad Saha Sarani, Bidhan Nagar,

Durgapur-713206, West Bengal, India.

3Department of Pharmaceutical Technology, Brainware University, 398-Ramkrishnapur

Road, Barasat, Kolkata-700125, West Bengal, India.

ABSTRACT

Coronaviruses (CoV) are a large family of viruses that cause illness

ranging from the common cold to more severe diseases such as Middle

East Respiratory Syndrome (MERS-CoV) and Severe Acute

Respiratory Syndrome (SARS-CoV). A novel coronavirus (nCoV) is a

new strain that has not been previously identified in humans.

Coronaviruses are zoonotic, meaning they are transmitted between

animals and people. Detailed investigations found that SARS-CoV was

transmitted from civet cats to humans and MERS-CoV from dromedary

camels to humans. Several known coronaviruses are circulating in

animals that have not yet infected humans. Common signs of infection

include respiratory symptoms, fever, cough, shortness of breath and

breathing difficulties. In more severe cases, infection can cause

pneumonia, severe acute respiratory syndrome, kidney failure and

even death. Standard recommendations to prevent infection spread include regular hand

washing, covering mouth and nose when coughing and sneezing, thoroughly cooking meat

and eggs. Avoid close contact with anyone showing symptoms of respiratory illness such as

coughing and sneezing.

KEYWORDS: Zoonotic, SARS (CoV), MERS (CoV), COVID-19, Alphacoronavirus,

Betacoronavirus, Gammacoronavirus, Deltacoronavirus.

World Journal of Pharmaceutical Research SJIF Impact Factor 8.084

Volume 9, Issue 4, 503-518. Review Article ISSN 2277– 7105

Article Received on

01 Feb. 2020,

Revised on 21 Feb. 2020,

Accepted on 12 March 2020,

DOI: 10.20959/wjpr20204-17117

*Corresponding Author

Prof. Dr. Dhrubo Jyoti Sen

Department of

Pharmaceutical Chemistry,

School of Pharmacy,

Techno India University,

Salt Lake City, Sector-V,

EM-4, Kolkata-700091,

West Bengal, India.



504

Figure-1: Zoonotic disease, WHO chair and origin.

Overview: World Health Organization chief Tedros Adhanom Ghebreyesus said "co"

stands for "corona", "vi" for "virus" and "d" for "disease", while "19" was for the year, as the

outbreak was first identified on 31 December 2019; so it is coined as COVID-19.

Coronavirus has created a Chaos in China. Corona in Latin means Crown. The surface of this

virus also has a series of spikes like crowns. That is where it has got the name Corona. The

2019 Novell Coronavirus has also been renamed as 2019-nCoV. The virus was first

identified in China's Wuhan. Novel has been planted in the name of this coronavirus because

it was never found anywhere before now.[1]

Taxonomy

Realm: Riboviria Subfamily: Orthocoronavirinae

Phylum: incertae sedis Genus: Betacoronavirus

Order: Nidovirales Subgenus: Sarbecovirus

Suborder: Cornidovirineae Species: Severe acute respiratory syndrome related coronavirus

Family: Coronaviridae Individuum: SARS-CoVUrbani, SARS-CoVGZ-02, ARS-CoVPC4-

227, SARSr-CoVBtKY7/2, SARS-CoV-2, Wuhan-Hu-1, SARSr-CoVRatG13

Genera: Alphacoronavirus, Betacoronavirus, Gammacoronavirus, Deltacoronavirus

Synonym: Coronavirinae.

Coronaviruses are a group of viruses that cause diseases in mammals and birds. In humans,

coronaviruses cause respiratory tract infections that are typically mild, such as the common

cold, though rarer forms such as SARS, MERS and COVID-19 can be lethal. Symptoms

vary in other species: in chickens, they cause an upper respiratory tract disease, while in cows

and pigs they cause diarrhea. There are yet to be vaccines or antiviral drugs to prevent or treat

human coronavirus infections.



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Coronaviruses comprise the subfamily Orthocoronavirinae, in the family Coronaviridae,

order Nidovirales and realm Riboviria. They are enveloped viruses with a positive-sense

single-stranded RNA genome and a nucleocapsid of helical symmetry. The genome size of

coronaviruses ranges from approximately 27 to 34 kilobases, the largest among known RNA

viruses. The name coronavirus is derived from the Latin corona, meaning "crown" or "halo",

which refers to the characteristic appearance reminiscent of a crown or a solar corona around

the virions (virus particles) when viewed under two-dimensional transmission electron

microscopy, due to the surface covering in club-shaped protein spikes.[2]

Figure 2: Scanning Electron Micrograph of virion.

Severe acute respiratory syndrome (SARS) is alphacoronavirus a viral respiratory disease

of zoonotic origin caused by the SARS coronavirus (SARS-CoV). Between November 2002

and July 2003, an outbreak of SARS in southern China caused an eventual 8,098 cases,

resulting in 774 deaths reported in 17 countries (9.6% fatality rate) with the majority of cases

in mainland China and Hong Kong. No cases of SARS have been reported worldwide since

2004. In late 2017, Chinese scientists traced the virus through the intermediary of civets to

cave-dwelling horseshoe bats in Yunnan province.

Signs and symptoms: Initial symptoms are flu-like and may include fever, muscle pain,

lethargy symptoms, cough, sore throat and other nonspecific symptoms. The only symptom

common to all patients appears to be a fever above 38°C (100°F). SARS may eventually lead

to shortness of breath and pneumonia; either direct viral pneumonia or secondary bacterial

pneumonia. The dried virus on smooth surfaces retained its viability for over 5 days at

temperatures of 22–25°C and relative humidity of 40–50%, that is, typical air-conditioned

environments. However, virus viability was rapidly lost (>3 log10) at higher temperatures

and higher relative humidity (e.g., 38°C, and relative humidity of >95%).



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The Cause: The primary route of transmission for SARS is contact of the mucous membranes

with respiratory droplets or fomites. Whilst diarrhea is common in people with SARS, the

fecal-oral route does not appear to be a common mode of transmission. The basic

reproduction number of SARS, R0, ranges from 2 to 4 depending on different analyses.

Control measures introduced in April 2003 reduced this down to 0.4. Average incubation

period for SARS is 4–6 days, although rarely it could be as short as 1 day or as long as 14

days.[3]

Figure-3: Viral epidemic.

Diagnosis: SARS may be suspected in a patient who has any of the symptoms, including a

fever of 38°C (100°F) or higher, and either a history of contact (sexual or casual) with

someone with a diagnosis of SARS within the last 10 days or travel to any of the regions

identified by the World Health Organization (WHO) as areas with recent local transmission

of SARS. The appearance of SARS in chest X-rays is not always uniform but generally

appears as an abnormality with patchy infiltrates.

Prevention: There is no vaccine for SARS. Clinical isolation and quarantine remain the most

effective means to prevent the spread of SARS. Other preventive measures include: (a) Hand-

washing (b) Disinfection of surfaces for fomites (c) Avoiding contact with bodily fluids (d)

Washing the personal items of someone with SARS in hot, soapy water (eating utensils,

dishes, bedding, etc.) (e) Keeping children with symptoms home from school.[4]

Simple hygiene measures: Isolating oneself as much as possible to minimize the chances of

transmission of the virus. Many public health interventions were made to try to control the

spread of the disease, which is mainly spread through respiratory droplets in the air. These



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interventions included earlier detection of the disease; isolation of people who are infected;

droplet and contact precautions; and the use of personal protective equipment (PPE),

including masks and isolation gowns. A screening process was also put in place at airports to

monitor air travel to and from affected countries. Although no cases have been identified

since 2004, the CDC is still working to make federal and local rapid response guidelines and

recommendations in the event of a reappearance of the virus.

Treatment: As SARS is a viral disease, antibiotics do not have direct effect, but may be used

against bacterial secondary infection. Treatment of SARS is mainly supportive with

antipyretics, supplemental oxygen and mechanical ventilation as needed. Antiviral

medications are used as well as high doses of steroids to reduce swelling in the lungs. People

with SARS must be isolated, preferably in negative pressure rooms, with complete barrier

nursing precautions taken for any necessary contact with these patients, to limit the chances

of medical personnel getting infected with SARS. In certain cases, natural ventilation by

opening doors and windows are documented to help decreasing indoor concentration of virus

particles. Some of the more serious damage caused by SARS may be due to the body's own

immune system reacting in what is known as cytokine storm. SARS is most infectious in

severely ill patients, which usually occurs during the second week of illness. This delayed

infectious period meant that quarantine was highly effective; people who were isolated before

day five of their illness rarely transmitted the disease to others.[5]

Middle East respiratory syndrome: MERS, also known as camel flu, is a viral respiratory

infection caused by the MERS-coronavirus (MERS-CoV). Symptoms may range from mild

to severe. They include fever, cough, diarrhea and shortness of breath. Disease is typically

more severe in those with other health problems. Mortality is about one-third of diagnosed

cases.

MERS-CoV is a betacoronavirus derived from bats. Camels have been shown to have

antibodies to MERS-CoV but the exact source of infection in camels has not been identified.

Camels are believed to be involved in its spread to humans but it is unclear how. Spread

between humans typically requires close contact with an infected person. Its spread is

uncommon outside of hospitals. Thus, its risk to the global population is currently deemed to

be fairly low.



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Figure-4: MERS virion.

As of 2020 there is no specific vaccine or treatment for the disease; a number of antiviral

medications were being studied. The World Health Organization recommends that those who

come in contact with camels wash their hands frequently and do not touch sick camels and

that camel-based food products be appropriately cooked. Treatments that help with the

symptoms may be given to those infected.

Just under 2000 cases have been reported as of 4 April 2017. About 36% of those who are

diagnosed with the disease die from it. The overall risk of death may be lower as those with

mild symptoms may be undiagnosed. The first identified case occurred in 2012 in Saudi

Arabia and most cases have occurred in the Arabian Peninsula. A strain of MERS-CoV

known as HCoV-EMC/2012 found in the first infected person in London in 2012 was found

to have a 100% match to Egyptian tomb bats. A large outbreak occurred in South Korea in

2015. A further outbreak of MERS was reported in 2018, affecting Saudi Arabia and other

countries (including South Korea) to which infected persons travelled, but from the years

2015–18, the number infected in Saudi Arabia in 2018 was the lowest.[6]

Symptoms: The clinical spectrum of MERS-CoV infection ranges from no symptoms

(asymptomatic) or mild respiratory symptoms to severe acute respiratory disease and death.

A typical presentation of MERS-CoV disease is fever, cough and shortness of breath.

Pneumonia is a common finding, but not always present. Gastrointestinal symptoms,

including diarrhoea, have also been reported. Severe illness can cause respiratory failure that

requires mechanical ventilation and support in an intensive care unit (ICU). The virus appears

to cause more severe disease in older people, people with weakened immune systems and

those with chronic diseases such as renal disease, cancer, chronic lung disease and diabetes.



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Source of the virus: MERS-CoV is a zoonotic virus, which means it is a virus that is

transmitted between animals and people. Studies have shown that humans are infected

through direct or indirect contact with infected dromedary camels. MERS-CoV has been

identified in dromedaries in several countries in the Middle East, Africa and South Asia. The

origins of the virus are not fully understood but, according to the analysis of different virus

genomes, it is believed that it may have originated in bats and was transmitted to camels

sometime in the distant past.[7]

Transmission: Non-human to human transmission: The route of transmission from animals to

humans is not fully understood, but dromedary camels are the major reservoir host for

MERS-CoV and an animal source of infection in humans. Strains of MERS-CoV that are

identical to human strains have been isolated from dromedaries in several countries,

including Egypt, Oman, Qatar and Saudi Arabia.

Figure-5: Dromedary camel and zoonotic region for MERS.

Human-to-human transmission: The virus does not pass easily from person to person unless

there is close contact, such as providing unprotected care to an infected patient. There have

been clusters of cases in healthcare facilities, where human-to-human transmission appears to

have occurred, especially when infection prevention and control practices are inadequate or

inappropriate. Human to human transmission has been limited to date and has been identified

among family members, patients and health care workers. While the majority of MERS cases

have occurred in health care settings, thus far, no sustained human to human transmission has

been documented anywhere in the world.[8]



510

Figure-6: MERS virion and symptoms.

Since 2012, 27 countries have reported cases of MERS including Algeria, Austria, Bahrain,

China, Egypt, France, Germany, Greece, Islamic Republic of Iran, Italy, Jordan, Kuwait,

Lebanon, Malaysia, the Netherlands, Oman, Philippines, Qatar, Republic of Korea, Kingdom

of Saudi Arabia, Thailand, Tunisia, Turkey, United Arab Emirates, United Kingdom, United

States and Yemen.

Approximately 80% of human cases have been reported by Saudi Arabia. What we know is

that people get infected there through unprotected contact with infected dromedary camels or

infected people. Cases identified outside the Middle East are usually traveling people who

were infected in the Middle East and then travelled to areas outside the Middle East. On rare

occasions, outbreaks have occurred in areas outside the Middle East.[9]

Prevention and treatment: No vaccine or specific treatment is currently available, however

several MERS-CoV specific vaccines and treatments are in development. Treatment is

supportive and based on the patient’s clinical condition.

As a general precaution, anyone visiting farms, markets, barns, or other places where

dromedary camels and other animals are present should practice general hygiene measures,

including regular hand washing before and after touching animals and should avoid contact

with sick animals. The consumption of raw or undercooked animal products, including milk

and meat, carries a high risk of infection from a variety of organisms that might cause disease

in humans. Animal products that are processed appropriately through cooking or

pasteurization are safe for consumption, but should also be handled with care to avoid cross

contamination with uncooked foods. Camel meat and camel milk are nutritious products that

can continue to be consumed after pasteurization, cooking, or other heat treatments. Until



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more is understood about MERS-CoV, people with diabetes, renal failure, chronic lung

disease and immunocompromised persons are considered to be at high risk of severe disease

from MERS-CoV infection. These people should avoid contact with camels, drinking raw

camel milk or camel urine, or eating meat that has not been properly cooked.[10]

Health-care facilities: Transmission of the virus has occurred in health‐care facilities in

several countries, including from patients to health‐care providers and between patients in a

health care setting before MERS-CoV was diagnosed. It is not always possible to identify

patients with MERS‐CoV early or without testing because symptoms and other clinical

features may be non‐specific.

Coronavirus syndrome 2019 (COVID-19) is an infectious disease (gammacoronavirus

and deltacoronavirus) caused by severe acute respiratory syndrome coronavirus 2 (SARS

coronavirus 2, or SARS-CoV-2), a virus closely related to the SARS virus. The disease was

discovered and named during the 2019–20 coronavirus outbreak. Those affected may develop

a fever, dry cough, fatigue and shortness of breath. A sore throat, runny nose or sneezing is

less common. While the majority of cases result in mild symptoms, some can progress to

pneumonia and multi-organ failure. The infection is spread from one person to others via

respiratory droplets produced from the airways, often during coughing or sneezing. Time

from exposure to onset of symptoms is generally between 2 and 14 days, with an average of 5

days. The standard method of diagnosis is by reverse transcription polymerase chain reaction

(rRT-PCR) from a nasopharyngeal swab or sputum sample, with results within a few hours to

2 days. Antibody assays can also be used, using a blood serum sample, with results within a

few days. The infection can also be diagnosed from a combination of symptoms, risk factors

and a chest CT scan showing features of pneumonia.[11-13]

Figure-7: Coronavirus symptoms.



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Correct handwashing technique, maintaining distance from people who are coughing and not

touching one's face with unwashed hands are measures recommended to prevent the disease.

It is also recommended to cover one's nose and mouth with a tissue or a bent elbow when

coughing. Those who suspect they carry the virus are recommended to wear a surgical face

mask and seek medical advice by calling a doctor rather than visiting a clinic in person.

Masks are also recommended for those who are taking care of someone with a suspected

infection but not for the general public. There is no vaccine or specific antiviral treatment,

with management involving treatment of symptoms, supportive care and experimental

measures. The case fatality rate is estimated at between 1% and 3%.

Sign and Symptoms: Those infected may either be asymptomatic or develop symptoms

including fever, cough and shortness of breath. Diarrhea or upper respiratory symptoms (e.g.

sneezing, runny nose, sore throat) are less frequent. Cases can progress to pneumonia, multi-

organ failure, and death in the most vulnerable. The incubation period ranges from 1 to 14

days with an estimated median incubation period of 5 to 6 days according to the World

Health Organization (WHO). Another study of 1,099 Chinese patients found that CT scans

showed ground-glass opacities in 56% of patients, but 18% had no radiological findings. 5%

of patients were admitted to intensive care units, 2.3% needed mechanical support of

ventilation, and 1.4% died. Bilateral and peripheral ground glass opacities are the most

typical CT findings, according to researcher Bernheim et al. Consolidation, linear opacities,

reverse halo sign are other radiological findings. Initially the lesions are located to one lung,

but as the disease progress, indications manifest to both lungs in 88% of patients. Children

seem to handle the disease better than adults as the symptoms are usually milder, but

sufficient evidence is still lacking.[14-16]

Cause: The disease is caused by the virus severe acute respiratory syndrome coronavirus 2

(SARS-CoV-2), previously referred to as the 2019 novel coronavirus (2019-nCoV). It is

primarily spread between people via respiratory droplets from coughs and sneezes. The virus

is thought to have an animal origin. Τhere has been a "continuous common source" of the

outbreak in December 2019, which would imply that several animal-to-human zoonotic

events occurred at the Huanan Seafood Wholesale Market. The primary source of infection

became human-to-human transmission in early January 2020.

Pathology: Histopathological examinations of post-mortem lung samples showed diffuse

alveolar damage with cellular fibromyxoid exudates in both lungs. Viral cytopathic changes



513

were observed in the pneumocytes. The lung picture resembled acute respiratory distress

syndrome (ARDS).

Diagnosis: The WHO has published several testing protocols for the disease. The standard

method of testing is real time reverse transcription polymerase chain reaction (rRT-PCR).

The test can be done on respiratory samples obtained by various methods, including

nasopharyngeal swab or sputum sample. Results are generally available within a few hours to

2 days. Blood tests can be used, but these require two blood samples taken two weeks apart

and the results have little immediate value. Chinese scientists were able to isolate a strain of

the coronavirus and publish the genetic sequence so that laboratories across the world could

independently develop polymerase chain reaction (PCR) tests to detect infection by the virus.

COVID-19 testing can also be done with antibody test kits. Antibody assays use a blood

serum sample and can provide a positive result even if the person has recovered and the virus

is no longer present. The first antibody test was demonstrated by a team at the Wuhan

Institute of Virology on 17 February 2020. On 25 February, a team from Duke–NUS Medical

School in Singapore announced another antibody test for COVID-19 that can provide a result

within a few days.[17-19]

Figure 8: Coronavirus precautionary measures.

Prevention: Global health organizations have published preventive measures to reduce the

chances of infection in locations with an outbreak of the disease. Recommendations are

similar to those published for other coronaviruses: stay home, avoid travel and public

activities, wash hands with soap and hot water often, practice good respiratory hygiene and



514

avoid touching the eyes, nose, or mouth with unwashed hands. According to the WHO, the

use of masks is recommended if a person is coughing or sneezing or when one is taking care

of someone with a suspected infection. To prevent transmission of the virus, the Centers for

Disease Control and Prevention (CDC) recommends that infected individuals stay at home

except to get medical care, call ahead before visiting a healthcare provider, wear a face mask

(especially in public), cover coughs and sneezes with a tissue, regularly wash hands with soap

and water, and avoid sharing personal household items. The CDC recommended that

individuals wash hands often with soap and water for at least 20 seconds, especially after

going to the toilet or when hands are visibly dirty, before eating, and after blowing one's

nose, coughing, or sneezing. It further recommended using an alcohol-based hand sanitizer

with at least 60% alcohol, but only when soap and water are not readily available. The WHO

advises individuals to avoid touching the eyes, nose, or mouth with unwashed hands.[20-22]

Coronavirus therapy

Antiviral: No drug has yet been approved to treat coronavirus infections in humans.

Research into potential treatments for the disease was initiated in January 2020 and several

antiviral drugs are already in clinical trials. Although completely new drugs may take until

2021 to develop, several of the drugs being tested are already approved for other antiviral

indications, or are already in advanced testing. Antivirals being tested include chloroquine,

darunavir, galidesivir, interferon beta, the lopinavir/ritonavir combination, the RNA

polymerase inhibitor remdesivir and triazavirin. Umifenovir (Arbidol) and darunavir were

proposed by the National Health Commission. Remdesivir and chloroquine effectively inhibit

the coronavirus in-vitro.[23,24]

CONCLUSION

Common human coronaviruses, including types 229E, NL63, OC43 and HKU1, usually

cause mild to moderate upper-respiratory tract illnesses, like the common cold. Most people

get infected with one or more of these viruses at some point in their lives. Symptoms of

common human coronaviruses: (1) runny nose (2) sore throat (3) headache (4) fever (5)

cough (6) general feeling of being unwell. Human coronaviruses can sometimes cause lower-

respiratory tract illnesses, such as pneumonia or bronchitis. This is more common in people

with cardiopulmonary disease, people with weakened immune systems, infants, and older

adults.



515

Common human coronaviruses usually spread from an infected person to others through: (1)

the air by coughing and sneezing (2) close personal contact, like touching or shaking hands

(3) touching an object or surface with the virus on it, then touching your mouth, nose, or eyes

before washing your hands.

In the United States, people usually get infected with common human coronaviruses in the

fall and winter, but you can get infected at any time of the year. Young children are most

likely to get infected, but people can have multiple infections in their lifetime.

Protect yourself from getting sick: (1) wash your hands often with soap and water for at least

20 seconds (2) avoid touching your eyes, nose, or mouth with unwashed hands (3) avoid

close contact with people who are sick.

Protect others when you are sick: (1) stay home while you are sick (2) avoid close contact

with others (3) cover your mouth and nose when coughing or sneezing (3) clean and disinfect

objects and surfaces.

There is no vaccine to protect you against human coronaviruses and there are no specific

treatments for illnesses caused by human coronaviruses. Most people with common human

coronavirus illness will recover on their own. However, to relieve your symptoms you can:

(1) take pain and fever medications (Caution: do not give aspirin to children) (2) use a room

humidifier or take a hot shower to help ease (3) a sore throat and cough (3) drink plenty of

liquids (4) stay home and rest. If you are concerned about your symptoms, contact your

healthcare provider.

Testing for common human coronaviruses

Sometimes, respiratory secretions are tested to figure out which specific germ is causing your

symptoms.

If you are found to be infected with a common coronavirus (229E, NL63, OC43, and

HKU1), that does not mean you are infected with the 2019 novel coronavirus.

There are different tests to determine if you are infected with 2019 novel coronavirus.

Your healthcare provider can determine if you should be tested.

CORONA

C: Clean your hands, O: Off from gatherings, R: Raise your immunity, O: Only think to wear

mask, N: No to hand shake, A: Avoid large crowds.



516

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