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Print ISSN: 0973-7510; E-ISSN: 2581-690X

MINI REVIEW ARTICLE OPEN ACCESS

COVID-19, an Emerging Coronavirus Infection: Current

Scenario and Recent Developments – An Overview
Alfonso J. Rodriguez-Morales1,2*, D. Katterine Bonilla-Aldana1,3, Ruchi Tiwari4 ,
Ranjit Sah5, Ali A. Rabaan6 and Kuldeep Dhama7*
1
Public Health and Infection Research Group, Faculty of Health Sciences, Universidad Tecnologica de Pereira,
Pereira, Colombia. 2Grupo de Investigacion Biomedicina, Faculty of Medicine, Fundacion Universitaria Autonoma
de las Americas, Pereira, Risaralda, Colombia. 3Semillero de Zoonosis, Grupo de Investigacion BIOECOS, Fundacion
Universitaria Autonoma de las Americas, Sede Pereira, Pereira, Risaralda, Colombia. 4Department of Veterinary
Microbiology and Immunology, College of Veterinary Sciences, UP Pandit Deen Dayal Upadhayay Pashu Chikitsa
Vigyan Vishwavidyalay Evum Go-Anusandhan Sansthan (DUVASU), Mathura - 281 001, Uttar Pradesh, India.
5
Department of Microbiology, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal.
6
Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran, Saudi Arabia. 7Division of Pathology,
ICAR-Indian Veterinary Research Institute, Izatnagar - 243 122, Bareilly, Uttar Pradesh, India.

ABSTRACT
During December 2019, a novel coronavirus virus (2019-nCov) emerged in China, which posed an
International Public Health Emergency in a couple of weeks, and very recently attained the position of
a very high-risk category by World Health Organization (WHO). This virus was named the Severe Acute
Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) by the International Committee on Taxonomy of
Viruses (ICTV), and the disease referred to as Coronavirus Disease-19 (COVID-19). Till March 8, 2020,
the virus has claimed the lives of nearly 3,600 humans out a total of approximately 110,000 confirmed
cases affected by this infection. The present editorial is a brief overview highlighting the most salient
features and facts with regards to COVID-19, an emerging coronavirus infection, its causative virus
(SARS-CoV-2), the current worldwide scenario, recent developments and currently ongoing progresses
to contain and control this disease which have now spread to more than 100 countries across the globe.
Of note, worldwide researchers and various health agencies are all together doing their best to halt
the spread of this virus and avoid any possible pandemic situation to be faced, which otherwise would
threaten the lives of millions of human beings.
Keywords: COVID-19, SARS-CoV-2, current situation, recent developments, prevention, control.

*Correspondence: [email protected]; [email protected]

(Received: 10 March 2019; accepted: 10 March 2020)

Citation: Alfonso J. Rodriguez-Morales, D. Katterine Bonilla-Aldana, Ruchi Tiwari, Ranjit Sah, Ali A. Rabaan, Kuldeep Dhama,
COVID-19, an Emerging Coronavirus Infection: Current Scenario and Recent Developments – An Overview, J. Pure Appl. Microbiol.,
2020; 14(1):.
© The Author(s) 2020. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License which
permits unrestricted use, sharing, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and
the source, provide a link to the Creative Commons license, and indicate if changes were made.

Journal of Pure and Applied Microbiology 1 www.microbiologyjournal.org

Rodriguez-Morales et al. J. Pure Appl. Microbiol., 14(1), | March 2020 |

INTRODUCTION receptors present in the body of animals (bats,

Coronaviruses are continually evolving. rodents, civets, cats, Malayan pangolins, camels,
Examples include the Severe Acute Respiratory among other potentially competent hosts) and
Syndrome (SARS) and the Middle East Respiratory humans21-23. Modifications at the level of spikes
Syndrome (MERS) that caused fatal outbreaks on receptor binding ligands are responsible for
earlier, and now the present emerging Coronavirus zoonotic spillover and crossing of the species
Diseases 2019 (COVID-19), caused by the SARS- barrier. As per high genomic similarities, it is
2 Coronavirus (SARS-CoV-2), initially expressed suggested that SARS-CoV-2 producing COVID-19
as pneumonia of unknown origin, thus posing in humans has its origin from bats as bats acted
a significant threat to public health across the as natural ancestral host24-28. Scanning electron
globe1-3. COVID-19 has represented a high negative microscopy, transmission electron microscopy,
impact on the economy of China as well as a few and cryo-electron microscopic images of the
other nations4,5. The lessons from such earlier structure of the SARS-CoV-2 confirmed the change
threats of SARS, MERS and of the current COVID-19 in spike glycoprotein of SARS coronavirus-229. In
situations need to be kept in mind for formulating the Coronaviridae family, seven viruses affect
plans for countering such and other emerging and mainly human beings, four producing mild
zoonotic pathogens that could pose pandemic respiratory illness, while three including- SARS-
threats while putting human lives at bay6. CoV-1, MERS, and current SARS-CoV-2 were
Current Scenario dangerous as produced epidemics. ICTV named
After its initial emergence in Wuhan, this pneumonia-causing virus as SARS-CoV-2
China,during December month of the year 2019, instead of 2019-nCoV as genetic studies revealed
this novel emerging CoV was included under the the similarity between SARS (2002-2003 severe
Public Health International Emergency category acute respiratory syndrome outbreak) coronavirus
on January 30, 20207,8. Besides affecting mainly and COVID-19 producing coronavirus30. Genomic
China, SARS-CoV-2/COVID-19 has now spread to studies indicated that there is a difference
more than 100 countries (9). Out of cumulative of merely five nucleotides in between SARS
111,354 confirmed cases, 3,892 human deaths coronavirus and SARS-CoV-2 and emphasized
have been documented as of March 9, 202010,11. that 2019-nCoV has emerged from SARS CoV31.
Due to such a quick jump with regards to the SARS-CoV-2 can be transmitted from animal to
total number of confirmed SARS-CoV-2 infected person or person to person via airborne particles/
persons as well as affecting several countries in a drops. The virus infects type 2 pneumocytes
short time interval, the WHO designated it under and ciliated bronchial epithelial cells through
a very high-risk category. Few of the reports have ACE2 receptors 18,32. The virus can be transmitted
mentioned the possibility of probable pandemic through respiratory droplets, tears, and body fluids
risks and threats with the bloom. They loom in if exposed to the mucous membranes of the eyes,
rapidly increasing cases of COVID-19, alarming mouth, or nose. Other transmission modes are yet
us to put very high efforts to check the spread to be further elucidated if so.
of this widely circulating virus among world The Disease (COVID-19)
population by following appropriate prevention COVID-19 is the third CoV outbreak in
and control measures along with formulating humans that occurred in last two decades, causing
global solutions and modified strategies with clinical manifestations of respiratory, digestive,
future perspectives12-19. and systematic affections, mainly expressed by
The Virus (SARS-CoV-2 ) pnemonia33,34. The case fatality rate is around
The SARS-CoV-2 is an enveloped, spherical 2-3%, but severely affected patients may die due
shape, single-stranded plus sense RNA virus with to excessive alveolar damage, which leads to
helical symmetry belonging to beta coronaviruses progressive respiratory failure as evident from
of Coronaviridae20. The virus has peplomers made many countries including Italy and China35. Due
up of glycoprotein projected over the envelope to close contact, few persons may remain as
in a manner of crown (hence named corona), asymptomatic carriers without manifesting any
and these spike proteins help in binding with clinical symptoms of cold, fever, fatigue or lung
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 Rodriguez-Morales et al. J. Pure Appl. Microbiol., 14(1), | March 2020 |

pathology. As competent carrier they can shed body parts are also used. As bats are employed as
virus till 21 days of period to other persons who materia medica, so we can not deny the probability
will come in contact to them36. Initial symptoms of zoonotic spillover through bats24,28. By involving
include fever, mild chills, dry cough, fatigue intermediate hosts (bridge hosts), SARS-CoV-2/
and shortness of breath, severe respiratory 2019-nCoV attained altered pathogenicity and
distress, pulmonary pneumonia, which worsen enhanced transmissibility through modified
if timely not diagnosed and not appropriately receptor binding domain (RBD)2,18,26,49-57.
medicated 37. As lung inflammation advances Diagnosis
hypoxemia triggers and to compensate shortness For prompt diagnosis of SARS-CoV-2,
of breath, sometimes cardiac arrest takes place, molecular tools are widely preferred 58-62 .
and hence patient sinks. Therefore, it is advised Serological diagnosis is not of much help at the
as soon as symptoms of dry cough and fever peak of the epidemic, though serum samples
begin to appear, consult a medical practitioner of recovered patients can be tested to know
to prevent further pathology within the body38. the titer of IgG. In severely infected patients,
Histological examination performed over biopsy computed tomography technique (CT) and X-Ray
tissues obtained from lung, liver, and heart tissue can be of help to observe the lesions of pulmonary
elaborated detailed picture of desquamation of pneumonia in the lungs in correlation with clinical
pneumocytes, the formation of hyaline membrane, symptoms to depict the picture of COVID-1937.
bilateral diffused alveolar damage, presence of For the diagnosis of exposed but asymptomatic
cellular fibromyxoidexudate. As marked cytopathic carriers, detection of viral nucleic acid (RNA) is of
effects, multi nucleated syncytial cells along with pertinent help, and by using pharyngeal swab the
atypical enlarged pneumocytes and interstitial viral RNA can be detected, such carriers should
mononuclear inflammatory infiltrates with the be kept in isolation to prevent the transmission
majority of lymphocytes in the affected lungs are and spread risk25,36. Most popularly, real-time
prominent features39. RT-PCR (rRT-qPCR) is performed over respiratory
Zoonotic links secretions so that within a short period, viral
Recently, few of the reports have RNA can be detected63. Researchers have also
highlighted the role of animals, veterinary, cross- developed a reverse transcriptional loop-mediated
species jumping, zoonotic links and spillover isothermal amplification (RT-LAMP) diagnostic
events of SARS-CoV-2 and its transmission to technique for rapid and colorimetric detection
humans, before acquiring human to human of COVID-19 coronavirus. This isothermal LAMP-
transmission, as have been implicated with SARS based method for COVID-19 detection is referred
and MERS2,6,40-46. Atypical exposure point of SARS- to as iLACO. In this technique, a fragment of the
CoV-2 has pointed out towards the implication of ORF1ab gene was amplified by using six primers,
seafood market in Wuhan, China47, as a wet-market and phenol red are used as a pH indicator when
that sells different kinds of poultry, bats, snakes, amplification takes place color changes from pink
marmots and other wildlife animals for human to light yellow. At the same time, in negative cases,
consumption at a single place, that can act as it remains pink64. In addition to that, multiple
hot spot acting as a human-animal interphase/ reference laboratories are progressing sequencing
interaction event, where zoonotic viruses can jump the complete genome from the rRT-PCR positive
to cross-species barrier-or spillover to humans isolates.
through seafood tanks, presence of live-dead Therapeutics/Drugs and Vaccines
animals body fluids, blood, excretion or air born As infected individuals are hospitalized,
mode of transmission leading to the emergence of human patients should immediately be given
novel pathogens such as SARS-COV-2 and others48. symptomatic and supportive treatment as
Still in some parts of world, western medicines are per severity of symptoms65,66. Therapy may be
not much popular or in practice and people yet comprised of supplementary oxygen or high-flow
rely on using traditional medicines which uses not nasal cannula (HFNC) oxygen therapy through
only various herbs but bat saliva, dung and other nasal route to reduce breathing stress if needed

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Rodriguez-Morales et al. J. Pure Appl. Microbiol., 14(1), | March 2020 |

methylprednisolone intravenously to correct or prefer to use sanitizers, should remain inside

hypoxemia and in extreme cases adrenaline by home, should refrain from crowded places and
intravenous route (IV), any repurposed drug avoid contacts with live-dead animals especially
such as lopinavir plus ritonavir as anti-viral drug wild animals, children, and older adults must take
by oral way, moxifloxacin or any antibiotic to precautions as they are more prone to the severe
prevent secondary bacterial infection by IM/IV respiratory distress syndrome of COVID-1987. If
route37,65. Nevertheless, multiple drugs are under people presents respiratory symptoms should wear
study, including other antiretrovirals, such as is face mask in order to avoid further transmission
the case of remdesevir, but also antivirals such to other susceptible people. China has forced
as oseltamivir and other therapies, including a temporary ban on the sale of wild animals in
chloroquine and even indomethacin. Researchers Wuhan animal market and planning to forbid the
are making high efforts to design and develop wildlife trading permanently88.
suitable vaccines for COVID-19, which may Indeed, considering previous experiences
take some time2,67-69. In this context, efficient of edidemics and pandemics in different regions
management of COVID-19 pneumonia by active of the world, with other emerging infectious
prevention and control in a scientific manner is diseases, as the case of SARS, MERS16,27, but also
of utmost importance following the national and swine flu and avian flu, Ebola, Nipah, Chikungunya
international developed guidelines70. and Zika2,67-69,89-91, health authorities and healthcare
Prevention and Control providers including hospitals must apply the
It is imperative to prevent the spark learned experiences on previous epidemics
(origin at the new place) and spread (transmission and pandemics to frame some implementable
between susceptible and infected) risk both to protective strategies14,16,92-95. That includes the
avoid the conversion of COVID-19 epidemic to rational use of quarantine and appropriate disease
pandemic and for this purpose rigorous surveillance prevention, management and control procedures
screening should be done to know-how the pattern to be timely implemented15,19,70,96. Besides all the,
of emerging zoonotic epidemics71,72. Individual One health approach also need due attention for
protection and community protection both need prevention and control of this disease and other
to be robust. World Health Organization (WHO), probable future epidemics2,50-52,67-69,97.
Centre for Disease Control and Prevention (CDC)
and Food and Agriculture Organization (FAO) have CONCLUSIONS AND FUTURE PROSPECTS
issued instruction and COVID-19 containment Worldwide scientists, researchers, and
strategies for the ordinary people, clinicians, various health agencies are working days and
travelers and for infected patients to follow so nights with very high efforts to stop the further
that transmission to healthy population can be transmission and spread of SARS-CoV-2 by
prevented11,73-79. It is advised to share awareness following strict vigilance, intervention strategies,
programs through social networking sites and heightened prevention and control policies,
platforms and follow intense epidemiological and are in a race to fight COVID-19 by designing
surveillance so that any new case (symptomatic appropriate vaccines and therapeutics to keep
and asymptomatic both) of COVID-19 can be away any pandemic situation which may arise
notified to WHO80-82. Epidemiological screening otherwise if this virus could not be halted. Although
of bat CoVs should be done at large global scale that many aspects, derived from the research, are
to have a datasheet which will be a pathfinder still to be developed, as is the case that facing the
for newly emerging and re-emerging zoonotic pandemic of COVID-19 many elements in certain
pathogens83. The governments should encourage age groups, as occurs in pediatricis not year
travelers to postpone their tours to avoid exposure clear14,98. Finally, One health approach would play
to COVID-19 affected countries and those who an essential role in combatting COVID-19 as well
are returning back from affected countries must as such diseases in the future. That is not a magic
be isolated and quarantined for health check-ups bullet, but yes, the world needs global solutions
and evaluation of their health status5,54-57,84-86. to prevent still or mitigate a pandemic19.
People should wash their hands with soap-water
Journal of Pure and Applied Microbiology 4 www.microbiologyjournal.org
 Rodriguez-Morales et al. J. Pure Appl. Microbiol., 14(1), | March 2020 |

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