• KRISHNANJANA S. NAIR Department ofPharmaceutical Chemistry and Analysis, Amrita School of Pharmacy, Amrita VishwaVidyapeetham, AIMS Health SciencesCampus, Kochi 682041,Kerala, India
  • SHIVALI KAMATH Department ofPharmaceutical Chemistry and Analysis, Amrita School of Pharmacy, Amrita VishwaVidyapeetham, AIMS Health SciencesCampus, Kochi 682041,Kerala, India
  • ARYA RAJAN Department ofPharmaceutical Chemistry and Analysis, Amrita School of Pharmacy, Amrita VishwaVidyapeetham, AIMS Health SciencesCampus, Kochi 682041,Kerala, India
  • SACHIN THOMAS Department ofPharmaceutical Chemistry and Analysis, Amrita School of Pharmacy, Amrita VishwaVidyapeetham, AIMS Health SciencesCampus, Kochi 682041,Kerala, India
  • ASWIN D. Department ofPharmaceutical Chemistry and Analysis, Amrita School of Pharmacy, Amrita VishwaVidyapeetham, AIMS Health SciencesCampus, Kochi 682041,Kerala, India
  • SUBIN MARY ZACHARIAH Department ofPharmaceutical Chemistry and Analysis, Amrita School of Pharmacy, Amrita VishwaVidyapeetham, AIMS Health SciencesCampus, Kochi 682041,Kerala, India


In December 2019, a rare case of pneumonia was reported in Wuhan, China. This was later analyzed and known to have similar characteristics as viral pneumonia caused by a novel coronavirus. Later, on 11 February 2020, the World Health Organization (WHO) officially named the disease as COVID19. The Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) ought to taint both the upper respiratory tract and the lower respiratory tract. This COVID-19 is spreading quickly with an immense rise in cases around the world. This infection's mechanism stays obscure, and the medications explicit for the infection were not grown at this point. Infection is highly contagious. Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2) is one of seven kinds of crown infection, including the one which causes severe maladies like Middle East respiratory disorder (MERS) and abrupt, intense respiratory syndrome(SARS). Since its revelation, the infection has spread and has caused anxiety and fear among people. Recent vaccines are tracked, and clinical trials can bring an immediate protocol on a medication approach. By including different therapeutic approaches, it is easier to combat the disease quickly. With very low mortality and high transmission rate, new approaches to vaccines and nanomedicines bring down the spread. Controlled patient care is also crucial. On 11 March, the World Health Organization (WHO) declared the disease as 'global pandemic’. COVID-19, therefore, poses a significant threat to global public health.

This article reviews the epidemiology, pathogenesis, and diagnostic methods. The review also focuses on repurposed drugs, traced vaccines, and a quick view of prophylactic nanomedicines as an alternative for COVID 19. For this review, the complete database has been collected from various search engines such as PubMed, ScienceDirect, Scopus, Elsevier, etc., from the year 2001-2020 using the following keywords.

Keywords: SARS-CoV-2, Covid-19, Infectious disease, Serology, Vaccine, Repurposing/repositioning drugs, Global pandemic, Cytokine storm, Pneumonia, Lung injury


1. Yang CJ, Chen TC, Chen YH. The preventive strategies of community hospitals in the battle of fighting pandemic COVID-19 in Taiwan. J MicrobiolImmunol Infect 2020;53:381-3.
2. Wu JT, Leung K, Bushman M, Kishore N, Niehus R, de Salazar PM, et al. Estimating clinical severity of COVID-19 from the transmission dynamics in Wuhan, China. Nat Med 2020;26:506-10.
3. Zhong NS, Zheng BJ, Li YM, Poon LLM, Xie ZH, Chan KH, et al. Epidemiology and cause of severe acute respiratory syndrome (SARS) in guangdong, people's republic of China. Lancet 2003;362:1353-8.
4. Wang N, Shi X, Jiang L, Zhang S, Wang D, Tong P, et al. Structure of MERS-CoV spike receptor-binding domain complexed with human receptor DPP4.Cell Res2013;23:986-93.
5. Paden C, Yusof M, Al Hammadi Z, Queen K, Tao Y, Eltahir Y, et al. Zoonotic origin and transmission of Middle East respiratory syndrome coronavirus in the UAE. Zoonoses Public Health 2018;65:322-33.
6. Gralinski LE, Menachery VD. Return of the coronavirus: 2019-nCoV. Viruses 2020;12:135.
7. Shereen MA, Khan S, Kazmi A, Bashir N, Siddique R. COVID-19 infection: origin, transmission, and characteristics of human coronaviruses.J Adv Res 2020;24:91-8.
8. Yu WB, Tang GD, Zhang L, Corlett RT. Decoding evolution and transmissions of novel pneumonia coronavirus using the whole genomic data.J Zool Res 2020;41:247-57.
9. Perlow RA, Broyde S. Evading the proofreading machinery of replicative DNA polymerase: Induction of mutation by an environmental carcinogen. J MolBiol 2001;309:519-36.
10. Liu J, Liao X, Qian S, Yuan J, Wang F, Liu Y,et al. Community transmission of severe acute respiratory syndrome coronavirus 2, Shenzhen, China. Emerging Infect Dis 2020;26:1320-3.
11. Emanuel Goldman. Exaggerated risk of transmission of COVID-19 by fomites. Lancet Infect Dis 2020;20:892-3.
12. Van DN, Bushmaker T, Morris DH, Holbrook MG, Gamble A, Williamson BN, et al. Aerosol and surface stability of SARS-CoV-2 as compared with SARS-CoV-1. N Engl J Med 2020;382:1564-7.
13. Bansal M, Walia MK. Covid 19-an overview on epidemiology, symptoms, prevention, management, treatment, and role of health workers. Int J Appl Pharm 2020;12:36-41.
14. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395:497-506.
15. Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: summary of a report of 72?314 cases from the chinesecenter for disease control and prevention. J Am Med Assoc 2020;323:1239-42.
16. Pan Y, Zhang D, Yang P, Poon LLM, Wang Q. Viral load of SARS-CoV-2 in clinical samples. Lancet Infect Dis 2020;20:411-2.
17. Zou L, Ruan F, Huang M, Liang L, Huang H, Hong Z, et al. SARS-CoV-2 viral load in upper respiratory specimens of infected patients. N Engl J Med 2020;382:1177-9.
18. Shi X, Gong E, Gao D, Zhang B, Zheng J, Gao Z, et al. Severe acute respiratory syndrome-associated coronavirus is detected in intestinal tissues of fatal cases. Am J Gastroenterol2005;100:169-76.
19. Zhang W, Du RH, Li B, Zheng XS, Yang XL, Hu B, et al. Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes.Emerging Microbes Infect 2020;9:386-9.
20. To KK,Tsang OT, Leung WS, Tam AR, Wu TC, Lung DC, et al. Temporal profiles of viral load in posterior oropharyngeal saliva samples and serum antibody responses during infection by SARS-CoV-2:an observational cohort study. Lancet Infect Dis 2020;20:565-74.
21. Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis 2020;20:689-96.
22. Channappanavar R, Zhao J, Perlman S. T cell-mediated immune response to respiratory coronaviruses. Immunome Res 2014;59:118-28.
23. Rabi FA, Al Zoubi MS, Kasasbeh GA, Salameh DM, Al-Nasser AD. SARS-CoV-2 and Coronavirus disease. Pathogens 2019;9:231.
24. Bosch BJ, van der Zee R, de Haan CA, Rottier PJ. The coronavirus spike protein is a class I virus fusion protein: structural and functional characterization of the fusion core complex. J Virol 2003;77:8801-11.
25. Baby B, Devan AR, Nair B, Nath LR. The impetus of COVID-19 in multiple organ affliction apart from respiratory infection: pathogenesis, diagnostic measures and current treatment strategy. Infect Disord Drug Targets 2020. DOI:10.2174/1871526520999200905115050.
26. Sims AC, Baric RS, Yount B, Burkett SE, Collins PL, Pickles RJ. Severe acute respiratory syndrome coronavirus infection of human ciliated airway epithelia: role of ciliated cells in viral spread in the conducting airways of the lungs. J Virol 2005;79:15511-24.
27. Ou X, Liu Y, Lei X, Li P, Mi D, Ren L, et al. Characterization of spike glycoprotein of SARS-CoV-2 on virus entry and its immune cross-reactivity with SARS-CoV. Nat Commun 2020;11:1620.
28. Tang NL, Chan PK, Wong CK, To KF, Wu AL, Sung YM, et al. Early enhanced expression of interferon-inducible protein-10 (CXCL-10) and other chemokines predicts adverse outcome in severe acute respiratory syndrome. ClinChem 2005;51:2333-40.
29. Mossel EC, Wang J, Jeffers S, Edeen KE, Wang S, Cosgrove GP, et al. SARS-CoV replicates in primary human alveolar type II cell cultures but not in type I-like cells. Virology 2008;372:127-35.
30. Zhou Y, Fu B, Zheng X, Wang D, Zhao C, Qi Y, et al.Pathogenic T cells and inflammatory monocytes incite inflammatory storm in severe COVID-19 patients. NatlSci Rev 2020;7:998-1002.
31. Tan M, Liu Y, Zhou R, Deng X, Li F, Liang K, et al.Immunopathological characteristics of coronavirus disease 2019 cases in Guangzhou, China. SciImmunol 2020;160:261-8.
32. Babu BM. Drug repurposing and its implication in therapy: an overview. Int J Res Pharm Sci 2020;2:4418-23.
33. Atlay O, Mohammadi E, Lam S, Turkez H, Boren J, Nielsen J, et al.Current status of COVID-19 therapies and drug repositioning applications. iScience 2020;23:101303.
34. Wang M, Cao R, Zhang L, Yang X, Liu J, Xu M,et al.Remdesivir and chloroquine effectively inhibit the recently emerged novel coronavirus (2019-nCoV) in vitro. Cell Res 2020;30:269-71.
35. Shrivastava A. Analytical methods for the determination of hydroxychloroquine in various matrices.Int J Appl Pharm 2020:12:55-61.
36. Gupta R, Ghosh A, Singh AK, Misra A. Clinical considerations for patients with diabetes in times of COVID-19 epidemic. Diabetes MetabSyndr 2020;14:212-2.
37. Colson P, Rolain JM, Lagier JC, Brouqui P, Raoult D. Chloroquine and hydroxychloroquine as available weapons to fight COVID-19. Int J Antimicrob Agents 2020;55:105932.
38. Gao J, Tian Z, Yang X. Breakthrough: chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Biosci Trends 2020;14:72-3.
39. Mason JW. Antimicrobials and QT prolongation. J AntimicrobChemother2017;72:1272-4.
40. Touret F, de Lamballerie X. Of chloroquine and COVID-19. Antivirl Res 2020;177:104762.
41. Muramatsu T, Takemoto C, Kim YT, Wang H, Nishii W, Terada T, et al.SARS-CoV 3CL protease cleaves its C-terminal autoprocessing site by novel subsitecooperativity.ProcNatlAcadSci 2016;113:12997-300.
42. Ortega JT, Serrano ML,Pujol FH, Rangel HF. Role of changes in SARS-CoV-2 spike protein in the interaction with the human ACE2 receptor: an in silico analysis.ExpClinToxicokinet2020;19:410-7.
43. Chu CM, Cheng VC, Hung IF, Wong MML, Chan KH, Kao RYT, et al. Role of lopinavir/ritonavir in the treatment of SARS: initial virological and clinical findings. Thorax 2004;59:252-6.
44. Cao B, Wang M, Wen D, Wang J, Fan G, Ruan L et al. A Trial of lopinavir-ritonavir in adults hospitalized with severe covid-19. N Engl J Med 2020;382:1787-99.
45. Hoffmann M, KleineWeber H, Schroeder S, Krüger N, Herrler T, Erichsen S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell 2020;181:271-80.
46. Sungnak W, Huang N, Becavin C, Berg C, Queen R, Litvinukova M, et al.SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes. Nat Med 2020;26:681-7.
47. Smit MR, Ochomo EO, Aljayyoussi G, Kwambai TK, Chen T, Bousema T,et al. Safety and mosquitocidal efficacy of high-dose ivermectin when co-administered with dihydroartemisinin-piperaquine in Kenyan adults with uncomplicated malaria (IVERMAL): a randomised, double-blind, placebo-controlled trial. Lancet Infect Dis 2018;18:615-26.
48. Crump A, Omura S. Ivermectin, wonder drug’ from Japan: the human use perspective. Proc Japan AcadSer B PhysBiolSci 2011;87:13-28.
49. Kircik LH, Del Rosso JQ, Layton AM, Schauber J. Over 25 y of clinical experience with ivermectin: an overview of safety for an increasing number of indications. J Drugs Dermatol 2016;15:325-32.
50. Canga AG, Prieto AMS, Liebana MJD, Martinez NF, Vega MS, VieitezJJG. The pharmacokinetics and interactions of ivermectinin humans–a mini-review. AAPS J 2008;10:42-6.
51. Zhang N, Truong Tran AQ, Tancowny B, Harris KE,Schleimer RS. Glucocorticoids enhance or spare innate immunity: Effects in airway epithelium are mediated by CCAAT/enhancer-binding proteins. J Immunol 2007;179:578-89.
52. Guaraldi G, Meschiari M, Lepri AC, Milic J, Tonelli R, Menozzi M, et al.Tocilizumab in patients with severe COVID-19:a retrospective cohort study. Lancet 2020;2:474-8.
53. Wang Y, Fei D, Vandelaan M, Song A. Biological activity of bevacizumab, a humanized anti-VEGF antibody in vitro. Angiogenesis 2020;7:335-45.
54. Liu X, Liu C, Liu G, Luo W, Xia N. COVID-19: progress in diagnostics, therapy and vaccination. Theranostics 2020;10:7821-35.
55. Pardi N, Hogan MJ, Porter FW, Weissman D. mRNA vaccines-a new era in vaccinology. Nat Rev Drug Discovery 2018;17:261-79.
56. Tu YF, Chien CS, Yarmishyn AA, Lin YY, Luo YH, Lin YY, et al. A review of SARS-CoV-2 and the ongoing clinical trials. Int J MolSci 2020;21:2657.
57. Modjarrad K, Roberts CC, Mills KT, Castellano AR, Paolino K, Muthumani K,et al. Safety and immunogenicity of an anti-Middle East respiratory syndrome coronavirus DNA vaccine: a phase 1, open-label, single-arm, dose-escalation trial. Lancet Infect Dis 2019;19:1013-22.
58. Zhu FC, Li YH, Guan XH, Hou LH, Wang WJ, Li JX,et al. Safety, tolerability, and immunogenicity of a recombinant adenovirus type-5 vectored COVID-19 vaccine: a dose-escalation, open-label, non-randomised, first-in-human trial. Lancet 2020;395:1845-54.
59. Vellozzi C, Burwen DR, Dobardzic A, Ball R, Walton K, Haber P. Safety of trivalent inactivated influenza vaccines in adults: background for pandemic influenza vaccine safety monitoring. Vaccine 2009;27:2114-20.
60. Rogliani P, Calzetta L, Coppola A, Cavalli F, Ora J,Puxeddu E, et al.Optimizing drug delivery in COPD: the role of inhaler devices. Respir Med2017;124:6-14.
61. Ratnam DV, Ankola DD, Bhardwaj V, Sahana DK, Kumar MNVR. Role of antioxidants in prophylaxis and therapy, a pharmaceutical perspective. J Controlled Release 2006;113:108-207.
62. Khalil MM, Alam MM, Arefin MK, Chowdhury MR, Huq MR, Chowdhury JA, et al.Role of personal protective measures in prevention of COVID-19 spread among physicians in bangladesh: a multicenter cross-sectional comparative study. SN ComprClin Med 2020;28:1-7.
63. Kamalasanan K, Biomimetric conjoining pathways for COVID-19 drug discovery nanomedicine drug discovery and medical devices: prophylactic medicines as alternative for vaccines. Trends BiomaterArtif Organs 2020;34:73-4.
64. Kucharski AJ, Klepac P, Conlan AJK, Kissler SM, Tang ML, Fry H, et al. CMMID COVID-19 working group. Effectiveness of isolation, testing, contact tracing, and physical distancing on reducing transmission of SARS-CoV-2 in different settings: a mathematical modelling study. Lancet Infect Dis 2020;20:1151-60.
65. Gogna KA, Tay H, Tan BS. Severe acute respiratory syndrome: 11 y later—a radiology perspective. Am JRoentgenol 2014;203:746-8.
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