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*Corresponding author: E-mail: mdbashiralam101@gmail.com; 
 
 
 

Asian Journal of Immunology 
 
3(1): 191-198, 2020; Article no.AJI.56779 
 

 
 

 

 

Novel Coronavirus COVID-19: A General Overview 
for Emergency Clinicians and Current Scenario 

 
Md. Bashir Alam1* 

 
1
Department of Food Technology and Nutrition Science, Noakhali Science and Technology University, 

Sonapur-3814, Bangladesh. 
 

Author’s contribution  
 

The sole author designed, analysed, interpreted and prepared the manuscript. 
 

Article Information 
 

Editor(s): 
(1) Dr. Wagner Loyola, Agricultural Research Corporation (Embrapa) Concordia, Brazil. 

Reviewers: 
(1) Jorge Castro Bedriñana, Universidad Nacional del Centro del Perú, Peru. 

(2) Silke Weber, UNESP, Brazil. 
(3) Si Thu Aung, University of Medicine Mandalay, Myanmar. 

Complete Peer review History: http://www.sdiarticle4.com/review-history/56779 

 
 
 
 

Received 19 April 2020  
Accepted 11 May 2020 

Published 25 May 2020 

 
 

ABSTRACT 
 

A cluster of pneumonia cases linked to the novel coronavirus (2019-nCoV) were announced by 
China at the end of December 2019. The current global situation, recent trends and ongoing 
progress in the containment and control of this epidemic, which has now spread 187 countries 
across the globe. A novel coronavirus virus (2019-nCov) has emerged in China, posing an 
International Public Health Emergency in a few weeks, and has recently become a very high-risk 
group by the World Health Organization (WHO). A third introduction of a highly pathogenic and 
large-scale corona virus disease in humans was the SARS- CoV-2 outbreak as a result of a severe 
acute respiratory syndrome coronavirus (SARS-CoV) in 2003 and the Middle East respiratory 
syndrome coronavirus (MERS-CoV) in 2012. This virus was named Coronavirus-2 Severe Acute 
Respiratory Syndrome (SARS-CoV-2) by the International Committee on Virus Taxonomy (ICTV) 
and Coronavirus Disease-19 (COVID-19) disease. Clinical symptoms of COVID-19 patients include 
fever, cough, fatigue, and a small number of patients with signs of gastrointestinal infection. SARS-
CoV and MERS-CoV are particularly pathogenic in humans and are associated with high mortality. 
In this review, the epidemiology, pathophysiology, transmission, and clinical characteristics, and 
discussed current treatment and scientific developments and management of the recently 
discovered COVID-19 are reviewed, with a focus on best practices and the public health 
complications. 

Review Article 



 
 
 
 

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Keywords: SARS-CoV; SARS-CoV-2; COVID-19; Coronavirus; outbreak; current situation; 
prevention; control. 

 
ABBREVIATIONS 
 
SARS-CoV :  Severe Acute Respiratory 

Syndrome 
MARS-CoV :  Middle East Respiratory Syndrome  
COVID-19 :  Coronavirus Disease 2019 
2019-nCoV :  Novel Corona virus 2019  
WHO :  World Health Organization 
PPE :  Personal Protection Equipment 
FFP3 : Filtering Face Pieces (Protection in 

three classes against dangers)  
N95 :  Respirators and Surgical Mask 
 

1. INTRODUCTION 
 
Examples include the Extreme Acute Respiratory 
Syndrome (SARS) and the Middle East 
Respiratory Syndrome (MERS) that caused 
earlier fatal outbreaks, and now the new 2019 
Coronavirus Diseases (COVID-19), triggered by 
SARS2 Coronavirus (SARS-CoV-2), originally 
known as unknown pneumonia, posing a serious 
threat to the public [1-3]. A wide group of viruses 
is the coronavirus family of single-strand RNA 
viruses, which normally cause upper respiratory 
tract infection in humans. In 1960s, the first two 
members-229E and OC43-were recognized [4]. 
Owing to the discovery of a new virus that 
triggered the pandemic serious acute respiratory 
syndrome (SARS), this family of viruses gained 
attention only in 2003 [5,6]. Two additional novel 
coronaviruses were later identified, NL63 and 
HKU1, in 2004 and 2005. These two viruses 
cause infections in the respiratory tract and are 
widespread among humans [7,8]. Therefore, with 
no major morbidity, the four known human 
corona viruses, 229E, OC43, NL63, and HKU1, 
cause mild to moderate upper respiratory tract 
illness. A novel coronavirus has been found to 
cause sporadic cases of serious, acute 
respiratory infection (SARI) since September 
2012. The virus strain was previously unknown 
and genome sequencing suggested that this 
particular virus belongs to the genus Beta 
coronavirus and is distinct from other known 
corona viruses and from SARS [9]. In a small 
number of patients with SARS, 7/28 (25%) had 
low titers of neutralizing antibodies for this newly 
discovered virus [10]. The newly identified virus 
was recently called Middle East Respiratory 
Coronavirus Syndrome (MERS-CoV) [11]. 
MERS-CoV was initially isolated from the 
respiratory tract of a patient in Bisha, Saudi 

Arabia. The patient suffered serious pneumonia 
and acute renal failure in June 2012 [9]. The 
case was first released in ProMed in September 
2012 [12]. Apparently, the disease is going 
through a difficult path in the majority of patients. 
A continuum of disease incidence has been 
observed in a family cluster of four cases. From 6 
April to 17 May 2013, 21 confirmed cases of 
MERS-CoV infection were reported in the Al-
Ahsa district of the Eastern Province of Saudi 
Arabia (16 males and 5 females with a median 
age of 56 years) with nine deaths [13,14]. At the 
end of December 2019, a cluster of cases of 
pneumonia of unknown origin in Wuhan, China, 
caused concern among health officials. The 
Wuhan Municipal Health Commission released 
warning on 31 December; a rapid response team 
was sent to Wuhan by the Chinese Center for 
Disease Control and Prevention (China CDC) 
and a report was sent to the World Health 
Organization (WHO) [15-18]. On 7 January 2020, 
the most recent coronavirus identified the 
causative pathogen, accompanied by the 
development of genomic characteristics and test 
methods [16,18]. Now known as COVID-19, both 
SARS-CoV and MERS-CoV are distinct but 
closely related [19]. With the recent detection of 
the 2019 novel coronavirus (COVID-19), there 
are now a total of 7 coronaviruses known to 
infect humans: 
 

1. Human coronavirus 229E (HCoV-229E) 
2. Human coronavirus OC43 (HCoV-OC43) 
3. Human coronavirus NL63 (HCoV-NL63) 
4. Human coronavirus HKU1 
5. Severe acute respiratory syndrome-related 

coronavirus (SARS-CoV) 
6. Middle East respiratory syndrome-related 

coronavirus (MERS-CoV) 
7. Novel coronavirus (COVID-19, also known 

informally as Wuhan coronavirus) [20]. 
 

This analysis summarized the recent medical 
progress of the epidemiology, pathogenesis and 
clinical characteristics of COVID-19 and 
addressed new treatment and scientific 
advances in the battle against a novel 
coronavirus outbreak. The targets of this review 
was to summarize the recent medical 
advancement of COVID-19's epidemiology, 
transmission, and clinical features, and 
discussed current treatment and scientific 
method developments to fight the novel 
coronavirus outbreak. 



 
 
 
 

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2. CURRENT SCENARIO (COVID-19) 
 
After its initial appearance in Wuhan, China, in 
the month of December 2019, the novel CoV was 
included in the category of Public Health 
International Emergency on 30 January 2020 
[21,22]. Besides affecting mainly China, SARS-
CoV-2/COVID-19 has now spread 187 countries 
(Fig. 1). Out of the total 3,815,561 confirmed 
cases, 267,469 human deaths were reported as 
of 8 May 2020 (CSSE). As a result of such a fast 
leap in relation to the total number of confirmed 
SARS-CoV-2 infected persons and affecting 
many countries in a short period of time, it was 
classified by the WHO as a very high risk 
category and studies have classified pandemic 
risks and threats with the bloom. In increasingly 
growing cases of COVID-19, it is worrying that 
we are making very high efforts to monitor the 
spread of this widely circulating virus among the 
world's population by taking effective prevention 
and control steps together with formulating global 
approaches and updated strategies with potential 
perspectives [23-30]. It is important to emphasize 
that there is an underreporting of these    
numbers due to the lack of diagnosis in many 
countries. 

 
3. THE DISEASE (COVID-19) 
 
COVID-19 is the third CoV outbreak in humans 
that occurred in last two decades, causing 
clinical manifestations of respiratory, digestive, 
and systematic affections, mainly expressed by 
pneumonia [31,32]. COVID-19 is a modern, 
unexplained mutation of human beings. The 
COVID-19 source is still unknown, although the 
initial cases concerned the Huanan South China 
Seafood Market. Although many of the early 
patients were working in or visiting the market, 
none of the exported cases came into contact 
with the market, indicating either human to human 
transmission or a more widespread source of 
animals. In addition to seafood, social media 
sources report that the Huanan South China 
Market has sold snakes, birds, and other small 
mammals, marmots and bats. The WHO 
confirmed that environmental samples from the 
marketplace were positive for the novel 
coronavirus but no clear association of animals 
was found [33]. Because of close contact, few 
people can remain asymptomatic carriers without 
any clinical symptoms of cold, fever, fatigue or 
pathology of the lungs. As a professional carrier, 
they will shed virus to other people who come in 
contact with them up to 21 days [34]. Initial signs 

include fever, mild chills, dry cough, tiredness and 
shortness of breath, moderate respiratory failure, 
pulmonary pneumonia, which deteriorate if not 
treated properly and are not sufficiently 
medicated [35]. More recent work has shown that 
many bat coronaviruses can infect human cells 
without having to adapt intermediately [36,37]. In 
addition, human serology data indicate bat 
coronavirus protein recognition and suggest that 
low-level zoonotic SARS-like bat coronavirus 
transmission occurs outside recognized 
outbreaks [38]. MERS-CoV also has a zoonotic 
virus with possible bat origins [39]. In addition, 
human serology data indicate bat coronavirus 
protein recognition and suggest that low-level 
zoonotic SARS-like bat coronavirus transmission 
occurs outside recognized outbreaks. 
 

4. DIAGNOSIS OF COVID-19 
 

Serological testing at the height of the outbreak is 
of little use, though serum samples of recovered 
patients can be checked to know the IgG titer. 
For highly infected patients, computed 
tomography (CT) and X-Ray techniques may 
help detect pulmonary pneumonia lesions in the 
lungs in combination with clinical symptoms to 
demonstrate the COVID-19 image [35]. The 
detection of viral nucleic acid (VNA) is important 
for the diagnosis of exposed but asymptomatic 
carriers and it is possible to detect the viral RNA 
using pharyngeal swab to prevent transmission 
and spread risk [40]. Most popularly, RT-PCR 
(rRT-qPCR) is performed in real time over 
respiratory secretions so that viral RNA can be 
identified within a short time [41]. Researchers 
also developed a diagnostic technique for the 
rapid and colorimetric detection of COVID-19 
coronavirus by reverse transcriptional loop-
mediated isothermal amplification (RT-LAMP). 
This isothermic LAMP-based COVID-19 
detection system is called iLACO in this 
technique, six primers were used to amplify a 
fragment of the ORF1ab gene, and phenol red is 
used as a pH indicator when the amplification 
changes color from pink to light yellow. At the 
same time, it remains rosy in negative cases 
[42]. Moreover, several reference laboratories 
are advancing the sequencing of the full genome 
from the positive rRT-PCR isolates The full 
clinical outcome is not yet clear, as the 
symptoms reported range from mild to severe 
with even death in some cases [43]. Serological 
test is generally used to measure immunity           
as well as acute infection to mumps virus, 
measles virus, rubella virus of these viruses. 
Immunized patients will have persistent



 
 
 
 

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194 

 

 
 

Fig. 1. Corona virus (COVID -19) update situation (According to 8 May 2020) 
Globally, 8 May 2020, there have been 3,815,561 confirmed cases of COVID-19, including 267,469 deaths, in 

187 countries, reported to Center for Systems and Engineering (CSSE) 

 
immunoglobulin G (IgG) antibodies so detectable 
antibody levels antibody the patient is immune to 
infection. Serological method is used for the 
diagnosis of primary EBV infection and for 
screening and monitoring of nasopharyngeal 
carcinoma whereas molecular methods is used 
for diagnose EBV associated lymphoma of           
the brain and EBV involvement in other organ 
[44]. 
 

5. TREATMENT OF COVID-19 
 
When infected persons are hospitalized, 
symptomatic and supportive care should be 
provided to human patients immediately 
according to the severity of the symptoms [45,46]. 
Therapy may include supplemental oxygen or 

high-flow nasal cannula (HFNC) oxygen therapy 
through the nasal route to relieve breathing 
stress if methylprednisolone is required 
intravenously to correct hypoxemia and, in 
extreme cases, intravenous adrenaline (IV), any 
repurposed medication such as lopinavir plus 
ritonavir as an anti-viral drug by oral way, 
moxifloxacin or any antibiotic to prevent 
secondary bacterial infection by IM/IV route 
[35,44]. Nevertheless, there are many drugs 
under review, including other antiretrovirals, such 
as remdesevir, but also antivirals such as 
oseltamivir and other treatments, including 
chloroquine and also indomethacin. Researchers 
are making great efforts to design and grow 
effective COVID-19 vaccines, which could take 
some time [47-49]. 

 

Table 1. Potential treatment options of COVID-19 
  

Classes Potential treatment option 

Anti-viral > 85% of patients received antiviral agents, including oseltamivir (75 mg every 12 
h orally), ganciclovir (0.25 g every 12 h intravenously) and lopinavir / ritonavir 
tablets (400/100 mg twice daily). Remdesivir is currently being evaluated and 
known to prevent MARS-COV in more than 10 medical establishments in Wuhan 
[50]. 

Anti-malarial An ancient antimalarial, chloroquine phosphate, has been effective in inhibiting 
the exacerbation of pneumonia due to its antiviral and inflammatory activity.[51] 

Herbal- treatment Traditional Chinese medicine has been widely used during the last SARS COV 
outbreak and is currently being used in China. The five most commonly used 
herbs were AStragali Radix(Huanggi), Glycyrrhyzae Radix Et Rhozoma (Gancao), 
Sapposhnikovae Radix (Fangfeng), Atractylodis Macrocephalae Rhizoma 
(Baizhu) and Lonicerae JaponicaeFflo [52]. 



 
 
 
 

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6. PREVENTION OF COVID-19 
 
Preventing strategies focuses on patient isolation 
and diligent monitoring of pathogens, including 
appropriate screening and clinical treatment 
measures for infected patients to follow. For 
example, droplets, contact and airborne 
precautions should be taken during specimen 
processing, and incorporation of sputum should 
be avoided. 
 
The general guidelines of WHO and other 
organizations have issued the following general 
recommendations: 
 

1. Avoid close contact with people suffering 
from acute respiratory infections. 

2. Wash your hands frequently, particularly 
after contact with infected people. 

3. Avoid unprotected farm and wild animal 
contact. 

4. People with acute airway symptoms should 
stay a little away, cover coughs or 
sneezes, and wash their hands with 
disposable tissues or shoes. 

5. Strengthen the implementation of 
appropriate hygiene procedures for the 
prevention and control of diseases, in 
particular in emergency medicine 
departments. 

6. Immuno suppressed people can prohibit 
public meetings 

 
The most effective method for the population is 
to frequently wash their hands and use portable 
hand sanitizing to prevent contact with their face 
and mouth after working in a potentially polluted 
environment. Health workers who care for 
infected people should use touch and airborne 
measures to prevent pathogen transmission, 
including PPE helmets, eye protection, gowns 
and gloves such as N95 or FFP3 helmets. 
Scientific work is going on to produce a 
coronavirus vaccine [53]. The governments 
should inspire travelers to postpone their travel to 
avoid exposure to COVID-19 affected countries 
and those who are returning back from affected 
countries must be isolated and quarantined for 
health check-ups and evaluation of their health 
status [54]. People should wash their hands with 
soap-water or prefer to use sanitizers, should 
remain inside home, should refrain from 
gathering places and avoid contacts with live-
dead animals like wild animals, children, and 
older adults must take precautions as they are 
more prone to the severe respiratory distress 
syndrome of COVID-19 [55]. 

7. CONCLUSION 
 
Worldwide scientists, researchers and numerous 
health agencies work days and nights with a 
great deal of commitment to avoid further SARS-
CoV-2 transmission and spread by maintaining 
strict caution, preventive methods, improved 
prevention and control measures, and by 
developing adequate vaccines and treatments to 
avoid any pandemic situation that could 
otherwise occur if this virus could not be stopped. 
While many factors, resulting from the study, still 
need to be established, as is the case with many 
elements in other age groups facing the COVID-
19 pandemic, as is not evident in pediatrics year 
after year. Eventually, one approach to health will 
play an important role in the future battle against 
COVID-19 as well as against other diseases. It is 
not a silver bullet, but still, the world needs global 
solutions to stop a pandemic either or minimize it 
[30]. In the light of increasingly growing COVID-19 
outbreaks, proactive steps by long-term care 
facilities are needed to identify and remove 
potentially infected staff and visitors, actively 
monitor potentially infected patients and 
implement successful prevention and control 
measures to avoid COVID-19 infections. 
Scientific researchers perform multiple medicine 
clinical trials and I believe these repositioning 
studies can help establish options for treatment 
with COVID-19. 
 

CONSENT 
 
It is not applicable. 
 

ETHICAL APPROVAL 
 
It is not applicable. 
 

COMPETING INTERESTS 
 

Author has declared that no competing interests 
exist. 
 

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