Introduction- Coronoviridae consists of a group of RNA viruses named Corona viruses (CoV). CoV is a non segmented RNA virus that is enveloped. Historically, they have caused varying forms of infections affecting humans and other mammals. HCoV-229E, HCoV-OC43, HCoV-NL63, HCoV-HKU1 are milder forms of the virus than SARS-CoV MERS-CoV, which have resulted in higher case fatality rates. The genomic component of SARS-CoV-2 encodes four major structural proteins: spike (S), membrane (M), envelope (E), and nucleocapsid (N).
Diagnostic Approaches for COVID-19:-
Patients infected with SARS-CoV-2 have predominantly presented with fever, cough, and malaise. Other symptoms targeting the respiratory, gastrointestinal, and urinary systems have been documented based on the patient’s age and persisting co morbidities.
Nucleic Acid Test (NAT) :-
It is currently the gold standard test to detect SARS-CoV-2. It uses Reverse Transcription Polymerase Chain Reaction (RT-PCR) to detect the viral RNA from samples obtained through the specimen sites.
Antigen Test :-
This test detects the presence of SARS-CoV-2 nucleocapsid protein antigen on the viral surface from nasopharyngeal and oropharyngeal swabs. This test relies on specified monoclonal antibodies (MAb) to bind to specific viral antigens in fluid samples.
Antibody Test :-
It detects specific antibodies (IgG and IgM) produced against SARS-CoV-2 in the serum, plasma, or whole blood of the host in response to the viral infection. It plays a vital role detecting the infection during the later phases and identifying people with immunity against the disease. It can also be useful to monitor the disease’s progression and in the development of a vaccine.
Image-Based Test :-
RT-PCR is currently considered the gold standard to detect the SARS CoV-2. However, its low sensitivity for early detection of the disease due to low viral load, coupled with limited availability of the test kits in various parts of the world.
Therapeutic options for COVID-19 :-
Symptomatic cases should be admitted to hospitals and treated effectively. Treatment should always be initiated in designated hospitals that follow strict isolation and prevention protocol measures.
Corticosteroids have been restricted in managing cases infected with CoV due to their immune suppression effects.
Antiviral therapy :-
Remdesivir is a broad-spectrum antiviral drug used effectively in treating patients infected with the Ebola virus, MERS-CoV, and SARS-CoV-1.
The role of antibiotics in COVID-19 patients is mainly restricted to patients with co-infection or those suffering from secondary bacterial pneumonia. It should be used only in patients presenting with severe clinical respiratory insufficiency.
Immune-based therapy :-
Tocilizumab is a recombinant humanized monoclonal antibody directed against the IL-6 receptor. A retrospective study showed tocilizumab reduced the mortality rates, ICU admissions and also lowered the risk of invasive mechanical ventilation in severe COVID-19 patients.
Potential COVID-19 Vaccines :-
The rapid development, distribution, and administering of a vaccine is the most effective way to fight this pandemic. A global attempt is being made to expedite the development of a vaccine against the SARS-CoV-2.
1. Live Attenuated V Live Attenuated Vaccines (LAVs) and Inactivated vaccines (IVs).
2. Next-generation vaccines .
3. Nucleic acid-based Vaccine.
Ms. Shama Parveen, Assistant Professor, School of Pharmacy, Career Point University, Kota