International Journal of Advance Research, Ideas and Innovations in Technology

ISSN: 2454-132X
Impact Factor: 6.078
(Volume 7, Issue 3 - V7I3-1553)
Available online at: https://www.ijariit.com

A review on SARS-COVID-2 (Coronavirus-2019) virology,

diagnosis, treatments, and control measures
K. Kirubakaran G. Ramesh R. Harieshkumar
kirubak863@gmail.com gr532349@gmail.com kumarharish9976@gmail.com
P.S.V. College of Pharmaceutical Science P.S.V. College of Pharmaceutical Science P.S.V. College of Pharmaceutical Science
and Research, Krishnagiri, Tamil Nadu and Research, Krishnagiri, Tamil Nadu and Research, Krishnagiri, Tamil Nadu

V. Baskaran M. Elakiya M. Ramasamy

baskaran25v@gmail.com elakiya123vnb@gmail.com mramoo@gmail.com
P.S.V. College of Pharmaceutical Science P.S.V. College of Pharmaceutical Science P.S.V. College of Pharmaceutical Science
and Research, Krishnagiri, Tamil Nadu and Research, Krishnagiri, Tamil Nadu and Research, Krishnagiri, Tamil Nadu

ABSTRACT
In late December 2019, Chinese health authorities reported an outbreak of pneumonia of unknown origin in Wuhan, Hubei
Province. Wuhan This coronavirus was provisionally named 2019-nCoV, now SARS-COVID-2 according to the Coronavirus
Study Group of the International Committee on Taxonomy of Viruses. SARS-COVID-2 belongs to the Coronaviridae family,
Beta coronavirus genus, subgenus Sarbecovirus. Since its discovery, the virus has spread globally, causing thousands of
deaths and having an enormous impact on our health systems and economies. In this review, we summarize the current
knowledge about the epidemiology, phylogenesis, homology modeling, and diagnostics of SARS-COVID-2.

Keywords⸻ Middle East Respiratory Syndrome (MERS), Severe Acute Respiratory Syndrome (SARS), Receptor Binding
Domain [RBD], SARS-COVID-2, Ribavirin, Niclosamide, Netikriya –VataNeti, Jalaneti, nucleocapsid.
1. INTRODUCTION
Scientists first identified a human coronavirus in 1965. It caused a common cold. Later that decade, researchers found a group of
similar human and animal viruses and named them after their crown-like appearance. Seven coronaviruses can infect humans. The
one that causes SARS emerged in southern China in 2002 and quickly spread to 28 other countries. More than 8,000 people were
infected by July 2003, and 774 died. A small outbreak in 2004 involved only four more cases. This coronavirus causes fever,
headache, and respiratory problems such as cough and shortness of breath. MERS started in Saudi Arabia in 2012. Almost all of
the nearly 2,500 cases have been in people who live in or travel to the Middle East. This coronavirus is less contagious than its
SARS cousin but more deadly, killing 858 people. It has the same respiratory symptoms but can also cause kidney failure.
Coronavirus and respiratory syncytial virus (RSV) are two kinds of respiratory illnesses that have some similar symptoms. So far,
the new coronavirus appears to be more dangerous for adults, especially older ones. RSV is riskier for young children, but it can
also be serious for older people and those who have other health problems. Coronaviruses are a large family of viruses that are
known to cause illness ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome
(MERS) and Severe Acute Respiratory Syndrome (SARS). A novel coronavirus (COVID-19) was identified in 2019 in Wuhan,
China.

2. VIOROLOGY OF SARS- COVID-2

There are enveloped viruses with a positive sense single standard RNA genome and a nucleocapsid of helical symmetry. The
genome size of coronavirus are ranges from approximately 26 to 32 kilobases. One of the largest among RNA viruses they have a
club-shaped spikes that project from its surface. Corona virus is large, roughly spherical particles with bulbour surface projection.
The average diameter of envelope is 85nm and envelop of virus in electron micrographs appears as a distinct pair of electrons-
dense shells (shells that are relatively opaque to the electron beam used to see the virus particles) [1]. The viral envelope consists of

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 International Journal of Advance Research, Ideas and Innovations in Technology
a lipid bilayer, in which the membrane(M), envelope(E), and spike(S) structural protein are anchored. The ratio E:S:M in the lipid
bilayer is approximately 1:20:300.

Spike glycoproteins on the corona virus particles has 74 surface spikes. A subset of corona virus specifically the members of beta
corona virus subgroup A, also have a shorter spike-like protein. which is called hemagglutinin esterase [HE][2]. The surface spikes
are homotrimers of the S-protein which is composed of an S1 and S2 subunits. S1 subunit forms the head of the spike and has the
receptor binding domain [RBD]. S2 subunit forms the stem which anchors the spike in the viral envelope and on protease
activation enable fusion [3].

RNA and n-protein: Inside the envelope, there is a nucleocapsid, which is formed from multiple copies of the nucleocapsid(N)
protein. Which are bound to the positive sense single standard RNA genome in continuous beads on a string type conformation.
The lipid bilayer envelope, membrane proteins, and nucleocapsid protect the virus when it is outside the host cell.
M-protein and E-protein are important in forming the viral envelope and maintaining its structural shape [4,6].

3. VIRAL CLASSIFICATION [5]:

(a) Unranked: Virus
(b) Realm: Riboviria
(c) Kingdom: orthornavirae
(d) Plylum: pisuviricota
(e) Class: pisonaviricetes
(f) Order: nidovirales
(g) Family: coronaviridae
(h) Subfamily: orthocoronacoronavirinae
Genera: Alpha coronavirus, beta coronavirus, gamma coronavirus, delta coronavirus.

4. TESTING KIT ADVANCED TECHNIQUES

The structure of SARS-COV-2 consist of spike protein, which include two regions of S1 & S2.S1 is host cell receptor binding
site,S2 is membrane fusion site. Spike protein is mainly cat against neutralizing the antibody & vaccine. The nucleocapsid protein
is the most abundant protein SARS-COV-2. The N-protein is an Immunogenic Phosphoprotein and rarely changes. The N-protein
of SARS-COV-2 is often used as marker in diagnostic assay. This is also the hemogglutinin esterase dimer a membrane
glycoprotein an, envelop protein and RNA.

IMMUNOASSAY
Antibody test are performed with blood samples of infected person. This detects specific IgA &IgG against the virus in blood.
Antigen test consist of monoclonal antibody specifically for the viral antigen and seen by chromatographic particles in naked eye.
But this not much effective.[7]

COVID 19 NUCLEIC ACID AMPLIFICATION TEST (NAAT)

Each assay is targets a various genes in virus .1) these targets are Orf1 gene {human RNA polymerase protein}, 2) N-gene
{nucleocapsid protein},3) E-gene {envelope protein},4) S-gene {spike protein }but these S-gene target is limitedly used[8]. The
CDC COVID-19 diagnostic panel is a real-time reverse transcription-polymerase chain reaction (qRT-PCR) test. In qRT-PCR,
oligonucleotide primers are used to amplify pieces of nucleic acid (i.e, RNA or DNA), which can be detected by a fluorescently
labeled probe[9].

CDC INFLUENZA SARS-COV-2 MULTIPLEX ASSAY

CDCs is the newest laboratory test,detects two types of influenza virus {A&B} and SARS-COV-2 at the same time[10]. Due to
increasing number of products have received EUA {Emergency use authorisation} from the FDA and have received CE-marked
for sale, but some products are still available for research purpose only.

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 International Journal of Advance Research, Ideas and Innovations in Technology
TEST METHODS AVAILABLE:
1. next generation sequencing [NGS]based on whole genome sequence,
2. RT-PCR based on specific premier probe detection,
3. Loop mediated isothermal amplification [LAMP] based on more than two set of primer pair detection,
4. serological & Rapid serological methods based on antigen and antibody,
5. CT-SCAN based on chest image and propagation 6 virus isolation based on invitro live virus isolated [11].

LIST OF 32 TEST KITS BASED ON RT-PCR BY THE APPROVAL OF FDA AS EUA & CE-MARKED:
1. In Bios Smart Detect SARS-CoV-2 rRT-PCR Kit
2. Gnomegen COVID-19 RT-Digital PCR Detection Kit
3. CO-DIAGNOSTICS INC. Logix Smart Coronavirus 2019 (COVID-19) Kit
4. ScienCell SARS-CoV-2 Coronavirus Detection Kit
5. Luminex ARIES SARS-CoV-2 Assay
6. LuminexNxTAG® CoV Extended Panel
7. BD BioGX SARS-CoV-2 Reagents for the BD MAX™ System
8. BD SARS-CoV-2 Reagents for the BD MAX™ System
9. Ipsum Diagnostics COV-19 IDx Assay
10. Cellex qSARS-CoV-2 IgG/IgM Rapid Test
11. QIAGEN QIAstat-Dx Respiratory SARS-CoV-2 Panel
12. NeuMoDx Molecular™ SARS-CoV-2 Assay
13. Abbot ID NOW™ COVID-19 Assay
14. BGI Genomics Real-Time Fluorescent RT-PCR Kit
15. Avellino CoV-2 Test
16. PerkinElmer New Coronavirus Nucleic Acid Detection Kit
17. Mesa Biotech Accula™ SARS-Cov-2 Test
18. Bio Fire Diagnostics BioFire® COVID-19 Test
19. Cepheid Xpert® Xpress SARS-CoV-2 Test
20. Primerdesign Ltd. COVID-19 genesig Assay
21. GenMark Diagnostics ePlex® SARS-CoV-2 Test
22. DiaSorin Molecular Simplexa® COVID-19 Direct Assay
23. Abbott RealTime SARS-CoV-2 Assay
24. QuestDiagnostics SARS Coronavirus With CoV-2 RNA Test
25. QuidelLyra SARS-CoV-2 Assay
26. LabCorp COVID-19 Test
27. Hologic Panther Fusion®SARS-CoV-2Test
28. ThermoFisher Scientific TaqPath COVID-19 Multiplex Diagnostic Solution
29. DiaCartaQuantiVirus™ SARS-CoV-2 Test Kit
30. Roche cobas® SARS-CoV-2 Test
31. New York State Department of Public Health’s New York SARS-CoV-2 Diagnostic Panel
32.
The Centers for Disease Control and Prevention (CDC) 2019-nCoV Diagnostic Panel[11]

5. EXISTING DRUG THERAPY(ALLOPATHY SIDDHA &AYURVEDIANATUROPATHY& YOGA):

Allopathic system of medicine is currently using the already existing drug acts against a viral infection are used alternative to the
COVID-19. Favipravir, Remdesivir, Tenofovir, Azithromycin, Oseltamivir, Pyrazofurin, Irbesartan, Mesalazine, Toremifene,
Eplerenone, Paroxetine, Dactinomycin, Quinacrine, Carvedilol, Colchicine, Tideglusib [12].

Siddha and ayurvedhic traditional system of medicines are used to treat the covid-19 under Indian system of medicine list of
herbs used are Plectranthusamboinicus, Sennaauriculata, Neotea Azadirachta Indica Neem, Macrotylomauniflorum,
Solanumprocumben, Solanumvirginianum, Justiciaadhatoda, Ecliptaprostrate, Ocimumtenuiflorum. Ginger (Chukku), Piper
longum (pippali), Clove (lavangam), Dusparsha (cirukancoriver), Akarakarabha, Kokilaksha (mulliver), Haritaki(kadukkaithol),
malabarnut(adathodaielai), Ajwain(Karpooravalli), Kusta (kostam), Guduchi (seenthilthandu), Bharangi (Siruthekku),Kalamegha
(siruthekku),Raja pata (Vattathiruppi),Musta (koraikizhangu) [13]. In this herbal drug treatment over 539 patients completely cured,
205 patients are under treatment, according to age condition admitted in the hospital are over theage of 70 years are 20 patients ,
above 50 years are 100 patients with the pre-existing diseased conditioned patients are getting out of the symptoms within one
week, with the use of traditional system of medicine mild infected patients getting cured within 4 to 10 days. But not the seriously
infected patients under ventilated condition[14].

Chines system of medicine various herbs are used Arneniacae Semen as Amarum,magnolia officinalis cortex,forsythiae fructus ,
glycyrrhizae radix et rhizome,ephedrae Herba,ptatycodonis radix, agasytachis Herba,atracpylovis rhizome, soutelariae radix. [15]

Naturopathy and yoga they by both are emerging in improving the immune system there is a heterogeneity in susceptibility to
infections during a flu epidemic. Psychological stress, Fitness and physical activity,Nutrition, Sleep, comorbid conditions and
lifestyle play a vital role in shaping this immune response. Improving Mucosal Immunity And reducing airway reactivityNetikriya
–VataNeti and Jalaneti followed by Kapalabhatikriya twice a week to reduce airway reactivity.Aromatic oils for inhalation such as
peppermint oil and eucalyptus oil and Tulsi[16], Improving InnateImmunity or immunehomeostasis Naturopathic Nutrition with
balanced diet consisting of plenty offruits and vegetables ReducingStress Psychologic Stress can increase susceptibility to

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 International Journal of Advance Research, Ideas and Innovations in Technology
Infections(1). Regular practice of Yoga ( Minimum 20 minutes) Loosening /Breathing exercises-5 min, Suryanamaskar 6 rounds -
6 minutes, Yogic relaxation techniques – 5 min, Kapalabhati-3 rounds followed byNadishodana Pranayama-9 rounds, Ujjayi
Pranayama -9 rounds and Bramari -3 rounds) Improving fitness and respiratory healthRegular moderate intensity exercise such as
walking 30 minutes daily prevents incidence of respiratory infections [17].

6. GOVERNMENT SECTORS INVOLVEMENT IN PANDEMIC AT WORLDWIDE.

The covid-19 pandemic has demonstrated that indeed the world was not prepared. A whole of government and society approach is
essential not only for defeating the pandemic but for the recovery. Since 31 st December 2019 when we received the first report of
cases in china WHO has been working day and night to coordinated the global response. We have launched a large international
trial to find solution fast about which drug are most effective. We have trained millions of head worker around world through
open who.org online platform. That way WHO has made preparedness of priority. International health regulation provides an
important legal frame work for countries to work together for mutual security. The IHR were last update in 2005 in wake of
SARS. A strong health system in many countries have managed to successfully control covid-19 without vaccines, that’s why
WHO highest priority is supporting countries to strength their health system, world leader come together as united general
assembly to adopt a landmark political declaration on universal health coverage. Seven areas in which international community
must work together to mitigate and prevent pandemic.
(a) The world needs coordinated predictable transparent, broad-base and flexible funding implement international health
regulation.
(b) world needs a step-change towards coordinated and capacitated data management and real time communication.
(c) world need to fundamentally shift the atomized and uncoordinated mechanism by which essential health comadities are
manged.
(d) all countries must invest in their health hereafter as backbone of health system and health security.
(e) the world urgently needs coordinated approach to discover develop and deliver effective such vaccine diagnostic.
(f) all countries must make universal health coverage or priority[18].

7. COVID-19 MORTALITY RATE BY AGE AND GENDER

According to early estimation by china NHC (National health commission) above 80% of those died was over the age of 60 years.
75% of them are pre-existing condition such as cardiovascular disease and diabetes. Outside china median age detected is 45 years
ranging from (2-74years) ,71% cases were male[19].

Why male is more susceptible than female? According to New york state department of health around 60% are male. The
European countries for disease prevention and control reported that male to female ration for covid-19 death across the Europe,
UKs office for national statistic reported death rate of covid-19 was double rate male than female [20]. For reasons the remain
novel corona virus appears to present a significant, higher mortality risk to man then women. covid-19 mortality rate for males
and females across different age and compare then will all cases mortality rates taken from human mortality database ,they have
bigger variation than the difference in all cases GMR(General mortality rate) ratio between 1:1 to 1:3 among the female and males
than over the age of 60-70 years death rate is higher existing between 1:2 to1:9. In wuhan fatality rate as 2.8% in males and 1.4%
in females respectively. Smoking prevalence in china is much closer in men and women 28% of men and 19% women smokers[21].

7.1 SARS EPIDEMIC IN 2003 CONTROLLED MEASURES:

The out break was 1stidentified inshunde, Guangdong, china on 16 Nov 2002. epidemic continued from 16 nov 2002 to 31 stjuly
2003. But in world wide it was continued till 19 may 2004. (china & outside china). Total affected cases – 8096, Total deaths -774
.From 29 different countries & territories[22],[23].

7.2 SARS-COV-2 TRANSMISSION

SARS-CoV-2 is transmitted to other people mainly by respiratory droplets during coughing or sneezing. Droplets containing viral
particles are propelled several meters in the air and can be deposited in the mucous membranes of the mouth, nose or eyes of an
individual. Transmission can also occur via contact with contaminated surfaces followed by self-inoculation of mucous
membranes of the nose, eyes or mouth. Analysis of a number of coronaviruses showed that they can survive on inanimate surfaces
for up to 9 days but can be efficiently inactivated by surface disinfection. Recently published study reported that SARS-CoV-2
remained viable in aerosols for 3 hours, but with decrease in infectious titer. The same study reported that SARSCoV-2 can
remain viable for up to 72 hours on stainless steel and plastic, but with a 3-fold decrease of the virus titer. As the pandemic
progresses, new routes of transmission are being discovered. SARS-CoV-2 positive fecal samples indicate on the possibility of
becoming infected via the fecal-oral route. This is supported by the detection of SARS-CoV-2 in stool samples even after
nasopharyngeal swab switched from positive to negative after treatment. Fecal-oral route of transmission was also proposed
during the SARS epidemic. Proof that asymptomatic patients can take part in SARS-CoV-2 transmission has also been reported
on multiple occasions. The fact that asymptomatic individuals can act as infection vectors has urged countries to advise their
citizens to self-isolate and practice social distancing. Possibility of numerous transmission routes is strongly supported by the fact
that the virus has been found in not only respiratory excretions and fecal matter, but also in blood and urine samples of COVID-19
patients. 3.1.2. Incubation period and basic reproductive number Many parameters of the infection are still uncertain as the
pandemic is still ongoing and they are being reported from many researchers. Incubation period on average seems to be about 6,4
days, but it can last as long as 24. The basic reproductive number (R0) is used as a measure to determine the potential and severity
of an infectious disease. The larger R0 is, the stronger the transmission power will be, the smaller – the faster the infection will die
out. It is defined as the number of new cases an existing case can create, respectively, how many individuals can an infected
individual infect. A lot of R0 values have been reported. In the beginning of the outbreak WHO estimated the R0 to range between
1.4 – 2.5, but some researchers suggest that it may be as high as 3.8, surpassing that of SARS-CoV and MERS-CoV. It is

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 International Journal of Advance Research, Ideas and Innovations in Technology
important to keep in mind that the estimation of R0 during an epidemic can be riddled with uncertainty and variability of libraries,
youth and community centres. The third wave doesn’t have to crash on undefended shores.

Controlled Measures:
SARS is an infectious disease, the controlled measure of SARS epidemic involved diagnosis, treatment, prevention. There is no
specific drug (or) vaccine were available for the SARS infection. If we diagnosis the infected person can isolate individual & can
give treatment than avoid spreading from index patient to others [24]. They are called negative pressure rooms because the air
pressure inside the room is lower than the air pressure outside the room. This means that when the door is opened, potentially
contaminated air or other dangerous particles from inside the room will not flow outside into non-contaminated areas.
We can diagnosis the SARS infection by following ways,
• SARS – COV may be suspected on a patient who has any symptoms including fever of 38degree C (or) higher.
• Higher of contact (sexual /casual): Contact with someone with a diagnosis is of SARS within the last 10 days or travel to any
of the region identified by the world health organisation (WHO) as areas with recent level transmission of SARS.
• Clinical criteria – of SARS –COV diagnosis rarely illness: -chills and rigors, myalgia, Malaise, Rhinorrhea or coryza,Arthalgia
,diarrhoea ,sore throat[25],[26]
• Mild to moderate illness: - temperature of greater (greater than 38 degree plus) indications of lower respiratory tract infections
(cough, dyspnea) [7]

LABORATORY TESTS
The laboratory tests confirmed SARS are listed below [28],[29],[30]. Tested positive for SARS based on one of approved tests [ELISA
–(enzyme linked immunosorbant assay) , IFA – (Immunofluorescence ) (or) PCR test – (polymerase chain reaction , Antibody ,
cell culture).

ANTIBODY TESTS
There tests detect antibodies produced in response to the SARS coronavirus infection different type of antibodies (IgM&IgG )
appear & change in level during the course of infection they can be undetectable at the early stage of infection

ELISA TESTS
A test detecting a mixture of IgM&IgG antibodies in the serum of SARS patients yields positive results at around day 4 after the
onset of illness IFA – A set detecting positive results after day 10 of illness.

PREVENTION
There is no vaccine for SARS , only way to control the infection by diagnosis & isolating them & quarantine remain the most
effective means to prevent the spread of SARS and giving supportive treatment to the infected persons .

Others measures includes:

• Hand –washing with soap & water (or) using hand sanitizer which contains alcohol for certain percentage
• Wearing face masks, N -95 mask, goggle apron.
• Avoiding contact with bodily fluids.
• Washing the personal items of someone with SARS in hot soaps water. (eating, utensils dishes, bedding)
• Simple hygiene measures
• Isolating oneself as much as possible [31],[32]

CONTAINMENT MEASURES
Promote detection of cases through good surveillance network including early warning system .
• Isolation of suspected cases with good control using barrier nursing techniques in health care institute .
• Backward tracing to identify the source of infection & forward tracing to identify contacts that may developed disease .
• Voluntary quarantine for 10 days for suspected contacts.
• Exit screening for outgoing passengers from area with recent local transmission by asking question & temperature
measurement & similar for incoming passengers .
• Quarantine for those who arrived from the area with local transmission.
• Encourage physical distancing arranging seating in waiting rooms so patients can sit at least 6 feet apart .
• Minimize the chance of transmission o SARS virus .
• This prevention includes earlier detection of disease isolation of people who are infected & use of personal protective
equipment (PPE) .an 2017 meta –analysis found that for medical professional wearing N-95 mask could reduce chance of
getting sick up to 80% when compared to no mask .
• Screening process in place at airports to monitor air travel to & from affected countries .
• SARS –COV is most infectious in severely all patients which usually occurs during the 2nd week of illness, this delayed
infectious period meant , so quarantine was highly effective[33],[34],[35]

Eye protection – put on eye protection (i.e.,goggles (or) a face shield that covers the front & sides of the face) upon entry to the
patient room (or) care area if not already wearing as part of extended use [36] .

TREATMENT

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 International Journal of Advance Research, Ideas and Innovations in Technology
There is no current treatment to cure the SARS infection we can use only a supportive medications to treat SARS & reduce the
symptoms.

ANTIBIOTIC
During the 2002 -2003 outbreak of SARS cases were usually treated initially with broad spectrum antibacterial drugs which are
effective against typical bacterial causes acute community acquired pneumonia. [37]
The administration of broad spectrum antibiotic. -eg :fluroquinolones ,
2nd generation – cephalosporins ,
3rd generation – cephalosporins macrolide is recommended at the first s of sign of SARS
But there is no evidence that antibiotics are clinically beneficial in the treatment of SARS .

ANTIVIRAL DRUG
Ribavirin : - It is a synthetic nucleoside with broad spectrum antiviral activity clinical studies that have assessed the effectiveness
of ribavirin in SARS range from anecdotal case reports is retrospective case series to one randomised clinical trial with multiple
treatment arms none of these studies definitively determine whether (or) not ribavirin is effective against SARS studies describe
clinical ad radiological improvements in patients treated with ribavirin & steroids [38] .
Involving multiple different treatment arms suggest that ribavirin given at a low dose (400 -600 mg /day ) was less effective
compared with an early & aggressive use of steroids with interferon alpha.
Side effect has been associated with ribavirin , 110 people were treated with ribavirin 61% of these had evidence of haemolytic
anaemia , hypocalcemia&hypomagnesaemia were reported in 58% & 46% of people respectively .

Niclosamide: - wu & colleagues screened a set of marketed drugs that were not registered as antiviral but used to determine
actively against SARS . they found that niclosamide an existing anthelmintic drug was able to inhibit replication of the SARS
corona virus[39],[40] .
The treatment of SARS is mainly supportive with antipyretics , supplemental oxygen & to mechanical ventilation as needed .
There is currently no proven antiviral therapy including ribavirin,lopinavir,ritonavir , type 1-interferon , that have thus far shown
no contribution to the disease course.
Administration of corticosteroids is recommended by the british thoracic society/british infections society in patients with severe
disease & O2 saturation of less than 90% .And some more medication were also used such as viral binding inhibitors, fusion
inhibitors , RNA interference, glyrrhizin,nitric oxide , steroids[41] .

IMMUNICATION
Because most patients develop antibodies against SARS corona virus & survive the disease passive &active immunization are
viewed as possible effective means to prevents (or) treat SARS.

Status Of Vaccine And Disease[42],[43]

Over 75 countries has submitted expression of intrest to covax facility ,joining upto 90 further countries could be supported by the
covax advance market commitment (AMC).the vaccines are under clinical and preclinical research stages.

VACCINE DEVELOPMENT
Vaccine development is never easy and fast, a lot has to be done to ensure that an efficacious and safe vaccine reaches the public.
With this new coronavirus it is especially challenging since there are no existing vaccines, but the rapid response of researchers
has aided the process. The causative agent of COVID-19 was identified in record time and the genomic sequence of the virus was
swiftly made available aiding the development of potential therapeutics and vaccines. Also, data from studies on SARS-CoV and
MERS-CoV vaccines showed that the spike protein is an ideal target for a vaccine, as antibodies targeting the spike protein
interfered with virus binding and neutralized the virus and the structure of SARS-CoV-2 has already been solved. The SARS-
CoV-2 vaccine will have to overcome numerous issues, like the waning of the antibody response, as antibody titers of SARSCoV
waned after 2-3 years, which could be dangerous if the virus becomes endemic with recurrent outbreaks. Also, higher titers of
neutralizing antibodies will be necessary since older individuals are more affected and they are more immunosenescent. As
SARS-CoV neutralizing antibodies can cross-react with SARSCOV-2, SARS-CoV-1 vaccines might cross-protect against
SARSCoV-2, but these vaccines were not developed further than phase I clinical trials and are not available for use. The Coalition
for Epidemic Preparedness Innovations has given funds to several prospective vaccine developers one of whom has started phase I
clinical trials. This is an mRNA-based vaccine which expresses the stabilized spike protein of the virus in vivo. First participant
has already been dosed with the vaccine and a total of 45 healthy adults will be enrolled in this trial. Several vaccine candidates
are still in the preclinical phase, such as recombinant protein based, viral vector based, DNA and live attenuated vaccines.
Currently developed vaccine against SAR-COVID 2.
• Comirnaty (BNT162b2) is a mRNA-based vaccine
• Moderna COVID‑19 Vaccine (mRNA-1273) is a mRNA-based vaccine
• COVID-19 Vaccine AstraZeneca (AZD1222); also known as Vaxzevria and Covishield is a Adenovirus vaccine
• Sputnik V is a Recombinant adenovirus vaccine (rAd26 and rAd5)
• Sputnik Light is a Recombinant adenovirus vaccine (rAd26)
• COVID-19 Vaccine Janssen (JNJ-78436735; Ad26.COV2.S) is a Non-replicating viral vector
• CoronaVac is a Inactivated vaccine (formalin with alum adjuvant)
• BBIBP-CorV is a Inactivated vaccines.
• The currently developing vaccines are status mention in figure (2)

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 International Journal of Advance Research, Ideas and Innovations in Technology

vaccine status
7% 16%
pre-clinical
41%
36% phase 1
phase 2
phase 3

Figure 1: Overall vaccines status at worldwide.

CONCLUSION
With this review, we summarize that the disease profile of SARS-COVID-2 potent and continues to rapidly evolve. Still now we
have not known answers for many questions arising about SARS-COVID-2 as it is evident that through this review, as more and
more suspected cases of SARS-COVID-2 infection arises, crisis of medication and threatening of people life is also increase in
day to day. we demonstrate that the diagnosis of infection by RT-PCR kits and CT-imaging of chest. The progression of lungs
changes of covid-19 on CT-imaging is also resemble to SARS, with the ground state and consolidation getting worsen over
several days by mortality rate around 33% based on number of confirmed cases and death. Notwithstanding, our study continues
to add knowledge about the disease in a growing number of outbreaks in serious condition.

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viruses. For the disease involved in the ongoing COVID-19 pandemic, see Coronavirus disease 2019. For the virus that
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Formulations!https://www.netmeds.com/health-library/post/kabasura-kudineer-benefits-ingredients-and-side-effects-of-this-
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AnnaPawełczyk&LucjuszZaprutkoPublished Online:23 Jul 2020https://doi.org/10.4155/fmc-2020-0204
[16] Information and guidance on how to efficiently engage with FDA and expedite clinicaltrial initiation may be found at: Drug
Development Inquiries for Drugs to Address theCOVID-19 Public Health Emergency (/drugs/coronavirus-covid-19-
drugs/drugdevelopment-inquiries-drugs-address-covid-19-public-health-emergency)
[17] Information on expediting quality assessments for products to treat COVID-19 patientsand transferring manufacturing to
new or alternative sites to avoid supply disruptionsmay be found at: COVID-19 Manufacturing, Supply Chain, and Drug
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[18] The National Center for Biotechnology Information advances science and health by providing access to biomedical and
genomic information. National Center for Biotechnology Information, U.S. National Library of Medicine8600 Rockville
Pike, Bethesda MD, 20894 USA ,https://www.ncbi.nlm.nih.gov/
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[19] Reinsurance Group of America, Incorporated is a leader in the global life reinsurance industry. With headquarters in St.
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living benefits reinsurance, group reinsurance, financial solutions, facultative underwriting and product development.
https://www.rgare.com/
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