Journal of Infertility and Reproductive Biology, 2020, Volume 8, Issue 2, Pages: 18-21  
COVID 19 Pandemic, Mechanism of Pathogenesis,  
Preventions and Possible Cures to Save Humanity:  
A Study  
Samanwita Banerjee, Jainendra Gupta, Anil Kanaujia  
Ayurvet Research Foundation, Chidana, Haryana, India  
Received: 06/05/2020  
Accepted: 03/06/2020  
Published: 20/06/2020  
The name "coronavirus" is derived from Latin corona, meaning "crown" or "wreath due to the characteristic appearance  
of virions , which have a fringe of large, bulbous surface projections creating an image reminiscent of a crown or of a solar  
corona. Human coronaviruses were discovered in the 1960s. The third novel coronavirus to emerge in this century is called SARS-  
CoV-2. It caused coronavirus disease 2019 (COVID-19), which emerged from China in December 2019 and was declared a global  
pandemic by the World Health Organization on March 11, 2020. The virus enters into the host body through the mouth, nose and eye.  
From there, the virus makes its way down into the air sacs inside the lungs, known as alveoli. Once in the alveoli, the envelope spike  
glycoprotein present in the virus binds to its cellular receptor, angiotensin-converting enzyme 2 (ACE2) for SARS-CoV-2. There are  
two commonly used nucleic acid detection technologies forSARS-CoV-2 are real-time quantitative polymerase chain reaction (RT-  
qPCR) and high-throughput sequencing. With no sure shot vaccine/ drug in sight till late 2021, medical practioners are using existing  
therapies and repurposing drugs to save lives. Prevention is the only way to stay safe and healthy. Immunity plays an important role in  
this disease, so it important have nutritious and healthy food to boost the immunity.  
Keywords: COVID 19, SARS-CoV-2, Vaccine, ACE2, RT-q PCR  
2 Morphology  
Coronaviruses belongs to the family Coronaviridae,  
The name "coronavirus" is derived from Latin corona,  
meaning "crown" or "wreath due to the characteristic  
appearance of virions , which have a fringe of large, bulbous  
surface projections creating an image reminiscent of a crown  
or of a solar corona. It is spherical and pleomorphic and  
having a diameter of 0.12 micrometer. The virus envelops  
consist of lipid bi layer with structural protein such as  
membrane, spike anchored on it. There are small spike like  
surface proteins also known as hemagglutanin esterase (HE).  
Inside the envelope, there is the nucleocapsid, which is  
formed from multiple copies of the nucleocapsid (N) protein,  
which are bound to the positive-sense single-  
stranded RNA genome in a continuous beads-on-a-string type  
conformation. The combined structure protects the virus  
polyadenylated tail (3). The two-thirds of the genome  
ORF1a/b encodes polyproteins, which form the viral replicase  
transcriptase complex and the other ORFs on the one-third of  
the genome encode four main structural proteins: spike (S),  
envelope (E), nucleocapsid (N) and membrane (M) proteins,  
as well as several accessory proteins (8).  
in mammals and birds (1-3). The family is further divided into  
Torovirinae and Coronavirinae sub families. The sub family  
Coronavirinae is further sub categorized into alpha-, beta-,  
gamma- and delta- COVs (2-5). In humans, coronaviruses  
cause respiratory tract infections that can range from mild to  
lethal. Among the group there are few lethal varieties which  
with different species such as in chickens, they cause an upper  
respiratory tract disease, while in cows and pigs they  
cause diarrhea. It was first discovered in the 1930s when an  
acute respiratory infection of domesticated chickens was  
shown to be caused by infectious bronchitis virus (IBV) (3).  
Human coronaviruses were discovered in the 1960s (3, 6).  
Four of the seven known coronaviruses that sicken people  
cause only mild to moderate disease. Three can cause more  
serious, even fatal, disease. SARS coronavirus (SARS-CoV)  
emerged in November 2002 and caused severe acute  
respiratory syndrome (SARS). That virus disappeared by  
004. Middle East respiratory syndrome (MERS) is caused by  
the MERS coronavirus (MERS-CoV). Transmitted from an  
animal reservoir in camels, MERS was identified in  
September 2012 and continues to cause sporadic and localized  
outbreaks. The third novel coronavirus to emerge in this  
century is called SARS-CoV-2. It caused coronavirus disease  
019 (COVID-19), which emerged from China in December  
019 and was declared a global pandemic by the World  
Health Organization on March 11, 2020 (6, 7).  
Corresponding author: Samanwita Banerjee, Ayurvet  
Research Foundation, Chidana, Haryana, India. E-mail:  
inflammation cause cytokine storm i.e. it starts affecting its  
own body cells than to virus it’s trying to defeat which lead to  
acute respiratory distress syndrome (ARDS). At this stage, the  
surfactant that helps keeping the alveoli being collapsing has  
been diluted and fluid containing debris is imparing the gas  
exchange process that supplies oxygen to our bloodstream. In  
severe cases, it enters into the bloodstream, resulting in septic  
shock and multiple organ failure (10, 13, 14). To better  
survive in host cells, SARS-CoV and MERS-CoV use  
multiple strategies to avoid immune responses (8).  
Diagnosis of COVID 19  
Clinical diagnosis of COVID-19 is mainly based on  
epidemiological history, clinical manifestations and some  
auxiliary examinations, such as nucleic acid detection, CT  
scan, immune identification technology (Point-of-care Testing  
Figure 1: Structure of corona virus (9)  
(POCT) of IgM/IgG, enzyme-linked immunosorbent assay  
ELISA) and blood culture. However, the clinical symptoms  
Modes of transmission  
Patients with COVID-19 show symptoms such as fever,  
and signs of patients infected withSARS-CoV-2 are highly  
atypical, including respiratory symptoms, cough, fever,  
dyspnea, and viral pneumonia. Therefore, auxiliary  
examinations are necessary for the diagnosis of COVID-19,  
just as the epidemiological history. There are two commonly  
used nucleic acid detection technologies for SARS-CoV-2 are  
real-time quantitative polymerase chain reaction (RT-qPCR)  
and high-throughput sequencing (8). The high throughput  
sequencing is limited due to its equipment dependency and  
highly expensive whereas RT-q PCR is effective and  
commonly used for the detection of viruses from the  
respiratory secretion of patients. In this RT q PCR techniques  
two primers and probes are used in ORF1ab and N gene  
region for the detection. RT qPCR has to detect both the  
targeted region of viral genome present in the patients to be  
confirmed as infected. Although RT qPCR are specific but  
false negative rate cannot be denied (8). So, some of the  
medical practitioner use Ct scan of the chest is along with the  
RT q PCR. In CT Scan of the patients shows clear view of the  
abnormalities if presents. The typical CT images show  
bilateral pulmonary parenchymal ground-glass and  
consolidative pulmonary opacities, sometimes with a rounded  
morphology and a peripheral lung distribution (8, 10). Both  
the diagnosis method has its own limitation. Currently, POCT  
of IgM/IgG and ELISA kits for SARS-CoV-2 have been  
developed and pre-tested by some companies and have shown  
higher detection rates than nucleic acid detection (8,15).  
Another laboratory investigation that are based on the count  
of white blood cell count. The lymphocyte counts less than  
nonproductive cough, sneezing, dyspnea, myalgia, fatigue,  
normal or decreased leukocyte counts, shortness of breathing  
and radiographic evidence of pneumonia which are similar to  
the symptoms of SARS-CoV and MERS-CoV infections (8).  
People get infected in the neighbourhood of infected person  
who has symptoms from the virus includes cough and  
sneezing as it spreads through airborne zoonotic droplets  
shown in Fig. 2 (4, 6). The severity and onset of COVID-19 is  
dependent on age and immunity of the patients. The  
incubation period ranges from 2- 14 days and can be last for  
more than 2 weeks (2, 10). Many studies showed that Patients  
with comorbidity such as hypertension, coronary heart  
disease, obesity, are at high risk (10, 11).  
Figure 2: Airborne zoonotic droplets transmission (12)  
000 has been associated with severe disease. There also  
decrease level of platelet count (15). It is necessary for the  
development of specific and detection kit for the diagnosis of  
Pathogenesis of COVID 19  
The pathogenic mechanism of Coronavirus seems to be  
complex (10). The life cycle of the corona virus includes four  
steps i.e. attachment and entry, Replicase protein expression,  
replication and transcription and assembly and release (1).  
The virus enters into the host body through the mouth, nose  
and eye. From there, the virus makes its way down into the  
air sacs inside your lungs, known as alveoli. Once in the  
alveoli, the envelope spike glycoprotein present in the virus  
binds to its cellular receptor, angiotensin-converting enzyme 2  
Prevention and its mechanism  
In world, the cases of COVID 19 increases with high rate,  
so it is very much essential to opt the prevention. COVID 19  
is inversely proportional to the immune system of the  
individual. Most of the people get infected with COVID-19  
have mild symptoms and recover due to the proper  
medication, early stage or good immunity, whereas some  
patients are deceased due to the low immunity with having the  
previous diseases such as asthma, heart disease, diabetics, etc.  
there is no clinically proven drug for the treatment of COVID-  
(ACE2) for SARS-CoV-2. Once the virus’ RNA has entered a  
cell, new copies are made and the host cell is killed in the  
process, releasing new viruses to infect neighboring cells in  
the alveolus and cause inflammation in lung which in turn  
activate the immune response. During this process of unfolds,  
fluid begins to accumulate in the alveoli which stimulate nasal  
secretion, dry cough, sneezing and making breathing difficult.  
In severe cases, the immune system’s response to the  
9. Prevention is the only way to stay safe and healthy. As per  
the WHO guidelines, there are few prevention guidelines  
which need to be followed during this pandemic.  
India, Moderna BioNtech USA and others are in various  
stages of vaccine development. It will take at least 18 months  
or by late 2021 to establish effectiveness and safety.  
Washing of Hand Frequently: Washing your hands  
with soap and water or using alcohol-based hand rub  
regularly and thoroughly kills viruses that may be on  
your hands (16, 17).  
Using existing therapies and repurposing  
Maintain social distancing: Maintain at least 1 metre (3  
feet) distance between yourself and anyone who is  
coughing or sneezing. When someone coughs or sneezes,  
they spray small liquid droplets from their nose or mouth  
which may contain virus. If you are too close, you can  
breathe in the droplets, including the COVID-19 virus if  
the person coughing has the disease (16, 17). Avoid  
touching eyes, nose and mouth: Hands touch many  
surfaces and can pick up viruses. Once contaminated,  
hands can transfer the virus to your eyes, nose or mouth.  
From there, the virus can enter your body and can make  
you sick (16, 17).  
drugs to save lives  
With no sure shot vaccine/ drug in sight till late 2021,  
medical practioners are using existing therapies and  
repurposing drugs to save lives.  
a. Combination of Hydroxychloroquine and the antibiotic  
azithromycin has shown some effectiveness in a very  
small French study and reports from China. Chloroquine  
act as an effective antiviral drug against SARS-CoV-2  
infection at entry and post entry its stage and prevent the  
virus cell fusion by interfering with glycosylation of  
ACE2 receptor and its binding with spike protein (21,  
Practice respiratory hygiene: Make sure you, and the  
people around you, follow good respiratory hygiene.  
This means covering your mouth and nose with your  
bent elbow or tissue when you cough or sneeze. Then  
dispose of the used tissue immediately. Droplets spread  
virus. By following good respiratory hygiene, you  
protect the people around you from viruses such as cold,  
flu and COVID-19 (16, 17).  
b. Arbidol which is also known as Umifenovir inhibits viral  
fusion in the targeted membrane, that blocks the viral  
entry and Oseltamivir suppresses the viral neuraminidase  
and inhibits the release of viral particle into the targeted  
cells (22, 23).  
c. India has so far approved the combination of two  
antivirals drugs (Lopinavir and ritonavir) that targets  
viral protease to treat COVID -19 (20).  
d. Convalescent plasma (Antibody therapy) - Giving sick  
patients with antibody rich plasma from those who have  
recovered is a century old therapy with proven track  
e. Clot bursting drugs - tissue plasminogen activator is used  
to treat heart attack and stroke patients, may work to treat  
Covid-19. Clinical trials will take few months before  
safety is ensured.  
Seek medical care early: Stay home if you feel unwell.  
If you have a fever, cough and difficulty breathing, seek  
medical attention and call in advance (16).  
Cloth face covering: Wear cloth face covering in the  
public setting where the social distance cannot be opted.  
It is additionally advised to use cloth mask rather than  
N95 mask to avoid spreading of the virus and help  
people who may have the virus and do not know it from  
transmitting it to others (18).  
f. Ayurvedic medicines and herbal drugs are also used  
along with the therapeutic drug for boosting the  
immunity. Specific prophylaxis includes Sanjeevani bati,  
chitrakadi, combination of Guduchi, (Tinospora  
cordifolia) Shunthi (Zingiber officinale) and Haridra  
Disinfecting surfaces: Proper cleaning of frequently  
touched surfaces such as door, cabinet, etc. has to be  
performed using household detergent and water because  
COVID-19 virus survives on surfaces for many hours  
(Curcuma longa Linn.). Sanjeevani bati act against cold  
cough and communicable diseases and also strengthens  
and rejuvenates the immune system. Other herbs such,  
Ocimum sanctum, Glycyrrhiza glabra, Adhatoda vasica,  
Andrographis paniculata, Swertiachirata, Moringa  
oleifera, Triphala and Trikatu has antiviral properties and  
inhibits the viral protease (24).  
Apart from the aforementioned steps, there are several  
other steps, which can be opt by individual as a prevention  
such as resting and avoiding overexertion, drinking sufficient  
amount of water, avoiding smoking and smoky areas, etc. (1).  
Current development strategies on treatment  
of COVID 19  
Currently, there is no clinically approved drug or vaccines are  
available which show effectiveness against COVID-19. Many  
trials are on process for drug development in worldwide. The  
supportive treatments are under trial to relive discomfort  
during illness. In February Hydroxychloroquine was found to  
effectively reduce COVID-19 illness. Preliminary results from  
a trial indicated that chloroquine is effective and safe in  
COVID-19 pneumonia, "improving lung imaging findings,  
promoting a virus-negative conversion, and shortening the  
disease course but it has numerous, potentially serious, side  
effects. High doses of hydroxychloroquine are proving to be  
lethal (20). Remdesevir, adenosine nucleotide analog act as a  
viral RNA- dependent RNA polymerase inhibitor that inhibits  
RNA synthesis in coronavirus and act as an antiviral agent  
The sudden outbreak of the infectious disease COVID-19  
is a threat to each and every individual globally. The  
remarkable point of this infection is its spreading rate among  
the communities. Scientific communities are working on the  
development of drugs and vaccines to eradicate the disease  
from the root level. During the period of this pandemic, it is  
necessary to opt the precautionary measures and avoid the  
spreading among the community. It is also important not to  
believe the rumors about the pandemic and depend on the  
reliable and authentic information. Immunity plays an  
important role in this disease, so it important have nutritious  
and healthy food to boost the immunity as per ministry of  
AYUSH, Govt. of India.  
21). Recombinant human monoclonal antibody can bind with  
receptor binding site and can be effective against COVID 19  
infection. Vaccine development with a live-attenuated virus,  
viral vectors, inactivated virus, subunit vaccines, recombinant  
DNA, and proteins vaccine is another mode of strategy which  
can reduce the severity of outbreak (8). Serum Institute if  
We would like to convey our thanks to Shri Mohan Ji  
Saxena, Managing Trustee for his valuable guidance and  
Shrikrushna Subhash Unhale, Quazi Bilal Ansar, Shubham Sanap  
Suraj Thakhre, Shreya Wadatkar, Rohit Bairagi, Prof. Suraj  
Sagrule and Prof. Dr. K. R. Biyani, A REVIEW ON CORONA  
VIRUS (COVID-19), World Journal of Pharmaceutical and life  
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