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ISSN (Print): 2666-7967
ISSN (Online): 2666-7975

Review Article

The Emergence of Novel Coronavirus Disease, Global Treatment Update and its Containment Strategies in Overpopulated Countries: A Review

Author(s): Fazli Azim, Md Shahidul Islam, Hedaeytullah Saju, Kaniz Fatema, Aneela Hayat, Mostofa Kamal, Md Sarfraz, Nawshad Muhammad and Syed A.A. Rizvi*

Volume 2 , Issue 5 , 2021

Published on: 22 November, 2020

Article ID: e060521188250 Pages: 10

DOI: 10.2174/2666796701999201123101730


The ongoing pandemic of the novel coronavirus SARS-CoV-2 (COVID-19) has created a major challenge for the public health worldwide. The reported cases indicate that the outbreak is more widespread than initially assumed. Around 18 million people have been infected with 689,000 reported deaths (August 2020; the number is increasing daily); with a high mutation rate, this virus poses an even more serious threat worldwide. The actual source of COVID-19 is still unclear; even if the initial reports link it to the Chinese seafood wet market in Wuhan, other animals such as birds, snakes, and many small mammals including bats are also linked with this novel coronavirus. The structure of the COVID-19 shows distinctive proteins among which spike proteins have a pivotal role in host cell attachment and virus-cell membrane fusion in order to facilitate virus infection. Currently, no specific antiviral treatment or vaccine is available. Various drug candidates, including SARS-CoV and MERS-CoV protease inhibitors, neuraminidase inhibitors, RNA synthesis inhibitors, ACE2 inhibitors and lungs supportive therapy, are under trials. Cell-based therapy also appeared with remarkable treatment possibilities. In this article, we endeavored to succinctly cover the current and available treatment options, including pharmaceuticals, cell-based therapy, and traditional medicine. We also focused on the extent of damages by this novel coronavirus in India, Pakistan, and Bangladesh; the strategies adopted and the research activities initiated so far by these densely populated countries (neighboring China) are explained in this review.

Keywords: SARS-CoV, MERS-CoV, SARS-CoV-2, COVID-19, antivirals, cell-based therapy, mesenchymal stem cells (MSCs), traditional chinese medicine (TCM).

Graphical Abstract
Zhavoronkov A, Vladimir A, Alexander Z, et al. Potential COVID-2019 3C-like protease inhibitors designed using generative deep learning approaches. ChemRciv, preprints
Sanchez-Gonzalez MA, Moskowitz D, Issuree PD, Yatzkan G, Rizvi SAA, Day K. A Pathophysiological perspective on COVID-19's lethal complication: from viremia to hypersensitivity pneumonitis-like immune dysregulation. Infect Chemother 2020; 52(3): 335-44.
[] [PMID: 32537960]
Zhou P, Yang XL, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature 2020; 579(7798): 270-3.
[] [PMID: 32015507]
Sahin AR, Erdogan A, Mutlu Agaoglu P, et al. 2019 Novel coronavirus (COVID-19) outbreak: a review of the current literature. EJMO 2020; 4(1): 1-7.
Commision WMH. Wuhan Municipal Health Commission on the current situation of pneumonia in our city 2019. accessed on 19 January 2020. Available from:
Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020; 395(10223): 497-506.
[] [PMID: 31986264]
Chen RC, Tang XP, Tan SY, et al. Treatment of severe acute respiratory syndrome with glucosteroids: the Guangzhou experience. Chest 2006; 129(6): 1441-52.
[] [PMID: 16778260]
Siemieniuk RA, Meade MO, Alonso-Coello P, et al. Corticosteroid therapy for patients hospitalized with community-acquired pneumonia: a systematic review and meta-analysis. Ann Intern Med 2015; 163(7): 519-28.
[] [PMID: 26258555]
Organization WHO. WHO welcomes preliminary results about dexamethasone use in treating critically ill COVID-19 patients 2020. Available from:
Therapy RREC. Dexamethasone results Available from:
Organization WHO. Clinical management of severe acute respiratory infection when novel coronavirus (‎‎‎‎‎‎2019-nCoV)‎‎‎‎‎‎ infection is suspected: interim guidance 2020. Available from:
Russell CD, Millar JE, Baillie JK. Clinical evidence does not support corticosteroid treatment for 2019-nCoV lung injury. Lancet 2020; 395(10223): 473-5.
[] [PMID: 32043983]
Shang L, Zhao J, Hu Y, Du R, Cao B. On the use of corticosteroids for 2019-nCoV pneumonia. Lancet 2020; 395(10225): 683-4.
[] [PMID: 32122468]
Gralinski LE, Menachery VD. Return of the Coronavirus: 2019-nCoV. Viruses 2020; 12(2): 135.
[] [PMID: 31991541]
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.
[] [PMID: 32257431]
Ji W, Wei W, Xiaofang Z, et al. Homologous recombination within the spike glycoprotein of the newly identified coronavirus may boost cross-species transmission from snake to human. J Med Virol 2020; 92(4): 433-40.
[] [PMID: 31967321]
Omrani AS, Saad MM, Baig K, et al. Ribavirin and interferon alfa-2a for severe Middle East respiratory syndrome coronavirus infection: a retrospective cohort study. Lancet Infect Dis 2014; 14(11): 1090-5.
[] [PMID: 25278221]
Wu C, Liu Y, Yang Y, et al. Analysis of therapeutic targets for SARS-CoV-2 and discovery of potential drugs by computational methods. Acta Pharm Sin B 2020; 10(5): 766-88.
[] [PMID: 32292689]
Morse JS, Lalonde T, Xu S, Liu WR. Learning from the past: possible urgent prevention and treatment options for severe acute respiratory infections caused by 2019‐nCoV. ChemBioChem 2020; 21(5): 730-8.
[] [PMID: 32022370]
Organization WHO. Coronavirus disease (COVID-19) pandemic: Coronavirus disease (COVID-19) outbreak situation. Available from:
Worldometer. Covid-19 coronavirus pandemic 2020. Available from:
Lu H. Drug treatment options for the 2019-new coronavirus (2019-nCoV). Biosci Trends 2020; 14(1): 69-71.
[] [PMID: 31996494]
Deng X, StJohn SE, Osswald HL, et al. Coronaviruses resistant to a 3C-like protease inhibitor are attenuated for replication and pathogenesis, revealing a low genetic barrier but high fitness cost of resistance. J Virol 2014; 88(20): 11886-98.
[] [PMID: 25100843]
Rosa SGV, Santos WC. Clinical trials on drug repositioning for COVID-19 treatment. Rev Panam Salud Publica 2020; 44: e40.
[] [PMID: 32256547]
Krogan N. We found and tested 47 old drugs that might treat the coronavirus: Results show promising leads and a whole new way to fight COVID-19. Available from:
Hurst M, Faulds D. Lopinavir. Drugs 2000; 60(6): 1371-9.
[] [PMID: 11152017]
Yao TT, Qian JD, Zhu WY, Wang Y, Wang GQ. A systematic review of lopinavir therapy for SARS coronavirus and MERS coronavirus-A possible reference for coronavirus disease-19 treatment option. J Med Virol 2020; 92(6): 556-63.
[] [PMID: 32104907]
Lai C-C, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (COVID-19): The epidemic and the challenges. Int J Antimicrob Agents 2020; 55(3): 105924.
[] [PMID: 32081636]
Boffito M, Arnaudo I, Raiteri R, et al. Clinical use of lopinavir/ritonavir in a salvage therapy setting: pharmacokinetics and pharmacodynamics. AIDS 2002; 16(15): 2081-3.
[] [PMID: 12370509]
Sheahan TP, Sims AC, Leist SR, et al. Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir, and interferon beta against MERS-CoV. Nat Commun 2020; 11(1): 222.
[] [PMID: 31924756]
Recoverytrial. Lopinavir-Ritonavir results: Statement from the Chief Investigators: No clinical benefit from use of lopinavir-ritonavir in hospitalised COVID-19 patients studied in RECOVERY Available from:
Tan T. First antiviral drug gets go signal to fight COVID-19. The Filipino Times. Available from:
Recoverytrial. Hydroxychloroquine results: Statement from the Chief Investigators: No clinical benefit from use of hydroxychloroquine in hospitalised patients with COVID-19. Available from:
Gilead Press release. Gilead presents additional data on investigational antiviral remdesivir for the treatment of COVID-19. Available from:
European Commission. European Commission secures EU access to Remdesivir for treatment of COVID-19. Available from:
Institute SBPMD. Nature study identifies 21 existing drugs that could treat COVID-19. Available from:
Li G, De Clercq E. Therapeutic options for the 2019 novel coronavirus (2019-nCoV). Nat Rev Drug Discov 2020; 19(3): 149-50.
[] [PMID: 32127666]
Hennigan S, Kavanaugh A. Interleukin-6 inhibitors in the treatment of rheumatoid arthritis. Ther Clin Risk Manag 2008; 4(4): 767-75.
[PMID: 19209259]
Guaraldi G, Meschiari M, Cozzi-Lepri A, et al. Tocilizumab in patients with severe COVID-19: a retrospective cohort study. Lancet Rheumatol 2020; 2(8): e474-84.
[] [PMID: 32835257]
Michot J-M, Albiges L, Chaput N, et al. Tocilizumab, an anti-IL-6 receptor antibody, to treat COVID-19-related respiratory failure: a case report. Ann Oncol 2020; 31(7): 961-4.
[] [PMID: 32247642]
Roche. Roche provides an update on the phase III COVACTA trial of Actemra/RoActemra in hospitalised patients with severe COVID-19 associated pneumonia. Available from:
Rothan HA, Stone S, Natekar J, Kumari P, Arora K, Kumar M. The FDA-approved gold drug auranofin inhibits novel coronavirus (SARS-COV-2) replication and attenuates inflammation in human cells. Virology 2020; 547: 7-11.
[] [PMID: 32442105]
Russian News Agency. Koronavir anti-coronavirus drug released in Russia. Available from:
Yañez R, Lamana ML, García-Castro J, Colmenero I, Ramírez M, Bueren JA. Adipose tissue-derived mesenchymal stem cells have in vivo immunosuppressive properties applicable for the control of the graft-versus-host disease. Stem Cells 2006; 24(11): 2582-91.
[] [PMID: 16873762]
Djouad F, Bouffi C, Ghannam S, Noël D, Jorgensen C. Mesenchymal stem cells: innovative therapeutic tools for rheumatic diseases. Nat Rev Rheumatol 2009; 5(7): 392-9.
[] [PMID: 19568253]
Barbado J, Tabera S, Sánchez A, García-Sancho J. Therapeutic potential of allogeneic mesenchymal stromal cells transplantation for lupus nephritis. Lupus 2018; 27(13): 2161-5.
[] [PMID: 30290717]
Dulamea A. Mesenchymal stem cells in multiple sclerosis - translation to clinical trials. J Med Life 2015; 8(1): 24-7.
[PMID: 25914733]
Rahim F, Arjmand B, Shirbandi K, Payab M, Larijani B. Stem cell therapy for patients with diabetes: a systematic review and meta-analysis of metabolomics-based risks and benefits. Stem Cell Investig 2018; 5: 40.
[PMID: 30596080]
Choi EW, Shin IS, Lee HW, et al. Transplantation of CTLA4Ig gene-transduced adipose tissue-derived mesenchymal stem cells reduces inflammatory immune response and improves Th1/Th2 balance in experimental autoimmune thyroiditis. J Gene Med 2011; 13(1): 3-16.
[] [PMID: 21259404]
Lu D, Li Y, Wang L, Chen J, Mahmood A, Chopp M. Intraarterial administration of marrow stromal cells in a rat model of traumatic brain injury. J Neurotrauma 2001; 18(8): 813-9.
[] [PMID: 11526987]
de Witte SFH, Luk F, Sierra Parraga JM, et al. Immunomodulation by therapeutic mesenchymal stromal cells (MSC) is triggered through phagocytosis of MSC by monocytic cells. Stem Cells 2018; 36(4): 602-15.
[] [PMID: 29341339]
Luz-Crawford P, Djouad F, Toupet K, et al. Mesenchymal stem cell‐derived interleukin 1 receptor antagonist promotes macrophage polarization and inhibits B cell differentiation. Stem Cells 2016; 34(2): 483-92.
[] [PMID: 26661518]
Ge W, Jiang J, Arp J, Liu W, Garcia B, Wang H. Regulatory T-cell generation and kidney allograft tolerance induced by mesenchymal stem cells associated with indoleamine 2,3-dioxygenase expression. Transplantation 2010; 90(12): 1312-20.
[] [PMID: 21042238]
Luk F, Carreras-Planella L, Korevaar SS, et al. Inflammatory conditions dictate the effect of mesenchymal stem cells on B cell function. Front Immunol 2017; 8: 1042.
[] [PMID: 28894451]
Spaggiari GM, Capobianco A, Abdelrazik H, Becchetti F, Mingari MC, Moretta L. Mesenchymal stem cells inhibit natural killer-cell proliferation, cytotoxicity, and cytokine production: role of indoleamine 2,3-dioxygenase and prostaglandin E2. Blood 2008; 111(3): 1327-33.
[] [PMID: 17951526]
Leng Z, Zhu R, Hou W, et al. Transplantation of ACE2-mesenchymal stem cells improves the outcome of patients with COVID-19 pneumonia. Aging Dis 2020; 11(2): 216-28.
[] [PMID: 32257537]
Liang B, Junhui C, Tao L, et al. Clinical remission of a critically ill COVID-19 patient treated by human umbilical cord mesenchymal stem cells. ChinaXiv 2020 Medicine 2020; 99: e21429.
Trails IRC. Mesenchymal stem cell therapy for SARS-CoV-2-related acute respiratory distress syndrome Available from:
US Food and Drug. FDA warns about stem cell therapies Available from:
Qin H, Zhao A. Mesenchymal stem cell therapy for acute respiratory distress syndrome: from basic to clinics. Protein Cell 2020; 11(10): 707-22.
[] [PMID: 32519302]
Ren JL, Zhang AH, Wang XJ. Traditional Chinese medicine for COVID-19 treatment. Pharmacol Res 2020; 155: 104743.
[] [PMID: 32145402]
Du HZ, Hou XY, Miao YH, Huang BS, Liu DH. Traditional Chinese Medicine: an effective treatment for 2019 novel coronavirus pneumonia (NCP). Chin J Nat Med 2020; 18(3): 206-10.
[] [PMID: 32245590]
Chen YZJ, Liu Y, Shang HC. Comprehensive comparison and analysis of the prevention and treatment of coronavirus disease 2019 and severe acute respiratory syndrome with traditional chinese medicine. World J Tradit Chin Med 2020; 6: 124-31.
Tao Z, Gao J, Zhang G, et al. Shufeng Jiedu Capsule protect against acute lung injury by suppressing the MAPK/NF-κB pathway. Biosci Trends 2014; 8(1): 45-51.
[] [PMID: 24647112]
Mhatre S, Srivastava T, Naik S, Patravale V. Antiviral activity of green tea and black tea polyphenols in prophylaxis and treatment of COVID-19: A review. Phytomedicine 2021; 85: 153286.
[] [PMID: 32741697]
Bhuiyan ZSHK. What can the India experience tell Bangladesh about Covid-19?. Dhaka Tribune Available from:
The Economic Times India declares Covid-19 as ‘notified disaster’. Available from:
Regan MSH. India’s Modi extends nationwide coronavirus lockdown until May 3. Available from:
The Indian Council of Medical Research (ICMR). SARS-CoV-2 (COVID-19) Testing Status 2020. Available from:
ICMR. Information on COVID-19. Available from:
India Today. Coronavirus: 80% cases asymptomatic, but no need to revise testing criteria, says ICMR. Available from:
Reuters. Two more coronavirus cases confirmed in Pakistan. Available from:
Business Today. Pakistan reports 730 active coronavirus cases; shuts all international flights. Available from:
Pakistan Gov. Coronavirus in Pakistan, confirmed cases. Available from:
Latif A. COVID-19: Pakistan extends lockdown until April 30. Available from:
Latif A. Pakistan awaits clinical trials for COVID-19 treatment. Available from:
The News. Sindh government gives go-ahead to trial of passive immunisation to treat coronavirus. Available from:
Khan M. Pakistani patient who recovered from coronavirus donates blood plasma for treatment. Available from:
Health NIO. COVID-19. Available from:
Qureshi AK. Ayub Medical College becomes part of global research for COVID-19 treatment. Available from:
Institute of Epidemiology, Disease Control and Research. Covid-19 status Bangladesh. Available from:
Qureshi AK. UNB. Coronavirus in Bangladesh: Large onus on self-quarantine for recent arrivals. Available from:
The Daily Star. Coronavirus: Four-level emergency plan in place. Available from:

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