INFECTIOUS DISEASE

- COVID-19
 PREFACE

From the formation stage of an embryo to human death, we have found a variety of
diseases.in that some are not vulnerable but others are.Along with the information
collected from history, there have been many outbreaks that have turned heaven earth
into death catacombs.However, we can even infer that past outbreaks are not as
serious as present outbreaks. Even though we found vaccines and drugs to use, we
cannot control mortality. So I collected some information about COVID-19 as a
biology student.
 HISTORY
HOW DID CORONAVIRUS START:

The first case of COVID-19 was reported Dec. 1, 2019, and the cause was a then-new
coronavirus later named SARS-CoV-2. SARS-CoV-2 may have originated in an animal
and changed (mutated) so it could cause illness in humans. In the past, several infectious
disease outbreaks have been traced to viruses originating in birds, pigs, bats and other
animals that mutated to become dangerous to humans. Research continues, and more
study may reveal how and why the coronavirus evolved to cause pandemic disease.
WHY IS IT CALLED AS CORONAVIRUS:

The pathogen got its name due to the spiky crown (or corona in Latin) that you can
see on its surface when you take a look at it underneath a microscope, explains Rishi
Desai, MD, a former epidemic intelligence service officer in the division of viral
diseases at the Centers for Disease Control and Prevention (CDC). And there isn't one
sole coronavirus. Coronaviruses are actually a family of viruses that cause respiratory
infections, according to the information. While many of the coronaviruses out there
don’t give humans too much trouble (some strains are responsible for mild cases of
the common cold, for example), other types that initially infect animals can evolve to
infect humans with more severe diseases, like Middle East respiratory syndrome
(MERS) and severe acute respiratory syndrome (SARS), says Dr. Desai. The latest
coronavirus to make the leap from animals to humans is the one the world is
concerned about right now: SARS-CoV2.
You may have also heard the coronavirus on everyone's radar right now
referred to as the new or novel coronavirus—and that's simply because it’s the
latest coronavirus to be discovered in humans, says Natasha Bhuyan, MD, a
specialist in infectious diseases and family physician in Phoenix, Arizona. As
such, it’s quite literally new to us.
Why is it necessary to name new viruses and the
diseases they cause?

Too often when a health situation like this happens, the illness quickly gets
nicknamed based on where it originated or the first animal species or human
populations it infects, which can lead to misinformation and xenophobia (not
cool). As Ghebreyesus said on Twitter, "having a name matters to prevent the
use of other names that can be inaccurate or stigmatizing."

The WHO even has best practices for naming new human diseases. The aim of
those guidelines is "to minimize unnecessary negative impact of disease names
on trade, travel, tourism or animal welfare, and avoid causing offense to any
cultural, social, national, regional, professional or ethnic groups," the
organization states.
TIMELINE COVID-19
31 Dec 2019

Wuhan Municipal Health Commission, China, reported a cluster of cases of pneumonia in

Wuhan, Hubei Province. A novel coronavirus was eventually identified.

1 January 2020

WHO had set up the IMST (Incident Management Support Team) across the three levels of the
organization: headquarters, regional headquarters and country level, putting the organization on
an emergency footing for dealing with the outbreak.

4 January 2020

WHO reported on social media that there was a cluster of pneumonia cases – with no deaths – in
Wuhan, Hubei province.

5 January 2020

WHO published our first Disease Outbreak News on the new virus. This is a flagship technical
publication to the scientific and public health community as well as global media. It contained a
risk assessment and advice, and reported on what China had told the organization about the
status of patients and the public health response on the cluster of pneumonia cases in Wuhan.

10 January 2020

WHO issued a comprehensive package of technical guidance online with advice to all countries
on how to detect, test and manage potential cases, based on what was known about the virus at
the time. This guidance was shared with WHO's regional emergency directors to share with
WHO representatives in countries.

Based on experience with SARS and MERS and known modes of transmission of respiratory
viruses, infection and prevention control guidance were published to protect health workers
recommending droplet and contact precautions when caring for patients, and airborne
precautions for aerosol generating procedures conducted by health workers.

12 January 2020

China publicly shared the genetic sequence of COVID-19.

13 January 2020

Officials confirm a case of COVID-19 in Thailand, the first recorded case outside of China.

14 January 2020

WHO's technical lead for the response noted in a press briefing there may have been limited
human-to-human transmission of the coronavirus (in the 41 confirmed cases), mainly through
family members, and that there was a risk of a possible wider outbreak. The lead also said that
human-to-human transmission would not be surprising given our experience with SARS, MERS
and other respiratory pathogens.

20-21 January 2020

WHO experts from its China and Western Pacific regional offices conducted a brief field visit to
Wuhan.

22 January 2020

The WHO mission to China issued a statement saying that there was evidence of
human-to-human transmission in Wuhan but more investigation was needed to understand the
full extent of transmission.
22- 23 January 2020

The WHO Director- General convened an Emergency Committee (EC) under the International
Health Regulations (IHR 2005) to assess whether the outbreak constituted a public health
emergency of international concern. The independent members from around the world could not
reach a consensus based on the evidence available at the time. They asked to be reconvened
within 10 days after receiving more information.

28 January 2020

A senior WHO delegation led by the Director-General travelled to Beijing to meet China’s
leadership, learn more about China’s response, and to offer any technical assistance.

While in Beijing, Dr. Tedros agreed with Chinese government leaders that an international team
of leading scientists would travel to China on a mission to better understand the context, the
overall response, and exchange information and experience.

30 January 2020

The WHO Director-General reconvened the Emergency Committee (EC). This was earlier than
the 10-day period and only two days after the first reports of limited human-to-human
transmission were reported outside China. This time, the EC reached consensus and advised the
Director-General that the outbreak constituted a Public Health Emergency of International
Concern (PHEIC). The Director-General accepted the recommendation and declared the novel
coronavirus outbreak (2019-nCoV) a PHEIC. This is the 6th time WHO has declared a PHEIC
since the International Health Regulations (IHR) came into force in 2005.

WHO’s situation report for 30 January reported 7818 total confirmed cases worldwide, with the
majority of these in China, and 82 cases reported in 18 countries outside China. WHO gave a
risk assessment of very high for China, and high at the global level.

3 February 2020
WHO releases the international community's Strategic Preparedness and Response Plan to help
protect states with weaker health systems.

11-12 February 2020

WHO convened a Research and Innovation Forum on COVID-19, attended by more than 400
experts and funders from around the world, which included presentations by George Gao,
Director General of China CDC, and Zunyou Wu, China CDC's chief epidemiologist.

16-24 February 2020

The WHO-China Joint mission, which included experts from Canada, Germany, Japan, Nigeria,
Republic of Korea, Russia, Singapore and the US (CDC, NIH) spent time in Beijing and also
travelled to Wuhan and two other cities. They spoke with health officials, scientists and health
workers in health facilities (maintaining physical distancing). The report of the joint mission can
be found here:
https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-fina
l-report.pdf

11 March 2020

Deeply concerned both by the alarming levels of spread and severity, and by the alarming levels
of inaction, WHO made the assessment that COVID-19 can be characterized as a pandemic.

13 March 2020

COVID-19 Solidarity Response Fund launched to receive donations from private individuals,
corporations and institutions.

18 March 2020

WHO and partners launch the Solidarity Trial, an international clinical trial that aims to generate
robust data from around the world to find the most effective treatments for COVID-19.
FAMILY OF VIRUSES:

The original ICTV viral classification, which is entirely separate from the tree of
cellular life, included only the lower rungs of the evolutionary hierarchy, from species
and genus up to the order level — a tier equivalent to primates or trees with cones in
the classification of multicellular life. There were no higher levels. And many viral
families floated alone, with no links to other kinds of virus. So in 2018, the ICTV
added higher-order levels: classes, phyla and kingdoms.

At the very top, it

invented ‘realms’,
intended as
counterparts to the
‘domains’ of
cellular life —
Bacteria, Archaea
and Eukaryota —
but using a different
word to differentiate
between the two
trees. (Several years ago, some scientists suggested that certain viruses might fit into
the cell-based evolutionary tree, but that idea has not gained widespread favour.)

The ICTV outlined the branches of the tree, and grouped RNA-based viruses into a
realm called Riboviria. SARS-CoV-2 and other coronaviruses, which have
single-stranded RNA genomes, are part of this realm. But then it was up to the
broader community of virologists to propose further taxonomic groups. As it
happened, Eugene Koonin, an evolutionary biologist at the National Center for
Biotechnology Information in Bethesda, Maryland, had assembled a team to analyse
all the viral genomes, as well as the latest research on viral proteins, to create a
first-draft taxonomy9.

They reorganized Riboviria and proposed three more realms (see ‘Virus realms’).
There was some quibbling over the details, Koonin says, but the taxonomy was
ratified without much trouble by ICTV members in 2020. Two further realms got the
green light in 2021, but the original four realms will probably remain the largest, he
says. Eventually, Koonin speculates, the realms might number up to 25.
MOLECULAR STRUCTURE OF CORONAVIRUS:

Coronaviruses are members of the family

Coronaviridae, order Nidovirales. These
enveloped viruses possess genomes in the
form of single-stranded RNA molecules
of positive sense, that is, the same sense
as the messenger RNA (mRNA). At
present, four genera are known:
Alphacoronavirus, Betacoronavirus,
Gammacoronavirus, Deltacoronavirus.
Members of the genera Alphacoronavirus
and Betacoronavirus are identified to
cause human disease, whereas those of the genera Gammacoronavirus and Deltacoronavirus are
causative agents of animal disease .

Coronaviruses have a typical characteristic in negative-stain electron microscopy showing a

fringe on their surface structure like a spike. This fringe resembles the solar corona, from which
the name coronavirus was derived . These viruses are roughly spherical with an average diameter
of 80–120 nm. The surface spikes of the coronaviruses project about 17–20 nm from the surface
of the virus particle and have been described as club-like, pear-shaped, or petal-shaped, having a
thin base which swells to a width of approximately 10 nm at the distal extremity . A schematic
visualization of the coronavirus virion is presented in. In infection, the coronavirus particle
serves three important functions for the genome: first, it provides the means to deliver the viral
genome across the plasma membrane of a host cell; second, it serves as a means of escape for the
newly synthesized genome; third, the viral particle functions as a durable vessel which protects
the genome integrity on its journey between cells .
The genome of the coronaviruses codes four main structural proteins: the spike (S) protein, the
nucleocapsid (N) protein, the membrane (M) protein and the envelope (E) protein, each of which
play primary roles in the structure of the virus particle as well as in other aspects of the viral
replication cycle. Generally, all of these proteins are needed to form a structurally complete
virion. Some coronaviruses, however, do not require the full assemblage of the structural proteins
to produce a complete, infectious viral particle. This indicates that some structural proteins are
likely dispensable, or that those viruses may encode additional proteins with compensatory roles
. The envelope of coronaviruses contains three or four viral proteins. The major proteins of the
viral envelope are the S and the M proteins. In some, but not all coronaviruses, a third major
envelope protein, the hemagglutinin esterase (HE) is found. Lastly, the small E protein
constitutes a minor, however critical structural component of the viral envelope . Many of the
coronavirus proteins are modified by post-translational modifications which change the protein
structure by proteolytic cleavage and disulfide bond formation or extend the chemical repertoire
of the 20 standard amino acids by introducing new functional groups. Functional groups are
commonly added through phosphorylation, glycosylation and lipidation (such as palmitoylation
and myristoylation). The post-translational modifications play critical roles in regulating folding,
stability, enzymatic activity, subcellular localization and interaction of the viral protein with other
proteins .
ACCESSORY PROTEINS PRESENT IN CORONAVIRUS:

All coronavirus genomes contain accessory

genes interspersed among the canonical
genes, replicase, S, E, M, N which vary
from as few as one (HCoV-NL63) to as
many as eight genes (SARS-CoV). These
accessory proteins are dispensable for
coronavirus replication, however, they may
confer biological advantages for the
coronaviruses in the environment of the
infected host cells. Some accessory
proteins have been shown to exhibit roles in virus-host interaction and seem to have functions in
viral pathogenesis. For SARS-CoV, some of the accessory proteins have been shown to be able to
influence the interferon signaling pathways and the generation of pro-inflammatory cytokines .
Most of the characterized coronavirus accessory proteins have been indicated to have a role in
antagonizing the host response. The MERS-CoV accessory proteins have also been shown to be
important for the virus pathogenesis. Deletion of four ORFs (ORF3, ORF4a, ORF4b, and ORF5)
causes major impacts on viral replication and pathogenesis . The ORF4a protein of the human
coronavirus 229E has been shown to form homo-oligomers that have ion channel activity and is
suggested to function as a viroporin which is critical for regulating the viral reproduction.
Functionally, it is analogous to the SARS-CoV 3a protein, which also plays a role as a viroporin
that regulates virus production . Similarly, the ns12.9 accessory protein of the human coronavirus
OC43 has been shown to act as a viroporin involved in virion morphogenesis and pathogenesis .
The human coronavirus NL63 has one ORF encoding an accessory protein 3 (ORF3). The
hCoV-NL63 ORF3 protein has been demonstrated to colocalize extensively with the E and M
proteins within the ERGIC. It is incorporated into virions and therefore it functions as an
additional structural protein .
LIFE CYCLE OF CORONAVIRUS:

When SARS-CoV-2 enters into the alveolar epithelial cell of the human respiratory tract, the
virus triggers human immune response owing to the rapid cell multiplication rate of
SARS-CoV-2. Next, the pulmonary tissue present in the human respiratory tract gets damaged by
eliciting the activation of more white blood cells, which is commonly known as cytokine release
syndrome . Cytokine release syndrome or hypercytokinemia is a form of systemic inflammatory
response syndrome when a large number of human white blood cells are activated and
uncontrollably release inflammatory cytokines and cause severe lung conditions commonly
known as acute respiratory distress syndrome (ARDS) . This ARDS can prevent the organs from
receiving oxygen required for their proper functioning and eventually causing multiple organ
failure .

During the analysis of the first 99 confirmed cases of patients infected with SARS-CoV-2,
cytokine release syndrome was noticed for patients with severe COVID-19 symptoms; whereas
17 patients were diagnosed with ARDS and among them, the condition of 11 patients
deteriorated within a short period of time and eventually, they died due to multiple organ failure .
Moreover, due to the infection of COVID-19, the total number of lymphocyte cells reduces and
the functionally of these lymphocyte cells get exhausted which also affects the immune system
and therefore, causing respiratory organ failure [25].

The original ICTV viral classification, which is entirely separate from the tree of
cellular life, included only the lower rungs of the evolutionary hierarchy, from species
and genus up to the order level — a tier equivalent to primates or trees with cones in
the classification of multicellular life. There were no higher levels. And many viral
families floated alone, with no links to other kinds of virus. So in 2018, the ICTV
added higher-order levels: classes, phyla and kingdoms.

At the very top, it invented ‘realms’, intended as counterparts to the ‘domains’ of

cellular life — Bacteria, Archaea and Eukaryota — but using a different word to
differentiate between the two trees. (Several years ago, some scientists suggested that
certain viruses might fit into the cell-based evolutionary tree, but that idea has not
gained widespread favour.)

The ICTV outlined the branches of the tree, and grouped RNA-based viruses into a
realm called Riboviria. SARS-CoV-2 and other coronaviruses, which have
single-stranded RNA genomes, are part of this realm. But then it was up to the
broader community of virologists to propose further taxonomic groups. As it
happened, Eugene Koonin, an evolutionary biologist at the National Center for
Biotechnology Information in Bethesda, Maryland, had assembled a team to analyse
all the viral genomes, as well as the latest research on viral proteins, to create a
first-draft taxonomy.

They reorganized Riboviria and proposed three more realms (see ‘Virus realms’).
There was some quibbling over the details, Koonin says, but the taxonomy was
ratified without much trouble by ICTV members in 2020. Two further realms got the
green light in 2021, but the original four realms will probably remain the largest, he
says. Eventually, Koonin speculates, the realms might number up to 25.
SIMILARITY BETWEEN COVID -19 AND FLU
How COVID-19 and flu spread

The viruses that cause COVID-19 and the flu spread in similar ways. They can both
spread between people who are in close contact (within 6 feet, or 2 meters). The
viruses spread through respiratory droplets or aerosols released through talking,
sneezing or coughing. These droplets can land in the mouth or nose of someone
nearby or be inhaled. These viruses can also spread if a person touches a surface with
one of the viruses on it and then touches his or her mouth, nose, or eyes.

1.COVID-19 and flu symptoms

COVID-19 and the flu have many signs and symptoms in common, including:

● Fever
● Cough
● Shortness of breath or difficulty breathing
● Tiredness
● Sore throat
● Runny or stuffy nose
● Muscle aches
● Headache
● Nausea or vomiting, but this is more common in children than in adults

The signs and symptoms of both diseases can range from no symptoms to mild or
severe symptoms. Because COVID-19 and the flu have similar symptoms, it can be
hard to diagnose which condition you have based on your symptoms alone. Testing
may be done to see if you have COVID-19 or the flu. You can also have both diseases
at the same time.

2.COVID-19 and flu complications

Both COVID-19 and the flu can lead to serious complications, such as:

● Pneumonia
● Acute respiratory distress syndrome
● Organ failure
● Heart attacks
● Heart or brain inflammation
● Stroke
● Death

Many people with the flu or mild symptoms of COVID-19 can recover at home with
rest and fluids. But some people become seriously ill from the flu or COVID-19 and
need to stay in the hospital.
DIFFERENCE BETWEEN COVID-19 AND FLU:
COVID-19 and the flu have several differences, including different causes,
complications and treatments. COVID-19 and the flu also spread differently, have
different severity levels and a few different symptoms, and can be prevented by
different vaccines.

1.COVID-19 and flu causes

COVID-19 and the flu have several differences. COVID-19 and the flu are caused by
different viruses. COVID-19 is caused by a new coronavirus called SARS-CoV-2,
while influenza is caused by influenza A and B viruses.

2.COVID-19 and flu symptoms

Symptoms of COVID-19 and the flu appear at different times and have some
differences. COVID-19 symptoms generally appear 2-14 days after exposure. Flu
symptoms usually appear about 1-4 days after exposure.

3.COVID-19 and flu spread and severity

COVID-19 appears to be more contagious and to spread more quickly than the flu.
With COVID-19, you may experience loss of taste or smell. Severe illness such as
lung injury is more frequent with COVID-19 than with influenza. The mortality rate
also is higher with COVID-19 than the flu.

So far, more than 38 million people have had COVID-19 in the U.S. as reported by
the Centers for Disease Control and Prevention (CDC). More than 630,000 people
have died of COVID-19 in the U.S. in 2020 and 2021.

By comparison, during the 2019-2020 flu season in the U.S., about 38 million people
had the flu and about 22,000 people died of the flu.
4.COVID-19 and flu complications

COVID-19 can cause different complications from the flu, such as blood clots and
multisystem inflammatory syndrome in children.

5.COVID-19 and flu treatments

Another difference is that the flu can be treated with antiviral drugs. Only one antiviral
drug, called remdesivir, is currently approved to treat COVID-19. Researchers are
evaluating many drugs and treatments for COVID-19. Some drugs may help reduce the
severity of COVID-19.

6.COVID-19 and flu prevention

You can get an annual flu vaccine to help reduce your risk of the flu. The flu vaccine can
also reduce the severity of the flu and the risk of serious complications. Each year's flu
vaccine provides protection from the three or four influenza viruses that are expected to
be the most common during that year's flu season. The vaccine can be given as a shot
(injection) or as a nasal spray.

The flu vaccine doesn't prevent you from getting COVID-19. Some research has found
getting a flu vaccine might lower the risk of getting COVID-19. Research also shows that
getting the flu vaccine does not make you more likely to get COVID-19 or other
respiratory infections.

The U.S. Food and Drug Administration (FDA) has given emergency use authorization to
some COVID-19 vaccines in the U.S., and one vaccine has been approved. A vaccine can
prevent you from getting the COVID-19 virus or prevent you from becoming seriously ill
if you get the COVID-19 virus. Getting a COVID-19 vaccine will also allow you to start
doing many things that you might not have been able to do because of the pandemic,
including not wearing a mask or social distancing — except where required by a rule or
law.
SYMPTOMS OF COVID-19:

COVID-19 symptoms include:

● Cough
● Fever or chills
● Shortness of breath or difficulty breathing
● Muscle or body aches
● Sore throat
● New loss of taste or smell
● Diarrhea
● Headache
● New fatigue
● Nausea or vomiting
● Congestion or runny nose

Some people infected with the coronavirus have mild COVID-19 illness, and others
have no symptoms at all. In some cases, however, COVID-19 can lead to respiratory
failure, lasting lung and heart muscle damage, nervous system problems, kidney
failure or death.
TREATMENT FOR COVID -19

The most common symptoms of COVID-19 are a fever, coughing, and breathing
problems. Unless you have severe symptoms, you can most likely treat them at home,
the way you would for a cold or the flu. Most people recover from COVID-19 without
the need for hospital care. Call your doctor to ask about whether you should stay
home or get medical care in person.

Scientists are trying to make new medicines and test some existing drugs to see
whether they can treat COVID-19. In the meantime, there are a number of things that
can relieve symptoms, both at home and at the hospital.

At-Home Coronavirus Treatment

If your symptoms are mild enough that you can recover at home, you should:

● Rest. It can make you feel better and may speed your recovery.
● Stay home. Don't go to work, school, or public places.
● Drink fluids. You lose more water when you're sick. Dehydration can make
symptoms worse and cause other health problems.
● Monitor. If your symptoms get worse, call your doctor right away. Don't go to
their office without calling first. They might tell you to stay home, or they may
need to take extra steps to protect staff and other patients.
● Ask your doctor about over-the-counter medicines that may help, like
acetaminophen to lower your fever.
The most important thing to do is to avoid infecting other people, especially those
who are over 65 or who have other health problems.

That means:

● Try to stay in one place in your home. Use a separate bedroom and bathroom if
you can.
● Tell others you're sick so they keep their distance.
● Cover your coughs and sneezes with a tissue or your elbow.
● Wear a mask over your nose and mouth if you can.
● Wash regularly, especially your hands.
● Don't share dishes, cups, eating utensils, towels, or bedding with anyone else.
● Clean and disinfect common surfaces like doorknobs, counters, and tabletops.
OUTBREAKS SIMILAR TO COVID-19:
M - Number of people in millions
 BIBLIOGRAPHY

1. https://www.who.int/news/item/27-04-2020-who-timeline---covid-19
2. https://www.hopkinsmedicine.org/health/conditions-and-diseases/coronavirus
3. https://www.webmd.com/lung/coronavirus-history
4. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
5. https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-vs-flu/a
rt-20490339
6. https://www.mayoclinic.org/diseases-conditions/coronavirus/expert-answers/novel-coron
avirus/faq-20478727
7. https://capmh.biomedcentral.com/articles/10.1186/s13034-020-00329-3
8. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7426550/
9. https://www.nature.com/articles/d41586-021-01749-7
10. https://www.bbc.com/news/world-51235105