EMANATION OF COVID-19

The third type zoonotic human coronavirus of the century evolved in December
in a group of patients with links to Huanan South China Seafood Market in
Wuhan, Hubei Province, China. News reports of patients with unknown
pneumonia first emerged on December 31st. The Wuhan City Health
Department said it was closely monitoring the situation. On January 1, 2020, the
seafood market was closed and decontaminated, while countries with travel
links to Wuhan were placed at high risk in order to alert potential travelers with
unexplained respiratory illness. After extensive speculation about the pathogen,
the Chinese Center for Disease Control and Prevention (CDC) confirmed on the
Wall Street Journal report and announced the identification of a coronavirus on
January 9. The novel coronavirus (2019-nCoV) was isolated from a single
patient and subsequently detected in 16 additional patients. Although it has not
yet been confirmed to cause viral pneumonia, 2019-nCoV was quickly
identified as a causative agent for the problem.
The first sequence of 2019-nCoV was posted online the day after it was
confirmed on behalf of Dr. Yong-Zhen Zhang and scientists at Fudan College in
Shanghai. Subsequently, five more 2019-nCoV sequences from institutes across
China (Chinese CDC, Wuhan Institute of Virology, and Chinese Academy of
Medical Sciences & Peking Union Medical College) were deposited in the
GSAID database on January 11, allowing researchers around the world to begin
analysing the new coronavirus. There have been 62 confirmed cases in China as
of January 17th, with three exported cases from infected tourists detected in
Thailand and Japan . The GSAID database also has the sequences of these
exported cases as well as numerous more 2019-nCoV isolates from China.
Following that, diagnostic tests were established, with some of them being
employed in suspected instances in other countries such as Vietnam, Singapore,
and Hong Kong. Many of these patients had many comorbidities and were over
50 years old.. However, compared with mortality rate of SARS-CoV (10%
mortality) and MERS-CoV (35% mortality), 2019-nCoV ( 26%) with the
exception of the elderly and those with pre-existing health conditions.
There was no additionally 2019-nCoV cases were detected at some point of
initial surveillance of close contacts of the case. The modeling analysis based on
legitimate case counts and international unfold cautioned that there can be cases
that go undetected. On January 19, these fears appeared to be confirmed, as
further investigation added 136 cases, bringing the total number of infected
patients in Wuhan to 198, and out of the total 198 cases in Wuhan, 170
remained hospitalized also almost126 showed mild symptoms, 35 in serious
condition, and 9 in critical condition. The increased number of cases and the
extended date of the outbreak (December 12, 2019-January 18, 2020) indicate
that the disease was likely transmitted from person to person or through a
market or other primary sources. On January 20, the outbreak spread to other
parts of China (Beijing, Shanghai, and Shenzhen) and to additional exported
cases in South Korea. As of Jan. 24, the total number of cases has increased to
at least 870, with 26 deaths in 25 provinces in China and 19 exported cases in
10 countries. Health authorities have quarantined travel from Wuhan to contain
the spread of the virus, and other Chinese cities have reportedly been isolated as
well. With the peak Lunar New Year travel season underway in Asia, there is
great concern that the coronavirus outbreak will continue to spread.
which finally results has a wide range of clinical symptoms, from asymptomatic
conditions to acute respiratory distress syndrome and multi-organ failure. Fever,
cough, sore throat, headache, weariness, headache, myalgia, and dyspnea are all
typical clinical symptoms. There have also been patients reported with
conjunctivitis. As a result, they are difficult to identify from other respiratory
illnesses. In a small ratio of patients, the condition can develop into pneumonia,
respiratory failure, and mortality by the end of the first week.
with help of these The receptor-binding domain (RBD) is loosely bound in
several viruses; therefore, the virus can infect multiple hosts. Other
coronaviruses mostly recognize aminopeptidases or carbohydrates as a key
receptor for entry into human cells, while SARS-CoV and MERS-CoV
recognize exopeptidases. The entry mechanism of a coronavirus depends on
cellular proteases, which include human respiratory trypsin-like protease,
cathepsins, and the transmembrane protease serine 2, which cleave the spike
protein and cause further penetration changes. The MERS coronavirus uses
dipeptidyl peptidase 4, while the SARS coronavirus requires angiotensin-
converting enzyme 2 as a key receptor.
SARS-CoV-2 has the typical coronavirus structure with spike protein and also
expresses other polyproteins, nucleoproteins, and membrane proteins, such as
RNA polymerase, 3-chymotrypsin-like protease, papain-like protease, helicase,
glycoprotein, and accessory protein. Glutamine residue 394 in the RBD region
of SARS-CoV-2 is recognized by critical lysine residue 31 on the human ACE2
receptor.
GENETIC VARIATION OF SARS-CoV-1 AND SARS-CoV-2
The genome of SARS-CoV-2 is reported to be over 80% identical to the
previous human coronavirus (SARS-CoV). The structural proteins are encoded
by the four structural genes, including the spike (S), envelope (E), membrane
(M), and nucleocapsid (N) genes. The ORF1ab (open reading frames) is the
largest gene in SARS-CoV-2 and encodes one protein and 15 nsps. The orf1a
gene encodes the pp1a protein, which also contains 10 nsps. According to the
phylogenetic tree, SARS-CoV-2 is close to the SARS coronavirus group.
Recent studies have pointed out remarkable differences between SARS-CoV-1
and SARS-CoV-2, such as the absence of the 8a protein and differences in the
number of amino acids in the 8b and 3c proteins of SARS-CoV-2. It is also
reported that the spike glycoprotein of Wuhan coronavirus is modified by
homologous recombination. The spike glycoprotein of SARS-CoV-2 is a
mixture of bat SARS-CoV and an unknown beta-CoV. A fluorescence study
confirmed that SARS-CoV-2 uses the same cell receptor and mechanism for
host cell entry as ACE2 (angiotensin-converting enzyme 2). The single N501T
mutation in the spike protein of SARS-CoV-2 may have significantly increased
its binding affinity for ACE2.

World Health Organization General said on January that evolving COVID -19
is only a public health emergency in China, and it is not considered a Public
Health Emergency of International Concern (PHEIC). Until that date, all that
was known about the disease was that it resulted only causing severe symptoms
of respiratory illness and that more than 500 cases had been confirmed in China
and later found out in other countries such as South Korea, Japan, the United
States and Thailand.

Based on previous experience in dealing with the SARS pandemic, the Chinese
government has managed to meet the international standards in terms of
isolating the people with suspected cases, diagnosis, treatment, and preventive
measure campaigns. However, the virus continued to spread due to the
movement of those infected people, and stated that the daily increase in the
number of cases and the many gaps created by the incomplete and rapidly
changing epidemic are causes for concern.
Gralinski and Menachery depicted the evolution and onset of COVID -19 in
their study by showing the timeline of key COVID -19 events from December
31st when the cluster of pneumonia cases was reported until January 23rd. These
events included the isolation of the virus, the release of the genomes, the
reporting of the number of positive cases of travelers from Wuhan, and the
reporting of the new cases and deaths in China and worldwide. On January 30,
the World Health Organization declared COVID -19 a global health emergency
of international concern, indicating the international spread of the disease
requires a coordinated global response.

All age groups are susceptible to the infection. Studies have shown that viral
loads are higher in the nasal cavity than in the throat, with no difference
between symptomatic and asymptomatic individuals. Patients can be infectious
if symptoms persist and even during clinical recovery. Some people can act as
super-spreaders. For example, a British citizen attending a conference in
Singapore infected other people while at a resort in the French Alps and after
returning to the United Kingdom. These infected droplets can spread 1-2 m and
settle on surfaces. The virus can remain viable on surfaces for days under
favorable atmospheric conditions but is destroyed in less than a minute by
common disinfectants such as sodium hypochlorite, hydrogen peroxide, etc.
Infection occurs either by inhalation of these droplets or by touching surfaces
contaminated with them or by touching the nose, mouth, and eyes. The virus is
also found in fecal matter and is probably transmitted by contamination of the
water supply and subsequent transmission via aerosolization of the oral route.
To our current knowledge, transplacental transmission from pregnant women to
their foetuses has not been described. However, neonatal disease due to
postnatal transmission has been described. The incubation period differs from 2
and 14 days.