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both in vitro and in vivo anti-CoV potential. Although in vitro research carried out with these therapeutics showed efficacy, 1nost need appropriate support fro1n randon1ized ani1nal or hu1nan trials. Therefore, they 1night be of li1nited applicability and require trials against SARS-CoV-2 to gain practical usefulness. The binding of SARS-CoV-2 with ACE2 leads to the exacerbation of pneumonia as a consequence of the i1nbalance in the renin­ angiotensin syste1n (RAS). The virus-induced puhnonary inflammatory responses 1nay be reduced by the ad1ninistration of ACE inhibitors (ACEI) and angiotensin type-1 receptor (ATl R) (207).
Several investigations have suggested the use of s1nal1-n1olecule inhibitors for the potential control of SARS-CoV infections. Drugs of the FDA-approved co1npound library ,vere screened to identify four s1nal1-molecule inhibitors of MERS-Co V (chlorpro1nazine, chloroquine, lopera1nide, and lopinavir) that inhibited viral replication. These compounds also hinder SARS-CoV and human CoVs (208). Therapeutic strategies involving the use of specific antibodies or compounds that neutralize cytokines and their receptors will help to restrain the host infla1n1natory responses. Such drugs acting specifically in the respiratory tract will help to
respiratory syncytial virus, rhinovirus, human metapneumovirus and SARS coronavirus. It is advisable to distinguish COVID-19 from other pneumonias such as mycoplasma pneumonia, chlamydia pneumonia and bacterial
pneumonia.³³ Several published pieces of
literature based on the novel coronavirus reported in China declared that stool and blood samples can also collected from the suspected persons in order to detect the virus. However, respiratory samples show better viability in
identifying the virus, in comparison with the other specimens.³⁴-³⁶


6.2 Nucleic; acid amplification tests (NAAT) for COVID-19 virus
The gold standard method of confirming the suspected cases of COVID-19 is carried out by detecting the unique sequences of virus RNA through reverse transcription polymerase chain reaction (RT-PCR) along with nucleic acid sequencing if needed. The various genes of virus identified so far include N, E, S (N: nucleocapsid protein, E: envelope protein gene,

understanding of the lung intlanunation associated with this infection (24).

SARS is a viral respiratory disease caused by a formerly unrecognized animal CoV that originated fro1n the wet 1narkets in southern China after adapting to the human host, thereby enabling trans1nission between hu1nans (90). The SARS outbreak repo1ted in 2002 to 2003 had 8,098 confinned cases with 774 total deaths (9.6°/o) (93). The outbreak severely affected the Asia Pacific region, especially 1nainland China (94). Even though the case fatality rate (CFR) of SARS-CoV-2 (COVTD-19) is lower than that of SARS-CoV, there exists a severe concern linked to this outbreak due to its epide1niological si1nilarity to influenza viruses (95, 279). This can fail the public health syste1n, resulting in a pandemic (96).
MERS is another respiratory disease that was
first reported in Saudi Arabia during the year 2012. The disease was found to have a CFR of around 35%
(97). The analysis of available data sets suggests that
the incubation period of SARS-CoV-2, SARS-CoV, and MERS-CoV is in ahnost the saine range. The longest predicted incubation time of SARS-CoV-2 is 14 days. Hence, suspected individuals are isolated for 14 days to avoid the risk of further spread (98). Even though a high si1nilaritv has been reported