Environmental perspectives of COVID-19 outbreaks: A review

Table 1 Details of coronavirus (genus, species and receptor)

Genus	Species	Targets	Receptor
α-CoV	Alphacoronavirus 1:	Mammals
	Feline coronavirus serotype 2		Aminopeptidase N
	Canine coronavirus serotype 2		Aminopeptidase N
	Transmissible gastroenteritis virus		Aminopeptidase N
	Human coronavirus 229E		Aminopeptidase N
	Human coronavirus NL63		ACE2
	Porcine epidemic diarrhea coronavirus		Aminopeptidase N
	Rhinolophus bat coronavirus HKU2
	Scotophilus bat coronavirus 512/05
	Miniopterus bat coronavirus 1
	Miniopterus bat coronavirus HKU8
β-CoV	Betacoronavirus 1:	Mammals
	Bovine coronavirus		Neu 5,9 Ac2
	Human coronavirus OC43		Neu 5,9 Ac2
	Equine coronavirus
	Human enteric coronavirus
	Porcine haemagglutinating encephalomyelitis virus
	Canine respiratory coronavirus
	Murine coronavirus:
	Mouse hepatitis virus		CEACAM1
	Rat coronavirus
	Puffinosis virus
	Hedgehog coronavirus 1
	Human coronavirus HKU1
	Middle East respiratory syndrome-related coronavirus
	Pipistrellus bat coronavirus HKU5
	Rousettus bat coronavirus HKU9
	Severe acute respiratory syndrome-related coronavirus
	SARS-CoV
	SARS-CoV-2		ACE2
	Rhinolophus bat viruses
	Tylonycteris bat coronavirus HKU4
γ-CoV	Avian coronavirus:	Birds
	IBV (turkey, pheasant, duck, goose and pigeon)
	Beluga Whale coronavirus SW1
δ-CoV	Bulbul coronavirus HKU11	Birds
	Thrush coronavirus HKU12
	Munia coronavirus HKU13
	Porcine coronavirus HKU15

ACE2: Angiotensin-converting enzyme 2; SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2.

Table 2 Coronavirus disease 2019 outbreaks based on the World Health Organization (data as reported at 7.07 PM CEST on August 10, 2021)

Items	Confirmed cases	Deaths
Globally	202608306	4293591
Africa	5156790	122537
Americas	78718104	2032256
Eastern Mediterranean	13169171	243217
Europe	61333662	1231439
South-East Asia	39271048	593565
Western Pacific	4958767	70564

Table 3 Coronavirus disease 2019 state-wise status in India (as on August 10, 2021; Ministry of Home Affairs, GoI)

No.	Name of State / UT	Total confirmed cases*	Cured/discharged/migrated	Deaths**
1	Andaman and Nicobar Islands	7546	7412	129
2	Andhra Pradesh		1950623	13549
3	Arunachal Pradesh	50372	47520	246
4	Assam		558720	5404
5	Bihar		715303	9646
6	Chandigarh	61984	61146	811
7	Chhattisgarh		988004	13540
8	Dadar Nagar Haveli	10656	10612	4
9	Delhi		1411235	25067
10	Goa		167884	3164
11	Gujarat		814778	10077
12	Haryana		759769	9650
13	Himachal Pradesh		202569	3519
14	Jammu and Kashmir		316957	4390
15	Jharkhand		342074	5130
16	Karnataka		2859552	36817
17	Kerala		3377691	17852
18	Ladakh	20393	20117	207
19	Madhya Pradesh		781307	10514
20	Maharashtra		6151956	134064
21	Manipur		96128	1657
22	Meghalaya	69358	63450	1174
23	Mizoram	44520	32854	168
24	Odisha		971391	6554
25	Puducherry		119031	1800
26	Punjab		582753	16320
27	Rajasthan		944670	8954
28	Tamil Nadu		2522470	34340
29	Telengana		637789	3828
30	Tripura	80208	77230	767
31	Uttarakhand		328569	7368
32	Uttar Pradesh		1685449	22774
33	West Bengal		1505808	18240
34	Nagaland	28709	25906	585
35	Sikkim	27908	24544	355
36	Lakshadweep	10257	10112	51

Table 4 Recommended drugs for coronavirus disease 2019 treatments (Food and Drug Administration and World Health Organization)

Common drugs	Dose	Mechanism
Chloroquine; Antimalarial	50% for GFR < 10 mL/min	In vitro activity and has immunomodulating properties
		Inhibits viral enzymes or processes such as viral DNA and RNA polymerase, viral protein glycosylation, virus assembly, new virus particle transport, and virus release
		ACE2 inhibition due to acidification at cell membrane surface, inhibits fusion of virus, and cytokine release
Hydroxychloroquine; Antimalarial	800 mg orally on day one, followed by 400 mg/d orally for four to seven days	Same as chloroquine
Chloroquine phosphate; Antimalarial	1 g orally on day one, followed by 500 mg/d orally for four to seven days	Same as chloroquine
Remdesivir; Nucleoside Analogue	200 mg IV on day 1 followed by 100 mg IV daily on days two to five or 200 mg IV on day 1 followed by 100 mg IV daily on days two to ten	In vitro activity; Inhibitor of RNA-dependent RNA polymerases (RdRps)
		Remdesivir-TP competes with adenosine-triphosphate for incorporation into nascent viral RNA chains
		Once incorporated into the viral RNA at position i, RDV-TP terminates RNA synthesis at position i+3
		Because RDV-TP does not cause immediate chain termination (i.e., 3 additional nucleotides are incorporated after RDV-TP), the drug appears to evade proofreading by viral exoribonuclease (an enzyme thought to excise nucleotide analogue inhibitors)
Azithromycin; Macrolide Antibacterial	500 mg on day one, followed by 250 mg daily for four days	Prevents bacterial superinfection, has immunomodulatory action on pulmonary inflammatory disorders
		Downregulates inflammatory responses and reduces excessive cytokine production associated with respiratory viral infections; however, its direct effects on viral clearance are uncertain
		Immunomodulatory mechanisms include reducing chemotaxis of neutrophils (PMNs) to lungs by inhibiting cytokines (i.e., IL-8), inhibition of mucus hypersecretion, decreased production of ROS, accelerating neutrophil apoptosis, blocking activation of nuclear transcription factors
Lopinavir; Ritonavir; HIV protease inhibitor	400 mg/ritonavir 100 mg orally twice daily for up to 21 d	In vitro animal model studies show potential activity for other coronaviruses (SARS-CoV and MERS-CoV)
		Lopinavir and ritonavir may bind to Mpro, a key enzyme for virus replication and suppress virus activity
Tocilizumab; Interleukin-6 (IL-6) Receptor-InhibitingMonoclonal Antibody	4-8 mg/kg infused over more than 60 min (additional dose after 12 h)	Cytokine release syndrome; Inhibits IL-6-mediated signaling by competitively binding to both soluble and membrane-bound IL-6 receptors. IL-6 involved in T-cell activation, immunoglobulin secretion induction, hepatic acute-phase protein synthesis initiation, and hematopoietic precursor cell proliferation and differentiation stimulation
Baloxavir; Antiviral	80 mg orally on day 1 and on day 4, and another dose of 80 mg on day 7 (as needed); not to exceed 3 total doses	Active against influenza viruses; In vitro antiviral activity against SARS-CoV-2 demonstrated in one trial
Favipiravir; Antiviral	1600 mg twice daily on day 1, then 600 mg twice daily for 7-10 d; Severe: 1600 mg every 12 h on day 1, then 600 mg every 12 h days 2-10	In vitro activity against Vero E6 cells

SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2.

Table 5 Unani drugs for coronavirus disease 2019 treatment (Source: Department of AYUSH, Government of India)

Unani drugs	Doses
Symptomatic treatments
SharbatUnnab	10-20 mL twice a day
TiryaqArba	3-5 g twice a day
TiryaqNazla	5 g twice a day
KhamiraMarwareed	3-5 g once a day
ArqAjeeb	4-8 drops in fresh water and four times a day
Habb e IkseerBukhar (fever)	2 pills with lukewarm water twice daily
SharbatNazla	10 mL mixed in 100 mL of lukewarm water twice daily
Qurs e Suaal	2 tablets to be chewed twice daily
Decoction
Behidana	3 g
Unnab	7 nos
Sapistan	7 nos
Darchini	3 g
Banafsha	5 g
Berg-e-Gaozabaan	7 g
Sore throat
Khashkhash; Bazrulbanj; Post Khashkhash; Barg e Moard (Habbulaas); Tukhm e kahuMukashar; GuleSurkh	Any of them @12 g (each)