However, our previous attempts to develop a universal vaccine that is
effective for both
SARS-CoV and MERS-CoV based on T-cell epitope similarity pointed out the
possibility of
cross-reactivity among corona viruses (172). That can be made possible by
selected potential
vaccine targets that are common to both viruses. SARS-CoV-2 has been
reported to be
closely related to SARS-CoV(173, 174). Hence, knowledge and understanding
ofother
clinical trials in different phases are still ongoing elsewhere.
Immunomodulatory agents. SARS-CoV-2 triggers a strong immune
response which ma
cause cytokine storm syndrome60,61. Thus, immunomodulatory agents that
inhibit the
excessive inflammatory response may be a potential adjunctive therapy for
COVID-
19.Dexamethasone is a corticosteroid often used in a wide range of
conditions to relieve
inflammation through its anti-inflammatory and immunosuppressant effects.
Recently, the
RECOVERY trial found dexamethasone reduced mortality by about one third
in hospitalized
patients with COVID-19 who received invasive mechanical ventilation and by
one fifth in
patients receiving Oxygen. By contrast, no benefit was found in patients
without respiratory
support146. Tocilizumab and sarilumab, two types of interleukin-6(IL-6)
receptor-specific antibodies previously used to treat various types of
arthritis, including rheumatoid arthritis, and cytokine release syndrome,
showed effectiveness in the treatment of severe COVID-19 by attenuating
the cytokine storm in a small uncontrolled trial147.Bevacizumab is an anti-
vascular
endothelial growth factor (VEGF) medication that could potentially reduce
pulmonary
oedema in patients with severe COVID-19.Eculizumab is a specific
monoclonal antibody that
inhibits the proinflammatory complement protein C5.Preliminary results
showed that it
induced a drop of inflammatory markers and C-reactive protein levels,
suggesting its
potential to be an option for the treatment of severe COVID-19 (REF148.).
Another study, the average reproductive COVID-19 was found to be 3.28,
significantly higher than the initial WHO estimate of 1.4 to 2.5 (77). It is too
early to obtain the exact Ro Value, since there is a possibility of bias due to
insufficient data. The higher Ro value is indicative of the more significant
potential of SARS-CoV-2 transmission in a susceptible population. This is not
the first time where the culinary practices of China have been blamed for the
origin of novel coronavirus infection in humans. Previously, the animals
present in the live-animal market were identified to be the intermediate
hosts of the SARS outbreak in China (78). Several wildlife species were found
to harbor potentially evolving coronavirus strains that can overcome the
species barrier (79). One of the main principles of Chinese food culture is
that live-slaughtered animals are considered more nutritious (5). After 4
months of struggle that lasted from December 2019 to March 2020, the
COVID-19 situation now seems under control in China. The wet animal
markets have reopened, and people have started buying bats, dogs, cats,
birds, scorpions, badgers, rabbits, pangolins (scaly anteaters), minks, soup
from palm civet, ostriches, hamsters, snapping turtles, ducks, fish, Siamese
crocodiles, and other been used based on the experience with SARS and
MERS. In a historical control study in patients treated with lopinavir ritonavir
with ribavirin had better outcomes as compared to those given ribavirin
alone [15]. In the case series of 99 hospitalized patients with COVID-19
infection from Wuhan, oxygen was given to 76%, noninvasive ventilation in
13%, mechanical ventilation 4%, extracorporeal membrane oxygenation
(ECMO) in 3%, continuous renal replacement therapy (CRRT) in
