A Novel Corona Virus (COVID-19) Pandemic, Pathogenesis, Clinical Features and Management Options, Public Health Measures

Main Article Content

Mukoro Duke George


Introduction: SARS-CoV-2 is an unknown corona virus causing COVID-19 disease responsible for the ongoing pandemic affecting over 190 countries, with a mortality rate of about 5%. The high mortality rate resulted from its ability to elicit cytokine storm via non-specific immune response with delay in specific immune response, notably worst in the elderly, HIV, immunocompromised and cancer diseased patients. The article therefore provides frontline health care workers, the opportunity to understand and equip themselves with management options, public health measures used in coping with COVID-19 infections and enables personnel to make quick preparation for Symptomatic COVID-19 infection in-order to reduce mortalities in health facilities. It also provides a summarised teaching material for medical and allied health students around the world.

Methodology: Credible data and information were obtained from the World health organization situation report, Johns Hopkins University Corona Virus resource centre and other notable journal publications. Most information was on public domain.

Results: Clinical features reported include pneumonia, renal dysfunction, hepatobiliary dysfunction and residual tissue damage, especially in the lungs in those that survive. The literature highlights the blood work-up picture (Leucopenia, increased cytokines IL-6, ferritin, Serum creatinine, urea, AST, GGT, ALT and Viremia) and radiological features of the disease. ELISA and RT-qPCR test are required for diagnosis using sputum, or pharyngeal swab, blood, serum, urine and faecal samples which lead to faeco-oral transmission. ELISA/RT-PCR is also required for disease exclusions in co-existing epidemics such as MERS-CoV, SARS-COV and other viral diseases. Treatment modalities employed thus far are trials that have produce results including targeted therapy, anti-retroviral, Favipiravir, Remdesivir, antibody-serum and antimalaria drugs such as chloroquine and quinine which are found among some protocols in African setting and other developing countries. Currently, ongoing preventive measures (face mask, social distancing and hand hygiene, community testing, isolation of confirmed cases and tracking of the exposed, remain the key corner-stone in the management of COVID-19 pandemic.

Conclusion: COVID -19 disease still remain unclear to many scientists and its pandemic still ongoing. There are many research and clinical trials ongoing while some drugs are used off-label in-order to mitigate the damage caused by the virus in Human body. Cytokine storm needs immunomodulators and viral targeted therapy as discussed in-order to reduce tissue damage, and eventually morbidity and mortalities from COVID-19 infections.

COVID-19, SARS-CoV-2, corona virus, patho-physiology, prevention

Article Details

How to Cite
George, M. D. (2020). A Novel Corona Virus (COVID-19) Pandemic, Pathogenesis, Clinical Features and Management Options, Public Health Measures. International Journal of TROPICAL DISEASE & Health, 41(10), 11-21. https://doi.org/10.9734/ijtdh/2020/v41i1030324
Review Article


John Hopkins University. Corona Virus Resource Centre, COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU); 2020.


(Accessed 21/7/2020)

WHO; Coronavirus Disease 2019 (COVID-19) Situation Report – 72; 2020.

Wilkepedia 2019–20, Coronavirus pandemic by country and territory. Encyclopedia; 2020.


(Retrieved 1st April 2020)

Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, evaluation and treatment coronavirus (COVID-19). StatPearls Publishing; 2020.

Calvo C, García López-Hortelano M, de Carlos Vicente JC, Vázquez Martínez JL, Ramos JT, Baquero-Artigao F, Navarro ML, Rodrigo C, Neth O, Fumadó V, Menendez Suso JJ, Slocker Barrio M, Bustinza Arriortua A, Jordán García I, Pilar Orive J. Recommendations on the clinical management of the COVID-19 infection by the new coronavirus, SARS-CoV2. Spanish Paediatric Association Working Group; An Pediatr (Barc). 2020;S1695-4033(20)30076-X.

DOI: 10.1016/j.anpedi.2020.02.001

Hussin A. Rothana, Siddappa N. Byrareddy. Review article the epidemiology and pathogenesis of coronavirus disease (COVID-19) outbreak. Journal of Autoimmunity; 2020.

[PMID: 32113704]

DOI: 10.1016/j.jaut.2020.102433

WHO; Europe Regional Office. Preparedness, prevention and control of COVID-19 in prisons and other places of detention Interim guidance; 2020.

Chao Zhang, Lei Shi, Fu-Sheng Wang. Liver injury in COVID-19: Management and challenges; Gastroenterology and hepatology. The Lancet; 2020.

Mark Gladwin, Bill Trattler. Clinical microbiology made ridiculously simple 3rd Edition. Publisher MedMaster Inc; 2020.

Chen C, Zhang XR, Ju ZY, He WF. Advances in the research of cytokine storm mechanism induced by Corona Virus Disease 2019 and the corresponding immunotherapies. Chinese Journal of Burns. 2020;36.

Russell CD, Millar JE, Baillie JK. Clinical evidence does not support corticosteroid treatment for 2019-nCoV lung injury. Lancet. 2020;395:473-475.

Shakoory B, Carcillo JA, Chatham WW, et al. Interleukin-1 receptor blockade is associated with reduced mortality in sepsis patients with features of macrophage activation syndrome: Reanalysis of a prior phase III trial. Crit Care Med. 2016;44:275-281.

Chinese Clinical Trial Registry: A multicenter, randomized controlled trial for the efficacy and safety of tocilizumab in the treatment of new coronavirus pneumonia (COVID-19).


Wang C, Horby PW, Hayden FG, Gao GF. A novel coronavirus outbreak of global health concern. Lancet. 2020;395(10223): 470-473.

DOI: 10.1016/S0140-6736(20)30185-9

Huang CL, Wang YM, Li XW, et al. Clinical features of patient infected with 2019 novel corona virus in Wuhan, China [J]. Lancet. 2020;395(10223):497-506.

DOI: 10.1016/s0140-6736(20) 30183-5

Hu H, Ma F, Wei X, Fang Y. Coronavirus fulminant myocarditis saved with glucocorticoid and human immunoglobulin. Eur Heart J; 2020.

Chai X, Hu L, Zhang Y, et al. Specific ACE2 expression in cholangiocytes may cause liver damage after 2019-nCoV infection. bioRxiv; 2020.

Xu Z, Shi L, Wang Y, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med; 2020.

Sharifi-Razavi A, Karimi N, Rouhani N. COVID 19 and intra cerebral hemorrhage: Causative or coincidental. New Microbes and New Infections.


Neo Poyiadji, Gassan Shahin, Daniel Noujaim, Michael Stone, Suresh Patel, Brent Griffith. COVID-19–associated acute hemorrhagic necrotizing encephalopathy: CT and MRI features; Reviews and Commentary, Images in Radiology; 2020.


Wang L, Li X, Chen H, et al. SARS-CoV-2 infection does not significantly cause acute renal injury: An analysis of 116 hospitalized patients with COVID-19 in a single hospital, Wuhan, China. medRxiv; 2020.


Huang C, Wang Y, Li X, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020;395:497-506.

[PMID: 31986264]

DOI: 10.1016/S0140-6736(20)30183-5

Wang W, Xu Y, Gao R, et al. Detection of SARS-CoV-2 in different types of clinical specimens. JAMA; 2020.

[PMID: 32159775]

DOI: 10.1001/jama.2020.3786

Yongjian Wu, Cheng Guo, Lantian Tang, Zhongsi Hong, Jianhui Zhou, Xin Dong, et al. Prolonged presence of SARS-CoV-2 viral RNA in faecal samples. Lancet Gastroenterol Hepatol; 2020.


Cheng Y, Wong R, Soo YOY, et al. Use of convalescent plasma therapy in SARS patients in Hong Kong [J]. Eur J Clin Microbiol Infect Dis. 2005;24(1):44-46.

DOI: 10.1007/s10096-004-1271-9

Zhou B, Zhong N, Guan Y. Treatment with convalescent plasma for influenza A (H5N1) infection [J]. N Engl J Med. 2007;357(14):1450-1451.

DOI: 10.1056/NEJMc070359

Hung IF, To KK, Lee CK, et al. Convalescent plasma treatment reduced mortality in patients with severe pandemic influenza A (H1N1) 2009 virus infection [J]. Clin Infect Dis. 2011;52(4):447-456.

DOI: 10.1093/cid/ciq106

Barrett DM, Teachey DT, Grupp SA. Toxicity management for patients receiving novel T-cell engaging therapies [J]. Curr Opin Pediatr. 2014;26(1):43-49.

DOI: 10.1097/MOP.0000000000000043

Grupp SA, Kalos M, Barrett D, et al. Chimeric antigen receptor-modified T cells for acute lymphoid leukemia [J]. N Engl J Med. 2013;368(16):1509-1518.

DOI: 10.1056/NEJMoa1215134

Jeffrey K. Aronson, Robin E. Ferner, Nicholas DeVito, Carl Heneghan. COVID-19 trials registered up to 8 March 2020 — An analysis of 382 studies. CEBM Research, Oxford COVID-19 Evidence Service; 2020.

Lee JW, Fang XH, Krasnodembskaya A, et al. Concise review: Mesenchymal stem cells for acute lung injury: Role of paracrine soluble factors [J]. Stem Cells. 2011;29(6):913-919.

DOI: 10.1002/stem.643

Zhou W, Liu YS, Tian DD, et al. Potential benefits of precise corticosteroids therapy for severe 2019-nCoV pneumonia [J]. Signal Transduction and Targeted Therapy. 2020;5:18.

DOI: 10.1038/s41392-020-0127-9

Liu Youning. Thinking about new drugs for coronavirus infection. Chinese Journal of Tuberculosis and Respiratory Diseases. 2020;43.

Martinez MA. Compounds with therapeutic potential against novel respiratory 2019 coronavirus. Antimicrob Agents Chemother; 2020.

DOI: 10.1128/AAC.00399-20

Iyer AP, Al-Ghamdi MA. Inhaled statins to combat COVID-19 – prophylactic and treatment approach. Int J Clin Virol. 2020;4:079-080.

Johnson TS, Terrell CE, Millen SH, et al. Etoposide activated ablates activated T cells to control the immunoregulatory disorder hemophagocytic lymph histio-cytosis. J Immunol. 2014;192(1):84-91.

DOI: 10.4049/jimmunol.1302282

Hu H, Ma F, Wei X, Fang Y. Coronavirus fulminant myocarditis saved with glucocorticoid and human immunoglobulin. Eur Heart J; 2020.

Mukoro Duke George. Improving wound dressing techniques and infection control through support from International Non-governmental organizations in Sub-Sahara Africa. Asian Journal of Research in Medical and Pharmaceutical Sciences. 2017;2(1):1-8.


Mukoro Duke George. Revamping infection control through International Non-governmental support in autoclaving training for low capacity hospitals in the Sub-Sahara. Journal of Advances in Medicine and Medical Research. 2018;26(3):1-10.