COVID-19: global pandemic with divergent waves: an exigent public health concern worldwide with special context to Indian scenario

Shehna Sharaf, Faisal Moossa Athikkavil, Shiny Deena Varghese, Sreelekshmi Sreekumar, Reshmi Ramakrishnan, Jeslin Varghese, Lakshmi Sree Dharan Pillai, Saikant Regidi, Abi Santhosh Aprem


The review discusses, how the COVID-19 virus evolved to the present form, genome organization and genetic variation of SARS- CoV-2 prevalent globally with special emphasis on Indian strains, a comparison of the first vs. second wave in terms of infectivity and transmission patterns. The population impacted, importance of surveillance, study of genetic variants of COVID-19 virus, development of diagnostics developed in First and second waves of infection and preventive measures like physical means, vaccine administration and treatment strategies using different classes of anti-viral, anti-inflammatory, antibiotic and corticosteroid drugs. The study used the detailed and qualitative online research. The literature studies were conducted to explore the havoc of the COVID-19 Pandemic from the very beginning era to current and future repercussions in worldwide with special context to India. The idea of our work is to be on a high alert and vigilant in the constant studying of the varying characteristics of the pandemic and to produce resources and be able to modify treatment methodologies quickly, if needed, and disseminate our work to the scientific world and community as soon as possible for coordinating a global action to cut off the inevitable future waves of this pandemic. Securing vaccine is the most concern, along with the strategies that could be forward to strengthen the health care system. This paper gives insight by warning the third wave, unless taken utmost care by each individual, national as well international organization could be catastrophic to the entire World.



Transmission, Mutant viral strains, SARS-CoV-2, Anti-viral, Anti-inflammatory

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Lowenthal D, Jenkins S. Prizing the past for the present and the future. Br Acad Rev. 2011;18:34-40.

Mack A, Choffnes ER, Hamburg MA, Relman DA, editors. Microbial evolution and co-adaptation: a tribute to the life and scientific legacies of Joshua Lederberg: workshop summary. Nat Acad Press. 2009.

Brucker MC. Novel viruses, zoonotic infections, and travel health. Nurs Women's Health. 2020;24(2):65.

Zhong NS, Zheng BJ, Li YM, Poon LL, Xie ZH, Chan KH, et al. Epidemiology and cause of severe acute respiratory syndrome (SARS) in Guangdong, People's Republic of China, in February, 2003. Lancet. 2003;362(9393):1353-8.

Jamieson DJ, Honein MA, Rasmussen SA, Williams JL, Swerdlow DL, Biggerstaff MS, et al. H1N1 2009 influenza virus infection during pregnancy in the USA. Lancet. 2009;374(9688):451-8.

Scalera NM, Mossad SB. The first pandemic of the 21st century: review of the 2009 pandemic variant influenza A (H1N1) virus. Postgrad Med J. 2009;121 (5):43-7.

Shereen MA, Khan S, Kazmi A, Bashir N, Siddique R. COVID-19 infection: Origin, transmission, and characteristics of human coronaviruses. J Adv Res. 2020;24:91.

Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: A review. J Clin Immunol. 2020; 215:108427.

Wu F, Zhao S, Yu B, Chen YM, Wang W, Song ZG, et al. A new coronavirus associated with human respiratory disease in China. Nature. 2020;579 (7798):265-9.

Hu D, Zhu C, Ai L, He T, Wang Y, Ye F, et al. Genomic characterization and infectivity of a novel SARS-like coronavirus in Chinese bats. Emerg microbes & infect. 2018;7(1):1-0.

Elezkurtaj S, Greuel S, Ihlow J, Michaelis EG, Bischoff P, Kunze CA, et al. Causes of death and comorbidities in hospitalized patients with COVID-19. Sci Rep. 2021;11(1):1-9.

Lu X, Zhang L, Du H, Zhang J, Li YY, Qu J, et al. SARS-CoV-2 infection in children. N Engl J Med. 2020;382(17):1663-5.

Qiu H, Wu J, Hong L, Luo Y, Song Q, Chen D. Clinical and epidemiological features of 36 children with coronavirus disease 2019 (COVID-19) in Zhejiang, China: an observational cohort study. Lancet Infect Dis. 2020;20(6):689-96.

Zhang J, Litvinova M, Wang W, Wang Y, Deng X, Chen X, Li M, Zheng W, Yi L, Chen X, Wu Q. Evolving epidemiology and transmission dynamics of coronavirus disease 2019 outside Hubei province, China: a descriptive and modelling study. Lancet Infect Dis. 2020;20(7):793-802.

Zheng M, Gao Y, Wang G, Song G, Liu S, Sun D, Xu Y, Tian Z. Functional exhaustion of antiviral lymphocytes in COVID-19 patients. Cell Mol Immunol. 2020;17(5):533-5.

Fan G, Yang Z, Lin Q, Zhao S, Yang L, He D. Decreased case fatality rate of COVID‐19 in the second wave: a study in 53 countries or regions. Transbound Emerg Dis. 2021;68(2):213-5.

Saito S, Asai Y, Matsunaga N, Hayakawa K, Terada M, Ohtsu H, Tsuzuki S, Ohmagari N. First and second COVID-19 waves in Japan: a comparison of disease severity and characteristics. J Infect. 2021; 82(4):84-123.

Long SW, Olsen RJ, Christensen PA, Bernard DW, Davis JJ, Shukla M, Nguyen M, Saavedra MO, Yerramilli P, Pruitt L, Subedi S. Molecular architecture of early dissemination and massive second wave of the SARS-CoV-2 virus in a major metropolitan area. MBio. 2020;11(6):e02707-20.

Iftimie S, López-Azcona AF, Vallverdú I, Hernández-Flix S, De Febrer G, Parra S, et al. First and second waves of coronavirus disease-19: A comparative study in hospitalized patients in Reus, Spain. PloS one. 2021;16(3):e0248029.

Josh J. How the second wave of the coronavirus is different from the first wave in terms of symptoms, spread, age profile and mutant variants. National/India current affairs. 2021.

Callaway E. The coronavirus is mutating--does it matter?. Nature. 2020;585(7824):174-8.

Oran DP, Topol EJ. Prevalence of asymptomatic SARS-CoV-2 infection: a narrative review. Ann Intern Med. 2020;173(5):362-7.

Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, Si HR, Zhu Y, Li B, Huang CL, Chen HD. A pneumonia outbreak associated with a new coronavirus of probable bat origin. nature. 2020;579 (7798):270-3.

Chan JF, Kok KH, Zhu Z, Chu H, To KK, Yuan S, Yuen KY. Genomic characterization of the 2019 novel human-pathogenic coronavirus isolated from a patient with atypical pneumonia after visiting Wuhan. Emerg microbes infect. 2020;9(1):221-36.

Shang J, Ye G, Shi K, Wan Y, Luo C, Aihara H, Geng Q, Auerbach A, Li F. Structural basis of receptor recognition by SARS-CoV-2. Nature. 2020;581 (7807): 221-4.

Hou Y, Zhao J, Martin W, Kallianpur A, Chung MK, Jehi L, Sharifi N, Erzurum S, Eng C, Cheng F. New insights into genetic susceptibility of COVID-19: an ACE2 and TMPRSS2 polymorphism analysis. BMC Med. 2020;18(1):1-8.

Rahimi F, Abadi AT. Implications of the Emergence of a New Variant of SARS-CoV-2, VUI-202012/01. Arch Med Res. 2021.

Franceschi VB, Caldana GD, de Menezes Mayer A, Cybis GB, Neves CA, Ferrareze PA, Demoliner M, de Almeida PR, Gularte JS, Hansen AW, Weber MN. Genomic epidemiology of SARS-CoV-2 in Esteio, Rio Grande do Sul, Brazil. BMC genomics. 2021; 22(1):1-7.

Srivastava S, Banu S, Singh P, Sowpati DT, Mishra RK. SARS-CoV-2 genomics: An Indian perspective on sequencing viral variants. J. Biosci. 2021;46(1): 1-4.

Lemmermann NA, Lieb B, Laufs T, Renzaho A, Runkel S, Kohnen W, et al. SARS-CoV-2 genome surveillance in Mainz, Germany, reveals convergent origin of the N501Y spike mutation in a hospital setting. medRxiv. 2021.

Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. nature. 2020;579(7798):270-3.

Letko M, Marzi A, Munster V. Functional assessment of cell entry and receptor usage for SARS-CoV-2 and other lineage B betacoronaviruses. Nat Microbiol. 2020;5(4):562-9.

Grubaugh ND, Petrone ME, Holmes EC. We shouldn’t worry when a virus mutates during disease outbreaks. Nat microbiol. 2020;5(4):529-30.

Vasilarou M, Alachiotis N, Garefalaki J, Beloukas A, Pavlidis P. Population genomics insights into the recent evolution of SARS-CoV-2. BioRxiv. 2020.

Dalamaga M, Christodoulatos GS, Karampela I, Vallianou N, Apovian CM. Understanding the co-epidemic of obesity and COVID-19: Current evidence, comparison with previous epidemics, mechanisms, and preventive and therapeutic perspectives. Curr Obes Rep. 2021;2:1-30.

Bikbov B, Bikbov A. Communication on COVID-19 to community–measures to prevent a second wave of epidemic.

Liu X, Liu C, Liu G, Luo W, Xia N. COVID-19: Progress in diagnostics, therapy and vaccination. Theranostics. 2020;10(17):7821.

O’Shea J, Prausnitz MR, Rouphael N. Dissolvable microneedle patches to enable increased access to vaccines against SARS-CoV-2 and future pandemic outbreaks. Vaccines. 2021;9(4):320.

Samudrala PK, Kumar P, Choudhary K, Thakur N, Wadekar GS, Dayaramani R, Agrawal M, Alexander A. Virology, pathogenesis, diagnosis and in-line treatment of COVID-19. Eur J Pharmacol. 2020;883:173375.

Asselah T, Durantel D, Pasmant E, Lau G, Schinazi RF. COVID-19: Discovery, diagnostics and drug development. J Hepatol. 2021;74(1):168-84.

Kifle ZD, Ayele AG, Enyew EF. Drug Repurposing Approach, Potential Drugs, and Novel Drug Targets for COVID-19 Treatment. J environ public health. 2021;2021.

Callard F. Very, very mild: Covid-19 symptoms and illness classification. Somatosphere. 2020.

Fisayo T, Tsukagoshi S. Three waves of the COVID-19 pandemic. Postgrad Mel J. 2020; 97(1147):332.