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Year : 2020  |  Volume : 18  |  Issue : 2  |  Page : 83-86

COVID-19 – A replay of the 1918 pandemic?

Department of Emergency Medicine, Christian Medical College, Vellore, Tamil Nadu, India

Correspondence Address:
Dr. Govind Sreekumar
Department of Emergency Medicine, Christian Medical College, Vellore - 632 004, Tamil Nadu
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/cmi.cmi_36_20

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COVID-19 outbreak is likely to have started from a zoonotic transmission event associated with a large seafood market that also traded in live wild animals. Initial epidemiological studies suggested a predilection for older adult males with comorbidities due to their immunocompromised status and very rarely, coinfection with bacteria and fungi. An exponential increase in the number of nonlinked cases in the late December 2019 pointed toward the risk of human-to-human transmission. Similar to its predecessor, severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) also acts on the angiotensin-converting enzyme-2 (ACE2) present on the type 1 and type 2 alveolar epithelial cells. ACE2 expression has been found to be higher in males than females and in Asian populations compared to White and African-American populations. This led to an agreement that the Asian males were more susceptible to SARS-CoV-2 infection. The ability of SARS-CoV-2 to bind to ACE2 receptor was found to be 10–20 times more than that of the SARS-CoV, thus making the new pathogen much more aggressive. At the time of writing this article, the global burden of confirmed cases of COVID-19 has risen to half a million with death toll touching 25,000 people. For the first time, we may be looking at a pandemic which could be controlled on a short-term basis and prevented on a long term with adequate research and clinical trials for newer therapeutic agents.

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