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Background: In December 2019, a cluster of pneumonia cases caused by a novel corona virus (2019-nCov), later named as severe acute respiratory syndrome corona virus-2 (SARS-CoV-2) was detected in China. In India, 30th January 2020 first positive case ofSARS-CoV-2was reported from Kerala. The reverse transcriptase polymerase chain reaction (RT-PCR) is the standard method of choice for diagnosis of SARS-CoV-2 infection. Certain biomarker molecules that are being evaluated for assessment of severity and prognosis are; D-dimer, C reactive protein (CRP), lactate dehydrogenase (LDH), complete blood counts (CBC) and serum ferritin. The elevated levels of these biomarkers were associated with extent of inflammation. Objective: This prospective study was designed to assess the severity and prognosis of pneumonia cases caused by SARS-CoV-2 using different haematological and biochemical biomarkers. Materials and Methods: This study was conducted among 242 participants attending covid-19 facility of BRD Medical College Gorakhpur, after confirmation by RT-PCR. Different haematological and biochemical biomarkers were analyzed using 5 ml fasting venous blood samples and these were analysed in auto analysers using standard protocol as per manufacturer’s instructions. Finally result was analyzed using standard statistical calculation by %positivity, confidence interval, p values and ≤ 0.05 is considered as statistically significant. Results: Among a total of 242 COVID-19 cases based on different haematological and biomarkers assessment; 92 were critically ill and 150 non-critically ill. The mean ±SD of various haematological parameters among critically ill cases were; haemoglobin (13.0±1.8),TLC (13846.13±3903.76),PLT (92213.48±61415.07),NLR(36.5±30.4).The mean ±SD of the biochemical parameters of critically ill participant was; CRP 44.7±35.4 (95%CI 25.06,2.93),D. dimer 2.9±2.6 (95%CI 1.69,0.10), serum ferritin 1204.7±750.7 (95%CI 581.8,60.1),LDH 397.2±180.8 (95% CI 133.01,0.0163). The level of different haematological and biochemical parameters was raised also in non-critically ill cases but at lower side. Out of these 242 cases; 106 (43.8%) were died and 136 (56.2%) survived but the mortality was high in critically ill cases. Conclusion: Our findings show that level of D-dimer, LDH, CRP, NLR and serum ferritin,can be used to assess the severity and prognosis of COVID-19 cases. Among these biomarkers; D-dimer levels correlate more precisely with severity and can be considered as a reliable prognostic marker.

The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Wuhan City, China, in 2019. After that, the outbreak has grown into a global pandemic and definite treatment for the disease, termed coronavirus disease 2019 (COVID-19), is currently unavailable. The slow translational progress in the field of research suggests that a large number of studies are urgently required for targeted therapy. In this context, this hypothesis explores the role of bacteriophages on SARS-CoV-2, especially concerning phage therapy (PT). Several studies have confirmed that in addition to their antibacterial abilities, phages also show antiviral properties. It has also been shown that PT is effective for building immunity against viral pathogens by reducing the activation of NF kappa B; additionally, phages produce the antiviral protein phagicin. Phages can also induce antiviral immunity by upregulating expression of defensin 2. Phages may protect eukaryotic cells by competing with viral adsorption and viral penetration of cells, virus mediated cell apoptosis as well as replication. Moreover, by inhibiting activation of NF-κB and ROS production, phages can down regulate excessive inflammatory reactions relevant in clinical course of COVID-19. In this chapter, we hypothesize that the PT may play a therapeutic role in the treatment of COVID-19.

Coronavirus disease 2019 (Covid-19) is a highly infectious disease, and its replication decreasing rapidly after the first week, while some level of immunity is built up. A small proportion of discharged patients may become positive again for severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) RNA, even if they meet the discharge criteria. Reinfection of SARS-CoV-2 is an apparently uncommon entity and only a few case reports or case series have been reported from across the whole world. Herein, we have reported two rare Covid-19 cases with recurrence of positive SARS-CoV-2 RNA after a complete clinical cure. The first case was redetected with Covid-19 with more severity after a gap of approximately three weeks after cure, and the second case has recurred after approximately seven weeks with a complication of pulmonary thromboembolism. We report here, the first few cases of a more vigorous Covid-19 recurrence with SARS-CoV-2 RNA in India.

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