The Sanskrit word Ayurveda translates to the knowledge of life. It is one of the oldest healing systems in the world that originated in Eastern culture and includes many medical concepts and is a hypothesis for the treatment and prevention of disease. In ancient times, about 3000 years ago in India when no synthetic medicines were developed, people used Ayurvedic plants to get treatment for various diseases. Ayurveda is based on the belief that health and well-being depend on the delicate balance of mind, body, and spirit. Ayurvedic herbs are the key components of Ayurveda. COVID-19 is an infectious disease that was discovered in December 2019 and has now become a pandemic. COVID-19 infection is caused by the virulent severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) virus, although various antiviral drugs are available to control the infection, but sometimes, they are in short supply to treat the population around the world. Therefore, it has become imperative to develop an effective medical strategy for the management of COVID-19 which has become a major threat to humanity. Herbs exhibit various biological activities; they can have effects
Introduction
The first human case of COVID-19 was first reported by the authorities in Wuhan city of China. It is caused by non-segmented positive single-stranded RNA virus. The impact of this pandemic is being felt at the economic and psychological level, the World Health Organization is constantly monitoring the mortality rate of the COVID-19 virus, according to its latest report, 3,44,110 confirmed cases of COVID-19 have been reported in the last 7 days. And 8,595 deaths occurred in India. This is due to the mutation of the virus and the rapid spread or transmission of the virus.Causes
According to WHO, COVID-19 disease is caused by the SARS-CoV-2 virus, which spreads between people in many different ways. The virus spreads mainly through close contact with an infected person through respiratory droplets emitted by sneezing or coughing. There are two more routes to transmit the virus they are contact and aerosol transmission.Symptoms
COVID-19 infected patients experience some typical symptoms ranging from mild to severe and may appear two to fourteen days after exposure to the virus. These symptoms are cough, shortness of breath, fever or chills, fatigue, muscle or body aches, loss of taste or smell, sore throat, runny nose, nausea or vomiting and diarrhea.Diagnosis
Direct or conformational detection is done by reverse transcriptase polymerase chain reaction RT-PCR which is the standard for diagnosis of COVID-19 infection along with other technologies like CRISPR-mediated detection. Some of the conventional techniques for detecting COVID-19 are molecular testing, rapid antigen testing, serology testing and computer tomography. Molecular tests work on the genome of the COVID-19 virus, specifically on the viral nucleic acid to increase the concentration of the viral genome by amplification so that it can be detected by the respective device. Serology tests detect antigen proteins and antibodies produced in response to the antigen. Rapid antigen tests detect active infection but its result may be inaccurate compared to RT-PCR.Pathophysiology
COVID-19 is the disease caused by the SARS-CoV-2 virus. The current COVID-19 is both similar and different from the preceding severe acute respiratory syndrome (SARS; 2002- 2003) and Middle East respiratory syndrome (MERS; 2012-ongoing). All 3 viral infections typically present with cough and fever, often leading to respiratory tract illness, with poorer clinical outcomes associated with older age and underlying health conditions. Nucleic acid testing of respiratory tract samples is required to confirm infection. Coronaviruses are a large family of single stranded RNA viruses. Based on the cells likely to be infected, COVID-19 can be divided into three stages that correspond to different clinical stages of the disease. Stage 1: Asymptomatic stage (early 1-2 days of infection) Inhaled virus likely attaches to epithelial cells in the nasal cavity and begins to replicate. SARS-CoV-2 uses SARS CoV receptor ACE2 for entry and the serine protease TMPRSS2 Ciliated cells are infected in the airways. The virus can be detected from nasal swabs in this stage. Stage 2: Upper airways and conduction of airway response (next few days) The virus produces destructive pneumonia with extensive alveolar damage and increased cytokines and chemokines. Secretory vesicles filled with virus RNA concentrations increased over time, released by exocytosis from the apical surface of a polarized type II cell. Viral infection reduces the secretion of surfactant proteins. At this stage, an infected patient who is already suffering from health problems and aging needs to be admitted to the ICU. It should be monitored under conservative symptomatic treatment. Stage 3: Hypoxia, progression to ARDS. 20% of infected patients reach stage 3 and develop pulmonary infiltration and very severe disease. The virus reaches the gas exchange unit of the lungs and infects alveolar type II cells. The cells undergo apoptosis and die. Alveolar type II cells are precursors of type I cells. And a secondary pathway for epithelial regeneration is triggered. SARS-CoV-2 binds to host cells via ACE2 receptors, which are expressed by epithelial cells of the lungs, intestine, kidney, brain and blood vessels. The healing of alveolar damage leads to scarring and fibrosis. ACE2 inhibitors reduce their weak immune response and ability to repair damaged epithelium. Symptoms of SARS-CoV-2 are similar to those of the common cold, including fever, cough and shortness of breath. These infections can lead to pneumonia, multi-organ failure, severe acute respiratory syndrome and even death. Ayurvedic Approach Ayurveda, a Sanskrit word, is made up of two words ayu which means life, and veda which means science; these two words combined to form the word Ayurveda, which means “science of life”. Hence, Ayurveda not only aims to be “natural” but it is also a holistic approach to physical and mental health. In this Covid pandemic, the mortality rate and the rate of people getting infected is increasing day by day. This situation is much more serious due to the potentially disastrous conditions caused by many social and economic factors. For effective management of this serious situation, we need to go back to our Ayurvedic knowledge. This situation has taught us a lesson “old is gold”. For effective management, we need to accept and practice yoga and Ayurveda and these can certainly play a vital role in enhancing preventive measures. There are different types of treatments in Ayurveda are medicines, special diets, meditation, yoga. Since your body is natural, natural treatments do not have any side effects on our body.Ayurvedic Treatments
These medicines have their origin in the foothills of Himalayas and various parts of India where sages like Acharya Charak, Acharya Sushrut applied the applications of these herbs in their daily lives. These medicines include neem, turmeric and ginger, basil, cinchona, emblica, etc. These medicines play a vital role in this pandemic on the body, they increase immunity and are also used in respiratory disorders. During dry cough/sore throat – as per latest survey steam inhalation with fresh neem, clove, or tulsi leaves can be practiced once a day, it has great potential to boost immunity, take kadha (decoction) made from tulsi (basil), dalchini (cinnamon), cloves, shunthi (dry ginger) – once or twice a day. Ginger rhizome diet for 12 weeks showed an increase in hemoglobin, hematocrit, WBC MCH, MCHC values.Ayurvedic Herbs and Drugs for COVID-19
1. Neem
Azadirachta indica is commonly called 'Indian Lilac' or Neem and in Sanskrit it is called 'Arista' which means whole and perfect. Neem has been used extensively in Ayurveda, Unani and Homeopathic medicine and has been the centre of attraction of modern medicine for more than 4000 years due to its medicinal properties. The pharmacological activities of A.indica that have been reported are antibacterial, antiviral, antifungal, anti-inflammatory, antipyretic, antiarthritic, hypoglycemic and antitumour etc. The pharmacological activities exhibited by Neem are due to the chemical constituents present in it, some of which are Azadirachtin, Nimbolinin, Nimbin, Nimbidin, Sodium Nimbinate, Gedunin and Quercetin. Neem leaves contain deacetylnimbinin, malonicanhydride, nemosynol, isomelonican, nimbolide and zafral.
According to the latest studies it was found that malonicanhydride and neem leaves derived compounds may have COVID-19 inhibitory properties. Neem leaves lower blood sugar and inhibit ACE2 receptors which are responsible for the entry of COVID-19 virus into the host cell. Neem acts as a natural immunomodulator as it contains vitamins like C, E and K. COVID-19 virus is enveloped by membrane (M) and envelope (E) proteins which are essential for the replication of the virus and in silico docking studies found that nimbolin A has the strongest binding free energy to this M and E proteins, thus, we can say that neem is a source of promising future antiviral drugs.
2. Zingiber Officinale
Zingiber officinale, commonly called ginger, belongs to the Zingiberaceae family. Ginger rhizomes have medicinal properties and are extensively used for treatment. Ginger is widely used in Ayurveda, Siddha, Unani and Chinese herbal medicine across the world. It is mostly used for anti-cancer, antiviral, antidiabetic, antimicrobial, antioxidant, nephron-protective, sedative, hepato protective, anti-inflammatory, analgesic, antiemetic and antitumor treatments. The characteristic odor and taste of ginger is due to the chemical constituents zingerone and shogaol. Some of the active components of ginger are 6-gingerol, gingerine, gingerberon, zingeranone, etc. Ginger has been proven to have effective effects on various viruses.
Ginger is one of the most effective natural immunomodulators, 6-gingerol present in ginger has been proven to have the highest binding affinity for spike protein and RNA binding protein target and has good antiviral action against it, so it can become a promising drug for treating COVID-19. It was also found that ginger's zingierenone, zingiberin and other phytochemicals have good binding affinity for ACE receptors and spike protein of COVID-19. Ginger is a natural immunomodulator that can boost immunity and provide great protection against the COVID-19 virus. The Ministry of AYUSH has recommended Zingiber officinale as the main ingredient of its herbal formulations due to its wide range of pharmacological activities. Therefore, Zingiber officinale can be a great preventive measure for COVID-19.
3. Cinchona
Cinnamon is one of the most important herbal medicines and has been widely used in Asia for about 4000 years. Cinchona is also called Peruvian bark and is found in South America and India. In India, it is mostly found in hilly areas. Cinchona belongs to the Rubiaceae family. More than 20 alkaloids are found in cinchona bark, the most important alkaloids of which are quinine, quinidine, cinchonine and cinchonidine. Along with this, it also contains triterpenes, essential oils, phytosterols, flavonoids, etc. Terpenoid indole alkaloids are mostly found in cinchona. Quinine alkaloid is obtained from the 'fever tree' traditionally used to treat malaria. Covid patients suffer from inflammation of the lungs; cinchona can help them by reducing inflammation due to its anti-inflammatory property. Also it has antimicrobial, antioxidant, antiparasitic properties.
Quinine is the most important component of hydroxychloroquine drug which is used to treat malaria and nowadays it is used to treat COVID-19 infection by glycosylation ACE 2 spike protein and prevents the entry of COVID-19 virus. It is also a natural immunomodulator which enhances immunity and provides protection against COVID-19. It has been found that quinine sulfate drug obtained from cinchona has antiviral action against COVID-19 by increasing the synthesis of RIG I and IFN-alpha synthesis which inhibits viral mRNA synthesis of COVID-19. Some analogs of quinine are currently being tested against COVID-19 virus.
4. Curcumin Longa
Curcumin is a medicinal plant traditionally used in India which is found in the rhizomes of the turmeric plant, Curcumin longa. Curcumin belongs to the Zingiberaceae family and is an active component of turmeric, it is known for its various pharmacological activities, as its active components are flavonoids and some volatile oils, including atlantone, turmeric and zingiberone. Turmeric is a powerful antioxidant, it can be used for cancer prevention and it is also a powerful anti-inflammatory agent that reduces inflammation by producing histamine. Along with this, it has pharmacological activities like antidiabetic and related disorders, anti-angiogenic, antioxidant, antibacterial, antiviral, etc.
Recently it has been studied that the COVID-19 virus enters the host by angiotensin-converting enzyme 2 (ACE2) membrane receptors present on the mucous membrane. The binding of S protein of the virus and ACE2 receptors occurs to enter the host cell. It has been found that curcumin acts as the receptor-binding domain (RBD) site of viral S protein and viral attachment site of ACE2 receptors. So, curcumin has become a potential blocking agent that blocks the interaction of virus and host cells.
Natural products of Curcumin with Vitamin C along with Zinc supplements that boost immunity and provide protection against COVID-19 infection.
5. Ocimum Sanctum
Ocimum sanctum is commonly called Tulsi. It belongs to the Lamiaceae family. Tulsi contains monoterpenes such as camphor, cineole, estragole, eugenol. The leaves of the plant contain vitamin A and C. Ursolic acid of Tulsi inhibits proliferation and induces apoptosis and accumulation of cells in the G1, G0 phase of the cell cycle. Aqueous extracts of Tulsi leaves are used to treat poisoning, stomachache, common cold, headache, malaria, inflammation and heart diseases. Oil extracted from Tulsi leaves and inflorescences has properties such as expectorant, analgesic, antiemetic and antipyretic; stress reliever and anti-inflammatory and as anti-asthmatic, hypoglycemic, hepatoprotective, hypotensive, hypolipidemic and immunomodulatory agent.
The alcoholic extract of the leaves shows immunomodulatory effects such as modulation of cytokine secretion, histamine real meaning, class switching, immunoglobulin secretion and protection against genotoxicants. Chewing of herbal leaves stimulates salivation, which increases salivary bicarbonate concentration, thereby increasing salivary pH. Tulsi tea is effective in treating chronic bronchitis and asthma and relieves stress, restores and improves body immunity and digestion. Tulsi is mostly used in fever, sore throat, headache, cold, flu, chest congestion.
Compounds like ursolic acid, carnosol, rosmarinic acid, circinol, apigenin, eugenol present in Ocimum sanctum increases hemoglobin concentration, decreases cyclo oxygenase (COX)-2 and lipoxygenase (LOX)-5 enzyme activity, suppresses NF-κB classical pathway, up-regulation of IL-2, IFN-γ, and TNF-α, downregulation of IL-1β and production of SRBC antigen-specific antibodies, which represents an important defense mechanism for assessing T-cell dependent antibody response capability, is also an immune modulator and regulator as it enhances immune-enhancing response by increasing T-helper and NK cells; phagocytic activity and lymphocyte count, along with increase in neutrophil count and antibody production. Tulsi plays an important role as an immunity booster to defeat COVID-19. The fixed oil has antipyretic activity by inhibiting prostaglandins. Tulsi has antihypoxic effects and increases survival time during anoxic stress.
6. Tinospora Cordifolia
Tinospora cordifolia (family Menispermaceae) is a climbing deciduous shrub and herbaceous vine. It is also called Gurcha or Giloy in Hindi. It is a well-known traditional medicine found in India, China, Bangladesh and Myanmar and Sri Lanka. There are various components extracted from T. cordifolia and they belong to different classes such as alkaloids, aliphatic compounds, lactones, glycosides, steroids, diterpenoids sesquiterpenoids, phenolics and polysaccharides. It shows various medicinal properties from different parts of the plant such as anti-diabetic, anti-cancer activity, immunomodulatory activity, anti-oxidant activity, anti-microbial activity, anti-toxic. T. cordifolia is the best remedy for children suffering from upper respiratory tract infection. Their daily use of Giloy in this pandemic can strengthen the respiratory system. The immunomodulatory property of Tinospora cordifolia is well documented. Active compounds 11-hydroxymustachone, N-methyl-2-pyrrolidone, and cytotoxic effects.
7. Cocos Nucifera
Cocos nucifera (genus Cocos and family Arecaceae) is called the "tree of life" or "Kalpavriksha". It is also called nariyal (Hindi) and naral (Marathi). It is cultivated in India, Sri Lanka, Thailand, and Malaysia. C. nucifera contains various components that have some biological effects such as antioxidant, antimicrobial, vasorelaxant, antihypertensive Due to various activities of Cocos nucifera, it is useful in versatile way36-39. Virgin coconut oil is naturally extracted from coconut and is rich in chain triglycerides, with lauric acid as the major fatty acid.
In vitro studies suggest that lauric acid or its derivatives exert suppressive activities on COVID-19. SARS-CoV-2 is a virus surrounded by a special lipid membrane having S-glycoproteins (spike proteins) on its surface that bind effectively to the angiotensin converter enzyme 2 (hACE2) human receptor; any disruption of viral membrane lipids can be detrimental to the viral infection process and hence may prevent the entry of the virus into human cells. Hence, the lauric acid-based novel prophylactic would be a useful nasal spray to prevent respiratory infections like COVID-19.
8. Ashwagandha
Ashwagandha is an adaptogenic botanical grown in India known for its ability to balance, energize, rejuvenate, and is a well-known herbal tonic also used for heart diseases. Stress is a major factor in the decline in immunity and to increase it, strengthening immune responses by nutrition is the most preferred remedy. Stress-induced increase in corticosterone production was blocked by feeding Ashwagandha extract and more so by WB365. Regular use of Ashwagandha churna is reported to purify the body and increase vitality. It enhances brain and nervous system function and improves memory. Various studies have concluded that it also has properties of antioxidant, anxiolytic, performance enhancer, memory enhancer, antiparkinsonian, antidote, anti-inflammatory, anti-stress, immunomodulation, tranquilizer type sedative activity, hypoglycemic and it has proven to be an effective remedy in cancer cells and also malignant growth of various organs. Moreover, it is highly recommended that consuming Ashwagandha with cow milk has the following effects on the human immune system: Through a survey, it has been observed that inflammatory responses are increased in COVID positive patients.
9. Syzygium Aromaticum
Commonly called clove (Family Myrtaceae), it is the most important traditional herb. For over 2,000 years it has been used in India and China to cure several health-related issues and treat diverse infections such as malaria, cholera, and tuberculosis. Cloves have antimicrobial, antioxidant, anti-inflammatory, analgesic, anti-cancer and anesthetic, antiseptic, antibacterial, antifungal and antiviral properties. Chemical analysis shows that cloves contain different elements, the most important being the essential oil called eugenol which acts as an analgesic and antioxidant. Cloves also contain a variety of flavonoids that contribute to the anti-inflammatory (and antioxidant) properties of cloves. In addition, its anti-inflammatory properties protect the lungs from acute injury caused by lipopolysaccharide- (LPS). Treatment with eugenol was also found to inhibit the recruitment of leukocytes to the lungs and reduce the expression of pro-inflammatory cytokines (IL-6 and TNF-α).
It exhibits broad antimicrobial activities against gram-positive, gram-negative and acid fact bacteria. Cloves may also help relieve muscle spasms and pain of certain nerve conditions. Cloves are used for expectorant which expels mucus from the respiratory tract. Daily use of cloves in pandemic can play therapeutic role in general stress relief: Clove oil stimulates the circulatory system, clears the mind and reduces mental exhaustion and fatigue. Corona virus affected a large part of human body, immunity system got weakened. Cloves are general immune system booster Clove powder can be taken 2-3 times a day by mixing it with natural sugar/honey, it reduces cough or throat irritation, by using cloves we can improve our immunity.
10. Bael
Limonia acidissima is a medium-sized deciduous tree grown throughout India. All parts of Limonia acidissima are prescribed in indigenous systems of medicine for treating various disorders, stimulants, cardiotonic astringents, aphrodisiacs, diuretics, tonics for liver and lungs, cough, hiccups and good for asthma. Bael pulp contains carbohydrates and proteins, beta carotene, vitamin B, vitamin C, thiamine and riboflavin which will be helpful in boosting immunity in the pandemic. Coronavirus mainly affects the respiratory system. Limonia acidissima has been reported to produce antibacterial activity, antioxidant activity and anti-inflammatory activity52. In some studies, the use of anti-inflammatory drugs was found to reduce the symptoms of COVID-19. This anti-inflammatory property of Limonia acidissima will possibly help in treating COVID-19.
Dietary And Lifestyle Changes
Consume freshly cooked hot food with proper nutrition keeping in mind the digestive power of the individual. Eat freshly prepared Laghu-Supachaya which is easily digestible. Drink warm water daily and boil it with medicinal herbs like Shunthi, cinnamon etc. Trikatu keeps the body hydrated. Avoid spicy, cold, chilled, heavy food. Restrict especially sweet and refrigerated products. Certain yogasanas can boost immunity.Effects Of Herbal Medicines On The Body
Ayurveda is based on 3 basic principles. These principles are known as doshas in Sanskrit, these include Vata, Pitta and Kapha. Herbal medicines are now in great demand in developing countries for primary health care, not because they are affordable but also because of better cultural acceptability, better compatibility with the human body and minimal side effects.Side Effects
Uncontrolled intake of Ayurvedic herbal preparations can cause serious, toxic health problems on the body. Deep awareness about the activities of these plants is essential for their safe selection and consumption. However, unlike drugs, herbal products are not regulated for purity and potency. Herbal drugs are considered food integrants and are readily available in the market without a prescription.Conclusion
In India, the Ayurvedic system has described a large number of such herbal drugs to provide a better understanding of their active principles and mode of action. This is evident from the products shown above and they are working because Ayurveda holds importance in today's medicinal research. Currently there are a lot of herbal medicines under research that can be used internally in the form of tablets, syrups and infusions, or externally in the form of plasters and liniments. This will make the drug safer, cheaper and more accessible. In a pandemic, using synthetic medicine has toxic effects on the body. To overcome the side effects we are looking for a herbal formulation that can overcome the adverse effects of synthetic drugs. So this review is a start to provide a wide choice of herbal sources for the treatment of Covid 19.
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AYURVEDIC MEDICINES
