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Novel SARS-Cov-2 and COVID-2019 Outbreak: Current Perspectives on Plant-Based Antiviral Agents and Complementary Therapy

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Novel SARS-Cov-2 and COVID-2019 Outbreak: Current Perspectives on Plant-Based Antiviral Agents and Complementary Therapy Review Article Novel SARS-CoV-2 and COVID-2019 Outbreak: Current Perspectives on Plant-Based Antiviral Agents and Complementary Therapy Sevgi Gezici1,2*, Nazim Sekeroglu2,3 1Department of Molecular Biology and Genetics, Faculty of Science and Literature, Kilis 7 Aralik University, Kilis, TURKEY. 2Advanced Technology Application and Research Center (ATARC), Kilis 7 Aralik University, Kilis, TURKEY. 3Department of Horticulture, Faculty of Agriculture, Kilis 7 Aralik University, 79000 Kilis-TURKEY. ABSTRACT The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) caused the novel Corona Virus Disease 2019 (COVID-19), which has been defined as a pandemic by the World Health Organization (WHO) in 2020. The rapid global spread of SARS-CoV-2 virus as a global health emergency has emphasized to findeffective treatment strategies in clinical trials. The several drug trials including Lopinavir (LPV) and Ritonavir, Chloroquine (CLQ), Hydroxychloroquine, Favipiravir (FPV), Remdevisir (RDV), Nitazoxanide, Ivermectin and Interferon, have been explored in COVID-19 patients and some of the drugs have been waiting clinical approval for their anti-SARS-CoV-2 activities. Clinical trials are still ongoing to discover promising new multidrug combination treatment for COVID-19 patients. Considering the difficulties to ascertain efficient drug candidates and the lack of specific anti-viral therapies against COVID-19 outbreak, the current management of SARS-CoV-2 should mainly be supportive. From this point of view, enhancing the immune system through medicinal plants with wide range of bioactive compounds, which exhibit antiviral activities, can play significant roles to increase defense barrier in COVID-19 patients. On the other hand, plant-based agents as complementary and alternative therapies have potential advantages to reduce symptoms of this life-threatening disease and could promote the public health. Recently, there has been a remarkable progress in the field of antiviral herbal therapy owing to increasing concerns about the development of drug resistance and limited advances in the field of antiviral drug discovery. This review provides an overview of published information onbiology, genomic structure, replication cycle and pathogenesis of SARS-CoV-2. It also aims to assemble the fact and Submission Date: 28-4-2020; a scientific intellectual groundwork on development of antiviral herbal therapy on the Revision Date: 16-5-2020; bases of extensive literature collection. Accepted Date: 20-7-2020 Key words: SARS-CoV-2, COVID-19, Outbreak, Medicinal plants, Antiviral. DOI: 10.5530/ijper.54.3s.143 Correspondence: Dr. Sevgi Gezici Associate Professor, INTRODUCTION Department of Molecular Biology and Genetics, Faculty Viral infections have emerged throughout of them can altered human civilization.1-4 of Science and Literature, Kilis 7 Aralik University, Kilis-79000, the human history and they caused Coronaviruses (CoVs) belong to family of Merkez/Kilis, TURKEY. dramatically outbreakssuch as Cholera, Coronaviridae, Arteriviridae, Roniviridae Phone: +90 537 634 80 61 E-mail: drsevgigezici@gmail. Ebola, Bubonic Plague, AIDS (Acquired and Mesoniviridae families. Of which, com Immunodeficiency Syndrome), Influenza, Coronaviridae is the largest family and SARS (Severe Acute Respiratory Syndrome), includes subfamily of Coronavirinae, that MERS (Middle East Respiratory Syndrome) is now classified into four main genera and currently COVID-19 (causative including alpha (α)-coronavirus, beta agent SARS-CoV-2 or 2019-nCoV). The (β)-coronavirus, gamma (γ)-coronavirus and emergence of the viral infections has delta (δ)-coronavirus. Alphacoronaviruses often been multifactorial and the results and β-coronaviruses infect variety of host www.ijper.org S442 Indian Journal of Pharmaceutical Education and Research | Vol 54 | Issue 3 [Suppl] | Jul-Sep, 2020 Gezici and Sekeroglu.: COVID-19 Outbreak and Antiviral Herbal Agents cells and can cause life-threatening pneumonia in more than 4,426,937 confirmed cases of COVID-19 humans and some animals such as feline, porcine, canine, have been reported in many countries and territories, mice, bovine, bat and rodent, while γ-coronavirus and resulting in approximately 301,937 deaths all around the δ-coronavirus are specific of birds, but some of them world. Moreover, the number of infected patients with can also infect other organisms.5-8 COVID-19 and death from this virus are alarmingly According to the International Committee for Taxonomy increasing day by day.19,20 Since its rapid infection ability of Viruses, FECV (Feline Enteric Coronavirus) and from person to person and high mortality rate, finding FIPV (Feline Infectious Peritonitis Virus), the porcine efficient and accurate therapy strategies are urgently TGEV (Transmissible Gastro-Enteritis Virus), Porcine necessary to combat this disaster. Hence, scientists have PEDV (Epidemic Diarrhea Virus), PRCoV (Porcine been racing to understand novel coronavirus disease Respiratory Coronavirus), CCoV (Canina Coronavirus) to reveal possible therapy strategies including drug and human coronaviruses (HCoV-229E and discovery, therapeutic antibodies, cytokines, nucleic HCoVNL63) are of α-coronaviruses. Betacoronaviruses acid-based therapy, vaccines with the potential for also compromise Murine coronavirus (MHV) and treating and preventing coronavirus infections. Among Bovine Coronavirus (BCoV) and human coronaviruses the given strategies, to discover effective drugs, which (HCoV-OC43, HCoV-HKU1, SARS-CoV, MERS-CoV may be applicable to COVID-19, have been seem to and SARS-CoV-2).9,10 be the most certain option for immediate treatment. Although, the history of CoVs began in the 1940’s, the Although, no specific drug has been investigated or first human CoVs subsequently, named as (i) human currently available for COVID-19 cases, clinical trials CoV-229E (HCoV-229E) and (ii) HCoV-OC43, were and evaluations of potential antiviral drug candidates reported in the 1960’s.1,2,7 After that, the virologist are ongoing at different laboratories.12,21 tried to identify general structure of CoVs, as well as Current researches on developing drugs against many replication and pathogenesis of them. The studies viral diseases undertaken that medicinal plants used in among the scientist provided to discovery of other new traditional folk medicine have significant importance human coronaviruses such as (iii) HCoV- Hong Kong for the ongoing development of therapeutic agents and University 1 (HKU1), (iv) HCoV-NL63, (v) Severe broad-spectrum drugs.22-25 The information included Acute Respiratory Syndrome (SARS)-CoV and (vi) in this review reveals that possible efforts to search Middle East Respiratory Syndrome (MERS)-CoV.5,11,12 for efficient complementary and alternative medicines Among these coronaviruses, SARS-CoV was identified from different herbal formulations against emerging as a global outbreak in 2003 and it had affected 8422 coronavirus outbreak that is urgently necessary to reduce people in 32 countries, with the mortality of rate of overwhelming impacts on worldwide healthcare systems. 10-15%. SARS-CoV initially infected the bats and Moreover, biological properties of coronaviruses and caused the disease by transmitting from bats to the their mechanisms of infection in the host cells, which palm musk cat and from there to humans.12-14 Then, are necessary to discover useful therapeutic routes for approximately after ten years, another highly pathogenic this outbreak, have been summarized in the presented coronavirus MERS-CoV epidemic emerged in Saudi review. Arabia and spread to other Middle Eastern countries in 2013. Although, the major MERS-CoV pandemic was Genomic Structure of Human Coronaviruses happened in the Republic of Korea, it was observed Coronaviruses are single stranded positive sense RNA worldwide at any age of people with the fatality rate of viruses encapsulated within a membrane envelopeand 39%.11,15,16 their genome comprises approximately 26-32 kilobases Following this outbreak, the novel coronavirus namely nucleotides. In all CoVs encode five structural proteins: 2019-nCoV or SARS-COV-2 has been caused COVID- (i) spike protein (S), (ii) hemagglutinin esterase (HE) 19 outbreak emerged in Wuhan State, Hubei Province, protein, (iii) membran protein (M), (iv) envelope protein China in December 2019. It has spread to more than (E), (v) nucleocapsid protein (N), respectively, from 180 countries and territories US, Spain, Italy, France, outside to inner membrane.26-28 These proteins play Germany, United Kingdom, China and Iran continue critical roles for virion assembly, viral replication and to be the countries hardest-hit. Since, it has been transcriptionas well as suppression the host immune infected many people and caused a high mortality response (Figure 1). rate in a short period, the World Health Organization (i) S protein, located outside of the virus, are a (WHO) has declared the new coronavirus outbreak glycoprotein that gives the typical shape for the called COVID-19 a pandemic.17,18 As of 15 May 2020, virion. These proteins act as cell surface receptor Indian Journal of Pharmaceutical Education and Research | Vol 54 | Issue 3 [Suppl] | Jul-Sep, 2020 S443 Gezici and Sekeroglu.: COVID-19 Outbreak and Antiviral Herbal Agents proteins for introduce the host cell and interact with enter and multiply into the host cell by suppressing membrane proteins.29 the host’s immune system.16,17,32,33 Phylogenetic tree (ii) Additionally, hemagglutinin esterase (HE) proteins
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