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A Review on Five Medicinal Plants Considering the Therapeutic Potentials in the Management of COVID-19

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A Review on Five Medicinal Plants Considering the Therapeutic Potentials in the Management of COVID-19 A review on five medicinal plants considering the therapeutic potentials in the management of COVID-19. Md. Fahad Jubayer1*, Md. Shahidullah Kayshar1, Md. Anisur Rahman Mazumder2, Syeda Sabrina Akter1 1Department of Food Engineering & Technology, Sylhet Agricultural University, Sylhet-3100, Bangladesh. 2Department of Food Technology and Rural Industries, Bangladesh Agricultural University, Mymensingh-2202, Bangladesh. *Corresponding author: Md. Fahad Jubayer Assistant Professor, Department of Food Engineering & Technology Sylhet Agricultural University, Sylhet-3100, Bangladesh. Email: [email protected] Phone: +88-01876-529642. Abstract: The spread of pandemic coronavirus disease-2019 has become a health emergency worldwide. Since the unprecedented outbreak, attention has been raised worldwide to develop and research for control options and treatments. Although several clinical trials are ongoing, no registered drugs or vaccines are available yet. As situation warrants for the exploration of a successful antiviral, there should be a search for the remedies in nature also. Medicinal plants and their metabolites have long been used as a treatment option for various life-threatening diseases with minimal or no side effects. Thus this review aims to summarize previous outcomes concerning the role of medicinal plants in treating several life-threatening diseases. Above all, this work intends to find the constituents of five selected medicinal plants and their possible working mechanisms in the management of COVID-19. Constituents of the presented medicinal plants possess excellent pharmacological properties, including significant antiviral and antimicrobial potential. Based on the traditional uses, pharmacological properties, and previous studies, these medicinal plants mentioned in this review can be considered as a possible therapeutic option for the management and treatment of COVID-19. However, further extensive researches and trials are suggested to discover specific effects and dosage for this pathogenic outbreak. Keywords: COVID-19; medicinal plants; black cumin; ginger; licorice; echinacea. Abbreviations: COVID-19, coronavirus disease 2019; SARS-CoV-2, severe acute respiratory syndrome coronavirus 2; SARS-CoV, severe acute respiratory syndrome coronavirus; MERS- CoV, middle east respiratory syndrome coronavirus; 2019-nCoV, novel coronavirus; ARDS, acute respiratory distress syndrome; CVD, cardio vascular disease; HIV, human immunodeficiency viruses; NDV, Newcastle disease virus; HSV, herpes simplex virus; VSV, vesicular stomatitis viruses; HCV, hepatitis C virus; HRSV, human respiratory syncytial virus; IV, influenza virus; ACE2, angiotensin-converting enzyme 2 gene; RdRp, RNA-dependent RNA polymerase; HCQ, hydroxychloroquine; TQ, hhymoquinone; RA, rheumatoid arthritis; 1L-1β, interleukin 1 beta; TNFα, tumor necrosis factor alpha; α-LA, α-lipoic acid; GC, glycyrrhizin; 18β-GA, 18β-glycyrrhetinic acid; LCA, licochalcone A; GLD, glabridin; HBsAg, hepatitis B antigen. Introduction Once identified in Wuhan, China, in December 2019, the global pandemic, as declared by the WHO, the novel coronavirus disease (COVID-19) has made its deadly mark in about all countries worldwide. The Chinese Centre for Disease Control and Prevention (CCDC) identified the contributory agent from throat swab samples on January 7, 2020 and designated it as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) [1]. As of September 09, 2020, there are nearly 27 million confirmed cases in almost every country and territory with a burden of about 895K deaths [2]. Coronavirus is an enveloped single-stranded positive-sense RNA virus which belongs to the subfamily Coronavirane [3]. The first article related to 2019-nCoV revealed that the virus belongs to the beta-coronavirus group, imparting family line to bat coronavirus HKU9-1, like SARS coronavirus [4]. Other studies featured that SARS-CoV-2 genes share <80% nucleotide identity and 89.10% nucleotide similarities with SARS-CoV genes [5]. In spite of succession assorted variety, its spike protein collaborates firmly with the human ACE2 receptor [4]. The key target of infection is the lower respiratory tract [6]. The commencement of the disease was found with high fever, fatigue, dry cough, sore throat, nasal blockage, headache, runny nose, sore throat, vomiting, and diarrhea. Along with these mild symptoms, some have appeared with different fatal complications like organ failure, septic shock, severe pneumonia and Acute Respiratory Distress Syndrome (ARDS) [7]. Presently, the SARS-CoV-2 infection has become a public health threat because of its high transmission rate as well as the unusualness of infection movement around the world. At present, no effective and standard treatment or vaccine is available against COVID-19. However, the role of several antiviral agents, anti-inflammatory agents, antibiotics, and their controlled clinical trials has been reviewed to explore the competence against COVID-19. Among the treatments, the combination of lopinavir-ritonavir, remdesivir, favipiravir, hydroxychloroquine, ivermectin, doxycycline – has been recommended different times till date [8], [9], [10]. Nutritional interventions are important to boost up the host immune system against different infections or diseases. Previous investigations on nutritional interventions have also shown the efficacy against measles, influenza, SARS-CoV and MERS-CoV. Vitamin A supplementation can reduce the morbidity and mortality rate in diseases like measles, diarrheal, measles-related pneumonia, HIV and malaria. Vitamin C boosts up immune functions and shows the potentiality against SARS coronavirus, atypical pneumonia, and lower respiratory tract infections. Moreover, patients with diseases like diabetes, hypertension, CVD, and cancer may establish a resistance to SARS-CoV-2 with the appropriate intake of vitamin D and vitamin E [11]. On the other hand, the combination of zinc and pyrithione at a certain dosage inhibits the replication of SARS-CoV [12]. In the absence of registered treatment or vaccine for this novel coronavirus, it is vital to find alternative methods to control the spread of the coronavirus disease (COVID-19) as well as to prevent the replication of the same. In this circumstance, based on historical records and evidence, the introduction of natural products and their derivatives hopefully will effective against SARS-CoV-2. There are solid attestation in favor of medicinal plants being utilized for fortifying body immune functions and treating different diseases in prehistoric systems of Unani, Ayurvedic, and Chinese tradional medicine. Natural products and herbal medicines have crucial role in drug discovery. The U.S. Food and Drug Administration have approved many drugs that are being prepared and derived from natural sources [13]. A good number of study indicated that natural products and their derivatives have significant antiviral activity and potential of inhibiting viral replication [14]. Moreover, during the outbreak of COVID-19, some Chinese traditional medicine was widely used as it considered enhancing host immunity against the infection. However, adequate research and evidence on the development of antiviral medications from natural products and their derivatives, is lacking. Ample researches and rigorous clinical trials should be conducted to assure the possible preventive effect of these medicinal plants and their constituents. In accordance with the foregoing discussion, this review aims to draw a current status of efficacy of five medicinal plants (black cumin, licorice, Echinacea, ginger, and costus) and their metabolites as possible management option of COVID- 19. This review will also help the general people think of the benefits of the medicinal plants and tend them to include these kinds of plants in their daily lifestyle during this time. Why medicinal plant-based approach? Till date, there has been no breakthrough in antiviral vaccines and therapeutic drugs for the management of COVID-19. Alongside with containment strategies, ongoing treatments are primarily focused on symptomatic and respiratory support according to the diagnosis. Severe atypical pneumonia is the main cause observed for the death in this disease. The infected patients usually observed with symptoms of mild upper respiratory tract infection, which has similarities with the common cold attack. Prognosis refers, the most common symptoms of COVID-19 includes fever (88-98%), upper airway congestion, dry cough, fatigue, sore throat, shortness of breath, diarrhea, myalgia, and gastrointestinal disorders [7], [15]. Based on currently available information and clinical expertise, people of any age who have severe underlying medical conditions like diabetes, CVD, asthma etc. might be at higher risk from this disease [6]. In a cohort study, it was observed that, patient with hypertension (19.4%) and diabetes (10.9%) had greater comorbidity rate compared to other patients [16]. Previous experience of fighting the epidemic SARS-CoV and MERS-CoV, some treatment approaches against coronavirus have been practiced around the world following the most efficient research strategy “old drug, new use”. Currently, symptom-based treatments for SARS-CoV-2 infections are carrying out at different parts of the world. In ancient times, people used to search for drugs in nature. A significant amount of world populations rely on medicinal plants and herbs for attaining their primary healthcare needs [17]. In this grave state, it is
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