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COVID-19 and Phytotherapy COVID-19 Ve Fitoterapi

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COVID-19 and Phytotherapy COVID-19 Ve Fitoterapi Review DOI: 10.14235/bas.galenos.2020.4962 Bezmialem Science 2020;8(4):428-437 COVID-19 and Phytotherapy COVID-19 ve Fitoterapi Melike Nur AKBAŞ1, Adem AKÇAKAYA2 1Bezmialem Vakıf University, Phytopharmacy, İstanbul, Turkey 2Bezmialem Vakıf University Faculty of Medicine, Department of General Surgery, İstanbul, Turkey ABSTRACT ÖZ SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus Çin’in Wuhan şehrinde ortaya çıkan ve COVID-19 hastalığına 2), emerging in Wuhan city, China, causing COVID-19 disease, sebep olan SARS-CoV-2 (Şiddetli Akut Solunum Sendromu has been described as a pandemic by WHO (World Health Korona Virüsü 2), pnömoni salgınlarına yol açarak DSÖ (Dünya Organization), leading to outbreaks of pneumonia. The COVID-19 Sağlık Örgütü) tarafından pandemi olarak nitelendirilmiştir. pandemic continues to affect millions of people worldwide. SARS- COVID-19 pandemisi dünya genelinde milyonlarca kişiyi COV-2 enters the cell via ACE-2 (Angiotensin-converting enzyme etkilemeye devam etmektedir. SARS-COV-2, ACE-2 (Anjiyotensin 2) receptor. These receptors are predominantly found in lung, small dönüştürücü enzim 2) reseptörünü kullanarak hücre içine giriş intestine, and vascular endothelial cells. Since ACE 2 is found more yapmaktadır. Bu reseptörler ağırlıklı olarak akciğer, ince barsak frequently in these tissues, common clinical symptoms include ve vasküler endotel hücrelerinde bulunmaktadır. ACE 2’nin bu fever, cough, sore throat, fatigue, dyspnea, and diarrhea. Currently, dokularda daha sık bulunması sebebiyle, yaygın görülen klinik although symptomatic treatments are applied for COVID-19, there semptomlar arasında ateş, öksürük, boğaz ağrısı, yorgunluk, dispne is no specific treatment yet. It takes a long time before targeted ve ishal yer almaktadır. Şu anda, COVID-19 için semptomatik therapies can be found. For this reason, it is necessary to develop tedaviler uygulansa da henüz spesifik bir tedavisi bulunmamaktadır. emergency treatment or methods that can quickly control the Hedefe yönelik tedavilerin bulunabilmesi için çok uzun bir disease. Phytotherapeutic compositions offer a potentially valuable zaman geçmesi gerekmektedir. Bu sebeple acil tedavi veya hızlı bir resource for this purpose. Many countries, especially China, şekilde hastalığı kontrol altına alabilecek yöntemler geliştirilmesi aimed to reduce morbidity and mortality by using phytotherapy gerekmektedir. Fitoterapötik bileşimler, bu amaçla potansiyel olarak throughout COVID-19 patients. Phytotherapeutic products are değerli bir kaynak sunmaktadır. Başta Çin olmak üzere pek çok known to be safe and tolerable with their background knowledge. ülke COVID-19 hastalarında, tedavi seyri boyunca fitoterapiyi In this regard, the use of phytotherapy as a complementary uygulayarak morbiditeyi ve mortaliteyi azaltabilmeyi amaçlamıştır. treatment in COVID-19 patients is very important. In this review, Fitoterapötik ürünler geçmişten gelen bilgi birikimi ile birlikte phytotherapeutic approaches related to symptoms that may occur in güvenli ve tolere edilebilir olduğu bilinmektedir. COVID-19 the clinical course of COVID-19 disease will be discussed. hastalığında tamamlayıcı tedavi olarak kullanımı bu açıdan çok Keywords: COVID-19, coronavirus, phytotherapy, comlementary önemlidir. Bu derlemede COVID-19 hastalığının klinik seyrinde therapy ortaya çıkabilecek semptomlara ilişkin fitoterapötik yaklaşımlardan bahsedilecektir. Anahtar Sözcükler: COVID-19, koronovirüs, fitoterapi, tamamlayıcı tedavi Address for Correspondence: Adem AKÇAKAYA, Bezmialem Vakıf University Faculty of Medicine, Received: 23.06.2020 Department of General Surgery, İstanbul, Turkey Accepted: 26.07.2020 E-mail: [email protected] ORCID ID: orcid.org/0000-0003-3116-7033 Cite this article as: Akbaş MN, Akçakaya A. COVID-19 and Phytotherapy. Bezmialem Science 2020;8(4):428-437. ©Copyright 2020 by the Bezmiâlem Vakıf University Bezmiâlem Science published by Galenos Publishing House. 428 Bezmialem Science 2020;8(4):428-437 Introduction gained an increasing usage area in our country as well as in the world. In this review, phytotherapeutic approaches which are Coronaviruses are enveloped RNA viruses that threaten human used in COVID-19 disease or having potential efficacy against health by causing diseases usually in the respiratory tract, digestive symptoms such as URTI (upper respiratory tract infection), system and central nervous system of humans and animals. Six bronchitis etc., that may occur in the course of the disease will coronavirus species are known to cause illness in humans. Four be mentioned. of these (229E, OC43, NL63 and HKU1) are common and they also cause typical cold symptoms in the individuals with strong COVID-19 and Clinical Findings immune system. The other two strains which are severe acute ACE-2 receptor is the intracellular entry receptor for SARS- respiratory syndrome coronavirus (SARS-CoV) and Middle East COV-2 and some types of coronavirus (SARS-CoV, HCoV- respiratory syndrome coronavirus (MERS-CoV) are zoonotic and NL63). ACE-2 plays an important role in the renin-angiotensin- wile some bodies can survive with mild symptoms, sometimes aldosterone system (RAAS) regulating blood pressure and they can be fatal. SARS-CoV is the virus that caused severe acute body-fluid balance. ACE-2 also has functions such as protecting respiratory syndrome outbreaks in Guangdong province of China organs from inflammatory damage and regulating intestinal in 2002 and 2003. MERS-CoV is the pathogen responsible for functions. The outer membrane of SARS-CoV-2 contains S severe respiratory disease outbreaks that occurred in the Middle (spike) glycoprotein, which binds with high affinity to the ACE- East in 2012 (1). 2 receptor in the host cell. Although 79% of the current SARS- In December 2019, as a result of studies conducted on a group of CoV-2 genome is similar to SARS-CoV, it has been reported patients with pneumonia of unknown cause, it was determined that due to mutations in the S glycoproteins, the ability of that the factor causing pneumonia was a previously undiscovered SARS-CoV-2 to bind to ACE-2 receptors has increased, and betacoronavirus. This virus, which is different from MERS-CoV hence the contagiousness of SARS-CoV-2 has risen (8). When and SARS-CoV, was named 2019-nCoV and registered as the 7th glycoprotein S is cut by proteases such as TMPRSS2 in the host member of the coronavirus family (1). The name 2019-nCoV cell, it becomes possible to bind to ACE-2 receptors and initiates was later changed to SARS-CoV-2 (Severe Acute Respiratory the infection. ACE-2 receptor and TMPRSS2 are co-expressed Syndrome Corona Virus 2) by the International Virus Taxonomy in human respiratory and intestinal tract cells. Therefore, these Committee (ICTV) (2). The disease caused by the SARS-COV-2 tissues will be the main target of the virus (9). virus was called COVID-19, which means 2019 coronavirus disease by the World Health Organization (WHO) (3). Early Like many respiratory diseases, COVID-19 is spread through reports of COVID-19 point to a similar incubation period with droplets. Researchers have reported that SARS-CoV-2 can SARS-CoV and MERS-CoV. Clinical features are also very remain infectious in airborne droplets for at least 3 hours (4). similar among these viruses: fever, cough, chest pain, dyspnea, Since these droplets will also land on the surface, it has been and respiratory distress (4). This similarity between symptoms stated that the virus can remain alive on that surface for a certain of SARS-CoV and COVID-19 is due to the fact that they both time depending on the type of surface (4). The virus can be use the ACE-2 (angiotensin converting enzyme 2) receptor (4). transmitted by droplets emitted from sick individuals through coughing, sneezing, or by contact with surfaces contaminated by Since the first reports of COVID-19, it has been stated that the patients (mouth, nose and eye mucosa). infection has affected more than 12 million people worldwide. There are approximately 3 million confirmed cases in the While COVID-19 may be clinically asymptomatic, it may cause USA, where COVID-19 is most effective. Countries with the clinical pictures ranging from ARDS (acute respiratory distress highest number of cases after the USA were reported as Brazil, syndrome) and multiorgan failure. SARS-COV-2, which enters India, Russia, Peru, Chile, Mexico, England, Spain, and Iran, through the mucous membranes, binds to epithelial cells and respectively. The number of people who died due to the virus has starts replication. Although the virus can be detected by the RT- reached to 559.047 (5). PCR method in the asymptomatic phase, there are no clinical symptoms or pathological pulmonary imaging findings (10). COVID-19 was declared an international public health emergency by WHO on January 30, 2020 (6) and later labeled as As the virus travels through the airways, a stronger natural a pandemic. Although existing chemical drugs or combinations immune response is triggered. In individuals with a strong have been tried against COVID-19 disease, which appears immune system, symptoms and clinical course may be milder due to cause serious morbidity, mortality and economic losses, to the natural immune response. This is the case in approximately there is no specific treatment or vaccine yet. Phytotherapeutic 80% of infected patients and the disease is mostly limited to the prophylaxis is very important at this point. The correct use of upper airways (10). This group of patients has symptoms such
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