Journal of Pharmacovigilance

Corona virus and traditional approach for developing immunity through unani herbal medicine

Arsheed Iqbal^1*, Adil Rashid¹, Haider Ali Quraishi¹, Afroza Jan² and Shiekh Zahoor Ahmad^{1 1}Regional Research Institute of Unani Medicine, Srinagar, Jammu and Kashmir, India
²Institute of Asian Medical Science, Zakura, Sgrinagar, Jammu & Kashmir, India
^*Correspondence: Arsheed Iqbal, Research Officer (Scientist-III), Regional Research Institute of Unani Medicine, University of Kashmir, India, Tel: 9419078302, Email:

Received: 02-Jan-2021 Published: 23-Jan-2021, DOI: 10.35248/2329-6887.21.9.296

Introduction

Corona virus disease known as COVID-19 is a highly contagious disease caused by coronavirus [1]. This disease can affect people of all ages however older people immuno compromised people and people with comorbidities like diabetes, chronic respiratory disease and cardiovascular disease are more likely to develop complications and may die. COVID-19 virus primarily spreads through droplet infection of infected person by coughing or sneezing [2,3]. The virus survives on the surface for few hours and hence public transport system, hospitals, religious places and educational institutes are considered at high risk. The common symptoms include cough, pyrexia (high grade fever) [4,5] usually dry in nature, tiredness, shortness of breath [6,7]. The other associated symptoms can be myalgia, sore throat, diarrhoea [8- 12]. In most of the cases the symptoms are mild like fever, cough and sore throat or like other viral disease like influenza [13]. However, in small percentage of patients the disease progresses to pneumonia and complicates into multi-organ failure [14,15]. It is observed that most of the deaths occur in elderly people with age group above 60 years and immune compressed people. Children are found to be relatively less infected by 1-2 % corona virus [16-18].

Antiviral drugs like Remdesivir, Oseltamivir, lopinavir and ritonavir are found effective against the corona virus and are still under trial [19-24].

Pathophysiology

Corona viruses are enveloped single stranded RNA viruses found in birds, mammals and humans and are responsible for pulmonary, hepatic, central nervous system and intestinal disease. The closest animal coronavirus by genetic sequence is a bat. Corona virus and this is most probably the only origin of the virus [25].

Aetiology

SARS CoV -2 is the cause (WHO) of COVID-19. It is member of beta coronavirus genus, genera of corona varied family.

Six coronaviruses are found to cause human disease. Two are zoonoses SARS-CoV and MERS-CoV. Both of the viruses are reported to be almost fatal, and rest four viruses usually cause common cold [26,27].

Transmission

Since corona virus originate from animals but covid-19 is not considered a direct zoonosis as its transmission is now human to human. It is initially transmitted through droplet infection by coughing or sneezing of an infected person, the way common cold transmits. It gets its cellular entry by attachment of its spike protein to the angiotensin- converting enzyme-2 (ACE-2) receptor. This receptor is found on alveolar cells of the lung epithelium resulting in the respiratory symptoms as the commonest presentation of CoVID-19 [28].

The viruses use a special surface glycoprotein known as peplomer to attach to ACE2 and enter the host cell. The virus invades the human gut as ACE2 is abundantly produced in the glandular cells of duodenal, gastric, rectal epithelium [25,26]. Endothelia cells and enterocytes of the small intestine. It is important put forth that the corona virus has been found positive in faces of 53% [25] of hospitalised people. It is also observed that anal samples are more positive than oral one [27]. The virus was found in gastrointestinal tract though patient did not found any chest symptoms. This indicates that the virus can directly involve the gastrointestinal tract and there is potential feco-oral transmission possibility for long time even if the chest symptoms are over [25].

Sign and symptoms

It is important to known that those infected with novel coronavirus-2019 may be asymptomatic or develop only flue like symptomatic [28-32]. Symptoms and signs may be mild or severe and include;

• Fever (85-90%) • Cough (65-70%) • fatigue (35-40%) • Sputum production (30-35%) • Shortness of breath (15-20%)

• Myalgia / arthralgia (10-25%)

• Headache (10-15%) • sore throat (10-15%) • Chills (10-12%) • Pleuritic pain

• Nausea, vomiting, nasal congestion (<10%), diarrhoea (<5%) [29] And some cases may develop palpitations, chest tightness [30], anosmia, and dysphasia [33-35].

Critical symptoms include difficulty in breathing, persistent chest pain, confusion, difficulty in walking and bluish face or lips due to anoxia. The lungs are the organs usually affected as the virus accesses host cells via the enzyme ACE, which is most abundant in the type-II alveolar cells of the lungs [35].

Materials and Methods

In corona virus infection the severity of disease is purely dependent on patient’s immune competence. Here in Unani System of medicine a variety of natural resources in the form of herbal medicine and food supplements are available and clinically time tested to boost the immunity and to produce the sense of wellbeing. This research article has been an attempt to provide the knowledge about the use of natural treasures for developing the immunity and to maintain the state of wellbeing during the corona virus pandemic and otherwise.

Protective equipment

1. Eye protecting goggles

2. N95 face mask with respirator

3. Complete PPE suit which water proof and fire proof also.

4. Thick medical gloves

5. Gown

6. Face shield / vibors [36-40]

Facility of mechanical ventilation

A small percentage of the patients need artificial respiratory support [41,42]. However it has been noted that the invasive local mechanical ventilation limits the spread of aerosolized transmission vectors [41]. In Wuhan usually geriatric cases of COVID positive patients needed the ventilation support in ICU, but in Italy and California the young adults where mostly affected by the disease and needed mechanical ventilation in ICU.

Investigation and diagnosis of corona

Among several testing methods the WHO most recommended test is real-time reverse transcription polymerase chain reaction (rRTPCR) [43]. Here the nasopharyngeal swab or sputum sample is taken, and the results are expected within few hours to two days [44,45]. Bilateral and peripheral ground glass opacities are the most diagnostic CT findings. Consolidation, linear opacities and reverse halo sign are also well-known radiological findings.

Preventive measures

The majors to reduce the chances of infection are avoiding contact with the people which is best possible by staying at home avoid crowded place, frequent washing of hand with soap and using sanitizer after touching different objects, covering the nose and mouth with tissue while sneezing or coughing [46]. Avoid touching nose, mouth and eye with unhygienic hands [46-48]. Practice social distancing and it is better to close the schools and work place so that the large number of people may not come out of home and get mingled and ultimately infected [49,50]. WHO recommended use of masks when a person is coughing or sneezing or when a worker is delivering the services to suspected infectious patients? Use of PPE suits of 120 GSM are recommended for front line workers with N95 mask and face shield.

Food and beverage enriched with natural herbs recommended for daily use for boosting immunity and maintaining proper health

1. Breakfast with herbal tea enriched with Mulaithi, Zafran, Tulsi, Dalchini along with Honey sandwich.

2. Milk curcumin shake to be kept as major meal in lunch.

3. Decoction of Mako, Kasni, Baranjasif, Sapistan, Tukhme- Sambhalu, Tukm-e-Hulba and Kalonji < 15 ml of this decoction is given in evening after lite dinner with mixed vegetables and fresh fruit.

4. 100 ml of goat milk is given at bed time. (Table 1)

Table 1: Prescribed Unani Drugs for SARS-CoV-2 like symptoms in Classical Unani literature

Prognosis

The intensity of COVID-19 symptomatology varies from patients to patients and also from one country to another. Now a days it is believed that this virus is having multiple strains and the strains affecting Indian population is observed to be less virulent. Some patients have simple flu like symptoms and the patients even does not pay any attention to it, while as mild cases recover is about two weeks and patients who are severe may take about six weeks to recover. In Wuhan it has been experienced that young adults mostly recovered while are the geriatric patients were subjected that the death. However, in Italy and USA. The young adult also was a major percentage of mortality observed. In India few pregnant ladies and new born where also found positive.

In complicated cases the virus affects the lungs resulting pneumonia progressing to acute respiratory distress syndrome leading to respiratory failure [149,150] sepsis, multiorgan failure, clotting abnormalities. Comorbidity like diabetes mellitus, cardio vascular disease and hypertension trigger the mortality rate through the world.

Histopathological examination of post-mortem lung samples shows diffused alveolar damage with cellular fibromyxoid exudates in both lungs. As of now it is clinically observed that age, virulence of the viral strain and comorbidity plays a vital role of predicting the prognosis of disease.

Discussion

Like other viral infection corona virus is challenged to the medical fraternity. Since the mode of transmission of this virus is poorly understood, a lot of difficulties are being faced in controlling the outbreak of this pandemic infection. Doctors and scientists are working hard in finding the effective drug against the corona. Multiple animal trials have been conducted to produce the vaccine against this virus, but the human trails are yet to be successfully completed. Medicine like chloroquine and hydroxychloroquine was initially considered moderately effective but by the advent of remdesivir and favipiravir the chloroquine is less in use now a days. Presently dexamethasone is found much effective in controlling the symptoms of corona virus and simultaneously plasma therapy is also proving much effective.

Conclusion

Since there is no definite treatment till date so it in finally concluded that corona virus pandemic can be only controlled by social distancing and wearing the mask to avoid the contaminated aerosols. The same is possible if people are educated through social and print media and by providing the essential logistics needed to maintain the personal hygiene. More over clinically it is observed that immunity has a prominent role to play in combating the corona virus symptoms and for the same immunoboosting herbs are recommended for sound health.

Ethical Clearance

There is no need of IEC clearance because this article /paper are a literature review (no interventional).

Source of Funding

Self-funded by corresponding author. No any external or other funding source.

Conflict of Interest

The authors have no any conflict of interest

Acknowledgement

Authors duly acknowledge the Director General CCRUM, Ministry of AYUSH, GoI, New Delhi, Assistant Director Incharge and Hospital, library staff of Regional Research Institute of Unani Medicine, Srinagar, J&K, India.

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