Mohammad Ali Zakeri, Mahlagha Dehghan

Role of herbal medicines to treat the symptoms of COVID-19 disease

Mohammad Ali Zakeri1, Mahlagha Dehghan2*

1Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.2Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran.

The need for effective therapeutic options for patients has received increasing attention in response to the prevalence of COVID 19. Although there are several options for the prevent of COVID-19, including vaccines, monoclonal antibodies, oligonucleotide-based therapies, peptides, and interferon therapies, no treatment for coronaviruses has yet been approved [1]. Complementary and alternative medicine (CAM) is used in many countries. CAM has been used in epidemics similar to COVID 19, including influenza. Some CAMs have been effective in treating influenza [2]. One study in Korea showed that 76.1 percent of the respondents used one or more types of CAM during the outbreak of MERS (Middle East Respiratory Syndrome) [3]. In the future, CAM is expected to play a greater role in controlling the spread of epidemics such as COVID 19. In previous epidemics such as the influenza, some governments, including China allocated funds to test herbal medicines in accordance with evidence-based medicine [2]. Studies on herbal extracts in traditional Chinese, Indian and Iranian medicines show a promising approach to the prevention, treatment and recovery of diseases, including COVID-19 and suggest some plants in this regard [4]. However, the beneficial effects of herbal medicines require clinical and applied trials.

Among the types of CAM, herbal medicines have been very popular among people due to their abundances, ease of uses and cultural values. Traditional herbal medicines have long been used to prevent or treat colds, influenza and respiratory infections. The presence of chemical or biochemical agents in plants such as polyphenols, flavonoids, saponins, glucosides and alkaloids has influenced the control and treatment of influenza [5]. Plant extracts fight respiratory viruses by different mechanisms of action.

Several herbal medicines have been used to prevent and treat upper respiratory tract infections. A spray containing aromatic essential oils of five plants (Eucalyptus citriodora, Eucalyptus globulus, Mentha piperita, Origanum syriacum, and Rosmarinus officinalis) brings about a significant and immediate improvement in symptoms of upper respiratory ailment [6]. Some essential oil vapors, such as that of Citrus bergamia (bergamot), Eucalyptus globulus (eucalyptus), Pelargonium graveolens (geranium), Cinnamomum zeylanicum leaf oil (cinnamon), and Cymbopogon flexuosus (lemongrass), has anti-influenza virus activity [7]. In addition, Sambucus nigra (black elder) fruit, Andrographis paniculata (kalmegh), Pelargonium sidoides (African geranium) and ma′ hua′ng tang (mao-to, ephedra decoction) been used to treat and prevent viral respiratory infections [8]. Mousa et al. showed that the most influential factors for prevention or treatment of colds and flu were maoto (is one of Kampo (traditional Japanese herbal)), licorice roots, antiwei, North American ginseng, berries, Echinacea, plants extracted carnosic acid, pomegranate, guava tea and Bai Shao [9]. However, further studies are needed to reveal potential therapeutic effects.

The effects of medicinal plants on the COVID-19 are not yet known. Herbal medicines do not play a proven role in the treatment of the COVID-19 and are mostly used to reduce the signs and symptoms of the COVID-19. The combined use of herbal and Western medicines has been effective in reducing symptoms and accelerating the healing process [10]. The following shows the effects of herbal medicines on the treatment of COVID 19 in different countries. The Indian medicinal system known as AYUSH includes Ayurveda, Unani, Siddha and Homeopathy. Studies show that AYUSH has the potential to prevent and treat COVID-19. AYUSH recommends homeopathy and Ayurveda as immune boosters to combat SARS-CoV-2 [11].

Herbal medicines such as garlic, ginger, Korean red ginseng, eucalyptus, tea tree, Tianmingjing, Machixian, fish mint, Chinese mahogany, cape jasmine, zhebeimu have been shown to exhibit antiviral activity against the influenza virus [7] combined with Western medicine have also been used to reduce fever, cough, fatigue, diarrhea, lung exudation and other mild symptoms in patients with COVID-19. The integrated approach could reduce lung leakage and prevent further progression of COVID-19 disease [10]. Herbal medicines such as glycyrrhizin (extract from liquorice root) may inhibit replication of the Severe Acute Respiratory Syndrome (SARS) associated virus, as a resultreduced the duration of fever, symptoms, chest X-ray abnormalities, secondary fungal infections, and mortality in patients during SARS epidemic. These results indicated that herbal medicines combined with modern medicines might have beneficial effects on the patients with SARS [12]

Herbal medicines have been used to relieve the symptoms of diseases. The active ingredients of plants used in CAM can eliminate the symptoms of the disease and increase the patient's health [13]. Obviously, there are still many challenges and obstacles to the definite treatment of COVID-19 and effective drugs should be studied more. The potential of herbal medicines needs to be further examined to address the challenge of COVID-19. Current literature provides obvious evidence supporting herbal medicine as potential effective antivirals against SARS-CoV-2 and as preventive agents against COVID-19 [7].

However, compared with chemical drugs, herbal medicines have various advantages such as low cost, accessibility and ease of use, and storage. Attention to acute side effects and the possibility of resistance to chemical drugs in the treatment of diseases are other factors that make the use of herbal medicines more attractive [14].

Due to the typical signs and symptoms of COVID 19 include fever (83%), cough (82%), bilateral pneumonia (75%) and shortness of breath (31%) [15], the following herbal medicines can be used for several reasons:

1) Cardamom (cardamon) to prevent and treat throat troubles and congestion of the lungs [16, 17].

2) Amla () [18] and Saffron () [19] has a protective effect on bronchial epithelial cells and prevent bacterial pulmonary inflammation.

3) Damask rose, the tonic of the lungs and alleviates infectious fevers [20].Clove () to promotes sweating with fevers, colds, and flu [16]. Clove has been suggested to prevent secondary bacterial infections in COVID-19 patients [18]. Ginger () and [21, 22],Eucalyptus Oil [16] have used as antiseptic in microbial diseases of the lungs and bronchitis.

4) Garlic () and liquorice () root or Mulhati [16] has been used for asthma, hoarseness, coughs, difficulty of breathing, and most other disorders of the lungs, chronic bronchitis and promoting expectoration [16, 17, 22]. Rhubarb () and Fenugreek () used as a lung tonic and causing pulmonary mucolytic activity [16, 23].

5) Jujube () [18], Echinacea [24] and Ginseng [25] may be effective in reducingthe symptoms of the common cold, acute respiratory infections (ARI) and influenza.

Herbal medicines are expected to play a greater role in controlling symptoms or even treating infectious diseases such as COVID-19 in the future. Further studies and future clinical trials should be considered to understand the potential of herbal medicines in the treatment and improvement of diseases.

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10.12032/TMRCR20210522009

Mahlagha Dehghan. Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Haft-Bagh Highway, Kerman, Iran. Email: m_dehghan@kmu.ac.ir

:CAM, complementary and alternative medicine; SARS, Severe Acute Respiratory Syndrome.

:The authors declare that they have no conflict of interest.

: Zakeri MA, Dehghan M. Role of herbal medicines to treat the symptoms of COVID-19 disease.. 2021;4(2):9.

:Ying Chen.

:06 May 2021,

20 May 2021,

:22 May 2021

? 2021 By Authors. Published by TMR Publishing Group Limited. This is an open access article under the CC-BY license (http://creativecommons.org/licenses/BY/4.0/)