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Pharmintel

CORONIL: A New Hope for COVID-19 Management

COVID-19 is an emerging global viral infection, originating from Wuhan, China in December 20191. There is no proven effective curable management for COVID-19. However, developments in the treatment of COVID-19 are in progress.

Understanding immunopathogenesis of COVID-19 is very important for developing efficient treatment regimens. There are a rapidly increasing number of clinical investigations of different therapeutic approaches for COVID-19. Moreover, a variety of anti-inflammatory agent that can reduce the entry of the virus into the cell, various antivirals studied for other viruses, anticoagulants, vitamins, antibiotics, immune system modulators and immune plasma are in pipeline2,3.

Researchers and vaccine makers across the world are still racing to hunt for a safe and effective vaccine against the novel coronavirus infection that has claimed several lives globally. Multiple clinical trials are being conducted around the world and various medicines and herbs have come out as a possible treatment for the COVID-19 virus4

Ayurvedic elements such as Ashwagandha, Giloy, and Tulsi, may have potential in treatment and prevention of COVID-194.

Pathogenesis of COVID-19

COVID-19 has been shown to bind to the cell membrane protein angiotensin-converting enzyme (ACE2) via the S protein on its surface. During infection, the S protein is cleaved into subunits, S1 and S2. S1 contains the receptor binding domain (RBD) which allows coronaviruses to directly bind to the peptidase domain (PD) of ACE2. S2 then likely plays a role in membrane fusion5.

In a randomized controlled clinical trial in 120 patients where asymptomatic, mild to moderately symptomatic COVID-19 patients were enrolled and CORONIL was given. It was found that 69 per cent of patients recovered within 3 days and 100 per cent within 7 days4,6.

Constituents of CORONIL Tablet7

  • Ashwagandha Extract
  • Giloy Extract
  • Tulsi Extract

Ashwagandha: also known as Withania somnifera is a medicinal herb and a viable option for controlling COVID-19 entry into host cells. It was found to dock very well in the binding interface of ACE2-RBD complex, and was demonstrated to move slightly towards the interface centre on simulation. Withanone (a component of Ashwagandha) significantly decreased electrostatic component of binding free energies of ACE2-RBD complex. Two salt bridges were also identified at the interface; incorporation of Withanone destabilized these salt bridges and decreased their occupancies. Such an interruption of electrostatic interactions between the RBD and ACE2 would block or weaken COVID-19 entry and its subsequent infectivity8.

Tulsi (Ocimum tenuiflorum): Tulsi is known to have antimicrobial, anti-oxidant, anti-inflammatory and anti-diarrheal properties. It was hypothesized that Tulsi phytochemicals may inhibit the corona virus replication and could contain its growth and spread9.

Literature evidence has demonstrated that Tulsi improves respiratory parameters and provides relief from symptoms of asthma with three days of consumption. Phenolic compounds and antioxidant properties of Tulsi were reported to contribute its therapeutic effects. Tulsi consumption increases the anti-oxidant molecules and enzymes in the body and protects the cells and its membrane from being damaged by the toxic substances. Tulsi boosts the immunity of the body and helps to defence the threatening virus and bacteria. Improvement in humoral and cellular immunity was observed in animal studies after treatment with Tulsi oil10.

Giloy (Tinospora cordifolia): Giloy is an anti-inflammatory, antipyretic (reduces fever) herb and is useful in building up the immune system and the body’s defence against infections. It enhances the activity of macrophages (the cells responsible for fighting foreign bodies as well as microorganisms) and thus helps in early recovery11.

The major phytocomponents reported in Giloy (Tinospora cordifolia) are tinosporine, tinocordiside, diterpenoid furano lactone, tinosporaside, cordifolide, cordifol, syringin, clerodane furano diterpene, tinosporidine, columbin, heptacosanol, b-sitosterol and tinosporide. Cordifolioside-A and syringin have been reported to possess immunomodulatory activity. Tinosporin, diterpenoid has been claimed specially for the treatment of the targeted viruses including (retroviruses) (HIV-1, HIV-2) all subgroups, HTLV, Herpes simplex Virus (HSV) and other viral diseases. The rich tinocordiside extracts of Giloy would be one more viable option for controlling COVID-19 entry into host cells and the general immunomodulatory nature of Giloy would enhance innate immunity against COVID-19 infections9.

The novel coronavirus is usually cleared within 14 days if a patient has a strong immune system12.

Based on currently epidemiological survey, the latency period is generally from 3 to 7 days, with a maximum of 14 days. Unlike SARSr-CoV (SARS), 2019-nCoV (COVID-19) is contagious during the latency period13.

As claimed by Patanjali for the clinical trial results of CORONIL, if 69% of patients after 3 days and 100% patients after day 7 are disease free or RT-PCR negative then CORONIL may be a suitable option for preventing further spread by decreasing contagious period. This will help in early discharge of patients, lessening the burden on health care system which currently all the countries across globe are encountering.

Disclaimer: No conflict of interest with Patanjali and its commercial products. CORONIL data is based on published media news, full clinical trial data is yet to be published by Patanjali.

References

  1. Karaahmet F., Karaahmet O.Z. Potential effect of natural and anabolizan steroids in elderly patient with COVID-19. Med Hypotheses. 2020;22(140).
  2. Alanagreh L., Alzoughool F., Atoum M. The human coronavirus disease COVID-19: its origin, characteristics, and insights into potential drugs and its mechanisms. Pathogens. 2020;9(5):29.
  3. Iyer M., Jayaramayya K., Subramaniam M.D. COVID-19: an update on diagnostic and therapeutic approaches. BMB Rep. 2020;53:191–205
  4. https://www.india.com/viral/baba-ramdev-claims-that-giloy-ashwagandha-can-100-percent-fight-off-covid-19-infection-4054787/
  5. https://www.drugtargetreview.com/news/56895/scientists-demonstrate-how-covid-19-infects-human-cells/
  6. http://ctri.nic.in/Clinicaltrials/showallp.php?mid1=43900&EncHid=&userName=patanjali
  7. https://www.nationalheraldindia.com/health/natural-phytochemicals-in-ashwagandha-giloy-tulsi-can-fight-covid-19-patanjali
  8. https://www.researchsquare.com/article/rs-17806/v1
  9. https://www.businesstoday.in/current/corporate/have-ashwagandha-giloy-tulsi-to-fight-coronavirus-says-patanjalis-balkrishna/story/400102.html
  10. https://pharmascope.org/ijrps/article/view/1976/3383
  11. Saha S, Ghosh S.Tinospora cordifolia: One plant, many roles. Anc Sci Life. 2012; 31(4):151–159.
  12. https://covid-19.chinadaily.com.cn/a/202004/04/WS5e87c6faa3101282172845c0.html
  13. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7003341/

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