Background of COVID-19
A sudden outbreak of serious respiratory pneumonia started in Wuhan city, Hubei province of China in December 2019,1 which on 7 January 2020, was declared as a resistant strain of coronavirus termed SARS-CoV-2.2 Thus on 11 February 2020, this unexplainable pneumonia was called, by the World Health Organization, Coronavirus Disease-2019 (COVID-19).3 COVID-19 symptoms include flu-like symptoms, fever, cough, along common respiratory disorder including lung damage while minor symptoms include diarrhea, fatigue and myalgia.4,5 On 17 February 2020, China reported a total of 72,332 cases of COVID-19.6 The spread rate of COVID-19 was very fast, every single day, the cases with COVID-19 reported were multiplied compared to the previous day. It is transmitted through human to human via coughing, sneezing and even touching. On gene examination, SARS-Co-2 appeared as an enveloped β-coronavirus with single-stranded RNA .7 The genomic comparison of SARS-CoV-2 with SAR-CoV showed 79.5% similarity in the genomic sequence. Furthermore, both SARS-CoV-2 and SAR-CoV use spike (S) proteins to enter into human alveolar epithelial cells, which bind to angiotensin-converting enzyme 2 (ACE2) receptor in humans.8
Several major techniques are available to diagnose COVID-19, such as lab testing and chest radiograph but unluckily, there are not any vaccines or antivirals present for the sake of treatment.9 Thus China reported its current clinical guidelines to treat COVID-19 or Middle East Respiratory Syndrome (MERS), and according to that traditional Chinese medicines (TCM) and traditional medicines are presently the only way to treat COVID-19.10 This literature covers the TCM treatment in the context of current conventional management to treat COVID-19 patients. It was already documented in 2002–200311 that TCM therapy had been used to treat SARS-CoV infected individuals and with the outbreak of COVID-19, it was found that COVID-19 showed identical genomic sequence, pathological processes, and epidemiology as SARS-CoV.8 Thus, results obtained after TCM treatment were evaluated on the molecular basis and lab studies which give the benefits of using TCM treatment in combating COVID-19.
Scope of TCM Against COVID-19
As there is no specific treatment available to treat COVID-19, it is necessary to adopt some supportive therapy to combat the risk of the disease. It includes antivirals (lopinavir, ritonavir, ribavirin, favipiravir, remdesivir, oseltamivir, chloroquine, and interferon), broad-spectrum antibiotics (amoxicillin, azithromycin, and fluoroquinolones),12 corticosteroids,7 and convalescent plasma.22 Thus, SARS-CoV-2 infected individuals were treated with HIV protease inhibitors ritonavir and lopinavir along with antibiotics or IFNα-2b.13 Besides, ribavirin (nucleoside analogs) was also found to be useful in treating COVID-19 as it was already documented to treat infections produced by a syncytial virus (RSV),14 MERS and SARS-CoV. Still, its use is limited due to its disadvantage of causing anemia and whether the antiviral spectrum of ribavirin covers SARS-CoV-2 infection is still not clear. Favipiravir (T-705), another nucleoside analog, can exclusively treat influenza due to RNA polymerase of RNA virus.15 A current in vivo study regarding favipiravir documented its activity against SARS-CoV-2,16 but still, in vivo effects of favipiravir are not clear. Another antiviral drug that might show the most suitable results against SARS-CoV-2 is remidesivir. It shows promising in vitro and in vivo activity against a wide range of SARS and MERS …….