SARS-CoV-2 virus is responsible for the ongoing pandemic known as COVID-19. More than 218 million cases have been confirmed worldwide and the disease has claimed around 45 million lives (3 September 2021 COVID Database, WHO) The wide spread of COVID-19 has highlighted the challenges that the already overburdened healthcare systems faces. Proper healthcare is required to care for the patients. COVID positive patients’ world over have shown major symptoms like fever, cough and breathing difficulties (Vincent et al, 2020). In more severe cases, they can cause pneumonia, severe acute respiratory syndrome, kidney failure and even death (Pitchiah et al, 2020)
WHO initiated the “Solidarity Trial” in many countries to compare the medicines’ effectiveness, such as Remdesivir, Lopinavir/ Ritonavir with interferon beta and Hydroxycholroquine against the Coronavirus infection (WHO- Guidelines 2019). Because of the side effects, antiviral therapy cannot be continued in the long run and relief from ailments is only symptomatic (Aminu Saleh Ahmad & Ruchi Sharma 2020). There is a need to look out for solutions present in other health care systems like Ayurveda, Siddha, Herbal medicine etc.
The concept of epidemics is very well defined and established in Ayurveda and Siddha. As per the siddha literature the contamination and vitiation of environmental factors such as- water, air, environment and season is responsible for the epidemics along with the disequilibrium of the doshas in the hosts that makes them more receptive to the disease (Jain et al, 2019)
In this study, Kabasura Kudineer is suggested as an intervention to influence the immune response in a way which is beneficial for the host and stop the viral replication. In case of Siddha medicine, many ingredients are immune-modulators and have the capacity to inhibit the virus by enhancing and restoring immunity. Kabasura Kudineer, an official Siddha formulation described in Siddha manuscript is used for phlegmatic fevers and is a dependable siddha prescription with flu-like symptom. (Kiran et al, 2020).
The Siddha & Ayurveda medicines are not usually tested in labs and there is lack of in vitro studies on these medicines. Kabasura Kudineer has shown great potential in RCTs and is required to explore its antiviral efficacy and mechanism of action. Kabasura Kudineer is typically used as a concoction. To increase the ease of consumption, it was converted to a tablet form by Sri Sri Tattva (Sriveda Sattva Pvt. Ltd.)
Earlier research studies on few of the individual constituents of Kabasura Kudineer have shown several benefits; like Piper longum (one of the constituent of Kabasura Kudineer) has demonstrated significant anti-inflammatory activity (Kumar et al, 2009).
Ali et al, 2008, documented the pharmacological, phytochemical and toxicological properties of Zingiber officinale (Ginger). High concentration of fresh rhizome of ginger could stimulate mucosal linings to secrete the interferon, IFN- β, which helps in thwarting viral infection (Chang et al, 2013).
The hepatoprotective and immune-modulatory effects of Tinospora codifolia, present in Kabasura Kudineer, were established by Bishayi et al in 2002. Extracts of Tinospora cordifolia possess antimicrobial activity against both gram-positive and gram-negative organisms (Tambekar, 2010). They also possesses antioxidant properties (Subramanian et al, 2002). Terminalia chebula, also present in Kabasura Kudineer, has shown antiviral activity against the influenza A virus (Badmev and Nowakowski, 2000). Chebulaguc acid and punicalagin isolated from Terminalia chebula inactivate the free respiratory viral particles and prevent early entry including attachment and penetration phases (Lin et al, 2013). The toxicity, anti-inflammatory, antipyretic, antibacterial and antioxidant activities of Kabasura Kudineer have been scientifically reported (Neethu Devasia, 2017; Koppala et al, 2020). A review article on the pharmacological activities of the ingredients of Kabasura Kudineer substantiates its use in swine flu (Thillaivanan et al, 2015)
This research study investigates the in-vitro efficacy of the well-known anti-viral Siddha Polyherbal Drug Kabasura Kudineer as a powdered tablet on COVID-19 infected Vero-E6 cell lines and discusses its potential in the treatment armamentarium for COVID-19.