A Review on Efficacy of Siddha Medicinal Herbs as Antiviral Drugs against COVID-19

In a very short time, the Coronavirus disease (COVID-19) caused by the SARS-CoV-2 virus, has become a global pandemic. It has infected about 29,155,581 patients and brought forth death rate about 926,544 among 216 countries as recorded by World Health Organization on 15th September 2020. At present, there is no specific and direct treatment or vaccine for this infectious disease. No therapeutic options available to cure the infection in till date which increases the mortality rate across the countries. Currently there is no antiviral treatments have been approved, several approaches have been proposed in western medicine, Chinese medicine, CAM, AYUSH and other systems. Siddha Herbal medicines are achieving high attention because of the extensive therapeutics like potent anti-microbial, immunomodulatory, anti-inflammatory, and antioxidant properties. Ministry of AYUSH, Govt. of India recommended 12 Siddha herbals (Inji – Zingiber officinale, Thulasi – Ocimum sanctum, Milaku – Piper nigrum, Karunjeeragam – Nigella sativa, Keezhanelli – Phyllanthus niruri, Adhimathuram – Glycyrrhiza glabra, Vellaippoondu – Allium sativum, Citramutti – Sida cardifolia, Seenthil – Tinospora cordifolia, Manjal – Curcuma longa, Elumitchai – Citrus lemon and Vembu – Azadirachta indica) for the prevention by enhancing immunity as well as for the management of this infectious disease in its recent official publication ‘Guidelines for Siddha Practitioners for COVID 19’. This is the common advisory and the anti-viral activity of these herbals against COVID 19 is not established yet. The current situation demands proper herbal drug utilization to prepare the population immunity to fight against the infection. The present review spotlight on the literature review and the review of pharmacological actions of these herbals. 1 * Corresponding Author: Muralidass SD Siddha Physician, Arumbakkam, Chennai – 600106 Tamil Nadu. India. Email Id: drmuralinis@gmail.com Muralidass SD et.al., A Review on Efficacy of Siddha Medicinal Herbs as Antiviral Drugs against COVID-19 Published online in http://ijam.co.in ISSN No: 0976-5921 The symptoms present in COVID-19 are compared with the disease ‘Kabasuram’ mentioned in SSM. As per the Siddha literature tamil quote ‘ver paaru thazhai paaru minjinakkaal parpa chenduram paarae’, herbal medicines are the first choice of drugs for all diseases in SSM, if satisfied result not occurs with herbal ingredients, higher order medicines prepared from Metal and Mineral, and from Marine products are prescribed. So, this emphasizes the usage and importance of Herbals in SSM (9). Ministry of AYUSH, Govt. of India recently released its official publication ‘Guidelines for Siddha Practitioners for COVID 19’ on May 31, 2020. This guideline recommended Siddha herbs for the prevention by enhancing immunity as well as for the management of this infectious disease which are being prescribed for acute viral and bacterial respiratory diseases and other chronic respiratory diseases in SSM from ancient times. These Anti-viral Siddha herbs are tabulated in Table I. This guideline is the common advisory for Siddha Practitioners and the anti-viral activity of these herbals against COVID 19 are not established yet (8). So, the author made attempt to discuss the literature review and the review of pharmacological actions of these herbals in this article. Materials and Methods Data source The relevant literature is referred and collected from Siddha text and contemporary literature. Literature related to title is referred from all Siddha reliable journals and other herbal related journals. Published research works on individual herbs have been collected based on their therapeutic actions from net resources and reviewed. Table I –Anti-Viral Siddha Herbs and their therapeutic uses in SSM (8, 10) S.No Common Name Botanical Name Usage 1 Inji Zingiber officinale ROSC. 1. Inji Surasam – Herbal water infusion made up of half teaspoon of Chukku (Dried Ginger) boiled in two liters of water can be used as drinking water -10 ml Once a day 2. Inji Thenooral – dipped and processed in honey – one piece at early morning 3. Inji Tea (Ginger tea) as hot beverage 2 Thulasi Ocimum tenuiflorum L. 1. Thulasi Kudineer – Prepared as decoction 60 ml Twice a day 2. Used as Steam inhalation 3 Milagu Piper nigrum L. 1. With Thulasi as Kudineer Prepared as decoction 60 ml Twice a day 2. A quarter teaspoonful of Manjal (Turmeric) with one pinch of Milagu (Pepper) is added in boiling milk and taken at bed time. 4 Karunjeerakam Nigella sativa L. Karunjeeraka Chooranam Prepared as powder 1gm Twice a day 5 Keezhanelli Phyllanthus amarus SCHUM. & THENN. Keezhanelli Samoolam (whole plant) – Prepared as powder 2gm Twice a day 6 Athimadhuram Glycyrrhiza glabra L. 1. Athimadhura Chooranam Prepared as powder 1 gm Twice a day 2. Adhimadhuram (Licorice) Tea – taken as hot beverage 7 Vellaipoondu Allium sativum L. Poonduthaen – Juice of Poondu (Garlic) is processed with honey by heating process then used as externally to apply on tongue, tonsils and oral cavity 8 Citra mutti Sida cordifolia L. Citramutti Kudineer Prepared as decoction 30 ml Twice a day 9 Seenthil Tinospora cordifolia (WILLD.) HOOK.F. & THOMS. Seenthil Chooranam – Prepared as powder 1gm Twice a day 10 Manjal Curcuma longa L. 1. A quarter teaspoonful of Manjal (Turmeric) with one pinch of Milagu (Pepper) is added in boiling milk and taken at bed time. 2. Water boiled with a pinch of Salt and Manjal (Turmeric) should be used for gargling not less than 3 times 11 Elumitchai Citrus limon (L.) BURM.F. Elumitchai (Lemon) Tea – taken as hot beverage 12 Vembu Azadirachta indica A. JUSS. Vembu (Neem) leaves fumigation is advocated for Environmental sanitation


Abstract
In a very short time, the Coronavirus disease  caused by the SARS-CoV-2 virus, has become a global pandemic. It has infected about 29,155,581 patients and brought forth death rate about 926,544 among 216 countries as recorded by World Health Organization on 15 th September 2020. At present, there is no specific and direct treatment or vaccine for this infectious disease. No therapeutic options available to cure the infection in till date which increases the mortality rate across the countries. Currently there is no antiviral treatments have been approved, several approaches have been proposed in western medicine, Chinese medicine, CAM, AYUSH and other systems. Siddha Herbal medicines are achieving high attention because of the extensive therapeutics like potent anti-microbial, immunomodulatory, anti-inflammatory, and antioxidant properties. Ministry of AYUSH, Govt. of India recommended 12 Siddha herbals (Inji -Zingiber officinale, Thulasi -Ocimum sanctum, Milaku -Piper nigrum, Karunjeeragam -Nigella sativa, Keezhanelli -Phyllanthus niruri, Adhimathuram -Glycyrrhiza glabra, Vellaippoondu -Allium sativum, Citramutti -Sida cardifolia, Seenthil -Tinospora cordifolia, Manjal -Curcuma longa, Elumitchai -Citrus lemon and Vembu -Azadirachta indica) for the prevention by enhancing immunity as well as for the management of this infectious disease in its recent official publication 'Guidelines for Siddha Practitioners for COVID 19'. This is the common advisory and the anti-viral activity of these herbals against COVID 19 is not established yet. The current situation demands proper herbal drug utilization to prepare the population immunity to fight against the infection. The present review spotlight on the literature review and the review of pharmacological actions of these herbals.
The symptoms present in COVID-19 are compared with the disease 'Kabasuram' mentioned in SSM. As per the Siddha literature tamil quote 'ver paaru thazhai paaru minjinakkaal parpa chenduram paarae', herbal medicines are the first choice of drugs for all diseases in SSM, if satisfied result not occurs with herbal ingredients, higher order medicines prepared from Metal and Mineral, and from Marine products are prescribed. So, this emphasizes the usage and importance of Herbals in SSM (9).
Ministry of AYUSH, Govt. of India recently released its official publication 'Guidelines for Siddha Practitioners for COVID 19' on May 31, 2020. This guideline recommended Siddha herbs for the prevention by enhancing immunity as well as for the management of this infectious disease which are being prescribed for acute viral and bacterial respiratory diseases and other chronic respiratory diseases in SSM from ancient times.
These Anti-viral Siddha herbs are tabulated in Table I. This guideline is the common advisory for Siddha Practitioners and the anti-viral activity of these herbals against COVID 19 are not established yet (8). So, the author made attempt to discuss the literature review and the review of pharmacological actions of these herbals in this article.

Data source
The relevant literature is referred and collected from Siddha text and contemporary literature. Literature related to title is referred from all Siddha reliable journals and other herbal related journals. Published research works on individual herbs have been collected based on their therapeutic actions from net resources and reviewed.   Seenthil -Tinospora cordifolia Stem A l t e r a t i v e , S t i m u l a n t , Demulcent, Antiperiodic   Vellaipoondu -Allium sativum alliin, vitamin C, gallic acid, catechin hydrate, fructose, glucose, adenosine, arginine, ascorbic-acid, calcium, magnesium, potassium, quercetin, tryptophan and tyrosinase.

Discussion and Conclusion
In this review, mentioned herbals are being prescribed for acute respiratory infectious diseases and other chronic respiratory diseases in Siddha System of Medicine from ancient times. They are also indicated for various ailments. Studies proven the antibacterial, anti-viral and other anti-microbial effects against various microbes of these Siddha herbals. Most of these herbals having anti-pyretic, anti-inflammatory and antioxidant effects which were proved through various studies. Some herbals in guideline have specific effects on Asthma and other respiratory diseases. Moreover, all the herbals are having good effect on Diabetes. And they are prescribed for neurological, cardio vascular, Gastro intestinal, excretory, and Genito urinary diseases and effect in the systems also were proven in research studies.
The Siddha formulations mentioned in the 'Guidelines for Siddha Practitioners for COVID 19' are Kabasura Kudineer Chooranam, Nilavembu Kudineer Chooranam, Nellikkai legiyam, Amukkara Chooranam, Thalisadhi Chooranam, Adhimadura Chooranam, Thippili Rasayanam, Notchi Kudineer Chooranam, Vishasura Kudineer Chooranam. They are highly used in the Covid care centers of South India indicating possible effects at present and some clinical trials are going on such siddha medicines. Most of these 12 herbals are as one of the ingredients of the abovementioned preparations.
Anti-viral activity of these herbals against COVID 19 is not established yet, anyway the Pharmacological review these herbals indicates that they may be suitable for the treatment of COVID 19 disease even with co morbidity conditions because all 10 Manjal -Curcuma longa the herbals are having good effects on Respiratory system as well as other systems. Proper combination of herbs for activity study against current viral infection may help to prepare the healthcare to prepare against any health-related issues. The creation of awareness is very important among all people regarding prevention of Covid-19 infection.