COVID-19 has emerged as the latest pandemic that erupted in the Wuhan City of People’s Republic of China in December 2019, which is affecting human health and economy across the world. 8,242,999 cases have been reported globally as on June 19, 2020, according to the WHO Dash board with total deaths at 445,535. The occurrence of the ongoing COVID-19 in developed countries also highlights the fact that developed countries and rich populations are not immune to the outbreaks of infectious diseases.

India currently has around 16,32,48 cases with the death toll at 12753 as on 19 June 2020. In Maharashtra, the death toll is significantly higher than other states that have a high number of cases, such as Tamil Nadu and Delhi.The first case of the 2019–20 coronavirus pandemic in the Indian state of Maharashtra was confirmed on 9^thMarch 2020.

Coronaviruses (CoVs) belong to the family Coronaviridae and are enveloped, single-stranded, positive-sense RNA viruses.The SARS-CoV-2 belongs to the beta CoV genus which also includes the SARS-CoV-1 and the MERS-CoV. The lack of approved effective drug therapeutic protocols for CoVs would be a challenge for the treatment of the newly emerged COVID-19 infections worldwide.

In general, after a virus invades the host, it is first recognized by the host innate immune system through pattern recognition receptors (PRRs) including C-type lectin-like receptors, Toll-like receptor (TLR), NOD-like receptor (NLR), and RIG-I-like receptor (RLR). Through different pathways, the virus induces the expression of inflammatory factors, maturation of dendritic cells, and synthesis of type I interferons (IFNs) which limit the spreading of the virus and accelerate macrophage phagocytosis of viral antigens.  T lymphocytes including CD4⁺ and CD8⁺ T cells play an important role in the defense. CD4⁺ T cells stimulate B cells to produce virus-specific antibodies, and CD8⁺ T cells directly kill virus-infected cells. T helper cells produce pro-inflammatory cytokines to help the defending cells.The humoral immunity including complements such as C3a and C5a and antibodies is also essential in combating the viral infection.

Drug repurposing, which is defined as identifying alternative uses for approved or investigational drugs outside their defined indication, could be a possible way to overcome the time limitation of research and development needed to design a therapeutic drug to combat the pathogen. The drug repurposing or repositioning approach thus can facilitate prompt clinical decisions at lower costs than de novo drug development. Though drug repurposing is sometimes based on chance observations, target-based repurposing of drugs depends on prior understanding of the precise molecular or cellular element that is recognized by the proposed drug.

Ayurveda and traditional systems of Medicine in India have been treating diseases of infectious and non-infectious origin equally with expansive success rates, treating the patients through an individualized person-to-person approach depending upon the presentation of clinical symptoms in each.

Ashwagandha :  (API, Part I, Vol 1 page 19)

Withania somnifera Dunal. (Fam. Solanaceae) has been used as part of conventional Traditional medicine for many ailments. It is described in classics as having Tikta, Kasaya Rasa and Ushna guna and its Prabhava is Rasayana and Vajikarana. The active constituents of plant (Withaferin A, Sitoindosides VII–X) are reported to have an antioxidant activity which may contribute at least in part to the reported antistress, immunomodulatory, cognition facilitating, antiinflammatory and antiageing properties (Bhattacharya et al., 1997b).

It has been used as an adaptogen or to build resistance to stress or diseases in indigenous medical systems in India for centuries. Modern scientific data indicate several bioactive molecules (withanolides, withanosides, indosides, withaferin-A, others) with significant immunomodulatory, anti-inflammatory and stress reducing properties. The selective Th1 up-regulation by aqueous extract of Ashwagandha roots has been shown in a mice model.  Administration of W. somnifera was found to increase total WBC and bone marrow cells significantly indicating that the extract could stimulate the haemopoetic system. Moreover there was increased presence of a-esterase positive bone marrow cells indicating that Withania treatment could also enhance the differentiation of stem cells. In the same study, it was also observed that W. somnifera extract was found to increase the circulating antibody titre and antibody forming cells and immunological activity was found to be active several days thereafter.

Shunti (API, Part I, Vol 1 page 137):

Shunti is the dried rhizome of Zingiber officinale Roxb and is used as part of diet and medicine in Indian Tradition. It is having Katu Rasa and Ushna Guna and Vata-Kapha Haraproperties. The rich phytochemistry of ginger includes components that scavenge free radicals produced in biological systems. The anti-oxidative properties of ginger and its components have been explored in various in vitro and in vivo tests. Strengthening the body’s defenses by improving the antioxidant status will undoubtedly protect human against many chronic diseases. Gingerol, shogaol, and other structurally-related substances in ginger inhibit prostaglandin and leukotriene biosynthesis through suppression of 5-lipoxygenase or prostaglandin synthetase. Additionally, they can also inhibit synthesis of pro-inflammatory cytokines such as IL-1, TNF-α, and IL-8.