India’s Council of Scientific & Industrial Research (CSIR) on 8 May started a clinical trial, to test the efficacy of Ayurvedic remedies like Ashwagandha, Yashtimadhu (mulethi), Guduchi Pippali and a formulation known as AYUSH-64 against COVID-19.

Guduchi Pippali is a combination of giloy and long pepper. AYUSH 64 is an Ayurvedic anti-malaria drug that contains Saptaparna stem bark (Alstonia scholaris), Katuki root (Picrorhiza kurroa), Chirayata (Swertia chirata) and Kuberaksha seed (Cesalpinia crista).

According to the AYUSH ministry, frontline workers, including sixty-four healthcare workers and lakhs of people working in high-risk zones, will be given these Ayurvedic medicines during the trial. The idea is to test the effectiveness of these remedies as an add-on to fight the new coronavirus infection that has already made nearly 60,000 people sick in India.

Add-on means that the ayurvedic medicines will be given in addition to standard care for COVID-19, and not as a replacement for therapies and allopathic medicines approved by the Indian Council of Medical Research (ICMR).

Results of the trial--a joint initiative of India’s Ministry of Health and Family Welfare, Ministry of AYUSH, and the Ministry of Science and Technology, being conducted by CSIR with technical support from the ICMR--are of course some time away. In the meantime, here’s a quick look at the four Ayurvedic remedies and what we know about their antiviral and anti-inflammatory properties so far.

  1. Fighting inflammation in COVID-19
  2. Antiviral effects of Ayurvedic medicines
  3. Repurposing Ayurvedic remedies for COVID-19
Doctors for CSIR begins clinical trials of four Ayurvedic medicines for COVID-19 treatment

Ashwagandha (Withania somnifera) is a traditional remedy that is thought to reduce inflammation in arthritis patients and boost overall immunity.

A study published in the Indian Journal of Medical Research in 2015 found that taking five grams of Ashwagandha twice a day for three weeks, followed by a four-week course of taking 100 grams Sidh makardhwaj with honey once a day, reduced inflammation and joint pain in people with rheumatoid arthritis (RA). However, the study included only 86 people, of whom 78 completed the course of medication.

This trial will put Ashwagandha to a bigger test. If it is seen to reduce inflammation here, this could be significant: remember, medical researchers are already looking into the efficacy of RA medicines like baricitinib for the treatment of COVID-19. (Read more: Existing drugs being tried out to find a cure for COVID-19)

Inflammation occurs naturally when our immune system fights an infection. In the case of COVID-19, researchers say, the immune response can sometimes be so over-the-top or excessive (cytokine storm) that the inflammation doesn’t subside even after the viral infection is gone. This is what causes some COVID-19 patients to become severely ill.

If, however, the inflammation can be controlled early on, then the patient’s chances of survival might improve.

That said, Ayurvedic remedies should not be taken without consulting a doctor about usage and dosage. Research has pointed to some side-effects of Ashwagandha: it is thought to cause liver injury in some people. However, more research needs to be done into the side-effects of Ashwagandha, too.

Yashtimadhu is the Sanskrit name for mulethi or liquorice root. Researchers have argued that the glycyrrhizic acid present in Yashtimadhu gives it “antiviral, antiinflammatory, antioxidant, and immune-modulating properties”.

Research also shows that glycyrrhizic acid, which gives liquorice its distinctive sweet taste, is effective against both RNA and DNA virus. The new coronavirus SARS-CoV-2 which causes COVID-19 is a single-stranded RNA virus, which means that it’s genetic material is ribonucleic acid or RNA.

Guduchi or giloy (Tinospora cordifolia) is similarly said to be imbued with antiviral properties. Researchers have argued that it contains compounds like tinosporone, giloin and polysaccharides that give it adaptogenic (stress-reducing) and immunomodulating properties.

Ayurveda is a traditional system of medicine that is supposed to be thousands of years old. However, this doesn’t necessarily mean that its tenets cannot be used to explore treatments for new illnesses.

Indeed, in the absence of an approved drug or vaccine to treat COVID-19, doctors around the world are depending on off-label use of drugs (using medicines that were made or approved for some other illness) and supportive therapies to treat the new coronavirus infection.

This trial, provided that it is indeed large enough and randomised, could help to understand if Ayurveda may have a few remedies that can be repurposed to treat COVID-19, too.

On that note, here’s a quick look at AYUSH 64 and what it is meant to do. The Central Council for Research in Ayurvedic Science, Ministry of AYUSH, has recommended its use against malaria, an infection caused by Plasmodium parasite. The formulation contains Saptaparna: in addition to malaria, it is said to be useful for people with asthma or bronchitis, too. Next, it contains Katuki or Picrorhiza kurroa. In addition to malaria, it is thought to be effective against upper respiratory tract infections.

COVID-19 infection begins in the nose and throat (upper respiratory tract) and then travels to the windpipe, airways and air sacs of the lungs (lower respiratory tract).

To be sure, the clinical trial would tell us about the efficacy (or lack thereof) of these medicines. And a lot will depend on how these trials are conducted. But the fact that we are finally seeing some clinical trials of Ayurvedic medicines is heartening.

Dr. Nipa Brahmbhatt

Dr. Nipa Brahmbhatt

General Physician
13 Years of Experience

Dr. Rohith Jaiswal

Dr. Rohith Jaiswal

General Physician
8 Years of Experience

Lalitha Nageshwari

Lalitha Nageshwari

General Physician
1 Years of Experience

Dr. Sneha Patil

Dr. Sneha Patil

General Physician
5 Years of Experience


Medicines / Products that contain CSIR begins clinical trials of four Ayurvedic medicines for COVID-19 treatment

References

  1. Jaiswal Y.S. & Williams L.L. A glimpse of Ayurveda – The forgotten history and principles of Indian traditional medicine. Journal of Traditional and Complementary Medicine, January 2017; 7(1): Pp 50-53
  2. Kumar G., Srivastava A., Sharma S.K., Rao T.D., Gupta Y.K. Efficacy & safety evaluation of Ayurvedic treatment (Ashwagandha powder & Sidh Makardhwaj) in rheumatoid arthritis patients: a pilot prospective study. Indian Journal of Medical Research, January, 2015;141(1): 100-6.
  3. Baliga M.S. Review of the phytochemical, pharmacological and toxicological properties of Alstonia Scholaris Linn. R. Br (Saptaparna). Chinese Journal of Integrative Medicine (28 March 2012).
  4. Central Council for Research in Ayurvedic Science, Ministry of AYUSH, Janakpuri, Delhi [Internet]. AYUSH-64: An Ayurvedic anti-malarial drug.
  5. Yasmin A.R., Chia S.L., Looi Q.H., Omar A.R., Noordin M.M., Ideris A. Herbal extracts as antiviral agents. In "Feed Additives Aromatic Plants and Herbs in Animal Nutrition and Health" 2020: 122. Academic Press [Internet].
  6. Björnsson H.K. et al. Ashwagandha-induced liver injury: A case series from Iceland and the US Drug-Induced Liver Injury Network. Liver International, 11 February 2020 [EPub]; 40(4): 825-829.
  7. Pompei R., Pani A., Flore O., Marcialis M.A., Loddo B. Antiviral activity of glycyrrhizic acid. Experientia, April 1980; 36(3): 304.