Therefore, exploring the repurposing of natural compounds may provide alternatives against COVID19. Several nutraceuticals have a proven ability of immune- boosting, antiviral, antioxidant, anti-inflammatory effects. These include Zn, vitamin D, vitamin C, curcumin, cinnamaldehyde, probiotics, selenium, lactoferrin, quercetin, etc. Grouping some of these phytonutrients in the right combination in the form of a food supplement may help to boost the immune system, prevent virus spread, preclude the disease progression to severe stage, and further suppress the hyperinflammation providing both prophylactic and therapeutic support against COVID-19

1. A REVIEW ON STRATEGIES TO COUNTERACT THE SARS-CoV-2
INFECTION USING IMMUNE BOOSTING ANTI-OXIDANT AND ANTI-
INFLAMMATORY FOOD SUPPLEMENTS
Guide : Dr. Suvendu Saha Presented by : S. Rajinikanth (17T21R0033)
M.Pharm, Ph.D. G. Pragna (17T21R0066)
Associate Professor, Dept. of Pharmacology G. Niveditha (17T21R0013)
CMR College of Pharmacy

2. CONTENTS:
• Introduction
• Clinical symptoms
• Origin of covid-19
• Pathogenesis
• Food supplements
• Conclusion

3. Introduction:
 Severe acute respiratory syndrome coronavirus 2 (SARS-
CoV-2) is a novel severe acute respiratory syndrome
coronavirus. It was first isolated from three people with
pneumonia connected to the cluster of acute respiratory
illness cases in Wuhan.
 The COVID-19 is an acute and contagious disease
characterized by pneumonia and ARDS. The disease is caused
by SARS-CoV-2, which belongs to the family of Coronaviridae
along with MERS-CoV and SARS-CoV-1. The virus gets
transmitted through the contact of aerosol droplets from
infected persons.
 Currently, several vaccines and drugs are being evaluated
for their efficacy, safety, and for determination of doses for
COVID-19 and this requires considerable time for their
validation.

4.  Therefore, exploring the repurposing of natural compounds
may provide alternatives against COVID-19.
 Several nutraceuticals have a proven ability of immune-
boosting, antiviral, antioxidant, anti-inflammatory effects. These
include Zn, vitamin D, vitamin C, curcumin, cinnamaldehyde,
probiotics, selenium, lactoferrin, quercetin, etc.
 Grouping some of these phytonutrients in the right
combination in the form of a food supplement may help to boost
the immune system, prevent virus spread, preclude the disease
progression to severe stage, and further suppress the hyper
inflammation providing both prophylactic and therapeutic
support against COVID-19.

5. Novel coronavirus (Covid-19) is a latest strain that
has not been identified in humans previously. The
name has been assigned to it after the observations
made via microscopes which revealed the morphology
of it stating that it has spike-proteins on its outer
core which looks like a crown. Then they came up
with the name corona which means “Crown” in Latin
language.

6. CLINICAL SYMPTOMS:
Generally, covid-19 clinical manifestations
include respiratory illness and flu like
symptoms. The incubation period of this
novel corona virus has been noted to be 2 to
14 days.
oRespiratory symptoms
oFever
oCough
oShortness of breath
oBreathing difficulties
oFatigue
oSore throat
oHeadache

7. There are some warning signs where the patients need to be
hospitalized and provided the utmost care which include the
following,
oDifficulty in breathing or shortness of breathe
oPersistent pain or pressure in the chest
oNew confusion or inability to arouse
oBluish lips or face

8. The individuals who are at high risk/vulnerable to this novel
corona virus (nCoV) are following,
▪Old people (people over 65 years of age)
▪People with serious chronic illnesses such as:
oDiabetes
oCardiovascular diseases
oChronic respiratory diseases
oCancer
oHypertension
oChronic liver disease

9.  Adequate preventive measures like social distancing, wearing
masks and using alcohol-based hand sanitizers are
recommended.
 Maintaining a proper hygiene and diet plan will help boost the
immunity and strengthen the body.
 The WHO and CDC guidelines and notifications must be
followed and also implemented to prevent the infection and its
spread.

10. ORIGIN OF COVID- 19:
In December 2019, Wuhan City, Province of China, became the centre of an
outbreak of novel contagious coronavirus disease (COVID-19) of unknown
etiology. The SARS-CoV-2 was found to be a positive-stranded RNA virus
belonging to the genus Beta coronavirus with a crown due to the presence of
spike glycoproteins on the envelope.

11. SARS-CoV-2 presents a high transmissibility and pathogenicity. It could be
transmitted from human to human by droplets and contact.
Several reports have suggested that symptomatic people are the most frequent
source of COVID-19 spread.
It primarily spreads between people through respiratory droplets by coughing
or sneezing from an infected individual. Moreover, there are suggestions that
individuals who remain asymptomatic could transmit the virus.

12. PATHOGENISIS:
Clinical Presentation of COVID-19:
In general, common cold CoVs tend to cause mild URT symptoms and occasional
gastrointestinal involvement (Figure 3). By contrast, infection with highly
pathogenic CoVs, including SARS-CoV-2, causes severe ‘flu’-like symptoms that
can progress to acute respiratory distress (ARDS), pneumonia, renal failure, and
death. The most common symptoms are fever, cough, and dyspnea, accounting for
83%, 82%, and 31% of patients with COVID-19.

13. As the pandemic is progressing, it has become increasingly clear that COVID-19
encompasses not only rapid respiratory/ gastrointestinal illnesses, but can also have
long-term ramifications, such as myocardial inflammation.
Furthermore, severe COVID-19 is not restricted to the aged population as initially
reported; children and young adults are also at risk.
Together, COVID- 19 initially presents with ‘flu’-like symptoms and can later
progress to life-threatening systemic inflammation and multiorgan dysfunction.

14. Proposed Severe Acute Respiratory Syndrome Coronavirus 2
(SARS-CoV-2) Transmission Routes

15. The ongoing COVID-19 pandemic has resulted in numerous accounts of different
transmission routes between humans.
Droplet transmission (>5 μm) is the most pronounced and heavily implicated
mode of transmission reported during the pandemic.
Direct contact spread from one infected individual to a second, native person has
also been considered a driver of human-to- human transmission, especially in
households with close interactions between family members.
Both airborne and faecal–oral human-to-human transmission events were reported
in the precursor SARS-CoV epidemic but have yet to be observed in the current
crises.

16. Solid arrows show confirmed viral
transfer from one infected person
to another, with a declining
gradient in arrow width denoting
the relative contributions of each
transmission route. Dashed lines
show the plausibility of
transmission types that have yet
to be confirmed. SARS-CoV-2
symbol in ‘infected patient’
indicates where RNA/infectious
virus has been detected.

17. IMMUNE-BOOSTING, ANTIOXIDANT AND
ANTI-INFLAMMATORY FOOD
SUPPLEMENTS AGAINST COVID-19
 Several shreds of evidence indicate that many
nutritional supplements from various spices, herbs,
fruits, roots, and vegetables can reduce the risk or
severity of a wide range of viral infections by boosting
the immune response, particularly among people
with inadequate dietary sources and also by their
anti-inflammatory, free radical scavenging, and
viricidal functions.

18.  Eating healthy and nutritious food has always been considered crucial for
strengthening the immune system. A strong immune system protects your
body from disease-causing pathogens and helps you enjoy a long and
healthy life.
 These nutrients can be repurposed in mitigating the pathological effects induced
by the SARS-CoV-2 infection. Therefore, the use of natural compounds may
provide alternative prophylactic and therapeutic support along with the therapy
for COVID-19 In the following section, the beneficial effects of some of the
nutrients are described.

20. Summary of food supplements and their major functional effects
Sl.no: Food supplements Properties
1. Zinc (Zn) (Antiviral) • Protects against oxidative stress and inhibit TNF-α, IFN-γ,
FasR and JAK-STAT signalling
pathways.
• Modulates the viral entry, fusion, replication, viral
protein translation and virus budding of respiratory
viruses.
2. Vitamin D (VD)
(Immune-boosting anti-
inflammatory)
• Decreases the expression of the pro-
inflammatory type 1 cytokines: IL-12, IL-16, IL-8, TNF-α
and IFN-γ
 And increases type 2 cytokines IL-4, IL-5, IL-
10.

21. 3. Vitamin C (VC)
(Immune-boosting,
antioxidant)
 Decreases pro-inflammatory cytokines, TNF-α and IFN-γ and
increases anti-inflammatory IL- 10 production.
 Reduces the duration and severity of upper
respiratory infections (viral infections).
 Scavenges ROS, prevents lipid peroxidation, and protein alkylation
and thus protect cells
from oxidative.
4. Curcumin
(Immune-boosting,
antiviral,
anti-inflammatory, and
antioxidant)
 Stimulates host interferon production to activate the host
innate immunity.
 Binds to S protein at RBD and ACE2 receptor
and inhibits virus entry.
 Neutralizes free radicals and enhances the production of
antioxidant enzymes.

22. 5. Cinnamaldehyde
(Anti-inflammatory)
 Suppress the NF-κB, TLR4, and NLRP3
signalling pathways.
 Downregulates the production of
prostaglandins.
6. Allicin (Antiviral,
anti-inflammatory)
 Downregulates the proinflammatory cytokines
and inhibits the nitric oxide synthase
expression in macrophages.
 Possess antiviral effect on broad spectrum of
viruses of HSV family, parainfluenza virus and
human rhinovirus.

23. Piperine
(Anti-inflammatory and
antioxidant)
• Reduces the production of the IL-1β, IL-6, TNF-
α, COX-2, nitric oxide synthase-2, and NF-κB.
• Neutralizes free radicals, ROS, and hydroxyl
radicals.
Probiotics (Immune
boosting,
anti-inflammatory)
• Anti-inflammatory cytokines IL-10, IL-4.
• Lactobacillus acidophilus CMCC878 reduces the
bacterial load and inflammation in mice lungs
infected with staphylococcus and pseudomonas.
• Bifidobacterium longum BB536 prevents
infection from influenza and improves innate
immunity.

24. 9. Lactoferrin (antiviral)  Downregulates the IL-6, TNF-α, and ferritin.
 Inhibits the viral entry and suppress the viral
replication.
10. Quercetin (antiviral)  Inhibits the production of the TNF-α, IL-8, IL- 1α,
COX, and LOX enzymes.
 Possesses antiviral effects against both RNA
(influenza and coronavirus) and DNA viruses
(herpesvirus).

25. CONCLUSION:
Coronavirus is a family of viruses which mainly attacks the respiratory and
gastrointestinal systems of the body. Respiratory system illness conditions can be
ranging from common cold symptoms to respiratory shock and multiple organ failure
especially in case of covid-19.
Treatment for covid-19 based on level of infection and health complications have been
given by MoHFW and NCDC, India. Many investigational therapies have been identified in
this study by many countries around the globe.

26. Corona virus has been declared has pandemic in the month of march 2020 by world
health organization.
Many regulatory bodies like WHO, CDC, MoHFW and NCDC.
India have constantly issuing guideline right from the symptom’s assessments to
treatment and if in case the patient does not survive to the crematorium or burial-
ground.
These regulatory bodies also have published the guidelines for management of bio-
waste and other medical equipments used and transportation of these by covid infected
patients.

27. People with low immunity are more prone for this world pandemic named as COVID‐19.
To help or boost the immunity, the plant‐based foods play vital role by promoting beneficial
bacteria in the body.
Various vitamins like C, D, and E are investigated to provide important aspects for
improving immunity. Fruits like oranges, papaya, kiwi, and guava are rich in vitamin C,
while vegetables like eggplant, bell peppers, beetroots, spinach, and cauliflower are known
to be quite rich in vitamin C and are good for immunity.
Vitamin D improves cellular resistance, partially by raising the cytokine storm that the
innate immune system causes.

28. Green vegetables like broccoli, mushrooms, and even kale are a few immunity boosters
that improve the immune system of older people quite rapidly.
There are several drug candidates that have been identified and most are in various
stages of research and development, whilst some of them have been repurposed and
approved for emergency use in this pandemic. The notable ones approved for use in an
emergency include hydroxychloroquine, favipiravir, remdesivir, tocilizumab, etc.,
Furthermore, no substantial research supports the use of specific food supplements as
adjuvant therapy for the management of COVID-19 subjects.