ABSTRACT
Objective: Coronavirus disease 2019 (COVID-19) is primarily a respiratory illness causing thrombotic disorders. Pro-inflammatory cytokines are one of the responsible causes of cytokine storm syndrome in patients with COVID-19. Coagulopathy and inflammation are associated with COVID-19 severity. The coronavirus spike protein facilitates the entry of the virus into the target cells causing coagulopathy and inflammation.Other infections include direct viral toxicity, endothelial cell damage, inflammation, and deregulation of the immune response and renin-angiotensinaldosterone system. The study aims to estimate levels of D-Dimer and Serum Ferritin in symptomatic and asymptomatic COVID-19 patients and its comparison with healthy controls. Method(s): The study includes 30 healthy control and 30 symptomatic and 30 asymptomatic COVID-19 patients of both sexes. Analysis of serum ferritin was done on a fully automated immunology analyzer-SIEMENS based on the principle of chemiluminescence. D-dimer was estimated on mLab which is cartridge-based. Result(s): We observed that the levels of D-Dimer and Serum Ferritin significantly increased in symptomatic COVID-19 patients as compared to asymptomatic COVID-19 positive patients and healthy non-COVID-19 controls. Conclusion(s): The elevated serum ferritin and D-dimer were associated with a poor outcome and poor prognosis and could predict the worsening of COVID-19 patients. The significant increase showed that D-Dimer and serum ferritin accurately predicts patients developing severe COVID- infection. Copyright © 2022 The Authors. Published by Innovare Academic Sciences Pvt Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
ABSTRACT
Ethnopharmacological relevance: Chyavanprash is an ayurvedic formulation, a Rasayana known to promote overall well-being, immunity, and vitality. It contains powerful antioxidants, good hepatoprotective and immunomodulating agents. Chyavanprash is also known to protect and strengthen respiratory health, thereby providing immunity against respiratory infections. A novel ayurvedic proprietary formulation (based on the aqueous extracts of herbs used in Chyavanprash) was developed to offer a differential taste experience and deliver a standardized quality for health benefits. The immune-stimulatory role of these extracts and the underlying mechanistic evidence had to be studied. Aim of the study: The goal of this study was to evaluate the safety and prophylactic efficacy of the test product based on extracts of herbs used in Chyavanprash in a preclinical study. Material and methods: The test product was studied to evaluate acute toxicity and prophylactic efficacy in influenza-like virus (HCoV-229E)-infected mice model for viral ribonucleic acid (RNA) load estimation in lung tissues. Immunophenotyping of B cells, natural killer (NK) cells, and T cell subpopulations were assessed. Cytokines immunoglobulin G (IgG), immunoglobulin M (IgM), interleukin 6 (IL-6), interferon-gamma (IFN-γ), and tumor necrosis factor α (TNF-α) were also evaluated in serum samples. Two doses of the test product, 1,000 mg/kg body weight and 500 mg/kg body weight against the disease and normal control were studied. Quality control of the test product was carried out using high-performance liquid chromatography (HPLC) with gallic acid and ascorbic acid as marker compounds. Results: At a dose of 1,000 mg/kg body weight, the test product showed a 99.79% reduction in viral RNA load in lung tissues and a significant 2-fold increase in B cells, i.e., 19.89 ± 0.25% cells vs. 9.46 ± 1.67% in disease control (p <0.01). A significant change with increase in IgG, IgM and a decrease in IL-6, TNF-α was observed in both the test groups as compared with disease control. Mast cell degranulation in rat mesenteric bits, preincubated with test product 250 µg/mL concentration showed a 76.7% protection against compound 48/80 treatment. The product was safe even at the highest tested dose (5 g/kg body weight) in the acute toxicity study. Conclusion: This study proves that the formulation with extract of herbs used in Chyavanprash contains phytocompounds, which could be potential immunomodulatory agents that provide immunity and protection against allergies. © 2022