Abstract

Antiviral herbal medicines have already been used in many epidemics, notably in the two previous coronavirus outbreaks - MERS-CoV in 2012, SARS-CoV in 2013 - or in seasonal epidemics caused by influenza or dengue viruses.

In coronavirus infection (COVID-19), cellular adaptive immunity is primarily involved, in particular CD8 and CD4 lymphocytes that stimulate the B lymphocytes responsible for the production of antibodies targeting the coronavirus. In addition, there is a cytokine storm in patients infected with COVID-19 responsible for a major inflammatory response and their very severe progressive clinical state. The increase in interleukin-10 and TNF alpha reduces CD4 counts, causes functional exhaustion of immune cells and induces, at their site of action (liver, vascular endothelium), runaway production and action of inflammation proteins, causing the secondary aggravation of COVID-19 patients.

Artemisia annua has a recognized antiviral activity (anti HSV1, Poliovirus, RSV, hepatitis C anti-virus, type 2 dengue virus, hantavirus, human cytomegalovirus) and antiHIV in vitro thanks to the flavonoids, quercetin and dicaffeoylquinic acids it contains. These molecules have been shown to inhibit the enzymaticactivity of CLPro (Chymotrypsin-like protease), an enzyme produced by SARS-CoV-2.

The antiviral action of Artemisia annua, which is achieved by stimulating adaptive immunity, regulating the production of the pro-inflammatory cytokines prostaglandin E2 (PGE2), IL-6, IL-10, TNF alpha and increasing the genesis of CD4, CD8 and interferon gamma, involves many minerals and biomolecules: the properties of flavonoids, polyphenols, triterpenes, sterols, saponins, polysaccharides, artemisinin and its derivatives, the concentration of zinc, gallium and selenium in the plant play a role in the immune, antiviral, antioxidant and anti-inflammatory response.

The plant is rich in Vitamins A and E, of which one, when supplemented, is known to reduce morbidity and mortality in viral infections, HIV among others, and the other is a powerful antioxidant.

It is therefore the combination of these biomolecules and the intake of Artemisia annua in totum that could improve exhausted adaptive immunity and modulate the runaway inflammatory response during COVID-19 infection, as this plant has already demonstrated in other serious viral and parasitic infections.