HEATH

Neem leaves can inhibit and slow down Coronavirus

“Neem” leaves in Ayurvedic treatment of COVID-19/SARS-CoV-2 : A Case Report

Dr Pallavi Moreshwar Kanitkar BAMS MS (Shalya), SAI Ayurvedha College, Vairag (MH), India

Shanmuga Subramanian B.E, Govt College of Engineering Tirunelveli, India.

Dr Neeta Deshpande MD (Dravyaguna)

Dr K.Shirish (MD)

Email: [email protected]

Abstract:
                   These are some of the first known cases of SARS-CoV-2 (COVID-19) patients who recovered quickly and become asymptomatic after taking “Neem” leaves mixed with water orally. The age group of patients in this study varies from 5 to 40 years with 2 children being aged 5 and 13 years and adults were in the 36-40 age group. All the 5 of them had tested positive and the patients had typical COVID-19  symptoms like cough, bodyache,fever with 3 of them being symptomatic and the other 2 being asymptomatic .After taking Neem leaves mixed with water orally in equal doses over 2 days, all of them had become asymptomatic and recovered fully clinically. Though this is a small case study done with 5 people, this would implore scientists and Governments around the world to look into Neem as an option for inhibiting COVID-19 as nearly 25+ compounds in Neem leaves has shown high inhibition against COVID-19 Main Protease in the Molecular Docking study.In addition to that Neem has been extensively used in Indian traditional medicine systems like Ayurvedha and Siddha  for many centuries,Also different research studies proves that Neem (Azadirachta Indica) is known to posess anti-viral properties and has been found to be effective against different viruses, as well as it is a well-known anti-inflammatory agent and an immunomodulator.The treatment given above correlates with principles of “Jwara Chikitsa” in Ayurveda.

1.Introduction:
                     In December 2019, health officials at Wuhan, China reported a cluster of pneumonia cases within the city. Shortly after that they determined that the pneumonia was caused by virus which is of Zoonotic origin and it’s caused by novel coronavirus. The virus is referred to SARS-CoV-2 and the disease caused by it is known as COVID-19. Initially there was an assumption that the virus transmission is happening only between animals to humans because the initial cases were related to Huanan Sea Food market but it was soon found out that the virus transmission also happens between humans. Soon it spread from China to other parts of the world .Each and every country was affected by COVID-19 . People around the world were affected directly and indirectly by it as the lockdowns imposed to prevent the spread of COVID-19 made the economies come to a standstill which lead to loss of jobs for millions of people leading to a worldwide recession. But till now no cure or drug has been found to prevent the spread of the virus and even some of the prominent drugs candidates also failed in clinical trials due to lot of reasons.

Neem in Ayurvedha/Siddha:
Neem also known as Azadirachta Indica (Nimtree or Indian lilac) is a tree in the mahogany family Meliaceae. It’s one of the two species in the genus Azadiractha and is native to the Indian Sub-continent. It’s mostly found in tropic and semi tropic regions around the world. Neem leaves, seeds, flowers are well known for its medicinal properties in India for centuries and there has been evidence of Neem being used for healing even 4500 years ago (1) in Ayurvedha and Siddha medicinal systems. In Sanskrit, Neem is called as Universal healer (Sarva Roga Nivarini) which means one that cures all ailments and ills. In Africa it’s called as “40 cures”. Neem leaves, fruits, flowers, oil from seeds has been used extensively in South East Asia to cure various diseases. And Neem is also known as Nimba which means ‘bestower of good health’. The Neem leaf extracts have a powerful antiseptic, antifungal, antiviral and anti-bacterial effect. unlike synthetic chemicals that often produce side effects such as allergic reactions, rashes etc.

2.Neem in Research papers:

Neem is not new to researchers around the world as it has been subject of around 3000 research papers all over the world and has been found to be effective against host of viruses, bacteria and also has been well known for its anti-inflammatory,anti-pyretic,anti-diabetic and other pharmacological properties. Let us see in more detail about the scientific research papers published on Neem and it’s uses.


2.1 Neem as an Anti-Viral
Neem leaves are well known for its anti-viral properties and has been used against viruses in Indian traditional medicinal systems like Ayurvedha, Siddha etc., Different research papers on Neem’s effectiveness also proves the same. As of today, various research studies have proved Neem leaves to be effective against these viruses

  • HIV (2) (3)
  • HSV – Herpes Simplex Virus (4)
  • Dengue (5) (6)
  • Fowl pox viruses like Chickenpox, Smallpox (7)
  • Coxsackie viruses which cause Hand, Foot & Mouth Disease (HFMD) (8)
  • Hepatitis  (9) (10)

Research has shown that Crude extracts of Neem leaves absorbed the viruses and effectively preventing them from entering the uninfected cells , thereby Neem leaves can be used a preventive medicine in inhibiting the virus from spreading to other uninfected cells. (11)

2.2 Neem as Anti-Inflammatory & Immunomodulator
Neem leaves are also known to possess anti-inflammatory and anti-proliferative properties  and various research papers prove that (12). In addition to that a comparative study of Neem and Dexamethasone indicated that Neem leaves does possess anti-inflammatory properties but not on the same scale as Dexamethasone (13) and also Neem leaves are known to act as Immunomodulators (14) (15) (16)

2.3 Anti-Diabetic properties of Neem
Research papers have also proven that Neem leaves & seeds also have anti-Diabetic properties by effectively lowering blood glucose level with minimal or no side-effects.They are known to possess hypolipidemic, hypoglycemic , immunostimulant and hepatoprotective properties (17) (18)

2.4 Neem & ACE Inhibition

Neem is also known to posses ACE inhibition properties, researchers have proven that Neem leaves & Seed extract can be used as potential nutraceutical with antioxidant capacity and inhibitory activity against ACE. (19) (20)

In addition all these Neem is known to reduce Blood pressure (21) (22) And it also used in the treatment of pulmonary inflammation (23) .Neem is known to have anti-depressant effects as it increases the level of serotonin which is responsible for controlling anxiety in humans (24)

3. Neem against COVID-19

Neem leaves are known to have 100+ compounds. (25) An in-silico study has shown that nearly 20+  compounds in Neem leaves show high inhibition against COVID-19 Main Protease (6LU7) with values ranging from -14.3 kcal/mol to a minimum of -9.1 kcal/mol and in-addition to those compounds there are other compounds from Neem leaves which exhibits medium binding affinity with COVID-19 Main Protease (6LU7). (26)

And in addition to that Neem is effective for its anti-viral properties and it’s known to inhibit viruses at any early stage. (11) and also, it’s an immunomodulator. All these properties of Neem make it as an ideal choice to inhibit COVID-19 as it can inhibit virus at any early stage and also Neem leaves can control the “over response” of immune system due to which many COVID-19 deaths occur. (27)

Neem leaves have shown to exhibit toxicity only at a level of 6g/kg of body weight and the amount of leaves  that can be ingested varies depending upon the body weight of the patient.And for any patient up to 10g might be a safe limit when taken over different doses during a day. (28)

4.Case Presentation:

4.1 Patient Information:
The 5 patients were from in the age group 5 to 39 and all of them  tested positive for COVID19 and had typical COVID19 symptoms like bodyache, cough, fever etc., Out of the 5 patients ,2 were children and they aged 5 and 13 respectively and others were adult in the age group 36-40. Out of the entire group, 3 were male and 2 were female. All these patients belonged to the same family and stayed in the same house.

Patient 1:
Patient 1 was a female aged 34 years and has started showing COVID-19 symptoms like bodyache and cough etc., The patient had started showing symptoms even before 1 week she tested positive for COVID-19.

DatePatient history
June 27thPatient tested Positive for COVID-19 and started taking HCQ tablets
June 28thNeem treatment was started. It consisted of 9~10g of Neem leaves mixed with water and taken orally in equal doses over 24 hours for a period of over 5 days
June 29th25% Improvement was seen in condition of the patient
June 30th50% Improvement was seen in the condition of the patient
July 1stPatient got fully recovered clinically and become asymptomatic within 3 days

Patient 2:
Patient 2 was a male  aged 40  years and has started showing COVID-19 symptoms like body ache etc., and the patient became asymptomatic only after taking Neem leaves mixture.

DatePatient history
June 27thPatient tested Positive for COVID-19 and started taking HCQ tablets
June 28thNeem treatment was started. It consisted of 9~10g of Neem leaves mixed with water and taken orally in equal doses over 24 hours for a period of over 5 days 
June 30thPatient got fully recovered clinically and become asymptomatic within 2 days

Patient 3:

Patient 3 was a female child aged 5  years and had myalgia

DatePatient history
June 27thPatient tested Positive for COVID-19 and was not taking HCQ tablets due to age
June 28thNeem treatment was started and it consisted of 1~2g of Neem leaves mixed with water and taken orally in equal doses over 24 hours for a period of over 5 days  (due to her age Neem doses were smaller)
June 29thPatient got fully recovered clinically and become asymptomatic

All the above patients continued to take Neem leaves for the remaining prescribed period even though they became asymptomatic within 2~3 days of taking Neem.

Patient 4 & Patient 5

Patient 4 was a male aged 37 years and Patient 5 was a male aged 13 years. Both of them were asymptomatic but tested positive for COVID-19. They were prescribed about 4~5g of Neem leaves per day from June 28th and after that they have not become symptomatic even though all of them were in close contact with one another as they are from the same family and were living within the same house.


The treatment given above correlates with principles of “Jwara Chikitsa” in Ayurveda.In Jwara Chikitsa and presymptoms (purvaroopa) of Jwara. ”Tikta Rasa” is advised as first line of treatment. Neem is a medicine of “Tikta Rasa”. Nimba is Vishahara and purifier of blood as per Ayurveda. Reference about it  in “Charak Samhita Jwara Chikitsa”

“लंघनं स्वेदनं कालो यवाग्व स्तीक्तको रसः I

पाचनानि अविपक्वानां दोषानां तरुणे ज्वरे  I I

चरक संहिता चिकित्सा स्थान ज्वर अध्याय”

Conclusion:
This case study clears proves beyond doubt the effect of Neem leaves on inhibiting COVID-19. The 5-year-old female child was not taking any other medicines but was taking about 0.8~1g of Neem leaves and got completely recovered of myalgia within a day and the other 2 patients also recovered quickly within 3 days of taking Neem along with HCQ. They were previously taking HCQ tablets but as research has shown it had no effect within a short period of time and we can only hypothesize that after taking Neem leaves mixture they started showing remarkable improvements within 2~3 days and other 2 asymptomatic patients also didn’t show any signs or symptoms, which proves that Neem leaves can be used as prophylactic medication also. Since Neem is non-toxic up to 6g/Kg of body weight, Neem leaves can be taken in doses over a period of time and all these patients had doses of less than 10g each day with doses spread over as  their bodyweight was in the range of 65~81kg which is well within the limits of Neem’s toxicity.Also the patients didn’t become critically ill due to anti-viral properties of Neem which inhibited the virus within affected cells and prevented it from spreading to other cells within the body.Unlike other drugs Neem doesn’t have any side effects unless taken over a long period of time and also orally available which makes it easily available for common people .Neem leaves as an treatment presents a huge opportunity for the Government,Organizations and others to put an end to this pandemic as it can be taken both as prophylactic medicine and also in inhibition of COVID-19.

References

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10. Rukhsana Sher, Tehseen Abaid, Muhammad Zahid and Arshad Kamal Butt. Evidence of effectiveness of Azadirachta indica leaves in chronic hepatitis C in addition of conventional therapy failure. [Online] December 2018. https://annalskemu.org/journal/index.php/annals/article/view/2630.

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12. Marc Schumacher, Claudia Cerella, Simone Reuter, Mario Dicato, and Marc Diederichcorresponding author. Anti-inflammatory, pro-apoptotic, and anti-proliferative effects of a methanolic neem (Azadirachta indica) leaf extract are mediated via modulation of the nuclear factor-κB pathway. [Online] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3092905/.

13. Abu Syed Md. Mosaddek, Md. Mamun Ur Rashid. A comparative study of the anti-inflammatory effect of aqueous extract of neem leaf and dexamethasone. [Online] https://doi.org/10.3329/bjp.v3i1.836.

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16. Alzohairy, Mohammad A. Therapeutics Role of Azadirachta indica (Neem) and Their Active Constituents in Diseases Prevention and Treatment. [Online] March 2016. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4791507/.

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26. Subramanian, Shanmuga. Nearly 20+ compounds in Neem leaves extract exhibit high binding affinity with some of them as high as -14.3 kcal/mol against COVID-19 Main Protease (Mpro) : A Molecular Docking Study. [Online] April 2020. https://doi.org/10.35543/osf.io/pyqx4.

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Author

Shanmuga Subramanian

 @Ramanean 

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