Role of Rasayana in Prevention of COVID-19-A Review

Sneha Dhakite*1, Sadhana Misar Wajpeyi2 1Department of Kayachikitsa, Mahatma Gandhi Ayurved College, Hospital & Research Centre, Salod (H), Wardha, Datta Meghe Institute of Medical Sciences (DU), Nagpur, Maharashtra, India 2Department of Swasthavritta, Mahatma Gandhi Ayurved College, Hospital & Research Centre, Salod (H), Wardha, Datta Meghe Institute of Medical Sciences (DU), Nagpur, Maharashtra, India


INTRODUCTION
The "Coronavirus disease 19 (COVID-19)" is caused by "Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)", a newly discovered member of the Coronaviridae family of viruses which is a highly communicable which emerged in Wuhan, China and extend all over the world (Boulos and Geraghty, 2020). The primary target for Corona viruses is Respiratory system. Corona virus disease spreads mostly through contact with an infected person when they sneeze or cough. It also spreads by touching a surface or object infected by virus, through eyes, nose or mouth. The common symptoms of COVID-19 are pyrexia, cough and breathlessness. Associated symptoms include weakness, body ache, sore throat, loss of smell, diarrhoea and abdominal pain (CDC, 2020). The incubation period of COVID-19 ranges between 2-14 days (Covid and Team, 2020). More than 1.77 million cases have been accounted in more than 210 countries and union territories at April 2020, causing more than 108,000 deaths. The number of recovered people is more than 404,000 (Skiera et al., 2020). Diagnosis can be made from samples obtained by a nasopharyngeal swab, similarly samples from nasal swab or sputum may also be used. The Respiratory system is the most affected system by COVID-19 because the virus enters the host cells through the enzyme angiotensin-converting enzyme 2 (ACE2), which is abundantly present in type II alveolar cells of the lungs (Letko, 2020). Rasayana are compounds or herbs that support the functioning of the immune system including the production of immune cells, detection of antigens, and the elimination of infectious agents. As no effective medical treatment till date for Corona virus disease, Prevention is the best way to keep disease away. Rasayana is the highly ef icacious and cost-effective therapy for the Prevention and Control of viral infections when vaccines and standard therapies are lacking.

Need of study:
Now-a-days there is a gradual decrease in immunity of human beings. Many new and incurable diseases are spreading worldwide, COVID-19 is one such viral diseases. Currently there is neither effective antiviral drugs nor effective vaccines are available for COVID-19. Prevention is the best strategy to deal with it. Hence it is necessary to boost immunity in order to prevent this disease. It is possible with Rasayana Chikitsa (Rejuvenating therapy). Rasayana plays important role in boosting immunity for Fighting and Preventing from COVID-19. This review aims to study the role of Rasayana described in Ayurveda in Prevention of COVID-19.

METHODOLOGY
Relevant data was collected from Ayurvedic classical books; internet and research articles were searched from PubMed and Google Scholar.

Concept of Immunity in Ayurveda-
Immunity is the defence mechanism of body that protects against disease by identifying and destroying pathological organisms. It identi ies variety of pathogens like viruses, bacteria, fungus and parasitic worms, and have ability to destroy them. The immune system mainly protects the body from foreign matters that causes damage by disturbing the homeostatic balance. Principles of Vyadhikshamatva in Ayurveda are free from ailments and lead healthy and wealthy life (Byadgi, 2011). Various factors which contribute towards Vyadhikshamatva are normal Doshas, equilibrium state of Dhatus, normal Agni and patency of Srotas (microchannels) (Singh and Verma, 2012). Vyadhikshamatva is involved in Prevention of the occurrence of a new disease and it also decreases the virulence and progression of an existing disease (Singh, 2015). Vyadhikshamatva is an attribute of inherent Ojas, Dhatu or vital immune strength. Immunomodulation is a process which can adjust the immune system of an organism by interfering with its functions and results in development of immune reactions that in turn decline the in lammatory response. Rasayana means the way for achieving excellent Rasaadi seven Dhatus.

Concept of Rasayana
The Dravyas which promotes the Dhatus are known as Rasayana. Rasayana therapy is one which delays the Jara (old age) and helps to Cures the diseases. Hence Rasayana is used for promotion of strength in the healthy, for Prevention as well as Curative purpose of the diseases.

Types of Rasayana
Dravyabhuta Rasayana and Adravyabhuta Rasayana (Achara Rasayana) are two types of Rasayana. According to the mode of administration Rasayana is divided into Kutipraveshika Rasayana (Intensive indoor rejuvenate regimen) and Vatatapika Rasayana (Outdoor rejuvenate regimen) (Singh, 2014). On the basis of diet and life styles it is categorized into Aushdha Rasayana (Drug based Rasayana), Ahara Rasayana (Dietary Rasayana) and Achara Rasayana (Life style Rasayana) (Rahul and Pankaj, 2009). According to the purpose there are three types of Rasayana namely Naimittika, Ajasrika and Kamya Rasayana Naimittika Rasayana is the type of Rasayana therapy used for speci ic Curative purpose. It accelerates the recovery from prevailing diseases. Ajasrika Rasayana is used in improving health and preserving good healthy lifestyle, diet or exercise. It involves utilization of milk, ghee, honey and maintenance of discipline life style. Kamya Rasayana is used to improve certain function that is desirous.

Chyavanprasha, Agastya Haritaki
and Pippali Rasayana are mainly indicated in disorders of Respiratory system like cough, asthma and hiccough. They also help in increasing immunity and strengthening Respiratory organs.

Probable mode of action of Rasayana
Rasayana helps to improve digestion and metabolism as well as microcirculations, thus allowing to obtain the best qualities of all Dhatus. Rasayana acts on seven Dhatus which further improves the Oja which is responsible for producing good immune power in the body. This Oja gives immunity to the body by nonspeci ic way mediated through neutrophils and monocytes and by speci ic way mediated by B lymphocytes which acts against the virus and bacterial pathogens. Humoral mediated by B lymphocytes become plasma cells and produces immunoglobin which destroys antigens. Majority of Rasayana drugs works on numerous organs by improving their functions by acquiring Vyadhikshamatva through its appetizer, digestive, cognition enhancement, antioxidant, adaptogenic and immunomodulators properties are as shown in Figure 1 (Bhinde, 2013).

Ayurveda & COVID-19
As the changes in lifestyle and environment are bound to happen, newer conditions are gaining to come up hence it can be tackled as per the Tridosha theory explained in classics of Ayurveda. Acharya Sushruta has described Aupasargika rogas i.e. communicable & contagious diseases which can be transmitted through breathing or touching. Centre for Disease Control & Prevention (Tavakoli, 2020) says that human Corona viruses are most commonly spread between an infected person and others by touching infected surface, coughing or sneezing (WHO, 2020). In Ayurveda a term called "Srotas" ie Channel or path which carry essential nutrients to different organs, acts as one of the signi icant factors in the pathogenesis of diseases. Obstruction in the Srotas is one of the processes in pathogenesis of disease. The transportation & transfusion of Pranavayu is the main function of Pranavaha Strotas (Respiratory system). This Pranavaha Srotas gets vitiated because of various reasons like Raja (dust particles containing viruses), Dhuma (smoke containing air pollutants) Sheetasthana (cold environment). This Raja when enters through mouth and nose develops disease like Kasa (cough), Hikka (hiccups), Shwasa (asthma), Pratishay a (running or stuffy nose) which are similar to Coronavirus.

Prevention and management of COVID-19 through Rasayana
Pranavaha Srotas carries Pranavayu, in connection (moolsthna) with Hruday (heart) and Dashadhamanis. In COVID-19 the Respiratory system mainly get affected which is evident from its symptoms like cold, cough and breathlessness. Here the drugs working on Respiratory system and strengthening its functions can be useful. For boosting immune system for Prevention of Coronavirus Giloy, Tulsi, Agastya Rasayana, Pippali Rasayana are the best Rasayana working on Pranvaha Strotas (Respiratory (N=99): ATD as an adjunct with Ashwagandha (Withaniasomnifera) and a multi-herbal formulation Chyavanprasha Body weight showed improvement, appreciable change in IgA and IgM patterns and signi icantly increased bioavailability of isoniazid and pyrazinamide were recorded.Hence it brings up solutions in public health initiatives to boost health care delivery system in India in pulmonary tuberculosis care. Health is de ined as a "state of complete physical, mental and social well-being and not merely an absence of disease or in irmity to lead a socially and economically productive life" (Park, 2011). Ayurveda can be used effectively in the management of immune-compromised conditions like acquired immune de iciency syndrome (AIDS), Tuberculosis and malignancy. The Rasayana therapy or rejuvenation therapy makes it easily possible with its remarkable bene its on immunity, health, longevity, regeneration of cells and tissues in the body. Rasayana as immunomodulator herbs are perhaps the only drug that can be taken securely for long period, even in a healthy state, without any speci ic contradictions. Acharya Charaka has described Chyavanprasha which rejuvenated Chyavana Rishi whereas Acharya Sushruta described many Rasayana formulations that increase the life span and refers to them as Ayuskara. Rasayana therapy has various bene icial effects on our body like Jaravyadhi Nashana, promotion of body strength including immunity, promotes body tissues and alleviation of disorders. Immunomodulators corrects the immune functioning that is out of balance. The immunomodulators have ability to stimulate natural and adaptive defence mechanism of the body that can be helpful in boosting immunity for Prevention of COVID-19.

CONCLUSIONS
Rasayana are effective in enhancing immunity of the body. Rasayana working on Respiratory system helps in strengthening function of Respiratory organs as well as reducing symptoms of Respiratory disorders. Immunity plays an important role in Prevention of diseases. So, it can be concluded that Rasayana Chikitsa can be effective in the Prevention as well as reducing symptoms of COVID-19.

ACKNOWLEDGEMENT
I am very thankful to Mahatma Gandhi Ayurved College, Hospital & Research Centre, Salod (H), Wardha, constituent unit of Datta Meghe Institute of Medical Sciences (DU), Nagpur, Maharashtra, India for giving me opportunity and environment to conduct such review study.