Can Panax ginseng help control cytokine storm in COVID-19?

Abstract

Coronavirus disease 2019 (COVID-19) is currently a pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 are directly associated with hyper-activation of innate immune response that excessively produce pro-inflammatory cytokines and induce cytokine storm, leading to multi-organ-failure and significant morbidity/mortality. Currently, several antiviral drugs such as Paxlovid (nirmatrelvir and ritonavir) and molnupiravir are authorized to treat mild to moderate COVID-19, however, there are still no drugs that can specifically fight against challenges of SARS-CoV-2 variants. Panax ginseng, a medicinal plant widely used for treating various conditions, might be appropriate for this need due to its anti-inflammatory/cytokine/viral activities, fewer side effects, and cost efficiency. To review Panax ginseng and its pharmacologically active-ingredients as potential phytopharmaceuticals for treating cytokine storm of COVID-19, articles that reporting its positive effects on the cytokine production were searched from academic databases. Experimental/clinical evidences for the effectiveness of Panax ginseng and its active-ingredients in preventing or mitigating cytokine storm, especially for the cascade of cytokine storm, suggest that they might be beneficial as an adjunct treatment for cytokine storm of COVID-19. This review may provide a new approach to discover specific medications using Panax ginseng to control cytokine storm of COVID-19.

Keywords: Coronavirus disease 2019; Cytokine storm; Panax ginseng; SARS-CoV-2; Therapeutic strategies.

Graphical abstract

Fig. 1

The immunopathological mechanisms of cytokine storm in COVID-19. SARS-CoV-2 infects the respiratory epithelial cells or induces immune response, resulting in secretion of inflammatory cytokines and damage of cells and tissues. The cytokines stimulate innate immune response as well as adaptive immune response to induce the excessive production of circulating cytokines. The excessive cytokines can destroy epithelial cells or produces hemophagocytic lymphohistiocytosis, macrophage activation/acute respiratory distress syndrome and intravascular coagulation. This events together produce to acute respiratory distress syndrome, multiple organ dysfunction syndromes (lung, liver, heart, kidney, brain, etc.), or death.