Plant-based therapeutics against SARS-CoV-2 variants: A translational perspective from preclinical to clinical studies

AbstractCOVID-19, first reported in late 2019, continues to be a significant public health threat due to the emergence of SARS-CoV-2 variants such as Alpha, Delta, and Omicron. Despite modern medications, mass vaccination campaigns, variant-driven immune escape, and rapid transmission, global containment remains challenging. Currently, KP.3.1.1, XEC, LP.8.1, NB.1.8.1, and XFG are the emerging variants under monitoring. It is too early to comment on the protection provided by current vaccinations against new variants because of initial efficacy trials. Herbal medicine played a crucial role in managing COVID-19, being widely used to alleviate symptoms such as fever, cough, fatigue, and respiratory problems. In this context, a narrative review of published literature was conducted, analyzing the therapeutic potential of botanicals, highlighting their antiviral and immunomodulatory effects with a focus on preclinical and clinical evidences. In vitro and in silico investigations identified multiple phytochemicals with strong antiviral activity against SARS-CoV-2 targets. Additionally, herbal formulations have demonstrated immunomodulatory and antiviral properties in clinical studies. Although preliminary findings are promising, large multicenter clinical trials are required to establish safety, efficacy, and integration of these formulations with conventional therapies. The integration of herbal medicine, modern intensive care, and vaccination has opened up a new front in the fight against emerging SARS-CoV-2 variants.