key: cord-1008551-ueivvk0t
authors: Córdoba-Tovar, Leonomir; Ríos-Geovo, Virleydys; Viveros, Mackcheembergs Francoees Largacha; Salas-Moreno, Manuel Haminton; Marrugo-Negrete, José Luis; Ramos Barón, Pablo A.; Chaverra, Lina Marcela Mosquera; Jonathan, M. P.
title: Cultural belief and medicinal plants in treating COVID 19 patients of Western Colombia
date: 2021-11-01
journal: Acta Ecologica Sinica
DOI: 10.1016/j.chnaes.2021.10.011
sha: eb26b0515e49f760001f41b4e6b0b07fa96a8acf
doc_id: 1008551
cord_uid: ueivvk0t

The main background of this study is that corona virus (COVID-19) has caused a global chaos where there was a complete lockdown of the whole planet as well as the collapse of the health system in many developed, developing and under-developed countries. This situation has caused a public health system and till date no decisive treatment is being confirmed so far. The present study from western Colombia focuses on the importance of traditional, cultural and generations history with reference to the use of importance and significance of medicinal plants, especially to find out a strategy to fight the new virus. The study was designed based on three major novel ethno-environmental strategies based on infusion, hot drinks, fresh baths and jelly types were identified. Based on the generated results, the calculated highest used species in the present pandemia indicates Zingiber officinale Roscoe (1.0), Eucalyptus globulus Labiil. (0.86), Citrus x limon (L.) Osbeck (0.80), Gliricidia sepium (Jacq.) Walp (0.56) and Matricaria recutita L. (0.52) were the species with the highest use. No significant difference was observed between men and women for the level of knowledge on these traditional medicinal plants. Moreover, many of the scientific information demonstrate their effectiveness in treating the respiratory infections caused due to the corona virus. The results infer the importance of traditional medicine, knowledge which needs more attention and research to counter attack the outbreak especially in medically weak health systems.

The new corona virus outbreak "COVID-19" is a respiratory disease that has affected the whole planet and it is recorded as one of the fastest spreading disease in the modern times with a high death rate (WHO, 2021) . The disease was detected in late December 2019, but it gained attention World-wide during mid-March 2020 when the whole planet went into a complete lock down with all human movements stopped as per the advice of World Health Organization (WHO 2020a). Specifically, the outbreak of the disease was traced to Wuhan, China in late 2019 early 2020 and it spread around exponentially in a roaring manner (Munster et al., 2020) . The most important symptoms are high fever, cough and fatigue and in the worst case it affected the respiratory system where the patient ultimately dies (Huang et al., 2020; Stower 2020) . According to updated data on 21 st May 2021, nearly 165,772,430 confirmed cases are reported world-wide and 3,437,545

persons have lost their lives due to this deadly pandemic (WHO, 2021) . The main attraction in this pandemia is the mortality rate which prompted the scientific community go on a war footing in search of vaccines and medications that can stop the spread of the disease and most importantly to arrest the control the mortality rate (Capell et al., 2020) .

In the present scenario, the interest in putting into practice on the traditional knowledge associated with the use of medicinal plants in particular as a strategy to mitigate the impacts of COVID-19 was identified (Li et al., 2020; Ren et al., 2020) . Recent report indicates that in the world 390,000 plant species are identified, where approximately 60,000

have been exclusively used as medicinal plants and around 26,000 of those have direct scientific evidence and confirmed through cultural practice in different geographical regions (Paredes et al., 2020; Timoshyna et al., 2020) . More importantly, the use of J o u r n a l P r e -p r o o f Journal Pre-proof medicinal plants and trade has raised in recent decades internationally with a net revenue that has tripled over time 1.3 (in 1998) to 3.3 billion USD (in 2018) (Timoshyna et al., 2020) . The growth on use of the medicinal plants has responded very well recently to meet the economic challenge of many recently during the current pandemia (Afonso et al., 2019).

Recently, in China a study indicates that the Radix glycyrrhizae rhizome Luo et al., 2020) is an option that is important for its healing properties.

Moreover, according to Chinese guidelines it can be used as a guide for treatment of 

Based on experience and with reference to the subject to assess the relevance of the study, a survey was applied using the Google Drive tool and a general questionnaire was prepared and distributed to patients with possible symptoms in the Chocó Department of Western Colombia during June/July 2020 ( Figure 1 ). The questionnaire was distributed in two different manner: 1) through emails and 2) through whatsup messages as these are the widely used online messaging softwares/ programs used in this region of Colombia. The questionnaire was focused on just six different easy enquiry which will brought the answers Table T2 ). The number of participants was also not pre-fixed, but due to the low response of participants the response was very low and it was decided to close the questionnaire, which was also statistically sufficient for any general analysis. Moreover, based on ethnobiological concepts has been applied in the present study and due to the present limitations 100 participants has only been presented (Albuquerque et al., 2014) .

The plants used during the treatment were recognized by photographs and the description of the diagnostic characteristics of the participants. The plants were also identified using the list of plants (https://www.theplantlist.org) and the virtual herbarium of the Universidad Nacional de Colombia (https://www.biovirtual.unal.edu.co/ nombrecomunes/en) were consulted to corroborate scientific names assigned to each species (Hoffman and Gallaher, 2007; Nesbitt 2014) . Herbarium data information was extracted from the already published data and was compared with the ethnobotanical data (Nesbitt, 2014) . In addition, the plant species was also identified based on the herbarium list in Universidad Tecnológica del Choco, Colombia in Department of Choco, Colombia, which was validated with all available scientific names. The whole data was organized based on genus and species as categorized along with the WHO International Classification 

The present study was approached in a mixed way which was focused on ways to because it was not considered as an ethnobotanical study.

The collected information was tabulated in an Excel spreadsheet and was purified until obtaining the necessary information for our analysis. The use value index that refers to the importance of use that a given species has according to its reporting frequency in the sampling was applied and is obtained through the following process explained in equation 1 (Castellanos 2011).

Where, UV is the use of value index of the species usage. The maximum value is calculated by the most species used that obtained the highest report in the entire individual sample (ie the most used). Moreover, it can be a same species or a different species. The UV is varies between o and 1, where 1 being the species with higher values which is highly sought for and used regularly. Significant differences were evaluated between men and 

Where, nif is equal to the number of informants citing the species, and n equal to the total number of informants.

Where, use of species (s) is equal to the number of citations for each species and (nis) number of people surveyed.

In a direct attempt to understand the use of medicinal plants, direct interviews were video recorded on the experience undergone during the treatment and only willing COVID-19 patients who wished to share the direct evidence of the process involved in using the traditional medicinal plants are presented in this study.

J o u r n a l P r e -p r o o f Journal Pre-proof

Based on the results from the questionnaire the results generated in this study are presented based on botanical importance and its use with reference to cultural heritage.

The 

Based on the results, the participants were divided into 75 women and 25 men. 

The thirty-seven species, three different patterns of formulas associated with the treatment of COVID-19 were identified. They were seen as: infusion / or hot drinks (56%), cool bath (33%) and jelly/ or syrup (11%). According to the information reported by the participants, the acquisition of the botanical formulas obtained were of the following order:

Cultural beliefs (64%) > Recommended (24%) Other (7%) > Acquired from internet (5%) respectively (Suppl. Figure 1) .

Overall, 19 persons reported having been infected with the disease and have described in detail on how they used the medicinal plants the formulas they adopted during the treatment process ( Table 2 ). The main observation in the formulas documented were accounted as cooked (various medicinal plants), fresh bathing (using leafs), mixing the aromatics with lemon (to drink), fermented drinks (based on different mixtures) and

inhalations (steam vapor generation).

The traditional knowledge associated with medicinal plants nowadays is taking on wide spread importance worldwide, possibly due to the appearance of the new disease of COVID-19 (Luo et al., 2020) . Traditional medicine reveals the exclusivity of many plants used for the treatment based on health problems. During these treatments, notable differences are observed between one botanical family and another based on its distribution and sociocultural importance (Hedge, 1992; Gras et al., 2019) . During the present treatment process, mostly C. citratus (Lemongrass) was used as an ancestral medicine in communities of this region and this is well supported by its use in the southwest Asian countries (Shah et al., 2011) . Its healing potential is attributed to the presence of essential oils which includes terpenes, alcohol esters, aldehydes and ketones 

Ethnobotanical studies have increased widely during the present COVID-19 pandemia especially in underdeveloped and smaller countries (Jasmine et al., 2017) . However, many studies are required to help validate the effectiveness of these medicinal plants . In the present situation, government guidelines can be advanced to promote public health policies linked to traditional medicine (based on medicinal plants) that can J o u r n a l P r e -p r o o f save some live around the world (Ang et al., 2020b; Xu and Zhang, 2020) . In addition, computational (in silico) studies, drug repurposing and genetic engineering will be a good ally in finding a safe and effective treatment against COVID-19 (Khan and Al-Balushi, 2021).

Historical evidences evaluated during the 20 th and 21 st century suggest that during various pandemic, the medicinal plants have played a role in the treatment process before the arrival of major vaccine (Suppl . Table T3 ).

In the 20 th century 1957-58 "Asian Flu" outbreak, species like Garlic Red, Spider lily, and la equinaceae was used. During the 1960´s when the "Dengue virus" arrived various species related to Papaya, Mint, Eucalyptus, Lemon grass, Mat grass were widely 

The results generated from this cultural and traditional based study for treating COVID-19 patients justify the role of society and how it has been helpful in counteracting the outbreak to some extent. Generally, the study also suggests the commonly used plants The plant is cooked and lemon juice is added and it is taken hot PCS Several leaves are cooked, lemon is added and it is drunk in hot aromatics AMG Leaves are cooked and fresh baths are given from head to toe MT Leaves are crushed in water, then strained and fresh baths are prepared JLE Cook a piece of the rhizome, add lemon to taste and drink hot AC Crush several cloves of garlic, chop the onion, then mix and take a tablespoon three times a day NLCJMZ Three oranges, four lemons, two cinnamon sticks, a fist of chamomile, a piece of ginger are squeezed, then all the ingredients are cooked in two liters of water and taken hot in the mornings and nights HA

The leaves are cooked and taken in hot aromatics and infusion JEMZLI In a liter of boiling water, add three centimeters of ginger, three cross-cut lemons, seven lemongrass leaves, add honey and drink hot J o u r n a l P r e -p r o o f MGSES The leaves are crushed in water and left to serene for a day. Then fresh baths are given for after days in the mornings, then several days are allowed to pass and the elderberry with santamaria is added. Subsequently, hot drinks and infusion of garlic, lemon, ginger, lemongrass are taken during the treatment EJ 1/4 of panela, a piece of ginger rhizome, a crushed garlic clove, onion juice, lemon and chamomile juice and zest, boil the ingredients for half an hour. Then inhalations are made and a cup is taken three times a day for a week Code: E = Eucaliptus; MZ = Manzanilla; PCS = Prontoalivio + Celedonia + Sauco; AMG = Anamú + Matarratón + Guácimo; MT = Matarratón; JLE = Jengibre + Limón + Eucaliptus; AC = Ajo + Cebolla; NLCJMZ=Naranja + Limon + Canela + Jengibre + Manzanilla; HA = Hierbabuena + Albahaca; JEMZLI = Jengibre + Eucaliptus + Manzanilla + Limoncillo; MTGSES = Matarratón + Galve + Sauco + Espabonilla; EJ = Eucaliptus + Jengibre. *Note: Do not drink hot drinks during treatment. Supplementary Figure F1 Frequency and ways of using plants. Plants were grouped into three large groups of formulas. Infusion and hot drinks = (2 + 3 + 4 + 6 + 7 + 8 + 9 + 19 + 20 + 21 + 24 + 27 + 28 + 29 + 26 + 10 + 11 + 12 + 13 + 14 + 16 + 17 + 18 + 32 + 30 + 33 + 34 + 35 + 36) = hot drinks are made in panela water or made only in water. Panela or honey is also added and inhalations are made during the night and in the morning. In some cases they are taken as ordinary water. Fresh baths (1 + 5 + 15 + 22 + 23 + 25) = macerate and head-to-toe baths to control body temperature. Jelly (31 + 37) = the leaves are crushed and honey is added to it and one tablespoon is taken three times a day.

Graphical abstract J o u r n a l P r e -p r o o f

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The local help provided by each participants are greatly appreciated. LCT