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The COVID-19 pandemic has induced dramatic effects on the population of the industrialized north of Italy, whereas it has not heavily affected inhabitants of the southern regions. This might be explained in part by human exposure to high levels of fine particulate matter (PM) in the air of northern Italy, thus exacerbating the mortality. Since trees mitigate air pollution by intercepting PM onto plant surfaces and bolster the human immune system by emitting bioactive volatile organic compounds (VOCs), we hypothesize a protective role of evergreen forested areas in southern Italy. We compared the mortality rate due to COVID-19, the death number, the positivity rate and the forest coverage per capita in various Italian regions. Hectares of forest per capita and prevalence of deciduous versus evergreen forestal species were also estimated. In silico docking studies of potentially protective compounds found in Laurus nobilis L., a typical Mediterranean plant, were performed to search for potential antivirals. We found that the pandemic’s severity was generally lower in southern regions, especially those with more than 0.3 hectares of forest per capita. The lowest mortality rates were found in southern Italy, mainly in regions like Molise (0.007%) and Basilicata (0.005%) where the forest per capita ratio is higher than 0.5 Ha/person. Our findings suggest that evergreen Mediterranean forests and shrubland plants could have protected the southern population by emission of immuno-modulating VOCs and provision of dietary sources of bioactive compounds. Moreover, in silico studies revealed a potential anti-COVID-19 activity in laurusides, which are unexplored glycosides from bay laurel. Overall, our results highlight the importance of nature conservation and applications to the search for natural antivirals.
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Environmental Chemistry Letters
https://doi.org/10.1007/s10311-020-01063-0
ORIGINAL PAPER
Lower COVID‑19 mortality inItalian forested areas suggests
immunoprotection byMediterranean plants
ValentinaRoviello1 · GiovanniN.Roviello2
Received: 19 June 2020 / Accepted: 28 July 2020
© Springer Nature Switzerland AG 2020
Abstract
The COVID-19 pandemic hasinduced dramatic effects on the population of the industrialized north of Italy, whereas it has
not heavily affected inhabitants of the southern regions. This might be explained in part by human exposure to high levels of
fine particulate matter (PM) in the airof northern Italy, thus exacerbating the mortality. Since trees mitigate air pollution by
intercepting PM onto plant surfaces and bolster the human immune system by emitting bioactive volatile organic compounds
(VOCs), we hypothesize a protective role of evergreenforested areas in southern Italy. We compared the mortality rate due
to COVID-19, the death number, the positivity rate and the forest coverage per capita in variousItalian regions. Hectares of
forest per capita and prevalence of deciduous versus evergreen forestal species werealso estimated. In silico docking studies
of potentially protective compounds found in Laurus nobilis L., a typical Mediterranean plant, were performed to search for
potential antivirals. We found that the pandemic’s severity was generally lower in southern regions, especially those with more
than 0.3 hectares of forest per capita. The lowest mortality rates were found in southern Italy, mainly in regions likeMolise
(0.007%) and Basilicata (0.005%) where the forest per capita ratio is higher than 0.5 Ha/person. Our findings suggest that
evergreenMediterranean forests and shrubland plants could have protected the southern population by emission of immuno-
modulating VOCs and provision of dietary sources of bioactive compounds. Moreover, in silico studies revealed a potential
anti-COVID-19 activity in laurusides, which are unexplored glycosides from bay laurel. Overall, our results highlight the
importance of nature conservation and applications to the search for natural antivirals.
Keywords SARS-CoV-2· COVID-19· Air pollution· Particulate matter· Forest bathing· Mediterranean vegetation·
Laurus nobilis· Plant therapeutics· Plant toxicity· Mpro inhibitors
Introduction
COVID-19 (COronaVIrus Disease 19) is a novel disease
characterized in several cases by severe pneumonia, caused
by severe acute respiratory syndrome coronavirus 2 (SARS-
CoV-2) previously indicated as 2019-new coronavirus
(2019-nCoV). COVID-19 emerged in Wuhan, central China,
in December 2019 (Lai etal. 2020; Wu etal. 2020). How-
ever, COVID-19 hasspread rapidly worldwide, becoming a
global issue with several countries all over the world report-
ing numerous cases of infection (Hunter 2020). This led the
world health organization (WHO) to declare it a pandemic
on 11 March 2020 (Sinonquel etal. 2020).
SARS-CoV-2 is a betacoronavirus closely related to other
bat-derived severe acute respiratory syndrome (SARS)-
like coronaviruses (Lu etal. 2020; Park etal. 2020), and
it is a subject of several research studies in environmental
chemistry in the attempt to understand its behaviour in the
environment (Sharma etal. 2020). This virus is also related
to the SARS-CoV-1, sharing about 79% genomic identity,
which caused SARS in 2002–2003 (Anderson etal. 2004),
a coronaviral epidemic which led to deaths mainly in Asia
(Anderson etal. 2004).
Recently, the ESA (European Space Agency) and NASA
(U.S. National Aeronautics and Space Administration)
Electronic supplementary material The online version of this
article (https ://doi.org/10.1007/s1031 1-020-01063 -0) contains
supplementary material, which is available to authorized users.
* Giovanni N. Roviello
giroviel@unina.it; giovanni.roviello@cnr.it
1 Department ofChemical, Materials andIndustrial
Production Engineering (DICMaPI), University ofNaples
Federico II, Piazzale V. Tecchio 80, 80125Naples, Italy
2 Istituto Di Biostrutture E Bioimmagini IBB - CNR, Via
Mezzocannone 16, 80134Naples, Italy
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released data showing that pollution in the main epicentres
of COVID-19 such as China, a country heavily affected by
air pollution (Feng and Zheng 2019), Italy, Spain and the
USA, has reduced significantly, up to 30% (Muhammad
etal. 2020), even though an unexpected rise of ozone air
pollution (Yu 2018) was observed in both urban and rural
areas (Wang etal. 2020). On the other hand, several studies
showed that air pollution is a risk factor for acute respira-
tory infection by affecting the body’s immune system and by
carrying microorganisms (Cai etal. 2007; Susanne Becker
1999; Sun etal. 2016; Xie etal. 2019). It was also shown
that environmental pollutants are in correlation with the
severity of COVID-19 (Bashir etal. 2020; Zhu etal. 2020)
and, in particular, particulate matter (PM) (Mukherjee and
Agrawal 2017, 2018; Dang and Shan 2017) in combination
with humidity significantly increases the risk of COVID-19
incidence (Jiang etal. 2020).
This would suggest that air pollution control can
reduce the harmful effects of the global pandemic (Bashir
etal. 2020). The air quality effect on the confirmed cases
of COVID-19 was stronger in the temperature range of
10–20°C, while the relative risk of COVID-19 transmission
associated with air quality was higher in the 10–20% relative
humidity range, suggesting a higher impact of air quality
on the COVID-19 spread under low relative humidity (Xu
etal. 2020). Northerly latitude was generally associated with
increased mortality and hospitalization rates for COVID-19
worldwide due to several factors such as the deficiency of
vitamin D, a vitamin with immuno-modulatory properties,
caused by low ultraviolet exposure, as well as low tempera-
ture and relative humidity conditions allowing the virus to
survive longer outside the human body (Panarese and Sha-
hini 2020).
Interestingly, several Mediterranean countries have expe-
rienced a milder impact of the virus, with low morbidity
and mortality linked to COVID-19 (Panarese and Shahini
2020). This can be explained by the rigorous control meas-
ures taken by the local governments who did not ignore the
lessons from northern Italy (Frogoudaki 2020; Saglietto
etal. 2020). Nevertheless, in concurrence with the measures
put in place, the above-cited effects of latitude, climate, the
availability of vitamin D as well as other environmental fac-
tors together with the Mediterranean diet could have resulted
in the more favourable outcome recorded in the Mediterra-
nean area (Cena and Chieppa 2020).
Italy showed significant regional differences in the impact
of COVID-19, with it being more dramatic in the north when
compared to the significantly milder situation observed in
the south (Signorelli etal. 2020).
Owing to the importance of trees in air pollution mitiga-
tion, as emitters of bioactive volatile organic compounds
(VOC) and as having beneficial effects in bolstering the
body’s immune system, we decided to explore the impact of
COVID-19 in the Italian regions in relationship to the abun-
dance of forest cover. Moreover, as an example, we inves-
tigated a typical Mediterranean plant, i.e. bay laurel (Lau-
rus nobilis L.) (Alessi etal. 2018), as a source of potential
anti-COVID-19 natural products, studied in silico for their
abilities to bind Mpro, the main protease of SARS-CoV-2 (Jin
etal. 2020). They were also studied for their toxicity with a
particular attention paid to laurusides, a scarcely explored
class of compounds from laurel that could disclose interest-
ing biological activities (Duc Dat etal. 2019).
Experimental
Estimation offorest area/inhabitant andother
parameters mentioned inthis work
The 2015 forest area data for the Italian regions, released
by Italian National Forest Service (INFC), are available in
the table reported on page 4 (CREA INFC 2015) of the fol-
lowing link: https ://www.polit ichea grico le.it/flex/cm/pages
/Serve Attac hment .php/L/IT/D/7%252Fe %252Fd %252FD
.fad37 6b863 247ad 7355a /P/BLOB%3AID%3D146 52/E/pdf.
To calculate the forest area per capita values of TableS1
(see Results and Discussion) for each region, we divided
the number of hectares of forest reported at the link above
by the number of inhabitants (reported at the link https ://
dati.istat .it/Index .aspx?Query Id=18460 &lang=en). We esti-
mated prevalence of deciduous vs. evergreen forestal species
in Aosta Valley, Trentino and South Tyrol regions (Results
and Discussion) by using the data furnished by INFC, avail-
able at the link: https ://www.sian.it/inven tario fores tale/caric
aDocu mento ?idAll e=421 COVID-19 data for Italian regions
were reported at the link https ://en.wikip edia.org/wiki/
COVID -19_pande mic_in_Italy (data as of 20 May 2020).
Molecular docking
The three-dimensional structure of the protein target from
SARS-Cov–2, i.e. the main protease Mpro (PDB ID: 6YB4),
was obtained from Protein Data Bank (Berman etal. 2002).
The 2D structures for the ligands were retrieved from
PubChem database (https ://pubch em.ncbi.nlm.nih.gov/),
while those not available in PubChem were drawn using the
molecular editor provided in 1-Click Mcule (Mcule Inc.,
Palo Alto, CA, USA) (Potemkin etal. 2019; Fik-Jaskółka
etal. 2020a,b, a; Kiss etal. 2012), a web-based platform
powered by AutoDock Vina docking algorithm (Trott and
Olson 2009) by which we realized our docking experi-
ments. The atomic coordinates of the binding site were
those reported in the recent literature (Umesh etal. 2020) (X:
9.204, Y: − 4.557 and Z: 19.602), and the size of the binding
site was 22 Angstrom. We selected the docking poses with
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the most negative docking scores (kcal/mol) corresponding
to the highest binding affinities. We validated the method
applying it to other literature dockings targeting Mpro, find-
ing our binding energy scores in line with those previously
reported for carnosol (Umesh etal. 2020), apixaban and
other ligands docked to the same protein target (Chakraborti
etal. 2020). The molecular graphics program incorporated
in 1-Clik Mcule was used for structural visualization of
protein–ligand interactions and to obtain the snapshot of
Fig.4,while the protein–ligand interaction diagram shown
in the same figure was obtained by ProteinsPlus (https ://
prote ins.plus/) (Rarey etal. 2020).
Potential oral lethal dose toxicity class
determination andother toxicity parameters.
The potential oral lethal dose toxicity class forlauruside 5
and reference compounds was evaluated on the ProTox web-
based server (tox.charite.de). The toxicities are classified
into six classes (I-VI) (Drwal etal. 2014) and the predicted
toxic doses (in rodents) were reported as LD50 values in mg/
kg body weight. ProTox also suggested the potential toxicity
targets for lauruside 5.
Results anddiscussion
COVID‑19 impact inItalian regions withdierent
forest cover areas
Comparing the number of deaths due to COVID-19 with
rates of forest area per inhabitants in the different Italian
regions (Fig.1, TableS1), we found there to be generally
less deaths in the regions having 0.34 hectares of forest/
number of inhabitants.
If one considers the Italian regions which have to date (as
of 26th May 2020) less than 300 fatalities related to SARS-
CoV-2 infection (TableS1), all but Sicily are endowed with
almost an acre of forest per capita (TableS1). Normalizing
the number of victims by total population, we observed that
5 out of 7 regions with less than 0.01% COVID-19 deaths/
total population still had at least 0.34 hectares of forest/
number of inhabitants. Peculiar features including proximity
Fig. 1 Bar graphs showing the abundance of forest areas (a) as well
as some parameters useful to describe the COVID-19 impact on
local populations within eight representative regions of Italy. These
include the percentage of COVID-19 fatalities/number of inhabitants
(b), positivity rates (c) and the number of deaths (d). Note the higher
coronavirus impact on regions like Emilia Romagna, Lombardia and
Veneto which have less than 0.2 hectares of forest per capita when
compared to the significantly more favourable situation within the
regions where the above ratio was higher than 0.34 hectares/inhabit-
ant
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to the coast of the largest cities, particularly mild weather,
presence of cultivated areas with Mediterranean orchards
and Mediterranean wild shrubland with oleanders (Nerium
Oleander L.), holm oaks (Quercus Ilex L.), wild olive trees
(Olea europaea L.) or other plants with promising effects on
air pollution mitigation (Blanusa etal. 2015; Abed-Esfahani
etal. 2013a,b; Kaur and Nagpal 2017), could all account for
the favourable outcome of Sicily. This latter, in fact, pre-
sents the third lowest percentage of positive COVID-19 tests
(3.0%, TableS1) after Calabria (2.7%) and Basilicata (2.4%).
Interestingly, the two italian regions with the lowest mortali-
ties due to COVID-19, i.e. Molise and Basilicata, are also
situated in southern Italy and have high ratios of hectares
of forest/number of inhabitants: 0.56 and 0.70, respectively
(Fig.1, TableS1). Examining the same aspects for northern
Italy, we still found higher forest areas per inhabitant in the
regions with lower numbers of deaths due to COVID-19.
Remarkably, Lombardy, having the lowest forest area per
capita within northern Italy, was not only the region with
the highest number of COVID-19 victims (> 15,000, Fig.1,
TableS1), but it also had the highest level of occupancy
of intensive care unit beds (Odone etal. 2020) as well as
the highest rate of positive tests (23.8%, Fig.1, TableS1).
Within the northern regions with less than 300 COVID-19
victims, this rate (4.7–17.1%) was lower than Lombardy, but
generally higher than the ‘greener’ regions of southern Italy
(2.4–3.8%, TableS1). As an example, South Tyrol (520,000
inhabitants, northern Italy) presents a similar forest area per
capita (~ 0.7 Ha/person) compared to Basilicata (560,000
inhabitants, southern Italy), but a ~ 5 times higher rate of
positive tests (TableS1). This could be associated to sev-
eral factors including differences in virus abundance, due
to obvious different geographic distances from the regions
where the pandemic started in Italy (Odone etal. 2020), but
which could also include the differences in latitude, climate,
proximity to coast and the local diet. Nevertheless, there
is the possibility that the Mediterranean vegetation present
in the southern regions of the country could be playing a
protective role.
When comparing the neighbouring South Tyrol and
Trentino, we notice that the former, with forests composed
mainly of evergreen trees (see Experimental section) has a
significantly lower rate of COVID-19 deaths/total population
(0.053%) than the latter (0.084%) which has a large pre-
dominance of winter-dormant deciduous trees (see Experi-
mental section). Interestingly, Aosta Valley, despite its very
high ratio of hectares of forest (butwith a significant rate of
deciduous trees, see Experimental section)/number of inhab-
itants (0.89 Ha/person) presents a COVID-19 death rate per
total population that is more than 10 times higher than that
of Molise (0.007%) and Basilicata (0.005%). Lockdown
measures were undertaken in Aosta Valley at the same time
as these two regions. This difference could be tentatively
explained on the basis of a combination of factors besides
the most obvious, i.e. distance from COVID-19 epicentre
and the intense winter tourism fluxes in Aosta Valley from
Lombardy: latitude, sunlight/climate and the abundance in
southern Italy of Mediterranean plants, both cultivated and
spontaneous trees. Remarkably, studying the pandemic in
Italy using the basic reproduction number R0, average num-
ber of people that can be infected by an already infected
person, the four lowest R0 values determined by Distante
etal. (Distante etal. 2020) were given to the four southern
regions with the highest forest cover area per inhabitant.
A hypothesis of association between severity of the cur-
rent pandemic of COVID-19 and high levels of fine par-
ticulate matter (PM) in urban areas, an issue in Lombardy
and other areas of northern Italy, was recently brought forth
(Conticini etal. 2020). In fact, the particulate matter could
play a role in spreading the SARS-CoV-2 virus in the air
(Setti etal. 2020) and is also linked to respiratory patholo-
gies in turn responsible for higher COVID-19 mortality rates
(Dutheil etal. 2020). Fine PM penetrating into the respira-
tory system can easily provoke inflammatory responses as
well as cardiovascular and pulmonary diseases, thus exac-
erbating respiratory distress. This seemed particularly evi-
dent in northern Italy where COVID-19 disease provoked
the highest number of victims in the country, as well as one
of the most worrying situations worldwide, and where PM
concentrations of ≥ 50µg/m3 as PM10 daily averages were
often recorded (Setti etal. 2020).
The beneficial role of trees in removing air pollution
is well known and described in the literature (Grzędzicka
2019). In fact, by intercepting the particulate matter on
leaves and other plant surfaces, and absorbing gaseous pol-
lutants through their leaf stomata, urban trees are notoriously
adept to air purification (Nowak etal. 2014, 2018). In this
context, several plants belonging to the class of Mediter-
ranean vegetation, such as the holm oak (Quercus ilex L.),
bay laurel (Laurus nobilis L.) and others, were found able
to cleanse the atmosphere, trapping among other pollutants
several polycyclic aromatic compounds (Sgrigna etal. 2015;
Gratani and Varone 2013; Fellet etal. 2016). Owing to the
role of urban forests in decreasing concentrations of particu-
lates and other pollutants, thus improving air quality, it was
recently argued that they can also contribute to reducing the
impact of COVID-19 (Fares etal. 2020).
Mediterranean trees assources ofbiogenic volatile
organic compounds withimmune‑modulatory
activities
We have analysed the literature data on the protective role
of Mediterranean plants, viewed as unique sources of use-
ful metabolites displaying positive effects against various
pathogens (Kahkha etal. 2013), within the context of the
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current pandemic episode. We payed particular attention to
the effect on the human immune system triggered by the
inhalation of volatile compounds emitted by trees. We found
that ‘forest bathing’, the practice of visiting a forest for its
health benefits, has positive effects, especially on the human
immune function (Li 2009), which last more than one week
post-exposure (Li etal. 2008). These include the increase
in natural killer (NK) activity, mediated by increased NK
cell numbers and intracellular granulysin, perforin and gran-
zymes A/B release, with reported effects against tumours
and virus-infected cells (Li 2009). We also found several
literature reports on the beneficial effects of some plant ter-
penes on the anti-inflammation response elicited by these
volatile organic compounds (VOC) on airway inflammation
in animal models (Kim etal. 2020), as well as reports on
essential oil components able to reduce pulmonary inflam-
mation induced by air pollution (Kfoury etal. 2016).
Borneol and terpineol have been shown to have anti-
asthmatic activity, inhibiting invitro bronchoconstriction in
guinea pigs (Kim etal. 2020), whereas a placebo-controlled,
double-blind trial revealed the clinical efficacy of 1,8-cineole
in inflammatory airway diseases, such as chronic obstruc-
tive pulmonary disease and asthma (Worth and Dethlefsen
2012; Juergens 2014). A positive therapeutic effect of bornyl
acetate, a volatile compound isolated from twigs, leaves and
fruits of several plants including the Mediterranean Laurus
nobilis L. (Fidan etal. 2019), has been reported for the treat-
ment of lung inflammation in an animal model of acute lung
injury (Chen etal. 2014). Moreover, α-pinene was effective
for treatment of allergic rhinitis (Nam etal. 2014), while
β-caryophyllene has demonstrated both anti-inflammatory
and antinociceptive activity (da Silva etal. 2020; Klauke
etal. 2014). Since COVID-19 emerged in Italy during the
cold season, we wondered whether the VOC emissions in
Mediterranean countries were completely inhibited dur-
ing fall and winter months. Through literature analysis, we
found that even though biogenic VOCs are emitted in larger
amounts by plants during spring and summer than during
fall and winter, significant amounts of bioactive terpenes
can still be detected in Mediterranean ecosystems during
winter. This phenomenon has also been observed with beta-
caryophyllene, whose winter emission from Cistus mon-
speliensis L. was similar to that found during spring and
six times higher than the amount detected during summer
(Rivoal etal. 2010).
Mediterranean trees are classified as isoprene, α-pinene,
linalool and limonene emitters, and the most representative
of these is the Mediterranean oak, i.e. Quercus ilex L., also
known as holm oak, which is able to release in the air up to
19 VOCs (Owen etal. 2001). More abundant VOCs in Lau-
rus nobilis L are β-pinene (19.44%), 1,8-cineole (19.38%),
β-caryophyllene (8.55%) and sabinene (7.91%); however,
numerous other volatile compounds are found in lesser
amounts in this Mediterranean plant (D’Auria and Racioppi
2015).
Antiviral activity ofnatural compounds
fromMediterranean plants
Besides the study of plant VOCs with beneficial effects on
the immune system, we also focused on several other com-
pounds with therapeutic potential which are contained in
vegetal sources. We analysed the literature reports finding
that several Mediterranean plants of culinary use, such as
Salvia officinalis L., Satureja thymbra L. and Laurus nobi-
lis L., are used as folk remedies in different countries to
treat numerous diseases including viral ones (Loizzo etal.
2008). Strikingly, one of the most promising anti-COVID-19
candidates emerged by our literature analysis is Laurus
nobilisL. oil, characterized by the presence of β-ocimene,
1,8-cineole, α -pinene and β-pinene as its main constituents,
which exerted an interesting activity against SARS-CoV-1
with anIC50value of 120μg/ml and a selectivity index (SI)
of 4.16 (Loizzo etal. 2008). Laurus nobilis L. is a typical
Mediterranean plant, constituent of Laurisilva forests (Pig-
natti etal. 2015), commonly used as a flavouring agent for
food preparation, but also endowed with many biological
activities. These antioxidant and antimicrobial properties are
due to the chemical composition of the essential oil found
within its leaf which varies depending on the latitude and
climate of its cultivation site (Riabov etal. 2020).
For its part, Pistacia vera L. kernels and seeds showed
significant activity against Herpes simplexandParainflu-
enzaviruses in cell experiments (Özçelik etal. 2005). The
chemical components of the methanolic extract of Onopor-
dum illyricum L. aerial parts showed significant inhibition
activities against human immunodeficiency virus 1 (HIV-1)
reverse transcriptase, but also against HIV-1 integrase and
blocked viral replication in cell-based assays (Sanna etal.
2018). The ethyl acetate and methanol extracts of Daucus
virgatusexhibited significant inhibitory effects againstCox-
sackievirus B, a small RNA virus of the Picornaviridae fam-
ily (Snene etal. 2017). Worthy of note is the fact that the
wood extract from one of the most abundant trees in the
Mediterranean forests, Quercus ilex L., showed antiviral
effects against (H9N2) influenza and bovine viral diarrhoea
(BVD) viruses, this latter being a pestivirus model of hepa-
titis C virus (HCV), on MDCK cells (Yousef etal. 2014a, b).
In addition, we also explored the published data on the
olive tree (Olea europaea L.), a symbol of the Mediterra-
nean world since ancient times, and found that it is used as
a folk remedy for the cure of numerous disorders including
those of viral origin (Hashmi etal. 2015). This practice has
found scientific justification through the demonstrated anti-
viral activity of olive leaf extracts, safe both for our health
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and the environment, and the effectiveness of its main con-
stituent oleuropein (Micol etal. 2005).
Laurus nobilis againstSARS‑CoV‑2: insilico studies
onpotential laurel‑derived inhibitors ofSARS‑CoV‑2
main protease (Mpro) andtoxicity prediction
We decided to investigate laurel components as potential
anti-COVID-19 drugs starting from the evaluation in silico
of their binding affinity for one of the main viral protein tar-
gets. In fact, as reported in the previous section, an invitro
investigation on the biomedical properties of the essential
oil taken from Laurus nobilis L. revealed its potential anti-
viral activity against SARS-CoV-1 (Loizzo etal. 2008). This
called our attention to its possible therapeutic use against the
genetically close SARS-CoV-2, a hypothesis which has also
been brought forth in recent literature (Hensel etal. 2020).
The essential oil from the aerial parts of the plant, which
contains the monoterpenes 1,8-cineol and β-ocimene, and
the sesquiterpene dehydrocostus lactone in larger amounts
than other essential oils, inhibited the replication of SARS-
CoV-1 invitro (Loizzo etal. 2008).
Furthermore, we found published reports showing that,
besides the terpenic compounds, several other phytochemi-
cal constituents were isolated from Laurus nobilis L. includ-
ing alkaloids, phenolics and megastigmanes (De Marino
etal. 2004). Within this latter group, we noticed that the
recently identified laurusides 1–7 (Duc Dat etal. 2019) are
an almost unexplored class of laurel-derived compounds
(Fig.2).
Among the coronaviral protein targets evaluated in
computational studies, Mpro (also called 3CLpro) protease
represents a first choice potential target for the inhibition
of SARS-CoV–2 replication. This is a well-characterized
protein of SARS-CoV–2 which shares 96% identity with
SARS-CoV-1 Mpro (Zhang etal. 2020) and has a key role in
Fig. 2 Laurus nobilis L. plant foliage and molecular structure repre-
sentation of some of the compounds extracted from laurel with the
highest predicted affinity for SARS-CoV-2 main protease (Mpro). Of
these, Laurusides 1,2,5,6 and 7 belong to the class of laurel glyco-
sides, while 3α-acetoxyeudesma-1 4(15) 11(13)-trien-12 6α-olide and
Kaempferol are classified as sesquiterpene and flavonoidcompounds,
respectively. Photograph taken by Dr. V. Roviello in Aversa, South
Italy on 21 May 2020
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the coronaviral life cycle. All these aspects, together with
the absence of any similar protein homologues in humans,
rendered it an attractive target for our anti-COVID-19 drug
discovery. One should note that some of the repurposed
treatments for COVID-19 (Costanzo etal. 2020) are protease
inhibitors such as the lopinavir–ritonavir combination (Man-
gum and Graham 2001). Based on the importance of Mpro as
a drug target in the fight against SARS-CoV–2, we focused
on several phytochemicals derived from the bay laurel for
their potential antiviral activity towards the novel coronavi-
rus studied by docking to the main protease Mpro of SARS-
CoV-2. By using 1-Click Mcule docking server (Potemkin
etal. 2019; Kiss etal. 2012), which makes use of AutoDock
Vina software (Trott and Olson 2009), we have analysed
44 laurel-derived compounds. Nine molecules, belong-
ing to three molecular families: laurusides, sesquiterpene
lactones and tetrahydroxyflavones, showed high affinity
scores towards SARS-CoV-2 Mpro, with ≤ − 7.0 kcal/mol
binding energy values for the top ranked poses, as shown in
Fig.3 and TableS2.
Six out of nine of these ligands belong to the family of
laurusides described by Duc Dat etal. (Duc Dat etal. 2019),
natural products extracted by Laurus nobilis L. able to
inhibit, in cell, the lipopolysaccharide (LPS)-induced nitric
oxide release.
In particular, lauruside 5 showed in silico the lowest
binding energy (− 8.2kcal/mol, BE for the top scoring
pose, and 7.5kcal/mol, average score; Fig.3, TableS2)
and, thus, the highest affinity for Mpro. Other good affinity
scores were found for laurusides 1, 2, 6 and 7, as well as for
kaempferol (− 7.4kcal/mol, score of the top ranked pose).
We examined the pose corresponding to the lowest energy
Fig. 3 Bar graph showing the predicted binding energy (BE) scores
in kcal/mol (as obtained by 1-Click Mcule web-based docking pro-
gram) for different classes of compounds, such as volatile compounds
and glycosides, found in the Laurus nobilis L. plant. Bars indicat-
ing the binding energy for the compounds with the highest affinities
for the protein target, SARS-CoV-2 main protease (Mpro; PDB ID:
6YB4), are evidenced in red
Environmental Chemistry Letters
1 3
for lauruside 5 and observed that this glucoside derivative
was involved in multiple H-bonding with residues Ser46,
Asn142, His163, Glu166 and Gln189 (Fig.4). These latter
interactions were previously reported for the interaction of
carnosol to the same protease target (Umesh etal. 2020).
We evaluated in silico the toxicity of the most promising
candidates belonging to the lauruside group by using the
program ProTox (tox.charite.de) and found, with a predic-
tion accuracy of ~ 70%, that all of them are assigned to the
predicted toxicity class IV (see as an example Fig. S1 for
lauruside 5, TableS3), that is the same corresponding to the
commonly-used anti-COVID-19 drug hydroxychloroquine
(Peytavin etal. 2020) (Fig. S3), with apredicted median
oral lethal dose (LD50) in rodents for the most promising
lauruside 5 of 2500mg/kg (Fig. S1). Possible toxicity targets
were predicted as Amine Oxidase A and Prostaglandin G/H
Synthase 1 (Fig. S2). On the other hand, the predicted toxic-
ity class (class V) of kaempferol (Fig. S3, TableS3) suggests
a higher biosafety potential for this tetrahydroxyflavone iso-
lated from Mediterranean plants, even though its affinity for
Mpro is lower than lauruside 5 (TableS2).
Since AutoDock Vina software tends to underestimate the
binding affinity of the ligands for the target (Lambert etal.
2019), our complexes could be endowed with an even lower
binding energy and thus, with a higher affinity than that the-
oretically computed. In other terms, our study could serve
as a starting point for future experimental investigations
directed to characterize the above ligand–protease interac-
tions and the invitro/in vivo anti-SARS-CoV-2 effects of
the compounds extracted from bay laurel and from other
Mediterranean plants. Nevertheless, before proposing lau-
rusides as antiviral drugs or the inhalative applications of
Laurus nobilis L. oil for ameliorating the health conditions
of COVID-19 patients, the toxicity of the compounds and
the allergenic potential of bay laurel essential oil should be
carefully evaluated (Hensel etal. 2020). In this context, we
suggest that chemical modifications of lauruside 5 could lead
to structures endowed with high affinity for Mpro and, hope-
fully, with even better toxicity profiles, which could be effec-
tively and safely employed in the anti-COVID-19 treatments.
Conclusion
We analysed the impact of COVID-19 in different Italian
regions and found clues on the relationship between the
severity of the disease and certain environmental factors,
including scarcity of non-deciduous vegetation. The low-
est impact of the pandemic was observed in the southern
regions which have the highest rates of forest area per capita
(≥ 0.34 hectares/inhabitant) such as Basilicata, Calabria and
Molise. This is interesting when compared to certain regions
of northern Italy like Lombardy, Emilia Romagna and
Veneto, which have less than 0.20 forest hectares/inhabitant
and where the effects of COVID-19 were much more severe.
We have, thus, suggested that a possible protective factor
could be the presence of Mediterranean evergreen vegetation
formed by both spontaneous and cultivated trees and shrubs.
Fig. 4 Putative best docking pose (a) and 2D protein–ligand interac-
tion diagram (b) at the active site of main protease Mpro for lauruside
5. Proximity of functional groups of the laurel glycoside to Ser46,
Asn142, Glu166 protein residues is observed in the pose view (a),
while main interactions, including H-bonds with amino acids Ser46,
Gln189, His163, Asn142, Glu166, are evidenced in the diagram (b).
Note the highly stabilized nature of the predicted lauruside-protease
complex due to the multiple H-bonding possibilities given by the
interactions of the compound hydroxyl moieties with the protein
amino acids
Environmental Chemistry Letters
1 3
In our hypothesis, we speculate that during the mild winter
of the Mediterranean regions, non-deciduous plants main-
tain, even though at a lower level, activities of air depuration
and biogenic VOC emission able in some cases to bolster the
human body’s immunity and, thus could have contributed to
the protection of southern populations from SARS-CoV-2.
Nevertheless, mild climate, higher average sunlight exposure
and the Mediterranean diet, which includes the consump-
tion of foods containing polyphenols and natural compounds
with potential antiviral activities, could have all contributed
in the defence against the pandemic. As an example, we
examined more than forty compounds discovered in bay
laurel, a typical Mediterranean evergreen tree of common
culinary use, and found that nine of them had a significantly
high affinity for SARS-CoV-2 main protease Mpro, one of
the most important targets in the anti-COVID-19 therapeutic
strategies. Among these laurel-derived ligands, lauruside 5
emerged from our study as the most promising candidate
as a potential Mpro inhibitor. Moreover, despite its lower
binding affinity for the protease when compared to lauru-
side 5, kaempferol, a natural compound isolated not only
from Laurus nobilis L. but also from other Mediterranean
plants like Quercus Ilex L. (Sebai etal. 2019), especially
in glucosidated form (Karioti etal. 2010), could act as a
potentially effective Mpro inhibitor. Remarkably, still show-
ing an interesting predicted binding energy (− 7.4kcal/mol
for the top scoring pose), it is also endowed with an even
more favourable predicted toxicity profile (Class V) than
laurusides.
Acknowledgements We are grateful to Mr. Gergely Prikler and Mr.
Gergely Takács (Mcule team, Hungary) for their kind support in molec-
ular docking studies, and to Mrs. Melinda Gilhen-Baker (Ottawa, Can-
ada) for useful discussion and editing the manuscript for English style
and logical flow.This study was performedby the authors in smart-
working mode (activated by Consiglio Nazionale delle Ricerche-CNR
and University of Naples Federico II-UNINAduring the COVID-19
crisis).We dedicate this study to all the health-care workers, and to all
the people who suffered and still suffer around the world as a result of
theCOVID-19 pandemic.
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... [35] During the COVID-19 pandemic, studies conducted in Italy demonstrated that regions with higher forest cover experienced lower rates of infection and mortality. [36] Conversely, areas with higher levels of air pollution were associated with increased mortality rates. [37] The volatile organic compounds (VOCs) emitted by forest vegetation are thought to play a role in inhibiting the spread of viral pathogens. ...
... [37] The volatile organic compounds (VOCs) emitted by forest vegetation are thought to play a role in inhibiting the spread of viral pathogens. [36] Asthma is a chronic inflammatory disease of the airways that remains incurable. [38] The persistent inflammation of the airways leads to hyperreactivity, causing bronchoconstriction in response to triggers such as allergens, microbes, physical exertion, and emotional stress. ...
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Introduction and Purpose: This comprehensive review aims to synthesize and analyze the existing scientific literature concerning the multifaceted impact of forest bathing, also known as shinrin-yoku, on human health and overall well-being. We will delve into the historical origins of shinrin-yoku while also meticulously examining the specific health domains. Materials and Methods: A systematic search of the PubMed database was conducted to extract relevant articles published between 1975 and 2023. The search strategy employed the following key terms: "forest bathing," "shinrin-yoku," "human health," and "well-being." Results: The analysis of the retrieved data revealed a consistent pattern of beneficial physiological effects associated with forest bathing. Specifically, a reduction in heart rate, as well as systolic and diastolic blood pressure, was observed in individuals who participated in forest excursions. The biogenic volatile organic compounds (BVOCs) emitted by forest vegetation were shown to exert potent anti-inflammatory effects, inhibiting inflammatory processes implicated in conditions such as asthma, atopic dermatitis (AD), and rheumatoid arthritis (RA). Notably, a lower incidence of COVID-19 was observed in densely forested areas, potentially attributable to the natural barrier effect of forest vegetation against viral transmission and the lower levels of air pollution prevalent in these environments. Shinrin-yoku was also found to play a crucial role in maintaining mental health. In patients with dementia symptoms, forest bathing interventions resulted in improvements in language function and memory, among other cognitive domains. Conclusions: Forest bathing represents an accessible and cost-effective intervention that holds significant potential for enhancing human quality of life. Therefore, it should be considered as an integral component of a healthy lifestyle and incorporated into routine daily activities.
... in the forest and hence limits the potential impact of infectious diseases such as COVID-19 (Karjalainen et al. 2010;Roviello and Roviello 2021). Roviello and Roviello (2021) indicated in their study of the effects of forest areas on COVID-19 in Italy, that larger forest areas reduce the risk of "contamination from the jungle" while highly forested regions enjoyed the protective characteristics of the trees in the forest. ...
... in the forest and hence limits the potential impact of infectious diseases such as COVID-19 (Karjalainen et al. 2010;Roviello and Roviello 2021). Roviello and Roviello (2021) indicated in their study of the effects of forest areas on COVID-19 in Italy, that larger forest areas reduce the risk of "contamination from the jungle" while highly forested regions enjoyed the protective characteristics of the trees in the forest. On the other hand, contact with forested areas through exploration and deforestation exposes the population to certain diseases that would otherwise have been confined to the forest. ...
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Infectious diseases continue to be a global health menace to society. Admittedly, there have been improvements in public health infrastructure and structural response to these diseases, however, a lot more needs to be done to have a firm grip. This study applied the geographically weighted poisson regression (GWPR) model to study the spatial variations in the effects of socioeconomic factors on COVID-19 Mortality in the African subregion. The performance of the GWPR model was compared to the conventional Poisson regression model. The results suggest that accounting for the spatial heterogeneity through the GWPR model (RMSE = 100.604, MAE = 70.582, Pseudo R² = 0.773) improves the modelling performance compared to the conventional Poisson regression model (RMSE = 118.574, MAE = 83.054, Pseudo R² = 0.530). In addition, the effects of all the socioeconomic variables considered (i.e., educational index, unemployment rates, income index, gross domestic product, and forest area) on COVID-19 mortality were found to be spatial non-stational across the subregion. These results highlight the need to draw preventive and response policies applicable to infectious diseases with greater consideration of the different geographical points on the continent.
... During the COVID-19 pandemic, a study conducted in Italy revealed that regions with higher rates of forest area per capita experienced lower mortality rates from COVID-19. The study suggests that forests play a role in the prevention and/or treatment of COVID-19 by emitting immune-modulating VOCs [27]. ...
... This may be due not only to the ongoing pleasant temperatures at this time of year, but also to the ecosystem services provided by vegetation, which capture airborne pollutants, such as particles and NO 2 (Dzierżanowski et al. 2011;Tiemann and Ring 2022). In fact, Roviello and Roviello (2021) found a strong relationship between the severity of the pandemic and non-deciduous vegetation. However, during winter, solar radiation decreases and temperatures drop, Van Doremalen et al. 2020). ...
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Three years have passed since the outbreak of Coronavirus Disease 2019 (COVID-19) brought the world to standstill. In most countries, the restrictions have ended, and the immunity of the population has increased; however, the possibility of new dangerous variants emerging remains. Therefore, it is crucial to develop tools to study and forecast the dynamics of future pandemics. In this study, a generalized additive model (GAM) was developed to evaluate the impact of meteorological and environmental variables, along with pandemic-related restrictions, on the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Córdoba, Argentina. The results revealed that mean temperature and vegetation cover were the most significant predictors affecting SARS-CoV-2 cases, followed by government restriction phases, days of the week, and hours of sunlight. Although fine particulate matter (PM2.5) and NO2 were less related, they improved the model’s predictive power, and a 1-day lag enhanced accuracy metrics. The models exhibited strong adjusted coefficients of determination (R2adj) but did not perform as well in terms of root-mean-square error (RMSE). This suggests that the number of cases may not be the primary variable for controlling the spread of the disease. Furthermore, the increase in positive cases related to policy interventions may indicate the presence of lockdown fatigue. This study highlights the potential of data science as a management tool for identifying crucial variables that influence epidemiological patterns and can be monitored to prevent an overload in the healthcare system.
... To meet these challenges, health/fitness professionals will need to become familiar with exercise genomics (i.e., studying how genetic and environmental factors affect exercise performance) and how it affects muscle strength, aerobic capacity, and other exercise-related phenotypes. Finally, we believe that all measures taken to counteract the movement asymmetries can lead to enhanced results when exercises are conducted in a green environment thanks to the huge benefits provided by nature, not only with therapeutic compounds [78][79][80], but also with forest bathing, river therapy, and other practices that can help improve human health status [81][82][83][84][85] and, more specifically, can have positive effects on treating movement asymmetries, that are important issues for athletes [86,87]. ...
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Asymmetry plays a major role in biology at all scales. This can be seen in the helix of DNA, the fact that the human heart is on the left side, or that most people use their right hand. A single protein such as Myosin 1D can induce helical motion in another molecule. This causes cells, organs, and even entire bodies to twist in a domino effect, causing left–right behaviour. More generally, athlete movements are often asymmetric and, during the physical rehabilitation after injury, the asymmetry is visually discernible. Herein, we review the molecular basis of the movement asymmetries and report on the available knowledge on the few therapeutics investigated so far such as meloxicam. From a more rehabilitative perspective, it is very important to use effective methods to control the process of resolving the injury-related movement asymmetry through the complex use of specialised exercises, measurements, and gait analysis, which can all provide useful information on the effectiveness of the rehabilitation plans. If for each athlete, the normal range of asymmetry is known, the asymmetry can be individually treated and the evolution can be monitored over time. Appropriate measures should be taken if the movement asymmetry is outside this range. In addition, genetic, physiological, and psychological factors relevant to athlete health should be considered in the process of assessing and improving exercise asymmetry, which we also discuss in this review. The main proposal of this work is that the movement asymmetries in athletes should be individually treated, while taking into account the athlete’s genetics, physical condition, and previous injuries.
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The outbreak of coronavirus named COVID-19, initially identified in Wuhan, China in December 2019, has spread rapidly at the global scale. Most countries have rapidly stopped almost all activities including industry, services and transportation of goods and people, thus decreasing air pollution in an unprecedented way, and providing a unique opportunity to study air pollutants. While satellite data have provided visual evidence for the global reduction in air pollution such as nitrogen dioxide (NO2) worldwide, precise and quantitative information is missing at the local scale. Here we studied changes in particulate matter (PM2.5, PM10), carbon monoxide (CO), NO2, sulfur dioxide (SO2) and ozone (O3) at 10 urban sites in Hangzhou, a city of 7.03 million inhabitants, and at 1 rural site, before city lockdown, January 1–23, during city lockdown, January 24-February 15, and during resumption, February 16–28, in 2020. Results show that city lockdown induced a sharp decrease in PM2.5, PM10, CO, and NO2 concentrations at both urban and rural sites. The NO2 decrease is explained by reduction in traffic emissions in the urban areas, and by lower regional transport in rural areas during lockdown, as expected. SO2 concentrations decreased from 6.3 to 5.3 μg m−3 in the city, but increased surprisingly from 4.7 to 5.8 μg m−3 at the rural site: this increase is attributed both to higher coal consumption for heating and emissions from traditional fireworks of the Spring Eve and Lantern Festivals during lockdown. Unexpectedly, O3 concentrations increased by 145% from 24.6 to 60.6 μg m−3 in the urban area, and from 42.0 to 62.9 μg m−3 in the rural area during the lockdown. This finding is explained by the weakening of chemical titration of O3 by NO due to reductions of NOx fresh emissions during the non-photochemical reaction period from 20:00 PM to 9:00 AM (local time). During the lockdown, compared to the same period in 2019, the daily average concentrations in the city decreased by 42.7% for PM2.5, 47.9% for PM10, 28.6% for SO2, 22.3% for CO and 58.4% for NO2, which is obviously explained by the absence of city activities. Overall, we observed not only the expected reduction in some atmospheric pollutants (PM, SO2, CO, NO2), but also unexpected increases in SO2 in the rural areas and of ozone (O3) in both urban and rural areas, the latter being paradoxically due to the reduction in nitrogen oxide levels. In other words, the city lockdown has improved air quality by reducing PM2.5, PM10, CO, and NO2, but has also decreased air quality by augmenting O3 and SO2.
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The ongoing global pandemic of COVID-19 has brought life to almost stand still with implementations of lockdown and social distancing as some of the preventive measures in the absence of any approved specific therapeutic interventions. To combat this crisis, research community world-wide are falling back on the existing repertoire of approved/investigational drugs to probe into their anti-coronavirus properties. In this report, we have described our unique efforts in identifying potential drugs that could be repurposed against main protease of SARS-CoV-2 (SARS-CoV-2 Mpro). To achieve this goal, we have primarily exploited the principles of ‘neighbourhood behaviour’ in protein 3D (workflow-I) and chemical 2D structural space (workflow-II) coupled with docking simulations and insights into the possible mode of actions of the selected candidates from available literature. Such an integrative approach culminated in prioritizing 29 potential repurpose-able agents (20 approved drugs and 9 investigational molecules) against SARS-CoV-2 Mpro. Apart from the approved/investigational anti-viral drugs, other notable hits include anti-bacterial, anti-inflammatory, anti-cancer and anti-coagulant drugs. Our analysis suggests that some of these drugs have the potential to simultaneously modulate the functions of viral proteins and host response system. Interestingly, many of these identified candidates (12 molecules from workflow-I and several molecules belonging to the chemical classes of alkaloids, tetracyclines, peptidomimetics from workflow-II) are suggested to possess anti-viral properties which are supported by laboratory and clinical data. Further, this work opens a new avenue of research to probe into the molecular mechanism of action of many drugs which are known to demonstrate anti-viral activity but are so far not known to target viral proteases.
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In December 2019, the novel coronavirus COVID-19 outbreak was first detected in Wuhan Hubei province, China. The April 24, 2020, the Centers for Disease Control and Preventions (CDC) has confirmed more than 39,000 cases, including >1800 deaths. California's Governor Gavin Newsom ordered mandatory stay at home after World Health Organization (WHO) declared COVID-19 as a global pandemic in early March. We have evaluated the correlation between environmental pollution determinants and the COVID-19 outbreak in California by using the secondary published data from the Centers for Disease Control and the Environmental Pollution Agency (EPA). We employed Spearman and Kendall correlation tests to analyze the association of PM 2.5, PM 10, SO2, NO2, Pb, VOC, and CO with COVID-19 cases in California. Our findings indicate that environmental pollutants such as PM10, PM2.5, SO2, NO2, and CO have a significant correlation with the COVID-19 epidemic in California. Overall, our study is a useful supplement to encourage regulatory bodies to promote changes in environmental policies as pollution source control can reduce the harmful effects of environmental pollutants.
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Around the world, several dose regimens of hydroxychloroquine have been used for COVID-19 infection treatment, with the objective of identifying a short-term course. Hydroxychloroquine was found to decrease the viral replication in a concentration-dependent manner in vitro and to be more active when added prior to the viral challenge. A loading dose is used to rapidly attain a target drug concentration, which is usually considered as approximately the steady-state concentration. With a loading dose, the minimum effective concentration is reached much more rapidly than when using only the maintenance dose from the start. Thus, we propose a hydroxychloroquine sulphate dose regimen of 400 mg twice daily at Day 1 then 400 mg once daily from Day 2 to Day 10. We aim to evaluate this in the C-20-15 DisCoVeRy trial.
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As viral infections are an increasing threat to human societies, the need for new therapeutic strategies is becoming even more obvious. As no vaccine is available for COVID-19, the development of directly acting antiviral agents and preventive strategies have to be considered. Nature provides a huge reservoir of anti-infectious compounds, from which we can deduce innovative ideas, therapies, and products. Anti-adhesive natural products interact with the receptor-mediated recognition and early interaction of viruses with the host cells, leading to a reduced internalisation of the virus and reduced infections (e.g., procyanidin-B-2-di-O-gallate against influenza and herpes virus). Lignans like podophyllotoxin and bicyclol show strong antiviral activities against different viruses, and essential oils can directly interact with viral membranes and reduce the hostʼs inflammatory responses (e.g., 1,8-cineol). Echinacea extracts stimulate the immune system, and bioavailable alkamides are key players by interacting with immunomodulating cannabinoid receptors. COVID-19 and SARS-CoV-2 infections have, in part, successfully been treated in China by preparations from traditional Chinese medicine and, while it is too early to draw conclusions, some promising data are available. There is huge potential, but intensified research is needed to develop evidence-based medicines with a clearly defined chemical profile. Intensified research and development, and therefore funding, are needed for exploiting natureʼs reservoir against viral infections. Combined action for basic research, chemistry, pharmacognosy, virology, and clinical studies, but also supply chain, sustainable sourcing, and economic aspects have to be considered. This review calls for intensified innovative science on natural products for the patients and for a healthier world!