FIELD OF INVENTION

The invention relates to herbal compositions. In particular this invention relates to use of herbal compositions in alleviating symptoms of respiratory disease including COVID 19, viral infections like Chikugunya and Dengue; inflammatory and autoimmune diseases like Rheumatoid arthritis and for managing the raised blood sugar levels.

BACKGROUND OF THE INVENTION

Since the COVID-19 pandemic began, until the date of this specification, it is an admitted position that there is no medicine that has shown evidence of efficacy in a clinical trial. Some anti-virals for repurposing for COVID-19 are permitted for use under emergency consideration as investigational therapies, despite lack of clinical evidence of efficacy. Such anti-virals include Remdesivir, Convalescent plasma, Tocilizumab, and Hydroxychloroquine (HCQ) on coronavirus patients. HCQ has been recommended for use in as early stage of the disease course as possible to achieve any meaningful effects and should be avoided in patients with severe disease. The use of Tocilizumab drug as an off-label application is advised in patients with moderate disease with progressively increasing oxygen requirements. Favipiravir is also a latest entrant in this list of repurposed drugs. It is very much clear that the list of chemical drugs have not provided final answer and there is a need for investigating newer options and evaluate them to provide more effective and more relevant solution to the problem of handling COVID-19.

Ayurveda is an ancient Indian school of medicine that has remedies to many diseases validated by several centuries of their use, the information of which has been standardized in ancient scripts known as “Samhita” and “Granthas”. They are repository of the traditional wisdom and treasure of time tested knowledge on treatment. However, since the concept of “Virus”, particularly Coronavirus, did not exist then, there is no guidance or suggestions available from Ayurveda on the challenges thrown up by the New Coronavirus virus SARS-COV-2 which causes COVID-19.

Hence, we started exploring herbs for their effect on COVID-19 patients.

SUMMAY OF THE INVENTION

This invention discloses a composition comprising ingredients derived at least from plants of Kirat-tikta (Swertia chirata Linn Nimba (Azadiracta indica A. Juss., 1830/ Vasa (Adhatoda vasica Nees/ Pippali (Piper longum Linn and optionally: (a) additional herbal or non-herbal ingredients, and (b) pharmaceutically permitted excipients. The ingredient derived from Kirat-tikta is powder of whole plant, derived from Nimba is powder of leaves, derived from Vasa is powder of leaves and the one derived from Pippali is powder of fruits. The composition illustrated herein has ingredients of Kirat-tikta, Nimba, Vasa and Pippali taken in a proportion of 30:30:30:10; although variants of this ratio showing reasonable extent of efficacy are also included within the scope of this invention. . To this composition, additional herbal ingredients can also be added selected, one or more, from the group comprising ingredients derived from plants of Patol (Trichosanthes dioica Roxb , Kalmegh (Andrographis paniculata), Guduchi (Tinospora cordifolia (Thunb.) Miers Pushkarmool (Inula recemosa Hook.f, Chandan (Santalum album), Musta (Cyperus rotundus), Haritaki (Terminalia chebula Retz and Anantamula (Hemidesmus indicus).

The additional non-herbal ingredients added to the claimed inventive composition are selected one or more from the group comprising Rajatbhasma (herbally prepared silver micro-particles), Pravalbhasma (coral) and Mauktikbhasma (herbally prepared pearl micro-particles).

In another embodiment, this invention discloses a composition comprising ingredients derived at least from Kirat-tikta (Swertia chirata Linn), Nimba (Azadiracta indica A. Juss., 1830), Vasa (Adhatoda vasica Nees), Pippali (Piper longum Linn) and optionally®a) additional herbal or non-herbal ingredients, and (b) pharmaceutically permitted excipients for making medicinal composition for treatment and prophylaxis of diseases and disorders, restoration of health and for well being. The said diseases and disorders include those caused by virus, bacteria, inflammation, autoimmune disorder and systemic infection.

The diseases and disorders comprise respiratory diseases, Chikungunya, cold, influenza, dengue, Rheumatoid arthritis, osteoarthritis and hyperglycemia

DETAILED DESCRIPTION OF INVENTON

It is an embodiment of this invention that the “composition 1” provided below in Table 1 , and its variations obvious to a person of an ordinary skill in the art, provide/s relief to COVID-19 patients having mild to moderate severity. It is also possible that patients having acute symptoms of severe category may also get relief in course of time; if tested on such cases.

In the specification below, names of the plants are given as are used in Ayurveda scriptures, and their botanical names are also given in parentheses.

It is also an embodiment of this invention that a composition comprising ingredients derived from plants of Marich (Piper nigrum Linn,), Pippali (Piper longum Linn Kirat-tikta (Swertia chirata Linn Guduchi (Tinospora cordifolia (Thunb.) Miers/ Patol (Trichosanthes dioica Roxb./ Pushkarmool (Inula racemos Hook.f and Nimba (Azadiracta indica A. Juss., 1830,1 have antiviral property, the composition is virucidal, and the plants comprising above composition are valuable sources to derive active agents for virucidal activity for the SARS-cov-2 in particular and for all viruses in general. Hence, they can provide a reliable therapy for treatment of COVID-19 in particular and all viral diseases in general.

Considering the overall nature of the formulation, we consider that it is obvious that the “Composition 1” could even act against other infections including common cold, influenza, dengue, chikungunya etc.

Per Ayurvedic point of view Paachan is an important concept in the treatment of fever. Aam or undigested food / weakly formed tissue / waste formed in the metabolism need to get rid of. We hypothesise that “Composition 1” does not allow this Aam to get accumulated in the body. Thus, patients consuming “Composition 1” would be better protected for considerable duration of time from fever and all the diseases that has Aam as one of the causative factor. Though virus is an external disease-producing factor, presence of Aam in the body is a vital factor having prognostic importance. Patients having comparatively more Aam in their systems tend to have more severe / chronic disease as compared to the others. Medicines that do the Pachan karma (tackling the Aam), are considered better for early recovery and for non-recurrence of the disease.

It is also possible that “Composition 1” possess prophylactic properties. We believe that the same formulation should work (in the lower dose) in preventing the infection. One dose each day by a non-infected person should help him in keeping Covid-19 and other respiratory infections at bay.

In another embodiment of this invention, the “Composition 1” has an application in:

• non-infected people for preventing the infection,

• virus-infected patients for early cure,

• post-infection rehabilitated people in controlling the post-recovery complications.

• preventing reinfection of patients who have become infection-free after treatment for Cobid-19 to them.

In yet another embodiment of this invention, Nimba (Azadiracta indica A. Juss., 1830 Vasa (Adhatoda vasica Nees Kirat-tikta (Swertia chirata Linn and Pippali (Piper longum Linn,) are essential ingredients of the “Composition 1”. The “Composition 1” may also optionally have other herbs as additional optional ingredients one or more selected from, without limitation, from the group comprising Patol (Trichosanthes dioica Roxb./ Kalmegh (Andrographis paniculata), Guduchi (Tinospora cordifolia (Thunb.) Miers/ Pushkarmool (Inula recemosa Hook.f, Chandan (Santalum album), Musta (Cyperus rotundus), Haritaki (Terminaha cnebula Retz./ Anantamula (Hemidesmus mdicus), and the like. Apart from this, it might also optionally contain one or more other non-herbal Ayurvedic ingredients including, without limitation, Rajatbhasma (herbally prepared silver micro-particles), Pravalbhasma (coral), Mauktikbhasma (herbally prepared pearl micro-particles) and the like.

Certain single herbs were tried on a few COVID positive patients. These included Guduchi (Tinospora cordifolia (Thunb.) Miers/ Vasa (Adhatoda vasica Nees Ashwagandha (Withania somnifera), Nimba (Azadiracta indica A. Juss., 1830/ Marich (Piper nigrum Linn/ Shunthi (Zinziber officinale), Pippali (Piper longum Linn/ Kirat-tikta (Swertia chirata Linn/ Haritaki (Terminalia chebula Retz J etc. These are the herbs frequently used in treating fever and in managing respiratory symptoms. Single herbs were tried for preliminary exploration of their efficacy on COVID-19 patients. Although some relief in some of the symptoms was seen, we did not get noteworthy / significant overall outcomes of any of the herbs mentioned. The herbs were given as add-on to the Standard Care of treatment (multi-vitamins, zinc, paracetamol etc.) prescribed by the treating physicians.

We tried permutations and combinations of above-mentioned herbs however they did not give satisfactory results; it seemed that something was still missing, and there has to be a ‘balanced’ formulation to address all the symptoms. Arresting pathophysiology (progression) of the disease was needed so that symptoms will be taken care of automatically. After trying several combinations, with deductive approach, we have narrowed down our search to Kirat-tikta (Swertia chirata Linn leaves of Nimba (Azadiracta indica A. Juss., 1830/ leaves of Vasa (Adhatoda vasica Nees/ and Pippali (Piper longum Linn,) taken in proportion of, respectively: 30:30:30:10. However, all obvious permutations and combinations around this proportion that would give substantially same efficacy are possible; and all of them are covered within the composition claimed herein. Optionally, Piper nigrum Linn is shallow-fried in castor-oil before mixing.

In critical conditions, thorough mixing of any one of the following herbo-mineral drugs mentioned in Ayurved treatises, thoroughly mixed with Composition 1 in the ratio of 1 :10 can prove to be life-saving.:

1 ) Bruhat Vaat Chintamani Rasa (Bhashajya Ratnavali Vatavyadhi Rogadhikar 61/141 -144. Contents: Suvarna Bhasma (micro particles of gold prepared with the help of herbs), Rajat Bhasma (micro particles of silver prepared with the help of herbs), Abhrak (mica) bhasma, Loh (iron) Bhasma, Praval (coral) Bhasma, Mauktik (pearl) Bhasma, Ras sindoor)

2) Trailokya Chintamani (Bhashajya Ratnavali Jwaradhikar 315/766-772; Contents: Ras-sindoor, Nag Bhasma, Purified Aconitum Ferox (Vatsanabh), Purified Orpiment (Arsenic Tri Oxide) (Hartaal), Godanti Bhasma, Abhrak Bhasma, Purified copper sulphate, Purified Arsenic disulphide- (Manashila), Purified sulphur, Purified Shilajit, Purified Jaypal (Croton) Purified Dhatura (Datura stramonium / metel) Seeds, Kanhermool (Roots of Nerium Indicum (N. Odorum Soland), Langlimool (Gloriosa superba Linn)

3) Mahalaxmivilas Rasa (Bhaishajya Ratnavali shirirogadhikara. 65/57-59; Contents: Loha bhasma (herbally prepared micro particles of iron), Abhrak bhasma (herbally prepared micro particles of mica), Vatsanabh (Aconitum ferox Linn), Nagarmotha (Cyperus rotundus), Shunthi (dried Zinziber officinalis), Pippali (Piper longum), Maricha (Piper nigrum), Triphala (equal quantities of Phyllanthus emblica, Terminalia chebula, Terminalia bellerica), Dhattur beej (seeds of Datura stramonium / metel), Vidhara beej, Bhang churna, Gokshur (Tribulus terestris), Pippalimula (roots of Piper longum), Bhavana (trituration of- juice from leaves of Datura metel / stramonium)

4) Shwaas-Kaas Chintamani Rasa (Bhaishajya Ratnavali Hikka swasarogadhikar 16/57-60; contents: Shudha Parad, Swanamakshik, Swarna bhasma, Mauktik bhasma, Gandhak, Abhrak bhasma, Loha bhasma. Bhavana [trituration in] - kantakari kwath, aja dugdha, yashtimadhu kwath, tambul swarasa.)

Pharmaceutically acceptable excipients may be added to this bitter formulation for improving its acceptability/palatability.

In the following are described illustrative examples of working of this invention on Covid-19 patients. The examples are not construed to limit the claims, and any variations obvious to a person of an ordinary skill in the art are construed to be covered within the scope of the disclosure below.

Example 1 :

“Composition 1” for treatment of COVID-19 patients and method of making the same

Table 1

Powder of Pippali was optionally shallow-fried in castor oil. After complete drying of it, all the powders were mixed in the proportion mentioned in the table 1 above. Formulation was packed thereafter in zip locked pouches and was given to patients.

Example 2:

Case Report 1 : Treatment of COVID-19-positive patients using “Composition 1”

A patient reported that she and her all family members (total 7 members) were all COVID-19 positive as determined by RT-PCR and were home quarantined. Initially, we started treatment to the patient and her three other family members.

All of them had mild cough and fever. They were given Kirat-tikta (Swertia chirata Linn,) and Pippali (Piper longum Linn) in proportion of 4:1 as a mixture of around 500 mg per dose three times a day. The very next day morning patient reported that she and another member, an adolescent girl, got relief from symptoms, and that it had worked very well. Her two other family members also had some relief.

However, they still had some symptoms. Hence, they were given Composition 1 as a mixture of around 500 mg per dose and increase in the frequency of the dose up to six times a day worked for them. None of them was hospitalized and did not receive any treatment other than the “Composition 1”. We observed the effect of the formulation on the symptoms of the patients as well as determined viral load by taking patients’ nasal and pharyngeal swab before start of the treatment and after they felt better in just 2 days. There was a marked decline in the viral load.

Details of these four cases are provided in Table 2 as follows:

Table 2

None of them was hospitalized and did not receive any treatment other than the “Composition 1”.

Example 3: Case Report 2: Treatment of COVID-19-positive patients using “Composition 1”

All patients from another family who had tested positive were having moderate symptoms that included fever, cough and moderate breathlessness. One of the male patient from that family especially had slightly advanced symptoms wherein he could not speak even one sentence without gasping. His mother also had intermittent cough. Immediate treatment of “Composition 1” was started to them. Same day, they called and informed that there was a ‘sense of well-being’ in all of them. The next day morning they called us again and the male patient who could not speak a sentence at a stretch earlier, was now speaking for 15 minutes without any issue of breathlessness His voice was very clear and he said, he was more than happy. None of them was hospitalized and did not receive any treatment other than the “Composition 1”. Details of treatment of members of this family are provided below in Table 3:

Table 3

All these 4 patients were symptom-free, and they were considered recovered after two weeks of their positive report; and started to go out of house for their work. Half teaspoon of Composition 1 was administered three times a day.

Example 4

Case Report 2: Treatment of COVID-19-positive patients using “Composition 1”

A family of 3 persons reported Covid-19 positive was referred to us. Husband and wife of the family had barely slept for last 3 nights and they were having intermittent cough and mild fever. After taking the “Composition 1”, they had a sound sleep and all the symptoms disappeared within a day. One more lady (initials: RS) from a different family was also treated by “Composition 1”. She had slightly raised CRP (C-Reactive Protein) and had fever. Only 2 doses made her comfortable, however she continued it for 2 weeks. No new symptom were observed. She began to go out of home from 14 ^th day onwards. Details of these cases are provided below in table 4: Table 4

Half teaspoon of Composition 1 was administered three times a day. If symptoms were felt more acute, during that period, frequency was advised to increase to every two hours. There were more such cases where “Composition 1” worked very well. Example 5

In-vitro evaluation of virucidal activity of the herbal ingredients by RT-PCR

“Ghanavati” (solidified decoction of plant parts) is prepared from each of above plant parts individually. To the plant part, sixteen times its weight of water is added, the water is boiled down until the proportion of the raw material to water in the boiling mixture is about 1 :4, when the insoluble portion of the raw material is filtered off and the filtrate is boiled down to dryness or, alternatively optionally, up to a syrupy consistency and to that syrup dried fine powder of the plant part is added to transform the syrup into powdery matter. “Ghanavati” of each such plant apart was powdered.

Following protocol was followed for In-vitro evaluation of virucidal activity of the herbal ingredients:

2 Covid-19 positive patient’s swabs in viral transport media was taken for performing the experiment. As mentioned in the table 5 below, for first three herbs, the baseline viral load (copies / mL) was 4.4*10 ^A 8 and for last four, the baseline viral load was 3.33*10 ^A 9.

• 1 % solution of each individual herbal powder was made in water by using following steps: o For first three herbs, it was powder (of fruits of Marich and Pippali, and whole plant of Kirat-tikta); and for last four herbs mentioned in the table no 5 below, it was ghanavati that was used while preparing the solution. o Solution of 1 gm of herb powder / ghanavati was made with 1 ml of water (weight / volume %) • Initially we took viral transport medium (VTM) having known Covid-19 positive sample collected from patient’s nasal and pharyngeal area. We then put 100ul from this sample in various microfuge tubes (1.5 ml capacity). • For control sample we took one of such microfuge tubes (containing 10Oul

Covid-19 positive VTM) and was mixed with 100ul distilled water: This served our control microfuge tube.

• Another microfuge tube (containing 10Oul Covid-19 positive VTM was taken and was mixed with 100ul of solution of the powder: This served as treatment microfuge tube. For individual herb, different microfuge tube was used.

• The control microfuge tube as well as treatment microfuge tubes were incubated at room temperature for half an hour.

• RNA was extracted from all these samples and quantitative RT-PCR was carried out by providing the microfuge tubes to a diagnostic laboratory.

• The results are provided in Table 5 below:

Table 5

Example 6

C-Reactive Protein (CRP) is an important blood marker to identify inflammatory response of the body. Three patients’ increased CRP came down to normal within a day of starting the treatment. This analysis was done by providing the samples to pathology Diagnostic Laboratories.

Table 6

These observations give an evidence of anti-inflammatory properties of the composition comprising Kirat-tikta (Swertia chirata), Vasa (Adhatoda vasica Nees and Nimba (Azadiracta indica A. Juss., 1830 show anti-inflammatory activity thereby reducing markers like CRP.

Example 7

Rapid improvement in Favipiravir-non-responsive case:

One patient, with initials JP, 44-year female was consuming Tab. Favipiravir that her physician had prescribed for her COVID 19 positive status. Accordingly she started the course and followed it for first three days i.e. 200 mg tablet on first day (9 tablets in morning, 9 tablets in evening) followed by 2 more days with 2 tablets in morning and 2 tablets in evening. Thereafter she was advised to continue the course at the dosage she followed for 2 ^nd and 3 ^rd day for 11 more days. However, Since she did not notice any progress, she opted to switch over to another treatment.. She was mildly symptomatic, with cough and anosmia (loss of sensation of smell). After a week’s treatment, she still was not feeling well and there was no indication of improvement. We started Composition 1 to her and within a day she started feeling better, and was symptom-free in two days. Example 8:

Rapid improvement in Remdesivir-injection-non-responsive case:

One male patient aged 40 years was having fever and cough. He got his blood investigations done on 24 ^th September 2020. His Total WBC count was 3400 I cu.mm (Normal Range: 4000 - 1 1000 I cu.mm) and his NLR (Neutrophils to Lymphocytes Ratio) was 2.55 (more than 3.13 is generally a bad prognostic factor for COVID-19). His CRP was very mildly increased to 8.6 ug/ml (Normal Range: 0- 6). He was treated symptomatically and with Doxycycline 100mg twice a day for the first day followed by 100mg once a day for 4 more days. Patient however did not get any relief and rather his symptoms got worsened. He got admitted in a private hospital with fever, cough and severe breathlessness. When blood tests were repeated on 29 ^th September 2020, his Total WBC count increased to 10,100 I cu.mm. NLR was found to be increased to 8.8 (indicating worsening of the condition); his CRP increased to 47.3 ug/ml. His lnterleukin-6 level was also raised (25.3 pg/mL). His HRCT (High Resolution Computed Tomography) showed score: 13/25 (moderate disease), and his CO-RADS level of suspicion for COVID-19 infection was Very High (Typical COVIC-19 Findings).

Symptomatically too, he was deteriorating. He was not able to talk a sentence at a stretch. With 12-14 liters of oxygen, his SpOs was struggling at 91%. Even after 4 injections of Remdesivir (29 ^th September till 2 ^nd October) there was no sign of improvement. Treating physicians were thinking to start plasma therapy, and also injection Tocilizumab. Treatment options were exhausting.

Considering the severity and seriousness, we thoroughly mixed Bruhat Vaat Chintamani Rasa (a herbo-mineral drug mentioned in Ayurved treatises) with Composition 1 in the ratio of 1 :10 by weight to make “Composition 2”. We asked him to consume 2-3 pinches of “Composition 2” every 15 minutes. Composition 2 was started at around 7 PM on 2 ^nd of October 2020. After an hour, he started feeling better, and after 3 hours of starting this “Composition 2”, patient called and talked for about 15 minutes (to us and to his relatives). His SpOs went up to 94%. On the morning of 3 ^rd October he felt more than 50% improvement. On the evening of 3 ^rd of October, only 4 liters of oxygen was sufficient, and his SpOs (Oxygen saturation) was up to 96%. There was no need of procuring injection Tocilizumab or plasma with antibodies. The patient reached symptom-less stage in next two days. Example 9:

To make the “Composition 1 ” a commercial product, we got it manufactured from a GMP certified manufacturing company.

Following is the list of ingredients along with quantity:

Table 7

This tablet is named as ‘CoReach™

A clinical trial entitled, ”A prospective case control interventional study to assess safety and efficacy of proprietary Ayurvedic medicine Tab. ‘CoReach™ ’ in non- critical and antiviral naive COVID-19 positive patients” was conducted with CTRI registration number: CTRI2021/05/033626. A total of 53 Covid positive non-critical and antiviral naive patients (patients in whom antiviral medicines are not used for the management of Covid 19) were enrolled. Objective of enrolling such patients was to impartially assess effectiveness of tab. CoReach™. Age, gender and baseline-condition-matched Covid positive patients were considered as controls for comparison. The results of the trial show statistical significant efficacy of Tab. of CoReach™ .

Around 56% of women were enrolled in the trial and average age of patients was 38 years. WHO ordinal scale for Covid 19 is a quick assessment tool for clinical domain for Covid patients. It is a 7-point scale (0 for uninfected, and 8 for death) where increase in the score denotes increased severity. Days required for 2-point reduction in the WHO ordinal scale is considered as a good marker to assess efficacy of an intervention in a clinical trial. Hence this was considered as a Primary Endpoint in the trial. Days required for 2-point reduction in the drug group are significantly lower than in the control group (p value <0.0001).

Table 8 Independent Samples Test Average days required for 2-point reduction in the ordinal scale in the control group were 7.74 (Std. Dev. 2.9) days, whereas that for the drug group was 4.03 (Std. Dev. 1.2) days. In short, more than 3 days of benefit, as far as early recovery is considered can be expected for the patients taking Tab. CoReach™. There were 8 asymptomatic patients in each group, which were not considered for ordinal scale analysis. 4 patients had to be dropped from the control group for this assessment parameter, as those experienced an increase in the ordical scale score (from 3 to 4).

Covid RTPCR test was repeated in 42 patients taking CoReach™. 24 patients (57%) out of those 42 patients, who were done repeat RTPCR were negative on day 4 (+2). Ct values (Cycle threshold) of those who were positive increased significantly, referring to the decreased viral load. Hence, we can confirm efficacy of Tab. CoReachTM showing virucidal activity. This activity reflected in the clinical picture and we noticed significant improvement in the clinical recovery giving 3+ days of early- recovery benefit to the patients taking CoReach™.

Also, as many as 4 patients (7.5%) in the control group required management in other hospital with advanced facilities for their Covid management which included treatments with drugs like Favipiravir, Remdesivir, Tociluzumab etc; use of nasal cannula for external oxygen, use of ventilator. No patient in the CoReach™ group required such referral. Laboratory investigations (repeat RTPCR) and blood investigations (Hemogram, CRP) were done in the patients receiving Tab. CoReach™. All the blood biomarkers viz. Hemoglobin, WBC, Neutrophils, Lymphocytes and other parameters considered under complete blood count and C-Reactive Protein (CRP) were well-maintained in patients receiving Tab. CoReach™. Only 2 patients in the Tab. CoReach™ group had adverse event (diarrhea and anxiety, one each) and both got resolved before study completion. Most probably those were not related to Tab. CoReach™.

Thus, safety and efficacy of Tab. CoReach™ was proved in a clinical trial conducted in Covid 19 positive patients.

When followed-up telephonically after a month of their covid disease, all the patients who received Tab. CoReach™ for 10 days reported no health complaints related to the disease, unlike those, who did not receive CoReach™, reported symptoms like fatigue, forgetfulness, excessive hair-loss etc. CoReach™ might thus be helpful in reducing the long-term complications / after-effects of Covid, and the toll generally Covid takes on the overall health of the patients.

Example 10:

Feedback from clinical observations on some Covid-19 patients treated with capsule of CoReach™ showed that blood sugar levels of diabetic patients were better managed with Tab. CoReach™. Similar experience was reported by one patient aged 45 years, who informed that his thirst and nocturnal micturition decreased after starting with Tab. CoReach™.

It was also observed that inflammation in the body is reduced after starting Tab. CoReach™. Patients having inflammatory conditions like Rheumatoid arthritis, osteoarthritis also reported reduced pain after starting Tab. CoReach™.

A female patient, aged 49 was suffering from Chikungunya, and another female patient aged 19 was having Dengue. In both the cases, symptoms reduced drastically after initiating Tab. CoReach™. These observations are on patients who used Tab. CoReach™ and were suffering from conditions other than Covid-19, which indicate that “Combination 1” or Tab. CoReach™ is effective in managing viral, inflammatory and auto-immune conditions. It was also observed in the Covid-19 group receiving CoReach™ that type-ll diabetics amongst them, whose blood sugar levels used to be high despite state-of-art treatment for type-ll diabetes, showed reduction in blood sugar below those levels after starting administration of CoReach™ during ongoing disease.