Squalene for COVID-19

AbstractIn this study, the efficacy of sublingual squalene in decreasing the mortality rate among patients with COVID-19 was investigated. Squalene was extracted from pumpkin seed oil with a novel method. Then, the microemulsion form of squalene was prepared for sublingual usage. In the clinical study, among 850 admitted patients, 602 eligible COVID-19 patients were divided in two groups of control (N = 301) and cases (N = 301) between Nov 2021 and Jan 2022. Groups were statistically the same in terms of age, sex, BMI, lymphocyte count on 1st admission day, hypertension, chronic kidney disease, chronic respiratory disease, immunosuppressive disease, and required standard treatments. The treatment group received five drops of sublingual squalene every 4 h for 5 days plus standard treatment, while the control group received only standard treatment. Patients were followed up for 30 days after discharge from the hospital. The sublingual form of squalene in the microemulsion form was associated with a significant decrease in the mortality rate (p < 0.001), in which 285 (94.7%) cases were alive after one month while 245 (81.4%) controls were alive after 1 month of discharge from the hospital. In addition, squalene appears to be effective in preventing re-hospitalization due to COVID-19 (p < 0.001), with 141 of controls (46.8%) versus 58 cases (19.3%). This study suggests sublingual squalene in the microemulsion as an effective drug for reducing mortality and re-hospitalization rates in COVID-19 patients.Trial Registration Number: IRCT20200927048848N3.

ABSTRACT Objectives: The recent global coronavirus disease 2019 (COVID-19) pandemic, resulting from infection by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), can cause severe and fatal pneumonia along with other life-threatening complications. Materials and Methods: The rare and limited accessibility of approved therapeutic agents or vaccines is of great distress. Swiftly working on designing and identifying inhibitors against all possible viral key protein targets, seven key SARS-CoV-2 viral enzymes were selected as targets, particularly in the action on the virus-entry, viral replication, and immune evasion of COVID-19. Papain-like protease, main protease, RNA-dependent RNA polymerase, endoribonuclease (nsp15), receptor-binding domain-angiotensin-converting enzyme 2, transmembrane serine protease 2 (TMPRSS2), and 2’- O-ribose methyltransferase (2′MTase), which were subjected to an unbiased in silico screening against 22 small molecules originating from Garcinia linii concomitantly with Remdesivir, Nirmatrelvir, and Molnupiravir were approved by Food and Drug Administration as repurposing drugs against SARS-CoV-2 invasion. Results: The in silico results showed that natural bioactive compounds containing α-Tocopheryolquinone, 6β-Hydroxystigmast-4-en-3-one, Squalene, Rutin and Quercetin have a high binding affinity with seven selected viral protein targets concurrently with the preference of absorption, distribution, metabolism, excretion, and toxicity and drug-likeness. Conclusion: This study provides potential phytoactive compounds from G. linii through multi-target screen with molecular dynamic simulation for combating COVID-19 pandemics that need further experimental validation to confirm the prospective efficacy.