Abstract

COVID-19 is caused by a coronavirus and was first identified in Wuhan, China. Clinical symptoms of COVID-19 patients show a significant decrease in lymphocytes. Decreased lymphocyte count is a factor that increases severity in COVID-19 disease. COVID-19 patients who died reported a very low number of lymphocytes compared to COVID-19 patients who recovered. Increasing lymphocytes to normal levels again, especially in the initial phases of infection, is one of the keys to healing COVID-19 patients. The immune system can be used as a strategy for COVID-19 treatment. Still, immunomodulators must be given at the right time at the beginning of infection, with the right dose, not to cause deterioration in the patient. Immunomodulator administration in the final stage can cause severity in COVID-19 disease due to increased cytokine storm. Therefore, Immunodulator screening, which increases lymphocyte counts, is essential for COVID-19 treatment strategies in the initial stage. Lymphocytes are easily isolated from human blood and consist of NK (Natural Killer) cells, T cells (for cell-mediated, adaptive cytotoxic immunity), and B cells (for humoral, antibody-driven adaptive immunity). Lymphocytes can be isolated from the blood and cultured in vitro. Animal intervention studies showed that immunomodulatory substances could be used for immunomodulator screening candidates for COVID-19 in initial stage therapy. Some candidates for active ingredients that can be used as immunomodulators are honey. Honey has been shown to increase mouse T cell proliferation. This systematic review shows that honey can increase lymphocyte proliferation and have an anti-inflammatory function by lowering IL-6 levels in several in vivo studies.

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