Potential Implications of Black Seed and its Principal Constituent Thymoquinone in the Treatment of COVID-19 Patients

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the current pandemic of coronavirus disease-2019 (COVID-19). The progression of COVID-19 is related to an excessive host inflammatory immune response to SARS-CoV-2 infection, which is considered a major cause of disease severity and death. Dysregulated immune response produces huge amounts of pro-inflammatory cytokines and chemokines called "cytokine storm". Moreover, the activation of microthrombi formation plays an important role in multiple organ failure. Methods: Keeping into the consideration of the potent anti-inflammatory activity of black seed and its major constituent thymoquinone (TQ), we hypothesize their potential implication in the treatment of COVID-19 patients. A literature search was performed in PubMed, ScienceDirect, Google scholar and Scopus electronic databases by using the terms, including black seed, N. sativa, thymoquinone, SARS-CoV-2, COVID-19 and inflammatory immune response. Reslts: Various studies confirmed that Black seed and TQ reduced the thrombus formation, the expression of tissue factor and the immune activation. Furthermore, TQ demonstrated the broad spectrum antimicrobial activity that may be effective in controlling the secondary infections in COVID-19 patients. Conclusion: Keeping into consideration the multi-targeting nature of the black seed and TQ, they may be used as a potential therapeutic formulation or as an adjunct therapy in the treatment of COVID-19 patients.