The Perpetual Impact of COVID-19 on the Geriatric Population's Quality of Life and Potential Preventive and Therapeutic Measures in Unani Medicine: An Evidence-based Review

Background: COVID-19 pandemic has affected the elderly population more severely than many other patient groups. Due to their constitutional weakness and co-morbidities, geriatric populations are more prone to complications and adverse outcomes, especially with a high viral load. The Unani system of medicine encompasses several guidelines for the prevention and treatment of epidemics, which are stratified for different types of people with respect to age, geography, and health status, among others. Objective: Since Unani drugs are both safe and efficient, it has been found that demand for them has surged since COVID-19. This paper aims to discuss the various immunomodulatory, longevity-promoting agents, and organ-specific tonics specified in Unani medicine for the care of the elderly, which may be helpful during epidemics, and also, to present the scientific evidence of their efficacy. Methods: A thorough assessment of the available literature was carried out utilizing several electronic databases, including PubMed, Science Direct, Web of Science, Wiley Online, Google Scholar, and Springer Link, using the terms "Geriatrics," "Elderly," "SARS-CoV-2," "Unani," and many others, up until October 2022. A total of 61 pertinent reviews were included. To gather information on epidemics and their specific response in geriatrics, monographs in Urdu, Arabic, and English were explored in addition to classic Unani texts such Al-Qanun fit Tibb (The Canon of Medicine), Kamil-us-Sana'at (Liber Regius), Kitab al-Hawi fit Tibb (Liber Continence), and others. Plant names were confirmed by "The Plant List" (www.theplantlist.org). Results: During pandemics, Unani medicine aims to promote and preserve the health of the elderly by regulating six important factors (Asbab Sitta Daruriyya), which include adopting a specific diet, regimen and drugs as effective prophylactic strategies. However, the role of Unani medicine in immunological regulation relies on major organ protection, viz., general body tonic, nervine tonic, heart tonic, and liver tonic. Several Unani single drugs, such as Sibr (Aloe barbadensis Mill.), Zafran (Crocus sativus L.), and Mur (Commiphora myrrh Nees.), and formulations, such as Khameera Marwareed, Tiryaq-i- Arba, and Habb-i- Jadawar have also been found to be very effective in validated scientific preclinical and clinical studies. Furthermore, Unani drugs have anti-inflammatory, analgesic, and tonic actions, contributing to their holistic efficacy. Conclusion: It is observed in this review that Unani medicine employs a holistic approach to the health protection of the elderly. There are various dietary recommendations, lifestyle modifications, regimental therapy, and pharmacotherapy prescribed as per the individual's requirements and needs to reduce geriatric mortality in times of epidemics. Modern pharmacological studies have discovered many bioactive compounds in health-protective drugs prescribed in Unani medicine, such as Vitis vinifera L., Ziziphus jujube Mill., and many others, further substantiating the literature.