Impact of Drug Metabolism/Pharmacokinetics and its Relevance Considering Traditional Medicine-based Anti-COVID-19 Drug Research

Background: The representative anti-COVID-19 herbs, i.e., Poriacocos, Pogostemon, Prunus, and Glycyrrhiza plants, are commonly used in the prevention and treatment of COVID-19, a pandemic caused by SARSCoV- 2. Diverse medicinal compounds with favorable anti-COVID-19 activities are abundant in these plants, and their unique pharmacological/pharmacokinetic properties have been revealed. However, the current trends in Drug Metabolism/Pharmacokinetic (DMPK) investigations of anti-COVID-19 herbs have not been systematically summarized. Methods: In this study, the latest awareness, as well as the perception gaps regarding DMPK attributes, in the anti- COVID-19 drug development and clinical usage was critically examined and discussed. Results: The extracts and compounds of P.cocos, Pogostemon, Prunus, and Glycyrrhiza plants show distinct and diverse absorption, distribution, metabolism, excretion, and toxicity (ADME/T) properties. The complicated herbherb interactions (HHIs) and herb-drug interactions (HDIs) of anti-COVID-19 Traditional Chinese Medicine (TCM) herb pair/formula dramatically influence the PK/pharmacodynamic (PD) performance of compounds thereof, which may inspire researchers to design innovative herbal/compound formulas for optimizing the therapeutic outcome of COVID-19 and related epidemic diseases. The ADME/T of some abundant compounds in anti-COVID-19 plants have been elucidated, but DMPK studies should be extended to more compounds of different medicinal parts, species, and formulations and would be facilitated by various omics platforms and computational analyses. Conclusion: In the framework of pharmacology and pharmacophylogeny, the DMPK knowledge base would promote the translation of bench findings into the clinical practice of anti-COVID-19 and speed up the anti-COVID-19 drug discovery and development.