MEDICAL GROUP 015 Citation: Sayıner S, Velioğlu-Öğünç A, Şehirli AÖ (2021) Bromelain: A potential therapeutic application in SARS-CoV-2 infected patients. Ann Antivir Antiretrovir 5(1): 015-018. DOI: https://dx.doi.org/10.17352/aaa.000011 https://dx.doi.org/10.17352/aaa DOI: 2692-4625 ISSN: Abstract The SARS-CoV-2 infection has led to a global pandemic which has led to almost 4 million deaths worldwide. However, to date, a specific antiviral drug does not exist to treat the disease and control the virus. Here, we focus on the potential use of bromelain in line with its anti-oxidant, anti-inflammatory, and immunomodulatory effects. Additionally, bromelain exerts fibrinolytic, anti-invasive and antithrombotic activities that may become a therapeutic candidate against SARS-CoV-2 infection. In this paper, we focused on bromelain’s therapeutic potential concerning its potential role in reducing the severity of symptoms and the adverse effects of other antiviral drugs currently being used. The therapeutic effects of bromelain suggests that it may reduce mortality and morbidity rates in patients with CoVID-19 infections, through its anti-oxidant, anti-inflammatory, immunomodulator and anticoagulant effects. These positive effects leads us to propose that bromelain may be clinically valuable in the treatment of COVID-19 and that it therapeutic attributes should be fully investigated. Mini Review Bromelain: A potential therapeutic application in SARS- CoV-2 infected patients Serkan Sayıner 1,2 , Ayliz Velioğlu-Öğünç 3 and Ahmet Özer Şehirli 4 * 1 Department of Biochemistry, Faculty of Veterinary Medicine, Near East University, Nicosia, Cyprus 2 Diagnostic Laboratory of Animal Hospital, Faculty of Veterinary Medicine, Near East University, Nicosia, Cyprus 3 Vocational School of Health-Related Professions, Marmara University, Istanbul, Turkey 4 Department of Pharmacology, Faculty of Dentistry, Near East University, Nicosia, Cyprus Received: 26 April, 2021 Accepted: 18 June, 2021 Published: 19 June, 2021 *Corresponding author: Ahmet Özer Şehirli, Depart- ment of Pharmacology, Faculty of Dentistry, Near East University, Near East Boulevard Post Code: 99138, Nicosia, Cyprus, Tel: +90 392 680 20 30; E-mail: Keywords: Bromelain; Immunomodulation; Inflammation; ACE2; SARS-CoV-2; COVID-19 https://www.peertechzpublications.com Background Known as SARS-CoV-2, COVID-19 continues its negative impact on the world with its increasing morbidity and mortality rate [1]. Although the attempted control of the pandemic has been focused on the development of novel vaccine studies, the fact that the virus has reached a dangerous level through multiple mutations, there is necessity to develop newradical treatments and profolatic measures. The most critical factor limiting treatments is the negative potential for side effects due to the high doses of drugs delivered in the treatments so far [2]. For this purpose, the importance of immunomodulatory agents with high therapeutic index, which have anti-oxidant and anti-inflammatory properties, which can reduce the side effects of these drugs and play a role in the modulation of the immune system and prevent the devastating effects of a cytokine storm [3]. As a potential alternative treatment for COVID-19 we propose that bromelain, a phytotherapeutic drug, may provide an alternative solution . Bromelain Bromelain is a group of enzymes present in all parts of the pineapple plant (Ananas comosus), who’s enzyme’s first isolation was accomplished in 1891 [4,5]. Despite being found in all parts of the pineapple, extracts from the seed are commercially preferential. Bromelain extract is a mixture of different enzymes (thiol endopeptidases and phosphatase, glucosidase, peroxidase, cellulase), glycosidase- like components, carbohydrates, glycoproteins and several protease inhibitors. Extensive data has been collected from numerous studies on the administration of large doses of bromelain, which are based on close or similar models, which have yielded varying results. Bromelain’s LD50 is >10 g/ kg in rodents, 12 g/day orally is a safe dose for humans, without significant side effects [6,7]. Bromelain contains cysteine proteinases that have differences in proteolytic activity. It is unclear how bromelain