Infection and the accompanying inflammation of the upper and lower respiratory tract, influenza and Covid-19, are among the deadliest diseases in human life of the world. Due to the high emergence of bacterial resistance to antibiotics, we strive to find alternatives to contribute to the treatment by using new formulation of a mixture of six essential oils in the form of a drop called it Respira drops   for therapeutic approach of the upper or lower parts of the respiratory system infection, either by inhalation or sniffing, or by touching it with the body in the form of a skin patch on the head, neck, or chest. The present study suggested that natural essential oils may act as prophylactic and therapeutic agent in respiratory tract hypoxia, inflammation and bacterial and viral infection (influenza and COVID-19).

Essential oils (EOs) are the mixture of several volatile compounds such as mono- and sesquiterpenoids, phenylpropanoids, which contain many chemical constituents responsible for their activity. The EOs have good effects as anti-inflammatory in the treatment of inflammation. They can regulate the levels of cytokines and inhibit multiple signalling pathways that trigger responses to inflammation. Many studies reported that EOs have antimicrobial and viral activity. Also, reported that the oxygenated terpenoids in EOs, e.g. alcohols, aldehydes, esters, ketones, peroxides, and phenols lead to increase the antimicrobial action.[3] World Health Organization (WHO) reported that lower respiratory tract infections are responsible for 5% (3.1 million people) of deaths worldwide regarding both sexes. This number was 6% in the female and 5% in the male.[5] Pneumonia was responsible for 13% of causes of death among post-neonatal (1–59 month) children.[6]  lower respiratory tract infections and chronic obstructive pulmonary disease (COPD) have remained the top major killers during the past decade.[6] Although WHO has a well-organized global vaccine action plan against most bacteria or viruses causing respiratory tract infections, many people suffer from influenza, pneumonia or tuberculosis and without proper treatment these diseases can kill many people worldwide. EOs may possess a preventive role in the treatment of respiratory tract infections. The application of EOs via inhalation seems to be the most effective way to cure patients, because of their volatile nature they can reach the site intended to be treated.[7] Many studies found that SpO2 levels direct correlate with respiratory tract pathology infection, and the SpO2 levels are proportional to the potency of the immune response in influenza infection as well as best indicator for evaluate the function and respiratory viral and bacterial infections. [8] Also, pneumonia and bronchitis as well as lower respiratory tract infection were found correlated with low SPO2 level. Therefore, SPO2 which is considered a good indicator of respiratory infection. [9-10] The hypothesis of new formulation of Respira drops contain mixture of six natural essential oils like peppermint, clove, ginger etc oils with different amounts for each one which was done by Prof. Dr. Hussien O. Kadi (Patent). The present study suggested that natural essential oils may effective as prophylactic and therapeutic agent in respiratory tract hypoxia, inflammation and bacterial and viral infection (influenza and COVID-19).

A 62-years-old Yemeni male patient volunteer for taken Respira drops inhalation three times daily for one week. Volunteer gave a written informed consent and the Ethics Committee of Yemen University; Faculty of medical Sciences approved the clinical protocol and have been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. was suffering from acute pneumonia which was diagnostic by chest X-ray, blood tests and clinical signs. His C-reactive protein (CRP) was 56 mg/L, Hemoglobin (Hb) 9.5 g/L, White blood cells count (WBC) 20.000x103 /mm3, red blood cells (RBC) 3x106 /mm3 and platelets 120x103 then he had used antibiotics and his condition improved, but he was suffering from difficulty breathing and stayed on the use of oxygen at home for more than three months, and his SpO2 (peripheral oxygen saturation)  measured with a pulse Oximeter ranged between 75 to 85%, and he also suffered from an abdominal hernia, and he went for a procedure Surgery, and when the SpO2 was measured with a pulse Oximeter at 86%, the surgery was not completed as a result, so he used Respira drops by inhalation and by steam for twenty-four hours, and the next day he went to the Cairo hospital, Sana’a, Yemen  and the SpO2 was measured with a pulse Oximeter 96% , and the operation was performed and he continued using Respira for two weeks three times per day and his condition improved completely.

Many causes of hypoxemia include pneumonia, pnemothorax inflammation, bronchial asthma and infection like COVID-19 which lead to decrease the SPO2 level and may causes death [11]. Volatile oils are a mixture of several compounds [1114-]. The main ingredients are monoterpene and sesquiterpene, which have antibacterial, anti-inflammatory and antiviral effects [13]. The anti-inflammatory effect is attributed to the regulation of cyclooxygenase (COX) and the stimulation of the synthesis of nitric oxide (iNOS) and a variety of cytokines, which play an important role in the inflammatory processes [14]. It also plays a role in regulating the levels of cytokines and inhibiting the signaling pathway that causes inflammation, and because of its complex effect mechanism resulting from the different compounds it possesses. It has an excellent effect in inhibiting signaling pathways such as NF-κB, MAPK, and AKT. Many of the antigens will be recognized and defined by the corresponding T cell, B cell and Toll-like receptors, cytokines such as TNF and IL will be recognized by TNF and IL receptors, which will stimulate the inflammatory signaling pathways. Respiratory diseases associated with bacterial infection and inflammation affect many people of all ages in the world. Because of the easy access of volatile oils to the upper and lower parts of the respiratory system, and their effective effect in cases of influenza, pneumonia or tuberculosis. and their effective effect as antibacterial, antiviral, and anti-inflammatory, it is considered the easiest and fastest way in prevention and treatment [15]. The present study suggests that Respira drops act via removing inflammation and killing bacteria and viruses, if any, and thus improving the percentage of SPO2 and returning to normal within a week. Many studies were found that there is a strong relationship between infection of the respiratory system with Covid-19 and pneumonia, as the blood oxygen saturation level decreases to less than 95% a measure by pulse oximetry. Covid-19 patients who were admitted to the hospital had a low blood oxygen saturation (SPO2), as the study suggested that it is an important and good diagnostic and therapeutic indicator for patients with Covid-19 and pneumonia. The deaths of Covid-19 patients in hospitals were associated with a low level of blood oxygen saturation (SPO2) and they were under receiving oxygen [16-18]. The virucidal effect of essential oils like ginger, thymus, tea tree, lemon, camphor and peppermint oils against enveloped RNA and DNA viruses such a influenza and COVID-19 was demonstrated [19-22].  On other hand, chemical constituents of cinnamon, lemon, thyme, lavender essential oils have been demonstrated potent effective against H5N1, COVID-19 and influenza. The mechanism of action was reported to cause disintegration of nucleoprotein core(capsid), inhibit hemaglutinin and growth of virus as well as inhibit the viral redox signalling pathway [23]. The present case study shows excellent therapeutic response for Respira drops as inhalation and smile three times per day increased SPO2 level which reflect the anti-inflammatory, antimicrobial and anti-viral effects (influenza and COVID-19).

The present case indicated that Respira drops very excellent effective in the treatment respiratory tract hypoxia associated with bacterial, inflammation and viral infections (influenza and COVID-19.