Dâmaris Silveira1, Jose Maria Prieto-Garcia2, Fabio Boylan3, Omar Estrada4, Yris Maria Fonseca-Bazzo1, Claudia Masrouah Jamal5, Pérola Oliveira Magalhães1, Edson Oliveira Pereira1, Michal Tomczyk6, Michael Heinrich7. 1. Department of Pharmacy, Faculty of Health Sciences, University of Brasilia, Brasilia, Brazil. 2. School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, United Kingdom. 3. School of Pharmacy and Pharmaceutical Sciences and Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland. 4. Biophysics and Biochemistry Center, Venezuelan Institute of Scientific Research, Caracas, Venezuela. 5. Center of Health Sciences, Federal University of Espirito Santo, Vitória, Brazil. 6. Faculty of Pharmacy, Medical University of Bialystok, Bialystok, Poland. 7. Pharmacognosy and Phytotherapy, School of Pharmacy, University College of London, London, United Kingdom.
Abstract
BACKGROUND: Current recommendations for the self-management of SARS-Cov-2 disease (COVID-19) include self-isolation, rest, hydration, and the use of NSAID in case of high fever only. It is expected that many patients will add other symptomatic/adjuvant treatments, such as herbal medicines. AIMS: To provide a benefits/risks assessment of selected herbal medicines traditionally indicated for "respiratory diseases" within the current frame of the COVID-19 pandemic as an adjuvant treatment. METHOD: The plant selection was primarily based on species listed by the WHO and EMA, but some other herbal remedies were considered due to their widespread use in respiratory conditions. Preclinical and clinical data on their efficacy and safety were collected from authoritative sources. The target population were adults with early and mild flu symptoms without underlying conditions. These were evaluated according to a modified PrOACT-URL method with paracetamol, ibuprofen, and codeine as reference drugs. The benefits/risks balance of the treatments was classified as positive, promising, negative, and unknown. RESULTS: A total of 39 herbal medicines were identified as very likely to appeal to the COVID-19 patient. According to our method, the benefits/risks assessment of the herbal medicines was found to be positive in 5 cases (Althaea officinalis, Commiphora molmol, Glycyrrhiza glabra, Hedera helix, and Sambucus nigra), promising in 12 cases (Allium sativum, Andrographis paniculata, Echinacea angustifolia, Echinacea purpurea, Eucalyptus globulus essential oil, Justicia pectoralis, Magnolia officinalis, Mikania glomerata, Pelargonium sidoides, Pimpinella anisum, Salix sp, Zingiber officinale), and unknown for the rest. On the same grounds, only ibuprofen resulted promising, but we could not find compelling evidence to endorse the use of paracetamol and/or codeine. CONCLUSIONS: Our work suggests that several herbal medicines have safety margins superior to those of reference drugs and enough levels of evidence to start a clinical discussion about their potential use as adjuvants in the treatment of early/mild common flu in otherwise healthy adults within the context of COVID-19. While these herbal medicines will not cure or prevent the flu, they may both improve general patient well-being and offer them an opportunity to personalize the therapeutic approaches.
BACKGROUND: Current recommendations for the self-management of SARS-Cov-2 disease (COVID-19) include self-isolation, rest, hydration, and the use of NSAID in case of high fever only. It is expected that many patients will add other symptomatic/adjuvant treatments, such as herbal medicines. AIMS: To provide a benefits/risks assessment of selected herbal medicines traditionally indicated for "respiratory diseases" within the current frame of the COVID-19 pandemic as an adjuvant treatment. METHOD: The plant selection was primarily based on species listed by the WHO and EMA, but some other herbal remedies were considered due to their widespread use in respiratory conditions. Preclinical and clinical data on their efficacy and safety were collected from authoritative sources. The target population were adults with early and mild flu symptoms without underlying conditions. These were evaluated according to a modified PrOACT-URL method with paracetamol, ibuprofen, and codeine as reference drugs. The benefits/risks balance of the treatments was classified as positive, promising, negative, and unknown. RESULTS: A total of 39 herbal medicines were identified as very likely to appeal to the COVID-19 patient. According to our method, the benefits/risks assessment of the herbal medicines was found to be positive in 5 cases (Althaea officinalis, Commiphora molmol, Glycyrrhiza glabra, Hedera helix, and Sambucus nigra), promising in 12 cases (Allium sativum, Andrographis paniculata, Echinacea angustifolia, Echinacea purpurea, Eucalyptus globulus essential oil, Justicia pectoralis, Magnolia officinalis, Mikania glomerata, Pelargonium sidoides, Pimpinella anisum, Salix sp, Zingiber officinale), and unknown for the rest. On the same grounds, only ibuprofen resulted promising, but we could not find compelling evidence to endorse the use of paracetamol and/or codeine. CONCLUSIONS: Our work suggests that several herbal medicines have safety margins superior to those of reference drugs and enough levels of evidence to start a clinical discussion about their potential use as adjuvants in the treatment of early/mild common flu in otherwise healthy adults within the context of COVID-19. While these herbal medicines will not cure or prevent the flu, they may both improve general patient well-being and offer them an opportunity to personalize the therapeutic approaches.
Authors: E A Carlini; D P Contar J de; A R Silva-Filho; N G da Silveira-Filho; M L Frochtengarten; O F Bueno Journal: J Ethnopharmacol Date: 1986-07 Impact factor: 4.360
Authors: Monica R Loizzo; Antoine M Saab; Rosa Tundis; Giancarlo A Statti; Francesco Menichini; Ilaria Lampronti; Roberto Gambari; Jindrich Cinatl; Hans Wilhelm Doerr Journal: Chem Biodivers Date: 2008-03 Impact factor: 2.408
Authors: Leen A Aldwihi; Shahd I Khan; Faisal F Alamri; Yazed AlRuthia; Faleh Alqahtani; Omer I Fantoukh; Ahmed Assiri; Omar A Almohammed Journal: Int J Environ Res Public Health Date: 2021-05-11 Impact factor: 3.390