TY  - JOUR
PB  - FRONTIERS MEDIA SA
UR  - https://doi.org/10.3389/fphar.2020.581840
ID  - discovery10112875
N2  - 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.
KW  - Science & Technology
KW  -  Life Sciences & Biomedicine
KW  -  Pharmacology & Pharmacy
KW  -  herbal medicine
KW  -  coronavirus (2019-nCoV)
KW  -  COVID-19
KW  -  benefit
KW  -  risk assessment
KW  -  respiratory diseases
KW  -  MIKANIA-GLOMERATA SPRENGEL
KW  -  PERFORMANCE LIQUID-CHROMATOGRAPHY
KW  -  ZINGIBER-OFFICINALE ROSCOE
KW  -  PREGNANCY-INDUCED NAUSEA
KW  -  PLANTAGO-LANCEOLATA L.
KW  -  WILLOW BARK EXTRACT
KW  -  POLYGALA-TENUIFOLIA WILLDENOW
KW  -  OREGANO LIPPIA-GRAVEOLENS
KW  -  ESSENTIAL OIL COMPOSITION
KW  -  THISTLE SILYBUM-MARIANUM
A1  - Silveira, D
A1  - Prieto-Garcia, JM
A1  - Boylan, F
A1  - Estrada, O
A1  - Fonseca-Bazzo, YM
A1  - Jamal, CM
A1  - Magalhaes, PO
A1  - Pereira, EO
A1  - Tomczyk, M
A1  - Heinrich, M
JF  - Frontiers in Pharmacology
EP  - 44
VL  - 11
AV  - public
Y1  - 2020/09/23/
TI  - COVID-19: Is There Evidence for the Use of Herbal Medicines as Adjuvant Symptomatic Therapy?
N1  - This work is licensed under a Creative Commons Attribution 4.0 International License. The images
or other third party material in this article are included in the Creative Commons license,
unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license,
users will need to obtain permission from the license holder to reproduce the material. To view a copy of this
license, visit http://creativecommons.org/licenses/by/4.0/
ER  -