eprintid: 10112875
rev_number: 16
eprint_status: archive
userid: 608
dir: disk0/10/11/28/75
datestamp: 2020-10-21 15:58:56
lastmod: 2021-09-21 21:56:23
status_changed: 2020-10-21 15:58:56
type: article
metadata_visibility: show
creators_name: Silveira, D
creators_name: Prieto-Garcia, JM
creators_name: Boylan, F
creators_name: Estrada, O
creators_name: Fonseca-Bazzo, YM
creators_name: Jamal, CM
creators_name: Magalhaes, PO
creators_name: Pereira, EO
creators_name: Tomczyk, M
creators_name: Heinrich, M
title: COVID-19: Is There Evidence for the Use of Herbal Medicines as Adjuvant Symptomatic Therapy?
ispublished: pub
divisions: UCL
divisions: B02
divisions: C08
divisions: D10
divisions: G09
keywords: Science & Technology, Life Sciences & Biomedicine, Pharmacology & Pharmacy, herbal medicine, coronavirus (2019-nCoV), COVID-19, benefit, risk assessment, respiratory diseases, MIKANIA-GLOMERATA SPRENGEL, PERFORMANCE LIQUID-CHROMATOGRAPHY, ZINGIBER-OFFICINALE ROSCOE, PREGNANCY-INDUCED NAUSEA, PLANTAGO-LANCEOLATA L., WILLOW BARK EXTRACT, POLYGALA-TENUIFOLIA WILLDENOW, OREGANO LIPPIA-GRAVEOLENS, ESSENTIAL OIL COMPOSITION, THISTLE SILYBUM-MARIANUM
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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.
date: 2020-09-23
date_type: published
publisher: FRONTIERS MEDIA SA
official_url: https://doi.org/10.3389/fphar.2020.581840
oa_status: green
full_text_type: pub
language: eng
primo: open
primo_central: open_green
verified: verified_manual
elements_id: 1822965
doi: 10.3389/fphar.2020.581840
lyricists_name: Heinrich, Michael
lyricists_id: MHEIN39
actors_name: Austen, Jennifer
actors_id: JAUST66
actors_role: owner
full_text_status: public
publication: Frontiers in Pharmacology
volume: 11
article_number: 581840
pages: 44
citation:        Silveira, D;    Prieto-Garcia, JM;    Boylan, F;    Estrada, O;    Fonseca-Bazzo, YM;    Jamal, CM;    Magalhaes, PO;             ... Heinrich, M; + view all <#>        Silveira, D;  Prieto-Garcia, JM;  Boylan, F;  Estrada, O;  Fonseca-Bazzo, YM;  Jamal, CM;  Magalhaes, PO;  Pereira, EO;  Tomczyk, M;  Heinrich, M;   - view fewer <#>    (2020)    COVID-19: Is There Evidence for the Use of Herbal Medicines as Adjuvant Symptomatic Therapy?                   Frontiers in Pharmacology , 11     , Article 581840.  10.3389/fphar.2020.581840 <https://doi.org/10.3389/fphar.2020.581840>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/10112875/1/fphar-11-581840.pdf