COVID-19 : is there evidence for the use of herbal medicines as adjuvant symptomatic therapy?

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Main Author: Silveira, Dâmaris
Publication Date: 2020
Other Authors: Prieto-Garcia, Jose Maria, Boylan, Fabio, Estrada, Omar, Fonseca-Bazzo, Yris Maria, Jamal, Claudia Masrouah, Batista, Pérola de Oliveira Magalhães Dias, Pereira, Edson Oliveira, Tomczyk, Michal, Heinrich, Michael
Format: Article
Language: eng
Source: Repositório Institucional da UnB
Download full: https://repositorio.unb.br/handle/10482/39687
https://doi.org/10.3389/fphar.2020.581840
Summary: 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.
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author Silveira, Dâmaris
author2 Prieto-Garcia, Jose Maria
Boylan, Fabio
Estrada, Omar
Fonseca-Bazzo, Yris Maria
Jamal, Claudia Masrouah
Batista, Pérola de Oliveira Magalhães Dias
Pereira, Edson Oliveira
Tomczyk, Michal
Heinrich, Michael
author2_role author
author
author
author
author
author
author
author
author
author_browse Batista, Pérola de Oliveira Magalhães Dias
Boylan, Fabio
Estrada, Omar
Fonseca-Bazzo, Yris Maria
Heinrich, Michael
Jamal, Claudia Masrouah
Pereira, Edson Oliveira
Prieto-Garcia, Jose Maria
Silveira, Dâmaris
Tomczyk, Michal
author_facet Silveira, Dâmaris
Prieto-Garcia, Jose Maria
Boylan, Fabio
Estrada, Omar
Fonseca-Bazzo, Yris Maria
Jamal, Claudia Masrouah
Batista, Pérola de Oliveira Magalhães Dias
Pereira, Edson Oliveira
Tomczyk, Michal
Heinrich, Michael
author_role author
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bitstream.url.fl_str_mv http://repositorio2.unb.br/jspui/bitstream/10482/39687/1/ARTIGO_Covid-19EvidenceUse.pdf
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collection Repositório Institucional da UnB
dc.contributor.author.fl_str_mv Silveira, Dâmaris
Prieto-Garcia, Jose Maria
Boylan, Fabio
Estrada, Omar
Fonseca-Bazzo, Yris Maria
Jamal, Claudia Masrouah
Batista, Pérola de Oliveira Magalhães Dias
Pereira, Edson Oliveira
Tomczyk, Michal
Heinrich, Michael
dc.date.accessioned.fl_str_mv 2020-12-01T18:43:15Z
dc.date.available.fl_str_mv 2020-12-01T18:43:15Z
dc.date.issued.fl_str_mv 2020-09-23
dc.identifier.citation.fl_str_mv SILVEIRA, Dâmaris et al. COVID-19: is there evidence for the use of herbal medicines as adjuvant symptomatic therapy?. Frontiers in Pharmacology, v. 11, art. 581840, 23 set. 2020. DOI: https://doi.org/10.3389/fphar.2020.581840. Disponível em: https://www.frontiersin.org/articles/10.3389/fphar.2020.581840/full. Acesso em: 01 dez. 2020.
dc.identifier.doi.pt_BR.fl_str_mv https://doi.org/10.3389/fphar.2020.581840
dc.identifier.uri.fl_str_mv https://repositorio.unb.br/handle/10482/39687
dc.language.iso.fl_str_mv eng
dc.publisher.none.fl_str_mv Frontiers
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
dc.source.none.fl_str_mv reponame:Repositório Institucional da UnB
instname:Universidade de Brasília (UnB)
instacron:UNB
dc.subject.keyword.pt_BR.fl_str_mv Fitoterapia
Covid-19
Avaliação benefício/risco
Doenças respiratórias
dc.title.pt_BR.fl_str_mv COVID-19 : is there evidence for the use of herbal medicines as adjuvant symptomatic therapy?
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
description 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.
eu_rights_str_mv openAccess
format article
id UNB_fcab20a5e4eaf17a023cffd6565a7e7e
identifier_str_mv SILVEIRA, Dâmaris et al. COVID-19: is there evidence for the use of herbal medicines as adjuvant symptomatic therapy?. Frontiers in Pharmacology, v. 11, art. 581840, 23 set. 2020. DOI: https://doi.org/10.3389/fphar.2020.581840. Disponível em: https://www.frontiersin.org/articles/10.3389/fphar.2020.581840/full. Acesso em: 01 dez. 2020.
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language eng
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oai_identifier_str oai:repositorio.unb.br:10482/39687
publishDate 2020
publishDateSort 2020
publisher.none.fl_str_mv Frontiers
reponame_str Repositório Institucional da UnB
repository.mail.fl_str_mv repositorio@unb.br
repository.name.fl_str_mv Repositório Institucional da UnB - Universidade de Brasília (UnB)
repository_id_str
spelling Silveira, DâmarisPrieto-Garcia, Jose MariaBoylan, FabioEstrada, OmarFonseca-Bazzo, Yris MariaJamal, Claudia MasrouahBatista, Pérola de Oliveira Magalhães DiasPereira, Edson OliveiraTomczyk, MichalHeinrich, Michael2020-12-01T18:43:15Z2020-12-01T18:43:15Z2020-09-23SILVEIRA, Dâmaris et al. COVID-19: is there evidence for the use of herbal medicines as adjuvant symptomatic therapy?. Frontiers in Pharmacology, v. 11, art. 581840, 23 set. 2020. DOI: https://doi.org/10.3389/fphar.2020.581840. Disponível em: https://www.frontiersin.org/articles/10.3389/fphar.2020.581840/full. Acesso em: 01 dez. 2020.https://repositorio.unb.br/handle/10482/39687https://doi.org/10.3389/fphar.2020.581840FrontiersCopyright © 2020 Silveira, Prieto-Garcia, Boylan, Estrada, Fonseca-Bazzo, Jamal, Magalhães, Pereira, Tomczyk and Heinrich. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.info:eu-repo/semantics/openAccessCOVID-19 : is there evidence for the use of herbal medicines as adjuvant symptomatic therapy?info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleFitoterapiaCovid-19Avaliação benefício/riscoDoenças respiratóriasBackground: 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.engreponame:Repositório Institucional da UnBinstname:Universidade de Brasília (UnB)instacron:UNBORIGINALARTIGO_Covid-19EvidenceUse.pdfARTIGO_Covid-19EvidenceUse.pdfapplication/pdf1086388http://repositorio2.unb.br/jspui/bitstream/10482/39687/1/ARTIGO_Covid-19EvidenceUse.pdfb003fd59e39c069fe08794d42c8091ddMD51open accessLICENSElicense.txtlicense.txttext/plain163http://repositorio2.unb.br/jspui/bitstream/10482/39687/2/license.txtba54f8d1c5f5ec8df897ad678916c701MD52open access10482/396872024-02-06 11:52:41.38open accessoai:repositorio.unb.br:10482/39687U3VibWlzc8OjbyBlZmV0aXZhZGEgcG9yIGludGVncmFudGUgZGEgZXF1aXBlIGRvIFJlcG9zaXTDs3JpbyBJbnN0aXR1Y2lvbmFsIGRhIFVuQiBkZSBhY29yZG8gY29tIGxpY2Vuw6dhIGNvbmNlZGlkYSBwZWxvIGF1dG9yIGUvb3UgZGV0ZW50b3IgZG9zIGRpcmVpdG9zIGF1dG9yYWlzLg==Repositório InstitucionalPUBhttps://repositorio.unb.br/oai/requestrepositorio@unb.bropendoar:2024-02-06T14:52:41Repositório Institucional da UnB - Universidade de Brasília (UnB)
spellingShingle COVID-19 : is there evidence for the use of herbal medicines as adjuvant symptomatic therapy?
Silveira, Dâmaris
Fitoterapia
Covid-19
Avaliação benefício/risco
Doenças respiratórias
status_str publishedVersion
title COVID-19 : is there evidence for the use of herbal medicines as adjuvant symptomatic therapy?
title_full COVID-19 : is there evidence for the use of herbal medicines as adjuvant symptomatic therapy?
title_fullStr COVID-19 : is there evidence for the use of herbal medicines as adjuvant symptomatic therapy?
title_full_unstemmed COVID-19 : is there evidence for the use of herbal medicines as adjuvant symptomatic therapy?
title_short COVID-19 : is there evidence for the use of herbal medicines as adjuvant symptomatic therapy?
title_sort COVID-19 : is there evidence for the use of herbal medicines as adjuvant symptomatic therapy?
topic Fitoterapia
Covid-19
Avaliação benefício/risco
Doenças respiratórias
url https://repositorio.unb.br/handle/10482/39687
https://doi.org/10.3389/fphar.2020.581840