Efficacy of Covexir® (Ferula foetida oleo‐gum) treatment in symptomatic improvement of patients with mild to moderate COVID‐19: A randomized, double‐blind, placebo‐controlled trial

Abstract

The SARS-CoV-2 COVID-19 pandemic has emerged as an unprecedented emergency state in healthcare system and global challenge. In recent decade, the function of exogenous H 2 S in the treatment of respiratory diseases has been investigated using H 2 S-donor agents. Ferula foetida is a medicinal plant that is traditionally used in respiratory diseases including asthma and viral respiratory diseases. The oleo-gum of this plant is a rich source of several organic sulfides including thiophenes, disulfides and polysulfide derivatives, which can act as H 2 S-donor agents. The purpose of this study was to investigate the efficacy of Covexir ® (F. foetida oleo-gum) treatment as a rich source of H 2 S-donor compounds in clinical presentations of patients with COVID-19.The efficacy of Covexir ® was evaluated in a randomized, double-blind, placebocontrolled trial in outpatients with COVID-19. Covexir ® could significantly inhibit cough when compared to the placebo group (p < .01 and p < 001, respectively).Moreover, there was a significant difference (p < 001) between the two groups in dyspnea symptom at follow-up interval of 7 day after receiving Covexir ® . Furthermore, on days 3 and 7, statistically significant differences were observed in myalgia, anorexia, anosmia, and sense of taste severity between two groups. Our findings revealed that Covexir ® was very safe in the treatment of COVID-19 patients with mild to moderate symptoms and it can be recommended to improve clinical presentations of patients with COVID-19 such as cough, shortness of breath, myalgia, anorexia, anosmia, and sense of taste.

Exploring the Impact of Herbal Therapies on COVID-19 and Influenza: Investigating Novel Delivery Mechanisms for Emerging Interventions

“…One study used Viola odorata L. aqueous extract (violet syrup) [36]; one study used pomegranate juice added to SUMAC (a composition of tannins, flavonoids, anthocyanins, isoflavones, terpenoids, and diterpenes) [37]; one study used Covexir (Ferula foetida oleogum) [38]; one study used Zufa syrup (a composition of Nepeta bracteata, Ziziphus jujube, Glycyrrhizaglabra, Ficuscarica, Cordia myxa, Papaver somniferum, Fennel, Adiantumcapillus veneris, Viola, Viper's-buglosses, Lavender, and Iris) [39]; one study used sachets of Matricaria chamomilla L., Zataria multiflora Boiss., Glycyrrhiza glabra L., Ziziphus jujuba Mill., Ficus carica L., Urtica dioica L., Althaea officinalis L., Nepeta bracteata Benth, and capsules of Rheum palmatum L. rizhome, Glycyrrhiza glabra root, Punica granatum L. fruit peel, Rheum palmatum, and Nigella sativa L. [40]; one study used giloy, swasari ras, ashwagandha, and tulsi ghanvati [41]; one used a multicomponent over-the-counter formulation [42]; one used lacto-wolfberry [43]; one used aged garlic extract powder [44]; one used ephedra herb, apricot kernel, cinnamon bark and glycyrrhiza root [45]; one used ginseng [46]; two used broccoli sprout decoction [47,48]; one used a Chima qingwen decoction [49]; one used elderberry extract orally [50]; and one use posaconazole [51]. The administered doses ranged from 300 mg to 200 g per day, and the intervention period ranged from 4 days to 20 weeks.…”

“…Hasanpour et al [38] conducted a placebo-controlled, randomized, double-blind clinical trial to evaluate the effects of Covexir (Ferula foetida oleo-gum) against COVID-19 symptomatology. The results showed that Covexir significantly inhibited many COVID-19-related symptoms such as anosmia, ageusia, myalgia, and cough.…”

Efficacy and Safety of Add-On Plant-Based Drugs for COVID-19 Patients: A Review of the Randomized Control Trials

“…Of the 163 articles identified, 12 studies were reckoned to meet the eligibility criteria and these articles were included for analysis (depicted in Figure 2). Out of 12 studies, 11 studies are conducted in COVID-19 patients [14][15][16][17][18][19][20][21][22][23][24] and 1 study is conducted in post-COVID-19 patients. 25 There are 22 varieties of plants involved as add-on therapy for COVID-19 patients.…”

“…The studies used standard-of-care drugs, eg, a combination of NSAIDs (acetaminophen 500 mg) [14][15][16]18,21 or SAIDs (prednisolone), 20 antibiotics (azithromycin 500 mg), 18,21 chloroquine or hydroxychloroquine, 18,22 H1R antagonists (cetirizine 10 mg for allergy or dimenhydrinate for nausea), 15,21 anticoagulants (enoxaparin 40 mg), 16,22 antitussive (bromhexine or dextromethorphan), 15,16 antacids or H2R antagonists (famotidine), 24 and supplements (Vitamin C 500 mg). The antiviral drugs used were remdesivir (in general) or favipiravir (for mild severity symptoms) or oseltamivir (for moderate severity symptoms) or a combination of lopinavir/ritonavir.…”

Exploring the Impact of Herbal Therapies on COVID-19 and Influenza: Investigating Novel Delivery Mechanisms for Emerging Interventions

“…One study used Viola odorata L. aqueous extract (violet syrup) [36]; one study used pomegranate juice added to SUMAC (a composition of tannins, flavonoids, anthocyanins, isoflavones, terpenoids, and diterpenes) [37]; one study used Covexir (Ferula foetida oleogum) [38]; one study used Zufa syrup (a composition of Nepeta bracteata, Ziziphus jujube, Glycyrrhizaglabra, Ficuscarica, Cordia myxa, Papaver somniferum, Fennel, Adiantumcapillus veneris, Viola, Viper's-buglosses, Lavender, and Iris) [39]; one study used sachets of Matricaria chamomilla L., Zataria multiflora Boiss., Glycyrrhiza glabra L., Ziziphus jujuba Mill., Ficus carica L., Urtica dioica L., Althaea officinalis L., Nepeta bracteata Benth, and capsules of Rheum palmatum L. rizhome, Glycyrrhiza glabra root, Punica granatum L. fruit peel, Rheum palmatum, and Nigella sativa L. [40]; one study used giloy, swasari ras, ashwagandha, and tulsi ghanvati [41]; one used a multicomponent over-the-counter formulation [42]; one used lacto-wolfberry [43]; one used aged garlic extract powder [44]; one used ephedra herb, apricot kernel, cinnamon bark and glycyrrhiza root [45]; one used ginseng [46]; two used broccoli sprout decoction [47,48]; one used a Chima qingwen decoction [49]; one used elderberry extract orally [50]; and one use posaconazole [51]. The administered doses ranged from 300 mg to 200 g per day, and the intervention period ranged from 4 days to 20 weeks.…”