Herbal Medicine Intervention for the Treatment of COVID-19: A Living Systematic Review and Cumulative Meta-Analysis

Abstract

Background: Integrative herbal medicine has been reported to have beneficial effects in the treatment of coronavirus disease 2019 (COVID-19).Aim: To compile up-to-date evidence of the benefits and risks of herbal medicine for the treatment of COVID-19 symptoms.Methods: Eleven databases, including PubMed, Cochrane Register of Controlled Trials (CENTRAL), Embase, Allied and Complementary Medicine Database (AMED), Chinese National Knowledge Infrastructure Database (CNKI), Wanfang Database, and Chinese Science and Technique Journals Database (VIP), Research Information Service System (RISS), Korean Medical database (KMBase), Korean Association of Medical Journal database (KoreaMed), and OASIS database, were searched from 15 June, 2020, until 28 March 2022. Randomized controlled trials (RCTs), published in any language, reporting the efficacy and safety outcomes of herbal medicine in patients of all ages with a PCR-confirmed diagnosis of COVID-19 were included in this analysis. Data extraction and quality assessments were performed independently.Results: Random-effects meta-analyses showed evidence of favorable effects of treatment with herbal medicine when added to standard treatment, versus standard treatment alone, on the total effective rate (p = 0.0001), time to remission from fever (p < 0.00001), rate of remission from coughing (p < 0.0001), fatigue (p = 0.02), sputum production (p = 0.004), improvement of manifestations observed on chest computed tomography scans (p < 0.00001), incidence of progression to severe COVID-19 (p = 0.003), all-cause mortality (p = 0.003), time to a negative COVID-19 coronavirus test (p < 0.0001), and duration of hospital stay (p = 0.0003). There was no evidence of a difference between herbal medicine added to standard treatment, versus standard treatment alone, on the rate of remission from symptoms such as a fever, sore throat, nasal congestion and discharge, diarrhea, dry throat, chills, and the rate of conversion to a negative COVID-19 coronavirus test. Meta-analysis showed no evidence of a significant difference in adverse events between the two groups. There was an unclear risk of bias across the RCTs included in this analysis, indicating that most studies had methodological limitations.Conclusion: Current evidence suggests that herbal medicine added to standard treatment has potential benefits in the treatment of COVID-19 symptoms but the certainty of evidence was low.

Traditional Vietnamese medicine Kovir capsule for non‐severe COVID‐19 patients: A phase III double‐blind randomized controlled trial

“…Kovir shares the main feature with other herbal and traditional medicines, including healing and restoring the balance of the body (Ang et al, 2022;Chen et al, 2022;Devpura et al, 2021;Jiang et al, 2021;Karimi et al, 2021;Li et al, 2022;Natarajan et al, 2021;Srivastava et al, 2021;Tseng et al, 2022;Valizadeh et al, 2020;Varnasseri et al, 2022;Xia et al, 2021;Xiao et al, 2020;Xu et al, 2021;X. Y. Zhang et al, 2021;Zhou et al, 2021) This finding differs from a large study comparing symptom manifestation in omicron and delta variants (Menni et al, 2022), where omicron had a faster resolution of symptoms than delta.…”

“…Kovir shares the main feature with other herbal and traditional medicines, including healing and restoring the balance of the body (Ang et al, 2022; Chen et al, 2022; Devpura et al, 2021; Jiang et al, 2021; Karimi et al, 2021; Li et al, 2022; Natarajan et al, 2021; Srivastava et al, 2021; Tseng et al, 2022; Valizadeh et al, 2020; Varnasseri et al, 2022; Xia et al, 2021; Xiao et al, 2020; Xu et al, 2021; X. Y. Zhang et al, 2021; Zhou et al, 2021). The mechanism of this feature may be that Kovir contains several anti‐inflammatory components such as Radix Peucedani , Radix Bupleuri chinensis , Radix Codonopsis pilosulae , and Radix Angelicae pubescentis .…”

Traditional Vietnamese Medicine Containing Garlic Extract for Patients With Non-severe COVID-19: A Phase-II, Double-Blind, Randomized Controlled Trial

“…Many herbal and traditional medicines have been studied for the treatment of COVID-19, including non-severe and severe/critical diseases [ 4 , 10 - 25 ]. These medicines were developed from a wide range of herbs and formulae from countries with well-known traditional medicine, such as China, Iran, India, and Vietnam.…”

Effect and Mechanism of Schizandrin A in the Treatment of Liver Cancer Using Network Pharmacology, Molecular Docking, and Target Validation

“…In recent years, Traditional Chinese Medicine (TCM) has been increasingly widely used in clinics due to its high efficacy, safety, and other comprehensive therapeutic effects. 8 The multilevel, multitarget, and multipathway therapeutic mechanism is the main way to exert its efficacy. However, how to treat diseases through the key target or pathway of TCM has been a difficult problem puzzling the modernization of TCM.…”