Traditional Chinese medicine shenhuang granule in patients with severe/critical COVID-19: A randomized controlled multicenter trial

Zhou, Shuang; Feng, Jun; Xie, Qin; Huang, Tingrong; Xu, Xiaoming; Zhou, Daming; Zhang, Wen; Sun, Shuting; Li, Xudong; Wu, Xinxin; Che, Jinhua; Tian, Fan; Zou, Dengxiu; Wang, Junshuai; Zhan, Daqian; Peng, Dan; Feng, Yun‐Zhi; Yu, Gang; Yuan, Zhihang; Fang, Bangjiang

doi:10.1016/j.phymed.2021.153612

Cited by 44 publications

(56 citation statements)

References 12 publications

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“…Variation in NLR can be monitored to effectively assess the efficacy of treatment. A recent study using Shenhuang Granule (SHG), on COVID-19 patients reported similar improvements in NLR and reduction in the clinical symptoms (Zhou et al 2021 ). In another clinical trial, Viranorm, a formulation composed of six herbal ingredients, was used every six hours as an add-on treatment on asymptomatic mild COVID-19 patients.…”

Section: Discussionmentioning

confidence: 83%

Inflawell® improves neutrophil-to-lymphocyte ratio and shortens hospitalization in patients with moderate COVID-19, in a randomized double-blind placebo-controlled clinical trial

Tond

Balenci²,

Khajavirad

et al. 2022

Inflammopharmacol

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Aims COVID-19 is a significant global threat to public health. Despite the availability of vaccines and anti-viral drugs, there is an urgent need for alternative treatments to help prevent and/or manage COVID-19 symptoms and the underlying dysregulated immune response. We hypothesized that administration of Inflawell ® syrup, a Boswellia extract formulation enriched for boswellic acids (BAs), can reduce the excessive or persistent inflammation and thereby prevent disease progression. BAs are medicinally activated triterpenoids found in the resins of Boswellia spp ., and possess an immense therapeutic potential due to their anti-inflammatory and immunoregulatory activities. We investigated the effect of Inflawell ® syrup, on moderate COVID-19 patients along with the current standard of care treatment. Methods A randomized placebo-controlled double-blind clinical trial was conducted, following definitive confirmation of COVID-19. Forty-seven hospitalized patients with moderate COVID-19 were enrolled and received either the Inflawell ® syrup or placebo. Clinical symptoms and markers of inflammation were evaluated at baseline and completion of the trial. Results Our clinical trial revealed an increase in the percentage of oxygen saturation level in patients that received the BAs compared to placebo ( P < 0.0001). In addition, the average duration of hospitalization was significantly shorter in the BAs group compared with the placebo group ( P < 0.04). Concomitantly, some improvement in the clinical symptoms including cough, dyspnea, myalgia, headache, and olfactory and gustatory dysfunction were detected in the BAs group. Hematologic findings showed a significant decrease in the percentage of neutrophils ( P < 0.006) and neutrophil-to-lymphocyte ratio (NLR) levels ( P < 0.003), associated with a significant increase in the percentage of lymphocytes in the BAs group compared with the placebo ( P < 0.002). Additionally, a significant decrease in CRP, LDH, IL − 6 and TNF − α levels was detected in the BAs group. Following the intervention, fewer patients in the BAs group were PCR-positive for COVID-19 compared to placebo, though not statistically significant. Conclusion Overall, the treatment with Inflawell ® resulted in shorter hospital stay, alleviation of COVID-19 clinical symptoms and decline in the level of pro-inflammatory cytokines. Trial registration The trial has been registered in https://www.irct.ir with unique identifier: IRCT20170315033086N10 ( https://en.irct.ir/trial/51631 ). IRCT is a primary registry in the WHO registry network ( https://www...

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Section: Discussionmentioning

confidence: 83%

Inflawell® improves neutrophil-to-lymphocyte ratio and shortens hospitalization in patients with moderate COVID-19, in a randomized double-blind placebo-controlled clinical trial

Tond

Balenci²,

Khajavirad

et al. 2022

Inflammopharmacol

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“…Twenty-four RCTs reported the generation of random sequences, of which three RCTs [ 12 , 26 , 29 ] described the performance of allocation concealment. Two RCTs [ 12 , 29 ] blinded participants and researchers as well as outcome evaluators.…”

Section: Resultsmentioning

confidence: 99%

“…A high-quality RCT [ 26 ] we included indicated that the mortality rate of severe or critical patients in TCM group was visibly lower compared with CWM group [38.6% (22/57) vs 75.9% (41/54), RR = 0.51, 95% CI (0.35, 0.73), P = 0.0002]. Five RSs [ 52 , 54 , 55 , 57 , 58 ] reached the same conclusion [RR = 0.47, 95% CI (0.31, 0.70), I 2 = 54%, P = 0.0002] (Fig.…”

Section: Resultsmentioning

confidence: 99%

Efficacy and mechanisms of traditional Chinese medicine for COVID-19: a systematic review

Kang

Jin

et al. 2022

Chin Med

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Since the outbreak of coronavirus disease 2019 (COVID-19), traditional Chinese medicine (TCM) has made an important contribution to the prevention and control of the epidemic. This review aimed to evaluate the efficacy and explore the mechanisms of TCM for COVID-19. We systematically searched 7 databases from their inception up to July 21, 2021, to distinguish randomized controlled trials (RCTs), cohort studies (CSs), and case–control studies (CCSs) of TCM for COVID-19. Two reviewers independently completed the screening of literature, extraction of data, and quality assessment of included studies. Meta-analysis was performed using Review Manager 5.4 software. Eventually, 29 RCTs involving 3060 patients and 28 retrospective studies (RSs) involving 12,460 patients were included. The meta-analysis demonstrated that TCM could decrease the proportion of patients progressing to severe cases by 55% and the mortality rate of severe or critical patients by 49%. Moreover, TCM could relieve clinical symptoms, curtail the length of hospital stay, improve laboratory indicators, and so on. In addition, we consulted the literature and obtained 149 components of Chinese medicinal herbs that could stably bind to antiviral targets or anti-inflammatory or immune-regulating targets by the prediction of molecular docking. It suggested that the mechanisms involved anti-virus, anti-inflammation, and regulation of immunity. Our study made a systematic review on the efficacy of TCM for COVID-19 and discussed the possible mechanisms, which provided clinical reference and theoretical basis for further research on the mechanism of TCM for COVID-19.

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“…Another study randomly assigned 111 patients with severe and critical COVID-19 to the Shenhuang Granule (SHG) group and the control group [ 20 ]. After 2 weeks of treatment, the mortality rate was lower in the SHG group (38.6%, 22/57) than the control group (75.9%, 41/54).…”

Section: Favorable Treatment Outcomes In Patients With Severe Covid-19mentioning

confidence: 99%

“…Zhou et al [ 20 ] evaluated patients with severe and critical COVID-19 and found that the administration of SHG significantly reduced the incidence of adverse events, such as an increased blood sugar level, increased blood total bilirubin level, thrombocytopenia, respiratory failure or ARDS, cardiopulmonary failure, and multiple organ dysfunction syndrome. This study suggests that treatment with SHG is associated with an increased lymphocyte count and decreased incidence of adverse events.…”

Section: Treatment Safetymentioning

confidence: 99%

Effectiveness and Safety of Traditional Chinese Medicine in Treating COVID-19: Clinical Evidence from China

Xing

Liu

2021

Aging and disease

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Traditional Chinese medicine shenhuang granule in patients with severe/critical COVID-19: A randomized controlled multicenter trial

Cited by 44 publications

References 12 publications

Inflawell® improves neutrophil-to-lymphocyte ratio and shortens hospitalization in patients with moderate COVID-19, in a randomized double-blind placebo-controlled clinical trial

Inflawell® improves neutrophil-to-lymphocyte ratio and shortens hospitalization in patients with moderate COVID-19, in a randomized double-blind placebo-controlled clinical trial

Efficacy and mechanisms of traditional Chinese medicine for COVID-19: a systematic review

Effectiveness and Safety of Traditional Chinese Medicine in Treating COVID-19: Clinical Evidence from China

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