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Background: Most systems of traditional medicine have been using herbal medicines to prevent and treat acute respiratory conditions and various other conditions for centuries. The aim of this project is to identify and examine the systematic and narrative reviews reporting on the therapeutic use of herbal medicines as it relates to the prevention and treatment of COVID-19 and long COVID. Methods: This paper is part of an umbrella review of studies related to natural health products and natural therapies for the prevention or treatment of COVID-19. It is a follow-up to a live review that was conducted by the World Naturopathic Federation between May 2022 and May 2023. PubMed and Google Scholar were searched for systematic and narrative reviews that met defined quality criteria. Results: Over half of the initial systematic reviews were excluded as they did not meet the inclusion and AMSTAR criteria. The final paper included 25 narrative reviews and 41 systematic reviews (SR), with half of the SRs reporting on the safety of herbal interventions. Various therapeutic properties of over 60 herbal medicines were outlined, some individually and most of them as part of herbal formula (combinations). Conclusion/Summary: Herbal interventions demonstrated statistically significant improved recovery in patients with COVID-19. The most common therapeutic properties identified were immunological properties, anti-inflammatory, antimicrobial, and antioxidant while the most frequently investigated herbs were Glycyrrhiza glabra/uralensis, Tinospora cordifolia, and Curcuma longa. More attention is needed on the regulation of herbal medicines, the quality of research, and the safety of herbal medicines. [ABSTRACT FROM AUTHOR]

Background of the Study: Houttuynia cordata is an herbal medicinal plant with a variety of ethnomedicinal properties. The plant extract has potent anti-inflammatory and antioxidant effects, which may help to reduce the complications associated with diabetes. Additionally, it is used as an anti-inflammation, antidote, astringent, anti-bacterial, and anti-viral. Objectives: The present study is a scientometric analysis of Houttuynia cordata during 1992-2021 as covered in the SCOPUS database to find out the citation impact, growth rate, and research output of Houttuynia cordata research during a three-decade period. Materials and Methods: SCOPUS database was used to download data for three decades. The information gathered was quantified using bibliometrics; further, VOS viewer was used for visualizing the keyword network. Results: The study revealed that from 2005 onwards, there was an increase in Houttuynia cordata research and publication. China turns out to be at the top with the maximum number of research publications on Houttuynia cordata. Pharmacology, Toxicology, and Pharmaceutics were the top subject areas that constituted the leading publication. Keywords 'Traditional Medicine' and 'Medicinal Plants' were used mainly during the year 1992-2018, however, from 2019-2021 there is a tremendous shift from the keywords such as 'Traditional Medicine', and 'Medicinal Plants' to keywords such as 'Coronavirus' 'COVID-19' and 'Pandemic', indicating that research on Houttuynia cordata relating to COVID-19 and Pandemic has become an extensive area of research from 2019 onwards. Conclusion: This study concludes that research on Houttuynia cordata has been slow since the early years, with a significant surge during the COVID-19 pandemic. The onset of the COVID-19 pandemic has certainly reconfirmed the relevance of Houttuynia cordata as a medicinal herb. Additionally, this study will help researchers understand the current state of the Houttuynia cordata research and can act as an information road map to further explore research on its medicinal importance which may benefit humanity in the future. [ABSTRACT FROM AUTHOR]

COVID-19 emerged as a widespread worldwide ailment in 2019, with a continued breakdown of novel gamma and lambda variants. Given the high incidence of COVID-19 even in the vaccinated people, research is in progress to develop convenient used drugs to control coronavirus disease. Herein, to review the effectiveness and safety of the recent antiviral, antibacterial, and herbal medication utilized to treat COVID-19, electronic databases including Scopus, PubMed, and Cochrane Library were compiled from papers registered in clinical trials on COVID-19 from January 2021 to February 2022. Oseltamivir, remdesivir, ivermectin, casirivimab, imdevimab, sotrovimab, Tocilizumab, sarilumab, dexamethasone, methylprednisolon, paxlovid, fluvoxamine, molnupiravir, ruxolitinib, tofacitinib, baricitinib, favipiravir, molnupiravir, azithromycin, niclosamide, nitazoxanide, and tetracyclines are the most commonly used antiviral and antibiotics to control mild to severe COVID-19 illnesses in the clinic. Despite the efficacy of drugs solely and in combination, medicinal herbs and natural products were considered in some clinical trials due to the high cost and unwanted side effects. However, no substantial evidence has been reported to confirm the significant anti-COVID-19 impact of synthetic and herbal medicines. This scenario opens an exciting new perspective for the elucidation of convenient therapeutic pipelines. [ABSTRACT FROM AUTHOR]

Background: COVID-19 produces a great burden on obese individuals. Due to the age-long use of medicinal herbs in the management of obesity, their potential against the COVID-19 pandemic is increasingly investigated. This study aims to review phytochemicals or bioactive compounds with the potential of being useful for obese COVID-19 patients. Methods: Using search terms that include pairwise combinations of either COVID-19 or obesity with each of nine selected phytochemicals (epigallocatechin gallate, rutin, astaxanthin, resveratrol, genistein, curcumin, quercetin, ellagic acid, and hesperidin). Relevant articles published from January 2009 to August 2023 were retrieved from PubMed. Results: A total of 43 papers (17 clinical trials, 12 preclinical studies, 3 systemic reviews of randomized controlled trials, and 11 other review papers) met the inclusion criteria and were discussed in this review. These include research articles reporting the anti-COVID-19 properties of the selected phytochemicals, which have previous or recent “clinical evidence” against overweight or obesity Conclusion: Phenolic compounds make up to eight out of the nine selected bioactive compounds and are, therefore, concluded to be the best class of phytochemicals for managing obese COVID-19 patients.

When the COVID-19 pandemic struck and China reported the first case to the World Health Organization in December 2019, there was no evidence-based treatment to combat it. With the catastrophic situation that followed, materialised by a considerable number of deaths, researchers, doctors, traditional healers, and governments of all nations committed themselves to find therapeutic solutions, including preventive and curative. There are effective treatments offered both by modern medicine and traditional medicine for COVID-19 today. However, other therapeutic proposals have not been approved due to the lack of effectiveness and scientific rigour during their development process. Proponents of modern medicine prefer biomedical therapies while in some countries, traditional treatments are used regularly because of their availability, affordability and satisfaction they bring to the population. In this paper, we propose a transactional medicine approach where the interaction between traditional and modern medicine produces a change. With this approach, the promoters of traditional medicine and those of modern medicine will be able to acquire knowledge through the experience produced by their encounters. Transactional medicine aims to be a model for decolonising medicine and recognising the value of both traditional and modern medicine in the fight against COVID-19 and other global emerging pathogens. [ABSTRACT FROM AUTHOR]

Background: SARS-CoV-2 is the causative agent of the novel coronavirus disease (COVID-19). This virus is responsible for the pandemic which has resulted in the current global health crisis. Remdesivir is now used as an FDA-approved medication in addition to some emergency use authorization (EUA) agents such as Actemra (Tocilizumab), Sotrovimab, and REGEN-COV (Casirivimab and Imdevimab) to contain the COVID-19 infection. However, they are not 100% effective in all cases, and there are several hundreds of daily deaths worldwide. Furthermore, since nearly one year as of the beginning of global vaccination, various vaccines have been evaluated not completely efficient in containing new variants of SARS-CoV-2, although they have significantly reduced mortality. Herbal medicines with evidence-based beneficial effects can have positive roles in immunity enhancement, prevention of infection, and antiviral effects. This review presents the updates of some herbal medicines that may have potential effects on the containment of the COVID-19, especially those with antitussive, antipyretic, anti-viral, anti-inflammatory, and antioxidant effects. Methods: In this narrative review, a thorough literature review was conducted on the entries of Google Scholar, PubMed, Web of Science (Clarivate Analytics), Scopus and, and Science Direct published since 2019. This study includes the recently published papers, randomized clinical trials (RCTs), and World Health Organization updates about the COVID-19. The inclusion criteria were the papers that described the effects of the most efficient types of herbal medicines on the containment of the COVID-19. Results: Analyzing nearly more than 40 medicinal plants, we found seven herbals (Myrtus communis, Zingiber officinale, Allium Sativum, Nigella Sativa, Glycyrrhiza glabra, and Thymus Vulgaris) that might have some positive effects on deferent stages of the COVID-19. Conclusion: Since some herbal medicines might help alleviate or relieve the symptoms of the COVID-19 or have other therapeutic effects, randomized controlled trials should be conducted to confirm these effects. [ABSTRACT FROM AUTHOR]

Traditional Chinese Medicine (TCM) is a complete medical system that has evolved over millennia to include practices and procedures such as acupuncture, herbal medicine, manual therapies, nutrition, and mind–body therapies such as qi gong. In modern-day China and other Asian countries, TCM is a medical subspecialty utilized alongside western biomedicine. During the current Coronavirus Disease 19 (COVID-19) pandemic, TCM and TCM herbal medicine is being used and a number of single herbs and combination formulas have significant bioactivity and therapeutic potential. The purpose of this paper is to highlight the use of TCM in the treatment of COVID-19. This commentary provides the reader with a concise background on COVID-19 and summarizes TCM concepts including identification, pattern diagnosis, and treatment principles commonly used for the treatment of viral influenza-like diseases. It also highlights some of the challenges and potential for using TCM in an integrated medical setting. [ABSTRACT FROM AUTHOR]

At present, specific therapies for COVID-19 are not well established, being certain only that the immune system plays a decisive role in the initiation and progression of the disease. Plants have given and continue to give compounds with great efficiency and low toxicity, some of them being a starting point for extremely effective synthetic substances. Although herbal remedies are used mainly for preventive purposes, there are also guidelines issued by some countries that indicate the use of traditional remedies for different stages of COVID-19 disease.Europe has a long and strong tradition of using medicinal plants for therapeutic purposes, but clinical trials for this type of approach are scarce, compared to Asia. In this regard, a bridge between tradition and science, would have a strong impact on the capacity for prevention and treatment of COVID-19. The paper reviews compounds of plant origin that have previously proven effective in counteracting some coronaviruses but also some of their major effects - direct action on virus replicative apparatus (viral entry or replication, action on the viral enzymatic system), collateral action of natural compounds on the immune system and also the contribution of herbal medicine as vaccine adjuvants are tackled. [ABSTRACT FROM AUTHOR]

COVID-19 is a highly contagious disease caused by severe acute respiratory SARS CoV-2. The common symptoms include cough usually dry in nature, fever, tiredness, shortness of breath and anosmia. World Health Organization has declared it 'pandemic' with a higher mortality rate especially among elderly having weaker immune system. There is no specific treatment for this dreadful infection until now and prevention is the only way to curb the disease. Antiviral drugs like remdesvir, oseltamivir, lopinavir and ritonavir along with antimalarial drugs like chloroquine and hydroxychloroquine are found to be effective against the novel coronavirus but are still under trial. In any disease outbreak, those who are fit with strong immune system persist otherwise will face grave results. Nature has created a treasury of medicinal herbs which boost the immune system besides having other benefits. In this paper we have proposed a polyherbal formulation, along with a thorough review of its ingredients, with the aim to highlight its potential in prevention and cure of COVID-19. [ABSTRACT FROM AUTHOR]

Novel coronavirus (COVID-19) pneumonia has become a major threat to worldwide public health, having rapidly spread to more than 180 countries and infecting over 1.6 billion people. Fever, cough, and fatigue are the most common initial symptoms of COVID-19, while some patients experience diarrhea rather than fever in the early stage. Many herbal medicine and Chinese patent medicine can significantly improve these symptoms, cure the patients experiencing a mild 22form of the illness, reduce the rate of transition from mild to severe disease, and reduce mortality. Therefore, this paper summarizes the physiopathological mechanisms of fever, cough, fatigue and diarrhea, and introduces Chinese herbal medicines (Ephedrae Herba, Gypsum Fibrosum, Glycyrrhizae Radix et Rhizoma, Asteris Radix et Rhizoma, Ginseng Radix et Rhizoma, Codonopsis Radix, Atractylodis Rhizoma, etc.) and Chinese patent medicines (Shuang-huang-lian, Ma-xing-gan-shi-tang, etc.) with their corresponding therapeutic effects. Emphasis was placed on their material basis, mechanism of action, and clinical research. Most of these medicines possess the pharmacological activities of anti-inflammatory, antioxidant, antiviral, and immunity-enhancement, and may be promising medicines for the treatment or adjuvant treatment of COVID-19 patients. [ABSTRACT FROM AUTHOR]

Critical care medicine is a medical specialty engaging the diagnosis and treatment of critically ill patients who have or are likely to have life-threatening organ failure. Sepsis, a life-threatening condition that arises when the body responds to infection, is currently the major cause of death in intensive care units (ICU). Although progress has been made in understanding the pathophysiology of sepsis, many drawbacks in sepsis treatment remains unresolved. For example, antimicrobial resistance, controversial of glucocorticoids use, prolonged duration of ICU care and the subsequent high cost of the treatment. Recent years have witnessed a growing trend of applying traditional Chinese medicine (TCM) in sepsis management. The TCM application emphasizes use of herbal formulation to balance immune responses to infection, which include clearing heat and toxin, promoting blood circulation and removing its stasis, enhancing gastrointestinal function, and strengthening body resistance. In this paper, we will provide an overview of the current status of Chinese herbal formulations, single herbs, and isolated compounds, as an add-on therapy to the standard Western treatment in the sepsis management. With the current trajectory of worldwide pandemic eruption of newly identified Coronavirus Disease-2019 (COVID-19), the adjuvant TCM therapy can be used in the ICU to treat critically ill patients infected with the novel coronavirus. [ABSTRACT FROM AUTHOR]

In December 2019, a novel coronavirus SARS-CoV-2, causing the disease COVID-19, spread from Wuhan throughout China and has infected people over 200 countries. Thus far, more than 3,400,000 cases and 240,000 deaths have occurred worldwide, and the coronavirus pandemic continues to grip the globe. While numbers of cases in China have been steadying, the number of infections outside China is increasing at a worrying pace. We face an urgent need to control the spread of the COVID-19 epidemic, which is currently expanding to a global pandemic. Efforts have focused on testing antiviral drugs and vaccines, but there is currently no treatment specifically approved. Traditional Chinese medicine (TCM) is grounded in empirical observations and the Chinese people use TCM to overcome these sorts of plagues many times in thousands of years of history. Currently, the Chinese National Health Commission recommended a TCM prescription of Qing-Fei-Pai-Du-Tang (QFPDT) in the latest version of the "Diagnosis and Treatment guidelines of COVID-19" which has been reported to provide reliable effects for COVID-19. While doubts about TCM still exist today, this review paper will describe the rationalities that QFPDT is likely to bring a safe and effective treatment of COVID-19. [ABSTRACT FROM AUTHOR]

The Corona Virus Disease 2019 (COVID-19) is an acute respiratory infectious disease. At present, COVID-19 has no specific therapeutic drugs, and the main clinical treatment is symptomatic treatment and control of complications. On March 5, 2020, the National Health Commission of the People's Republic of China issued the Guidelines for the Diagnosis and Treatment of Novel Coronavirus (2019-nCoV) Infection (Trial Version 7), which integrated traditional Chinese medicine (TCM) into the treatment of COVID-19. The purpose of this study is to summarize recent studies on the clinic application, pharmacological action, chemical substances and mechanism of Qingwen Baidu Decoction (QBD) on the treatment of various diseases. The results suggested that QBD has multiple pharmacological effects such as anti-inflammation, antiviral, antibacterial, immunomodulatory, antipyretic and so on. It has been used in the treatment of sepsis, epidemic hemorrhagic fever, epidemic cerebrospinal meningitis, infantile pneumonia, sepsis-related encephalopathy, epidemic encephalitis B and other diseases. In addition, this study attempts to explore the possible mechanism of QBD in the prevention and treatment of COVID-19. Through the analysis of the chemical substances, pharmacological action and mechanism of QBD, this paper will provide a reference theoretical basis for the prevention and treatment of COVID-19 by QBD. [ABSTRACT FROM AUTHOR]

In December 2019, coronavirus disease-2019 (COVID-19) broke out in Wuhan and other places. Seven versions of the Diagnosis and Treatment Program for Coronavirus Disease-2019 successively issued by the Chinese government have designated traditional Chinese medicine (TCM) as a necessary medical strategy. Based on the changes in TCM diagnosis and treatment strategies in these seven versions of Diagnosis and Treatment Program for Coronavirus Disease-2019, this paper collected data reported by the Chinese government media; analyzed the understanding of the etiology, pathogenesis, syndrome differentiation, treatment methods, and prescriptions of COVID-19 by TCM and evaluated the clinical efficacy of TCM strategies. COVID-19 is associated with TCM disease of pestilence, and its pathogenesis can be summarized as an "epidemic pathogen invading the body, followed by entering the internal organs and transforming into heat, resulting in pathogen trapping in the interior and healthy qi collapsing, and deficiency of qi and yin". Pathological processes should be emphasized in syndrome differentiation. The manifestations of qi deficiency and yin deficiency are exhibited during the recovery period. TCM strategies represented by Qing Fei Pai Du Tang have shown apparent advantages in improving symptoms, promoting virus clearance, and shortening hospitalization, as well as surprising efficacy of zero patient progressing from mild to severe cases in a TCM cabin hospital. Clinical data illustrate the effectiveness of TCM strategies proposed by the Chinese government. This major epidemic may bring new opportunities for TCM development. [ABSTRACT FROM AUTHOR]

Background: The high virulence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for coronavirus disease 2019 (COVID-19), has triggered global health and economic concerns. The absence of specific antiviral treatments and the side effects of repurposed drugs present persistent challenges. This study explored a promising antiviral herbal extract against SARS-CoV-2 from selected Thai medicinal plants based on in vitro efficacy and evaluated its antiviral lead compounds by molecular docking. Methods: Twenty-two different ethanolic-aqueous crude extracts (CEs) were rapidly screened for their potential activity against porcine epidemic diarrhea virus (PEDV) as a surrogate using a plaque reduction assay. Extracts achieving ≥ 70% anti-PEDV efficacy proceeded to the anti-SARS-CoV-2 activity test using a 50% tissue culture infectious dose method in Vero E6 cells. Molnupiravir and extract-free media served as positive and negative controls, respectively. Potent CEs underwent water/ethyl acetate fractionation to enhance antiviral efficacy, and the fractions were tested for anti-SARS-CoV-2 performance. The fraction with the highest antiviral potency was identified using liquid chromatography–high-resolution mass spectrometry (LC–HRMS). Molecular docking analyses of these compounds against the main protease (Mpro) of SARS-CoV-2 (6LU7) were performed to identify antiviral lead molecules. The top three hits were further evaluated for their conformational stability in the docked complex using molecular dynamics (MD) simulation. Results: The water fraction of mulberry (Morus alba Linn.) leaf CE (WF-MLCE) exhibited the most potent anti-SARS-CoV-2 efficacy with low cytotoxicity profile (CC50 of ~ 0.7 mg/mL), achieving 99.92% in pre-entry mode and 99.88% in postinfection treatment mode at 0.25 mg/mL. Flavonoids and conjugates were the predominant compounds identified in WF-MLCE. Molecular docking scores of several flavonoids against SARS-CoV-2 Mpro demonstrated their superior antiviral potency compared to molnupiravir. Remarkably, myricetin-3-O-β-D-galactopyranoside, maragrol B, and quercetin 3-O-robinobioside exhibited binding energies of ~ − 9 kcal/mol. The stability of each ligand–protein complex of these compounds with the Mpro system showed stability during MD simulation. These three molecules were pronounced as antiviral leads of WF-MLCE. Given the low cytotoxicity and high antiviral potency of WF-MLCE, it holds promise as a candidate for future therapeutic development for COVID-19 treatment, especially considering its economic and pharmacological advantages. [ABSTRACT FROM AUTHOR]

CCOVID-19 was first reported in late 2019 in Wuhan, China, and spread throughout the world like a pandemic. The population all over the world used lots of medicinal plants for prevention purposes. India has been blessed with cultural wisdom. Social health practices across the country have been utilizing integrative treatments to fight against mild fever and cold flu-like infections. Herbal and Ayurveda medicines have shown their impact on treating such infections in the early stages. The impact of herbal medicines on Covid infection is quite evident and several drug tests and trials have proved its worth of it in treating mild to severe infections. The majority of these plants are used to treat respiratory diseases having the same signs and symptoms as coronavirus symptoms or other flu infections. Our body can fight infections only when immunity is strong and for that herbal drugs as immunomodulators work well. It has worked in boosting the immunity of the patients and normal people to fight against Corona. The paper analyzes such research studies on Covid-19 treatment by herbal medicines. It makes a point that herbal medicine-based treatments and social health practices will play a complementary role in managing Covid-19 and Post-Covid health emergencies. New-Normal social ethics will evolve through such an integrative social health culture. [ABSTRACT FROM AUTHOR]

The apparition of new morbific viral strain is an incessant threat to mankind, with the novel coronavirus strain (COVID-19) as the contemporary example. COVID-19, emerged from SARS-Cov-2 (severe acute respiratory syndrome coronavirus 2) virus, proliferates at an alarming rate, leading to an unprecedented medical condition across the globe. Aforesaid pandemic demands an expeditious formulation of drugs and vaccines to neutralize the virus and safeguard global population with immunity. Quest for vaccines paved the way for screening nutraceutical and phytochemicals with evident potentiality against the COVID-19. Bioactive compounds and herbal formulations were examined for their antiviral property, inhibitory role and immunity boosting efficiency. Compilation of literature related to plant based bioactive compounds showing inhibitory effect against COVID-19, were retrieved from distinct sources: Google Scholar and Pubmed. An inclusive literature survey from more than 50 papers was carried out to aware the readers about the range of bioactive therapeutics to combat COVID-19. The advent of high throughput screening and computational studies was strategically deployed to hunt for the plant based bioactive compounds as potential drug-like molecule to neutralise COVID-19. Several peer-reviewed studies have proved a strong activity of bioactive compounds against the COVID-19 target protein by virtue of its binding to the active site of target protein. The review summarizes inciting advanced research carried out against bioactive compounds based COVID-19 drug-discovery in order to anticipate the COVID-19 treatment paradigm. [ABSTRACT FROM AUTHOR]

In 2020, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) challenged the world with a global outbreak that led to millions of deaths worldwide. Coronavirus disease 2019 (COVID-19) is the symptomatic manifestation of this virus, which can range from flu-like symptoms to utter clinical complications and even death. Since there was no clear medicine that could tackle this infection or lower its complications with minimal adverse effects on the patients' health, the world health organization (WHO) developed awareness programs to lower the infection rate and limit the fast spread of this virus. Although vaccines have been developed as preventative tools, people still prefer going back to traditional herbal medicine, which provides remarkable health benefits that can either prevent the viral infection or limit the progression of severe symptoms through different mechanistic pathways with relatively insignificant side effects. This comprehensive review provides scientific evidence elucidating the effect of 10 different plants against SARS-CoV-2, paving the way for further studies to reconsider plant-based extracts, rich in bioactive compounds, into more advanced clinical assessments in order to identify their impact on patients suffering from COVID-19. [ABSTRACT FROM AUTHOR]

Background and aims: Chinese herbal medicine (CHM) was used to prevent and treat coronavirus disease 2019 (COVID-19) in clinical practices. Many studies have demonstrated that the combination of CHM and Western medicine can be more effective in treating COVID-19 compared to Western medicine alone. However, evidence-based studies on the prevention in undiagnosed or suspected cases remain scarce. This systematic review and meta-analysis aimed to investigate the effectiveness of CHM in preventing recurrent, new, or suspected COVID-19 diseases. Methods: We conducted a comprehensive search using ten databases including articles published between December 2019 and September 2023. This search aimed to identify studies investigating the use of CHM to prevent COVID-19. Heterogeneity was assessed by a random-effects model. The relative risk (RR) and mean differences were calculated using 95% confidence intervals (CI). The modified Jadad Scale and the Newcastle-Ottawa Scale (NOS) were employed to evaluate the quality of randomized controlled trials and cohort studies, respectively. Results: Seventeen studies with a total of 47,351 patients were included. Results revealed that CHM significantly reduced the incidence of COVID-19 (RR = 0.24, 95% CI = 0.11-0.53, p = 0.0004), influenza (RR = 0.37, 95% CI = 0.18-0.76, p = 0.007), and severe pneumonia exacerbation rate (RR = 0.17, 95% CI = 0.05-0.64, p = 0.009) compared to non-treatment or conventional control group. Evidence evaluation indicated moderate quality evidence for COVID-19 incidence and serum complement components C3 and C4 in randomized controlled trials. For the incidence of influenza and severe pneumonia in RCTs as well as the ratio of CD4+/CD8+ lymphocytes, the evidence quality was low. The remaining outcomes including the disappearance rate of symptoms and adverse reactions were deemed to be of very low quality. Conclusion: CHM presents a promising therapeutic option for the prevention of COVID-19. However, additional high-quality clinical trials are needed to further strengthen evidential integrity. [ABSTRACT FROM AUTHOR]

Background: This umbrella review aims to synthesize the existing literature on the preventive and therapeutic benefits of minerals zinc, selenium, iron, copper, magnesium, phosphorus, and calcium in the context of COVID-19 prevention and management. The objective is to highlight the clinical applicability and identify avenues of future research. Methods: A systematic search was conducted in PubMed and Google Scholar databases using predefined keywords for each mineral combined with COVID-19–related terms. Narrative and systematic reviews were included, following Cochrane guidelines. AMSTAR scoring was used to assess systematic review quality, while SANRA guidelines were used to evaluate narrative reviews. Data extraction and synthesis were performed, and reference overlap analysis was conducted (see Table S1 in the supplemental material). Results: Narrative reviews highlighted the range of therapeutic properties of minerals including antimicrobial, antiviral, antioxidant, anti-inflammatory, and immune-modulating and the essential role they play in the prevention and treatment of many conditions, including acute respiratory conditions such as COVID-19. The systematic reviews highlighted that deficiency of key minerals such as zinc, selenium, iron, copper, magnesium, phosphorus, and calcium are associated with increased risk of infection and decreased rate of recovery. Iron supplementation may be beneficial as functional anemia is common in those with COVID-19. Zinc supplementation may shorten the duration of olfactory dysfunction. Conclusion/Summary: Deficiency of minerals may increase the risk of infection and decrease the rate of recovery as it relates to COVID-19. Supplementation with and correction of zinc, iron and selenium deficiencies may improve clinical outcomes and immune responses in those with COVID-19. [ABSTRACT FROM AUTHOR]

Background: The outbreak of Coronavirus Disease 2019 (COVID-19) has originated from Wuhan, China and rapidly spread all over the world. This disease is caused by a coronavirus termed Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) that mainly infects the human respiratory tract. Herbal agents including Atractylodes lancea, Ephedra, Curcumin, and Echinacea purpurea had immunomodulatory effects and antiviral activities on other respiratory viruses including Influenza virus. They strengthen the innate immunity through increasing the phagocytic activity and anti-inflammatory activity. These herbs could be used as a complementary therapy to prevent entry of COVID-19 and improve immune system. This review delves into the role and therapeutic compounds of various herbal agents in relation to immunity, their effectiveness in treating other viral respiratory illnesses, and their potential influence on COVID-19 disease. [ABSTRACT FROM AUTHOR]

In 2019, a new disease called Covid-19 was detected in Wuhan located in China which caused seriously disease or death at any age. This disease has various symptoms such as fever, chills, cough, sore throat, headache, body pain, muscle pain, diarrhoea, and vomiting. In this review study, articles related to the subject were searched using scientific sites such as Medline, PubMed, and Google Scholar using the keywords of traditional medicine, medicinal plants, and Covid-19. After downloading the articles, irrelevant articles were removed and related articles were reviewed. According to the results obtained from the review of the literature, the effective medicinal herbs including Zingiber officinale, Alpinia officinarum, Cinnamomum zeylanicum, Nigllea sativa, Citrus paradise, Laurus nobilis L. and Echinacea purpura were the most important medicinal herbs used in treatment of Coronavirus. Antiviral chemical drugs usually inhibit the virus by disrupting the key protein and viral virulence factors. Probably, medicinal plants inhibit corona virus with a mechanism similar to the chemical drugs. Therefore, it is possible to produce effective herbal medicines as alternative for synthetic drugs and reduce the pain and suffering from Covid-19 in patients. [ABSTRACT FROM AUTHOR]

Introduction: Osteoporosis is a significant clinical and public health concern worldwide. Despite the impact of this condition on women's lives, most studies have focused on its clinical manifestations, drug efficacy, and medical treatment. Furthermore, most studies have been conducted in the West. This study aimed to uncover the personal experiences of postmenopausal Omani women living with osteoporosis. Methods: In this interpretive phenomenological study, a purposive sample of 15 postmenopausal Omani women with osteoporosis was recruited from primary and secondary care facilities in Muscat, Oman. Semi‐structured one‐to‐one interviews were conducted via Zoom and telephone because of coronavirus disease 2019 restrictions. The interviews were audio‐recorded, and the Ajjawi and Higgs framework was used to analyse the data thematically. Results: The following key themes were constructed from the interviews: the impact of osteoporosis on religious practices, cultural and social life, and financial status, and the benefits derived from religious and cultural practices and rituals, including Muslim prayer, recitation of Quranic verses, and herbal remedies to cope with osteoporosis‐related pain and suffering. Conclusion: Osteoporosis and fragility fractures have a significant impact on the religious, cultural, and financial lives of postmenopausal Omani women with osteoporosis. Muslim prayers, recitation of Quranic verses, and herbal remedies are coping strategies for pain in this population. Patient or Public Contribution: Postmenopausal Omani women with osteoporosis participated in this study through interviews and contributed their lived experiences. Orthopaedic doctors helped recruit patients with postmenopausal osteoporosis. [ABSTRACT FROM AUTHOR]

Many studies have suggested herbal medicines as alternatives or adjuvants to modern drugs for COVID-19. Their scientometric analyses can provide a scientific overview of this topic. Web of Science (WOS) and Scopus were searched for articles on the use of herbal medicines in COVID-19 published until 26 October 2020. Collected data were analyzed for document type, subject area, top journal, citation number, and authors' collaboration network using VOSviewer 1.6.15, ScientoPy 2.0.3, Gephi 0.9.2, and SPSS 15 statistical tools. After screening the 3185 retrieved records, 378 and 849 records, respectively from WOS and Scopus, remained for quantity analysis. Original and review articles were the two main types of papers in both databases. Top subject areas were drug and medicine, respectively in the WOS and Scopus databases. The top three productive countries in the field were China, the US, and India. The most cited article was a practice guideline in both databases. "Journal of Biomolecular Structure Dynamics" in WOS and "Chinese Traditional and Herbal Drugs" in Scopus were the top journals. Top keywords included "COVID-19″ and "Traditional Chinese Medicine". US authors had the highest collaboration with other authors. The current study provides a snapshot of the quantity and characteristics of published scholarly documents in recent months in the intersection of herbal medicines and COVID-19. Our findings help scientists to find the existing gaps, identify the active authors and scientific institutes to collaborate with and use their experience to produce new knowledge in the future. [Display omitted] • This scientometrics was propsed to show an overview of the published documents on herbal medicine therapy for COVID-19 in WOS and Scopus databases and compare their characteristics. • Quantity analysis showed original and review articles as the main types of papers, drug and medicine as top subject areas, and China as top productive country. • A practice guideline was the highest cited article "Journal of Biomolecular Structure Dynamics" and "Chinese Traditional and Herbal Drugs" were the toppest journals in WOS, and Scopus, respectively. • US authors had the highest collaboration with other authors. • The topic modeling could give an overview of issues that publications have been focused on whether it is clinical care, management, public heath, and pathogenesis. [ABSTRACT FROM AUTHOR]

COVID-19 emerged as a widespread worldwide ailment in 2019, with a continued breakdown of novel gamma and lambda variants. Given the high incidence of COVID-19 even in the vaccinated people, research is in progress to develop convenient used drugs to control coronavirus disease. Herein, to review the effectiveness and safety of the recent antiviral, antibacterial, and herbal medication utilized to treat COVID-19, electronic databases including Scopus, PubMed, and Cochrane Library were compiled from papers registered in clinical trials on COVID-19 from January 2021 to February 2022. Oseltamivir, remdesivir, ivermectin, casirivimab, imdevimab, sotrovimab, Tocilizumab, sarilumab, dexamethasone, methylprednisolon, paxlovid, fluvoxamine, molnupiravir, ruxolitinib, tofacitinib, baricitinib, favipiravir, molnupiravir, azithromycin, niclosamide, nitazoxanide, and tetracyclines are the most commonly used antiviral and antibiotics to control mild to severe COVID-19 illnesses in the clinic. Despite the efficacy of drugs solely and in combination, medicinal herbs and natural products were considered in some clinical trials due to the high cost and unwanted side effects. However, no substantial evidence has been reported to confirm the significant anti-COVID-19 impact of synthetic and herbal medicines. This scenario opens an exciting new perspective for the elucidation of convenient therapeutic pipelines.

The literature on coronavirus disease 2019 (COVID-19) treatments, including herbal medicine, has expanded rapidly due to intense global interest. We conducted this scoping review to map the characteristics and assess the quality of systematically conducted reviews of herbal medicine and COVID-19 published during the pandemic era. Electronic databases were searched to identify published systematic reviews and other research synthesis articles relating to herbal medicine vis-a-vis COVID-19 from 2020 to 2022. Forty-eight articles were included. Most were systematic reviews (SR) and/or meta-analyses (MA) on Chinese herbal medicine for clinical treatment during the acute phases of COVID-19 (44%). Regarding adherence to a measurement tool to assess systematic reviews (AMSTAR-2) critical items, only one-third (n=15) reported an a priori protocol, while 21% (n=10) presented a comprehensive literature search strategy. When analysed by type of review, SR/MA (n=23) of clinical interventions had better than the overall average adherence rate in having a pre-registered protocol (87%, n=20) and comprehensive literature search strategy (45%, n=9). Exploratory analysis showed that most articles reported search results from at least two established electronic databases. Risk of bias assessment was performed in almost all SR/MA though there was limited exploration of any potential sources of heterogeneity. Overall, there is a need to improve the methodological design and implementation of systematically conducted reviews of herbal medicine in general to enhance the robustness and reliability of findings, especially given the rapid expansion of literature during unique circumstances such as the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to determine the role of Iranian herbal Zofa® syrup in improving the clinical symptoms of patients with COVID-19. Materials and Methods: This randomized clinical trial was conducted on 105 patients with COVID-19. Patients were randomly assigned to the intervention (n=35) group (received 10 ml of Zofa® syrup every 8 hours/seven days plus standard treatment) or the control (n=70) group (received only standard treatment). Assessments were performed before and after treatment. Results: The groups were comparable regarding age (p=0.980), gender (p=0.584), comorbidities (p=0.318), or drug history (p=0.771). There was no difference between patients' recovery status at the time of discharge (p=0.327) or two weeks postdischarge (p=0.165) in the intervention and control groups. No patient was hospitalized to the intensive care unit (ICU) for supplemental oxygen therapy and no patient died in the intervention group. However, in the control group, three (4.5%) patients were transferred to the ICU, and two (3.03%) patients died. Conclusion: Considering the better recovery status of the patients at the time of discharge and the absence of patient deaths in the intervention group, more additional studies are needed to confirm these findings and elucidate the role of Zofa® in COVID-19. [ABSTRACT FROM AUTHOR]

In Indonesia, the number of cases infected with Covid-19 peaked between mid-June and August 2021, resulting in the denial of hospital treatment to some people due to insufficient capacity. Therefore, people treat themselves by using natural ingredients. This study aims to identify plants that can treat Covid-19 with self-medication. This study took a description approach to investigate people using traditional herbs in self-medication for COVID-19 recovery. Snowball sampling is the approach used. Interviews and an online system (gform) were used to collect data. The number of samples collected allows for a more thorough analysis of the 104 respondents. The results showed that women (51.0%), people aged between 56 and 65 (52.9%), Banten residents (32.7%), secondary education (57. 7%), and people with comorbidities (86.5). %) were all interested in using traditional herbal medicine. Reduction of symptoms and results of laboratory tests were used to measure recovery. The most common comorbidities were hypertension (7-14 days to recovery), diabetes mellitus (15-21 days to recovery), and cardiovascular disease (7-14 days and 15-21 days to recovery). The Zingiberaceae family dominates traditional herbs. The most widely used traditional ingredients are Empon-Empon, which consists of red ginger, turmeric, nutmeg, aromatic ginger, bay leaves, lemongrass, galangal, cinnamon, and cloves. The average healing time is 7-14 days (32.7%). In conclusion people who utilized herbal medicines reported a speedy recovery and reduction in the severity of their symptoms. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus (SARS-CoV-2) is still a widespread concern. As one of the effective traditional Chinese medicine (TCM) formulae, Xuanfei Baidu formula (XFBD) shows significant efficacy for treatment of COVID-19 patients. However, its antiviral active compounds and mechanism are still unclear. Purpose: In this study, we explored the bioactive compounds of XFBD and its antiviral mechanism by integrating computational analysis and experimental testing. Methods: Focusing on the SARS-CoV-2 main protease (Mpro), as a key target in virus transcription and replication, the fluorescence resonance energy transfer (FRET) assay was built to screen out satisfactory natural inhibitors in XFBD. The surface plasmon resonance (SPR) and isothermal titration calorimetry (ITC) were undertaken to verify the binding affinity of ligand-Mpro. Omicron BA.1.1 and BA.2.3 variants were used to evaluate the antiviral activity of the focused compounds in non-cytotoxicity concentrations. For introducing the molecular mechanism, computational modeling and NMR spectra were employed to characterize the ligand-binding modes and identify the ligand-binding site on Mpro. Results: From a library of 83 natural compounds, acteoside, licochalcone B, licochalcone D, linoleic acid, and physcion showed the satisfactory inhibition effects on Mpro with IC50 ranging from 1.93 to 42.96 µM, which were further verified by SPR. Showing the excellent binding affinity, acteoside was witnessed to gain valuable insights into the thermodynamic signatures by ITC and presented antiviral activity on Omicron BA.1.1 and BA.2.3 variants in vitro. The results revealed that acteoside inhibited Mpro via forming the hydrogen bond between 7-H of acteoside and Mpro. Conclusion: Acteoside is regarded as a representative active natural compound in XFBD to inhibit replication of SARS-CoV-2, which provides the antiviral evidence and some insights into the identification of SARS-CoV-2 Mpro natural inhibitors. [ABSTRACT FROM AUTHOR]

Religion and spirituality have been key coping mechanisms of Pakistani Muslims amidst natural calamities such as the COVID-19 pandemic. This study aimed to identify and explore the role of religion and spirituality in the recovery of COVID-19 patients in lower socioeconomics. The data for this qualitative research study were collected from 13 people in Pakistan who survived COVID-19 infection during the wave of the Omicron variant. The participants of this study referenced four key themes about their story of getting infected by COVID-19 and recovering from it and referenced religion and spirituality as an overarching aspect of that story. The patients who recovered believed that COVID-19 was a punishment from God for sinful humanity, which was unavoidable. Amidst such a belief, the studied patients tried to avoid hospitalization but prayed to God for mercy, forgiveness, and help in their recovery. A few who took medical treatment also established and/or strengthened their spiritual connections seeking quick recovery from the infection. The participants of this study believed that their religion or spirituality played a medicinal role in their recovery from COVID-19 infection. [ABSTRACT FROM AUTHOR]

In spite of the large number of repositioned drugs and direct-acting antivirals in clinical trials for the management of the ongoing COVID-19 pandemic, there are few cost-effective therapeutic options for severe acute respiratory syndrome (SARS) coronavirus 2 (SCoV2) infection. In this paper, we show that xanthorrhizol (XNT), a bisabolane-type sesquiterpenoid compound isolated from the Curcuma xanthorrhizza Roxb., a ginger-line plant of the family Zingiberaceae, displays a potent antiviral efficacy in vitro against SCoV2 and other related coronaviruses, including SARS-CoV-1 (SCoV1) and a common cold-causing human coronavirus. XNT reduced infectious SCoV2 titer by ~3-log10 at 20 μM and interfered with the replication of the SCoV1 subgenomic replicon, while it had no significant antiviral effects against hepatitis C virus and noroviruses. Further, XNT exerted similar antiviral functions against SCoV2 variants, such as a GH clade strain and a delta strain currently predominant worldwide. Neither SCoV2 entry into cells nor the enzymatic activity of viral RNA polymerase (Nsp12), RNA helicase (Nsp13), or the 3CL main protease (Nsp5) was inhibited by XNT. While its CoV replication inhibitory mechanism remains elusive, our results demonstrate that the traditional folk medicine XNT could be a promising antiviral candidate that inhibits a broad range of SCoV2 variants of concern and other related CoVs. [ABSTRACT FROM AUTHOR]

Background: Although coronavirus disease 2019 (COVID-19) pandemic is still rage worldwide, there are still very limited treatments for human coronaviruses (HCoVs) infections. Xiaochahu decoction (XCHD), which is one of the traditional Chinese medicine (TCM) prescriptions in Qingfeipaidu decoction (QFPDD), is widely used for COVID-19 treatment in China and able to relieve the symptoms of fever, fatigue, anorexia, and sore throat. To explore the role and mechanisms of XCHD against HCoVs, we presented an integrated systems pharmacology framework in this study. Methods: We constructed a global herb-compound-target (H-C-T) network of XCHD against HCoVs. Multi-level systems pharmacology analyses were conducted to highlight the key XCHD-regulated proteins, and reveal multiple HCoVs relevant biological functions affected by XCHD. We further utilized network-based prediction, drug-likeness analysis, combining with literature investigations to uncover the key ani-HCoV constituents in XCHD, whose effects on anit-HCoV-229E virus were validated using cytopathic effect (CPE) assay. Finally, we proposed potential molecular mechanisms of these compounds against HCoVs via subnetwork analysis. Results: Based on the systems pharmacology framework, we identified 161 XCHD-derived compounds interacting with 37 HCoV-associated proteins. An integrated pathway analysis revealed that the mechanism of XCHD against HCoVs is related to TLR signaling pathway, RIG-I-like receptor signaling pathway, cytoplasmic DNA sensing pathway, and IL-6/STAT3 pro-inflammatory signaling pathway. Five compounds from XCHD, including betulinic acid, chrysin, isoliquiritigenin, schisandrin B, and (20R)-Ginsenoside Rh1 exerted inhibitory activity against HCoV-229E virus in Huh7 cells using in vitro CPE assay. Conclusion: Our work presented a comprehensive systems pharmacology approach to identify the effective molecules and explore the molecular mechanism of XCHD against HCoVs. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic continues, and this condition has caused many cases in various countries around the world, resulting in more than 6 million deaths worldwide. Herbal medicines can act as immunomodulators, anti-inflammatories, antioxidants, antimicrobials, and others depending on the type and content of the herbs used. Previous studies have shown that several types of herbs, such as Echinacea purpurea, Curcumin or Turmeric, Nigella sativa, and Zingiber officinale, have proven their effectiveness as herbal plants for COVID-19.Methods: We conducted a comprehensive literature search through five databases, namely, PubMed, Scopus, Embase, Wiley, and ProQuest to assess the efficacy of phytopharmaceuticals until July 12, 2022. We used the Cochrane RoB 2.0 for the quality assessment of the study.Results: Phytopharmaceuticals significantly improved patients' recovery rate (OR = 3.54; p < 0.00001) and reduced deaths (OR = 0.24; p < 0.0001) compared to the control group. Phytopharmaceuticals also performed as a protective factor for COVID-19 clinical symptoms, such as dyspnea (OR = 0.42; p < 0.05) and myalgia (OR = 0.31; p = 0.02) compared to the control group. However, there is no statistically significant effect on cough (OR = 0.76; p = 0.61) and fever (OR = 0.60; p < 0.20). The results were not affected by patients' covariates [hypertension, diabetes mellitus, and cardiovascular diseases (meta-regression p > 0.05)].Conclusion: Herbal medicine has the potential as an adjuvant therapy in the management of COVID-19. [ABSTRACT FROM AUTHOR]

COVID-19 has posed unprecedented challenges to global public health since its outbreak. The Qing-Fei-Pai-Du decoction (QFPDD), a Chinese herbal formula, is widely used in China to treat COVID-19. It exerts an impressive therapeutic effect by inhibiting the progression from mild to critical disease in the clinic. However, the underlying mechanisms remain obscure. Both SARS-CoV-2 and influenza viruses elicit similar pathological processes. Their severe manifestations, such as acute respiratory distress syndrome (ARDS), multiple organ failure (MOF), and viral sepsis, are correlated with the cytokine storm. During flu infection, QFPDD reduced the lung indexes and downregulated the expressions of MCP-1, TNF- α , IL-6, and IL-1 β in broncho-alveolar lavage fluid (BALF), lungs, or serum samples. The infiltration of neutrophils and inflammatory monocytes in lungs was decreased dramatically, and lung injury was ameliorated in QFPDD-treated flu mice. In addition, QFPDD also inhibited the polarization of M1 macrophages and downregulated the expressions of IL-6, TNF- α , MIP-2, MCP-1, and IP-10, while also upregulating the IL-10 expression. The phosphorylated TAK1, IKK α / β , and I κ B α and the subsequent translocation of phosphorylated p65 into the nuclei were decreased by QFPDD. These findings indicated that QFPDD reduces the intensity of the cytokine storm by inhibiting the NF- κ B signaling pathway during severe viral infections, thereby providing theoretical and experimental support for its clinical application in respiratory viral infections. [ABSTRACT FROM AUTHOR]

Objective: The ongoing COVID-19 pandemic has been associated with clinical signs characterized by fever, fatigue and cough. Our study aimed to assess the efficacy of a Persian medicine formulation, lavender syrup, as an add-on to standard care in patients with mild to moderate COVID-19. Materials and Methods: In this clinical trial which was conducted in Gorgan (Iran), 84 male and female COVID-19 outpatients were randomly allocated to either lavender syrup receiving 9 ml/twice/day for 21 days with standard conventional care or control groups. The primary objectives were to assess the improvement of clinical symptoms, while the secondary objectives were treatment satisfaction and anxiety levels which were evaluated once a week for 3 weeks. Results: Out of 84 participants, 81 were analyzed (41 in the addon group). The comparison between groups for cough severity and anosmia showed a higher reduction in the lavender group. The effect size was 0.6 for cough relief. Other symptoms and the Hamilton total score decreased in both groups with no statistically significant differences between the groups. The lavender group showed greater patients' satisfaction score. Conclusion: Adjunctive therapy with lavender syrup could reduce cough and improve the quality of life in patients with COVID-19 patients. [ABSTRACT FROM AUTHOR]

The advent of Corona virus Disease 2019 (COVID-19) distorted health systems of many countries. Efforts have been made to either develop new treatment solutions such as vaccines or repurpose previously adopted drugs. Challenges in accessing available treatment, inadequate, non-existent, or overstretched healthcare facilities, long COVID disease, cultural practices and beliefs about vaccination, vaccine hesitancy, availability, accessibility and perceived safety of herbal supplements seem to be major factors propelling individuals to use herbal supplements. Published reports advocating for clinical development of herbal supplements for COVID-19 and other emerging and re-emerging viral diseases are sparse. This paper aims to review the pathogenesis of COVID-19, use of herbal products during the pandemic and make case for clinical development of herbal supplements through the adoption of modern and acceptable technologies and research processes.This was a scoping review. Database searches of Google Scholar, PubMed and ResearchGate among others were performed using related keywords to identify relevant journals and lists of primary articles. Clinical trial databases:-Clinicaltrial.gov, Pan African Clinical Trial Registry (PACTR) and WHO international clinical trial registry (ICTRP) were reviewed to extract data.The use of herbal supplements during COVID-19 was not only peculiar to individuals living in Sub-Saharan Africa, but a global practice. Herbal supplements recommended to manage COVID-19 have not been validated using clinical trials. Available data showed that the number of herbal supplements undergoing clinical trial for COVID-19 indication in Africa was low.The availability of medicinal plants in Sub-Saharan Africa if well explored has great potentials to address various emerging and re-emerging viral diseases confronting the region. The economic potential of clinically validated herbal supplements are huge, and tapping into this opportunity created by preference of population to herbal supplement could increase export of herbal supplement and gross domestic product (GDP) of respective countries in Africa.

Objective: This living review of systematic reviews investigates the types and volume of research pertaining to natural health products and therapies as they relate to the prevention and/or treatment of COVID-19 and post-COVID syndrome. Methods: A monthly search for published peer-reviewed systematic reviews of the topic was initiated May 2022 and is ongoing. Using a systematic keyword search strategy with clear inclusion and exclusion criteria, a summary of the types of studies included, the overall outcome and treatment focus were assessed. Results: A total of 225 systematic reviews encompassing 5,636 studies of randomized controlled trials (49.8%, n=112), observational studies (21.3%, n=48), clinical studies (20.4%, n=46), and other studies (12%, n=27) were included. Of those, 28.9% (n=65) of the systematic reviews focused on prevention, 67.6% (n=152) on treatment, and 3.1% (n=8) on post-COVID. The natural health products reviewed included herbal medicine, vitamins, minerals, other natural health products, and other therapies, with 83.5% (n=188) of all systematic reviews stating a positive outcome and beneficial potential of the natural treatment or therapy investigated. Conclusion: This living systematic review concludes that there is a growing interest in research pertaining to natural health products and therapies with respect to the prevention of COVID-19 infections and addressing disease severity and mortality, especially in adjunct to conventional medical intervention. Nonetheless, there is a lack of high-quality evidence and consistency in outcome reporting across the large breadth of natural treatment and management options. [ABSTRACT FROM AUTHOR]

As a traditional Chinese medicine, Lianhua Qingwen capsules have been widely used to treat Coronavirus Disease 2019 (COVID-19). This study was aimed to demonstrate the association between treatment with Lianhua Qingwen capsules and the clinical outcomes of hospitalized patients with COVID-19. This retrospective study was conducted at four hospitals in Central China. Data of hospitalized COVID-19 patients were collected between December 19, 2019 and April 26, 2020. Based on whether Lianhua Qingwen capsules were used, patients were classified into Lianhua Qingwen and non-Lianhua Qingwen (control) groups. To control for confounding factors, we used conditional logistic regression in a propensity-score matched (PSM) cohort (1 : 1 balanced), as well as logistic regression without matching as sensitivity analysis. A total of 4918 patients were included, 2760 of whom received Lianhua Qingwen capsules and 2158 of whom did not. In the PSM model, after adjusting for confounders, the in-hospital mortality was similar between the Lianhua Qingwen group and the control group (6.8% vs. 3.3%, adjusted OR, 0.66 [95% CI, 0.38-1.15], p = 0.138). The negative conversion rate of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection was higher in the Lianhua Qingwen group (88.3% vs. 96.1%, adjusted OR, 4.02 [95% CI, 2.58-6.25], p < 0.001). The incidence of acute liver injury was comparable between the two groups (14.0% vs. 11.5%, adjusted OR: 0.85 [95% CI, 0.71-1.02], p = 0.083), and the incidence of acute kidney injury was lower in the Lianhua Qingwen group (5.3% vs. 3.0%, adjusted OR: 0.71 [95% CI, 0.50-1.00], p = 0.048). Treatment with Lianhua Qingwen capsules was not significantly associated with in-hospital mortality in COVID-19 patients. In the Lianhua Qingwen group, the negative conversion rate of SARS-CoV-2 infection was higher and the incidence of acute kidney injury was lower than in the control group. [ABSTRACT FROM AUTHOR]

Background: Since the outbreak of COVID-19 in 2019, the global economy, culture, politics, and people's lives and health have been severely damaged and threatened. Although western modern medical treatment has made great efforts, the treatment of COVID-19 has not achieved ideal clinical efficacy with severe sequelae. Qingfei Paidu (QFPD), an important herbal prescription for COVID-19 treatment, has shown remarkable therapeutic effects in China's fight against the epidemic. Materials and methods: We searched seven databases up to 7 September 2022, including PubMed, Chinese National Knowledge Infrastructure (CNKI), Wanfang Database, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, World Scientific and SpringerLink. We used the Cochrane Risk of Bias tool to assess the quality of randomized controlled trials. All analysis results were conducted by RevMan 5.4.1 to carry out a meta-analysis. Results: Fifteen studies with 10390 patients were included. QFPD could not only significantly improve the cure rate and lung CT of COVID-19, reduce the number of patients turning to critical condition and death, shorten the time for nucleic acid conversion and the length of hospital stay, but change laboratory indexes and relieve body symptoms quickly without adverse effects. Conclusions: Compared with patients only treated by conventional western treatment (CWM), QFPD combined with CWM could be more effective for patients. It is worth spreading to other countries in the global battle against COVID-19. [ABSTRACT FROM AUTHOR]

The tracing of an alternative drug, Phytochemicals is a promising approach to the viral threats that have emerged over the past two years. Across the world, herbal medicine is a better solution against anti-viral diseases during pandemic periods. Goniothalamus wightii is an herbal plant, which has diverse bioactive compounds with anticancer, antioxidant, and anti-viral properties. The aim of the study was to isolate the compound by chromatography studies and functionalization by FT-IR, LC-MS, and NMR (C-NMR, H-NMR). As a result, the current work focuses on whether (S)-Goniathalamin and its analogue could act as natural anti-viral molecules for multiple target proteins viz., MPro, RdRp, and SPro, which are required for SARS-CoV-2 infection. Overall, 954 compounds were examined and the molecular-docking studies were performed on the maestro platform of Schrodinger software. Molecular-dynamics simulation studies were performed on two complex major compounds to confirm their affinity across 150 simulations. This research suggests that plant-based drugs have high levels of antiviral properties against coronavirus. However, more research is needed to verify its antiviral properties. [ABSTRACT FROM AUTHOR]

Background: Complementary and Integrative Medicine (CIM) is often taken up by individuals seeking relief from different diseases. This study investigates the prevalence and associated factors of CIM use in patients with COVID-19. Methods: In this telephone-based, cross-sectional study, data on CIM usage were collected from COVID-19 patients from February till June 2020 in Fars province, Iran using a researcher-made checklist. Additionally, we asked about the patients' attitudes toward these treatments. Results: Out of 453 patients diagnosed with COVID-19, 400 (88.30%) responded to our calls and agreed to participate in the study. Among them, 276 patients reported using CIM to treat COVID-19 [prevalence: 69% (95% CI: 64.2 to 73.5)]. The most frequently used herbal medicine among COVID-19 patients was ginger (n = 273, 98.9%), thyme (n = 263, 95.3%), and black cumin (n = 205, 74.3%). Most of these patients were recommended to use herbal medicine by their families and friends (n = 96, 34.8%). Univariable logistic regression revealed that age under 50 years old, residency in urban areas (including the capital of the province and small cities), employment, academic education, and being an outpatient were statistically significant factors resulting in CIM usage. Multivariable logistic regression revealed that CIM use among outpatients was 3.65 times more than among inpatients. In addition, patients under 50 years old used CIM 85% more than older patients. Ultimately, only 9 (3.3%) patients consulted with their doctors regarding these medications. No side effects due to CIM use were reported. Conclusion: Many patients with COVID-19 used CIM, but few consulted with their physicians in this regard. Therefore, physicians should ask their patients about CIM usage, and patients should also report their use of CIM therapies during their medical visits. Furthermore, age and hospitalization status affected CIM use among patients with COVID-19. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) is still a pandemic globally, about 80% of patients infected with COVID-19 were mild and moderate. Chinese herbal medicine (CHM) has played a positive role in the treatment of COVID-19, with a certain number of primary studies focused on CHM inmanaging COVID-19 published. This study aims to systematically review the currently published randomized controlled trials (RCTs) and observational studies (OBs), and summarize the effectiveness and safety of CHM in the treatment of mild/moderate COVID-19 patients. Methods: We searched 9 databases up to 19 March 2022. Pairs of reviewers independently screened literature, extracted data and assessed risk of bias. For overall effect, we calculated the absolute risk difference (ARD) of weighted averages of different estimates, and certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system. Results: We included 35 RCTs and 24 OBs enrolling 16,580 mild/moderate patients. The certainty of evidence was very low to low. Compared with usual supportive treatments, most effect estimates of CHM treatments were consistent in direction. CHMs presented significant benefits in reducing rate of conversion to severe cases (ARD = 99 less per 1000 patients in RCTs and 131 less per 1000 patients in OBs, baseline risk: 16.52%) and mortality (ARD = 3 less per 1000 patients in RCTs and OBs, baseline risk: 0.40%); shortening time to symptom resolution (3.35 days in RCTs and 2.94 days in OBs), length of hospital stay (2.36 days in RCTs and 2.12 days in OBs) and time to viral clearance (2.64 days in RCTs and 4.46 days in OBs); increasing rate of nucleic acid conversion (ARD = 73 more per 1000 patients in OBs, baseline risk: 16.30%). No serious adverse reactions were found and the differences betweenCHMand usual supportive care were insignificant. Conclusion: Encouraging evidence showed that CHMs were beneficial in treating mild or moderate patients. CHMs have been proved to possess a safety profile that is comparable to that of usual supportive treatment alone. More rigorously designed clinical trials and mechanism studies are still warranted to further confirm the present findings. [ABSTRACT FROM AUTHOR]

Background Coronavirus disease 2019 (COVID-19) has spurred a boom in uncovering repurposable existing drugs. Drug repurposing is a strategy for identifying new uses for approved or investigational drugs that are outside the scope of the original medical indication. Motivation Current works of drug repurposing for s evere a cute r espiratory s yndrome c or o na v irus 2 (SARS-CoV-2) are mostly limited to only focusing on chemical medicines, analysis of single drug targeting single SARS-CoV-2 protein, one-size-fits-all strategy using the same treatment (same drug) for different infected stages of SARS-CoV-2. To dilute these issues, we initially set the research focusing on herbal medicines. We then proposed a heterogeneous graph embedding method to signaled candidate repurposing herbs for each SARS-CoV-2 protein, and employed the variational graph convolutional network approach to recommend the precision herb combinations as the potential candidate treatments against the specific infected stage. Method We initially employed the virtual screening method to construct the 'Herb-Compound' and 'Compound-Protein' docking graph based on 480 herbal medicines, 12,735 associated chemical compounds and 24 SARS-CoV-2 proteins. Sequentially, the 'Herb-Compound-Protein' heterogeneous network was constructed by means of the metapath-based embedding approach. We then proposed the heterogeneous-information-network-based graph embedding method to generate the candidate ranking lists of herbs that target structural, nonstructural and accessory SARS-CoV-2 proteins, individually. To obtain precision synthetic effective treatments forvarious COVID-19 infected stages, we employed the variational graph convolutional network method to generate candidate herb combinations as the recommended therapeutic therapies. Results There were 24 ranking lists, each containing top-10 herbs, targeting 24 SARS-CoV-2 proteins correspondingly, and 20 herb combinations were generated as the candidate-specific treatment to target the four infected stages. The code and supplementary materials are freely available at https://github.com/fanyang-AI/TCM-COVID19. [ABSTRACT FROM AUTHOR]

Background: The number of COVID-19 cases continues to grow in Indonesia. This phenomenon motivates researchers to find alternative drugs that function for prevention or treatment. Due to the rich biodiversity of Indonesian medicinal plants, one alternative is to examine the potential of herbal medicines to support COVID therapy. This study aims to identify potential compound candidates in Indonesian herbal using a machine learning and pharmacophore modeling approaches. Methods: We used three classification methods that had different decision-making processes: support vector machine (SVM), multilayer perceptron (MLP), and random forest (RF). For the pharmacophore modeling approach, we performed a structure-based analysis on the 3D structure of the main protease SARS-CoV-2 (3CLPro) and repurposed SARS, MERS, and SARS-CoV-2 drugs identified from the literature as datasets in the ligand-based method. Lastly, we used molecular docking to analyze the interactions between the 3CLpro and 14 hit compounds from the Indonesian Herbal Database (HerbalDB), with lopinavir as a positive control. Results: From the molecular docking analysis, we found six potential compounds that may act as the main proteases of the SARS-CoV-2 inhibitor: hesperidin, kaempferol-3,4'-di-O-methyl ether (Ermanin); myricetin-3-glucoside, peonidin 3-(4'-arabinosylglucoside); quercetin 3-(2G-rhamnosylrutinoside); and rhamnetin 3-mannosyl-(1-2)-alloside. Conclusions: Our layered virtual screening with machine learning and pharmacophore modeling approaches provided a more objective and optimal virtual screening and avoided subjective decision making of the results. Herbal compounds from the screening, i.e. hesperidin, kaempferol-3,4'-di-O-methyl ether (Ermanin); myricetin-3-glucoside, peonidin 3-(4'-arabinosylglucoside); quercetin 3-(2G-rhamnosylrutinoside); and rhamnetin 3-mannosyl-(1-2)-alloside are potential antiviral candidates for SARS-CoV-2. Moringa oleifera and Psidium guajava that consist of those compounds, could be an alternative option as COVID-19 herbal preventions. [ABSTRACT FROM AUTHOR]

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused a global pandemic in 2019—coronavirus disease (COVID-19). More and more Western medicine (WM) and Chinese herbal medicine (CHM) treatments have been used to treat COVID-19 patients, especially among Asian populations. However, the interactions between WM and CHM have not been studied. This study aims at using the network pharmacology approach to explore the potential complementary effects among commonly used CHM and WM in a clinical setting from a biomolecular perspective. Three well-published and widely used CHM formulas (National Research Institute of Chinese Medicine 101 (NRICM101), Qing-Fei-Pai-Du-Tang (QFPDT), Hua-Shi-Bai-Du-Formula (HSBDF)) and six categories of WM (Dexamethasone, Janus kinase inhibitors (JAKi), Anti-Interleukin-6 (Anti-IL6), anticoagulants, non-vitamin K antagonist oral anticoagulants (NOAC), and Aspirin) were included in the network pharmacology analysis. The target proteins on which these CHM and WM had direct effects were acquired from the STITCH database, and the potential molecular pathways were found in the REACTOME database. The COVID-19-related target proteins were obtained from the TTD database. For the three CHM formulas, QFPDT covered the most proteins (714), and 27 of them were COVID-19-related, while HSBDF and NRICM101 covered 624 (24 COVID-19-related) and 568 (25 COVID-19-related) proteins, respectively. On the other hand, WM covered COVID-19-related proteins more precisely and seemed different from CHM. The network pharmacology showed CHM formulas affected several inflammation-related proteins for COVID-19, including IL-10, TNF-α, IL-6, TLR3, and IL-8, in which Dexamethasone and Aspirin covered only IL-10 and TNF-α. JAK and IL-6 receptors were only inhibited by WM. The molecular pathways covered by CHM and WM also seemed mutually exclusive. WM had advantages in cytokine signaling, while CHM had an add-on effect on innate and adaptive immunity, including neutrophil regulation. WM and CHM could be used together to strengthen the anti-inflammation effects for COVID-19 from different pathways, and the combination of WM and CHM may achieve more promising results. These findings warrant further clinical studies about CHM and WM use for COVID-19 and other diseases. [ABSTRACT FROM AUTHOR]

COVID-19 infection causes complications, even in people who have had a mild course of the disease. The most dangerous seem to be neurological ailments: anxiety, depression, mixed anxiety–depressive (MAD) syndromes, and irreversible dementia. These conditions can negatively affect the respiratory system, circulatory system, and heart functioning. We believe that phytotherapy can be helpful in all of these conditions. Clinical trials confirm this possibility. The work presents plant materials (Valeriana officinalis, Melissa officinalis, Passiflora incarnata, Piper methysticum, Humulus lupulus, Ballota nigra, Hypericum perforatum, Rhodiola rosea, Lavandula officinalis, Paullinia cupana, Ginkgo biloba, Murraya koenigii, Crataegus monogyna and oxyacantha, Hedera helix, Polygala senega, Pelargonium sidoides, Lichen islandicus, Plantago lanceolata) and their dominant compounds (valeranon, valtrate, apigenin, citronellal, isovitexin, isoorientin, methysticin, humulone, farnesene, acteoside, hypericin, hyperforin, biapigenin, rosavidin, salidroside, linalool acetate, linalool, caffeine, ginkgolide, bilobalide, mihanimbine, epicatechin, hederacoside C,α-hederine, presegenin, umckalin, 6,7,8-trixydroxybenzopyranone disulfate, fumaroprotocetric acid, protolichesteric acid, aucubin, acteoside) responsible for their activity. It also shows the possibility of reducing post-COVID-19 neurological, respiratory, and cardiovascular complications, which can affect the functioning of the nervous system. [ABSTRACT FROM AUTHOR]