Safety and Efficacy of Popular Iranian Herbal Cold Remedy for COVID-۱۹: A Randomized Clinical Trial in Mild to Moderate COVID-۱۹ Cases

Background: In traditional Persian medicine, an herbal cold remedy containing Sugarcane, Black Myrobalan, and mastic is mentioned and it was being widely provided by grocery stores. With the advent of the COVID-۱۹ pandemic, the increased desire for this traditional remedy has led to a debate in society. Huge parts of the Iranian population have started using this remedy for the treatment of COVID-۱۹; while no study has evaluated its efficiency and possible side effects. Thus, we aimed to evaluate the effects of Sugarcane, Black Myrobalan, and Mastic herbal medications for COVID-۱۹ patients.Methods: This was a double-blinded randomized clinical trial study conducted over three months from May ۲۰۲۰ to July ۲۰۲۰ in SARS-COV۲ PCR positive patients admitted in the COVID-۱۹ ward of Peymaniyeh Hospital in Jahrom, Iran. Patients with severe COVID-۱۹ infection were not recruited. The intervention group received the routine COVID-۱۹ treatment protocol and the herbal supplement received the combination of black myrobalan and mastic and sugarcane, twice a day (۳ g of herbal supplement). Study groups were compared in terms of demographic variables, vital signs, and clinical and laboratory variables for safety and efficiency assessment.Results: Seventy-two patients with COVID-۱۹, divided into intervention (n=۳۷) and control (n = ۳۵) groups were studied. Intervention and control groups had not any significant difference in terms of baseline characteristics. The time-to-event analysis revealed a statistically significant difference in ۴ symptoms of cough, fever, dyspnea, and myalgia (P<۰.۰۵). There was no significant difference in averaged O۲ vital signs between the two groups (P>۰.۰۵). The Control group in comparison to the intervention group had a significantly lower decrease in C-reactive protein during ۷ days (P<۰.۰۵). Patients in the herbal supplement group were hospitalized for ۴.۱۲ days and patients in the control group were hospitalized for ۸.۳۷ days (P=۰.۰۰۱). ICU admission and death only happened in ۳ (۸.۶%) patients of the control group.Conclusion: This study showed that the proposed herbal remedy could be applied as supplementation to conventional management of COVID-۱۹ patients with mild disease, while more research is needed for clinical application of this remedy.

Keywords:

COVID , ۱۹ Herbal medicine SARS , CoV۲ Randomized clinical trial