Phytomedicine Plus (Nov 2023)
Iran's commercial herbal products for managing COVID-19: A review based on clinical trial-based approach
Abstract
Background: Despite the existence of treatment strategies, there was no effective drug treatment available during the outbreak of COVID-19. Consequently, medicinal herbs were commonly used as complementary drugs to prevent COVID-19 and reduce the symptoms of the disease in many countries. Medicinal plants used in the preparation of anti-COVID-19 supplements have proven effective in reducing the symptoms of this disease, with various mechanisms such as strengthening the immune system, antiviral effects, and anti-inflammatory activities. Several herbal products based on traditional and complementary medicine have been used worldwide for the treatment of COVID-19 infection. Examples include Chinese herbal medicines such as Jinhua Qinggan and Lianhua Qingwen, Indian Kadha used as an immune booster and, Artemisia annua, which gained popularity in African countries like Madagascar during the COVID-19 pandemic. Latin American and Caribbean regions, such as Cuba, have utilized 'Prevengho-VIR' to prevent severe respiratory symptoms of COVID-19. Purpose: This study was conducted with the aim of introducing Iran's commercial herbal products for the management of COVID-19 based on clinical trials. Methods: Research articles based on clinical evidence of Iran's commercial herbal supplements for managing COVID-19 were collected from Google Scholar, PubMed, and ScienceDirect databases. In addition, the anti-COVID potential of medicinal plants used in these herbal products has also been discussed. Results: This study presents a comprehensive review of the 12 approved COVID-19 herbal supplements in Iran, based on related articles published so far that discuss their clinical use. The Food and Drug Administration of Iran has approved the use of commercial herbal products, including Alerguard®, Imfluna®, Palminavir®, Co Iran Amin®, PHR 160®, Colchinale®, Thymonige®, Covexirpars®, Mocozift, Saliravira®, Relung ZMZ®, and Ferula astragalus ZMZ®. These products are produced with herbal medicine and are intended for the symptomatic treatment of COVID-19. Furthermore, this review analyzes the specific 41 herbal compounds which used in each formula and their effectiveness in combating COVID-19 along with potential mechanisms of action for each herb. Conclusion: Clinical evidence suggests that polyherbal formulations, such as Imfluna®, PHR 160®, Covexir®, and Saliravira®, when used in conjunction with routine care of COVID-19, can potentially decrease the duration of hospital stay, accelerate clinical improvement, enhance tolerance against COVID‐19, and reduce symptoms such as fever, anorexia, dry cough, and muscle pain.