Título:	COVID-19 : is there evidence for the use of herbal medicines as adjuvant symptomatic therapy?
Autor(es):	Silveira, Dâmaris Prieto-Garcia, Jose Maria Boylan, Fabio Estrada, Omar Fonseca-Bazzo, Yris Maria Jamal, Claudia Masrouah Batista, Pérola de Oliveira Magalhães Dias Pereira, Edson Oliveira Tomczyk, Michal Heinrich, Michael
Assunto:	Fitoterapia Covid-19 Avaliação benefício/risco Doenças respiratórias
Data de publicação:	23-Set-2020
Editora:	Frontiers
Referência:	SILVEIRA, Dâmaris et al. COVID-19: is there evidence for the use of herbal medicines as adjuvant symptomatic therapy?. Frontiers in Pharmacology, v. 11, art. 581840, 23 set. 2020. DOI: https://doi.org/10.3389/fphar.2020.581840. Disponível em: https://www.frontiersin.org/articles/10.3389/fphar.2020.581840/full. Acesso em: 01 dez. 2020.
Abstract:	Background: Current recommendations for the self-management of SARS-Cov-2 disease (COVID-19) include self-isolation, rest, hydration, and the use of NSAID in case of high fever only. It is expected that many patients will add other symptomatic/adjuvant treatments, such as herbal medicines. Aims: To provide a benefits/risks assessment of selected herbal medicines traditionally indicated for “respiratory diseases” within the current frame of the COVID-19 pandemic as an adjuvant treatment. Method: The plant selection was primarily based on species listed by the WHO and EMA, but some other herbal remedies were considered due to their widespread use in respiratory conditions. Preclinical and clinical data on their efficacy and safety were collected from authoritative sources. The target population were adults with early and mild flu symptoms without underlying conditions. These were evaluated according to a modified PrOACT-URL method with paracetamol, ibuprofen, and codeine as reference drugs. The benefits/risks balance of the treatments was classified as positive, promising, negative, and unknown. Results: A total of 39 herbal medicines were identified as very likely to appeal to the COVID-19 patient. According to our method, the benefits/risks assessment of the herbal medicines was found to be positive in 5 cases (Althaea officinalis, Commiphora molmol, Glycyrrhiza glabra, Hedera helix, and Sambucus nigra), promising in 12 cases (Allium sativum, Andrographis paniculata, Echinacea angustifolia, Echinacea purpurea, Eucalyptus globulus essential oil, Justicia pectoralis, Magnolia officinalis, Mikania glomerata, Pelargonium sidoides, Pimpinella anisum, Salix sp, Zingiber officinale), and unknown for the rest. On the same grounds, only ibuprofen resulted promising, but we could not find compelling evidence to endorse the use of paracetamol and/or codeine. Conclusions: Our work suggests that several herbal medicines have safety margins superior to those of reference drugs and enough levels of evidence to start a clinical discussion about their potential use as adjuvants in the treatment of early/mild common flu in otherwise healthy adults within the context of COVID-19. While these herbal medicines will not cure or prevent the flu, they may both improve general patient well-being and offer them an opportunity to personalize the therapeutic approaches.
Licença:	Copyright © 2020 Silveira, Prieto-Garcia, Boylan, Estrada, Fonseca-Bazzo, Jamal, Magalhães, Pereira, Tomczyk and Heinrich. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
DOI:	https://doi.org/10.3389/fphar.2020.581840
Aparece nas coleções:	Artigos publicados em periódicos e afins UnB - Covid-19

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