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Efficacy of Nanocurcumin as an Add-On Treatment for Patients Hospitalized with COVID-19: A Double-Blind, Randomized Clinical Trial

Ahmadi et al., International Journal of Clinical Practice, doi:10.1155/2023/5734675, IRCT20211126053183N1
Jul 2023  
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Oxygen therapy 58% Improvement Relative Risk Improvement in SpO2 67% Recovery, chest pain 50% Recovery, chills -34% Recovery, cough 58% Recovery, sore throat 78% Recovery, fatigue 64% Recovery, myalgia 91% Recovery, anosmia -9% Recovery, ageusia 10% Recovery, anorexia 10% Recovery, diarrhea 64% Recovery, nausea -234% Curcumin  Ahmadi et al.  LATE TREATMENT  DB RCT Is late treatment with curcumin beneficial for COVID-19? Double-blind RCT 76 patients in Iran (December 2021 - March 2022) Improved recovery with curcumin (p=0.041) c19early.org Ahmadi et al., Int. J. Clinical Practice, Jul 2023 Favorscurcumin Favorscontrol 0 0.5 1 1.5 2+
Curcumin for COVID-19
14th treatment shown to reduce risk in February 2021
 
*, now with p = 0.000000015 from 26 studies.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,300+ studies for 77 treatments. c19early.org
RCT 76 hospitalized patients, showing improved recovery with nanocurcumin. Authors note that pure curcumin is limited due to rapid metabolism, low bio-availability, weak aqueous solubility, and systemic deletion, and that the nanocurcumin formulation used improves curcumin’s solubility, stability, half-life, and bioavailability. The dropout rate was higher in the curcumin group, in part due to discontinuation for side effects. Authors do not provide detailed discharge criteria.
This is the 20th COVID-19 RCT for curcumin, which collectively show efficacy with p=0.0000033.
This is the 26th COVID-19 controlled study for curcumin, which collectively show efficacy with p=0.000000015 (1 in 66 million).
risk of oxygen therapy, 58.0% lower, RR 0.42, p = 0.06, treatment 5 of 29 (17.2%), control 16 of 39 (41.0%), NNT 4.2.
relative improvement in SpO2, 67.2% better, RR 0.33, p = 0.04, treatment mean 3.32 (±3.84) n=29, control mean 1.09 (±4.71) n=39.
risk of no recovery, 49.6% lower, RR 0.50, p = 0.33, treatment 3 of 29 (10.3%), control 8 of 39 (20.5%), NNT 9.8, chest pain.
risk of no recovery, 34.5% higher, RR 1.34, p = 1.00, treatment 1 of 29 (3.4%), control 1 of 39 (2.6%), chills.
risk of no recovery, 58.0% lower, RR 0.42, p = 0.06, treatment 5 of 29 (17.2%), control 16 of 39 (41.0%), NNT 4.2, cough.
risk of no recovery, 77.7% lower, RR 0.22, p = 0.50, treatment 0 of 29 (0.0%), control 2 of 39 (5.1%), NNT 20, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), sore throat.
risk of no recovery, 63.8% lower, RR 0.36, p < 0.001, treatment 7 of 29 (24.1%), control 26 of 39 (66.7%), NNT 2.4, fatigue.
risk of no recovery, 91.3% lower, RR 0.09, p = 0.03, treatment 0 of 29 (0.0%), control 6 of 39 (15.4%), NNT 6.5, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), myalgia.
risk of no recovery, 8.9% higher, RR 1.09, p = 0.81, treatment 17 of 29 (58.6%), control 21 of 39 (53.8%), anosmia.
risk of no recovery, 10.3% lower, RR 0.90, p = 1.00, treatment 8 of 29 (27.6%), control 12 of 39 (30.8%), NNT 31, ageusia.
risk of no recovery, 10.3% lower, RR 0.90, p = 1.00, treatment 2 of 29 (6.9%), control 3 of 39 (7.7%), NNT 126, anorexia.
risk of no recovery, 63.6% lower, RR 0.36, p = 1.00, treatment 0 of 29 (0.0%), control 1 of 39 (2.6%), NNT 39, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), diarrhea.
risk of no recovery, 234.5% higher, RR 3.34, p = 0.43, treatment 1 of 29 (3.4%), control 0 of 39 (0.0%), continuity correction due to zero event (with reciprocal of the contrasting arm), nausea.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Ahmadi et al., 28 Jul 2023, Double Blind Randomized Controlled Trial, placebo-controlled, Iran, peer-reviewed, 5 authors, study period December 2021 - March 2022, trial IRCT20211126053183N1. Contact: masoumi7415@gmail.com.
This PaperCurcuminAll
Efficacy of Nanocurcumin as an Add-On Treatment for Patients Hospitalized with COVID-19: A Double-Blind, Randomized Clinical Trial
Sedigheh Ahmadi, Zeinab Mehrabi, Morteza Zare, Sara Ghadir, Seyed Jalil Masoumi
International Journal of Clinical Practice, doi:10.1155/2023/5734675
Background. Curcumin is a polyphenol derivative of the Curcuma longa rhizome, with potential antioxidant, anticancer, antidepressant, antiviral, and anti-infammatory efects. Tis compound can be prepared as biodegradable polymer nanoparticles, called nanocurcumin, to improve its solubility, stability, half-life, and bioavailability. Aim. We explored nanocurcumin's efect on the clinical manifestations of patients hospitalized with mild-to-moderate COVID-19. Methods. Tis double-blind, randomized clinical trial involved 76 COVID-19 patients admitted to Ali-Asghar Hospital from December 2021 to March 2022. All patients received standard coronavirus treatment as per national guidelines. In addition, four times a day for two weeks, the curcumin group received 40 mg of nanocurcumin, while the control group received a placebo. Clinical manifestations were examined and recorded by the associate doctors working in the department. Statistical analysis was done using SPSS v. 21. Results. Tirty-nine people from the control group and 29 from the curcumin group completed the study. At baseline, the groups were comparable in age, gender, body mass index, hospitalization duration, and background diseases. Te mean age of patients in the control and treatment groups was 53.9 ± 11.9 and 54.6 ± 13.4, respectively. Compared with the placebo, nanocurcumin minimized coughs (P � 0.036), fatigue (P � 0.0001), myalgia (P � 0.027), oxygen demand (P � 0.036), oxygen usage (P � 0.05), and respiratory rate (P < 0.0001). By discharge, the curcumin group had a signifcantly greater increase in SPO 2 than the control group (P � 0.006). Conclusions. Tis preliminary study suggests that nanocurcumin has a potentiating anti-infammatory efect when combined with standard COVID-19 treatment, helping the recovery from the acute infammatory phase of the disease in hospitalized patients with mild-to-moderate disease severity. Tis trial is registered with Iranian Registry of Clinical Trials: IRCT20211126053183N1 (registered while recruiting on 13/12/2021).
Ethical Approval Tis study was conducted in line with the ethical principles of Shiraz University of Medical Sciences (Ethics Committee approval code: IR.SUMS.SCHEANUT.REC.1400.031) and the Helsinki Declaration of 1964 and its later amendments. Consent Informed consent was obtained from all subjects. Disclosure Te present article was extracted from the dissertation written by Sedigheh Ahmadi. Conflicts of Interest Te authors declare that they have no conficts of interest. Authors' Contributions SA was responsible for study design, implementation, data interpretation, original draft preparation, and manuscript revision. ZM was responsible for study design, data collection, and manuscript revision. MZ was responsible for study design, data analysis, and manuscript revision. SG was responsible for study implementation, data interpretation, and original draft preparation. SJM was responsible for study concept, design, funding acquisition, implementation, supervision, and manuscript revision. All authors have read and approved the fnal version of the manuscript.
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{ 'indexed': {'date-parts': [[2023, 7, 29]], 'date-time': '2023-07-29T04:24:28Z', 'timestamp': 1690604668584}, 'reference-count': 41, 'publisher': 'Hindawi Limited', 'license': [ { 'start': { 'date-parts': [[2023, 7, 28]], 'date-time': '2023-07-28T00:00:00Z', 'timestamp': 1690502400000}, 'content-version': 'unspecified', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0/'}], 'funder': [ { 'DOI': '10.13039/501100004320', 'name': 'Shiraz University of Medical Sciences', 'doi-asserted-by': 'publisher', 'award': ['23550']}], 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'published-print': {'date-parts': [[2023, 7, 28]]}, 'abstract': '<jats:p>Background. Curcumin is a polyphenol derivative of the Curcuma longa rhizome, with ' 'potential antioxidant, anticancer, antidepressant, antiviral, and anti-inflammatory effects. ' 'This compound can be prepared as biodegradable polymer nanoparticles, called nanocurcumin, to ' 'improve its solubility, stability, half-life, and bioavailability. Aim. We explored ' 'nanocurcumin’s effect on the clinical manifestations of patients hospitalized with ' 'mild-to-moderate COVID-19. Methods. This double-blind, randomized clinical trial involved 76 ' 'COVID-19 patients admitted to Ali-Asghar Hospital from December 2021 to March 2022. All ' 'patients received standard coronavirus treatment as per national guidelines. In addition, ' 'four times a day for two weeks, the curcumin group received 40\u2009mg of nanocurcumin, while ' 'the control group received a placebo. Clinical manifestations were examined and recorded by ' 'the associate doctors working in the department. Statistical analysis was done using SPSS v. ' '21. Results. Thirty-nine people from the control group and 29 from the curcumin group ' 'completed the study. At baseline, the groups were comparable in age, gender, body mass index, ' 'hospitalization duration, and background diseases. The mean age of patients in the control ' 'and treatment groups was 53.9\u2009±\u200911.9 and 54.6\u2009±\u200913.4, respectively. ' 'Compared with the placebo, nanocurcumin minimized coughs (<jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M1">\n' ' <mi>P</mi>\n' ' <mo>=</mo>\n' ' <mn>0.036</mn>\n' ' </math>\n' ' </jats:inline-formula>), fatigue (<jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M2">\n' ' <mi>P</mi>\n' ' <mo>=</mo>\n' ' <mn>0.0001</mn>\n' ' </math>\n' ' </jats:inline-formula>), myalgia (<jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M3">\n' ' <mi>P</mi>\n' ' <mo>=</mo>\n' ' <mn>0.027</mn>\n' ' </math>\n' ' </jats:inline-formula>), oxygen demand (<jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M4">\n' ' <mi>P</mi>\n' ' <mo>=</mo>\n' ' <mn>0.036</mn>\n' ' </math>\n' ' </jats:inline-formula>), oxygen usage (<jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M5">\n' ' <mi>P</mi>\n' ' <mo>=</mo>\n' ' <mn>0.05</mn>\n' ' </math>\n' ' </jats:inline-formula>), and respiratory rate (<jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M6">\n' ' <mi>P</mi>\n' ' <mo>&lt;</mo>\n' ' <mn>0.0001</mn>\n' ' </math>\n' ' </jats:inline-formula>). By discharge, the curcumin group had a ' 'significantly greater increase in SPO2 than the control group (<jats:inline-formula>\n' ' <math xmlns="http://www.w3.org/1998/Math/MathML" id="M7">\n' ' <mi>P</mi>\n' ' <mo>=</mo>\n' ' <mn>0.006</mn>\n' ' </math>\n' ' </jats:inline-formula>). Conclusions. This preliminary study suggests that ' 'nanocurcumin has a potentiating anti-inflammatory effect when combined with standard COVID-19 ' 'treatment, helping the recovery from the acute inflammatory phase of the disease in ' 'hospitalized patients with mild-to-moderate disease severity. This trial is registered with ' 'Iranian Registry of Clinical Trials: IRCT20211126053183N1 (registered while recruiting on ' '13/12/2021).</jats:p>', 'DOI': '10.1155/2023/5734675', 'type': 'journal-article', 'created': {'date-parts': [[2023, 7, 29]], 'date-time': '2023-07-29T02:20:12Z', 'timestamp': 1690597212000}, 'page': '1-7', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Efficacy of Nanocurcumin as an Add-On Treatment for Patients Hospitalized with COVID-19: A ' 'Double-Blind, Randomized Clinical Trial', 'prefix': '10.1155', 'volume': '2023', 'author': [ { 'ORCID': 'http://orcid.org/0000-0002-2969-3125', 'authenticated-orcid': True, 'given': 'Sedigheh', 'family': 'Ahmadi', 'sequence': 'first', 'affiliation': [ { 'name': 'Student Research Committee, Shiraz University of Medical ' 'Sciences, Shiraz, Iran'}]}, { 'ORCID': 'http://orcid.org/0000-0002-5855-2153', 'authenticated-orcid': True, 'given': 'Zeinab', 'family': 'Mehrabi', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Internal Medicine, Shiraz University of Medical ' 'Sciences, Shiraz, Iran'}]}, { 'ORCID': 'http://orcid.org/0000-0001-7157-9265', 'authenticated-orcid': True, 'given': 'Morteza', 'family': 'Zare', 'sequence': 'additional', 'affiliation': [ { 'name': 'Nutrition Research Center, School of Nutrition and Food ' 'Sciences, Shiraz University of Medical Sciences, Shiraz, Iran'}]}, { 'ORCID': 'http://orcid.org/0000-0001-9976-5887', 'authenticated-orcid': True, 'given': 'Sara', 'family': 'Ghadir', 'sequence': 'additional', 'affiliation': [ { 'name': 'Student Research Committee, Shiraz University of Medical ' 'Sciences, Shiraz, Iran'}]}, { 'ORCID': 'http://orcid.org/0000-0001-6712-6802', 'authenticated-orcid': True, 'given': 'Seyed Jalil', 'family': 'Masoumi', 'sequence': 'additional', 'affiliation': [ { 'name': 'Nutrition Research Center, School of Nutrition and Food ' 'Sciences, Shiraz University of Medical Sciences, Shiraz, Iran'}, { 'name': 'Gastroenterohepatology Research Center, Shiraz University of ' 'Medical Sciences, Shiraz, Iran'}, { 'name': 'Center for Cohort Study of SUMS Employees’ Health, Shiraz ' 'University of Medical Sciences, Shiraz, Iran'}]}], 'member': '98', 'reference': [ { 'issue': '10223', 'key': '1', 'doi-asserted-by': 'crossref', 'first-page': '497', 'DOI': '10.1016/S0140-6736(20)30183-5', 'article-title': 'Clinical features of patients infected with 2019 novel coronavirus in ' 'Wuhan, China', 'volume': '395', 'author': 'C. 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Khan', 'year': '2018', 'journal-title': 'Artificial Cells, Nanomedicine, and Biotechnology'}, { 'issue': '2', 'key': '39', 'doi-asserted-by': 'crossref', 'DOI': '10.1371/journal.pone.0057285', 'article-title': 'Curcumin modulates the inflammatory response and inhibits subsequent ' 'fibrosis in a mouse model of viral-induced acute respiratory distress ' 'syndrome', 'volume': '8', 'author': 'S. Avasarala', 'year': '2013', 'journal-title': 'PLoS One'}, { 'issue': '9', 'key': '40', 'doi-asserted-by': 'crossref', 'first-page': '2147', 'DOI': '10.3390/nu11092147', 'article-title': 'Dietary curcumin: correlation between bioavailability and health ' 'potential', 'volume': '11', 'author': 'M. Dei Cas', 'year': '2019', 'journal-title': 'Nutrients'}, { 'issue': '2', 'key': '41', 'volume': '2', 'author': 'P. 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Late treatment
is less effective
Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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