Patients’ Behavior Regarding Dietary or Herbal Supplements before and during COVID-19 in Saudi Arabia
Leen A Aldwihi, Shahd I Khan, Faisal F Alamri, Yazed Alruthia, Faleh Alqahtani, Omer I Fantoukh, Ahmed Assiri, Omar A Almohammed
International Journal of Environmental Research and Public Health, doi:10.3390/ijerph18105086
The use of traditional medicinal plants in Saudi Arabia stems mainly from consumers' belief in prophetic medicine. This study was conducted to explore changes in patients' use of dietary or herbal supplements among individuals infected with COVID-19 before and during infection and the association between herbal or dietary supplements and hospitalization. A cross-sectional, questionnaire-based study was conducted enrolling symptomatic patients who had recently recovered from COVID-19. Data were collected through phone interviews, and McNemar's test was used to investigate changes to consumption of dietary or herbal supplements before and during infection. Multivariable logistic regression was used to investigate the association between supplements use during patients' infection and hospitalization. A total of 738 patients were included in this study, of whom 32.1% required hospitalization. About 57% of participants were male with a mean age of 36.5 (±11.9) years. The use of lemon/orange, honey, ginger, vitamin C, and black seed among participants significantly increased during their infection. In contrast, patients using anise, peppermint, and coffee peel before their infection were more likely to stop using them during their infection. In addition, using lemon/orange (p < 0.0001), honey (p = 0.0002), ginger (p = 0.0053), vitamin C (p = 0.0006), black seed (p < 0.0001), peppermint (p = 0.0027), costus (p = 0.0095), and turmeric (p = 0.0012) was significantly higher among nonhospitalized patients than hospitalized ones. However, in the multivariable logistic regression, only use of vitamin C (OR = 0.51; 95% CI 0.33-0.79), peppermint (OR = 0.53; 95% CI 0.31-0.90), and lemon/orange (OR = 0.54; 95% CI 0.33-0.88) was associated with significantly lower odds of hospitalization. The study reveals that patients' consumption of dietary or herbal supplements changed in response to their COVID-19 infection, with hospitalized patients having a lower likelihood of using these supplements. Because some supplements were associated with lower odds of hospitalization, these supplements or their bioactive components should be further investigated as feasible options for COVID-19 treatment.
Informed Consent Statement: Verbal informed consent was obtained from all subjects involved in the study during the phone interview.
Conflicts of Interest: The authors declare no conflict of interest.
References
Ahmadi, Rajabi, Vasfi-Marandi, Evaluation of the antiviral effects of aqueous extracts of red and yellow onions (Allium Cepa) against avian influenza virus subtype H9N2, Iran. J. Vet. Sci. Technol,
doi:10.22067/veterinary.v2i10.74060Al-Hatamleh, Hatmal, Sattar, Ahmad, Mustafa et al., Antiviral and immunomodulatory effects of phytochemicals from honey against COVID-19: Potential mechanisms of action and future directions, Molecules,
doi:10.3390/molecules25215017Ali, Blunden, Tanira, Nemmar, Some phytochemical, pharmacological and toxicological properties of ginger (Zingiber officinale Roscoe): A review of recent research, Food Chem. Toxicol,
doi:10.1016/j.fct.2007.09.085Ali, Kunugi, Propolis, bee honey, and their components protect against Coronavirus Disease 2019 (COVID-19): A review of in silico, in vitro, and clinical studies, Molecules,
doi:10.3390/molecules26051232Alkhamaiseh, Aljofan, Prevalence of use and reported side effects of herbal medicine among adults in Saudi Arabia, Complementary Ther. Med,
doi:10.1016/j.ctim.2019.102255Alsayari, Almghaslah, Khaled, Annadurai, Alkhairy et al., Community pharmacists' knowledge, attitudes, and practice of herbal medicines in Asir region, Kingdom of Saudi Arabia, Evid. Based Complementary Altern. Med,
doi:10.1155/2018/1568139Alyami, Orabi, Aldhabbah, Alturki, Aburas et al., Knowledge about COVID-19 and beliefs about and use of herbal products during the COVID-19 pandemic: A cross-sectional study in Saudi Arabia, Saudi Pharm. J,
doi:10.1016/j.jsps.2020.08.023Azkur, Akdis, Azkur, Sokolowska, Van De Veen et al., Immune response to SARS-CoV-2 and mechanisms of immunopathological changes in COVID-19, Allergy,
doi:10.1111/all.14364Babaei, Nassiri-Asl, Hosseinzadeh, Curcumin (a constituent of turmeric): New treatment option against COVID-19, Food Sci. Nutr,
doi:10.1002/fsn3.1858Baliga, Haniadka, Pereira, Thilakchand, Rao et al., Radioprotective effects of Zingiber officinale Roscoe (ginger): Past, present and future, Food Funct,
doi:10.1039/c2fo10225kBalogun, Ashafa, A review of plants used in South African traditional medicine for the management and treatment of hypertension, Planta Med,
doi:10.1055/a-0801-8771Banerjee, Srivastava, Giri, Possible nutritional approach to cope with COVID-19 in Indian perspective, Adv. Res. J. Med. Clin. Sci
Barakat, El Wakeel, Hagag, Effects of Nigella sativa on outcome of hepatitis C in Egypt, World J. Gastroenterol,
doi:10.3748/wjg.v19.i16.2529Besharati-Seidani, Jabbari, Yamini, Headspace solvent microextraction: A very rapid method for identification of volatile components of Iranian Pimpinella anisum seed, Anal. Chim. Acta,
doi:10.1016/j.aca.2004.09.006Brahmi, Madani, Mohamed, Duez, Chemical composition and biological activities of Mentha species,
doi:10.5772/67291Briguglio, Pregliasco, Lombardi, Perazzo, Banfi, The malnutritional status of the host as a virulence factor for new Coronavirus SARS-CoV-2, Front. Med,
doi:10.3389/fmed.2020.00146Chrubasik, Pittler, Roufogalis, Zingiberis rhizoma: A comprehensive review on the ginger effect and efficacy profiles, Phytomedicine,
doi:10.1016/j.phymed.2004.07.009Davies, Abbott, Barnard, Jarvis, Kucharski et al., Estimated transmissibility and impact of SARS-CoV-2 lineage B.1.1.7 in England, Science
Desam, Al-Rajab, Sharma, Mylabathula, Gowkanapalli et al., Chemical constituents, in vitro antibacterial and antifungal activity of Mentha × Piperita L. (peppermint) essential oils, J. King Saud Univ. Sci
Dorsch, Ring, Anti-inflammatory, anti-thrombotic and antiviral substances from Onions could be an option for the treatment of COVID-19: A hypothesis, J. Bacteriol. Parasitol
Ekor, The growing use of herbal medicines: Issues relating to adverse reactions and challenges in monitoring safety, Front. Pharmacol,
doi:10.3389/fphar.2013.00177Fan, Gu, Alemi, Research Group for Evidence-Based Chinese Medicine. Chinese herbal medicine for COVID-19: Current evidence with systematic review and meta-analysis, J. Integr. Med,
doi:10.1016/j.joim.2020.07.008Forouzanfar, Bazzaz, Hosseinzadeh, Black cumin (Nigella sativa) and its constituent (thymoquinone): A review on antimicrobial effects, Iran. J. Basic Med. Sci
Gopinath, Karthikeyan, Turmeric: A condiment, cosmetic and cure, Indian J. Dermatol. Venereol. Leprol
Gupta, Gupta, Bhargava, Potential use of turmeric in COVID-19, Clin. Exp. Dermatol,
doi:10.1111/ced.14357Hamer, Kivimäki, Gale, Batty, Lifestyle risk factors, inflammatory mechanisms, and COVID-19 hospitalization: A community-based cohort study of 387,109 adults in UK, Brain Behav. Immun,
doi:10.1016/j.bbi.2020.05.059Hamulka, Jeruszka-Bielak, Górnicka, Drywie Ń, Zielinska-Pukos, Dietary supplements during COVID-19 outbreak. Results of Google trends analysis supported by PLifeCOVID-19 online studies, Nutrients,
doi:10.3390/nu13010054Hong, Lee, Lee, Kim, Effects of dietary antioxidant vitamins on lung functions according to gender and smoking status in Korea: A population-based cross-sectional study, BMJ Open,
doi:10.1136/bmjopen-2017-020656Julianti, Hata, Zimmermann, Kaiser, Hamburger et al., Antitrypanosomal sesquiterpene lactones from Saussurea costus, Fitoterapia,
doi:10.1016/j.fitote.2011.05.010Khalil, Tazeddinova, The upshot of polyphenolic compounds on immunity amid COVID-19 pandemic and other emerging communicable diseases: An appraisal, Nat. Prod. Bioprospecting,
doi:10.1007/s13659-020-00271-zKhubber, Hashemifesharaki, Mohammadi, Gharibzahedi, Garlic (allium Sativum, ): A potential unique therapeutic food rich in organosulfur and flavonoid compounds to fight with COVID-19, Nutr. J,
doi:10.1186/s12937-020-00643-8Klimek-Szczykutowicz, Szopa, Ekiert, Citrus limon (Lemon) phenomenon-a review of the chemistry, pharmacological properties, applications in the modern pharmaceutical, food, and cosmetics industries, and biotechnological studies, Plants,
doi:10.3390/plants9010119Koca, Tasci, Garlic as a functional food
Koshak, Koshak, Heinrich, Medicinal benefits of Nigella sativa in bronchial asthma: A literature review, Saudi Pharm. J,
doi:10.1016/j.jsps.2017.07.002Koshak, Koshak, Mobeireek, Badawi, Wali et al., Nigella sativa supplementation to treat symptomatic mild COVID-19: A structured summary of a protocol for a randomised, controlled, clinical trial, Trials,
doi:10.1186/s13063-020-04647-xKulkarni, Deshpande, Anti-inflammatory and antioxidant effect of ginger in tuberculosis, J. Complementary Integr. Med,
doi:10.1515/jcim-2015-0032Ling, Traditional Chinese medicine is a resource for drug discovery against 2019 novel coronavirus (SARS-CoV-2), J. Integr. Med,
doi:10.1016/j.joim.2020.02.004Mallhi, Khan, Alotaibi, Alzarea, Alanazi et al., Drug repurposing for COVID-19: A potential threat of self-medication and controlling measures, Postgrad. Med. J,
doi:10.1136/postgradmedj-2020-138447Meneguzzo, Ciriminna, Zabini, Pagliaro, Review of evidence available on hesperidin-rich products as potential tools against COVID-19 and hydrodynamic cavitation-based extraction as a method of increasing their production, Processes,
doi:10.3390/pr8050549Moghaddam, Omidbaigi, Pourbaig, Ghaemi, Composition and antifungal activity of peppermint (Mentha piperita) essential oil. Iran, J. Pharm. Sci,
doi:10.1080/0972060X.2013.813265Morais, Aquino, Da Silva-Maia, Vale, Maciel et al., Nutritional status, diet and viral respiratory infections: Perspectives for severe acute respiratory syndrome coronavirus 2, Br. J. Nutr
Mosavat, Jaberi, Sobhani, Mosaffa-Jahromi, Iraji et al., Efficacy of Anise (Pimpinella anisum L.) oil for migraine headache: A pilot randomized placebo-controlled clinical trial, J. Ethnopharmacol,
doi:10.1016/j.jep.2019.01.047Pandey, Rastogi, Rawat, Saussurea costus: Botanical, chemical and pharmacological review of an ayurvedic medicinal plant, J. Ethnopharmacol,
doi:10.1016/j.jep.2006.12.033Panyod, Ho, Sheen, Dietary therapy and herbal medicine for COVID-19 prevention: A review and perspective, J. Tradit. Complementary Med,
doi:10.1016/j.jtcme.2020.05.004Park, Bae, Lee, Antibacterial activity of [10]-gingerol and [12]-gingerol isolated from ginger rhizome against periodontal bacteria, Phytother. Res,
doi:10.1002/ptr.2473Peeri, Shrestha, Rahman, Zaki, Tan et al., The SARS, MERS and novel coronavirus (COVID-19) epidemics, the newest and biggest global health threats: What lessons have we learned?, Int. J. Epidemiol,
doi:10.1093/ije/dyaa033Qin, Zhou, Hu, Zhang, Yang et al., Dysregulation of immune response in patients with Coronavirus 2019 (COVID-19) in Wuhan, China, Clin. Infect. Dis,
doi:10.1093/cid/ciaa248Qureshi, Shafa, Elhassan, Abdallah, Evaluation of some biological properties of Saussurea costus crude root extract, Biosci. Biotechnol. Res. Commun,
doi:10.21786/bbrc/10.4/2Rahman, Hussain, Ullah, Ullah, Zai, Phytochemical analysis and chemical composition of different branded and unbranded honey samples, Int. J. Microbiol. Res,
doi:10.5829/idosi.ijmr.2013.4.2.1103Rodríguez-Pérez, Molina-Montes, Verardo, Artacho, García-Villanova et al., Changes in dietary behaviours during the COVID-19 outbreak confinement in the Spanish COVIDiet study, Nutrients,
doi:10.3390/nu12061730Shariatpanahi, Taleban, Mokhtari, Shahbazi, Ginger extract reduces delayed gastric emptying and nosocomial pneumonia in adult respiratory distress syndrome patients hospitalized in an intensive care unit, J. Crit. Care
Shi, Sun, Zhang, Zhang, Xu et al., Early therapeutic interventions of traditional Chinese medicine in COVID-19 patients: A retrospective cohort study, J. Integr. Med,
doi:10.1016/j.joim.2021.01.002Silveira, Prieto-Garcia, Boylan, Estrada, Fonseca-Bazzo et al., COVID-19: Is there evidence for the use of herbal medicines as adjuvant symptomatic therapy?, Front. Pharmacol,
doi:10.3389/fphar.2020.581840Wang, Conlon, Ren, Chen, Ączek, Natural products as targeted nodulators of the immune system, J. Immunol. Res,
doi:10.1155/2018/7862782Wu, Mcgoogan, Characteristics of and important lessons from the Coronavirus Disease 2019 (COVID-19) outbreak in China: Summary of a report of 72314 cases from the Chinese Center for Disease Control and Prevention, JAMA,
doi:10.1001/jama.2020.2648Xian, Zhang, Bian, Zhou, Zhang et al., Bioactive natural compounds against human coronaviruses: A review and perspective, Acta Pharm. Sin. B,
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'abstract': '<jats:p>The use of traditional medicinal plants in Saudi Arabia stems mainly from consumers’ '
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'dietary or herbal supplements among individuals infected with COVID-19 before and during '
'infection and the association between herbal or dietary supplements and hospitalization. A '
'cross-sectional, questionnaire-based study was conducted enrolling symptomatic patients who '
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'McNemar’s test was used to investigate changes to consumption of dietary or herbal '
'supplements before and during infection. Multivariable logistic regression was used to '
'investigate the association between supplements use during patients’ infection and '
'hospitalization. A total of 738 patients were included in this study, of whom 32.1% required '
'hospitalization. About 57% of participants were male with a mean age of 36.5 (±11.9) years. '
'The use of lemon/orange, honey, ginger, vitamin C, and black seed among participants '
'significantly increased during their infection. In contrast, patients using anise, '
'peppermint, and coffee peel before their infection were more likely to stop using them during '
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'https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf'},
{'key': 'ref6', 'doi-asserted-by': 'publisher', 'DOI': '10.3389/fcimb.2021.596201'},
{'key': 'ref7', 'doi-asserted-by': 'publisher', 'DOI': '10.1126/science.abg3055'},
{'key': 'ref8', 'doi-asserted-by': 'publisher', 'DOI': '10.1136/postgradmedj-2020-138447'},
{'key': 'ref9', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.bbi.2020.05.059'},
{'key': 'ref10', 'doi-asserted-by': 'publisher', 'DOI': '10.1111/all.14364'},
{'key': 'ref11', 'doi-asserted-by': 'publisher', 'DOI': '10.1093/cid/ciaa248'},
{'key': 'ref12', 'doi-asserted-by': 'publisher', 'DOI': '10.1017/S0007114520003311'},
{'key': 'ref13', 'doi-asserted-by': 'publisher', 'DOI': '10.3389/fmed.2020.00146'},
{'key': 'ref14', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.jtcme.2020.05.004'},
{'key': 'ref15', 'doi-asserted-by': 'publisher', 'DOI': '10.1155/2018/7862782'},
{'key': 'ref16', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.apsb.2020.06.002'},
{'key': 'ref17', 'doi-asserted-by': 'publisher', 'DOI': '10.3390/pr8050549'},
{ 'key': 'ref18',
'first-page': '207',
'article-title': 'Possible nutritional approach to cope with COVID-19 in Indian '
'perspective',
'volume': '6',
'author': 'Banerjee',
'year': '2020',
'journal-title': 'Adv. Res. J. Med. Clin. Sci.'},
{'key': 'ref19', 'doi-asserted-by': 'publisher', 'DOI': '10.22271/plants.2020.v8.i5c.1218'},
{'key': 'ref20', 'doi-asserted-by': 'publisher', 'DOI': '10.1007/s13659-020-00271-z'},
{'key': 'ref21', 'doi-asserted-by': 'publisher', 'DOI': '10.1002/fsn3.1858'},
{'key': 'ref22', 'doi-asserted-by': 'publisher', 'DOI': '10.1021/acs.jnatprod.5b01055'},
{'key': 'ref23', 'doi-asserted-by': 'publisher', 'DOI': '10.3389/fphar.2013.00177'},
{'key': 'ref24', 'doi-asserted-by': 'publisher', 'DOI': '10.3390/nu12061730'},
{'key': 'ref25', 'doi-asserted-by': 'publisher', 'DOI': '10.3390/nu13010054'},
{'key': 'ref26', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.joim.2020.02.004'},
{'key': 'ref27', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.joim.2020.07.008'},
{'key': 'ref28', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.joim.2021.01.002'},
{'key': 'ref29', 'doi-asserted-by': 'publisher', 'DOI': '10.1155/2018/1568139'},
{'key': 'ref30', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.ctim.2019.102255'},
{'key': 'ref31', 'doi-asserted-by': 'publisher', 'DOI': '10.3390/plants9010119'},
{'key': 'ref32', 'doi-asserted-by': 'publisher', 'DOI': '10.1055/a-0801-8771'},
{'key': 'ref33', 'doi-asserted-by': 'publisher', 'DOI': '10.1136/bmjopen-2017-020656'},
{'key': 'ref34', 'doi-asserted-by': 'publisher', 'DOI': '10.3390/nu9111211'},
{'key': 'ref35', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.jsps.2020.08.023'},
{ 'key': 'ref36',
'first-page': '929',
'article-title': 'Black cumin (Nigella sativa) and its constituent (thymoquinone): A '
'review on antimicrobial effects',
'volume': '17',
'author': 'Forouzanfar',
'year': '2014',
'journal-title': 'Iran. J. Basic Med. Sci.'},
{'key': 'ref37', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.jsps.2017.07.002'},
{'key': 'ref38', 'doi-asserted-by': 'publisher', 'DOI': '10.3748/wjg.v19.i16.2529'},
{'key': 'ref39', 'doi-asserted-by': 'publisher', 'DOI': '10.1186/s13063-020-04647-x'},
{'key': 'ref40', 'doi-asserted-by': 'publisher', 'DOI': '10.5772/67291'},
{'key': 'ref41', 'doi-asserted-by': 'publisher', 'DOI': '10.22271/phyto.2020.v9.i3y.11525'},
{'key': 'ref42', 'doi-asserted-by': 'publisher', 'DOI': '10.1080/0972060X.2013.813265'},
{'key': 'ref43', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.jksus.2017.07.013'},
{'key': 'ref44', 'doi-asserted-by': 'publisher', 'DOI': '10.3390/molecules26051232'},
{'key': 'ref45', 'doi-asserted-by': 'publisher', 'DOI': '10.5829/idosi.ijmr.2013.4.2.1103'},
{'key': 'ref46', 'doi-asserted-by': 'publisher', 'DOI': '10.3390/molecules25215017'},
{'key': 'ref47', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.fct.2007.09.085'},
{'key': 'ref48', 'doi-asserted-by': 'publisher', 'DOI': '10.1039/c2fo10225k'},
{'key': 'ref49', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.phymed.2004.07.009'},
{'key': 'ref50', 'doi-asserted-by': 'publisher', 'DOI': '10.1002/ptr.2473'},
{'key': 'ref51', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.jcrc.2009.12.008'},
{'key': 'ref52', 'doi-asserted-by': 'publisher', 'DOI': '10.1515/jcim-2015-0032'},
{'key': 'ref53', 'doi-asserted-by': 'publisher', 'DOI': '10.4103/ijdvl.IJDVL_1143_16'},
{'key': 'ref54', 'doi-asserted-by': 'publisher', 'DOI': '10.1111/ced.14357'},
{'key': 'ref55', 'doi-asserted-by': 'publisher', 'DOI': '10.22067/veterinary.v2i10.74060'},
{ 'key': 'ref56',
'first-page': '1000387',
'article-title': 'Anti-inflammatory, anti-thrombotic and antiviral substances from Onions '
'could be an option for the treatment of COVID-19: A hypothesis',
'volume': '12',
'author': 'Dorsch',
'year': '2021',
'journal-title': 'J. Bacteriol. Parasitol.'},
{'key': 'ref57', 'doi-asserted-by': 'publisher', 'DOI': '10.17660/ActaHortic.2016.1143.20'},
{'key': 'ref58', 'doi-asserted-by': 'publisher', 'DOI': '10.1186/s12937-020-00643-8'},
{'key': 'ref59', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.mehy.2020.109934'},
{'key': 'ref60', 'doi-asserted-by': 'publisher', 'DOI': '10.21786/bbrc/10.4/2'},
{'key': 'ref61', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.fitote.2011.05.010'},
{'key': 'ref62', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.jep.2006.12.033'},
{'key': 'ref63', 'doi-asserted-by': 'publisher', 'DOI': '10.21608/smj.2020.31144.1163'},
{'key': 'ref64', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.jep.2019.01.047'},
{'key': 'ref65', 'doi-asserted-by': 'publisher', 'DOI': '10.1016/j.aca.2004.09.006'},
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