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Efficacy of Persian medicine herbal formulations (capsules and decoction) compared to standard care in patients with COVID-19, a multicenter open-labeled, randomized, controlled clinical trial

Karimi et al., Phytotherapy Research, doi:10.1002/ptr.7277
Oct 2021  
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Mortality 51% Improvement Relative Risk ICU admission 61% Hospitalization time 70% primary Fever 67% Dyspnea 14% Nigella Sativa  Karimi et al.  LATE TREATMENT  RCT Is late treatment with nigella sativa + several herbal medicines beneficial for COVID-19? RCT 381 patients in Iran (March - July 2020) Shorter hospitalization (p=0.001) and improved recovery (p=0.0013) c19early.org Karimi et al., Phytotherapy Research, Oct 2021 Favorsnigella sativa Favorscontrol 0 0.5 1 1.5 2+
12th treatment shown to reduce risk in January 2021, now with p = 0.00016 from 14 studies.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 109 treatments. c19early.org
RCT 358 hospitalized patients in Iran, 184 receiving treatment with a combination of nigella sativa and several other herbal medicines, showing shorter hospitalization time and improved recovery with treatment. IR.TUMS.VCR.REC.1399.024.
risk of death, 50.8% lower, RR 0.49, p = 0.45, treatment 2 of 192 (1.0%), control 4 of 189 (2.1%), NNT 93.
risk of ICU admission, 60.6% lower, RR 0.39, p = 0.28, treatment 2 of 192 (1.0%), control 5 of 189 (2.6%), NNT 62.
hospitalization time, 70.0% lower, HR 0.30, p < 0.001, treatment 184, control 174, Cox proportional hazards, primary outcome.
fever, 66.5% lower, OR 0.33, p = 0.001, treatment 184, control 174, inverted to make OR<1 favor treatment, RR approximated with OR.
dyspnea, 13.7% lower, OR 0.86, p < 0.001, treatment 184, control 174, inverted to make OR<1 favor treatment, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Karimi et al., 4 Oct 2021, Randomized Controlled Trial, Iran, peer-reviewed, 37 authors, study period March 2020 - July 2020, this trial uses multiple treatments in the treatment arm (combined with several herbal medicines) - results of individual treatments may vary.
This PaperNigella SativaAll
Abstract: Received: 6 December 2020 Revised: 12 August 2021 Accepted: 26 August 2021 DOI: 10.1002/ptr.7277 RESEARCH ARTICLE Efficacy of Persian medicine herbal formulations (capsules and decoction) compared to standard care in patients with COVID-19, a multicenter open-labeled, randomized, controlled clinical trial Mehrdad Karimi1 | Azadeh Zarei1 | Samaneh Soleymani2 | 3 4 Saeidreza Jamalimoghadamsiahkali | Asmaa Asadi | Mohsen Shati5 6 Mohieddin Jafari Ayeh Naghizadeh1 | | 7 Hassan Rezadoost | Gholamreza Kordafshar Raefeh Mardi1 | Parva Namiranian1 | 1 | | Seyed Peyman Khamechi1,8 | Narges Ansari9 | Mohammad Sadegh Adel Mehraban1 Hananeh Aliakbarzadeh1 | Mahnaz Khanavi10 | Niusha Esmaealzadeh2 | | Alireza Moravveji11 | Mehrdad Salahi12 | Maryam Khoi12 | Reza Razzaghi13 | Hamid Reza Banafshe14 | Mostafa Alizadeh8,15 | Marzieh Akhbari1,8 | Mina Atharizadeh8,16 | Akram Izadikhah17 | Mahin Elsagh18 | Mahdi Hossein Zade Ghahnavieh17 | Fatemeh Eghbalian19 | Azam Vanai20 | Hossein Izadi21 | Seyed Ali Al-hadi Moravej18,19 | Seyede Ferdos Jazayeri18,19 | Houman Bayat22 | Hamid Emadi Koochak23 | Arman Zargaran2 1 Department of Traditional Medicine, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran 2 Department of Traditional Pharmacy, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran 3 Ziaeian Hospital, Tehran University of Medical Sciences, Tehran, Iran 4 Department of Infectious Diseases, Pakdasht Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran 5 Mental Health Research Center, Iran University of Medical Sciences, Tehran, Iran 6 Faculty of Medicine, University of Helsinki, Helsinki, Finland 7 Department of Phytochemistry, Medicinal Plants and Drugs Research Institute, Shahid Beheshti University, Tehran, Iran 8 Evidence Based Integrative Medicine Research Center, Kashan University of Medical Sciences, Kashan, Iran 9 Department of Internal Medicine, School of Medicine, Al-Zahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran 10 Department of Pharmacognosy, School of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran 11 Social Determinants of Health Research Center, Kashan University of Medical Sciences, Kashan, Iran 12 Department of Infectious Disease, Isabn-e-Maryam Hospital, Isfahan, Iran 13 Department of Infectious Disease, School of Medicine, Shahid Beheshti Hospital, Kashan University of Medical Sciences, Kashan, Iran 14 Department of Pharmacology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran 15 Department of Persian Medicine, School of Persian Medicine, Babol University of Medical Sciences, Babol, Iran 16 Department of Persian Medicine, School of Persian Medicine, Qom University of Medical Sciences, Qom, Iran 17 Department of Persian Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 18 Department of Persian Medicine, School of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran 19 Research Institute for Islamic and Complementary Medicine, School of Persian Medicine, Iran University of Medical Sciences, Tehran, Iran 20 Department of Nephrology, Shahid Beheshti University of Medical Sciences, Tehran, Iran 21 Department of Internal Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran Phytotherapy Research. 2021;35:6295–6309. wileyonlinelibrary.com/journal/ptr © 2021 John Wiley & Sons..
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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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