A Randomized, Double-Blind, Placebo-Controlled Study to Assess the Efficacy and Safety of a Nutritional Supplement (ImmuActiveTM) for COVID-19 Patients
Muhammed Majeed, Kalyanam Nagabhushanam, Kalpesh Shah, Lakshmi Mundkur
Evidence-Based Complementary and Alternative Medicine, doi:10.1155/2021/8447545
Background. SARS-CoV-2 has emerged as a global threat due to its infectivity and rapid transmission. We evaluated the safety and efficacy of herbal and mineral formulation (ImmuActive) as an adjunct therapy in COVID-19 patients. Methods. A randomized, double-blind, placebo-controlled study was conducted in 100 COVID-19 patients in three centers in Southern India, and 92 subjects completed the study. Subjects were followed up until they were discharged from the hospital or for a maximum of 28 days, whichever was earlier. e primary outcome parameters were the mean change and time required to change the ordinal scale of disease severity by one unit. e secondary outcomes were the time required to turn RT-PCR negative or get discharged from the hospital, change in modified Jackson's Symptom Severity score, and COVID-19 quality of life questionnaire. Results. e ordinal scale at the end of the study was significantly lower in COVID-19 patients supplemented with ImmuActive (0.57) than placebo (1.0), with a p value of 0.0043. e ordinal scale decreased by one unit within 2.35 days in ImmuActive-supplemented patients, while it took 3.36 days in placebo-supplemented patients. Days of hospitalization and time required to turn RT-PCR negative were comparatively lower in the ImmuActive arm than the placebo arm. Change in modified Jackson's Symptom Severity Score and COVID-19 QOL were significant from screening to the end of the study in both ImmuActive and placebo arms. ere were no adverse events observed during the study period. Conclusion. e study results suggest that ImmuActive could be a beneficial and safe adjunct treatment for effectively managing COVID-19 infection symptoms.
Conflicts of Interest All the authors are affiliated to Sami-Sabinsa Group Limited or Sabinsa Corporation.
References
Akbar, Andrographis paniculata: a review of pharmacological activities and clinical effects, Alternative Medicine Review: A Journal of Clinical erapeutic
Ali, COVID-19: are we ready for the second wave?, Disaster Medicine and Public Health Preparedness
Askari, Ravansalar, Naghizadeh, e efficacy of topical sesame oil in patients with knee osteoarthritis: a randomized double-blinded active-controlled noninferiority clinical trial, Complementary erapies in Medicine
Barnes, Bloom, Nahin, Complementary and alternative medicine use among adults and children: United States, 2007, Natural Health State Report
Basak, Cooper, Roberge, Banik, Chrétien et al., Inhibition of proprotein convertases-1, -7 and furin by diterpines of Andrographis paniculata and their succinoyl esters, Biochemical Journal
Benarba, Pandiella, Medicinal plants as sources of active molecules against COVID-19, Frontiers in Pharmacology
Chakraborty, Sharma, Sharma, Bhattacharya, Lee, SARS-CoV-2 causing pneumonia-associated respiratory disorder (COVID-19): diagnostic and proposed therapeutic options, European Review for Medical and Pharmacological Sciences
Chang, Wallis, Tiralongo, Use of complementary and alternative medicine among People with type 2 diabetes in Taiwan: a cross-sectional survey, Evidence-based Complementary and Alternative Medicine: eCAM
Chowdhury, Hossain, Kashem, Shahid, Alam, Immune response in COVID-19: a review, Journal of Infection and Public Health
Coon, Ernst, Andrographis paniculata in the treatment of upper respiratory tract infections: a systematic review of safety and efficacy, Planta Medica
Du, Shi, Cao, Zuo, Zhou, Add-on effect of Chinese herbal medicine in the treatment of mild to moderate COVID-19: a systematic review and meta-analysis, PLoS One
Enmozhi, Raja, Sebastine, Joseph, Andrographolide as a potential inhibitor of SARS-CoV-2 main protease: an in silico approach, Journal of Biomolecular Structure and Dynamics
Filardo, Di Pietro, Mastromarino, Sessa, erapeutic potential of resveratrol against emerging respiratory viral infections, Pharmacology & erapeutics
Gammoh, Rink, Zinc in infection and inflammation, Nutrients
Gammoh, Rink, Zinc in infection and inflammation, Nutrients
Guillin, Vindry, Ohlmann, Chavatte, Selenium, selenoproteins and viral infection, Nutrients
Hawkes, Kelley, Taylor, e effects of dietary selenium on the immune system in healthy men, Biological Trace Element Research
Hong-Zhi, Xiao-Ying, Yu-Huan, Huang, Da-Hui, Traditional Chinese Medicine: an effective treatment for 2019 novel coronavirus pneumonia (NCP), Chinese Journal of Natural Medicines
Hu, Wu, Logue, Andrographis paniculata (Chu� an X � in Lián) for symptomatic relief of acute respiratory tract infections in adults and children: a systematic review and meta-analysis, PLoS One
Jiang, Xia, Ying, Lu, A novel coronavirus (2019-nCoV) causing pneumonia-associated respiratory syndrome, Cellular and Molecular Immunology
Jothimani, Kailasam, Danielraj, COVID-19: poor outcomes in patients with Zinc deficiency, International Journal of Infectious Diseases
Kedzierski, Linossi, Kolesnik, Suppressor of cytokine signaling 4 (SOCS4) protects against severe cytokine storm and enhances viral clearance during influenza infection, PLoS Pathogens
Kieliszek, Lipinski, Selenium supplementation in the prevention of coronavirus infections (COVID-19), Medical Hypotheses
Kim, Marks, Clemens, Looking beyond COVID-19 vaccine phase 3 trials, Nature Medicine
Kopansky-Giles, Vernon, Boon, Steiman, Kelly et al., Inclusion of a CAM therapy (chiropractic care) for the management of musculoskeletal pain in an integrative, inner city, hospital-based primary care setting, Journal of Alternative Medicine Research
Kumar, Sinha, Cardiovascular disease in India: a 360 degree overview, Medical Journal Armed Forces India
Liu, Ying, e inhibitory effect of curcumin on virus-induced cytokine storm and its potential use in the associated severe pneumonia, Frontiers in Cell and Developmental Biology
Majedi, Majedi, Existing drugs as treatment options for COVID-19: a brief survey of some recent results, Journal of Chemistry Letters
Majeed, Nagabhushanam, Gowda, Mundkur, An exploratory study of selenium status in healthy individuals and in patients with COVID-19 in a south Indian population: the case for adequate selenium status, Nutrition
Maurya, Kumar, Prasad, Bhatt, Saxena, Structure-based drug designing for potential antiviral activity of selected natural products from Ayurveda against SARS-CoV-2 spike glycoprotein and its cellular receptor, Virus Disease
Nayebi, Esteghamati, Meysamie, e effects of a Melissa officinalis L. based product on metabolic parameters in patients with type 2 diabetes mellitus: a randomized double-blinded controlled clinical trial, Journal of Complementary & Integrative Medicine
Pormohammad, Monych, Turner, Zinc and SARS-CoV-2: a molecular modeling study of Zn interactions with RNA-dependent RNA-polymerase and 3C-like proteinase enzymes, International Journal of Molecular Medicine
Ramdani, Bachari, Potential therapeutic effects of Resveratrol against SARS-CoV-2, Acta Virologica
Rayman, Selenium and human health, e Lancet
Saydah, Eberhardt, Use of complementary and alternative medicine among adults with chronic diseases: United States 2002, Journal of Alternative & Complementary Medicine
Seifert, Jeitler, Stange, e relevance of complementary and integrative medicine in the COVID-19 pandemic: a qualitative review of the literature, Frontiers of Medicine
Shagufta, Asim, Qamar, Antihyperlipidemic effect of seeds of jamun (eugenia jambolana) in subjects of intermediate hyperglycemia: a pilot study, Traditional and Integrative Medicine
Shi, Huang, Chen, Andrographolide and its fluorescent derivative inhibit the main proteases of 2019-nCoV and SARS-CoV through covalent linkage, Biochemical and Biophysical Research Communications
Singer, Adams, Integrating complementary and alternative medicine into mainstream healthcare services: the perspectives of health service managers, BMC Complementary and Alternative Medicine
Singh, Malik, Raina, Computational investigation for identification of potential phytochemicals and antiviral drugs as potential inhibitors for RNA-dependent RNA polymerase of COVID-19, Journal of Biomolecular Structure and Dynamics
Soni, Mehta, Ratre, Curcumin, a traditional spice component, can hold the promise against COVID-19?, European Journal of Pharmacology
Verity, Okell, Dorigatti, Estimates of the severity of coronavirus disease 2019: a model-based analysis, e Lancet Infectious Diseases
Wessels, Rolles, Rink, e potential impact of zinc supplementation on COVID-19 pathogenesis, Frontiers in Immunology
Who, R&D Blueprint Novel Coronavirus COVID-19 erapeutic Trial Synopsis
Who, WHO Lists Two Additional COVID-19 Vaccines for Emergency Use and COVAX Roll-Out
Wintergerst, Maggini, Hornig, Immuneenhancing role of vitamin C and zinc and effect on clinical conditions, Annals of Nutrition and Metabolism
Yang, Wei, Huang, Resveratrol inhibits the replication of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in cultured Vero cells, Phytotherapy Research
Zahedipour, Hosseini, Sathyapalan, Potential effects of curcumin in the treatment of COVID-19 infection, Phytotherapy Research
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'abstract': '<jats:p>Background. SARS-CoV-2 has emerged as a global threat due to its infectivity and '
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