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All Studies   Meta Analysis    Recent:   

Effect of natural products use prior to infection with COVID-19 on disease severity and hospitalization: A self-reported cross-sectional survey study

Nimer et al., F1000Research, doi:10.12688/f1000research.121933.1
Jun 2022  
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0 0.5 1 1.5 2+ Hospitalization 31% Improvement Relative Risk Severe case 13% Curcumin for COVID-19  Nimer et al.  Prophylaxis Is prophylaxis with curcumin beneficial for COVID-19? Retrospective 2,148 patients in Jordan (March - July 2021) Lower hospitalization (p=0.08) and severe cases (p=0.47), not sig. c19early.org Nimer et al., F1000Research, June 2022 Favors curcumin Favors control
Curcumin for COVID-19
14th treatment shown to reduce risk in February 2021
 
*, now known with p = 0.000000015 from 26 studies.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,200+ studies for 70+ treatments. c19early.org
Survey 2,148 COVID-19 recovered patients in Jordan, showing lower hospitalization with turmeric prophylaxis, not reaching statistical significance.
Although the 31% lower hospitalization is not statistically significant, it is consistent with the significant 27% lower hospitalization [18‑35%] from meta analysis of the 12 hospitalization results to date.
This is the 20th of 26 COVID-19 controlled studies for curcumin, which collectively show efficacy with p=0.000000015 (1 in 66 million).
20 studies are RCTs, which show efficacy with p=0.0000033.
risk of hospitalization, 30.8% lower, RR 0.69, p = 0.08, treatment 29 of 329 (8.8%), control 179 of 1,819 (9.8%), adjusted per study, odds ratio converted to relative risk, multivariable.
risk of severe case, 12.6% lower, RR 0.87, p = 0.47, treatment 40 of 329 (12.2%), control 211 of 1,819 (11.6%), adjusted per study, odds ratio converted to relative risk, multivariable.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Nimer et al., 10 Jun 2022, retrospective, Jordan, peer-reviewed, survey, mean age 40.2, 4 authors, study period March 2021 - July 2021. Contact: rmnimer@just.edu.jo.
This PaperCurcuminAll
Effect of natural products use prior to infection with COVID-19 on disease severity and hospitalization: A self-reported cross-sectional survey study
Refat M Nimer, Omar F Khabour, Samer F Swedan, Hassan M Kofahi
F1000Research, doi:10.12688/f1000research.121933.1
Background: Managing coronavirus disease 2019 (COVID-19) using available resources is essential to reduce the health burden of disease. The severity of COVID-19 is affected by nutritional status. In this study the effect of natural product use prior to infection with COVID-19 on disease severity and hospitalization was explored. Methods: This was a cross-sectional study. Between March and July 2021, a self-administered survey was conducted in Jordan. Individuals who recovered from COVID-19 and were ≥18 years old were the study population. Study measures included the use of natural products, COVID-19 severity, and hospitalization status. A multivariate regression model was used for statistical analysis. Results: The mean age (mean ± SD) of the study sample (n=2,148) was 40.25 ± 15.58 years old. Multivariate logistic regression showed that the regular intake of carnation (OR [0.56], CI [0.37-0.85]), onion (OR [0.69], CI [0.52-0.92]), lemon (OR [0.68], CI [0.51-0.90]), and citrus fruits (OR [0.66], CI [0.50-0.89]) before infection were associated with a substantial reduction in COVID-19 severity (P<0.01). Also, the consumption of carnation (OR [0.55], CI [0.34-0.88]), lemon (OR [0.57], CI [0.42-0.78]), and citrus fruits (OR [0.61], CI [0.44-0.84]) were associated with a significant decrease in the frequency of COVID-19induced hospitalization (P<0.01). Conclusions: Regular consumption of carnation, lemon, and citrus fruits before infection was associated with better outcomes for COVID-19. Studies on other populations are required to confirm these findings.
Summary: The study explored the association between using specific natural products prior to COVID-19 infection and the severity of the disease and hospitalization status in a sample of Jordanian adults. Title: This is a retrospective study, the study design included a survey about prior COVID-19 infection and natural products consumption prior to infection. Methods: -Recruitment method is not clear, how the investigators reached out to the potential participants is not stated. The study suggests that only people who were previously infected with COVID-19 were included in the study. This assumption should be discussed in the inclusion criteria. -Calculation of the study sample assumed that the total population is the number of COVID-19 infected people as reported by the end of July 2021. Does this report include only adults or total confirmed cases? As the survey targeted only adults, the authors should identify precisely the study population as a reference for sample size calculation. Results: -Why is lemon considered a separate category from citrus? I suggest including all citrus fruit, including lemon as one category. -In table 1, the results were expressed in a different format, I suggest having all the results expressed as N (%). For this purpose, age can be categorized into 2-3 categories, and same for BMI. -In the multivariate logistic regression, the authors mentioned that after controlling for covariate, the findings... What are the covariates? The authors should..
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In this study the effect of natural product use ' 'prior to infection with COVID-19 on disease severity and hospitalization was ' 'explored.</ns3:p><ns3:p> <ns3:bold>Methods:</ns3:bold> This was a cross-sectional study. ' 'Between March and July 2021, a self-administered survey was conducted in Jordan. Individuals ' 'who recovered from COVID-19 and were ≥18 years old were the study population. Study measures ' 'included the use of natural products, COVID-19 severity, and hospitalization status. A ' 'multivariate regression model was used for statistical analysis.</ns3:p><ns3:p> ' '<ns3:bold>Results:</ns3:bold><ns3:italic> </ns3:italic>The mean age (mean ± SD) of the study ' 'sample (n=2,148) was 40.25 ± 15.58 years old. Multivariate logistic regression showed that ' 'the regular intake of carnation (OR [0.56], CI [0.37–0.85]), onion (OR [0.69], CI ' '[0.52–0.92]), lemon (OR [0.68], CI [0.51–0.90]), and citrus fruits (OR [0.66], CI ' '[0.50–0.89]) before infection were associated with a substantial reduction in COVID-19 ' 'severity (P&lt;0.01). Also, the consumption of carnation (OR [0.55], CI [0.34–0.88]), lemon ' '(OR [0.57], CI [0.42–0.78]), and citrus fruits (OR [0.61], CI [0.44–0.84]) were associated ' 'with a significant decrease in the frequency of COVID-19-induced hospitalization ' '(P&lt;0.01).</ns3:p><ns3:p> <ns3:bold>Conclusions:</ns3:bold> Regular consumption of ' 'carnation, lemon, and citrus fruits before infection was associated with better outcomes for ' 'COVID-19. 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[Dataset].', 'author': 'R Nimer', 'year': '2022', 'DOI': '10.6084/m9.figshare.19758820.v2'}], 'container-title': 'F1000Research', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://f1000research.com/articles/11-639/v1/xml', 'content-type': 'application/xml', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://f1000research.com/articles/11-639/v1/pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://f1000research.com/articles/11-639/v1/iparadigms', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2022, 7, 6]], 'date-time': '2022-07-06T11:50:21Z', 'timestamp': 1657108221000}, 'score': 1, 'resource': {'primary': {'URL': 'https://f1000research.com/articles/11-639/v1'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2022, 6, 10]]}, 'references-count': 63, 'URL': 'http://dx.doi.org/10.12688/f1000research.121933.1', 'relation': { 'has-review': [ { 'id-type': 'doi', 'id': '10.5256/f1000research.133852.r140507', 'asserted-by': 'subject'}, { 'id-type': 'doi', 'id': '10.5256/f1000research.133852.r140506', 'asserted-by': 'subject'}]}, 'ISSN': ['2046-1402'], 'subject': [ 'General Pharmacology, Toxicology and Pharmaceutics', 'General Immunology and Microbiology', 'General Biochemistry, Genetics and Molecular Biology', 'General Medicine'], 'container-title-short': 'F1000Res', 'published': {'date-parts': [[2022, 6, 10]]}, 'assertion': [ { 'value': 'Approved with reservations, Approved with reservations', 'URL': 'https://f1000research.com/articles/11-639/v1#article-reports', 'order': 0, 'name': 'referee-status', 'label': 'Referee status', 'group': {'name': 'current-referee-status', 'label': 'Current Referee Status'}}, { 'value': '10.5256/f1000research.133852.r140507, Fatin Y. Atrooz, Department of ' 'Pharmacological and Pharmaceutical Sciences, College of Pharmacy, University of ' 'Houston, Houston, TX, USA, 22 Jun 2022, version 1, 2 approved with reservations', 'URL': 'https://f1000research.com/articles/11-639/v1#referee-response-140507', 'order': 0, 'name': 'referee-response-140507', 'label': 'Referee Report', 'group': {'name': 'article-reports', 'label': 'Article Reports'}}, { 'value': '<b>Refat Nimer</b>; \n' '<i>Posted: 02 Jul 2022</i>; We would like to thank the reviewers for careful ' 'and thorough reading of this manuscript and for the thoughtful comments and ' 'constructive suggestions, which helped to improve the quality of this ' 'manuscript. Please find attached a point-by-point response to reviewers’ ' 'concerns. We hope that you find our responses satisfactory and that the ' 'manuscript is now acceptable for publication. \n' '<u>Reviewer #1 (Comments to the Author):</u>&nbsp; - Recruitment method is not ' 'clear, how the investigators reached out to the potential participants is not ' 'stated. The study suggests that only people who were previously infected with ' 'COVID-19 were included in the study. This assumption should be discussed in the ' 'inclusion criteria. \n' '<b>Authors’ response:</b> The recruitment method has now been illustrated in ' 'the revised manuscript. In the cover page for the questionnaire, we outlined ' 'the criteria for participation in the study, which includes infection with ' 'COVID-19 and recovery from illness. The research assistance emphasized that ' "participants' infection should have been confirmed by polymerase chain reaction " '(PCR). Participants were approached in public places such as bus stations, ' 'parks, religious places, universities and restaurants. - Calculation of the ' 'study sample assumed that the total population is the number of COVID-19 ' 'infected people as reported by the end of July 2021. Does this report include ' 'only adults or total confirmed cases? As the survey targeted only adults, the ' 'authors should identify precisely the study population as a reference for ' 'sample size calculation. \n' "<b>Authors' response:</b> The sample size for our study was calculated using " 'Raosoft Online Sample Size Calculator (Raosoft Inc., Seattle, WA, USA). 770,712 ' 'is the total confirmed cases reported by the end of July 2021, and the ' 'recommended sample size was 1067. However, this calculation is to check whether ' 'the sample size in our study is sufficient and representative. The number of ' 'cases under 18 years of age during the time of sample collection (before the ' 'emergence of the Omicron variant) was expected to be small compared to the ' 'adult cases (no data available). Therefore, if patients under 18 years are ' 'subtracted from the total cases, this would lead to a negligible change in the ' 'sample size. Nonetheless, the study sample size was larger than required (n= ' '2,148) even if child cases are considered. This point is now clarified in the ' 'Method section. - Why is lemon considered a separate category from citrus? I ' 'suggest including all citrus fruit, including lemon as one category. \n' '<b>Authors’ response:&nbsp; </b>Thank you for your comment. We prefer to keep ' 'lemon as a separate category from citrus because some studies showed variations ' 'in their nutritional values. This was clarified in the revised manuscript. - ' 'In table 1, the results were expressed in a different format, I suggest having ' 'all the results expressed as N (%). For this purpose, age can be categorized ' 'into 2-3 categories, and same for BMI. \n' "<b>Authors' response: </b>Done as suggested.\n" '<b> </b> - In the multivariate logistic regression, the authors mentioned that ' 'after controlling for covariate, the findings... What are the covariates? The ' 'authors should list the covariates here, and if that includes controlling for ' 'age and gender. \n' "<b>Authors' response:</b> The point raised by the reviewer is now incorporated " 'in the revised manuscript.', 'URL': 'https://f1000research.com/articles/11-639/v1#referee-comment-8464', 'order': 1, 'name': 'referee-comment-8464', 'label': 'Referee Comment', 'group': {'name': 'article-reports', 'label': 'Article Reports'}}, { 'value': '10.5256/f1000research.133852.r140506, Caterina Vicidomini, Istituto di ' 'Biostrutture e Bioimmagini IBB-CNR, Naples, Italy, 28 Jun 2022, version 1, 2 ' 'approved with reservations', 'URL': 'https://f1000research.com/articles/11-639/v1#referee-response-140506', 'order': 2, 'name': 'referee-response-140506', 'label': 'Referee Report', 'group': {'name': 'article-reports', 'label': 'Article Reports'}}, { 'value': '<b>Refat Nimer</b>; \n' '<i>Posted: 02 Jul 2022</i>; We would like to thank the reviewers for careful ' 'and thorough reading of this manuscript and for the thoughtful comments and ' 'constructive suggestions, which helped to improve the quality of this ' 'manuscript. Please find attached a point-by-point response to reviewers’ ' 'concerns. We hope that you find our responses satisfactory and that the ' 'manuscript is now acceptable for publication. \n' '<u>Reviewer #2 (Comments to the Author):</u>&nbsp; In my opinion, this paper ' 'has some limitations including those the authors have described in the text. ' 'The total number and quantity of natural products used by the subjects were ' 'unknown,.. \n' "<b>Authors' response:</b> We agree with the reviewer that the rate of " 'consumption of these natural products was unknown. However, this point was ' 'mentioned in the limitations (highlighted in red). And also, I didn’t find any ' 'information on whether the participants consumed these natural products as ' 'commercial supplements, or if they prepared them from natural sources at home, ' 'for example. \n' '<b>Authors’ response:</b> This study focuses on natural products, not ' 'commercial supplements.&nbsp; However, the point raised by the reviewer is now ' 'incorporated in the revised manuscript. Provide some information on the ' 'recruitment method adopted. \n' "<b>Authors' response:</b> More information was added at “Study design and " 'subjects” section. Specify, at least for the most active products such as ' 'carnation, how it is usually consumed. \n' '<b>&nbsp;</b>\n' '<b>Authors’ response:</b> Your suggestion is now incorporated in the updated ' 'version of the manuscript. Reading the questionnaire, I saw that the authors ' "collected data on potential confounders and comorbidities, but they didn't " 'specify anything on this aspect. Please, add what they considered confounders. ' 'If possible, it would be interesting to evaluate whether, for example, the ' 'cigarette smoking modified the beneficial effect of natural substances ' 'intake. \n' '<b>Authors’ response:</b> COVID-19 was reported to be more severe in people ' 'having high BMI or comorbidities. However, the aim of this study was to explore ' 'the effect of using natural products on the severity of the disease, regardless ' 'of the confounding factors. Therefore, multivariate regression analysis was ' 'applied to control for possible confounding factors such as age, gender, ' 'cigarette smoking, and the number of comorbidities (Table 3). The analysis ' 'without adjusted confounding factors is shown in Table 2. The point raised by ' 'the reviewer is now discussed in the revised manuscript.&nbsp; I know that ' 'there are other natural substances traditionally used to boost the immune ' 'system, but they were not mentioned or considered in the study. Please add a ' 'comment in the text and cite at least the following reference. PMID: 33511704 \n' "<b>Authors’ response: </b>We agree with the reviewer's comment. However, this " 'study covered the broadest range of natural products used by the Jordanian ' 'population. The point raised by the reviewer is now incorporated in the revised ' 'manuscript the last sentence in the introduction) and the proposed reference ' 'was added (ref no. 14).', 'URL': 'https://f1000research.com/articles/11-639/v1#referee-comment-8463', 'order': 3, 'name': 'referee-comment-8463', 'label': 'Referee Comment', 'group': {'name': 'article-reports', 'label': 'Article Reports'}}, { 'value': 'This work was supported by the Deanship of Research, Jordan University of ' 'Science and Technology (Grant number 20210173; to Dr. Refat Nimer). The funders ' 'had no role in study design, data collection and analysis, decision to publish, ' 'or preparation of the manuscript.', 'order': 4, 'name': 'grant-information', 'label': 'Grant Information'}, { 'value': 'This is an open access article distributed under the terms of the Creative ' 'Commons Attribution Licence, which permits unrestricted use, distribution, and ' 'reproduction in any medium, provided the original work is properly cited.', 'order': 0, 'name': 'copyright-info', 'label': 'Copyright'}]}
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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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