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The pharmacological mechanism of quercetin as adjuvant therapy of COVID-19

Rizky et al., Life Research, doi:10.53388/life2022-0205-302
May 2022  
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Quercetin for COVID-19
22nd treatment shown to reduce risk in July 2021
*, now known with p = 0.0031 from 11 studies.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,100+ studies for 60+ treatments.
Review of in silico and clinical evidence supporting the use of quercetin for COVID-19.
Reviews covering quercetin for COVID-19 include Agrawal, Biancatelli, Chen, Derosa, Dinda, Gasmi, Georgiou, Ho, Imran, Massimo Magro, Matías-Pérez, Mirza, Rizky, Shorobi, Vajdi, Yong.
Rizky et al., 15 May 2022, peer-reviewed, 5 authors.
This PaperQuercetinAll
Wahyu Choirur Rizky, Muhammad Candragupta Jihwaprani, Avicena Al Kindi, Arif Nur, Muhammad Ansori, Mazhar Mushtaq
oral supplements such as zinc, vitamin C, vitamin D, folic acid [5] , and flavonoids such as quercetin, as adjuvant pharmacotherapy in the management of . Quercetin (3, 3', 4', 5, 7-pentahydroxyfl avone) (C15H10O7) is a major polyphenol that belongs to the fl avonoid family. It is categorized as fl avonol, one of the six subclasses of fl avonoid compounds. Being the most abundant form of flavonoid molecules, quercetins are ubiquitously distributed in a variety of dietary plants, including apple, berries, onion, kale, tea, tomato, grape, as well as nuts. Furthermore, it is also aff ordably marketed in the form of tablet dietary supplements. Various in vitro and animal model studies have shown that quercetin has numerous physiological eff ects, including antioxidant, anti-infl ammatory, immunomodulatory, and antiviral properties. There is well-documented evidence pointing toward its eff ects in attenuating lipid peroxidation, platelet aggregation, and capillary permeability, which cumulatively result in cardioprotective eff ects, as well as anti-carcinogenic properties [7] . Too few human studies address the effectiveness of quercetin, specifically in the management of viral respiratory infection. Notwithstanding, some human studies have provided signifi cant results in specifi c populations with non-infectious causes of respiratory disease [8] [9] [10] [11] . Current evidence shows the specific pathomechanics of COVID-19-associated acute respiratory distress syndrome (CARDS), which include severe inflammation and pulmonary edema leading to impaired alveolar homeostasis, and alteration of lung physiology, and resulting in lung fi brosis, infl ammation of endothelium, vascular thrombosis, as well as an exaggerated immune response [12] . during the writing of this review [2] . Ergo, scientists and researchers are racing the clock and breaking records to develop COVID-19 vaccines and repurpose several therapeutic options to treat mild to severe COVID-19. Recently, albeit several trials that are underway to produce safe and effective vaccines, in conjunction with its distribution, over 4.9 million vaccine doses have been administered worldwide and obtained emergency use authorization by The United States food and drug administration (FDA) [2] . However, an approach called drug repurposed under ACTIV-6 protocol has been created by the national institute of health (NIH) to explore a pool of up to seven drugs approved by the FDA for other diseases, particularly antiviral drug remdesivir, the anti-infl ammatory baricitinib, and corticosteroid (e.g. dexamethasone) for treating mild to moderate 4] . Furthermore, there have been numerous ongoing trials evaluating
Funding The authors received no specifi c funding for this work. Author contribution All authors contributed equally to the manuscript and read and approved the fi nal version of the manuscript. Competing interests The authors declare no confl icts of interest. Abbreviations TCMSP, traditional Chinese medicine systems pharmacology; SARS-CoV-2, severe acute respiratory syndrome coronavirus-2; ACE2, angiotensin-converting enzyme 2; Mpro, main protease; 3CLpro, 3C-like protease; PLpro, Papain-like protease; RdRP, RNA-dependent RNA polymerase; COVID-19, Coronavirus Disease; NIH, national institute of health; CARDS, COVID-19-associated acute respiratory distress syndrome; SARS-CoV, SARS-Associated Coronavirus; MERS-CoV, Middle East respiratory syndrome coronavirus; WHO, World Health Organization; FDA, food and drug administration; SPR, Surface Plasmon Resonance; GO, Gene Ontology; rhACE2, recombinant human ACE2; IC50, inhibitory concentration; GEO, gene expression omnibus; SPR/FRET, surface plasmon resonance/fl uorescence resonance energy transfer; GSEA, Gene Set Enrichment Analyses; ITC, Isothermal titration calorimetry; WURSS, Wisconsin Upper Respiratory Symptom Survey; SFT-PC, surfactant protein-C; RDNI, Reduning Injection Peer review information Life Research thanks Kaloyan Asenov Kaloyanov, George Kluck, Sergio Sanchez Gambetta Dong Zhao Pratichi Singh Pravin D. Potdar for their contribution to the peer review of this paper.
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