Effectiveness and Safety of Turmeric for the Treatment of COVID-19: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials
Ratree Sawangjit, Saranrat Sadoyu, Siripong Manosanthipaibul, Nattawat Teerawattanapong, Panupong Puttarak, Kulthanit Wanaratna, Rawiwan Charoensup, Poonsit Hiransai, Thunyaluk Meetam, PharmD Nathorn Chaiyakunapruk
Complementary Therapies in Medicine, doi:10.1016/j.ctim.2025.103295
We conducted a comprehensive and updated systematic review and meta-analysis (SR-MA) to determine the effectiveness and safety of turmeric in patients with coronavirus disease 2019 (COVID-19). Multiple databases were searched from inception to July 31, 2024, for randomized controlled trials (RCTs) assessing turmeric in mild to severe COVID-19. This SR-MA uniquely includes recent trials conducted alongside modern antiviral-based regimens and explores effect modifiers by disease severity, comorbidity, formulation, and treatment duration. Twenty-three RCTs with 1,407 participants were included, making this the largest synthesis to date. Most studies (17/23, 73.9%) enrolled hospitalized patients; over half involved mild to moderate cases. The most common intervention was nano-curcumin 160-240 mg/day (39%), used as an adjunct to standard care. Nine studies were rated high risk of bias (ROB). Metaanalysis showed turmeric significantly reduced all-cause mortality (Relative risk (RR) = 0.39; 95% confidence interval (95%CI): 0.23-0.67; I² = 0%; n = 8 RCTs; moderate certainty), J o u r n a l P r e -p r o o f suggesting a 61% reduction in risk of death. It also reduced the need for intubation/mechanical ventilation (RR = 0.35; 95%CI: 0.17-0.72) and clinical deterioration (RR=0.36; 95%CI: 0.22-0.59), while improving overall symptom resolution (RR = 1.36; 95%CI: 1.16-1.59). These results remained robust after excluding high ROB studies. Adverse events, mostly mild gastrointestinal symptoms, were comparable to placebo. In conclusion, turmeric, particularly bioavailability-enhanced nano-curcumin, provides meaningful clinical benefits and favorable safety profile as adjunctive therapy for COVID-19. Further large-scale, high-quality, multicenter RCTs are warranted to confirm its therapeutic potential, particularly in resourcelimited settings.
Conflict of interest The authors declare no relevant conflicts of interest or financial relationships. J o u r n a l P r e -p r o o f 3 Other considerations for downgrading include publication bias. Other considerations for upgrading include a strong association with no plausible confounders, a dose response relationship, and if all plausible confounders or biases would decrease the size of the effect (if there is evidence of an effect), or increase it if there is evidence of no harmful effect (safety) 1 4 High = This research provides a very good indication of the likely effect. The likelihood that the effect will be substantially different** is low.
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