Use of Andrographis paniculata (Burm.f.) Wall. ex Nees and risk of pneumonia in hospitalised patients with mild coronavirus disease 2019: A retrospective cohort study
Jeeranan Tanwettiyanont, Napacha Piriyachananusorn, Lilit Sangsoi, Benjawan Boonsong, Chamlong Sunpapoa, Patcharawan Tanamatayarat, Nat Na-Ek, Sukrit Kanchanasurakit
Frontiers in Medicine, doi:10.3389/fmed.2022.947373
Background: Andrographis paniculata (Burm.f.) Wall. ex Nees (AP) has been widely used in Thailand to treat mild COVID-19 infections since early 2020; however, supporting evidence is scarce and ambiguous. Thus, this study aimed to examine whether the use of AP is associated with a decreased risk of pneumonia in hospitalised mild COVID-19 patients.
Materials and methods: We collected data between March 2020 and August 2021 from COVID-19 patients admitted to one hospital in Thailand. Patients whose infection was confirmed by real-time polymerase chain reaction, had normal chest radiography and did not receive favipiravir at admission were included and categorised as either AP (deriving from a dried and ground aerial part of the plant), given as capsules with a total daily dose of 180 mg andrographolide for 5 days or standard of care. They were followed for pneumonia confirmed by chest radiography. Multiple logistic regression was used for the analysis controlling for age, sex, diabetes, hypertension, statin use, and antihypertensive drug use.
Ethics statement The studies involving human participants were reviewed and approved by the Ethical Committee for clinical research of Phrae Hospital approved this study (no. 70/2564). Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.
Author contributions JT, SK, and NN-E conceptualised the study objectives, designed and collected the data, contributed to the literature review, data cleaning, data analyses, and interpretation of the findings. JT prepared an initial manuscript. NN-E further developed subsequent manuscripts. SK, PT, NP, LS, BB, and CS critically revised the initial manuscript. All authors contributed to manuscript revision, read, and approved the submitted version.
Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher's note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
Supplementary material The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/..
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doi:10.1002/ptr.7141{ 'indexed': {'date-parts': [[2023, 8, 22]], 'date-time': '2023-08-22T14:30:11Z', 'timestamp': 1692714611888},
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'abstract': '<jats:sec><jats:title>Background</jats:title><jats:p><jats:italic>Andrographis '
'paniculata</jats:italic> (Burm.f.) Wall. ex Nees (AP) has been widely used in Thailand to '
'treat mild COVID-19 infections since early 2020; however, supporting evidence is scarce and '
'ambiguous. Thus, this study aimed to examine whether the use of AP is associated with a '
'decreased risk of pneumonia in hospitalised mild COVID-19 '
'patients.</jats:p></jats:sec><jats:sec><jats:title>Materials and '
'methods</jats:title><jats:p>We collected data between March 2020 and August 2021 from '
'COVID-19 patients admitted to one hospital in Thailand. Patients whose infection was '
'confirmed by real-time polymerase chain reaction, had normal chest radiography and did not '
'receive favipiravir at admission were included and categorised as either AP (deriving from a '
'dried and ground aerial part of the plant), given as capsules with a total daily dose of 180 '
'mg andrographolide for 5 days or standard of care. They were followed for pneumonia confirmed '
'by chest radiography. Multiple logistic regression was used for the analysis controlling for '
'age, sex, diabetes, hypertension, statin use, and antihypertensive drug '
'use.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>A total of 605 out '
'of 1,054 patients (mostly unvaccinated) were included in the analysis. Of these, 59 patients '
'(9.8%) developed pneumonia during the median follow-up of 7 days. The incidence rates of '
'pneumonia were 13.93 (95% CI 10.09, 19.23) and 12.47 (95% CI 8.21, 18.94) per 1,000 '
'person-days in the AP and standard of care groups, respectively. Compared to the standard of '
'care group, the odds ratios of having pneumonia in the AP group were 1.24 (95% CI 0.71, 2.16; '
'unadjusted model) and 1.42 (95% CI 0.79, 2.55; fully adjusted model). All sensitivity '
'analyses were consistent with the main '
'results.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>The use of '
'AP was not significantly associated with a decreased risk of pneumonia in mild COVID-19 '
'patients. While waiting for insights from ongoing trials, AP’s use in COVID-19 should be done '
'with caution.</jats:p></jats:sec>',
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