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All Studies   Meta Analysis       

Effects of Lianhuaqingwen Capsules in adults with mild-to-moderate coronavirus disease 2019: an international, multicenter, double-blind, randomized controlled trial

Zheng et al., Virology Journal, doi:10.1186/s12985-023-02144-6, FLOSAN, ChiCTR2200056727
Nov 2023  
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Recovery 39% Improvement Relative Risk Viral clearance 11% Quercetin  FLOSAN  EARLY TREATMENT  DB RCT Is early treatment with quercetin beneficial for COVID-19? Double-blind RCT 815 patients in China (February - December 2022) Improved recovery with quercetin (p<0.000001) c19early.org Zheng et al., Virology J., November 2023 Favorsquercetin Favorscontrol 0 0.5 1 1.5 2+
Quercetin for COVID-19
24th treatment shown to reduce risk in July 2021, now with p = 0.0031 from 11 studies.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 111 treatments. c19early.org
RCT 815 mild-to-moderate COVID-19 patients in China, 410 treated with Lianhuaqingwen (LHQW) for 14 days, showing improved recovery with treatment. 86.8% of the LHQW group achieved symptom resolution by day 14 compared to 71.9% for placebo. No patients progressed to severe disease or died, and safety was comparable between groups. The active ingredient of LHQW include quercetin, kaempferol, luteolin, β-sitosterol, indigo, wogonin, tryptanthrin, [E]-4-phenyl-3-buten-2-one, 1-methyl-2-nonyl-4(1H)-quinolone, stigmasterol, naringenin, and 18β-glycyrrhetinic acid.
Bioavailability. Quercetin has low bioavailability and studies typically use advanced formulations to improve bioavailability which may be required to reach therapeutic concentrations.
This study is excluded in meta analysis: combined treatments may contribute more to the effect seen.
risk of no recovery, 38.7% lower, HR 0.61, p < 0.001, treatment 410, control 405, inverted to make HR<1 favor treatment.
risk of no viral clearance, 10.7% lower, HR 0.89, p = 0.21, treatment 410, control 405, inverted to make HR<1 favor treatment.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Zheng et al., 28 Nov 2023, Double Blind Randomized Controlled Trial, placebo-controlled, China, peer-reviewed, 20 authors, study period February 2022 - December 2022, trial ChiCTR2200056727 (FLOSAN). Contact: jpzhenggy@163.com, nanshan@vip.163.com.
This PaperQuercetinAll
Effects of Lianhuaqingwen Capsules in adults with mild-to-moderate coronavirus disease 2019: an international, multicenter, double-blind, randomized controlled trial
Jin-Ping Zheng, Yun Ling, Liang-Shuang Jiang, Piroon Mootsikapun, Hong-Zhou Lu, Methee Chayakulkeeree, Li-Xiu Zhang, Pureepat Arttawejkul, Feng-Yu Hu, Thi Ngoc Lan Truong, Roxan A Perez, Xing Gu, Hui-Min Sun, Jian-Jie Jiang, Ren-Jie Liu, Zhen Ding, Yang-Qing Zhan, Zi-Feng Yang, Wei-Jie Guan, Nan-Shan Zhong
Virology Journal, doi:10.1186/s12985-023-02144-6
Background In a randomized trial, Lianhuaqingwen (LHQW) capsule was effective for accelerating symptom recovery among patients with coronavirus disease 2019 (COVID-19). However, the lack of blinding and limited sample sizes decreased the level of clinical evidence. Objectives To evaluate the efficacy and safety of LHQW capsule in adults with mild-to-moderate COVID-19. Methods We conducted a double-blind randomized controlled trial in adults with mild-to-moderate COVID-19 (17 sites from China, Thailand, Philippine and Vietnam). Patients received standard-of-care alone or plus LHQW capsules (4 capsules, thrice daily) for 14 days. The primary endpoint was the median time to sustained clinical improvement or resolution of nine major symptoms. Results The full-analysis set consisted of 410 patients in LHQW capsules and 405 in placebo group. LHQW significantly shortened the primary endpoint in the full-analysis set (4.0 vs. 6.7 days, hazards ratio: 1.63, 95% confidence interval: 1.39-1.90). LHQW capsules shortened the median time to sustained clinical improvement or resolution of stuffy or runny nose (2.8 vs. 3.7 days), sore throat (2.0 vs. 2.6 days), cough (3.2 vs. 4.9 days), feeling hot or feverish (1.0 vs. 1.3 days), low energy or tiredness (1.3 vs. 1.9 days), and myalgia (1.5 vs. 2.0 days). The duration to sustained clinical improvement or resolution of shortness of breath, headache, and chills or shivering did not differ significantly between the two groups. Safety was comparable between the two groups. No serious adverse events were reported.
Supplementary Information The online version contains supplementary material available at https:// doi. org/ 10. 1186/ s12985-023-02144-6. Additional file 1: Online supplementary tables and figures. Author contributions J. P. Z., Z. F. Y. and N. S. Z. participated in study design; Y. L., L. S. J., P. M., H. Z. L., M. C., L. X. Z., P. A., F. Y. H., T. T. N. L., R. A. P., X. G., H. M. S., J. J. J., R. J. L., Z. D. and Y. Q. Z. recruited patients and performed follow up; W. J. G., J. P. Z. and N. S. Z. drafted the manuscript; J. P. Z. and N. S. Z. were responsible for study conception and provided critical review of the manuscript. All authors read and approved the final manuscript. J. P. Z. and N. S. Z. were the guarantors of the study. Declarations Ethics approval and consent to participate Ethics approval has been obtained the ethics committee of each participating site, based on Good Clinical Practice. All patients signed written informed consent. Competing interests None. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
References
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' 'Complement Ther Med. 2021;60:102754.', 'journal-title': 'Complement Ther Med'}, { 'issue': '21', 'key': '2144_CR21', 'doi-asserted-by': 'publisher', 'first-page': 'e26059', 'DOI': '10.1097/MD.0000000000026059', 'volume': '100', 'author': 'Z Fan', 'year': '2021', 'unstructured': 'Fan Z, Guo G, Che X, Yang Y, Liu Y, Li L, Chang X, Han L, Cai X, Tang H. ' 'Efficacy and safety of Lianhuaqingwen for mild or moderate coronavirus ' 'disease 2019: a meta-analysis of randomized controlled trials. Medicine ' '(Baltimore). 2021;100(21):e26059.', 'journal-title': 'Medicine (Baltimore)'}, { 'issue': '1', 'key': '2144_CR22', 'doi-asserted-by': 'publisher', 'first-page': '100644', 'DOI': '10.1016/j.imr.2020.100644', 'volume': '10', 'author': 'M Liu', 'year': '2021', 'unstructured': 'Liu M, Gao Y, Yuan Y, Yang K, Shi S, Tian J, Zhang J. Efficacy and ' 'safety of herbal medicine (Lianhuaqingwen) for treating COVID-19: a ' 'systematic review and meta-analysis. Integr Med Res. 2021;10(1):100644.', 'journal-title': 'Integr Med Res'}, { 'key': '2144_CR23', 'doi-asserted-by': 'publisher', 'first-page': '7962630', 'DOI': '10.1155/2021/7962630', 'volume': '2021', 'author': 'X Gong', 'year': '2021', 'unstructured': 'Gong X, Yuan B, Yuan Y, Li F. Efficacy and safety of Lianhuaqingwen ' 'capsules for the prevention of coronavirus disease 2019: a prospective ' 'open-label controlled trial. Evid Based Complement Alternat Med. ' '2021;2021:7962630.', 'journal-title': 'Evid Based Complement Alternat Med'}], 'container-title': 'Virology Journal', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://link.springer.com/content/pdf/10.1186/s12985-023-02144-6.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/article/10.1186/s12985-023-02144-6/fulltext.html', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/content/pdf/10.1186/s12985-023-02144-6.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2023, 11, 28]], 'date-time': '2023-11-28T16:08:35Z', 'timestamp': 1701187715000}, 'score': 1, 'resource': {'primary': {'URL': 'https://virologyj.biomedcentral.com/articles/10.1186/s12985-023-02144-6'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2023, 11, 28]]}, 'references-count': 23, 'journal-issue': {'issue': '1', 'published-online': {'date-parts': [[2023, 12]]}}, 'alternative-id': ['2144'], 'URL': 'http://dx.doi.org/10.1186/s12985-023-02144-6', 'relation': {}, 'ISSN': ['1743-422X'], 'subject': ['Infectious Diseases', 'Virology'], 'container-title-short': 'Virol J', 'published': {'date-parts': [[2023, 11, 28]]}, 'assertion': [ { 'value': '31 May 2023', 'order': 1, 'name': 'received', 'label': 'Received', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '26 July 2023', 'order': 2, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '28 November 2023', 'order': 3, 'name': 'first_online', 'label': 'First Online', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, {'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Declarations'}}, { 'value': 'Ethics approval has been obtained the ethics committee of each participating ' 'site, based on <i>Good Clinical Practice</i>. All patients signed written ' 'informed consent.', 'order': 2, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Ethics approval and consent to participate'}}, { 'value': 'None.', 'order': 3, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Competing interests'}}], 'article-number': '277'}
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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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