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The effect of quercetin supplementation on clinical outcomes in COVID‐19 patients: A systematic review and meta‐analysis

Ziaei et al., Food Science & Nutrition, doi:10.1002/fsn3.3715, PROSPERO CRD42023407390
Sep 2023  
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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
Systematic review and meta analysis of 5 studies, showing significantly lower mortality, ICU admission, and hospitalization with quercetin treatment.
Bioavailability. Quercetin has low bioavailability and studies typically use advanced formulations to improve bioavailability which may be required to reach therapeutic concentrations.
2 meta analyses show significant improvements with quercetin for mortality1, ICU admission1,2, and hospitalization1,2.
Currently there are 11 quercetin for COVID-19 studies, showing 61% lower mortality [-35‑89%], 89% lower ventilation [-92‑99%], 74% lower ICU admission [29‑90%], 48% lower hospitalization [19‑67%], and 93% fewer cases [73‑98%].
Ziaei et al., 26 Sep 2023, Randomized Controlled Trial, placebo-controlled, Iran, peer-reviewed, mean age 41.1, 6 authors, trial PROSPERO CRD42023407390. Contact: m-alimohammadik@alumnus.tums.
This PaperQuercetinAll
The effect of quercetin supplementation on clinical outcomes in COVID‐19 patients: A systematic review and meta‐analysis
Somayeh Ziaei, Malek Alimohammadi‐kamalabadi, Motahareh Hasani, Mahsa Malekahmadi, Emma Persad, Javad Heshmati
Food Science & Nutrition, doi:10.1002/fsn3.3715
COVID-19 is an extremely contagious respiratory disease that is caused by a newly identified type of coronavirus, known as SARS- CoV-2 (Sullivan et al., 2020). The disease was first identified in Wuhan, China, in December 2019, and quickly spread to become a global pandemic (Pollard et al., 2020) . To date, COVID-19 has infected millions of people worldwide, resulting in a significant number of deaths (Noor et al., 2020) . According to the WHO's website on March 7, 2023, there have been 759,408,703 confirmed cases of COVID-19 and 6,866,434 confirmed deaths directly or due to consequences of this pandemic infection (Melnyk et al., 2023) . COVID-19 can cause mild symptoms, such as coughing, diarrhea, high fever, muscle pain, fatigue, and a significant decrease in the sense of smell (Nehme et al., 2021) . However, if left untreated, it can lead to serious health complications. These may include acute respiratory distress
ACK N OWLED G M ENTS None. FU N D I N G I N FO R M ATI O N None. CO N FLI C T O F I NTE R E S T S TATE M E NT The authors have no competing interests to declare. S U PP O RTI N G I N FO R M ATI O N Additional supporting information can be found online in the Supporting Information section at the end of this article.
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The search has been conducted on PubMed, Scopus, Web of Science, EMBASE, and the ' 'Cochrane Library using relevant keywords until August 25, 2023. We included randomized ' 'controlled trials (RCTs) comparing COVID‐19 patients who received quercetin supplementation ' 'versus controls. We included five studies summarizing the evidence in 544 patients. ' 'Meta‐analysis showed that quercetin administration significantly reduced LDH activity ' '(standard mean difference (SMD): −0.42, 95% CI: −0.82, −0.02, ' '<jats:italic>I</jats:italic><jats:sup>2</jats:sup>\u2009=\u200948.86%), decreased the risk of ' 'hospital admission by 70% (RR: 0.30, 95% CI: 0.14, 0.62, ' '<jats:italic>I</jats:italic><jats:sup>2</jats:sup>\u2009=\u200900.00%), ICU admission by 73% ' '(RR: 0.27, 95% CI: 0.09, 0.78, <jats:italic>I</jats:italic><jats:sup>2</jats:sup>\u2009=\u2009' '20.66%), and mortality by 82% (RR: 0.18, 95% CI: 0.03, 0.98, ' '<jats:italic>I</jats:italic><jats:sup>2</jats:sup>\u2009=\u200900.00%). No significant ' 'changes in CRP, D‐dimmer, and ferritin were found between groups. Quercetin was found to ' 'significantly reduce LDH levels and decrease the risk of hospital and ICU admission and ' 'mortality in patients with COVID‐19 infection.</jats:p>', 'DOI': '10.1002/fsn3.3715', 'type': 'journal-article', 'created': {'date-parts': [[2023, 9, 26]], 'date-time': '2023-09-26T07:48:38Z', 'timestamp': 1695714518000}, 'update-policy': 'http://dx.doi.org/10.1002/crossmark_policy', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'The effect of quercetin supplementation on clinical outcomes in <scp>COVID</scp>‐19 patients: A ' 'systematic review and meta‐analysis', 'prefix': '10.1002', 'author': [ { 'given': 'Somayeh', 'family': 'Ziaei', 'sequence': 'first', 'affiliation': [ { 'name': 'ICU Department, Emam Reza Hospital Kermanshah University of ' 'Medical Sciences Kermanshah Iran'}]}, { 'given': 'Malek', 'family': 'Alimohammadi‐Kamalabadi', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Cellular‐Molecular Nutrition, School of ' 'Nutritional Sciences and Dietetics Tehran University of Medical ' 'Sciences Tehran Iran'}]}, { 'ORCID': 'http://orcid.org/0000-0002-9002-1192', 'authenticated-orcid': False, 'given': 'Motahareh', 'family': 'Hasani', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Nutritional Sciences, School of Health Golestan ' 'University of Medical Sciences Gorgan Iran'}]}, { 'given': 'Mahsa', 'family': 'Malekahmadi', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department of Cellular‐Molecular Nutrition, School of ' 'Nutritional Sciences and Dietetics Tehran University of Medical ' 'Sciences Tehran Iran'}, { 'name': 'Imam Khomeini Hospital Complex, Tehran University of Medicinal ' 'Sciences Tehran Iran Tehran University of Medical Sciences ' 'Tehran Iran'}]}, { 'given': 'Emma', 'family': 'Persad', 'sequence': 'additional', 'affiliation': [ { 'name': 'Department for Evidence‐based Medicine and Evaluation Danube ' 'University Krems Krems Austria'}]}, { 'ORCID': 'http://orcid.org/0000-0002-2676-0185', 'authenticated-orcid': False, 'given': 'Javad', 'family': 'Heshmati', 'sequence': 'additional', 'affiliation': [ { 'name': 'Songhor Healthcare Center Kermanshah University of Medical ' 'Sciences Kermanshah Iran'}]}], 'member': '311', 'published-online': {'date-parts': [[2023, 9, 26]]}, 'reference': [ { 'key': 'e_1_2_12_2_1', 'doi-asserted-by': 'crossref', 'first-page': '1693', 'DOI': '10.1016/j.ijbiomac.2020.07.235', 'article-title': 'Structural stability of SARS‐CoV‐2 3CLpro and identification of ' 'quercetin as an inhibitor by experimental screening', 'volume': '164', 'author': 'Abian O.', 'year': '2020', 'journal-title': 'International Journal of Biological Macromolecules'}, { 'issue': '5626', 'key': 'e_1_2_12_3_1', 'doi-asserted-by': 'crossref', 'first-page': '1763', 'DOI': '10.1126/science.1085658', 'article-title': 'Coronavirus main proteinase (3CLpro) structure: Basis for design of ' 'anti‐SARS drugs', 'volume': '300', 'author': 'Anand K.', 'year': '2003', 'journal-title': 'Science'}, { 'issue': '1', 'key': 'e_1_2_12_4_1', 'doi-asserted-by': 'crossref', 'first-page': '1', 'DOI': '10.1186/s13017-021-00354-3', 'article-title': 'Serum ferritin levels in inflammation: A retrospective comparative ' 'analysis between COVID‐19 and emergency surgical non‐COVID‐19 patients', 'volume': '16', 'author': 'Banchini F.', 'year': '2021', 'journal-title': 'World Journal of Emergency Surgery'}, { 'issue': '1', 'key': 'e_1_2_12_5_1', 'doi-asserted-by': 'crossref', 'first-page': '37', 'DOI': '10.1016/j.medcli.2020.07.043', 'article-title': 'Lactate dehydrogenase, COVID‐19 and mortality', 'volume': '156', 'author': 'Bartziokas K.', 'year': '2021', 'journal-title': 'Medicina Clínica'}, { 'issue': '3', 'key': 'e_1_2_12_6_1', 'doi-asserted-by': 'crossref', 'DOI': '10.1016/j.heliyon.2021.e06515', 'article-title': 'Evaluation of flavonoids as 2019‐nCoV cell entry inhibitor through ' 'molecular docking and pharmacological analysis', 'volume': '7', 'author': 'Bhowmik D.', 'year': '2021', 'journal-title': 'Heliyon'}, { 'key': 'e_1_2_12_7_1', 'first-page': '1', 'article-title': 'Antiviral effects of quercetin and related compounds', 'volume': '2020', 'author': 'Chaabi M.', 'year': '2020', 'journal-title': 'Naturopathic Currents'}, { 'key': 'e_1_2_12_8_1', 'doi-asserted-by': 'crossref', 'DOI': '10.1002/rmv.2427', 'article-title': 'Quercetin for the treatment of COVID‐19 patients: A systematic review ' 'and meta‐analysis', 'volume': '33', 'author': 'Cheema H. 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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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