Select Global Immune-Boosting Plants Used in Folklore Medicine

There are numerous foods and herbal plants that boost the immune system. They stimulate the activity of cells responsible for fighting infections. In fact, over centuries, people have relied on herbs and other plants for treating medical conditions and boosting immunity. Considering the worldwide coronavirus pandemic, natural immune boosters are being sought after in the current war against this viral infection. Most likely, immune-boosting plants help human health by tackling viruses, bacteria, and abnormal cells in the form of prevention, to support and strengthen the body's natural immune system. In this chapter, we review several terrestrial species and plants from various sources including China, India, Europe, and Africa, which have long folklore use, and we provide information on the chemistry and biological activity where available. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd. 2022.

Phytotherapy in the virus infections

The study is a review of natural raw materials that can prevent infection and help treat viral infections, including those that cause COVID-19. The condition of not getting infected with pathogens that cause infections of the upper and lower respiratory tract is high the body resistance. An important element that influences the proper immunity of the body is the diet. The functioning of the immune system is improved by bee products, and plant materials: purple coneflower herb, flower and root, licorice root, aloe gel and Baikal skullcap root, as well as black cumin seed oil, chaga mushroom, lemon balm leaves and chamomile flowers. Strengthening immunity is conducive to maintaining a good mood and reducing stress. The antiviral activity has been confirmed for many plant materials, especially those containing essential oils. Natural products can be used for prevention and treatment. The country that copes best with the coronavirus epidemic is China, thanks to a combination of academic and natural medicine. The study quotes an excerpt from the "Handbook of COVID-19 Prevention and Treatment", prepared by Chinese doctors, with particular attention to the recipes used by them.

Immunomodulatory meaning of diet and COVID-19

Introduction and objective:The latest scientific reports showed that there is a relationship between the state of the gastrointestinal tract and the immune system, and the incidence of COVID-19. Diet can exert an immunomodulatory effect and regulate the immune response of an organism. The aim of the review is to show the effects of immunomodulators contained/supplemented in a diet on the infection SARS-CoV-2 and the course of COVID-19. Review methods:The literature review was conducted using PubMed, Google Scholar and the Medline database. Abbreviated description of the state of knowledge:Regular vitamin D supplementation significantly reduces the risk of respiratory infection with SARS-CoV-2;vitamin C may inhibit the expression of the ACE2 receptor in human small alveolar epithelial cells and limit the penetration of SARS-CoV-2;reduced iron levels predispose people to severe COVID-19 symptoms;selenium deficiency may be responsible for a decreased level of antibodies and NK cell cytotoxicity. Alo.. vera isolated polysaccharides strengthens the immune system;the quercetin and ellagic acid in combination with virus proteins show potential antiviral activity against SARSCoV- 2. Subsequently, adaptogens, ginger, echinacea and curcumin - showed anti-inflammatory effects. Also, the optimal composition of the gut microbiota improved/maintained the integrity of the lymphoid tissue found in the gastrointestinal tract (GALT) and the functioning of the gut-pulmonary axis. Summary:Natural immunomodulators may be a relatively safe therapeutic option in patients during the course of COVID-19, but there are still no official recommendations for their practical use in therapy. It should be emphasized that there is a need for further scientific research into the mechanisms of action and efficacy of phytotherapy in the context of the effectiveness of plant-based immunostimulants in alleviating the course of COVID-19 disease.

Broad Antiviral Effects of Echinacea purpurea against SARS-CoV-2 Variants of Concern and Potential Mechanism of Action.

SARS-CoV-2 variants of concern (VOCs) represent an alarming threat as they show altered biological behavior and may escape vaccination effectiveness. Broad-spectrum antivirals could play an important role to control infections. The activity of Echinacea purpurea (Echinaforce® extract, EF) against (i) VOCs B1.1.7 (alpha), B.1.351.1 (beta), P.1 (gamma), B1.617.2 (delta), AV.1 (Scottish), B1.525 (eta), and B.1.1.529.BA1 (omicron); (ii) SARS-CoV-2 spike (S) protein-pseudotyped viral particles and reference strain OC43 as well as (iii) wild type SARS-CoV-2 (Hu-1) was analyzed. Molecular dynamics (MD) were applied to study the interaction of Echinacea's phytochemical markers with known pharmacological viral and host cell targets. EF extract broadly inhibited the propagation of all investigated SARS-CoV-2 VOCs as well as the entry of SARS-CoV-2 pseudoparticles at EC50's ranging from 3.62 to 12.03 µg/mL. The preventive addition of 25 µg/mL EF to epithelial cells significantly reduced sequential infection with SARS-CoV-2 (Hu-1) and OC43. MD analyses showed constant binding affinities to VOC-typical S protein variants for alkylamides, caftaric acid, and feruloyl-tartaric acid in EF extract and interactions with serine protease TMPRSS-2. EF extract demonstrated stable virucidal activity across seven tested VOCs, likely due to the constant affinity of the contained phytochemical substances to all spike variants. A possible interaction of EF with TMPRSS-2 partially would explain the cell protective benefits of the extract by the inhibition of membrane fusion and cell entry. EF may therefore offer a supportive addition to vaccination endeavors in the control of existing and future SARS-CoV-2 virus mutations.

C3H Expression Is Crucial for Methyl Jasmonate Induction of Chicoric Acid Production by Echinacea purpurea (L.) Moench Cell Suspension Cultures.

Echinacea purpurea (L.) Moench is one of the most economically important medicinal plants, cultivated worldwide for its high medicinal value and with several industrial applications in both pharmaceutical and food industries. Thanks to its various phytochemical contents, including caffeic acid derivatives (CADs), E. purpurea extracts have antioxidant, anti-inflammatory, and immuno-stimulating properties. Among CADs, chicoric acid is one of the most important compounds which have shown important pharmacological properties. The present research was aimed at optimizing the production of chicoric acid in E. purpurea cell culture. Methyl jasmonate (MeJa) at different concentrations and for different duration of treatments was utilized as elicitor, and the content of total polyphenols and chicoric acid was measured. Several genes involved in the chicoric acid biosynthetic pathway were selected, and their expression evaluated at different time points of cell culture growth. This was performed with the aim of identifying the most suitable putative molecular markers to be used as a proxy for the early prediction of chicoric acid contents, without the need of expensive quantification methods. A correlation between the production of chicoric acid in response to MeJa and an increased response to oxidative stress was also proposed.

Echinacea as a potential force against coronavirus infections?

Introduction Echinacea purpurea has been shown to broadly inhibit coronaviruses and SARS-CoV-2 in vitro [1]. Aim To assess the available clinical evidence for Echinacea preparations in the infection prevention against coronaviruses. Method In a systematic literature search on MEDLINE and EMBASE articles were selected for clinical trials with Echinacea studying RT-PCR-confirmed viral respiratory tract infections in humans. Results Jawad collected nasopharyngeal swabs from N=755 adults over 4 months of prevention. Overall, 24 and 47 enveloped virus infections occurred, including 21 and 33 coronavirus detections [229E;HKU1;OC43] with Echinaforce® (2400 mg/d) and placebo, respectively (p=0.0114) [2]. Ogal administered Echinaforce® extract (1'200 mg) or control for 4 months to N=203 children (4-12 years). The incidence of enveloped virus infections was reduced from 47 to 29 (p=0.0038). Viral loads in nasal secretions were significantly diminished by 98.5%, with Ct-values 31.1 [95%CI 26.3;35.9] versus 25.0 [95%CI 20.5;29.5] (p=0.0479) ([Fig.1]) [3]. Kolev applied Echinaforce® extract (2'400 mg/d) vs. no treatment over 5 months to N = 120 adults and reported 10 vs. 20 coronavirus infections (p=0.046) of which 5 vs. 14 samples tested SARS-CoV-2 positive (p=0.03) [4]. Conclusion Echinacea's broad antiviral spectrum was confirmed in clinical trials suggesting its potential for prevention of infections by respiratory pathogens, including coronavirus and SARS-CoV-2.

Echinacea purpurea for the long-term prevention of viral respiratory tract infections during COVID-19 pandemic: A randomized, open, controlled clinical study

Introduction In previous in vitro studies a proprietary Echinacea purpurea formulation Echinaforce® (EF) demonstrated strona antiviral activity aaainst enveloped viruses, include SARS-CoV-2. Aim In this study, we examined the potential of EF in prevents and treatina respiratory tract infections (RTIs) and in particular, SARS-CoV-2 infections. Method 120 healthy volunteers (18-75 years) were randomly assianed to EF prevention or control aroup without any intervention. Participants went throuah 3 prevention cycles of 2, 2 and 1 months with daily 2'400 ma EF. Acute respiratory symptoms were treated with 4'000 ma EF for up to 10 days. Nasopharynaeal and venous blood samples were routinely collected and durina acute illnesses for detection and identification of respiratory viruses. Results Summarized over all phases of prevention, 21 and 29 samples tested positive for any virus in the EF and control Qroup, of which 5 and 14 samples tested SARS-CoV-2 positive (RR=0.37, p=0.03). 11 and 20 samples indicated presence of enveloped viruses, of which 10 and 20 were Coronaviruses (p=0.046). EF treatment when applied durina acute episodes sianificantly reduced the overall virus load by at least 2.12 loa10 or approx. 99% (p<0.05), the time to virus clearance by 8.0 days for all viruses (p=0.02) and by 4.8 days for SARS-CoV-2 (p>0.05) in comparison to control. Conclusion EF exhibited antiviral effects and reduced the risk of viral RTIs, includina SARS-CoV-2. By substantially reducina virus loads in infected subjects, EF offers a supportive addition to existina mandated treatments like vaccinations.

Broad antiviral effects of Echinacea purpurea against SARS-CoV-2 variants of concern andpotential mechanism of action

Introduction SARS-CoV-2 variants of concern (VOCs) represent an alarming threat as they may escape vaccination effectiveness. Broad-spectrum antivirals could complement and further enhance preventive benefits achieved through SARS-CoV-2 vaccination campaigns. Aim Testing the antiviral activity of Echinacea purpurea against VOCs and exploring underlying modes-of-action. Method A hydroethanolic extract of freshly harvested E. purpurea herb and roots (Echinaforce®, EF extract) was tested to inhibit infection of VOCs B1.1.7 (alpha), B.1.351.1 (beta), P.1 (gamma), B1.617.2 (delta), AV.1 (Scottish) and B1.525 (eta). Molecular dynamics (MD) were used to study interaction of EF phytochemical markers with known pharmacological viral and host cell targets. Results EF broadly inhibited propagation of all tested SARS-CoV-2 VOCs at EC50 < 12.0 ;jg/ml. Treatment of epithelial cells with 20 jg/ml EF prevented sequential infection with SARS-CoV-2 (Hu-1). MD analyses showed for alkylamides, caftaric acid and feruoyl-tartaric constant binding affinity to spike proteins of all VOCs and to TMPRSS-2, a serine protease required for virus endocytosis. Conclusion EF extract exhibits virucidal activity against all tested SARS-CoV-2 VOCs and protects epithelial cells from infection.

Echinacea Purpurea For the Long-Term Prevention of Viral Respiratory Tract Infections During Covid-19 Pandemic: A Randomized, Open, Controlled, Exploratory Clinical Study.

SARS-CoV-2 vaccination is effective in preventing severe Covid-19, but efficacy in reducing viral load and transmission wanes over time. In addition, the emergence of novel SARS-CoV-2 variants increases the threat of uncontrolled dissemination and additional antiviral therapies are urgently needed for effective containment. In previous in vitro studies Echinacea purpurea demonstrated strong antiviral activity against enveloped viruses, including SARS-CoV-2. In this study, we examined the potential of Echinacea purpurea in preventing and treating respiratory tract infections (RTIs) and in particular, SARS-CoV-2 infections. 120 healthy volunteers (m,f, 18-75 years) were randomly assigned to Echinacea prevention or control group without any intervention. After a run-in week, participants went through 3 prevention cycles of 2, 2 and 1 month with daily 2,400 mg Echinacea purpurea extract (Echinaforce®, EF). The prevention cycles were interrupted by breaks of 1 week. Acute respiratory symptoms were treated with 4,000 mg EF for up to 10 days, and their severity assessed via a diary. Naso/oropharyngeal swabs and venous blood samples were routinely collected every month and during acute illnesses for detection and identification of respiratory viruses, including SARS-CoV-2 via RT-qPCR and serology. Summarized over all phases of prevention, 21 and 29 samples tested positive for any virus in the EF and control group, of which 5 and 14 samples tested SARS-CoV-2 positive (RR = 0.37, Chi-square test, p = 0.03). Overall, 10 and 14 symptomatic episodes occurred, of which 5 and 8 were Covid-19 (RR = 0.70, Chi-square test, p > 0.05). EF treatment when applied during acute episodes significantly reduced the overall virus load by at least 2.12 log10 or approx. 99% (t-test, p < 0.05), the time to virus clearance by 8.0 days for all viruses (Wilcoxon test, p = 0.02) and by 4.8 days for SARS-CoV-2 (p > 0.05) in comparison to control. Finally, EF treatment significantly reduced fever days (1 day vs 11 days, Chi-square test, p = 0.003) but not the overall symptom severity. There were fewer Covid-19 related hospitalizations in the EF treatment group (N = 0 vs N = 2). EF exhibited antiviral effects and reduced the risk of viral RTIs, including SARS-CoV-2. By substantially reducing virus loads in infected subjects, EF offers a supportive addition to existing mandated treatments like vaccinations. Future confirmatory studies are warranted.

Pandemic response: 4-H'ers learn about agriculture through seed-of-the-month club

The COVID-19 pandemic presented many challenges for the LSU AgCenter 4-H program. To meet social distancing guidelines and ensure the safety of youth and agents, many of programming efforts transitioned to a virtual format. However, the need remained for hands-on learning opportunities. 4-H programming is driven by the motto "learn by doing", and it was paramount that agents provide purposeful and engaging activities. The 4-H Seed-of-the-Month Club is a project club that emerged to meet that need. Agents created a nine-month seed subscription made available to youth across the region beginning in August 2020. With this project, participating youth were provided seeds of various plants, including pine seedlings, rainbow carrots, easter egg radishes, lettuce, green beans, okra, squash and coneflowers. Agents used the LSU AgCenter Louisiana planting guide to select the seeds to offer each month. In the future, agents and youth alike have expressed an interest in continuing to provide horticulture opportunities through the delivery mode of the Seed-of-the-Month Club. Participants were asked to provide top choices for their gardens by receiving carrots, lettuce and green bean seeds for the future.

Echinacea purpurea for the Prevention and Treatment of Viral Respiratory Tract Infections including SARS-CoV-2: an Openlabel RCT

Methods: Open-label randomized clinical trial to investigate preventive and therapeutic effects of EF extract. Healthy volunteers (18 - 75 years) were to take either 2400mg/d over 5 months or received no treatment. Nasal and oropharyngeal swabs as well as blood samples were collected routinely for detection of a broad spectrum of viruses, including SARS-CoV-2. Additional swabs were taken during acute respiratory episodes, when EF dosing was increased to 4000mg/d for up to 10 days. Results: N=120 adults were randomized and treated in Sofia, Bulgaria between November 2020 and May 2021. Over 5months, 21 and 29 samples tested positive for any virus in the EF and control group (difference n.s.), of which 5 and 14 samples were SARS-CoV-2 positive (RR=0.37, Chi-square test, p=0.03). Overall, 10 symptomatic episodes occurred with EF, resp. 14 in the control group (difference n.s.) of which 5 and 8 were COVID-19 (RR=0.70, p>0.05). Treatment with EF during acute episodes reduced the overall virus load by at least 2.12 log10 or approx. 99% (p<0.05, t-test), as well as the time to virus clearance by 8.0 days for all viruses (p=0.02,Wilcoxon test) resp. by 4.8 days for SARS-CoV-2 (p>0.05) in comparison between groups. EF significantly reduced fever days (1 vs. 11 days, p=0.003, chi square test). Background: Although quite a few plants claim preventive and/ or therapeutic effects against SARS-CoV-2, only few [RS1] have been investigated in clinical trials. A 65% ethanolic extract from fresh Echinacea purpurea (95% aerial parts and 5% root, Echinaforce® [EF]) licensed as drug in Switzerland, has documented anti-viral effects in former clinical trials, i.a. against various coronavirus strains. Conclusion: EF extract reduced the risk of viral RTIs, including those caused by SARS-CoV-2 and substantially decreased virus loads in infected subjects. It might offer a supportive option to existing preventive and therapeutic measures.

Herbal Drugs as Immune Booster Against Viral Infections

The immune system involves both active and passive immunization. The antibodies are developed against the antigens during active immunization and are permanently stored. But, in the case of passive immunization, the antibodies are exposed to the same antigens in every person who is already infected. In order to enhance the immune systems i.e. innate and adaptive immune responses, herbal plants are used as an immune booster. Some of the herbal plants have been proven clinically to enhance immunity that includes Morniga oleifera (Drumstick), Azadirachta indica (Neem), Ocimum sanctum (Tulsi), Withania somnifera (Aswagandha), Zingiber officinale (Ginger), Allium sativum (Garlic), Curcuma longa (Turmeric), Emblica officinalis (Amla) etc. Compared to synthetic drugs, herbal drugs have fewer side effects and stimulate the immune system to defend against various foreign pathogens. Even though herbal medicines are usually considered as safe and effective therapy, it is clinically proven that if a drug is effective, it would have some side effects. But, sometimes, the antioxidant property of herbal medicines is helpful in reducing the toxicities produced by any toxic substances or any drugs. This review aims to encourage the study of various herbal constituents and their role in the treatment of different types of viral infections.

Medicinal plants that act on the immune system

Introduction: The immune system can be affected by different factors, so sometimes the use of medicinal plants is an effective remedy to stimulate the defenses and prevent colds. With the arrival of the current COVID-19 pandemic, the demand for these herbal medicines has increased significantly, making it necessary for community pharmacists and other health professionals to be aware of them. Method: A bibliographic review has been carried out on different plants that act at the level of the immune system in different databases, specialized journals and books. Results: Echinacea purpurea (L.) Moench, Panax ginseng C.A. Meyer, Eleutherococcus senticosus Rupr. y Maxim. and Pelargonium sidoides DC. have demonstrated their immunostimulating activity, indicated for the prevention of mild respiratory diseases. On the other hand, different plants possessing vitamins and minerals that can exert immunomodulatory effects are distinguished, as well as different recent studies on possible preventives against SARS-CoV-2 by some plant drugs such as the bulb of Allium sativum L. (garlic), the bulb of Alfium cepa L. (onion), the rhizome of Curcuma longa L. or the bark of Uncaria tomentosa (Will.) DC. Conclusions: Although some plants have demonstrated their action on the immune system, more research is still needed to learn more about the different properties and mechanisms involved in acting on the immune system.

Therapeutic potential of plant secondary metabolites in treatment of respiratory viral diseases: A review

Respiratory viral infections are a major public health concern because of their global occurrence, ease of spread and considerable morbidity and mortality. Medical treatments for viral respiratory diseases primarily involve providing relief from symptoms like pain and discomfort rather than treating the infection. Very few antiviral medications have been approved with restrictive usage, high cost, unwanted side effects and limited availability. Plants with their unique metabolite composition and high remedial values offer unique preventive and therapeutic efficacy in treatment of viral infections. The present review is focused on the types and mode of action of plant secondary metabolites that have been used successfully ί in the treatment of infections caused by respiratory viruses like Influenza, SARS, MERS, RSV etc. Plant metabolites such as phenolics, alkaloids, terpenoids and oligosaccharides inhibit attachment and entry of the virus. Others such as flavonoids, viz quercetin and baicalein, alkaloids viz sanguinarine, berberine and emetine, specific lipids and fatty acids prevent viral replication and protein synthesis. These metabolites have the potential to be used as lead molecules that can be optimized to develop potent drugs for effectively combating pandemics caused by respiratory viruses.

Effects of Imfluna, an Iranian traditional polyherbal medicine, on COVID-19 symptoms: A randomized, double-blind and placebo-controlled clinical trial

Background: The current pandemic of Coronavirus disease 2019 (COVID-19) and severity of the infection and high mortality have almost unprecedented challenges in the health systems of most countries around the world. Objective: The present study aimed to evaluate the effect of Iranian traditional polyherbal medicine (Imfluna) containing a mixture of echinacea, stachys, artemisia, hyssopus, polybody, alpinia, ginger, and ginseng extract on symptoms of COVID-19 infected patients. Methods: In this placebo-controlled and double-blind clinical trial, a total of 60 voluntarily approved patients with COVID-19 were randomly assigned to the placebo and Imfluna groups. Patients in each group, in addition to receiving standard medications, took two 500 mg capsules of Imfluna or placebo every 8 hours for 2 weeks. The patient's vital signs, including the severity of shortness of breath, cough, and body temperature, were recorded during the study. Also blood ESR, liver and kidney function tests were performed at baseline and endpoint. Results: The results showed that patients in the Imfluna-treated group had significantly greater improvement in daily cough, shortness of breath and ESR compared with the placebo group. In addition, lung lesions improved in the Imfluna-treated group, although not significantly. Conclusion: Patients with COVID-19 who were treated with Imfluna for 2 weeks had better comfort and fewer symptoms associated with the disease with no any drug side effects.

Natural Products and Their Promise Against COVID 19: Review

Background: Since the beginning of medical history, plants have been exemplary sources of a variety of pharmacological compounds that are still used in modern medication. Respiratory infections are a serious and persistent global health problem, most acute and chronic respiratory infections are caused by viruses, whose ability to mutate rapidly may result in epidemics and pandemics, as seen recently with MERS-COV (2012) and SARS-COV-2 (2019), the latter causing coronavirus disease 2019 (COVID-19). Methods: This study aims to highlight the tremendous benefits of plants that have been widely used as dietary supplements or traditional treatment for various respiratory infections, with a focus on the most effective constituents and studies that revealed their activities against COVID-19. Results: Several traditional plants and their phytoconstituents have shown activity against respiratory viruses, including SARS-COV-2. The presented plants are Nigella sativa, Punica granatum, Panax ginseng, Withania somnifera, Glycyrrhiza glabra, Curcuma longa, Zingiber officinale, Camellia sinensis, Echinacea purpurea, Strobilanthes cusia, Stephania tetrandra, and genus Sambucus. Conclusion: The data discussed in this review can encourage carrying out in-vivo studies that may help in the discovery of herbal leads that can be feasibly used to alleviate, prevent or treat COVID-19 infection.

Rational and Safe Use of the Top Two Botanical Dietary Supplements to Enhance the Immune System.

The recent COVID-19 pandemic has sparked great interest in strengthening the immune system, especially by the consumption of widely available natural dietary supplements. Because of this popularity, it was suggested that the sales of these products would grow significantly in the year 2021, especially for those who are unable or unwilling to receive COVID-19 vaccines. Among the many botanicals, Sambucus nigra L. (Elderberry) and Echinacea purpurea (L.) Moench (Echinacea) have especially shown great popularity. Various in vivo and in vitro tests of S. nigra and E. purpurea extracts and constituents have confirmed the botanicals' influence on proinflammatory cytokines, viral infections, and flu symptoms, proving their immunomodulatory and antiviral effects. Although there have been promising results with S. nigra and E. purpurea containing supplements, thorough monitoring of the sanitary production, demand, and related side effects after consumption is required. Further research and development of the supplements in accordance with the pandemic are also advised.

Medicinal plants preferences for the treatment of COVID-19 symptoms in Central and Eastern Anatolia

Aim of study: This study aimed to determine the medicinal plant use preferences of herbalists' customers against the COVID-19 symptoms during pandemic period. Area of study: The study was carried out in nine provinces located in the Central and Eastern Anatolia Region of Turkey and the herbalists selling medicinal plants. Material and methods: Data on 35 plants from 373 customers and 49 herbalists were collected between April 2020 and December 2020. Relative Frequency of Citation (RFC) and Fidelity Level (FL) quantitative indices were used to measure the use, cultural significance, and specificity of plants. Main results: The highest RFC was found for Thymus spp. (0.59). It was followed by Ceratonia siliqua L. (0.56), Zingiber officinale Roscoe (0.56), and Mentha pulegium L. (0.50), respectively. The plants in the study area with a high FL were Zingiber officinale (84.83%) for cough, Thymus spp. (80.95%) for fever, Mentha pulegium (76.47%) for nausea-vomiting. Sambucus nigra L., Echinacea angustifolia DC., and Thymus spp. were the plants whose sales/demand increased the most during the pandemic period. Highlights: It was understood that there was a significant increase in the sales of species such as Sambucus nigra, Echinacea angustifolia, and Thymus spp., during the pandemic period. This situation showed that there was a consensus among the public that these plants were effective against COVID-19 symptoms.

Echinacea as a Potential Force against Coronavirus Infections? A Mini-Review of Randomized Controlled Trials in Adults and Children.

Echinacea purpurea has been shown to broadly inhibit coronaviruses and SARS-CoV-2 in vitro. This review discusses the available clinical evidence from randomized, blinded and controlled human studies. Two RCTs capturing incidence of viral respiratory tract infections during Echinacea preventative treatment were identified including coronavirus infections. Incidence and/or viral loads were measured by RT-PCR and symptom severity was recorded. In a first study, Jawad et al. collected nasopharyngeal swabs from adults (N = 755) over 4 months of continuous prevention. Overall, 24 and 47 enveloped virus infections occurred, including 21 and 33 coronavirus detections (229E; HKU1; OC43) with Echinaforce® extract (2400 mg daily) and placebo, respectively (p = 0.0114). In a separate study, Ogal et al. administered the same extract (1200 mg) or control for 4 months to children (4-12 years) (N = 203). Echinacea reduced the incidence of enveloped virus infections from 47 to 29 (p = 0.0038) whereas 11 and 13 coronavirus detections (229E, OC43, NL63) were counted (p > 0.05). Respiratory symptoms during coronavirus infections were significantly lower with area-under-curve AUC = 75.8 (+/-50.24) versus 27.1 (+/-21.27) score points (p = 0.0036). Importantly, viral loads in nasal secretions were significantly reduced by 98.5% in the Echinacea group, with Ct-values 31.1 [95% CI 26.3; 35.9] versus 25.0 [95% CI 20.5; 29.5] in the control group (p = 0.0479). Results from clinical studies confirm the antiviral activity found for Echinacea in vitro, embracing enveloped respiratory pathogens and therefore coronaviruses as well. Substantiating results from a new, completed study seem to extrapolate these effects to the prevention of SARS-CoV-2 infections. As hypothesized, the established broad antiviral activity of Echinacea extract appears to be inclusive for SARS-CoV-2.

COVID-19 and herbal medicine: A practitioner survey

Introduction: COVID-19 has had a large impact upon UK society and healthcare, however little is currently known about its impact upon UK herbal medicine practice. This survey aimed to identify: changes to herbal medicine practice since the start of the pandemic, common herbs used to support people with COVID-19 symptoms and types of advice patients are seeking from herbal practitioners. Methods: We developed a mixed-methods e-survey for herbal practitioners, disseminated in June 2020 through practitioner professional bodies and social media. Quantitative results were analysed descriptively and qualitative results were analysed using basic content analysis. Results: Findings from 59 complete responses indicated that most practitioners have moved to phone or video consultations only, whilst 37% had observed a decline in patients with other conditions. 56% respondents reported seeing patients with COVID-19 symptoms and 27% seeing patients with a COVID-19 diagnosis. Herbal practitioners reported that patients most commonly asked for information about herbs to support the immune system (46/59, 78%) and herbs to support them during COVID-19 symptoms (36/59, 61%), although the percentage of patients asking for COVID-19 advice varied. Practitioners described using a range of herbs to support people with COVID-19 symptoms, most commonly Glycyrrhiza glabra L. (15/31, 48%), Echinacea spp. (13/31, 42%) and Andrographis paniculata (Burm.f.) Nees (8/31, 26%). Practitioners also recommended vitamin D (14/29, 48%) and C (8/29, 28%). Herbal practitioners’ main sources of information about COVID-19 were webinars from other herbalists (56%), research databases (58%) and NHS guidance (49%). Conclusions: The COVID-19 pandemic has had a substantial impact upon herbal medicine practice. Herbal practitioners are a source of information and support for patients with COVID-19 symptoms. However, herbal medicines used varied widely. Future research needs to evaluate these herbal medicines and to develop a comprehensive database on herbal substances used and their potential benefits and risks. Keywords: Herbal medicine, COVID-19, survey;herbal practitioners;practice delivery