COVID-19 (coronavirus) researchers conclude that the Chinese herbal patent medicine Lianhua Qingwen Capsules decreased the number of virus particles in SARS-CoV-2 infected cells. Transmission electron microscopy (TEM) confirms that virus particles at cell membrane surfaces, in the cytoplasm, and in plasma vesicles decreased in cells treated with Lianhua Qingwen Capsules. In addition, the herbal medicine treatment results in a morphological deformation of virus particles. [1]
Typical novel coronavirus in cell membranes, cytoplasm, intracellular vesicles, and endoplasmic reticulum have a spherical and crown-like appearance. After the application of Lianhua Qingwen capsules, the number of virions reduced and the shape changed from spherical to a sharp spindle formation. [2]
A positive control also finds remdesivir effective in reducing the number of virions. Remdesivir is an antiviral compound that has been authorized for use in the USA by an Emergency Use Authorization (EUA) and is only approved for the treatment of COVID-19. Clinical trials continue for this drug with the purpose of obtaining FDA approval.
Another finding by the researchers is that Lianhua Qingwen Capsules suppressed proinflammatory cytokine expression (e.g. CXCL-10/IP-10, TNF-α, IL-6, CCL-2/MCP-1) in cells infected with SARS-CoV-2. Patients with COVID-19 have been documented with increased expression of these proinflammatory cytokines and Lianhua Qingwen Capsules were found effective in downregulating their expression. The researchers add that this indicates that the herbal medicine potentially inhibits SARS-CoV-2 cytokine storms; however, this hypothesis requires confirmation in vivo.
Based on the evidence of this laboratory (in Vero E6 cells) investigation, the researchers conclude that Lianhua Qingwen exhibits “anti-coronavirus activity by inhibiting virus replication and reducing the cytokine release from host cells.” [3] The reduction of proinflammatory cytokines was at the mRNA level and the herbal medicine also deformed the morphology of virions.
In related news, a multicenter randomized human clinical trial finds Lianhua Qingwen Capsules effective for improving the recovery rate from COVID-19 symptoms. The research finds that the herbal medicine shortens the time from initial symptoms to recovery and improves recovery from chest radiologic abnormalities. [4] In a fourteen day study of 284 patients with COVID-19, the group receiving Lianhua Qingwen Capsules plus usual care (4 pills, 3 times per day) had a significantly greater recovery rate than a group receiving usual care only (91.5% vs. 82.4% respectively). The Lianhua Qingwen Capsule group had a median recovery rate of seven days versus ten days in the usual care only group.
Severe fatigue in the herbal medicine group lasted for three days and in the usual care only group, the average was six days. Similar results were found for fevers and coughs. Coughing averaged seven days in the herbal medicine plus usual care group and averaged 10 days in the usual care only group. Fevers lasted two days in the herbal medicine group and three days in the usual care only group.
CT scans showed greater improvements in chest abnormalities in the herbal medicine group. The herbal medicine group had an 83.8% improvement rate and the usual care only group had a 64.1% improvement rate. No serious adverse effects were reported. Given the results of the two aforementioned studies, additional research is warranted to confirm the findings.
At the Healthcare Medicine Institute (HealthCMi), we actively provide acupuncture continuing education courses for CEUs, acupuncture and herbal medicine related news, and acupuncture research. Currently, we are encouraging researchers, acupuncturists, and other interested parties to contact us to join our COVID-19 investigation panel.
In another investigation, researchers tested the benefits of acupuncture plus herbal medicine for the treatment of COVID-19. A total of 33 patients diagnosed with COVID-19 (average age 59.4 years) participated. Out of the 33 total, 28 patients had moderate cases of COVID-19 and five had severe COVID-19.
After treatment, all 33 patients were cured and discharged and the average length of in-patient stay was 9.24 days. The 28 moderate cases were discharged with an average length of stay of 7.04 days. All five severe cases were discharged with an average length of stay of 21.60 days. Outcomes included relief from COVID-19 symptoms (e.g. tightness, chest pain, fatigue, panic, anxiety, anorexia, insomnia). No adverse effects were reported. [5]
References:
1. Runfeng, Li, Hou Yunlong, Huang Jicheng, Pan Weiqi, Ma Qinhai, Shi Yongxia, Li Chufang et al. "Lianhuaqingwen exerts anti-viral and anti-inflammatory activity against novel coronavirus (SARS-CoV-2)." Pharmacological research (2020): 104761.
2. Ibid.
3. Ibid.
4. Hu, Ke, Wei-jie Guan, Ying Bi, Wei Zhang, Lanjuan Li, Boli Zhang, Qingquan Liu et al. "Efficacy and Safety of Lianhuaqingwen Capsules, a repurposed Chinese Herb, in Patients with Coronavirus disease 2019: A multicenter, prospective, randomized controlled trial." Phytomedicine (2020): 153242.
5. Gong YB, Shi XJ, Zhang Y, Jiang K, et al. Clinical Application and Practice of Acupuncture for the Treatment of Coronavirus Disease [J]. Chinese Acupuncture and Moxibustion, doi: 10.13703/j.0255-2930.20200319-k0004.
