The Efficacy and Safety of Andrographalis paniculata Extract for Treatment of COVID-19 Patients with Mild Symptoms, Nakhonpathom Hospital

Abstract

Objectives: The aim was to determine the efficacy and safety of high dose versus standard dose Andrographis paniculata in capsule and extract forms toward the adjunctive therapy of covid-19 infected patients with mild symptoms.

Methods: This was a clinical experimental research. The efficacy and safety of four Andrographis paniculata alternatives as adjunctive treatment were compared. COVID-19 infected patients with mild symptoms who did not be treated with antiviral drugs were recruited from inpatient wards in Nakhonpathom Hospital from December 2020 to January 2021. Patients were randomly assigned into five groups by block sampling. The patients in the control group received the standard treatment without Andrographis paniculata. The studied patients received the standard treatment plus one of 4 types of Andrographis paniculata including 60 or 180 mg of Andrographis paniculata capsule daily, 60 or 180 mg of Andrographis paniculata extract daily for 5 consecutive days. We conducted statistical analyses such as frequency, percentage, mean, and standard deviation to present patient characteristics and types of adverse drug reaction. Chi-square test, t test, and one-way ANOVA were used to compare the variance of between groups of volunteers, length of COVID-19 recovery time, and length of recovery in each symptom. We set p-value <.05 for statistical significance.

          Results: Fifty-seven patients were included in the study. Average age of patients was 37.15–41.83 years. The number of patients in each group containing 13 in the control group, 12 in 60 mg Andrographis paniculata capsule daily, 13 in 180 mg Andrographis paniculata capsule daily, 9 in 60 mg Andrographis paniculata extract daily, and 10 in 180 mg Andrographis paniculata extract daily. All patients who received Andrographis paniculata had better symptoms since day 1 and had no any symptom since day 7, whereas the patients in the control group had no symptom 53.8%. Mean difference VAS scores between before and after treatment showed that the symptoms of running nose, severe cough, frequent cough, and loss of smell were less in Andrographis paniculata group than in the control group. Andrographis paniculata capsules reduced headache, muscle pain, and running nose rather than Andrographis paniculata extract, whereas Andrographis paniculata extract reduced sore throat, frequent cough, severe cough, loss of taste, and smell rather than Andrographis paniculata capsules. Additionally, 180 mg Andrographis paniculata capsule daily can reduce frequent cough better than 60 mg Andrographis paniculata capsule daily. In this study, adverse events in the group of 180 mg Andrographis paniculata capsule daily and groups of 60 and 180 mg Andrographis paniculata extract daily were diarrhea and burning pain in the stomach.

          Conclusion: Andrographis paniculata can reduce duration of symptom of COVID-19 and has efficacy on rhinorrhea, severity and frequency of cough, and loss of smell.