Randomized Clinical Trial Studies Show That Echinacea Is Effective Against A Variety Of Coronavirus Infections Including SARS-CoV-2

COVID-19 Herbs: Thailand Medical News had first brought up the issue of using Echinacea as a prophylaxis against SARS-CoV-2 infections in March 2020 but unfortunately many ignorant doctors who were trying to act smart were quick to retaliate and say that echinacea could exacerbate the so-called cytokine storms that infected patients could have. (We know that the cytokine storm concept is actually absolute as the trigger of various inflammatory agents are triggered by specific pathways depending on a wide range of factors.) https://www.thailandmedical.news/news/breaking-coronavirus-research-could-echinacea-act-as-a-prophylaxis-against-the-sars-cov-2-coronavirus-more-research-warranted
 


However, many other subsequent studies also showed the potential of Echinacea in preventing and also treating COVID-19 infections.
https://www.thailandmedical.news/news/covid-19-herbs-saudi-arabia-study-demonstrates-possible-use-of-echinacea-and-st-john-s-wort-as-therapeutic-agents-against-covid-19
 
https://www.thailandmedical.news/news/breaking-european-randomized-clinical-study-shows-that-echinacea-reduces-risk-of-viral-respiratory-tract-infections-including-covid-19
 
In this latest study led by Swiss researchers from iC-Cure Scientific-Switzerland along with scientists from  University of Graz-Austria, Universitätsmedizin Berlin-Germany, Italian Ministry of Defence and the Pediatric Clinic-Switzerland, that involved a detailed review and meta-analysis of data from past randomized clinical trials involving the usage of Echinacea, it was found that Echinacea was effective in both preventing and also treating a variety of Coronavirus infections including SARS-CoV-2.
 
The study review presents the available clinical evidence from randomized, blinded and controlled human studies. Two main 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 the first study, 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). https://www.hindawi.com/journals/ecam/2012/841315/
 
In the second study, the researchers 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 coronavir us 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). https://pubmed.ncbi.nlm.nih.gov/33832544/
 
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.
 
The study findings from the review cum meta-analysis study was published in the peer reviewed journal: Microorganisms https://www.mdpi.com/2076-2607/10/2/211/htm
 
Respiratory viruses such as influenza have been detected crossing species boundaries from animals to people on several occasions, resulting in catastrophic illness outbreaks such as the Spanish (H1N1), Asian (H2N2), or Hong Kong (H3N2) flu epidemics, as well as the more recent avian H5N1 flu epidemic.
 
Similarly, a variety of coronaviruses have emerged in the last few decades causing similar respiratory diseases but some on a more fatal scale including the SARS-CoV-2 coronavirus.
 
A variety of what we term as COVID-19 Herbs or plant extracts and phytochemicals that have the efficacy to prevent and also treat SARS-CoV-2 infections include Echinacea which is also used in our TMN prophylactic and therapeutic teas. https://www.thailandmedical.news/news/new-therapeutic-teas-

It is now known that rather than pure immunological activation, echinacea extracts alter the immune system in a way that is best defined as adaptive immune regulation. Echinacea lowered the expression of the inflammatory cytokines tumor necrosis factor TNF-α and interleukin IL-1-β by up to 24% and elevated the anti-inflammatory cytokine IL-10 when compared to baseline.
 
Furthermore, the synthesis of the immune-response modifying and antiviral interferon IFN-ϒ increases by up to 50%.
 
It has also been found that Echinacea's immunomodulatory processes also include significant activation of the endocannabinoid system (ECS) via the cannabinoid receptor type 2 (CB2) by particular N-alkylamides.
 
Many of these bioactive N-alkylamide found in Echinacea have structural similarities to endocannabinoids, which have an anti-inflammatory effect on the cytokine milieu at low nanomolar concentrations.
 
The activation of the ECS during COVID-19 progression could be a new way to combat systemic inflammation.
 
The main objective of this study review, which was carried out by a group of researchers from a variety of multi-national institutions, was to find clinical studies evaluating coronavirus infections in the context of Echinacea administration and to assess preventive and therapy advantages.
 
The first clinical study was conducted as a double-blinded, placebo-controlled, monocentric randomized control trial (RCT) at Cardiff University in the United Kingdom. Participants aged 18 and above from Cardiff, Wales, were asked to apply a 3 x 0.9 mL solution daily for four months.
 
A commercial preparation, standardized to contain 5 mg/100 g of dodecatetraenoic acid isobutylamide based on high-performance liquid chromatography measurements, was used to extract the hydro-ethanolic extract from freshly harvested aerial parts of Echinacea purpurea to 95% supplemented with 5% Echinacea purpurea roots extract.
 
In the study, 115 samples from the control group, the Echinacea group provided 86 nasopharyngeal samples, of which 54 and 74 samples, respectively, were positive for any respiratory virus. The presence of enveloped viruses was confirmed in 24 and 47 samples, respectively, and the resulting odds ratio OR = 0.49 was considered to be statistically significant.  Nine CoV-229E, 11 CoV-HKU1, and one CoV-OC43 infection were found in the Echinacea group, totaling 21 coronavirus infections. In the placebo group, 15 CoV-229E, 17 CoV-HKU1, and one CoV-OC43 infection were found, totaling 33 infections. The odds of getting coronavirus infection were identical to the overall results for cumulated enveloped viruses, with OR = 0.63.
 
Interestingly in a group of patients who had actively used their patient diary to report adverse events and/or cold-related symptoms, the prevention effects on coronaviruses were statistically significant. Echinacea had a 5.5% overall incidence rate compared to 14.6% for placebo.
 
The similar Echinacea extract packaged in tablets was given to children aged 4 to 12 years old residing in central Switzerland in a second blinded, multi-center RCT.
 
As a control, the researchers used a low-dose vitamin C 3 x of 50 mg/d. The commercial product was a child Echinacea formulation with a daily dosing recommendation of 1200 mg for children over the age of four. In the winter of 2016/17, 203 mostly healthy youngsters were participated in this study, with N = 103 receiving Echinacea 3 400 mg/d and N = 98 receiving Vitamin C 3 x 50 mg/d.
 
It was also noted that two CoV episodes pre-existed in each group at the time of inclusion, therefore they were used to assess treatment benefits rather than prevention. Cycle threshold (Ct) values for separate incidence tests were calculated in this investigation, evaluating the number of RNA copies as a measure of virus concentration in the nasopharyngeal sample.
 
In the study, the lower the viral load reflected by the sample's RNA level, the higher the Ct-value.
 
Echinacea boosted the average Ct-value by 6.1 Ct units from 25.0 to 31.1, showing a considerable reduction in coronavirus concentration of -1.81 log or 98.5% when compared to the control. For variants NL63 and OC43, Ct values of 5.53 and 11.92 were reported, resulting in a virus log reduction of 1.67 and 3.59, respectively, corresponding to an absolute virus reduction of 97.8% and 99.97%.
 
The Echinacea purpurea (L.) Moench extracts have been shown to have direct antiviral efficacy against a variety of respiratory infections, including coronaviruses. This extract promotes the tonic synthesis of IFN-ϒ and inhibits the production of inflammatory cytokines such as TNF-α.

The two RCTS involving adults and children, utilizing phytopharmaceutical formulations of Echinacea extract show excellent protection against enveloped viruses, including coronaviruses.
 
Preliminary published clinical results on SARS-CoV-2 may provide even more evidence that Echinacea can be used to combat this particular coronavirus. https://clinicaltrials.gov/ct2/show/NCT05002179
 
The study findings from that trial should be published in a month’s time.
 
For the latest about COVID-19 Herbs, keep on logging to Thailand Medical News.