Effect ofAndrographis paniculatatreatment for patients with early-stage COVID-19 on the prevention of pneumonia: A retrospective cohort study

Abstract

AbstractThere is a need for safe and cost-effective treatments for COVID-19.Andrographis paniculata(AP) is an herbal plant that has been used for centuries to treat upper respiratory tract infections. Andrographolide is the major active component of AP that inhibits intracellular SARS-CoV-2 replication and has anti-inflammatory action. We performed a retrospective cohort study to evaluate the therapeutic and adverse effects of oral AP-products on COVID-19 by using the risk of pneumonia diagnosed by chest radiography as an indicator. This study included patients 15 to 60 years of age with laboratory-confirmed early-stage (asymptomatic or mild) COVID-19 without comorbidities at seven hospitals in three adjacent provinces in Thailand, between December 2020 and March 2021. Patients were treated for five days with either AP-extract (60 mg andrographolide, 3 times daily) or crude-AP (48 mg andrographolide, 3 times daily), when available. Patient information was prospectively recorded in the structured medical records and retrospectively reviewed. All eligible patients who received AP-treatment were included and control patients who did not receive AP-treatment were randomly selected using a ratio of approximately 1:1. Pneumonia occurred in 1/243 AP-treatment patients and 69/285 control patients. The risks of pneumonia after adjusting for confounding effects were 0.3% (95%CI, 0%-0.9%) and 24.3% (95%CI, 19.0%-29.7%) in the AP-treatment and control groups, respectively. The number needed to treat to avoid pneumonia development in one patient was four (95% CI, 3-5). Eight patients developed mild adverse events. AP-treatment regimens are acceptably safe and associated with highly reduced rates of pneumonia for patients with early-stage COVID-19.