The Efficacy of a Persian Medicine-Based Dietary Protocol on Hospitalized COVID-19 Patients: A Randomized Controlled Trial

This study aimed to evaluate the effectiveness of a Persian Medicine-based dietary protocol (PM diet) in patients infected with COVID-19. A randomized clinical trial was performed from July 2020 to January 2021 in Tehran, Iran. Eighty patients admitted due to pulmonary dysfunction caused by COVID-19 were randomly allocated into two groups: the PM diet or the common hospital (CH) diet. Eight beds in 2 rooms were considered for each group. Patients were randomly hospitalized in these rooms and received these diets up to discharge or death. Oxygen saturation level and duration of hospitalization, the rate of mortality, duration of fever, and duration of cough were considered as the primary and secondary outcomes, respectively. Oxygen saturation and fever duration were not different between groups (P value= 0.08, 0.312, respectively). But the duration of hospitalization and the duration of cough in the PM diet group were significantly shorter than in the CH diet (P value= 0.002, 0.009, and HR=2.02, 1.86 respectively). The mortality rate was significantly lower in the PM diet group than in the CH diet group (Odds ratio: 0.12, P value=0.026). PM diet caused a lower mortality rate, shorter hospital stay, and better improvement in cough, but did not have a significant effect on O2 saturation and fever. Copyright © 2023 Tehran University of Medical Sciences.

The Efficacy of Medium-Chain Triglyceride on the Prognosis and Outcome of Suspected COVID-19 Outpatients: A Randomized Controlled Trial

Background: The novel coronavirus disease (COVID-19), as a global concern, has affected different economic and social aspects, as well as health costs in various communities. Finding effective and available treatment is an urgent need. A recent study has demonstrated that the ketogenic diet (KD) activates innate immunity and has a protective property against virus infection. Accordingly, we conducted this study to find the effect of oral medium-chain triglyceride (MCT) on COVID-19 and its clinical manifestations. Method(s): This was a randomized clinical trial on 195 patients clinically suspected of COVID-19 referred to infectious disease clinics of Kerman. Patients were randomly assigned into two groups. The Control group received standard supportive treatment, the recommendation for carbohydrate avoiding and diet modification. Patients in the intervention group received all mentioned recommendations beside MCT oil. Patients` clinical symptoms, including body temperature, respiratory rate, body pain, and dyspnea, were recorded in a checklist and analyzed. Result(s): The mean age of patients was 37.78 +/- 12.42 years in the intervention group and 40.81 +/- 13.23 years in controls (P = 0.231). The patients in the intervention group had lower duration of weakness (P = 0.004), body pain (P = 0.004), dyspnea (P = 0.004), gastrointestinal manifestations (P < 0.001), sore throat (P < 0.001), increased respiratory rate (P < 0.001), and high intensity of cough (P = 0.002). Indeed, weakness, cough frequency, sore throat, and gastrointestinal complications were significantly lower in the females of the intervention group (P = 0.006, P = 0.030, P = 0.005, and P = 0.001, respectively). In contrast, in the males of the intervention group, manifestations such as respiratory rates, dyspnea, cough intensity, and sore throat were significantly lower than those in the control group. Conclusion(s): Administration of MCT in outpatients suspected of COVID-19 alleviated clinical symptoms such as increased respiratory rate, cough intensity, dyspnea, body pain, and gastrointestinal symptoms and helps them overcome the probable disease morbidity.Copyright © 2023 The Author(s);Published by Kerman University of Medical Sciences.

Dose Kelofan Syrup Effective for Clinical Symptoms and Biochemical Factorsin COVID-19 Patients? A double-Blind Clinical Trials

Introduction: COVID-19 is one of the most severe, intestinal, respiratory, and systemic infections in animals and humans. The purpose of this experiment was to evaluate the effect of kelofan syrup on biochemical factors and clinical signs of patients with COVID-19. Materials and Methods: This randomized clinical trial was performed on 60 hospitalized patients with moderate or severe COVID-19. The intervention group received 7.5 cc of kelofan syrup(a traditional Persian medicine product) every 12 hours for one week and the placebo group received 7.5 cc of placebo syrup. Serum levels of white blood cells (WBCs), C - reactive protein (CRP), lactate dehydrogenase (LDH), creatinine, lymphocyte, and clinical outcomes were measured before the beginning of the intervention and on day 7. Results: Kelofan syrup enhanced the white blood cell and reduced creatinine and LDH in the syrup group. However, serum levels of WBC, lymphocyte, CRP, LDH, and creatinine(P > 0.05) in the kelofan group at the end of the study did not significantly change than in the placebo group. Also, clinical outcomes such as fever, respiratory rate, saturated oxygen, cough, dyspnea, myalgia, duration of hospitalization, and fatigue did not change significantly from in the placebo group. Conclusion: our findings indicate that kelofan syrup for seven days could not alter biochemical and clinical outcomes than in the placebo group in patients with COVID-19. However, in some clinical symptoms such as cough, dyspnea, weakness, and biochemical factors like WBC, Cr, and LDH, a significant change was observed at the end of hospitalization in the intervention group.

Efficacy and safety of add-on Viola odorata L. in the treatment of COVID-19: A randomized double-blind controlled trial.

ETHNOPHARMACOLOGICAL RELEVANCE: Severe Acute Respiratory Syndrome (SARS) due to the novel coronavirus has become the highest priority that threatens human health. This situation demands widespread vaccination and the innovation of new therapeutic methods. Despite drug discoveries, the need for approving new medicaments is felt because of adverse effects and lack of efficacy. Several medicinal plants including Viola odorata L. are recommended in traditional Persian medicine for alleviating respiratory infection symptoms. Recent studies showed anti-inflammatory, antioxidant, anti-asthmatic, antitussive, analgesic, and antibacterial activities of sweet violet. These enhance respiratory functions, reduce pulmonary inflammation, and decline mucous membrane edema. This study aimed to evaluate the efficacy of sweet violet syrup in alleviating the manifestations of COVID-19 infection. MATERIAL AND METHODS: A randomized parallel-group double-blind controlled trial was conducted at Al-Zahra general hospital, Isfahan, Iran. A total of 108 outpatients were enrolled in the study. The patients were randomly allocated to intervention and placebo groups, with 54 patients in each group. The allocation was concealed using sealed opaque envelopes. The intervention group received violet syrup and the control group received placebo syrup, an add-on to the conventional treatment. The outcomes were COVID-19 manifestations, such as dyspnea, cough, myalgia, headache, and diarrhea, considered as outcomes of the study and were evaluated twice using a visual analog scale before the intervention and after 7 days, at the end of the study. Patients were followed daily by phone calls to monitor proper drug consumption and possible side effects. RESULTS: No significant difference was between groups regarding demographic characteristics and vital signs before and after the treatment. Although all symptoms have improved significantly in both groups, patients who received violet syrup recovered faster and the mean severity scores of cough (P = 0.025), myalgia (P = 0.036), headache (P = 0.037), and diarrhea (P = 0.044) decreased greater in comparison to control group. CONCLUSION: This study, the first clinical trial on the effectiveness of Viola odorata on SARS-CoV-2 patients, showed that Viola odorata L. effectively controls prevalent manifestations of COVID-19 including cough, myalgia, headache, and diarrhea. Regarding this survey, the violet syrup can be mentioned as a complementary treatment for viral influenza-like infections in which cough, myalgia, headache, and diarrhea are prominent.

Acupuncture or cupping plus standard care versus standard care in moderate to severe COVID-19 patients: An assessor-blinded, randomized, controlled trial.

Background: Non-pharmacological strategies that have been proposed by complementary medical systems, can be effective in management of COVID-19. Methods: This study was designed as a three-arm, assessor-blinded, randomized controlled trial. A total of 139 hospitalized COVID-19 patients were randomly assigned into three groups: (1) acupuncture (ACUG), (2) cupping (CUPG), and (3) control (CTRG). All participants received conventional treatment. The primary study endpoint included changes in respiratory signs including oxygen saturation (SpO2) and respiratory rate (RR). The secondary endpoints were COVID-19-related hospitalization duration and serious adverse events such as intensive care unit (ICU) admission, intubation or death, all up to day 30. Also, improvements in cough, dyspnea, chest tightness, oxygen demand, anorexia, headache, weakness, sore throat, and myalgia were evaluated. Results: Forty-two patients in ACUG, 44 patients in CUPG, and 42 patients in CTRG completed the trial. After 3 days, SpO2 and RR improved significantly in CUPG and ACUG compared with CTRG (effect size: 8.49 (6.4 to 10.57) and 8.51 (6.67 to 10.34), respectively: p<0.001). Compared with CTRG, patients in CUPG and ACUG recovered faster (mean difference: 6.58 (4.8 to 8.35) and 9.16 (7.16 to 11.15), respectively) and except for two patients in ACUG who were admitted to ICU, none of patients in ACUG or CUPG needed ICU or intubation (p<0.001 in comparison to CTRG). Amelioration of clinical COVID-19 related symptoms reached a high level of statistical significance in CUPG and ACUG in comparison with CTRG (p<0.01). Conclusion: Cupping and acupuncture are promising safe and effective therapies in management of COVID-19. Trial registration: This study was registered at Iranian Registry of Clinical Trials: IRCT20201127049504N1 (https://en.irct.ir/trial/52621).

Efficacy of a Persian herbal medicine compound on coronavirus disease 2019 (COVID-19): A randomized clinical trial.

Background: The global attention to the capacities of traditional medicine for alleviating the clinical manifestations of COVID-19 has been growing. The present trial aimed to evaluate the efficacy and safety of a Persian herbal medicine formula among patients with COVID-19. Methods: The present trial was conducted in Afzalipour hospital, Kerman, Iran, from June to September 2020. Hospitalized COVID-19 patients were randomly divided into intervention (Persian herbal medicine formula + routine treatment) or control (only routine treatment) groups. The intervention group received both capsule number 1 and 2 every 8 hours for 7 days. Capsule number 1 contained extract of the Glycyrrhiza glabra, Punica granatum, and Rheum palmatum, and the second capsule was filled by Nigella sativa powder. Participants were followed up to 7 days. The primary outcome was the number of hospitalization days, while cough, fever, and respiratory rate, days on oxygen (O2) therapy, and mortality rate were considered as the secondary outcomes. Results: Eighty-two patients were enrolled to the study, while 79 cases completed the trial and their data were analyzed (mean age: 59.1 ± 17.1 years). Based on the results, the Persian medicine formula decreased the mean hospitalization days, so that the mean difference of length of hospitalization as primary outcome was 2.95 ± 0.43 days. A significant clinical improvement was observed regarding dyspnea, need for O2) therapy, and respiratory rate in the intervention group. No adverse effects were reported. Conclusion: The present study supported the use of the Persian medicine formula as an adjuvant therapy for hospitalized COVID-19 patients. Study registration: Iranian Registry of Clinical Trials (www.irct.ir): IRCT20200330046899N1. Study registration: Iranian Registry of Clinical Trials (www.irct.ir): IRCT20200330046899N1.

Effect of a diet based on Iranian traditional medicine on inflammatory markers and clinical outcomes in COVID-19 patients: A double-blind, randomized, controlled trial.

Introduction: SARS-CoV-2 causes severe acute respiratory syndrome prompting worldwide demand for new antiviral treatments and supportive care for organ failure caused by this life-threatening virus. This study aimed to help develop a new Traditional Persian Medicine (TPM) -based drug and assess its efficacy and safety in COVID-19 patients with major symptoms. Methods: In February 2022, a randomized clinical trial was conducted among 160 patients with a confirmed diagnosis of COVID-19 admitted to Emam Reza (AJA) Hospital in Tehran, Iran. During their hospitalization, the intervention group received a treatment protocol approved by Iran's Ministry of Health and Medical Education (MOHME), consisting of an Iranian regimen, Ficus carica; Vitis vinifera, Safflower, Cicer arietinum, Descurainiasophia seeds, Ziziphus jujuba, chicken soup, barley soup, rose water, saffron, and cinnamon spices. All patients were compared in terms of demographics, clinical, and laboratory variables. Results: One hundred and sixty COVID-19 patients were divided into two groups: intervention and control. In baseline characteristics, there was no significant difference between the intervention and control groups (p>0.05). Using SPSS software version 22, statistical analysis revealed a significant difference in four symptoms: myalgia, weakness, headache, and cough (p<0.05). During the 5-day treatment period, the control group had significantly lower C-reactive protein (p<0.05). Conclusion: While more research with a larger sample size is needed, the proposed combination appears to be effective in the treatment of symptoms as well as inflammatory biomarkers such as C-reactive protein in COVID-19 patients.Iranian registry of clinical trials (IRCT) IRCT20220227054140N1.

Correlation between Mizaj and Frequency of Clinical Signs in Patients with COVID-19

Background and purpose: Coronavirus disease (COVID-19) causes different symptoms. Mizaj or temperament in Persian traditional medicine is a specific feature of every human being. The aim of this study was to determine the relationship between Mizaj and severity of symptoms in patients with COVID-19. Materials and methods: A descriptive correlational study was performed in patients with symptomatic COVID-19 during recovery and interviews were carried out to record patients’ symptoms (fever, cough, chills, etc.). Salmannezhad Mizaj questionnaire was used to determine the patients’ temperament (warm, cold, wet, and dry). The number of symptoms in each patient was determined and the severity of symptoms was classified into three levels: mild, moderate, and severe. The relationship between Mizaj and COVID-19 clinical symptoms were assessed by Chi-square and Pearson correlation coefficients. Results: In this study, 168 patients (48 ± 13.3 years) were cared for between 4 and 30 days in COVID Recovery Center. Fever, dyspnea, and cough were seen in 73.2%. Among the patients, 47.6% had cold Mizaj and 26.2% had warm or moderate Mizaj. The frequency of severe symptoms was higher in patients with cold Mizaj compared with that in patients with warm or moderate Mizaj (P= 0.204). Myalgia was found to be considerably higher in cold-Mizaj patients than warm-Mizaj people (P= 0.006). Significant correlations were seen between wet and dry Mizaj and severity of symptoms (P<0.046, R= 0.554) and warm and cold Mizaj and frequency of symptoms (P< 0.054, R= 0.489). Conclusion: Patients with COVID-19, who had cold or wet Mizaj had more symptoms, therefore, support, care, and preventive measures of Persian traditional medicine are recommended for people with cold or wet Mizaj exposed to Coronavirus.

Warm Cupping of the Posterior Thorax in Combination with Standard Conventional Therapy for ARDS in COVID-19 Patients in ICU: a Case Series.

Acute respiratory distress syndrome (ARDS) is commonly found in critically ill patients with coronavirus disease 2019 (COVID-19). As a non-pharmacological treatment of complementary and alternative medicine (CAM), cupping has been clinically used for respiratory symptoms. We sequentially identified a series of patients with COVID-19 with ARDS who were admitted to the intensive care unit (ICU). Warm cupping of the posterior thorax was performed for seven days. We collected longitudinal severity scores on cough, breathlessness, chest tightness, type of oxygen therapy, and oxygen saturation (SpO2). We hereby report the changes in the severity scores in a series of eight patients who received 21 sessions of cupping in addition to conventional treatments. All patients reported improvement in symptom scores that was matched by an increase in SpO2 by as much as 3.16%. All patients were discharged and did not require the use of a mechanical ventilator. The results suggest that combining cupping with conventional treatment may provide a good prognosis for patients with COVID-19 with ARDS.

Efficacy of the barley-based remedy, a Persian medicine formula, in coronavirus disease 2019 (COVID-19) hospitalized patients: An open-labeled randomized controlled trial.

Background: With the pandemic of coronavirus disease 2019 (COVID-19), and the growing attention of people around the world to the use of traditional and complementary medicines to control of the disease, evaluating the effectiveness of these treatments has received special attention. Aim: This study aimed to assess the clinical efficacy of a barley-based (Hordeum vulgare) remedy combined with conventional medicine in comparison to the conventional therapy in confirmed COVID-19 patients. Materials and methods: Seventy COVID-19 patients were randomly divided into barley-based remedy plus conventional medicine (barley-based remedy group) and conventional therapy (control group). Both groups were treated for 5 days. The outcomes were oxygen saturation, main symptoms (fever, respiratory rate, cough, and fatigue), and laboratory data (lymphocytic count, and CRP); they were measured for 6 days. Results: In comparison to the control group, the oxygen saturation level in the barley-based remedy group significantly increased, from the second day of the intervention (P < 0.05). The herbal remedy significantly improved fatigue from the third day (P < 0.05). Meanwhile, the severity and frequency of cough between the groups were not significantly different. The herbal remedy had no significant effect on the CRP and the lymphocytic count of every time points of measurement. The average of respiratory rate and temperature of patients were in the normal range in both groups during the intervention. Conclusion: Barley-based remedy could significantly enhance the blood oxygen saturation and reduce fatigue. However, it needs to be confirmed by large sample size trials.

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.

A Telecare System for Use in Traditional Persian Medicine

Background: In Persian Medicine (PM), measuring the wrist temperature/humidity and pulse is one of the main methods for determining a person's health status and temperament. An important problem is the dependence of the diagnosis on the physician's interpretation of the above-mentioned criteria. Perhaps this is one reason why this method has yet to be combined with modern medical methods. Also, sometimes there is a need to use PM to diagnose patients remotely, especially during a pandemic. This brings up the question of how to implement PM into a telecare system. This study addresses these concerns and outlines a system for measuring pulse signals and temperament detection based on PM. Methods: A system was designed and clinically implemented based on PM that uses data from recorded thermal distribution, a temperament questionnaire, and a customized device that logs the pulse waves on the wrist. This system was used for patient care via telecare. Results: The temperaments of 34 participants were assessed by a PM specialist using the standardized Mojahedi Mizaj Questionnaire (MMQ). Thermal images of the wrist in the supine position (named Malmas in PM), the back of the hand, and the entire face were also recorded under the supervision of the physician. Also, the wrist pulse waves were evaluated by a customized pulse measurement device. Finally, the collected data could be sent to a physician via a telecare system for further interpretation and prescription of medications. Conclusion: This preliminary study focused on the implementation of a combinational hardware-software system for patient assessment based on PM. It appears that the design and construction of a customized device that can measure the pulse waves, and some other criteria, according to PM, is possible and can decrease the dependency of the diagnostic to PM specialists. Thus, it can be incorporated into a telemedicine system. © 2021 Nafisi and Ghods.

THE MODEL OF CLINICAL REASONING IN APPROACH TO FEBRILE INFECTIOUS DISEASES IN MEDIEVAL PERSIA

Reviewing ancient manuscripts of Persian medicine (PM) reveals that there have been some basic principles for decision-making in epidemic infectious diseases that existed in the past. These PM rules for clinical reasoning were applied through a personalized approach along with public health advice in such situations. Currently, the coronavirus pandemic has been the biggest problem in the world. Its mainstay of treatment is based on preventative measures and symptomatic treatments. Meanwhile, traditional medical systems for providing preven-tive, supportive, and rehabilitative care to patients have received more attention than before. Thus, the specific individual approach considered by PM scholars for clinical courses of ep-idemic infectious diseases may help shed more light on the spread of knowledge on epidemic diseases in ancient Persia.

Effect of Lavender (Lavandula angustifolia L.) syrup on olfactory dysfunction in COVID-19 infection: A pilot controlled clinical trial.

OBJECTIVE: The effect of lavender syrup on COVID-19-induced olfactory dysfunction (OD) has been assessed in this study. MATERIALS AND METHODS: This pilot clinical trial was conducted in Gonbad-E-Kavoos (Golestan province, Iran). Twenty-three outpatients with COVID-19 and OD in lavender group took 9 ml of lavender syrup/bid for 3 weeks along with the standard COVID-19 treatments and 20 patients in control group took only standard COVID-19 treatments. The severity of OD was assessed by the visual analogue scale (VAS). Data analysis was performed by Friedman and Mann-Whitney tests using SPSS software. RESULTS: The mean± standard deviation of age was 36.6±9.1, and 42.6±10.4 years (p=0.05), and the duration of symptoms was 7.4±3.5, and 7.5±3.4 days (p=0.98) in the lavender and control group, respectively. The VAS score for OD decreased from 6.8±3.04 to 0.26±0.86 in the lavender group and from 5.3±3.4 to 1±2.61 in the control group. Although, VAS for OD was significantly decreased in both groups (p<0.001), the amount of VAS decrease was 6.6±2.9 scores in the lavender group, and 4.3±4 in the control group (p=0.03). No side effects were observed in the lavender group. CONCLUSION: The present study showed that lavender syrup is an effective treatment for COVID-19-induced OD. It is suggested to conduct further studies with larger sample size.

Antiviral activity of Matricaria chamomilla in the treatment of COVID-19: Molecular Docking study

Introduction: SARS-CoV-2 infection is a lethal disease caused by a Novel strain of coronaviruses. Although vaccinations of healthy people and meticulous treatment of infected people are the main global health concerns, some plant species have therapeutic effects against viral infections. Matricaria chamomilla is one of the most famous medicinal plants used to manage flu or flu-like symptoms due to its antiviral bioactivity. M. chamomilla belongs to a large group of medicinal herbs used by Persian scholars such as Avicenna and Rhazes to treat respiratory diseases. It has more than 120 chemical constituents, including terpenoids, flavonoids, and some components with potential medicinal activity. In this study, the inhibitory effect of 2 major flavonoid components of M. chamomilla, apigenin and luteolin, was studies for the main protease protein of SARS-CoV-2. Methods: Molecular docking studies were performed using an in-house batch script (DOCKFACE) of Auto Dock 4.2. The 3D structures of the selected flavonoids were retrieved from PubChem, and each ligand was optimized with MM+ then AM1 minimization method using HyperChem 8. The 3D crystal structure of the main protease protein of SARS-CoV-2 (PDB ID: 6LU7) was obtained from the Protein Data Bank (http://www.rcsb.org./pdb). Results: Apigenin and luteolin exhibited good docking scores against 6LU7 receptor, -7.86 and -7.24, respectively, with a combination of hydrogen bonding, van der Waals, and other hydrophobic interactions in the docked complexes. Besides, the estimated inhibition constants, Ki, showed that luteolin exhibited a better inhibitory effect than apigenin. Conclusions: Based on these results, the authors proposed that M. chamomilla can be considered as a valuable resource recommended for preventing SARS-CoV-2 invasion into the human body. Keywords: COVID-19, M. chamomilla, Persian medicine, Molecular Docking, Herbal medicine

Efficacy of Persian medicine herbal formulations (capsules and decoction) compared to standard care in patients with COVID-19, a multicenter open-labeled, randomized, controlled clinical trial.

Persian medicine has recommended clinical experiences and proper herbal remedies for prevention and treatment of microbial infections and respiratory diseases. An open-label, randomized, controlled, multicenter trial was conducted at five hospitals in Tehran and Isfahan provinces of Iran on 358 hospitalized adult patients. A total of 174 patients received standard care and 184 received herbal remedies (polyherbal decoction every 8 hr and two herbal capsules every 12 hr) plus standard care for 7 days. The primary clinical endpoint was the duration of hospital stay, and secondary outcomes were clinical improvement of symptoms based on self-assessment questionnaire. Results demonstrated that these natural decoction and capsules treatment plus routine care significantly decreased duration of hospital dyspnea (3.291 day vs. 6.468 days), accelerated clinical improvement, and decreased symptoms such as dry cough, dyspnea, muscle pain, headache, fatigue, anorexia, chills, runny nose, sputum cough, and vertigo in the treatment group compared with standard-care group. Significant effects of these polyherbal formulations on improving the symptoms of COVID-19 could be incredibly promising for managing this pandemic with acceptable tolerability.

Cinnamon and its possible impact on COVID-19: The viewpoint of traditional and conventional medicine.

The COVID-19 global epidemic caused by coronavirus has affected the health and other aspects of life for more than one year. Despite the current pharmacotherapies, there is still no specific treatment, and studies are in progress to find a proper therapy with high efficacy and low side effects. In this way, Traditional Persian Medicine (TPM), due to its holistic view, can provide recommendations for the prevention and treatment of new diseases such as COVID-19. The muco-obstruction of the airway, which occurs in SARS-CoV-2, has similar features in TPM textbooks that can lead us to new treatment approaches. Based on TPM and pharmacological studies, Cinnamomum verum (Darchini)'s potential effective functions can contribute to SARS-CoV-2 infection treatment and has been known to be effective in corona disease in Public beliefs. From the viewpoint of TPM theories, Cinnamon can be effective in SARS-CoV-2 improvement and treatment through its anti-obstructive, diuretic, tonic and antidote effects. In addition, there is pharmacological evidence on anti-viral, anti-inflammatory, antioxidant, organ-o-protective and anti-depression effects of Cinnamon that are in line with the therapeutic functions mentioned in TPM.Overall, Cinnamon and its ingredients can be recommended for SARS-CoV2 management due to multi-targeting therapies. This review provides basic information for future studies on this drug's effectiveness in preventing and treating COVID-19 and similar diseases.

Potentials of Antitussive Traditional Persian Functional Foods for COVID-19 Therapy†.

Coronavirus disease 2019 is a worldwide pandemic resulting in a severe acute respiratory syndrome. Remdesivir is the only FDA-approved drug for hospitalized patients older than age 12. It shows the necessity of finding new therapeutic strategies. Functional foods (FFs) could have co-therapeutic and protective effects against COVID-19 infection. Traditional Persian medicine (TPM), one of the safest and most popular schools of medicine for hundreds of years, has recommended potential FF candidates to manage such a global pandemic. To reveal the potential of TPM in terms of antitussive FFs, traditional Persian pharmacopoeia "Qarabadin-e-Salehi" was searched using the keywords "Soaal" and "Sorfeh." Also, a search of MEDLINE, PubMed Central, Google Scholar, and Science Direct was performed for the relevant literature published from the inception up to March 2021. A combination of search terms including "cough, antitussive, antioxidant, anti-inflammation, antiviral, COVID-19, mucoactive, mucolytic, expectorant, and mucoregulatory" was also applied. The potential mechanism of action in SARS-CoV-2 infection was discussed. Twelve TPM FFs were found including Laooqs, Morabbas, a Saviq, a soup, and a syrup. They are combinations of two to seven ingredients. Natural compounds of mentioned formulations have the main pharmacological mechanisms including antiviral, anti-inflammatory, antioxidant, antihistamine, bronchodilator, immunomodulatory, and mucoactive effects as well as central or peripheral antitussive activities. FFs are cost-effective, easily accessible, and safe options for both treatment and prevention of COVID-19. They might have positive psychological effects along with their pharmacological effects and nutritional virtues. They could also manage persistent respiratory discomforts after recovery from COVID-19.