The use of andrographolide and effects on liver biochemistry in patients with gastrointestinal problems amid the pandemic of COVID-19

ABSTRACT

Objectives: In the situation of COVID-19 pandemic in Thailand, healthcare facility supply and access are limited. There was an announcement promoting Andrographolide (ADG) use in treatment of mild COVID-19 patients, but misconception of taking for prevention might occur. Moreover, the effect of ADG on liver function test (LFT) has not been established. We aim to study the prevalence of ADG use and effect on LFTs in patients with gastrointestinal (GI) problems. Materials and Methods: We conducted a cross-sectional study including GI patients at our center who voluntarily filled the ADG questionnaire in Aug-Sep 2021. LFT data at that visit and at the prior visit (if available) were obtained. The changes in LFT within the same person were analyzed using Wilcoxon signed-rank test. Wilcoxon rank-sum and Chi-square test were used to compare between patients with and without ADG consumption. Results: A total of 886 patients completed the survey, 170 patients (19.2%) took ADG within the past month. Patients who took ADG were more likely to have history of COVID-19 infection in their closed companies (5.6% vs 1.5%) compared with who did not (control group). LFT data were available in 486 (54.8%) patients, the median ALT change compared with the prior visit was higher in ADG vs control group (2 vs 0, p = 0.026), and 45% had increased ALT ([3 U/L) vs 32.2% in ADG and control group, respectively (p = 0.023). Multivariable logistic regression analysis found that factors independently associated with an increased ALT were ADG exposure (adjusted OR [aOR] of 1.62, p = 0.042), and patients with NAFLD who gained weight (aOR of 2.37, p = 0.046). Conclusion: One-fifth of GI patients recently took ADG, in which currently not indicated as it has no effect on preventing COVID-19 infection. Those who took ADG are more likely to experience an increase in ALT than who did not. Warning should be made regarding this issue.