Artemisia Spp. Derivatives for COVID-19 Treatment: Anecdotal Use, Political Hype, Treatment Potential, Challenges, and Road Map to Randomized Clinical Trials.

Paulin M Kapepula,Antoine Sadiki Kishabongo,Paul M Tulkens,Jimmy K Kabengele,Adam Zumla,Jean-Jacques Muyembe-Tamfum,Léon Tshilolo,Simon Tiberi,Alimuddin Zumla,Micheline Kingombe,Françoise Van Bambeke,Fatima Suleman,Eric Decloedt,Jean B Nachega

doi:10.4269/ajtmh.20-0820

Abstract

.The world is currently facing a novel COVID-19 pandemic caused by SARS-CoV-2 that, as of July 12, 2020, has caused a reported 12,322,395 cases and 556,335 deaths. To date, only two treatments, remdesivir and dexamethasone, have demonstrated clinical efficacy through randomized controlled trials (RCTs) in seriously ill patients. The search for new or repurposed drugs for treatment of COVID-19 continues. We have witnessed anecdotal use of herbal medicines, including Artemisia spp. extracts, in low-income countries, and exaggerated claims of their efficacies that are not evidence based, with subsequent political controversy. These events highlight the urgent need for further research on herbal compounds to evaluate efficacy through RCTs, and, when efficacious compounds are identified, to establish the active ingredients, develop formulations and dosing, and define pharmacokinetics, toxicology, and safety to enable drug development. Derivatives from the herb Artemisia annua have been used as traditional medicine over centuries for the treatment of fevers, malaria, and respiratory tract infections. We review the bioactive compounds, pharmacological and immunological effects, and traditional uses for Artemisia spp. derivatives, and discuss the challenges and controversies surrounding current efforts and the scientific road map to advance them to prevent or treat COVID-19.

Highlights

The unprecedented COVID-19 pandemic caused by the novel zoonotic pathogen of humans, SARS-CoV-2, has, as of July 12, 2020, caused 556,335 deaths of 12,322,395 confirmed cases reported by the WHO.[1]
COVID-19 commonly presents as a severe respiratory tract illness, it causes multisystem disease, and deaths have been attributed to cytokine storm, acute respiratory distress syndrome (ARDS), and excessive aberrant immunological responses
Of several recent and ongoing treatment intervention trials, only two randomized controlled trials have to date demonstrated benefits of specific therapies

Summary

Introduction

The unprecedented COVID-19 pandemic caused by the novel zoonotic pathogen of humans, SARS-CoV-2, has, as of July 12, 2020, caused 556,335 deaths of 12,322,395 confirmed cases reported by the WHO.[1]. The anecdotal use of Artemisia spp. extracts for COVID-19 treatment in low-income countries has led to exaggerated and unproven claims of its efficacy in the absence of a scientific basis or results from clinical trials.

Results

Conclusion