Severity Of Common Cold Symptoms Research Articles

The efficacy of a compounded micronutrient supplement on the incidence, duration, and severity of the common cold: A pilot randomized, double-blinded, placebo-controlled trial.

PurposeViral upper respiratory infections are associated with significant health and economic impact. This study sought to determine the efficacy of routine immune system micronutrient supplementation on the incidence, duration and severity of common cold symptoms.MethodsThis pilot study was a randomized, double-blinded, placebo-controlled trial of N = 259 with asymptomatic participants aged 18 to 65 in two cold seasons of 2016 and 2017. The treatment group received an immune system targeted micronutrient caplet, while the placebo group received a micronized cellulose caplet externally identical to the treatment caplet. Weekly surveys were sent electronically to participants to document common cold incidence, duration and severity. Primary statistical results were obtained using mixed-effects logistic regressions to account for longitudinal measurements for participants.ResultsThe odds of acquiring an upper respiratory infection, adjusted for potential confounders, was estimated to be 0.74 times lower in the treatment group (p = 0.14). The odds of reporting specific symptoms were statistically lower in the treatment arm compared to the placebo arm for runny nose (OR = 0.53, p = 0.01) and cough (OR = 0.51, p = 0.04). Shorter durations of runny nose and cough were also observed in the treatment arm compared to placebo (both p < 0.05). There was no significant difference in severity of symptoms in either group. The observed proportion of reported cold symptoms in the treatment group was lower compared to the placebo group between late January and February in two consecutive cold seasons. Given the physical, workplace and economic impact of upper respiratory infections, this low cost and low risk intervention should be further studied with more robust investigation and meticulous experimental design.

Effect of Daily Intake of Heat-Killed Lactobacillus plantarum HOKKAIDO on Immunocompetence: A Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study

Background: Consumption of Lactobacillus plantarum HOKKAIDO (HOKKAIDO strain) reportedly increases immunocompetence. However, the concentration of viable bacteria and the type of food they can be incorporated into limits their consumption. The study aims to demonstrate the effect of daily intake of the heat-killed L. plantarum HOKKAIDO strain (HK-HOKKAIDO strain; 5 × 1010 colony-forming units/day) by healthy subjects with low natural killer (NK) cell activity for 8 weeks.Method: In this randomized, double-blind, placebo-controlled, parallel-group study, 70 healthy Japanese subjects who showed relatively low NK cell activity were recruited and randomly assigned to the HK-HOKKAIDO strain or placebo group. All subjects ingested one capsule per day for 8 weeks. We conducted medical interviews and performed body composition measurements, vital sign examinations, and blood sampling at weeks 0 (baseline), 4, and 8, and we collected salivary samples at weeks 0 and 8. In addition, the frequency and severity of cold symptoms in the subjects were recorded daily during the intake period.Results: Intake of the HK-HOKKAIDO strain did not increase the NK cell activity or immunity marker levels, including those of immunoglobulin, leukocyte fraction, and salivary secretory immunoglobulin A. However, the frequency and severity of the common cold symptoms were significantly reduced after the daily consumption of the HK-HOKKAIDO strain.Conclusions: The results showed that HK-HOKKAIDO strain administration can decrease the frequency and severity of common cold symptoms in healthy subjects. Our findings support the use of the HK-HOKKAIDO strain as a functional food with health benefits.Clinical trial registration: UMIN000034822

Effects of paraprobiotic Lactobacillus paracasei MCC1849 supplementation on symptoms of the common cold and mood states in healthy adults.

We investigated the effects of paraprobiotic Lactobacillus paracasei MCC1849 (LAC-Shield™) on symptoms of the common cold and mood states in healthy young adults. A total of 241 participants were randomised to receive 1×1010 heat-killed L. paracasei MCC1849 cell powder (10LP), 3×1010 heat-killed L. paracasei MCC1849 cell powder (30LP), or placebo powder without any L. paracasei cells once daily for 12 weeks based on the incidence of the common cold in the previous year, so that the risk of the incidence was equal among the groups. The incidence and severity of common cold symptoms were rated daily in a subject diary. Salivary secretory immunoglobulin A concentrations and saliva flow rates were analysed at 0 and 6 weeks. The Profile of Mood States (POMS) was assessed using POMS 2 0, 6, and 12 weeks after the intervention. No significant differences were observed in the incidence of the common cold among the groups. In a prespecified subgroup of subjects who had the common cold in the previous year, the incidence, total number of days of symptoms, and symptom scores of the common cold significantly improved in the 10LP-intake group, and were slightly lower in the 30LP-intake group than in the placebo group. The level of deterioration in the positive mood state caused by stress was less in the MCC1849-intake group than in the placebo group. These results indicate that L. paracasei MCC1849 has the potential to improve resistance to common cold infections in susceptible subjects and maintain a desirable mood state, even under mental stress conditions. Further randomised controlled trials are needed in order to investigate the possible beneficial effects of paraprobiotic L. paracasei MCC1849 on the common cold in susceptible populations.

Smoking, leisure-time exercise and frequency of self-reported common cold among the general population in northeastern China: a cross-sectional study

BackgroundPhysical activity (PA) and smoking have been reported to be associated with the duration and severity of common cold symptoms. However, few studies have addressed the associations between the frequency of leisure-time exercise, cigarette smoking status and the frequency of the common cold in a cold area. This study was designed to investigate these issues in northeastern China.MethodsThis cross-sectional study included individuals who participated in a regular health examination conducted in Jilin Province, China. Information on episodes of the common cold, the frequency of leisure-time exercise and cigarette smoking status in the past year were collected by self-administered health questionnaires. Ordinal logistic regression models were used to analyse the associations between the frequency of leisure-time exercise, cigarette smoking status and the retrospective frequency of common cold.ResultsA total of 1413 employees participated in the study, with an average age of 38.92 ± 9.04 years and 44.4% of them were male. Of all participants, 80.8% reported having experienced the common cold in the past year. After adjustment, the risk of suffering from the common cold more than once (odds ratios (ORs), 1.59; 95% confidence interval (CI), 1.27–1.99) in passive smokers was 1.59 times as high as that in non-smokers. Nevertheless, the results of the adjusted analysis showed no statistically significant relation between current smoking and the frequency of the common cold. A high frequency of leisure-time exercise (≥3 days/week) was associated with a 26% reduced risk of having at least one episode of the common cold (OR, 0.74; 95% CI, 0.55–0.98) compared with a low frequency group (< 4 days/month). For current and passive smokers, the protective effect of a high frequency of leisure-time exercise appears not to be obvious (current smokers: OR, 0.68; 95% CI, 0.33–1.43; passive smokers: OR, 1.15; 95% CI, 0.69–1.93).ConclusionPassive smoking was associated with a higher risk of having self-reported common cold at least once, while a high frequency of leisure-time exercise was related to a lower risk of reporting more than one episode of the disease in Chinese.

WITHDRAWN: Zinc for the common cold.

Background The common cold is one of the most widespread illnesses and is a leading cause of visits to the doctor and absence from school and work. Trials conducted in high‐income countries since 1984 investigating the role of zinc for the common cold symptoms have had mixed results. Inadequate treatment masking and reduced bioavailability of zinc from some formulations have been cited as influencing results. Objectives To assess whether zinc (irrespective of the zinc salt or formulation used) is efficacious in reducing the incidence, severity and duration of common cold symptoms. In addition, we aimed to identify potential sources of heterogeneity in results obtained and to assess their clinical significance. Search methods In this updated review, we searched CENTRAL (2012, Issue 12), MEDLINE (1966 to January week 2, 2013), EMBASE (1974 to January 2013), CINAHL (1981 to January 2013), Web of Science (1985 to January 2013), LILACS (1982 to January 2013), WHO ICTRP and clinicaltrials.gov. Selection criteria Randomised, double‐blind, placebo‐controlled trials using zinc for at least five consecutive days to treat, or for at least five months to prevent the common cold. Data collection and analysis Two review authors independently extracted data and assessed trial quality. Main results Five trials were identified in the updated searches in January 2013 and two of them did not meet our inclusion criteria. We included 16 therapeutic trials (1387 participants) and two preventive trials (394 participants). Intake of zinc was associated with a significant reduction in the duration (days) (mean difference (MD) ‐1.03, 95% confidence interval (CI) ‐1.72 to ‐0.34) (P = 0.003) (I2 statistic = 89%) but not the severity of common cold symptoms (MD ‐1.06, 95% CI ‐2.36 to 0.23) (P = 0.11) (I2 statistic = 84%). The proportion of participants who were symptomatic after seven days of treatment was significantly smaller (odds ratio (OR) 0.45, 95% CI 0.20 to 1.00) (P = 0.05) than those in the control, (I2 statistic = 75%). The incidence rate ratio (IRR) of developing a cold (IRR 0.64, 95% CI 0.47 to 0.88) (P = 0.006) (I2 statistic = 88%), school absence (P = 0.0003) and prescription of antibiotics (P Authors' conclusions Zinc administered within 24 hours of onset of symptoms reduces the duration of common cold symptoms in healthy people but some caution is needed due to the heterogeneity of the data. As the zinc lozenges formulation has been widely studied and there is a significant reduction in the duration of cold at a dose of ≥ 75 mg/day, for those considering using zinc it would be best to use it at this dose throughout the cold. Regarding prophylactic zinc supplementation, currently no firm recommendation can be made because of insufficient data. When using zinc lozenges (not as syrup or tablets) the likely benefit has to be balanced against side effects, notably a bad taste and nausea.

Supportive treatment for children with the common cold

This review summarizes recent developments in the supportive treatment of common cold symptoms in children. Conventional common cold therapies are no longer recommended for use in young children because of safety concerns. There are no studies that convincingly demonstrate the efficacy of any therapy for treatment of common cold symptoms in children less than 6 years of age and it is unlikely studies that establish efficacy can be done. Recent studies report a significant effect of probiotics on the occurrence of common cold illnesses in children, and studies in animals provide a plausible mechanism of action. These data suggest that the use of probiotics may have promise for the prevention of common cold illnesses in children. The effect of treatment on the severity of common cold symptoms cannot be accurately assessed with current study designs. In the absence of convincing evidence of efficacy, treatment of young children with symptomatic therapies cannot be recommended. Preliminary data suggest a small, beneficial effect of probiotics for the prevention of common cold illness.

English

Children contract an average of approximately six colds each year and irrational antibiotic has been prescribed to 60% of cases that potentially cause antibiotic resistency. Some studies in humans have shown that probiotic are effective in reducing the severity of common cold symptoms. The mechanisms of probiotic are attributed to an increase of the innate and acquired immune response. The aim of our study was to investigate whether the consumption of Lactobacillus acidophilus R0052 and Lactobacillus rhamnosus R0011 in dosage of 0.1 x 10 9 CFU and 1.9 x 10 9 CFU per day during 7 days influences the severity of symptoms of the common cold in children. This study can be described as a randomized, double-blind, placebo-controlled clinical trial. 100 children who developed symptoms of the common cold within 24-48 hours before enrollment were included in the study. Patients in the probiotic group (n=50) received probiotic capsules containing 0.1x10 9 of Lactobacillus acidophilus and 1.9x10 9 Lactobacillus rhamnosus every day for 7 days. Patients in the placebo group (n=50) received similarly administered capsules that contained Saccharum lactis. Subjective daily symptom scores for cough symptoms, nasal symptoms, pharyngeal symptoms and systemic symptoms were used as main outcome measures. The daily mean symptom score during an episode was not significantly different in the probiotic-treated group than in the control group (p>0.05). There was also a nonsignificant relative risk reduction in the number of improvement from severity symptoms score of common cold in both of groups (unadjusted absolute % reduction 0, P=1). There was no report of adverse events in the probiotic and plasebo group. In conclusion, Lactobacillus acidophilus R005 and Lactobacillus rhamnosus R0011 in the form and dosage studied do not significantly reduce the severity of symptoms of the common cold.

Cochrane Review: Zinc for the common cold

AbstractBackgroundThe common cold is one of the most widespread illnesses and is a leading cause of visits to the doctor and absenteeism from school and work. Trials conducted since 1984 investigating the role of zinc for the common cold symptoms have had mixed results. Inadequate treatment masking and reduced bioavailability of zinc from some formulations have been cited as influencing results.ObjectivesTo assess the effect of zinc on common cold symptoms.Search methodsWe searched CENTRAL (2010, Issue 2) which contains the Acute Respiratory Infections Group's Specialised Register, MEDLINE (1966 to May week 3, 2010) and EMBASE (1974 to June 2010).Selection criteriaRandomised, double‐blind, placebo‐controlled trials using zinc for at least five consecutive days to treat, or for at least five months to prevent the common cold.Data collection and analysisTwo review authors independently extracted data and assessed trial quality.Main resultsWe included 13 therapeutic trials (966 participants) and two preventive trials (394 participants). Intake of zinc is associated with a significant reduction in the duration (standardised mean difference (SMD) ‐0.97; 95% confidence interval (CI) ‐1.56 to ‐0.38) (P = 0.001), and severity of common cold symptoms (SMD ‐0.39; 95% CI ‐0.77 to ‐0.02) (P = 0.04). There was a significant difference between the zinc and control group for the proportion of participants symptomatic after seven days of treatment (OR 0.45; 95% CI 0.2 to 1.00) (P = 0.05). The incidence rate ratio (IRR) of developing a cold (IRR 0.64; 95% CI 0.47 to 0.88) (P = 0.006), school absence (P = 0.0003) and prescription of antibiotics (P &lt; 0.00001) was lower in the zinc group. Overall adverse events (OR 1.59; 95% CI 0.97 to 2.58) (P = 0.06), bad taste (OR 2.64; 95% CI 1.91 to 3.64) (P &lt; 0.00001) and nausea (OR 2.15; 95% CI 1.44 to 3.23) (P = 0.002) were higher in the zinc group.Authors' conclusionsZinc administered within 24 hours of onset of symptoms reduces the duration and severity of the common cold in healthy people. When supplemented for at least five months, it reduces cold incidence, school absenteeism and prescription of antibiotics in children. There is potential for zinc lozenges to produce side effects. In view of this and the differences in study populations, dosages, formulations and duration of treatment, it is difficult to make firm recommendations about the dose, formulation and duration that should be used.Plain Language SummaryZinc for the common coldThe common cold is often caused by the rhinovirus. It is one of the most widespread illnesses and is a leading cause of visits to the doctor and absenteeism from school and work. Complications of the common cold include otitis media (middle ear infection), sinusitis and exacerbations of reactive airway diseases. There is no proven treatment for the common cold. However, a medication that is even partially effective in the treatment and prevention of the common cold could markedly reduce morbidity and economic losses due to this illness.Zinc inhibits rhinoviral replication and has been tested in trials for treatment of the common cold. This review identified 15 randomized controlled trials, enrolling 1360 participants of all age groups, comparing zinc with placebo (no zinc). We found that zinc (lozenges or syrup) is beneficial in reducing the duration and severity of the common cold in healthy people, when taken within 24 hours of onset of symptoms. People taking zinc are also less likely to have persistence of their cold symptoms beyond seven days of treatment. Zinc supplementation for at least five months reduces incidence, school absenteeism and prescription of antibiotics for children with the common cold. People taking zinc lozenges (not syrup or tablet form) are more likely to experience adverse events, including bad taste and nausea. As there are no studies in participants in whom common cold symptoms might be troublesome (for example, those with underlying chronic illness, immunodeficiency, asthma, etc.), the use of zinc currently cannot be recommended for them. Given the variability in the populations studied (no studies from low‐ or middle‐income countries), dose, formulation and duration of zinc used in the included studies, more research is needed to address these variabilities and determine the optimal duration of treatment as well as the dosage and formulations of zinc that will produce clinical benefits without increasing adverse effects, before making a general recommendation for zinc in treatment of the common cold.

Efficacy and safety of a multiherbal formula with vitamin C and zinc (Immumax) in the management of the common cold.

ObjectiveTo study the potential efficacy and tolerability of a natural multiherbal formula (Immumax) containing Echinacea extract 120 mg, garlic powder 100 mg, Nigella sativa oil 200 mg, and Panax ginseng extract 50 mg plus vitamin C 50 mg and elemental zinc 7.5 mg in the treatment of patients suffering from the common cold.Design and settingThe study was conducted in a prospective, double-blind, randomized, controlled study design in an outpatient setting.Patients and methodsSixty-two eligible patients with symptoms of the common cold were randomized to either Immumax or placebo treatment groups for the duration of their symptoms or a maximum of 14 days. Resolution rates were estimated using Kaplan–Meier analysis, and resolution profiles were compared between groups using the log-rank test. The mean percentage change in total symptom severity scores at days 4 and 8 from baseline were compared between the two groups by one-way analysis of variance (ANOVA).ResultsThe median (interquartile range) time to resolution of all symptoms was 8 (5–9) days in the placebo group and 4 (3–6) days in the Immumax group. The results of the log-rank test indicate that symptoms resolved significantly faster in the Immumax group than in the placebo group (P < 0.001). The mean percentage reduction in total symptom severity scores from baseline at days 4 and 8 was significantly greater in the Immumax group than in the placebo group by one-way ANOVA (P < 0.01).ConclusionWe can conclude from our study that Immumax is helpful in reducing the duration and severity of common cold symptoms.

Cochrane review: Vitamin C for preventing and treating the common cold

AbstractBackgroundThe role of vitamin C (ascorbic acid) in the prevention and treatment of the common cold has been a subject of controversy for 60 years, but is widely sold and used as both a preventive and therapeutic agent.ObjectivesTo discover whether oral doses of 0.2 g or more daily of vitamin C reduces the incidence, duration or severity of the common cold when used either as continuous prophylaxis or after the onset of symptoms.Search strategyWe searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 4, 2006); MEDLINE (1966 to December 2006); and EMBASE (1990 to December 2006).Selection criteriaPapers were excluded if a dose less than 0.2 g per day of vitamin C was used, or if there was no placebo comparison.Data collection and analysisTwo review authors independently extracted data and assessed trial quality. 'Incidence' of colds during prophylaxis was assessed as the proportion of participants experiencing one or more colds during the study period. 'Duration' was the mean days of illness of cold episodes.Main resultsThirty trial comparisons involving 11,350 study participants contributed to the meta‐analysis on the relative risk (RR) of developing a cold whilst taking prophylactic vitamin C. The pooled RR was 0.96 (95% confidence intervals (CI) 0.92 to 1.00). A subgroup of six trials involving a total of 642 marathon runners, skiers, and soldiers on sub‐arctic exercises reported a pooled RR of 0.50 (95% CI 0.38 to 0.66).Thirty comparisons involving 9676 respiratory episodes contributed to a meta‐analysis on common cold duration during prophylaxis. A consistent benefit was observed, representing a reduction in cold duration of 8% (95% CI 3% to 13%) for adults and 13.6% (95% CI 5% to 22%) for children.Seven trial comparisons involving 3294 respiratory episodes contributed to the meta‐analysis of cold duration during therapy with vitamin C initiated after the onset of symptoms. No significant differences from placebo were seen. Four trial comparisons involving 2753 respiratory episodes contributed to the meta‐analysis of cold severity during therapy and no significant differences from placebo were seen.Authors' conclusionsThe failure of vitamin C supplementation to reduce the incidence of colds in the normal population indicates that routine mega‐dose prophylaxis is not rationally justified for community use. But evidence suggests that it could be justified in people exposed to brief periods of severe physical exercise or cold environments.Plain language summaryVitamin C for preventing and treating the common coldThe term 'the common cold' does not denote a precisely defined disease, yet the characteristics of this illness are familiar to most people. It is a major cause of visits to a doctor in Western countries and of absenteeism from work and school. It is usually caused by respiratory viruses for which antibiotics are useless. Other potential treatment options are of substantial public health interest.Since vitamin C was isolated in the 1930s it has been proposed for respiratory infections, and became particularly popular in the 1970s for the common cold when (Nobel Prize winner) Linus Pauling drew conclusions from earlier placebo‐controlled trials of large dose vitamin C on the incidence of colds. New trials were undertaken.This review is restricted to placebo‐controlled trials testing at least 0.2 g per day of vitamin C. Thirty trials involving 11,350 participants suggest that regular ingestion of vitamin C has no effect on common cold incidence in the ordinary population. It reduced the duration and severity of common cold symptoms slightly, although the magnitude of the effect was so small its clinical usefulness is doubtful. Nevertheless, in six trials with participants exposed to short periods of extreme physical or cold stress or both (including marathon runners and skiers) vitamin C reduced the common cold risk by half.Trials of high doses of vitamin C administered therapeutically (starting after the onset of symptoms), showed no consistent effect on either duration or severity of symptoms. However, there were only a few therapeutic trials and their quality was variable. One large trial reported equivocal benefit from an 8 g therapeutic dose at the onset of symptoms, and two trials using five‐day supplementation reported benefit. More therapeutic trials are necessary to settle the question, especially in children who have not entered these trials.

Correlation of cleft type with incidence of perioperative respiratory complications in infants with cleft lip and palate.

A retrospective survey of 339 infants who had undergone primary plastic surgery for cleft lip and palate was performed to evaluate the concomitant preoperative assessment based on severity grading of the common cold and the correlation of cleft type with the incidence of perioperative respiratory complications. We assessed the severity of common cold symptoms in the preoperative period using the Common Cold Score, which comprises 10 symptoms and findings. We then determined the association of the incidence of perioperative respiratory complications with the increasing severity of common cold symptoms and also compared the complication incidence in the three cleft types in healthy infants without a common cold. The incidence of perioperative respiratory complications was greater in the group with a suspected presence of a common cold. Infants with severer cleft, who had bilateral cleft lip and palate, even without common cold symptoms, had a significantly higher incidence of perioperative respiratory complications (8.9%) than infants with simple cleft lip (1.7%, P < 0.05). Clinicians should consider postponing primary plastic surgery for cleft lip and palate in infants with a suspected presence of a common cold. Our results also suggest that the presence of a wide cleft is a risk factor for causing perioperative respiratory complications in infants with cleft lip and palate. We believe that a careful preoperative assessment of common cold symptoms in these infants can decrease the incidence of perioperative respiratory complications.

Evaluation of echinacea for treatment of the common cold.

Considered to have immunostimulating activity, echinacea is a widely used phytomedicinal for treatment of the common cold and upper respiratory tract infections (URTIs). We reviewed the literature from the MEDLINE database (January 1966–July 1999), International Pharmaceutical s (IPA) online database, Cambridge Scientific s Biological Sciences online database, Alt‐Health Watch online database, EMBase CD‐ROM database, and references from published articles, reviews, and letters to evaluate evidence from clinical trials of echinacea's purported efficacy for treating or preventing URTIs. Twelve clinical studies published from 1961–1997 concluded that echinacea was efficacious for treating the common cold, but the results are unclear due to inherent flaws in study design. Five trials were published since 1997; two showed that echinacea lacked efficacy for treating and preventing URTI symptoms, and three concluded that it was effective in reducing the frequency, duration, and severity of common cold symptoms. Again, these results are unclear because of methodologic uncertainties, such as small populations and use of noncommercially available, nonstandardized dosage forms. Although evidence for echinacea's efficacy is inconclusive, it appears to be safe. Patients without contraindications to it may not be dissuaded from using an appropriate preparation to treat the common cold.

Rhinovirus (RV)-Induced Interleukin-8 (IL-8) Production in Respiratory Epithelial Cells is Mediated by H2O2 and is Inhibited by N-Acetyl Cysteine (NAC) † 690

A direct correlation has been reported between the severity of common cold symptoms and the concentration of IL-8 in nasal secretions from volunteers with experimental RV colds. The purpose of these studies was to examine the mechanism by which RV infection stimulates IL-8 elaboration. All studies were done in a transformed respiratory epithelial cell line (BEAS-2b). Increased fluorescence staining of carbonyl groups and activation of dichlorofluorescein diacetate was seen in RV-challenged cells suggesting an increase in oxidative stress. Quantitative measurement of H2O2 with a colorimetric assay revealed H2O2 concentrations of 4.74 ± 2.04 μM and.40 ±.49 μM in media from challenged and control cells four hours after virus challenge, respectively (p<0.01). Stimulation of BEAS-2b cells with H2O2 resulted in elaboration of IL-8. Treatment of BEAS-2b cells with NAC significantly inhibited RV-induced IL-8 elaboration. IL-8 concentrations in supernatant media were 183 ± 64 pg/ml and 44 ± 4 six hours after virus challenge in treated (20 mM NAC) and untreated cells, respectively. In spite of the effect of NAC on IL-8 elaboration, RV stimulated increases in H2O2 concentration were not affected by NAC. These results demonstrate that H2O2 is produced in respiratory epithelial cells in response to RV infection and is a potential mediator of RV-induced IL-8 elaboration. NAC inhibits RV-induced IL-8 by a mechanism other than inhibition of H2O2 production.