Safety and Efficacy of Popular Iranian Herbal Cold Remedy for COVID-19: A Randomized Clinical Trial in Mild to Moderate COVID-19 Cases

Background: In traditional Persian medicine, an herbal cold remedy containing Sugarcane, Black Myrobalan, and mastic is mentioned and it was being widely provided by grocery stores. With the advent of the COVID-19 pandemic, the increased desire for this traditional remedy has led to a debate in society. Huge parts of the Iranian population have started using this remedy for the treatment of COVID-19; while no study has evaluated its efficiency and possible side effects. Thus, we aimed to evaluate the effects of Sugarcane, Black Myrobalan, and Mastic herbal medications for COVID-19 patients. Methods: This was a double-blinded randomized clinical trial study conducted over three months from May 2020 to July 2020 in SARS-COV2 PCR positive patients admitted in the COVID-19 ward of Peymaniyeh Hospital in Jahrom, Iran. Patients with severe COVID-19 infection were not recruited. The intervention group received the routine COVID-19 treatment protocol and the herbal supplement received the combination of black myrobalan and mastic and sugarcane, twice a day (3 g of herbal supplement). Study groups were compared in terms of demographic variables, vital signs, and clinical and laboratory variables for safety and efficiency assessment. Results: Seventy-two patients with COVID-19, divided into intervention (n=37) and control (n = 35) groups were studied. Intervention and control groups had not any significant difference in terms of baseline characteristics. The time-to-event analysis revealed a statistically significant difference in 4 symptoms of cough, fever, dyspnea, and myalgia (P 0.05). There was no significant difference in averaged O2 vital signs between the two groups (P 0.05). The Control group in comparison to the intervention group had a significantly lower decrease in C-reactive protein during 7 days (P 0.05). Patients in the herbal supplement group were hospitalized for 4.12 days and patients in the control group were hospitalized for 8.37 days (P=0.001). ICU admission and death only happened in 3 (8.6%) patients of the control group. Conclusion: This study showed that the proposed herbal remedy could be applied as supplementation to conventional management of COVID-19 patients with mild disease, while more research is needed for clinical application of this remedy.