Can Herbal Remedies Treat COVID-19?
A surgeon reflects on her Chinese heritage
When the COVID-19 quarantine orders started, my aunt decided we would have a group Zoom every Sunday morning.
I have a huge Chinese family. When we are all together at dinner, we can be thirty-some people, including three generations and significant others. We are also spread out all over the world: Toronto, Hong Kong, Vancouver, and, well, me in New York City.
During the first few video chats, we updated each other on the state of things in our respective locations. I have to admit, I often felt apprehensive about attending because I knew they would ask me how things were in NYC.
“It looks so scary in the news,” they would say. “Thousands of people dying. Are you okay?”
I would have to put on a brave face and say, “I’m fine.” They wanted to hear stories about the emergency rooms packed with stretchers full of coughing, dying patients. They wanted to hear about the spacesuit I had to wear. I obliged, satisfying their curiosity and ameliorating their concern.
About our third or fourth week (I have entirely lost track of time), my aunt asked me what I thought about herbal medicine in treating COVID-19. We had already discussed existing therapies, vitamin C (which I firmly believe in), and general immune boosting strategies.
I admitted that I had no opinion on traditional Chinese medicine (TCM) for COVID-19. I had not read any evidence for or against it.
My own exposure to TCM has been as follows: when I sprained my ankle really badly after falling down the stairs running after a girl in high school (to this day, I tell people that it happened during volleyball practice), my parents, instead of taking me to the emergency room for an x-ray, took me to an herbalist downtown (I went to high school in Hong Kong) and he prescribed this giant, stinky, wet poultice that I had to boil and put on my ankle every day. You know what? The swelling went away. Whether the inflammation would’ve gone down anyway, as per the natural history of the body healing, is hard to say. As I’ve grown older and gone through medical school, I still see my parents and my family turning to TCM, usually when they think that Western medicine doesn’t have an answer, or they don’t trust the answer that they were given. In residency, Ma Huang briefly came up, as an herb that thins the blood. As surgeons, we always watched out for this, fearful of the surgical bleeding that it could cause. We Chinese use a lot of food as medicine, too. I won’t go into that here; that is a whole other topic.
So when my aunt asked me that question, I immediately spent the rest of the Zoom chat looking up articles from an online medical library and ignoring the rest of the conversation. (So sorry!) I kept asking my aunt to repeat the names of the herbs her friend was purportedly buying for her. One note here: my family speaks Cantonese, and the names in the papers are in Mandarin. I speak both, so I had to do some quick translating in my head. I found the relevant articles, and then I took it one step further: I looked up what those Mandarin herbs were in English. And guess what.
The names were different, but herbs were reported to have the same properties, independently identified by two parallel cultures.
One caveat for my scientific article readers — there is no evidence saying TCM is better than Western medicine or that it completely cures COVID-19. In some cases, TCM in combination with Western medicine shortened the duration of symptoms (which is what remdesivir reportedly does). There were case reports of patients being discharged after being treated with TCM alone. The basis for this research is that during the first SARS crisis in 2002–2003, TCM featured heavily as a treatment in Hong Kong and China, with success rates of >80%.
A Biomed Central Systematic Review, which frankly was dense and difficult to read, with its paragraphs full of italicized script, went through the most commonly used TCM herbs, as well as common preparations, which are combinations of the herbs that, say, treat upper respiratory tract infections or lower gastrointestinal symptoms.
Astralagus membranaceous, for example, Huang Qi in Mandarin and Milkvetch in English, is known for treating seasonal allergies. Glycyrrhizae uralensis, Gancao or Chinese licorice, was featured in The Lancet in 2017 for its antiviral properties. Lonicera japonica, Jinyinhua or Japanese honeysuckle, is used to treat fevers and colds, based on its effect on inflammatory cytokines like IL-1 and TNF-alpha. Fructus forsythia, Lianqiao or Forsythia fruit, also has anti-inflammatory effects. Agastache rugosa, Huoxiang or Giant Purple Hyssop, is a culinary delicacy in Korea but also is used to treat nausea, vomiting, and poor appetite.
The popular Shuanghuanglian, made up of forsythia fruit, Chinese skullcap, and honeysuckle, sold out in China after authorities touted it as a cure for COVID-19. There was immediate controversy, as you might imagine, including US backlash saying that TCM undermined the actual research being done on SARS-CoV2.
Before you go rush out and buy an armful of herbs, I wanted to say that the point of this article was to indicate that foreign sounding drugs might not be so foreign after all. I specifically listed a few that had familiar sounding English names. The way these are used is not that much different than the way that we drink chamomile tea for sleep, or inhale lavender for relaxation. Let’s not forget that many of our ‘Western’ medicines were based on herbal therapies. Digitalis, which is Foxglove, is a component of heart failure medicine, and the ubiquitous aspirin comes from willow tree bark.
At the end of March, Google searches for chloroquine and hydroxychloroquine went up 442% and 1389%, respectively. Today, the hot topic of the week is remdesivir, which in early trials has been promising. A recently published article in The Lancet shows that remdesivir may shorten the duration of symptoms, but so far, has not been shown to affect mortality.
Everyone is looking for a miracle drug to end this pandemic. While I don’t think that one exists (yet), we need to continue to keep an open mind. We don’t know where we will find a cure for COVID-19.
References
- Remdesivir in adults with severe COVID-19: a randomised, double-blind, placebo-controlled, multicentre trial — The Lancet
- Internet Searches for Unproven COVID-19 Therapies in the United States
- ‘Traditional Chinese medicine harmed new coronavirus control’
- Liquorice: a treatment for all sorts? — The Lancet Oncology
- Traditional Chinese Medicine in the Treatment of Patients Infected with 2019-New Coronavirus (SARS-CoV-2): A Review and Perspective
- Traditional Chinese herbal medicine for treating novel coronavirus (COVID-19) pneumonia: protocol for a systematic review and meta-analysis