Shufeng Jiedu, a promising herbal therapy for moderate COVID-19: Antiviral and anti-inflammatory properties, pathways of bioactive compounds, and a clinical real-world pragmatic study

Background: Shufeng Jiedu capsules (SFJDC), a patented herbal drug composed of eight medicinal plants, is used for the treatment of different viral respiratory tract infectious diseases. Based on its antiviral, anti-inflammatory and immunoregulatory activity in acute lung injury, SFJDC might be a promising candidate for the treatment of COVID-19. Purpose: To evaluate the antiviral and anti-inflammatory properties and to discover the mechanism of action of SFJDC as a potential drug for the treatment of COVID-19. Furthermore, the study should determine the clinical effectiveness of SFJDC for the treatment of COVID-19. Design: We analyzed the antiviral and anti-inflammatory effects of SFJDC in a HCoV-229E mouse model on lung index, virus load in the lung, the release of cytokines, and on T- and B-lymphocytes. The mechanism of action was further investigated by network analysis. Additionally, we investigated data from a clinical pragmatic real-world study for patients with confirmed COVID-19, to evaluate the clinical effect of SFJDC and to determine the best time to start the treatment. Results: SFJDC significantly reduced the virus load in the lung of HCoV-229E mice (from 1109.29 +/- 696.75 to 0 +/- 0 copies/ml), decreased inflammatory factors IL-6, IL-10, TNF-alpha, and IFN-gamma in the lung, and increased the amount of CD4(+) and CD8(+) cells in the blood compared to the model group. Network analysis revealed that SFJDC reduces the activity of NF kappa B via several signaling pathways. Quercetin, wogonin, and polydatin bind directly to the main protease (M-pro) of SARS-CoV-2. Clinical data showed that SFJDC, added to standard antiviral therapy (AVD), significantly reduced the clinical recovery time of COVID-19 and fatigue (from 3.55 +/- 4.09 to 1.19 +/- 2.28 days) as well as cough (from 5.67 +/- 5.64 to 3.47 +/- 3.75) days compared to AVD alone. SFJDC therapy was significantly more effective when used within the first 8 days after the onset of symptoms. Conclusion: SFJDC might be a promising drug for the treatment of COVID-19, but large-scale randomized, double-blinded, placebo-controlled clinical trials are needed to complement the real-world evidence. It might be beneficial to start SFJDC treatment as early as possible in suspected cases of COVID-19.

Automated summary

The study demonstrated that Shufeng Jiedu capsules have antiviral and anti-inflammatory properties, significantly reducing virus load and inflammatory factors in COVID-19 patients while increasing immune cell levels. Clinical data showed that SFJDC therapy was most effective when initiated within the first 8 days after symptom onset.