Safety and Efficacy of Chyawanprash as a Prophylaxis Treatment for COVID-19: A Systematic Review and Meta-Analysis of Randomized Control Trials.

Amidst the multifaceted challenges posed by COVID-19, interest in complementary and alternative medicine (CAM) has risen. Chyawanprash (CP), an Ayurvedic formulation, is recognized for its multifunctional properties. This systematic review aims to evaluate its safety and effectiveness as a COVID-19 prophylactic. A literature search was conducted for articles published within the past three years from databases such as Cochrane Library, PubMed, and Google Scholar. A total of 1008 articles were identified, and 34 were included for full-text screening, resulting in five randomized controlled trials (RCTs) meeting the eligibility criteria. Meta-analysis was performed using a random effects model, with results represented in odds ratio (95% confidence intervals (CIs)), and publication bias presented through funnel plots. The five clinical trials conducted in India analyzed 153,343 participants. In the meta-analysis, the odds ratios for COVID-19-positive patients, COVID-19-positive in symptomatic patients, healthcare resource utilization (HCRU), and adverse events were 0.45 (95% CI 0.06-3.08, p = 0.41), 0.37 (95% CI 0.01-12.86, p = 0.58), 0.95 (95% CI 0.18-5.04, p = 0.95), and 0.94 (95% CI 0.63-1.40, p = 0.75) respectively. Notably, significant heterogeneity was observed among studies including both COVID-19-positive cases (I= 80%, p = 0.007) and symptomatic COVID-19 cases (I= 83%, p = 0.01), whereas non-significant zero heterogeneity was observed in HCRU (I= 0%, p = 0.74) and adverse events (I= 0%, p = 1.00). The meta-analysis reveals a trend in the efficacy of CP as prophylaxis for COVID-19 treatments. However, owing to high heterogeneity and bias, further research is recommended.