Licata Anna, Seidita Aurelio, Como Silvia, de Carlo Gabriele, Cammilleri Marcella, Bonica Roberta, Soresi Maurizio, Veronese Nicola, Chianetta Roberta, Citarrella Roberto, Giannitrapani Lydia, Barbagallo Mario
Unit of Internal Medicine, AOU Policlinico "P. Giaccone", Department of Health Promotion Sciences, Maternal and Infant Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90134 Palermo, Italy.
Unit of Internal Medicine, "V. Cervello" Hospital, Ospedali Riuniti "Villa Sofia-Cervello", 90146 Palermo, Italy.
Nutrients. 2025 Jan 9;17(2):230. doi: 10.3390/nu17020230.
During the COVID-19 pandemic, several observational studies proved a certain efficacy of nutraceuticals, herbal products, and other dietary supplements as adjuvant therapies used alongside antiviral drugs. Although their use has not been widespread in Italy, according to preliminary evidence, many supplements with demonstrated immunomodulatory effects, such as vitamins C and D, herbal medicines and essential oils, might relieve the respiratory symptoms of COVID-19, since SARS-CoV-2 can activate inflammasome-mediated inflammatory signaling pathways. Other observational studies have shown that herbal treatments, such as and ginseng, help alleviate respiratory symptoms and reduce serum levels of inflammatory cytokines, which are typically overexpressed in both adult and pediatric SARS-CoV-2 patients. Further, vitamins C and D can attenuate the immune response thanks to their cytokine suppression ability and to their known antimicrobial activity and potential to modulate T helper cell response. The strong immune response triggered by SARS-CoV-2 infection is responsible for the severity of the disease. Preliminary data have also shown that L-arginine, an endothelial-derived relaxing factor, is able to modulate endothelial damage, which appears to be one of the main targets of this systemic disease. Finally, some essential oils and their isolated compounds, such as eucalyptol, may be helpful in reducing many of the respiratory symptoms of COVID-19, although others, such as menthol, are not recommended, since it can lead to an undervaluation of the clinical status of a patient. In this narrative review, despite the lack of strong evidence in this field, we aimed to give an overview of the current available literature (mainly observational and cross-sectional studies) regarding herbal products and dietary supplements and their use in the treatment of mild disease from SARS-CoV-2 infection. Obviously, dietary supplements and herbal products do not constitute a standardized treatment for COVID-19 disease, but they could represent an adjunctive and useful treatment when used together with antivirals.
在新冠疫情期间，多项观察性研究证明了营养保健品、草药产品及其他膳食补充剂作为与抗病毒药物联用的辅助疗法具有一定疗效。尽管它们在意大利的使用并不广泛，但根据初步证据，许多具有免疫调节作用的补充剂，如维生素C和D、草药及精油，可能会缓解新冠病毒感染的呼吸道症状，因为严重急性呼吸综合征冠状病毒2（SARS-CoV-2）可激活炎性小体介导的炎症信号通路。其他观察性研究表明，诸如[此处原文缺失草药名称]和人参等草药疗法有助于缓解呼吸道症状并降低炎症细胞因子的血清水平，这些细胞因子在成年和儿童SARS-CoV-2患者中通常都会过度表达。此外，维生素C和D由于其细胞因子抑制能力、已知的抗菌活性以及调节辅助性T细胞反应的潜力，可减弱免疫反应。SARS-CoV-2感染引发的强烈免疫反应是导致疾病严重程度的原因。初步数据还表明，内皮源性舒张因子L-精氨酸能够调节内皮损伤，而内皮损伤似乎是这种全身性疾病的主要靶点之一。最后，一些精油及其分离出的化合物，如桉叶油，可能有助于减轻新冠病毒感染的许多呼吸道症状，不过其他一些，如薄荷醇，则不建议使用，因为它可能导致对患者临床状况的低估。在这篇叙述性综述中，尽管该领域缺乏有力证据，但我们旨在概述当前关于草药产品和膳食补充剂及其在治疗SARS-CoV-2感染轻症方面应用的现有文献（主要是观察性和横断面研究）。显然，膳食补充剂和草药产品并非新冠病毒感染疾病的标准化治疗方法，但与抗病毒药物联合使用时，它们可能是一种辅助且有用的治疗方法。
