Roberta Bonica

University of Palermo

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Nicola Veronese

University of Palermo

Mario Barbagallo

University of Palermo

Francesco Di Gennaro

University of Bari Aldo Moro

Mike Trott

University of Queensland

Olivier Bruyère

University of Liège

Annalisa Saracino

University of Bari Aldo Moro

Luigi Mirarchi

Ansaldo (Italy)

Davide Fiore Bavaro

University of Bari Aldo Moro

Ottavia Tulone

University of Palermo

Lee Smith

Anglia Ruskin University

Cooperative Institutions

University of Palermo

University of Bari Aldo Moro

University of Palermo

Azienda Ospedaliera Universitaria Policlinico "Paolo Giaccone" di Palermo

Policlinico S.Orsola-Malpighi

Humanitas University

IRCCS Humanitas Research Hospital

Doctors with Africa Cuamm

University of Sassari

University of Rome Tor Vergata

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Herbal and Dietary Supplements as Adjunctive Treatment for Mild SARS-CoV-2 Infection in Italy

Nutrients (2025)

Anna Licata Aurelio Seidita Silvia Como Gabriele de Carlo Marcella Cammilleri

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 Echinacea purpurea 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.

Phytotherapy

Nutraceutical

10.3390/nu17020230

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Long Covid: A Systematic Review and Meta-Analysis of 120,970 Patients

SSRN Electronic Journal (2022)

Francesco Di Gennaro Alessandra Belati Ottavia Tulone Lucia Diella Davide Fiore Bavaro

Background: The long-term consequences of the coronavirus disease 19 (COVID-19) are likely to be frequent but results hitherto are inconclusive. Therefore, we aimed to summarize the state-of-the-art literature in relation to long COVID symptomatology, using a systematic review and meta-analysis of observational studies.Methods: A systematic search in several databases was carried out up to 12 January 2022 for observational studies reporting the incidence rate of long COVID signs and symptoms divided according to body systems affected and defined using the World Health Organization criteria. Data are reported as incidence and 95% confidence intervals (CIs). Several sensitivity and meta-regression analyses were moreover performed.Findings: Among 11,162 papers initially screened, 196 studies were included, consisting of 120,970 participants (mean age: 52.3 years; 48.8% females) who were followed-up for a median of six months. The incidence of any long COVID symptomatology was 56.9% (95%CI: 52.2-61.6). General long COVID signs and symptoms were the most frequent (incidence of 31%), digestive issues the less frequent (7.7%). Higher percentage of females moderated the onset of any, neurological, general and cardiovascular long COVID symptomatology, whilst higher mean age was associated with higher incidence of psychiatric, respiratory, general, digestive and skin conditions. The incidence of long COVID symptomatology was different according to continent, age and follow-up length.Interpretation: Long COVID is a common condition in patients who have been infected with SARS-CoV-2, whether symptomatically or asymptomatically, and often regardless of the severity of the acute illness indicating the need for more cohort studies on this topic.Funding: No funding.Declaration of Interest: The authors declare no conflict of interest.Ethical Approval: Ethical review and approval were waived for this study since it relied on previously published data from original studies that had already received proper institutional review board approval.

10.2139/ssrn.4099429

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Interventions for Improving Long COVID-19 Symptomatology: A Systematic Review

Viruses (2022)

Nicola Veronese Roberta Bonica Sergio Cotugno Ottavia Tulone Michele Camporeale

Although the understanding of several aspects of long COVID-19 syndrome is increasing, there is limited literature regarding the treatment of these signs and symptoms. The aim of our systematic review was to understand which therapies have proved effective against the symptoms of long COVID-19.

2019-20 coronavirus outbreak

10.3390/v14091863

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Incidence of long COVID-19 in people with previous SARS-Cov2 infection: a systematic review and meta-analysis of 120,970 patients

Internal and Emergency Medicine (2022)

Francesco Di Gennaro Alessandra Belati Ottavia Tulone Lucia Diella Davide Fiore Bavaro

Cumulative incidence

10.1007/s11739-022-03164-w

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Citations (73)