Efficacy Of Ashwagandha In Ayush Standard Treatment Protocol For Covid-19
Since the start of the COVID-19 pandemic, symptoms such as pneumonia, clotting complications, acute respiratory distress syndrome, and septic shock have been reported in many cases of the infection. While these symptoms may arise in severe cases (~19% of the total cases), symptoms like fever, headache, cough, malaise, muscle pain, sore throat, and nasal congestion can occur in mild-to-moderate cases (Wu, Z. et al., 2020). However, some patients experience no symptoms of the infection and are referred to as ‘asymptomatic.’ AYUSH Standard Treatment Protocol On October 6, 2020, Union Health Minister Harsh Vardhan released an “AYUSH standard treatment protocol” for the clinical management of COVID-19. This protocol lists dietary measures, yoga, and Ayurvedic herbs with formulations. A long list of specific Ayurvedic recommendations for COVID-19 prevention and treatment was announced, including the herb Ashwagandha (Withania somnifera) for: Prevention of COVID-19 in a high-risk population such as healthcare workers, those living in COVID-19 hotspots, and primary contacts of COVID-19 patients. Prevention of COVID-19 complications in infected patients, such as fatigue, lung fibrosis (scarring of lung tissue), and changes in mental well-being associated with the COVID-19 infection. Claims by AYUSH According to Dr. Harsh Vardhan, the COVID-19 treatment protocol is based on research studies conducted by AYUSH. In healthy people, Ashwagandha can prevent COVID-19 infection. In COVID-19 patients, Ashwagandha can prevent disease complications like fatigue, lung scarring, and the impact of COVID-19 infection on mental health. Clinical Studies for Ashwagandha Against COVID-19 A total of nine studies were registered with their respective ethics protocols on the CTRI. As per the timeline of these studies on CTRI: One out of the nine has been completed (but unpublished). Three are ‘open to recruitment’ for participants. The remaining five have not even started. Summary of Registered Clinical Trials on Ashwagandha Against COVID-19 Status Healthy Volunteers COVID-19 Positive Patients Total No. of Studies Not yet recruited 3 1 4 Recruiting 3 1 4 Completed 0 1 1 Total 6 3 9 Conclusion: The AYUSH treatment protocol is not based on any published evidence for Ashwagandha. Ashwagandha as a Preventative Drug in Uninfected People While there are no published clinical trials showing any efficacy of Ashwagandha Capsules in preventing COVID-19 infection, six protocols included in the ethics application on the CTRI website were found. These studies were either ongoing or in the process of starting but not completed. Status of Six Unpublished, Ongoing Studies on Ashwagandha in Healthy People to Prevent COVID-19 Study Researcher Group Status Methodology from the Ethics Application 1 Saketh Ram High-risk, healthy Recruiting Not randomised; unclear exclusion sample. 2 Muralikrishna Healthy Recruiting Used as an immune-booster but excludes those with lowered immunity. 3 Jayanthi High-risk, healthy Not started A concoction of Ashwagandha with 10 other herbs; no information for safety against drug interactions. 4 Chopra High-risk, healthy Not started Comparison with hydroxychloroquine (HCQ); no control group to compare with Ashwagandha. 5 Singhal High-risk, healthy Recruiting No control group; protocol vague between healthy and asymptomatic cases. 6 Chopra Healthy Not started To compare Ashwagandha with HCQ; no mention of healthy participants in inclusion. Ashwagandha as a Treatment Measure in COVID-19 Patients Unlike the trials in healthy people, three studies were registered as trials for COVID-19 patients. Of these: One was completed (unpublished). One was in the recruitment phase. One had not yet started. Status of Three Unpublished, Ongoing Studies on Ashwagandha’s Effect in COVID-19 Patients Study Researcher Group Status Methodology from the Ethics Application 1 Jayanthi Patients Completed, unpublished Low-risk patients with mild/no symptoms; lack of control group; low sample size; concoction drug unclear. 2 Singhal Patients Recruiting Testing many interventions with Ashwagandha; lack of blinding; low-risk age group; unclear primary outcome. 3 Singh Patients Not started Includes only mild-moderate cases; excludes co-morbidities and those with severe symptoms. Critical Analysis of AYUSH Trials The AYUSH researchers designed studies in healthy people using small numbers of participants with no control groups, excluding patients with low immunity, older people, and people with other comorbidities—who are at a higher risk for severe COVID-19 symptoms. They evaluated the herb as an immunity booster, keeping the study outcomes ambiguous. Conclusion To evaluate the efficacy of Ashwagandha, nine studies were registered on Ashwagandha’s effect against COVID-19. Only one study was completed, and the remaining eight studies were either in the recruitment phase or had not been started by the time the AYUSH protocol was released. Without completion, publication, or peer review, the usage of herbal treatments in clinical patients is unethical and dangerous. It is essential to continue testing herbs for COVID-19 and other illnesses through scientifically designed clinical trials and peer review, similar to modern medicine. For those interested in exploring herbal options, it’s crucial to purchase from a trusted Ayurvedic Medical Store to ensure the quality and safety of the products.
