review · American Journal of Tropical Medicine and Hygiene
The COVID-19 pandemic prompted widespread searches for effective therapeutics, yet early options backed by clinical trials remained very limited. In response, anecdotal use of herbal preparations such as Artemisia species extracts expanded in low-income countries, accompanied by unsubstantiated claims of efficacy and political controversy. Derivatives of Artemisia annua possess a long history in traditional medicine for managing fevers, malaria, and respiratory tract infections. However, validating these botanical sources requires rigorous evaluation through randomised controlled trials. Moving from raw herbal extracts to standardized therapies demands isolating active ingredients, creating suitable formulations, determining appropriate dosing, and defining pharmacokinetic, toxicological, and safety parameters. A systematic scientific road map is needed to examine the bioactive compounds and pharmacological effects of Artemisia derivatives to establish whether they offer safe, genuine value for preventing or treating COVID-19.
Unverified claims regarding herbal treatments during global health emergencies risk public safety and create political controversy. Establishing a rigorous scientific framework to evaluate traditional remedies like Artemisia ensures that potential therapies are properly tested for efficacy, toxicity, and safe dosing before clinical use.
This work relates to early-stage pharmaceutical development, targeting researchers, formulation scientists, and drug developers. Practical application is distant from market use, as it requires moving from traditional herbal extracts to identified active ingredients, optimized dosing, safety profiling, and proof of clinical efficacy through randomised controlled trials.
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The world is currently facing a novel COVID-19 pandemic caused by SARS-CoV-2 that, as of July 12, 2020, has caused a reported 12,322,395 cases and 556,335 deaths. To date, only two treatments, remdesivir and dexamethasone, have demonstrated clinical efficacy through randomized controlled trials (RCTs) in seriously ill patients. The search for new or repurposed drugs for treatment of COVID-19 continues. We have witnessed anecdotal use of herbal medicines, including <i>Artemisia</i> spp. extracts, in low-income countries, and exaggerated claims of their efficacies that are not evidence based, with subsequent political controversy. These events highlight the urgent need for further research on herbal compounds to evaluate efficacy through RCTs, and, when efficacious compounds are identified, to establish the active ingredients, develop formulations and dosing, and define pharmacokinetics, toxicology, and safety to enable drug development. Derivatives from the herb <i>Artemisia annua</i> have been used as traditional medicine over centuries for the treatment of fevers, malaria, and respiratory tract infections. We review the bioactive compounds, pharmacological and immunological effects, and traditional uses for <i>Artemisia</i> spp. derivatives, and discuss the challenges and controversies surrounding current efforts and the scientific road map to advance them to prevent or treat COVID-19.
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DOI: 10.4269/ajtmh.20-0820
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