In the double-blind, randomised controlled clinical trial which involved 140 COVID-19 patients, the group given the curcumin (Curcumin C3 Complex) and piperine (BioPerine) combination twice a day for two weeks, observed early symptomatic recovery of fever, cough, sore throat, breathlessness, and better ability to maintain oxygen saturation (SpO2) above 94%, compared to the control group.
The findings suggest that the curcumin and piperine combination could be used as adjuvant therapy for COVID-19.
Sabinsa is a manufacturer and supplier of herbal extracts, cosmeceuticals, probiotics, minerals, and specialty fine chemicals.
Dr Muhammed Majeed, chairman and founder of Sami-Sabinsa Group told NutraIngredients-Asia: “With the COVID-19 pandemic raging around the world, the focus is now on ingredients and nutrients which can help the body to fight viral infections and stay healthy.
“Our customers are looking for more evidence-based immune support ingredients, and while regulatory adherence may not allow for any kind of COVID related claims, this study gives insight to promoting better immune health by Curcumin C3 Complex plus BioPerine.”
“To our knowledge, our study is the first to describe the efficacy of orally administered curcumin with piperine in the symptomatic treatment of COVID-19,” according to the study researchers. Findings were published in the Frontiers in Pharmacology.
The clinical trial was conducted in a rural hospital at Rui, Baramati in Maharashtra, India, recruiting 140 symptomatic adult patients with positive COVID-19 antigen tests from July to September 2020. Patients who required ventilator support or on intravenous drugs were excluded.
They were categorised with mild (SpO2 > 94% on room air), moderate (SpO2 between 90 and 94% on room air, with pneumonitis) or severe symptoms (SpO2 < 90% on room air). Patients with mild and moderate symptoms were admitted to wards, while those with severe symptoms were admitted to the intensive care unit.
Patients were then randomly assigned to the control or study groups. Each group consist of 30 patients with mild symptoms, 25 with moderate symptoms, and 15 with severe symptoms.
The study group received Curcumin C3 Complex (SamiDirect, India) containing 525 mg of curcumin with Bioperine (SamiDirect), containing 2.5 mg of piperine (improves curcumin absorption) in tablet form.
The control group was given a probiotic capsule (Nutrolin B Plus, which contains lactic acid Bacillus and Vitamin B; Ciplamed).
According to Majeed, the lactic acid bacteria support the gastrointestinal flora and help in restoring disturbed balance of intestinal flora back to normal. The vitamins may have immunomodulatory properties.
Supplements were taken twice a day for 14 days. On top of the test products, both groups received the conventional COVID-19 treatment.
Outcomes were the number of days required for remission of symptoms including fever, cough, sore throat, breathlessness, and duration of hospitalisation
SpO2 were monitored every four hours in the mild and moderate groups, and continuously in the severe group.
Blood testing for complete blood count, C-reactive protein, and D-Dimer was performed on admission and subsequently if required.
Patients were discharged after they remained asymptomatic for more than 48 hours.
It was found that patients in the study group showed early symptomatic recovery of fever, cough, sore throat, breathlessness, had reduced hospitalisation duration and fever deaths reported.
They could also maintain SpO2 above 94% on room air for more days.
Among patients with mild symptoms, the study and control groups had similar duration of hospitalisation. However, in patients with moderate and severe symptoms, the study group had significantly lower duration of hospitalisation compared to the control group.
Fewer patients required mechanical ventilator support and suffered thromboembolic episodes in the study group than in the control group.
There were no deaths in the mild and moderate study groups. The control group saw one death from a patient with mild symptoms, and five deaths with moderate symptoms.
The study group saw two deaths among patients with severe symptoms, and five deaths in the control group.
The known pathophysiology of COVID-19 involves inflammatory reactions, cytokine storms and coagulopathy.
Majeed said: “Curcumin has been studied in silico for its binding affinity to viral proteins and their human receptors. These in silico docking studies discovered that curcumin could potentially inhibit ACE2 and spike glycoprotein of the virus to suppress COVID19 entry to the cell. The proven anti-inflammatory activity of curcumin could prevent cytokine storm and the molecule may also be effective in alleviating the coagulation abnormalities observed in COVID-19 patients.
Besides curcumin’s anti-inflammatory and antithrombotic activities, it also exhibits antibacterial and antifungal effects which could play a role in preventing secondary infections and promote early recovery.
“Molecular docking studies have shown the binding affinity of piperine to RNA-binding pocket of the nucleocapsid of SARS-Cov-2 virus, thus inhibiting viral proliferation, suggesting that piperine by itself may also contribute to the anti-viral activity of Curcumin C3 Complex.”
Piperine helps enhance the bioavailability of curcuminoids.
“Our results suggest that the use of orally administered curcumin with piperine as adjuvant therapy in COVID-19 treatment could substantially reduce morbidity and mortality, reduces treatment costs, and decrease logistical burden healthcare systems,” researchers said.
"While larger trials will be needed to establish the findings of the study on a firmer footing, it is gratifying to learn of these promising preliminary results," added Majeed.
Sabinsa had earlier carried out the first Indian study to demonstrate that suboptimal selenium levels were associated with susceptibility to COVID -19 infection.
It was an exploratory study, which showed that serum selenium levels were lower in patients with COVID-19 than in healthy controls.
The study suggest that selenium supplementation may be helpful in reducing the susceptibility to COVID-19 infection. The company is working out a study on selenium supplementation.
Source: Frontiers in Pharmacology
“Oral Curcumin With Piperine as Adjuvant Therapy for the Treatment of COVID-19: A Randomized Clinical Trial”
Authors: Kirti S Pawar, et al.