With the reopening of many states starting in mid-May, we are facing a challenge of how to minimize the risk of being infected by the coronavirus, and how to address the damage caused by the virus for patients who have already been infected and recovered. Let's take a look at the process of how the coronavirus enters the respiratory system and discuss possible herbal solutions based on their efficacy treating viral infections.
Incubation
Most viruses have an incubation period in which they live in the upper respiratory system, like the nose and throat, before they move farther down into the lungs. COVID-19, for example, has a median incubation period of five days.1 During this time, an infected individual would not experience symptoms, but would still be contagious to others.
During this incubation period, the virus begins to replicate inside the epithelial cells in the lining of the nose, throat and larynx. Once the virus moves to the lungs and starts to replicate inside the lung cells, symptoms appear as the immune system starts to react with the production of high levels of proinflammatory cytokines.
During this initial incubation period, if patients received effective treatment, it could stop a viral infection from spreading deep into the lungs. Antiviral treatment should begin at this period. Unfortunately, current medical treatment misses that window of time. By the time the virus spreads to the lungs and massively replicates inside the lung tissue, the cytokine storm is already initiated, the bronchioles become blocked by mucus, and the damage is already too severe to be reversed simply by any antiviral treatment.
Chinese herbs have proven effective in boosting immunity to help clear viral infections at this early stage. Flos lonicerae (honeysuckle flowers / Jin Yin Hua), for example, has been utilized for several thousand years for many pharmacological uses. One of its benefits includes immunoregulation. Flos lonicerae significantly enhances thymus index, spleen index, macrophage index, and improves the proliferation of spleen lymphocytes to help fight off infections.2
Specific herbal teas have been formulated that utilize Flos lonicerae with other immune-boosting herbs. Drinking the herbal tea on a daily basis helps boost immunity and fight infections in the upper airways to prevent viruses from moving deep into the lungs.
Infection
Once the virus has entered into the lungs and begins its replication process, the immune system releases a plethora of inflammatory cytokines and chemokines to initiate and drive the immune response. At this point, the infected individual would have symptoms such as fever, fatigue, dry cough and body aches. The cytokine storm causes constriction in blood vessels, leading to decreased oxygen intake and mucus formation in the bronchioles.
In China, they created what is known as the "Qingfei Paidu Decoction," which was prescribed by the famous herbalist Dr. Tong Xiaolin. The exact meaning of Qingfei Paidu in Chinese means detoxifying the lungs and pushing out the toxins. The formula consists of 21 herbs and is a combination of several classic prescriptions described in Zhang Zhongjing's Shanhanlun for treating exogenous fever caused by "cold evil."
On Feb. 23, 2020, the National Administration of Traditional Chinese Medicine revealed that this herbal formula had a greater than 90 percent effective rate in the treatment of 214 patients who were diagnosed with coronary pneumonia. These patients ranged from having mild symptoms to being in critical states. Statistical data showed that within three days (one treatment course), more than 60 percent of patients had symptom and/or CT imaging improvement with decreased shortness of breath and mucus reduction; while 30 percent of patients' symptoms stabilized without worsening.3
A report on March 14, 2020,4 showed that the effective rate of the "Qingfei Paidu Decoction" had reached 97.78 percent, and no single case had progressed from mild to severe or critically ill. Among 1,261 coronavirus pneumonia patients who had taken the decoction, 1,102 cases were resolved, in 29 cases symptoms were completely eliminated, and 71 cases improved. Among the 40 severe patients, 28 had been discharged from the hospital; 12 patients remained in the hospital and 10 patients had experienced symptom improvement and achieved reversal from severe to mild condition.
The Damage Left Behind
Even after the virus has been cleared, the damage it leaves behind can cause future disease or worsen a current one. The combination of the viral infection and the inflammatory cytokines results in apoptosis and in some cases, necrosis of the airway and alveolar epithelium. This damage can lead to scar tissue formation in the lungs and even the heart, causing conditions such as pulmonary fibrosis.
Chinese herbs such as Platycodi radix are useful in the repair of damaged lungs through controlling airway inflammation, as well as proinflammatory cytokine expression in the lungs.5 Radix stemonae has been shown to mitigate alveolar wall thinning and alveolar enlargement and fusion to improve airway rebuilding in the lungs.6
Case Study: Complete Symptom Resolution in Coronavirus Patient
A 25-year-old patient who was an active restaurant worker started experiencing flu-like symptoms on March 15, 2020. The patient had lost her sense of smell and taste. She was tested on the 24th for COVID-19 and was confirmed positive on the 27th. Her primary care doctor gave her Tylenol with codeine for her fever and body aches.
She was experiencing difficulty and painful breathing, headache, dry cough, congestion, and difficulty speaking. Everything was labored. By the 30th, the Tylenol and codeine had helped the fever subside. However, there was no improvement in body aches, breathing, cough and congestion.
The patient started taking an herbal formula consisting of 21 herbs that is described in the "Qingfei Paidu Decoction" including Agastache rugosus, Fructus aurantii immaturus, Gypsum gibrosum, Herba asari, etc. Within two days, her body aches had improved by 50 percent. By the third morning, she had started to expel chest congestion and after day three, the patient's body aches/pains and congestion were almost completely gone. All symptoms were resolved by day six and the patient was finishing a two-week course of the formula as this article was written.
References
- Lauer SA, et al. The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: estimation and application. Ann Intern Med, 2020 [Epub ahead of print 10 March 2020].
- Li Y, et al. Lonicerae Japonicae Flos and Lonicerae Flos: a systematic pharmacology review. Evidence-Based Compl Alt Med: eCAM, 2015 (open access).
- [The total effective rate of Qingfei Paidu Decoction in treating patients with new coronary pneumonia can reach more than 90%.] Feb. 6, 2020 (translated).
- [Academician Tong Xiaolin: The total effective rate of Qingfei Paidu Decoction is 97%, and none of the patients changed from mild to severe. Times Weekly], March 14, 2020 (translated).
- Lee H-Y, et al. Platycodi Radix and its active compounds ameliorate against house dust mite-induced allergic airway inflammation and ER stress and ROS by enhancing anti-oxidation. Food Chem Toxicol, 2019;123:412-423.
- Wang Z, et al. Effect of Radix Stemonae concentrated decoction on the lung tissue pathology and inflammatory mediators in COPD rats. BMC Compl Alt Med, 2016;16(1):457.
Dr. Sarah Li is the founder of Wei Laboratories, Inc. (www.weilab.com), which offers a full range of Chinese herbal products with compressive training and services. Representative products include FASTT Patch and WHITEE Patch that address many tough-to-treat musculoskeletal conditions. Dr. Li attended the University of Science and Technology of China, majoring in biology and graduating with the highest honor as the valedictorian; and completed her PhD in Biochemistry at the University of Minnesota, Twin Cities. Dr. Li accomplished her research fellowship at Beth Israel Hospital, focusing on the pathogenesis of type II diabetes. She also worked as a research associate at Harvard Medical School.