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Meta-Analysis
. 2021 Sep;35(9):4930-4942.
doi: 10.1002/ptr.7122. Epub 2021 Apr 17.

Effectiveness of supplementation with quercetin-type flavonols for treatment of viral lower respiratory tract infections: Systematic review and meta-analysis of preclinical studies

Júlio César Moreira Brito  1   2 , William Gustavo Lima  2 , Lídia Pereira B Cordeiro  3 , Waleska Stephanie da Cruz Nizer  4
Affiliations
Meta-Analysis

Effectiveness of supplementation with quercetin-type flavonols for treatment of viral lower respiratory tract infections: Systematic review and meta-analysis of preclinical studies

Júlio César Moreira Brito et al. Phytother Res. 2021 Sep.

Abstract

Viral infections of the lower respiratory tract are considered a public health problem. They affect millions of people worldwide, causing thousands of deaths, and are treated with expensive medicines, such as antivirals or palliative measures. In this study, we conducted a systematic review to describe the use of quercetin-type flavonols against lower respiratory tract viruses and discussed the preclinical impact of this approach on different signs and clinical mechanisms of infection. The systematic review was performed in PubMed/MEDLINE, Scopus, Scielo, and Biblioteca Virtual de Saúde (BVS). After the database search, 11 relevant studies were identified as eligible. The analysis of these studies showed evidence of antiviral activity of quercetin-type flavonols with significantly reduced mortality rate (M-H = 0.19, 95% CI: 0.05 to 0.65, p-value = 0.008) of infected animals and a reduction in the average viral load (IV = -1.93, 95% CI: -3.54 to -0.31, p-value = 0.02). Additionally, quercetin and its derivatives reduced the amount of proinflammatory cytokines, chemokines, reactive oxygen species, mucus production, and airway resistance in animals infected with a respiratory virus. Overall, supplementation with quercetin-type flavonols is a promising strategy for treating viral-induced lower respiratory tract infections.

Keywords: chemoprophylaxis; flavonoids; influenza virus; quercetin; rhinovirus; virus-induced lower respiratory tract infections.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Flowchart of the selection of articles for systematic review according to the PRISMA criteria
FIGURE 2
FIGURE 2
Meta‐analysis of the mortality in animals with virus‐induced lower respiratory tract infections treated with quercetin‐type flavonols
FIGURE 3
FIGURE 3
Meta‐analysis of the pulmonary viral load in animals with virus‐induced lower respiratory tract infections treated with quercetin‐type flavonols
FIGURE 4
FIGURE 4
Chemical structure of quercetin and its glycosylated (rutin, isoquercetin, and quercetin‐3‐O‐β‐D‐glucuronide) and nonglycosylated (quercetin and isorhamnetin) derivatives
FIGURE 5
FIGURE 5
Schematic summary of the clinical activity of quercetin‐type flavonols in animals with virus‐induced lower respiratory tract infections
See this image and copyright information in PMC

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