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. 2021 Oct 28:279:114367.
doi: 10.1016/j.jep.2021.114367. Epub 2021 Jun 24.

Efficacy and safety of ReDuNing injection as a treatment for COVID-19 and its inhibitory effect against SARS-CoV-2

Qinhai Ma  1 , Yuqi Xie  1 , Zhoulang Wang  1 , Biao Lei  1 , Ruihan Chen  1 , Bin Liu  2 , Haiming Jiang  1 , Yutao Wang  1 , Qingquan Liu  3 , Zifeng Yang  4
Affiliations

Efficacy and safety of ReDuNing injection as a treatment for COVID-19 and its inhibitory effect against SARS-CoV-2

Qinhai Ma et al. J Ethnopharmacol. .

Abstract

Background: Although the rapid emergence of coronavirus disease 2019 (COVID-19) poses a considerable threat to global public health, no specific treatment is available for COVID-19. ReDuNing injection (RDN) is a traditional Chinese medicine known to exert antibacterial, antiviral, antipyretic, and anti-inflammatory effects. In addition, RDN has been recommended in the diagnosis and treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-associated pneumonia by the National Health Council and the National Administration of Chinese Medicine. However, there is no information regarding its efficacy against COVID-19.

Aim of study: This study was designed to determine the clinical efficacy of RDN in patients with COVID-19 and characterize its antiviral activity against SARS-CoV-2 in vitro.

Materials and methods: A total of 50 adults with COVID-19 were included in this study, and the primary endpoint was recovery from clinical symptoms following 14 days of treatment. General improvements were defined as the disappearance of the major symptoms of infection including fever, fatigue, and cough. The secondary endpoints included the proportion of patients who achieved clinical symptom amelioration on days 7 and 10, time to clinical recovery, time to a negative nucleic acid test result, duration of hospitalization, and time to defervescence. Plaque reduction and cytopathic effect assays were also performed in vitro, and reverse-transcription quantitative PCR was performed to evaluate the expression of inflammatory cytokines (TNF-α, IP-10, MCP-1, IL-6, IFN-α, IFN-γ, IL-2 and CCL-5) during SARS-CoV-2 infection.

Results: The RDN group exhibited a shorter median time for the resolution of clinical symptoms (120 vs. 220 h, P < 0.0001), less time to a negative PCR test result (215 vs. 310 h, P = 0.0017), shorter hospitalization (14.8 vs. 18.5 days, P = 0.0002), and lower timeframe for defervescence (24.5 vs. 75 h, P = 0.0001) than the control group. In addition, time to improved imaging was also shorter in the RDN group than in the control group (6 vs.8.9 days, P = 0.0273); symptom resolution rates were higher in the RDN group than in the control group at 7 (96.30% vs. 39.13%, P < 0.0001) and 10 days (96.30% vs. 56.52%, P = 0.0008). No allergic reactions or anaphylactic responses were reported in this trial. RDN markedly inhibited SARS-CoV-2 proliferation and viral plaque formation in vitro. In addition, RDN significantly reduced inflammatory cytokine production in infected cells.

Conclusions: RDN relieves clinical symptoms in patients with COVID-19 and reduces SARS-CoV-2 infection by regulating inflammatory cytokine-related disorders, suggestion that this medication might be a safe and effective treatment for COVID-19.

Keywords: COVID-19; Inflammatory cytokines; ReDuNing injection; SARS-CoV-2; Traditional Chinese medicine.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Image 1
Graphical abstract
Fig. 1
Fig. 1
The HPLC profile of RDN at 220 nm. (A) The HPLC profile of RDN. (B) The HPLC profile of the reference solution. 1. Neochlorogenic acid; 2. Chlorogenic acid; 3. Cryptochlorogenic acid; 4. Caffeic acid; 5. Geniposide; 6. Oxidation of brucine; 7. Isochlorogenic acid B; 8. Isochlorogenic acid A; 9. Isochlorogenic acid C.
Fig. 2
Fig. 2
Generation curve of recovery time (hours) of the two groups of patients.
Fig. 3
Fig. 3
Comparison of COVID-19 nucleic acid negative conversion time process between the two groups. (A) The survivor curve of nucleic acid negative conversion time process between the two groups. (B) Time of nucleic acid negative between the two groups of patients after treatment.
Fig. 4
Fig. 4
The length of hospital stay (days) in the two groups. (A) The survivor curve of the length of hospital stay (days) in the two groups. (B) Time (days) of hospital stay between the two groups of patients after treatment.
Fig. 5
Fig. 5
Time for defervescence and imaging improvement time (days) of the two groups of patients after treatment. (A) Time for defervescence of the two groups of patients after treatment. (B) Imaging improvement time (days) of the two groups of patients after treatment.
Fig. 6
Fig. 6
The reduction of virus-induced CPE and plaque formation by different concentrations of RDN. (A) The cytotoxicity of RDN in Vero E6 cells was determined by using MTT assay. (B) The antiviral effects of RDN on virus in cells. (C) The cytotoxicity of RDN in Huh-7 cells was determined by using MTT assay. (D) The inhibitory effects of RDN on plaque formation of virus. Data were obtained from three separate experiments and presented as the mean ± SD. *P < 0.05; **P < 0.01; ***P < 0.001, compared with SARS-CoV-2-infected cells.
Fig. 7
Fig. 7
The effects of RDN treatment on the mRNA expression levels of inflammatory factors (TNF-α (A), IP-10 (B), IL-6 (C), IFN-γ (D), CCL-5 (E), MCP-1 (F), IFN-α (G) and IL-2 (H)) in SARS-CoV-2-infected Huh-7 cells. Data were obtained from three separate experiments and presented as the mean ± SD. *P < 0.05; **P < 0.01; ***P < 0.001, compared with SARS-CoV-2-infected cells.
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References

    1. Assiri Abdullah, Al-Tawfiq Jaffar A., Al-Rabeeah Abdullah A., Al-Rabiah Fahad A., Al-Hajjar Sami, Al-Barrak Ali, Flemban Hesham, Al-Nassir Wafa N., Hanan H Balkhy, Al-Hakeem Rafat F., Hatem Q Makhdoom, Alimuddin I Zumla, Memish Ziad A. Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study. Lancet Infect. Dis. 2013;13:752–761. - PMC - PubMed
    1. Beigel J., Tomashek K., Dodd L., Mehta A., Zingman B.S., Kalil A.C., Hohmann E., Chu H.Y., Luetkemeyer A., Kline S., Lopez de Castilla D., Finberg R.W., Dierberg K., Tapson V., Hsieh L., Patterson T.F., Paredes R., Sweeney D.A., Short W.R., Touloumi G., Lye D.C., Ohmagari N., Oh M.D., Ruiz-Palacios G.M., Benfield T., Fätkenheuer G., Kortepeter M.G., Atmar R.L., Creech C.B., Lundgren J., Babiker A.G., Pett S., Neaton J.D., Burgess T.H., Bonnett T., Green M., Makowski M., Osinusi A., Nayak S., Lane H.C., ACTT-1 Study Group Members Remdesivir for the treatment of covid-19 -final report. N. Engl. J. Med. 2020;383:1813–1826. - PMC - PubMed
    1. Chang X.J., Zhang S., Chen J., Chen C.M., Zhou J., Wang Z.Z., Xiao W. Effect of reduning injection on acute lung injury of rats. Chin. J. Exp. Tradit. Med. Formulae. 2014;22:172–175.
    1. Channappanavar R., Perlman S. Pathogenic human coronavirus infections: causes and consequences of cytokine storm and immunopathology. Semin. Immunopathol. 2017;39:529–539. - PMC - PubMed
    1. Chen J., Chang X.J., Chen C.M., Lu Y.Z., Zhou J., Wang Z.Z., Xiao W. Study on analgesic and antipyretics effect of re-du-ning injection. Modernization Tradit. Chin. Med. Materia Medica-World Sci. Technol. 2014;9:1912–1915.

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