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      Possible Therapeutic Effects of Adjuvant Quercetin Supplementation Against Early-Stage COVID-19 Infection: A Prospective, Randomized, Controlled, and Open-Label Study

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          Abstract

          <div class="section"> <a class="named-anchor" id="s2001"> <!-- named anchor --> </a> <h5 class="section-title" id="d10624837e469">Background</h5> <p id="d10624837e471">Quercetin, a well-known naturally occurring polyphenol, has recently been shown by molecular docking, in vitro and in vivo studies to be a possible anti-COVID-19 candidate. Quercetin has strong antioxidant, anti-inflammatory, immunomodulatory, and antiviral properties, and it is characterized by a very high safety profile, exerted in animals and in humans. Like most other polyphenols, quercetin shows a very low rate of oral absorption and its clinical use is considered by most of modest utility. Quercetin in a delivery-food grade system with sunflower phospholipids (Quercetin Phytosome <sup>®</sup>, QP) increases its oral absorption up to 20-fold. </p> </div><div class="section"> <a class="named-anchor" id="s2002"> <!-- named anchor --> </a> <h5 class="section-title" id="d10624837e477">Methods</h5> <p id="d10624837e479">In the present prospective, randomized, controlled, and open-label study, a daily dose of 1000 mg of QP was investigated for 30 days in 152 COVID-19 outpatients to disclose its adjuvant effect in treating the early symptoms and in preventing the severe outcomes of the disease. </p> </div><div class="section"> <a class="named-anchor" id="s2003"> <!-- named anchor --> </a> <h5 class="section-title" id="d10624837e482">Results</h5> <p id="d10624837e484">The results revealed a reduction in frequency and length of hospitalization, in need of non-invasive oxygen therapy, in progression to intensive care units and in number of deaths. The results also confirmed the very high safety profile of quercetin and suggested possible anti-fatigue and pro-appetite properties. </p> </div><div class="section"> <a class="named-anchor" id="s2004"> <!-- named anchor --> </a> <h5 class="section-title" id="d10624837e487">Conclusion</h5> <p id="d10624837e489">QP is a safe agent and in combination with standard care, when used in early stage of viral infection, could aid in improving the early symptoms and help in preventing the severity of COVID-19 disease. It is suggested that a double-blind, placebo-controlled study should be urgently carried out to confirm the results of our study. </p> </div>

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          Overviews of Biological Importance of Quercetin: A Bioactive Flavonoid

          Antioxidants are substances that may protect cells from the damage caused by unstable molecules such as free radicals. Flavonoids are phenolic substances widely found in fruits and vegetables. The previous studies showed that the ingestion of flavonoids reduces the risk of cardiovascular diseases, metabolic disorders, and certain types of cancer. These effects are due to the physiological activity of flavonoids in the reduction of oxidative stress, inhibiting low-density lipoproteins oxidation and platelet aggregation, and acting as vasodilators in blood vessels. Free radicals are constantly generated resulting in extensive damage to tissues leading to various disease conditions such as cancer, Alzheimer's, renal diseases, cardiac abnormalities, etc., Medicinal plants with antioxidant properties play a vital functions in exhibiting beneficial effects and employed as an alternative source of medicine to mitigate the disease associated with oxidative stress. Flavonoids have existed over one billion years and possess wide spectrum of biological activities that might be able to influence processes which are dysregulated in a disease. Quercetin, a plant pigment is a potent antioxidant flavonoid and more specifically a flavonol, found mostly in onions, grapes, berries, cherries, broccoli, and citrus fruits. It is a versatile antioxidant known to possess protective abilities against tissue injury induced by various drug toxicities.
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            Antioxidant Activities of Quercetin and Its Complexes for Medicinal Application

            Quercetin is a bioactive compound that is widely used in botanical medicine and traditional Chinese medicine due to its potent antioxidant activity. In recent years, antioxidant activities of quercetin have been studied extensively, including its effects on glutathione (GSH), enzymatic activity, signal transduction pathways, and reactive oxygen species (ROS) caused by environmental and toxicological factors. Chemical studies on quercetin have mainly focused on the antioxidant activity of its metal ion complexes and complex ions. In this review, we highlight the recent advances in the antioxidant activities, chemical research, and medicinal application of quercetin.
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              Candidate drugs against SARS-CoV-2 and COVID-19

              Graphical abstract Coronavirus SARS-CoV-2 enters host cells via ligation of its spike protein (S glycoprotein) with host cell ACE2 receptor that is primed by TMPRSS2 protease. ACE2- and TMPRSS2-mediated cell entry can be blocked by experimental and established drugs. Virus replication and assembly can be inhibited by antiviral drugs targeting viral RNA-dependent RNA polymerase (RdRP) and main protease (Mpro).
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                Author and article information

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                Journal
                International Journal of General Medicine
                IJGM
                Informa UK Limited
                1178-7074
                2021
                June 2021
                : Volume 14
                : 2359-2366
                Article
                10.2147/IJGM.S318720
                59a76a4e-438f-4be6-848c-a9c9433bb204
                © 2021

                http://creativecommons.org/licenses/by-nc/3.0/

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