ERAVIRAL: Action of the ingredients from published studies

Vitamine D

The supply of Vitamin D is important for the defense functions against the replication of respiratory  virus.
The most recent clinical and epidemiological studies show that low blood values of Vitamin D are associated with the respiratory viral infections. Appropriate plasma values of Vitamin D are important, regardless of the age, to promote an increased resistance against Coronavirus (COVID-19 and influence virus), to reduce the risk of infection and the symptomatology.

Beard JA et al. Vitamin D and the antiviral state. J Clin Virol 50: 194–200, 2011.

Cannell JJ et al. Epidemic influenza and vitamin D. Epidemiol Infect 356:1129-4, 2006.

Castillo ME et al. Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot randomized clinical study. J. Steroid Biochem Mol Bio 203, 105751, 2020.

D'Avolio A et al. 25-hydroxyvitamin D concentrations are lower in patients with positive PCR for SARS-CoV-2.  Nutrients 12:1359, 2020. 

Grant WB et al. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19, Infections and Deaths. Nutrients 12: 1359, 2020.

Greiller CL et al. Modulation of the immune response to respiratory viruses by vitamin D. Nutrients 356:4240-70, 2015.

Ilie PC et al. The role of vitamin D in the prevention of Coronavirus disease: 2019 infection and mortality. Aging Clin. Exp. Res. 32: 1195–1198, 2020.

Jolliffe DA et al. Vitamin D in the prevention of acute respiratory infection: systematic review of clinical studies. Steroid Biochem Mol Biol 356:321-9, 2013. 

Laird E et al. Vitamin D and inflammation: potential implications for severity of COVID-19. Ir Med J. 81: 113: 81, 2020.

Mansur JL et al. Vitamin D high doses supplementation could represent a promising alternative to prevent or treat COVID-19 infection. Clin Investig Arterioscler.  29;S0214-9168(20)30048-6.doi:10.1016.

Martineau AR et al. Vitamin D for COVID-19: a case to answer ?  Lancet Diabetes and Endocrinol. 8: 735.736, 2020.

Martineau AR al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ 356, 2017.

Meltzer D et al.  Association of Vitamin D Status and Other Clinical Characteristics with COVID-19: Test Results. Jama Network Open 9, 2020.

Merzon E et al. Low plasma 25(OH) vitamin D level is associated with increased risk of COVID-19 infection: an Israelian population-based study. Med Rxiv. 2020; doi.org/10.1101/2020.07.01.20144329

Panagiotou G et al. Low serum 25-hydroxyvitamin D (25[OH]D) levels in patients hospitalised with COVID-19 are associated with greater disease severity. Clin Endocrinol 2020. doi.org/10.1111/cen.14276 

Pereira M et al. Vitamin D deficiency aggravates COVID-19: systematic review and meta-analysis. Crit Rev Food Sci Nutr. 4;1-9, 2020.

Zemb P et al. Vitamin D deficiency and the COVID-19 pandemic. J Glob Antimicrob Resist. S22:133-134, 2020.

Pelargonium Sidoides

Pelargonium sidoides root extract named "Pelagon P70" is approved by EMA (Medicines European Agency) as Traditional Herbal Medicinal Product for the treatment of respiratory infections. The active ingredients of the extract show indirect antiviral and antibacterial activity by stimulating non-antigen-specific immune defenses and with anti-adhesive viral action, muco-ciliary and secretion cellular activity. The extract is a phytotherapic drug for viral or bacterial respiratory infections. The action of the extract and its benefits have been demonstrated with clinical trials on thousands of subjects:

• Direct antiviral action: against Coronavirus (H1N1 and H2N3 influence virus, Sars-Cov-2, parainfluenza 3), cocksackie A9, herpes simplex (HSV-1 and HSV-2). The extract would prevent the attachment and infiltration virus into the cells of the respiratory mucosa. There is also evidence of bacteriostatic action against respiratory pathogens, including multi-drug resistant Staphylococcus  aureus strains. This direct action plays a synergistic role with the indirect action

• Indirect antiviral action: the extract supports the respiratory burst and the production of cytotoxic NO

• Anti-adhesive action: the viral inhibition depends on the interception of the extract with the superficial adhesion proteins of the infecting microorganism

• Secretion-motor action: the extract stimulates motility and muco-ciliary clearance of the respiratory epithelium responsible for expelling the pathogens.

Agbabiaka TB et al. Pelargonium sidoides for acute bronchitis: A systematic review and meta‐analysis. Phytomed. International J. Phytother. Phytopharmacol 15, 378–385, 2008.

Ahmad A. et al.  An alternative approach to minimize the risk of coronavirus (Covid-19) and similar infections. European Review Med. Pharmacol Sciences 24: 4030-4034, 2020.

Brendlera T et al. A historical, scientific and commercial perspective on the medicinal use of Pelargonium sidoides (Geraniaceae). J.  Ethnopharmacol. 119: 420-433, 2008.

International Drug Directory – Pelargonium sidoides – Edited by the Swiss Pharmaceutical Society. 2015. Medpharm Scientific Publishers, Stuttgart, Germany Licensed through Wissenschaftliche Verlagsgesellschaft mbH, Stuttgart, Germany.

Kolodziej H. Antimicrobial, Antiviral and Immunomodulatory Activity Studies of Pelargonium sidoides (EPs® 7630) in the Context of Health Promotion. Pharmaceuticals 4: 1295-1314, 2013.

Luna LA Jr et al. Immune responses induced by Pelargonium sidoides extract in serum and nasal mucosa of athletes after exhaustive exercise: modulation of secretory IgA, IL-6 and IL-15. Phytomed 18:303-8, 2011.

Matthys, H., Lizogub, V.G., Malek, F.A. & Kieser, M. Efficacy and tolerability of EPs 7630 tablets in patients with acute bronchitis: a randomised, doubleblind, placebo-controlled dose finding study with a herbal drug preparation from Pelargonium sidoides. Current Medical Research and Opinion. 26: 1413-14, 2010.

Michaelis M et al. Investigation of the influence of EPs® 7630, a herbal drug preparation from pelargonium sidoides, on replication of a broad panel of respiratory viruses. Phytomed International J of Phytother and Phytopharmacology 18: 384– 386, 2011.

Schnitzler P et al. Efficacy of an aqueous Pelargonium sidoides extract against herpesvirus. Phytomed 15:1108-16.

GLYCYRIZZINE

Glycyrizzine is the principle present in the extract obtained from the Liquorice root (Glyciriza glabra). It has been and still is very much studied for its well-known antiviral action. It is also widely used for the same purpose by the Traditional Chinese Medicine.

Anagha K et al. Scope of Glycyrrhiza glabra as an Antiviral agent: A Review. Int. J .Curr. Microbiol. App .Sci 3: 657-665, 2014.

Ashfaq UA et al. Glycyrrhizin as antiviral agent against Hepatitis C Virus. J Transl Med 9: 112, 2011.

Bailly C et al. Glycyrrhizin: An alternative drug for the treatment of COVID-19 infection and the associated respiratory syndrome ? Pharmacol Ther.

Baltina LA et al. Glycyrrhizic acid derivatives as influenza A/H1N1 virus inhibitors. Bioorg. Med. Chem. Letters 25: 1742-1746, 2015.

Chrzanowski J et al. Glycyrrhizin: An old weapon against a novel coronavirus. Phytother. Res.

Cinatl J et al. Glycyrrhizin, an active component of liquorice roots, and replication of SARS-associated coronavirus. Lancet 361:2045-6, 2020.

Feng YC et al. Water extract of licorice had anti-viral activity against human respiratory syncytial virus in human respiratory tract cell lines. J Ethnopharmacol. 148: 466–473. 2013.

Hoever G et al.  Antiviral activity of glycyrrhizic acid derivatives against SARS-coronavirus. J Med Chem. 48:1256-9, 2005.

Kao TC et al. Bioactivity and potential health benefits of licorice. J Agric Food Chem 62: 542-53, 2014.

Murck H. Symptomatic Protective Action of Glycyrrhizin (Licorice) in COVID-19 Infection ? Front Immunol 11: 1239, 2020. 

Pan L. et al. Pharmacological perspective: glycyrrhizin may be an efficacious therapeutic agent for COVID-19. Int J Antimicrob Agents 55: 105995, 2020. Virus Particles. Nature 281: 689-90, 1979.

Wolkerstorfer A et al. Glycyrrhizin inhibits influenza A virus uptake into the cell. Antiviral Res 83: 171-8, 2009.