Role of Herbal Immunomodulator (Viranorm) as Add-on Treatment in Asymptomatic or Mildly Symptomatic COVID-19 Confirmed Cases

Abstract

Background: Coronavirus disease 2019 (COVID-19) is a highly infectious disease known to be caused by severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2). Boosting the immune system seems to be a judicious strategy to combat
the coronavirus infection. Objective: The primary objective of this study was to compare the efficacy and safety of Viranorm +
standard of care with standard care alone in the prevention of disease progression in asymptomatic or mildly symptomatic
COVID-19 infection. Secondary objective was to compare the immunological response of Viranorm + standard of care with
standard care alone in asymptomatic or mildly symptomatic COVID-19 infection. Results: Of the 251 randomized subjects,
a total of 123 received Viranorm + standard of care and 128 received standard of care alone. After administration of study
treatment, on visit 1, follow-up was done on Days 3, 7, 14 and 21. The patients treated with Viranorm + standard of care
showed significantly lesser time to resolution of cough than the patients with standard of care alone. At Day 7 and Day 14,
the reverse transcription polymerase chain reaction (RT-PCR) results were available for only few patients. Therefore, no firm
conclusions can be drawn on the effect of the drug on the incidence of RT-PCR negative subjects. All subjects from both
treatment groups reported recovery and no deaths occurred during the study. At Day 14, neutrophil-to-lymphocyte ratio
(NLR) values decreased in both treatment groups. The magnitude of decrease in NLR was substantially higher in the group
that received Viranorm as an add-on treatment (8% median decrease) compared to the group that received only standard
of care (2.6% median decrease). No adverse events or deaths occurred during the entire study duration. Conclusion: The
add-on treatment with herbal immunomodulator Viranorm for COVID-19 is safe and effective in reducing the duration of
cough and is indicative of a significant decrease in systemic inflammation as shown by NLR.