{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T19:44:20Z","timestamp":1791056660591,"version":"4.1.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004704","name":"National Research Council of Thailand","doi-asserted-by":"publisher","award":["N41A650097"],"award-info":[{"award-number":["N41A650097"]}],"id":[{"id":"10.13039\/501100004704","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004944","name":"Naresuan University","doi-asserted-by":"publisher","award":["R2566C053"],"award-info":[{"award-number":["R2566C053"]}],"id":[{"id":"10.13039\/501100004944","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100014795","name":"Center of Excellence for Innovation in Chemistry","doi-asserted-by":"publisher","award":["NUPSD64\/64-001"],"award-info":[{"award-number":["NUPSD64\/64-001"]}],"id":[{"id":"10.13039\/501100014795","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p>\n                    The COVID-19 pandemic created a global health crisis, with limited effective treatments.\n                    <jats:italic>Andrographis paniculata<\/jats:italic>\n                    (Burm. f.) Nees (AP), with known anti-inflammatory and antiviral properties, has been explored as adjunctive therapy for COVID-19, but its clinical evidence remains inconclusive. We hypothesized that AP-derived compounds may improve symptoms and inflammatory responses in mild-to-moderate COVID-19. This systematic review and meta-analysis aimed to evaluate the clinical and biological effects of AP-derived compounds, its extract (APE), or its derivatives in patients with mild-to-moderate COVID-19. A systematic search was conducted in PubMed, EMBASE, CENTRAL, and EBSCO Open Dissertations from January 2020 to October 2024. Randomized controlled trials (RCTs) examining the effects of single-herb AP products compared to antivirals or supportive care (SC) in patients with mild-to-moderate COVID-19 were included if they reported clinical recovery, fever or cough resolution, C-reactive protein (CRP), or interleukin-6 (IL-6) levels. Risk of bias (RoB) was assessed using Cochrane RoB 2.0. A random-effects model was used to estimate pooled effects of included trials, expressed as relative risk (RR) and mean difference (MD) with 95% confidence intervals (CIs). Six RCTs involving 660 adults aged 18 to 60 were included. Compared to antivirals or SC, single-herb AP products showed no significant improvements in fever resolution (RR 1.12; 95%CI 0.90 to 1.38; I\n                    <jats:sup>2<\/jats:sup>\n                    = 0.0%) or cough resolution (RR 0.98; 95%CI 0.74 to 1.31; I\n                    <jats:sup>2<\/jats:sup>\n                    = 47.0%). No significant differences were observed in serum CRP (MD -0.04; 95%CI -0.26 to 0.18; I\n                    <jats:sup>2<\/jats:sup>\n                    = 0.0%) and IL-6 levels (MD -0.07; 95%CI -0.17 to 0.03; I\n                    <jats:sup>2<\/jats:sup>\n                    = 0.0%). While some studies not included in the meta-analysis suggested early reductions in CRP and IL-6, the findings were inconsistent. RoB was high for fever resolution but low for biomarkers. Mild adverse events, primarily liver enzyme elevations, resolved without severe complications. Our systematic review and meta-analysis suggest a potential role for AP extract and its derivatives as adjunctive therapy for COVID-19, with trends indicating possible benefits in symptom improvement and inflammation reduction. These findings highlight the need for further research to explore AP as a complementary therapeutic strategy in COVID-19 management.\n                  <\/jats:p>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD42024608858<\/jats:ext-link>\n                      , identifier CRD42024608858.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2025.1598255","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T07:32:34Z","timestamp":1753947154000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["Exploring the clinical effects of Andrographis paniculata-derived compounds, its extract, or derivatives for the treatment of COVID-19: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"16","author":[{"given":"Peerapong","family":"Prabhakornritta","sequence":"first","affiliation":[{"name":"Cosmetics and Natural Products Research Center (CosNat), Faculty of Pharmaceutical Sciences, Naresuan University","place":["Phitsanulok, Thailand"]},{"name":"Department of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences and Center of Excellence for Innovation in Chemistry, Naresuan University","place":["Phitsanulok, Thailand"]},{"name":"Universit\u00e9 Marie et Louis Pasteur, EFS, INSERM UMR1098 RIGHT","place":["Besan\u00e7on, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neti","family":"Waranuch","sequence":"additional","affiliation":[{"name":"Cosmetics and Natural Products Research Center (CosNat), Faculty of Pharmaceutical Sciences, Naresuan University","place":["Phitsanulok, Thailand"]},{"name":"Department of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences and Center of Excellence 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Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cindy","family":"Barnig","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Marie et Louis Pasteur, EFS, INSERM UMR1098 RIGHT","place":["Besan\u00e7on, France"]},{"name":"Department of Chest Diseases, University Hospital of Besan\u00e7on","place":["Besan\u00e7on, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siwaporn","family":"Boonyasuppayakorn","sequence":"additional","affiliation":[{"name":"Center of Excellence in Applied Medical Virology, Department of Microbiology, Faculty of Medicine, Chulalongkorn University","place":["Bangkok, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tasana","family":"Pitaksuteepong","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences and Center of Excellence for Innovation in Chemistry, Naresuan University","place":["Phitsanulok, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Parvapan","family":"Bhattarakosol","sequence":"additional","affiliation":[{"name":"Center of Excellence in Applied Medical Virology, Department of Microbiology, Faculty of Medicine, Chulalongkorn University","place":["Bangkok, Thailand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brice","family":"Moulari","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Marie et Louis Pasteur, EFS, INSERM UMR1098 RIGHT","place":["Besan\u00e7on, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yann","family":"Pellequer","sequence":"additional","affiliation":[{"name":"Universit\u00e9 Marie et Louis Pasteur, EFS, INSERM UMR1098 RIGHT","place":["Besan\u00e7on, France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teerapon","family":"Dhippayom","sequence":"additional","affiliation":[{"name":"The Research Unit of Evidence Synthesis (TRUES), Faculty of 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