Assessing the potential of Artemisia annua in the fight against COVID-19

Artemisia and Coronavirus

Scientific justification for research

Document presenting the scientific arguments justifying the implementation of clinical trials of Artemisia annua in the context of the fight against CoVid-19

Artemisia and Coronavirus

Assessing the potential of Artemisia annua in the fight against COVID-19

Scientific justification for research

Scientific justification for research

Dr Catherine Poisson-Benatouil
Anesthesiologist - Intensive Care Physician, Maison de l’Artemisia Pointe-Noire, Republic of Congo
Contact :

Jean-Luc Galabert
Consultant, Design and project management office Inter-Culturel, Nyamata, Rwanda
Contact :


During the course of infection with SARS-CoV-2, which is a highly contagious respiratory disease, 14% of patients will develop severe illness requiring hospitalization and oxygenation and 5% will be transferred to intensive care. The mortality rate varies from country to country and is related to the availability of screening and medical facilities in the country. There is an urgent need for treatments that could be effective from the onset of symptoms in order to avoid transferring patients to intensive care where the mortality rate is very high. SARS-CoV-2 belongs to the betacoronavirus family. The virus enters the body’s host cells where the two receptors ACE2 (angiotensin-converting enzyme 2) and serine protease (TMPRSS2) are found together.

After initial viral penetration, via TMPRSS2 which triggers activation of the ACE2 receptor, the virus enters the cell and then, during its maturation and intracytoplasmic penetration, it expresses CyPA (Cyclophillin A). This triggers the extra-membrane expression of basigin or CD147 or EMMPRIN and its intracytoplasmic activation. CD147 acts intra- and extra-membrane with many proteins. A third molecule, serine/threonine kinase (PAK1), whose expression is proportional to that of the activation of the ACE2 receptor, participates in the viral pathological process.

The activation of these molecules, which act outside and inside the cell, is at the origin of a cytokine storm and amplification of the body’s inflammatory reaction via intense chemotactic activity leading to the activity and circulation of leukocytes and macrophages and finally an induction of metalloproteases (MMP) whose inhibitors are submerged in this pathological state. In addition, there is a sideration of the lymphocyte

All clinical signs resulting from this uncontrolled post-invasive inflammatory reaction and activation of metalloproteases appear in the patient after a few days and are responsible for acute respiratory distress and its consequences. At the same time, with the receptors activated, viral replication continues.

Artemisia annua has known antiviral action against human cytomegalovirus, herpes simplex virus type 1, Epstein Barr virus, hepatitis C virus, dengue fever virus, and some strains of HIV-1. Furthermore, it was successfully tested during the SARS-CoV epidemic in 2003 in patients receiving traditional Chinese medicine as a complement to conventional medicine.

In this context, compounds of Artemisia annua are likely to induce a decrease in the expression of the ACE2 and TMPRSS2 proteins via alteration of the androgen pathway as well as the CD147 protein. The biomolecules of Artemisia annua are also inhibitors of metalloproteases and PAK1. By targeting these 5 membrane or intracytoplasmic proteins that are key to the entry and invasion of SARS-CoV-2 into host cells, Artemisia annua may slow the development of infection in the human body and thus slow the worsening of symptoms of COVID-19. We propose to test the efficacy and safety of Artemisia annua decoction administered for 14 days to patients infected with mild to moderate forms of SARS-CoV-2 in a phase II randomized controlled trial (standard of care) to be conducted in an open-label setting.

Due to cultural habits, African populations often resort to traditional plant-based pharmacopoeia. This appears to be an essential and pertinent therapeutic approach as and when conditions for monitoring practices validate its efficacy and safety. Validation of the anti-viral, immunomodulating and immunostimulating potential of Artemisia annua in the specific case of COVID-19 would make it possible to propose a standardized “improved traditional medicine” in Africa, whose raw material can be cultivated locally and made available at a lower cost, thanks to its capacity to stop the pathological cycle of SARS-CoV-2.
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