Is cannabidiol effective against COVID-19?

The coronavirus disease 2019 (COVID-19), caused by infection with acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused more than 6.4 million deaths to date.

new Cannabis and Cannabinoid Research a journal study discusses the usefulness of cannabidiol (CBD) in treating the inflammatory symptoms of COVID-19. This treatment approach can help contain or reduce the progression of COVID-19, thereby potentially lowering its severity and mortality.

Study: Cannabidiol As Treatment of COVID-19 Symptoms? A Critical Review. Image Credit: r.classen / Shutterstock.com

Study: Cannabidiol As a Treatment for COVID-19 Symptoms? Critical Review. Image Credit: r.classen / Shutterstock.com

introduction

COVID-19 is associated with a wide spectrum of presentations from mild to life-threatening illness. The hyper-inflammatory reaction to SARS-CoV-2 is thought to be responsible for the severe symptoms involving multiple organ systems.

Various drugs have been evaluated for their ability to reduce the severity of COVID-19. These include dexamethasone, a potent corticosteroid with anti-inflammatory and immunosuppressive activity; remdesivir, a nucleoside analogue that inhibits viral replication; hydrochloroquine, immunomodulatory antimalarial drugs, convalescent plasma containing specific antibodies to the virus, and SARS-CoV-2 monoclonal antibodies.

Of these, only dexamethasone showed a marked improvement in outcome for certain patient groups. In particular, this steroid has not been evaluated for its usefulness in treating early COVID-19.

While remdesivir is only useful for hospitalized patients, with a relatively long treatment period that requires parenteral administration. In addition, immunomodulators may have systemic effects.

Monoclonal antibodies are currently approved for use in patients with early disease who are at high risk for severe COVID-19.

Paxlovid and molnupiravir have been granted an emergency use authorization (EUA) for the treatment of high-risk COVID-19 positive patients. This agent is only suitable for those with early symptoms who are not receiving other treatment for severe COVID-19.

The need for safe and effective early intervention has prompted investigations into potentially useful drugs for COVID-19. One of them is CBD, which acts on endocannabinoid CB1 and CB2 receptors in the brain, as well as adenosine A2A receptors. These receptors are widely distributed in the human body.

CBD received approval in 2018 as an orphan drug for the treatment of one form of epilepsy. It is also known to have immunosuppressive and anti-inflammatory effects due to the expression of CB2 receptors in immune cells in the gut, lungs, and immune organs.

CBD in low doses can potentiate poisoning caused by other cannabis metabolites, in particular tetrahydrocannabidiol (THC); However, it seems to counteract these effects at high doses. Importantly, CBD is not known to cause dependence or addiction.

CBD side effects include drowsiness, fever, poor appetite, abnormal behavior, and euphoria. More research is needed to determine the relevance of these side effects after chronic use.

The current review summarizes current knowledge of the effects of CBD on COVID-19-associated inflammation and respiratory symptoms from studies published between September and December 2020.

Study findings

Of the nine papers that were eligible for inclusion in the study, five were: in vivo study and three are in vitro studies using human tissue. No animal models have COVID-19; however, they are used to determine the effect of CBD on acute lung inflammation or injury, asthma, and acute respiratory distress syndrome (ARDS).

CBD has been reported to decrease several inflammatory cytokines and reduce ARDS symptoms. Inflammatory infiltration of the lungs, as well as reduced protein exudation, inflammatory cytokine levels, and myeloperoxidase levels, were observed in response to CBD. Asthma-related inflammation is also reduced.

In in vitro In a human tissue model, CBD treatment was associated with lower A2A receptor expression and reduced inflammation. Compared with dexamethasone, CBD reduces the inflammatory signaling induced by lipopolysaccharide, which is a potent bacterial inflammation-inducing antigen.

A single randomized human clinical trial (RCT) of CBD treatment in patients with mild to moderate COVID-19 is also available. To this end, no significant improvement was reported for CBD compared with controls for severe disease prevention, reduced symptom duration, lower cytokine levels, reduced lung damage, hospitalization, or death. Psychological symptoms also did not differ between groups.

A single open-label trial reported reductions in fatigue and emotional exhaustion following treatment with CBD in frontline COVID-19 workers. However, 10% of study participants reported serious side effects, although all of them recovered completely.

In one recent study not included in the current review, the researchers identified several indications of an inhibitory effect of CBD replication on endoplasmic reticulum-mediated SARS-CoV-2. Data from the National COVID Cohort Collaborative database are cited, which show a lower rate of positive COVID-19 test results with CBD treatment.

Implication

While the current evidence does not support the use of CBD in the treatment of COVID-19, there is still an urgent need for more research to be conducted. It should explore different dosage levels with CBD of particular purity for prophylactic and therapeutic use, given the promising anti-inflammatory activity observed with this molecule. in vitro.

Drug interactions also need to be explored, especially as current COVID-19 treatment involves the use of multiple anti-inflammatory and immunomodulatory drugs.

Its anti-inflammatory properties can also be detrimental in suppressing the immune response, which may suppress the ability to fight infection and so the risk may be higher for viral and respiratory infections..”

Overall, there is insufficient evidence to support or refute CBD in the treatment of COVID-19.

Journal reference:

  • Holst, M. Nowak, D., & Hoch, E. (2022). Cannabidiol As a Treatment for COVID-19 Symptoms? A Critical Review. Cannabis and Cannabidiol Research. doi:10.1089/can.2021.0135.

#cannabidiol #effective #COVID19

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