The Effect of Barley Aqueous Extract on Clinical Signs of COVID-19: An Open-Labeled Randomized Clinical Trial
Abstract
Coronavirus has spread around the world with high prevalence rate and severe manifestations since 2019 (COVID-19) and imposed global economic, social, and health burden. Many studies were conducted to manage the complications of COVID-19 and to reduce the hospital stay but results were not satisfactory. Hence, according to the high potential of medicinal plants in management of diseases, we aimed to investigate the effects of barley aqueous extract (BAE) on clinical and laboratory features of COVID-19 in hospitalized patients. This study was an open-labeled, randomized, controlled clinical trial performed on 80 hospitalized COVID-19 patients in COVID-19 medical center, Isfahan, Iran, from July to August 2021. All patients received a same standard treatment according to the protocol of the Iranian Ministry of Health and BAE was added to the treatment of intervention group. Patients received BAE 200 mL every 4 hours for 5 days. Seventy-two patients completed the study and no significant differences were reported in the baseline data between groups. Results showed significant improvement of shortness of breath (p=0.012) and cough (p=0.09) after receiving BAE, compared to the control group. On the other hand, there was no significant difference between groups considering body temperature, respiratory rate, oxygen saturation, muscle pain, and laboratory factors. No serious adverse effect was reported. This study suggests that BAE may serve as a safe complementary treatment for alleviating symptoms of COVID-19; however, more clinical trials with higher sample size are needed.
Zhu N, Zhang D, Wang W, Li X, Yang B, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med 2020;382:727-733.
Valcheva KS. Health Prevention and Response Policies Against Infectious Diseases: Is the World Ready for a Novel Coronavirus Pandemic. Proceedings Book. 2020; p 138.
Sohrabi C, Alsafi Z, O'Neill N, Khan M, Kerwan A, et al. World health organization declares global emergency: a review of the 2019 novel coronavirus (COVID-19). Int J Surg 2020;76:71-76.
Nicholls JM, Poon LL, Lee KC, Ng WF, Lai ST, et al. Lung pathology of fatal severe acute respiratory syndrome. Lancet 2003;361:1773-1778.
Namburi US, Jadhav S, Kumar S, Hadole S. COVID-19: An applied intervention through ayurveda. IJAPR 2020;6:23-34.
Jorjani SE. Zakhireye Kharazmshahi. Sefir Ardehal 2018.
Khan MA. Exir Azam [Great Elixir]. Iranian Teb 2019.
Avicenna. Al Qanoun fe Al teb. Al elmy al matbouat Institute 2005.
Khorasani MH. Makhzan-al-advia (Persian). Safir Ardehal 2018.
Ibn Nafis A. Alshamel fi Sana’at Tebbi’at. Institute for Medical History Studies. 2008.
Razi M. Al-Hawi. Mashhad University of Medical Sciences. 2008.
Zeng Y, Pu X, Yang J, Du J, Yang X, et al. Preventive and therapeutic role of functional ingredients of barley grass for chronic diseases in human beings. Oxid Med Cell Longev 2018;2018:3232080.
Choi J, Kim J, Min DY, Jung E, Lim Y, et al., Inhibition of TNFα-induced interleukin-6 gene expression by barley (Hordeum vulgare) ethanol extract in BV-2 microglia. Genes Genomics 2019;41:557-566.
Faghfoori Z, Navai L, Shakerhosseini R, Somi MH, Nikniaz Z, et al. Effects of an oral supplementation of germinated barley foodstuff on serum tumour necrosis factor-α, interleukin-6 and-8 in patients with ulcerative colitis. Ann Clin Biochem 2011;48:233-237.
Choi KC, Hwang JM, Bang SJ, Son YO, Kim BT, et al. Methanol extract of the aerial parts of barley (Hordeum vulgare) suppresses lipopolysaccharide-induced inflammatory responses in vitro and in vivo. Pharm Biol 2013;51:1066-1076.
Liao Z, Cai H, Xu Z, Wang J, Qiu C, et al. Protective role of antioxidant huskless barley extracts on TNF-α-induced endothelial dysfunction in human vascular endothelial cells. Oxid Med Cell Longev. 2018;2018:3846029.
Iguchi T, Kawata A, Watanabe T, Mazumder T K, Tanabe S. Fermented barley extract suppresses the development of atopic dermatitis-like skin lesions in NC/Nga mice, probably by inhibiting inflammatory cytokines. Biosci Biotechnol Biochem 2009;73:489-493.
Hasheminasab FS, Azimi M, Khodadoost M, Chouban B, Shakeri N, et al. Efficacy of the barley-based remedy, a Persian medicine formula, in coronavirus disease 2019 (COVID-19) hospitalized patients: An open-labeled randomized controlled trial. Adv Integr Med 2022;9:185-190.
Azimi M, Hasheminasab FS, Chooban B, Shakeri N, Ghasemi S, et al. The efficacy of hot footbath in hospitalized COVID-19 patients: an open-label randomized controlled trial. Tradit Integr Med 2022;7:294-301.
Nguyen NT, Chinn J, De Ferrante M, Kirby KA, Hohmann SF, et al. Male gender is a predictor of higher mortality in hospitalized adults with COVID-19. PLoS One 2021;16:e0254066.
Tavakoli A, Molavi Vardanjani H, Namjouyan F, Cramer H, Pasalar M. Efficacy of persian barley water on clinical outcomes of hospitalized moderate-severity COVID-19 patients: a single-blind, add-on therapy, randomized controlled clinical trial. Eur Rev Med Pharmacol Sci 2022;26:1033-1041.
Derakhshan A, Khodadoost M, Ghanei M, Gachkar L, Hajimahdipour H, et al. Effects of a novel barley-based formulation on allergic rhinitis: A randomized controlled trial. Endocr Metab Immune Disord Drug Targets 2019;19:1224-1231.
Wong RS. Inflammation in COVID-19: from pathogenesis to treatment. Int J Clin Exp Pathol 2021; 14:831.
Cheng J, Zhang G, Liu L, Luo J, Peng X. Anti‐inflammatory activity of β‐glucans from different sources before and after fermentation by fecal bacteria in vitro. Journal of the Science of Food and Agriculture. J Sci Food Agric 2024;104:1116-1131.
| Issue | Vol 10, No 4, 2025 -In Press- | |
| Section | Research Article(s) | |
| Keywords | ||
| Covid-19 Persian medicine Phytotherapy Medicinal Plants Hordeum | ||
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