AYUSH-64 as an adjunct to standard care in asymptomatic, mild, and moderate COVID-19: A systematic review and meta-analysis

Abstract

The study was planned to systematically review the available evidence from randomized controlled trials on the efficacy and safety of AYUSH-64 in managing COVID-19. Electronic databases such as PubMed, Ayush Research Portal, DHARA, Cochrane CENTRAL, etc. were searched from December 2019 to October 2021, and updated in February 2022. The risk of bias was assessed through the RoB2 tool. Meta-analysis was done with the Review Manager 5.4 tool. The quality of cumulative evidence was evaluated through the GRADE approach. This study includes five RCTs with 420 participants. The risk of bias was assessed as low for most of the studies. The results demonstrated that AYUSH-64 administration as an adjunct to standard care was significantly better compared to standard care alone for asymptomatic, mild, and moderate COVID-19 in terms of clinical recovery (OR= 2.35; 95% CI= 1.33 to 4.16; p=0.003), and mean time to clinical recovery (SMD= -0.67; 95% CI= -1.16 to -0.18; p=0.007). There was no statistically significant difference between groups in SARS-CoV-2 clearance assessed by RT-PCR assay (OR= 1.21; 95% CI= 0.51 to 2.88; p=0.66). The overall incidence of adverse events showed no significant difference between groups (p=0.65). The quality of evidence was assessed as moderate for clinical recovery and low for SARS-CoV-2 clearance. Meta-analysis of five RCTs demonstrated that AYUSH-64 as an adjunct to standard care hastens clinical recovery and is safe in asymptomatic, mild, and moderate COVID-19. However, more robust RCTs would be required to generalize the results of this systematic review.