Does cannabidiol help with COVID-19?

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SARS-CoV-2 infection, which causes COVID-19, has resulted in more than 6.4 million deaths worldwide to date. Cannabidiol (CBD) has been shown in a new study published in the journal Cannabis and Cannabinoid Research to be effective in treating COVID-19’s inflammatory symptoms. COVID-19 could be halted or slowed down with this technique, which could lessen the disease’s severity and fatality rate.

Introduction

COVID-19 is associated with a wide range of symptoms, some mild and others potentially life-threatening. SARS-CoV-2-induced hyper-inflammation is assumed to be the cause of the severe symptoms that affect several organ systems. A wide range of medications can reduce COVID-19 severity.

A strong corticosteroid, Remdesivir, a nucleoside analog, hydrochloroquine, convalescent plasma with specific antibodies to the virus, and SARS-CoV-2 monoclonal antibodies are all included. For this specific patient group, only dexamethasone has shown a definite improvement. Notably, this steroid has not been tested for its ability to treat COVID-19 in its early stages.

Remdesivir, on the other hand, is only appropriate for usage in hospitalized patients undergoing a lengthy treatment regimen that necessitates intravenous administration. Immunomodulators can also affect the entire body. At this time, monoclonal antibodies can be used to treat patients who have early-stage disease but are at high risk of acquiring severe COVID-19 symptoms.

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Molnupiravir and Paxlovid received emergency use permission (EUA) for the treatment of COVID-19-positive patients. They are only acceptable for patients who have not received any other treatment for severe COVID-19 and are experiencing early symptoms. Efforts to find safe and effective early therapies for COVID-19 have encouraged research into potential new medications.

The endocannabinoid CB1 and CB2 receptors in the brain, as well as the adenosine A2A receptors, are all affected by CBD. In the human body, these receptors can be found in abundance. For the treatment of a specific type of epilepsy, CBD was approved as an orphan medication in 2018 by the Food and Drug Administration.

CB2 receptors on immune cells in the stomach, lungs, and other immunological organs have been shown to have immunosuppressive and anti-inflammatory effects. However, at large doses, CBD appears to counteract the effects of other cannabis metabolites, notably THC, on the user’s perception of intoxication. In contrast, CBD does not appear to be addictive or habit-forming.

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Unusual behaviors and euphoria are some of the side effects of CBD use. If these side effects persist after long-term usage, further study is needed to evaluate their significance. Studies published between September and December 2020 are included in this review of CBD’s impact on COVID-19-related inflammation and respiratory symptoms.

Findings from research

Three in vitro and five in vivo experiments employing human tissues were included in the analysis based on a total of nine papers. Acute lung inflammation or injury, asthma, and acute respiratory distress syndrome were all studied in the absence of COVID-19 in any of the animal models (ARDS).

Multiple inflammatory cytokines were reported to be decreased by CBD, as were ARDS symptoms. After using CBD, inflammation in the lungs was reduced, as well as protein exudation, inflammatory cytokines, and myeloperoxidase levels. Inflammation in asthmatics was also reduced.

CBD therapy was linked to decreased A2A receptor expression and reduced inflammation in human in vitro tissue models. Lipopolysaccharide, a powerful bacterial inflammation-inducing antigen, causes more inflammatory signaling when administered with dexamethasone than with CBD.

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One human RCT on CBD therapy was also available for those with mild to moderate COVID-19. This means that CBD did not show any improvement over controls in the avoidance of severe disease, symptom reduction, cytokine level reductions, lung damage reduction, hospitalization reduction, or mortality reduction. There were also no differences in the psychological symptoms between the groups.

A single open-label study found a reduction in COVID-19 frontline workers’ burnout and emotional exhaustion following treatment with CBD. However, 10% of the research participants had major adverse events, although they all recovered.

According to a recent study that was not included in this analysis, CBD appears to have an endoplasmic reticulum-mediated effect on SARS-CoV-2 replication. CBD medication was found to reduce the number of patients who tested positive for COVID-19 after looking at data from the National COVID Cohort Collaborative.

Implications

Despite the lack of evidence currently supporting the use of CBD in the treatment of COVID-19, more research is urgently required. In light of the promising anti-inflammatory action reported with this molecule in vitro, these studies should investigate various dose levels of CBD of a specific purity for preventative and therapeutic usage.

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Since COVID-19 treatment now entails the use of various anti-inflammatory and immunomodulatory medicines, it is also necessary to investigate drug interactions. To make matters worse, the anti-inflammatory characteristics of aspirin could impair the immune system, making it more vulnerable to infectious agents like viruses and respiratory illnesses.

“Its anti-inflammatory properties could also be detrimental in suppressing the immune response, which might suppress the ability to fight off infections so that the risk might be higher for viral and respiratory infections.”

Together, the evidence is insufficient to either support or deny the use of CBD in the treatment of COVID-19.

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