By Christina Sun
On January 31st, 2020, a state-run Xinhua News agency reported that Shuanghuanglian (SHL), an oral liquid made of herbal remedy, could inhibit the deadly Coronavirus. Two institutes, Shanghai Institute of Materia Medica and Wuhan Institute of Virology are the source of this discovery. “SHL: a potential cure of Coronavirus” and similar titles have since then flooded Chinese social media and have reached over 10 million hits within a day.
Shuang-Huang-Lian, is a popular OTC commonly used to relieve symptoms of fever, cough and sore throat. It is a modern antimicrobial formulation containing alcohol-water extracts of three herbs (Lonicerae Japonicae Flos, Scutellariae Radix, and Fructus Forsythiae). It is recorded in the Chinese Pharmacopoeia and is approved for production by the Chinese Food and Drug Administration (CFDA) in 1970s. Oral preparations are easily purchased at pharmacies as well as online shopping sites. Intravenous SHL has been widely used in China to treat respiratory infection when an oral preparation is ineffective. Despite its benefits and popularity, IV-SHL has been recorded to induce severe immediate Type I hypersensitivity reactions, though at a very low frequency[2-4,6]. Therefore, the CFDA has raised an alarm regarding this potentially life-threatening outcome .
The panic buying of SHL triggered overnight inevitably makes us take a step back and question how much is known about the effects of SHL on coronavirus. People’s Daily, news agency led by the Communist Party soon clarified after the report came out that “inhibiting does not equal preventing and treating”.
What exactly are the evidences so far? Not much, according to interviews with personnel from the two source institutes. The institute confirmed that a preliminary, in-vitro experiment at the Virology Institute of Wuhan has shown “suppressive” effects of SHL on the coronavirus but refused to comment on whether there are benefits taking OTC SHL on the prevention and treatment of Coronavirus. It is clear from the interview that no clinical data is available so far. With what we know currently, any benefits from taking oral SHL against Coronavirus are at best psychological.
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- Long, X. W. & Ma, J. X. Clinical analysis of Shuanghuanglian injection-induced allergic reaction (64 cases). Chinese Journal of Information on Traditional Chinese Medicine 15, 112 (2008).
- National drug adverse reaction monitoring center. Information bulletin of adverse drug reaction (No. 22)–warning the severe adverse reactions induced by levofloxacin and Shuanghuanglian injection. China Food and Drug Administration Web. http://www.sda.gov.cn/WS01/CL0078/38014_1.html(2009).
- Gao, Y., Hou, R., Han, Y. et al. Shuang-Huang-Lian injection induces an immediate hypersensitivity reaction via C5a but not IgE. Sci Rep 8, 3572 (2018).