Artemisia afra and COVID-19, the Media Storm Versus the Current State-of-the-Art

Abstract During the COVID-19 pandemic, the traditional herbal medicine Artemisia afra Jacq. ex Willd., Asteraceae, was widely used as a remedy, and a true media storm erupted in (South) Africa regarding this matter. Throughout the pandemic, A. afra was not only extensively used, but the herb was also exceedingly difficult to find, which is reminiscent of its historical popularity during the influenza pandemic of 1918. This popularity was further fueled by the launch of Covid-Organics in Madagascar, containing Artemisia annua L., which led to international media attention regarding Artemisia as a treatment for COVID-19. In 2020, millions in research funding were made available in South Africa to study promising traditional medicines, including A. afra , and for the development of an effective remedy which was lacking at the time. Due to its popularity and widespread use, this updated overview of A. afra aimed to collate all scientific data on its chemistry, general in vitro and in vivo biological bioactivity, and its antiviral and Sars-Cov-2 activity reported since 2019. Several studies reported good in vitro antiparasitic activity and in vivo antispasmodic activity. However, many studies reported on biological activities that were many orders of magnitude less active than their positive controls. Surprisingly, not a single in vivo study, patent, or (registered) clinical trial could be found regarding A. afra and COVID-19. Only one study, conducted by a German-Danish research group, reported on the in vitro activity of A. afra extracts against Sars-Cov-2. The results indicated that there was relatively weak activity of 0.09 mg/ml ± 0.03 (selectivity index of 26.22), but the context cannot be established due to the absence of a positive control, which did not exist at the time. Artemisia afra is still widely used as a general antiviral remedy, and in-depth research in this field must be conducted. Several promising results regarding antispasmodic and antischistosomal activity should also be further explored. Graphical Abstract