Artemisinin and Lignans Extracts: Innovative Adjuncts to Standard COVID-19 Treatment Protocols.

<ns7:p> Background Global health and economic consequences are still being attributed to coronavirus disease 2019 (COVID-19), despite developments in vaccine and antiviral therapy. The need for reliable and affordable supplements to current regimens is highlighted by the fast development of viral variations. A possible treatment choice for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is indicated by the broad-spectrum antiviral, anti-inflammatory, and immunomodulatory action of lignans from Linum usitatissimum and artemisinin from Artemisia annua. Methods 180 COVID-19-infected patients aged 20–70 years participated in a randomized controlled experiment conducted in Baghdad, Iraq, between September 2022 and August 2023. Patients were divided into mild, moderate and severe with comorbidities (n=60 each) and randomized to standard therapy alone or standard therapy and mixed artemisinin–lignan extract (10 g orally daily for 14 days). Recovery rate, time to symptom resolution, and viral RT-PCR clearance were the main outcomes. Secondary endpoints were length of hospitalization and safety. Results Adjuvant therapy significantly enhanced the prognosis of all the severity groups. The recovery rates (mild, moderate, and severe cases) were 95%, 85%, and 70% for patients, versus 80%, 65%, and 50% for the controls ( <ns7:italic>p</ns7:italic> &lt; 0.001). Symptoms resolved earlier (7 ± 2 vs 10 ± 3 days; <ns7:italic>p</ns7:italic> &lt; 0.01) in 80% of treated patients, with viral clearance by day 10 in 80% of treated patients compared with 60% of controls ( <ns7:italic>p</ns7:italic> &lt; 0.01). Moderate-to-severe hospitalizations were shortened by 2.5 days’ average. The extract was well-tolerated with mild, transient headaches (10%) and nausea (8%) being the only adverse events. Conclusion Artemisinin–lignan extracts as adjunctive therapy can promote recovery, viral clearance, shorten hospital stay, and have no apparent severe toxicity. These results support larger multicenter studies to confirm efficacy and to determine its formalized integration into COVID-19 treatment strategy. </ns7:p>