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ObjectiveTo assess the efficacy and safety of Andrographis paniculata extract (APE) in adults with mild COVID-19.MethodsThe alcoholic extract of the aerial part of A. paniculata was used. In this randomized, double-blinded, placebo-controlled trial, adults with laboratory-confirmed COVID-19, and mild symptoms were randomized 1:1 to receive APE (60 mg andrographolide,t.i.d,for 5 days) versus placebo, plus standard supportive care. Blood tests for CRP, liver and renal assessment were performed on Days 1, 3, and 5.The outcomes were occurrence of pneumonia detected by chest X-ray, nasopharyngeal SARS-CoV-2detection by rRT-PCR, changes of CRP levels, and adverse drug reactions.ResultsPatients were randomized to receive APE (n=29) or placebo (n=28). Pneumonia occurrence during illness was 0/29 (0%) versus 3/28 (10.7%), (p=0.039); andpatients with nasopharyngeal SARS-CoV-2detectionon Day 5 were10/29 (34.5%) versus 16/28 (57.1%), (p=0.086), for those who received APE and placebo, respectively. All three patients with pneumonia had substantially rising serum CRP; and high CRP levels on Day 5. None had evidence of liver or renal impairment.ConclusionThisAP-extract treatmentregimen was potentially effective and safe in adults with mild COVID-19. The rising of CRP suggested disease progression. Further studies are needed.

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