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Virgin Coconut Oil as Adjunctive Therapy for Hospitalized COVID-19 Patients in a Tertiary Referral Hospital: A Randomized Controlled Trial

Alejandria et al., Acta Medica Philippina, doi:10.47895/amp.vi0.7498 , NCT04849637
May 2024  
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Mortality 86% Improvement Relative Risk Ventilation 86% ICU admission 67% Hospitalization time 10% Recovery time 3% Viral clearance -8% VCO  Alejandria et al.  LATE TREATMENT  RCT Is late treatment with VCO beneficial for COVID-19? RCT 77 patients in Philippines Lower mortality (p=0.12) and ventilation (p=0.12), not sig. c19early.org Alejandria et al., Acta Medica Philipp.., May 2024 FavorsVCO Favorscontrol 0 0.5 1 1.5 2+
RCT 77 hospitalized patients showing no significant differences with virgin coconut oil (VCO) treatment.
Viral load measured by PCR may not accurately reflect infectious virus measured by viral culture. Porter et al. show that viral load early in infection was correlated with infectious virus, but viral load late in infection could be high even with low or undetectable infectious virus. Assessing viral load later in infection may underestimate reductions in infectious virus with treatment.
risk of death, 85.9% lower, RR 0.14, p = 0.12, treatment 0 of 39 (0.0%), control 3 of 38 (7.9%), NNT 13, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
risk of mechanical ventilation, 85.9% lower, RR 0.14, p = 0.12, treatment 0 of 39 (0.0%), control 3 of 38 (7.9%), NNT 13, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
risk of ICU admission, 67.0% lower, RR 0.33, p = 0.49, treatment 0 of 39 (0.0%), control 1 of 38 (2.6%), NNT 38, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm).
hospitalization time, 9.7% lower, relative time 0.90, p = 0.41, treatment mean 9.29 (±5.29) n=39, control mean 10.29 (±5.38) n=38.
recovery time, 3.4% lower, relative time 0.97, p = 0.77, treatment mean 6.5 (±3.5) n=39, control mean 6.73 (±3.3) n=38.
risk of no viral clearance, 7.9% higher, RR 1.08, p = 0.60, treatment 31 of 39 (79.5%), control 28 of 38 (73.7%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Alejandria et al., 15 May 2024, Randomized Controlled Trial, Philippines, peer-reviewed, 7 authors, trial NCT04849637 (history).
This PaperMiscellaneousAll
Virgin Coconut Oil as Adjunctive Therapy for Hospitalized COVID-19 Patients in a Tertiary Referral Hospital: A Randomized Controlled Trial
MD, MSc Marissa M Alejandria, Michelle M Leslie, PhD Dalmacio, Monica M Fresthel, MD Climacosa, Carol Stephanie, MD, MSc C Tan-Lim, MD Joseph M Abaca, Maria Llaine, MD J Callanta, Maria Elizabeth, MD, MAS P Mercado, Stephanie C Carol, MD, MSc Tan-Lim
Acta Medica Philippina, doi:10.47895/amp.vi0.7498
Background. Virgin coconut oil (VCO) has anti-viral and anti-inflammatory properties, making it a potential therapeutic candidate against COVID-19 infection. Objective. To determine the efficacy and safety of VCO as adjunctive therapy for hospitalized patients with COVID-19. Methods. We conducted a randomized, open-label controlled trial involving laboratory-confirmed COVID-19 patients admitted at the Philippine General Hospital. The study participants were randomized to the intervention group who received virgin coconut oil with local standard of care, or to the control group who received local standard of care alone. Results. We enrolled 39 participants into the VCO group and 38 participants into the control group. Significantly fewer participants in the VCO group had abnormal CRP levels at the end of treatment compared to control. (relative risk [RR] 0.75, 95% confidence interval [CI] 0.58 to 0.95; p=0.02) No significant difference was found in the duration of hospital stay (mean 9.33 days for VCO vs. 10.29 days for control; p=0.45) and time to symptom resolution (mean 6.8 days for VCO, vs. 6.74 days for control; p=0.91). Although the proportion of patients who developed the secondary outcomes of mortality, need for ICU admission, need for invasive ventilation, and negative viral conversion was lower in the VCO group, results did not reach statistical significance. The VCO group had larger reduction in the inflammatory markers ferritin, lactate dehydrogenase, TNF-alpha, IP-10 and IL-6, but results did not reach statistical significance. Adverse events were significantly higher in the VCO group (RR 4.87, 95% CI 1.14 to 20.79; p=0.03). Conclusion. This clinical trial on hospitalized patients showed significant benefit in CRP levels of participants given VCO compared to control. There was no significant benefit in the use of VCO as adjunctive therapy in reducing duration of hospital stay. Larger studies are needed to conclusively demonstrate the effect of VCO on other clinical outcomes and inflammatory markers.
Statement of Authorship All authors certified fulfillment of ICMJE authorship criteria. Author Disclosure This study was supported by the Department of Science and Technology -Philippine Council for Health Research and Development (DOST-PCHRD). The funding agency had no involvement in the study design; in the collection, analysis and interpretation of data; in the writing of the report; and in the decision to submit the article for publication.
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Late treatment
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