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Ashwagandha, Withania somnifera (L.) Dunal, for the prophylaxis against SARS-CoV-2 infection: A multicentric randomized hydroxychloroquine controlled clinical trial in Indian health care workers

Kulkarni-Munshi et al., Journal of Ayurveda and Integrative Medicine, doi:10.1016/j.jaim.2025.101135, CTRI/2020/05/025332, May 2025
https://c19hcq.org/kulkarnimunshi.html
Case 61% Improvement Relative Risk HCQ  Kulkarni-Munshi et al.  Prophylaxis  RCT Is pre-exposure prophylaxis with HCQ beneficial for COVID-19? RCT 400 patients in India (October 2020 - April 2021) Trial compares with withania somnifera, results vs. placebo may differ Fewer cases with HCQ (not stat. sig., p=0.28) c19hcq.org Kulkarni-Munshi et al., J. Ayurveda an.., May 2025 FavorsHCQ Favorswithania som.. 0 0.5 1 1.5 2+
HCQ for COVID-19
1st treatment shown to reduce risk in March 2020, now with p < 0.00000000001 from 423 studies, used in 59 countries.
No treatment is 100% effective. Protocols combine treatments.
5,800+ studies for 172 treatments. c19hcq.org
RCT 400 healthcare workers in India comparing HCQ and withania somnifera (WS) for COVID-19 prophylaxis, showing 2 cases for HCQ and 5 for WS. Both treatments had comparable safety profiles, with mostly mild gastrointestinal adverse events.
risk of case, 61.2% lower, RR 0.39, p = 0.28, treatment 2 of 194 (1.0%), control 5 of 188 (2.7%), NNT 61.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Kulkarni-Munshi et al., 31 May 2025, Randomized Controlled Trial, India, peer-reviewed, mean age 35.9, 35 authors, study period October 2020 - April 2021, this trial compares with another treatment - results may be better when compared to placebo, trial CTRI/2020/05/025332. Contact: mondhe33@gmail.com.
Ashwagandha, Withania somnifera (L.) Dunal, for the prophylaxis against SARS-CoV-2 infection: A multicentric randomized hydroxychloroquine controlled clinical trial in Indian health care workers
Renuka Kulkarni-Munshi, Deepti Talmohite, Anand More, Jaya Chakravarty, Sandhya Kamat, Akash Khobragade, D Himanshu Reddy, Manish Patel, Divya Kajaria, Raju Singh, Sarita Kumari, Priyanka Mishra, A K Srivastava, Vivek Bhagat, Saurabh Pandey, Meena Yadav, Rahul Darnule, Shobha Bhat, Sangeeta Kansal, Sonali Munot, Dipti Kumbhar, Raakhi Tripathi, Snehalata Gajbhiye, Padmaja Marathe, Jaee Parvatkar, Dhaiwat Shukla, Prakashkumar Panchal, Jui Shah, Jayashree Bhale, Viswajanani Sattigeri, Ashish Amarsheda, Anil Avhad, Nilima Kshirsagar, Dilip M Mondhe, Arvind Chopra
Journal of Ayurveda and Integrative Medicine, doi:10.1016/j.jaim.2025.101135
Background: The study was planned when, the hydroxychloroquine (HCQ) was the only prophylactic agent approved by health authorities in several countries and no prophylactic COVID-19 vaccine was available. Objective: The present study aimed to evaluate efficacy of Withania Somnifera (L.) Dunal (WS) as a chemoprophylactic and immunomodulatory agent against SARS-CoV-2 infection. Methods: In a 12 week, randomized, open label, parallel group, two arm, comparative, multicentric, controlled trial compared WS with hydroxychloroquine (HCQ) in health care workers (HCWs). Total 400 HCWs were randomized in 1:1 ratio to receive either oral WS (500 mg for 12 weeks) or HCQ 400 mg (for 7 weeks). The primary outcome was to establish equivalence between WS and HCQ for the proportion of participants contracting SARS-CoV-2 infection. Results: Seven participants contracted SARS-CoV-2 infection: 5 in WS arm and 2 in HCQ arm. The equivalence between WS and HCQ was established for the proportion difference of participants contracting SARS-CoV-2 infection for per-protocol (PP) (1.6%, 95% CI: -1.08%-4.33%) and in subgroup analysis (ITT, mIIT, nonvaccinated and seronegative).
Author contributions All authors participated in the manuscript review and writing. Conflict of interest All the authors confirm that there is no conflict of interest to declare. Cadila Pharmaceuticals Limited was the Contract Research Organization for this study. Appendix A. Supplementary data Supplementary data to this article can be found online at https://doi. org/10.1016/j.jaim.2025.101135 .
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