David Aronoff, MD, discusses an early study on CBD and on how to address interested patients UChicago Medicine study suggests high-purity CBD may help block virus from replicating Early Studies Suggest CBD May Help Prevent COVID-19 Medical formulations of the compound cannabidiol — known as CBD — have shown promise as a way to prevent COVID-19. Medical formulations of
CBD Gummies And Covid
In this video, David Aronoff, MD, chair of the department of medicine at Indiana University School of Medicine in Indianapolis, discusses a recent study testing cannabidiol (CBD) against COVID-19 in the lab and in mice, and how to guide patients seeking treatment for COVID-19.
The following is a transcript of his remarks:
If a patient were to come to me and ask about the use of CBD oil to prevent COVID-19 or reduce the severity of it, I would say that right now, that approach is not ready for prime time. There are other, better ways that we know are safe and very effective to prevent COVID-19 and reduce the severity if someone gets ill. So wear your mask, socially distance, get vaccinated, and if you get symptomatically ill with COVID, let a healthcare professional know, because you may be eligible for things like monoclonal antibodies or new medications like Paxlovid [nirmatrelvir/ritonavir] or repurposed medicines like fluvoxamine [Luvox]. But it’s really important to engage with a licensed healthcare professional if you’re sick with COVID-19.
These investigators thought that there may be some anti-inflammatory effects of CBD, and that might be useful to suppress some of the inflammation that can occur in patients who have COVID-19. But the investigators found a surprising result, which is that CBD and one of its active metabolites didn’t really have too much of an effect on the inflammatory response of the epithelial cells they were studying. But rather, and curiously, the CBD seemed to block the replication of the SARS CoV-2 virus in the respiratory epithelial cells.
This really led the investigators to dig deeper into trying to understand whether the effect they were seeing was specific to CBD or could be found in other compounds that may be also identified in marijuana and to try to drill down on mechanisms through which CBD could be limiting SARS CoV-2 replications in epithelial cells.
And finally, based on what they found in vitro, they wanted to know if there were any correlates of this compound being used in humans that may show some promise for reducing the risk of COVID-19 and even went as far as doing an interventional study in mice to look at the impact of CBD on reducing the severity of SARS COVID-2 infection in a mouse model.
While this study is really interesting and promising, we don’t yet have data in humans that show that we can use CBD oil in therapeutic ways to prevent COVID-19 or reduce the severity of COVID-19. And really what we need is an actual randomized placebo-controlled, double-blind study, which is now regularly being done to look at therapeutic and preventive strategies for COVID-19. Right now, the best we can say about CBD oil is that it’s a promising idea. But until we have properly controlled studies, we don’t actually know how effective or not this is in humans.
Even the human component of the study that was just published, although it was retrospective, which has its limitations, it was looking at essentially medical-grade CBD oil used in the treatment of people who have severe seizure disorders. So we really don’t know how commercially-available, easy-to-get CBD preparations might perform in protecting people from COVID-19.
Emily Hutto is an Associate Video Producer & Editor for MedPage Today. She is based in Manhattan.
Researchers recommend clinical trials for CBD to prevent COVID-19 based on promising animal data
UChicago Medicine study suggests high-purity CBD may help block virus from replicating
An interdisciplinary team of researchers from the University of Chicago has found evidence that cannabidiol, or CBD, a product of the cannabis plant, can inhibit infection by the COVID-19 virus in human cells and in mice.
The study, published on Jan. 20 in Science Advances, found CBD showed a significant negative association with positive COVID tests in a national sample of medical records of patients taking the FDA-approved drug for treating epilepsy. The researchers now say that clinical trials should be done to determine whether CBD could eventually be used as a preventative or early treatment for COVID-19.
They caution, however, that the COVID-blocking effects of CBD come only from a high-purity, specially formulated dose taken in specific situations. The study’s findings do not suggest that consuming commercially available products with CBD additives that vary in potency and quality can prevent COVID-19.
An unexpected avenue
The idea to test CBD as a potential COVID-19 therapeutic was serendipitous. “CBD has anti-inflammatory effects, so we thought that maybe it would stop the second phase of COVID infection involving the immune system, the so-called ‘cytokine storm,’” said Marsha Rosner, Charles B. Huggins Professor in the Ben May Department of Cancer Research and a senior author of the study. “Surprisingly, it directly inhibited viral replication in lung cells.”
To see this effect, the researchers first treated human lung cells with a non-toxic dose of CBD for two hours before exposing the cells to the COVID virus and monitoring them for the virus and the viral spike protein. They found that, above a certain threshold concentration, CBD inhibited the virus’ ability to replicate. Further investigation found that CBD had the same effect in two other types of cells and for three variants of the COVID virus in addition to the original strain.
CBD did not affect the ability of the virus to enter the cell. Instead, CBD was effective at blocking replication early in the infection cycle and six hours after the virus had already infected the cell.
Like all viruses, the COVID virus affects the host cell by hijacking its gene expression machinery to produce more copies of itself and its viral proteins. This effect can be observed by tracking virus-induced changes in cellular RNAs. High concentrations of CBD almost completely eradicated the expression of viral RNAs. It was a completely unexpected result.
“We just wanted to know if CBD would affect the immune system,” Rosner said. “No one in their right mind would have ever thought that it blocked viral replication, but that’s what it did.”
The researchers showed that the mechanism by which CBD blocks the COVID virus replication involves CBD activation of one of the host cell stress responses and generation of interferons, an antiviral cell protein.
Real-world data: Patients taking CBD test positive for COVID-19 at lower rates
The researchers wanted scientific data to show that CBD prevents viral replication in live animals. The team showed pretreatment with CBD for one week prior to infection with the virus suppressed infection both in the lung and the nasal passages of mice. “These results provide major support for a clinical trial of CBD in humans,” said Rosner.
And the success of CBD wasn’t limited to the laboratory: An analysis of 1,212 patients from the National COVID Cohort Collaborative revealed that patients taking a medically prescribed oral solution of CBD for the treatment of epilepsy tested positive for COVID-19 at significantly lower rates than a sample of matched patients from similar demographic backgrounds who were not taking CBD.
The potential for CBD to treat patients recently exposed to or infected by SARS-CoV-2—the virus that causes COVID—does not precede the first lines of defense against COVID-19, which are to get vaccinated and follow existing public health guidelines for masking in indoor spaces and social distancing. But the published results offer a potential new therapeutic, something still needed as the pandemic rages on.
“A clinical trial is necessary to determine whether CBD is really effective at preventing or suppressing SARS-CoV-2 infection, but we think this may have potential as a prophylactic treatment,” said Rosner. “Maybe you’re in a hot spot or you think you might have been exposed or you’ve just tested positive—that’s where we think CBD might have an effect.”
Not your dispensary’s CBD
The research team emphasized that the COVID-blocking effects of CBD were confined strictly to high purity, high concentrations of CBD. Closely related cannabinoids such as CBDA, CBDV and THC, the psychoactive element enriched in marijuana plants, did not have the same power. In fact, combining CBD with equal amounts of THC actually reduced the efficacy of CBD.
“Going to your corner bakery and buying some CBD muffins or gummy bears probably won’t do anything,” said Rosner. “The commercially available CBD powder we looked at, which was off the shelf and something you could order online, was sometimes surprisingly of high purity but also of inconsistent quality. It is also hard to get into an oral solution that can be absorbed without the special, FDA-approved formulation.”
Furthermore, CBD use is not without potential risks. It appears to be extremely safe when consumed in food or drink, but methods of use such as vaping can have negative side effects, including potential damage to the heart and lungs. It’s also not well studied in certain populations, such as pregnant people, and so should be used only under the supervision of a physician and with caution.
While the study’s results are exciting, additional study is needed to determine the precise dosing of CBD that is effective at preventing infection in humans as well as its safety profile and any potential side effects.
“We are very eager to see some clinical trials on this subject get off the ground,” Rosner said. “Especially as we are seeing that the pandemic is still nowhere near the end—determining whether this generally safe, well-tolerated and non-psychoactive cannabinoid might have anti-viral effects against COVID-19 is of critical importance.”
Rosner was also pleased that this research project was a case study in the power of scientific collaboration by bringing together a highly interdisciplinary group of researchers. Senior authors listed on the paper came from three different research universities and from departments as diverse as microbiology, molecular engineering, cancer biology and chemistry.
“This was truly a team-science effort, and that’s something that really excites me,” said Rosner. “From clinicians to David Meltzer’s group who did the patient analysis to virologists like Glenn Randall, and it goes on and on. This is the way science should be carried out.”
Additional authors include Long Chi Nguyen, Dongbo Yang, Thomas J. Best, Nir Drayman, Adil Mohamed, Christopher Dann, Diane Silva, Lydia Robinson-Mailman, Andrea Valdespino, Letícia Stock, Eva Suárez, Krysten A. Jones, Saara-Anne Azizi, James Michael Millis, Bryan C. Dickinson, Savaş Tay, Scott A. Oakes, and David O. Meltzer of the University of Chicago; Vlad Nicolaescu, Haley Gula, and Glenn Randall of UChicago and Argonne National Laboratory; Divayasha Saxena, Jon D. Gabbard, Jennifer K. Demarco, William E. Severson, Charles D. Anderson, and Kenneth E. Palmer of the University of Louisville; Shao-Nong Chen, Takashi Ohtsuki, John Brent Friesen, and Guido F. Pauli of the University of Illinois at Chicago; and the National COVID Cohort Collaborative Consortium.
Funding: BIG Vision grant from the University of Chicago, the National Institutes of Health, Harry B. and Leona M Helmsley Charitable Trust.
Early Studies Suggest CBD May Help Prevent COVID-19
Medical formulations of the compound cannabidiol — known as CBD — have shown promise as a way to prevent COVID-19.
Medical formulations of the compound cannabidiol — known as CBD — have shown promise as a way to prevent COVID-19.
What you need to know
Cannabidiol (CBD) is a cannabis compound with some medicinal properties. Unlike tetrahydrocannabinol (THC) — the main psychoactive component of cannabis — CBD does not produce a high or euphoria. The U.S. Food and Drug Administration (FDA) has approved one CBD-based medication to treat seizure disorders; other medications are in the development and testing pipeline.
Now some early studies show that CBD could help block infection with SARS-CoV-2, the virus that causes COVID-19.
What did the researchers do?
In a series of studies supported by the National Institute of General Medical Sciences, the National Institute of Allergy and Infectious Diseases, the National Cancer Institute (NCI), and the National Center for Advancing Translational Sciences, researchers tested the effects of CBD and other cannabis compounds on SARS-CoV-2. They looked at interactions between CBD and the virus in human lung cells and in mice. They also analyzed data from the National COVID Cohort Collaborative’s health records of volunteers who had been prescribed the CBD-based medication to help prevent seizures.
What did they learn?
In both the laboratory studies and the health records analyses, CBD seemed to have a protective effect against SARS-CoV-2. When the virus was introduced to human lung cells treated with CBD, it could not replicate and take hold as it usually does. Mice that were given therapeutic doses of CBD before being exposed to the virus were much less likely to develop COVID-19 than mice in the control group. And human patients who took the CBD-based medication were less likely to report a COVID-19 diagnosis than others, including people who had the same seizure disorders but had not been prescribed that medication.
Interestingly, out of more than 100 compounds in cannabis, only CBD showed this protective effect. In fact, when CBD was combined with THC, its ability to protect decreased.
What does this mean?
More research, including clinical trials, is needed, but these studies suggest that CBD might be a useful way of preventing COVID-19 in the future. The researchers caution that CBD is not a replacement for vaccination, masking, and social distancing. If anything, they write, CBD would be used along with these measures to prevent breakthrough infections.
The researchers also emphasize that the CBD used in their studies is different from the nonmedical products consumers might be familiar with. There is no evidence that taking over-the-counter CBD products can prevent or treat COVID-19 infection.
Where can I go to learn more?
NCI provides patient-friendly information about cannabis and its compounds.
The National Center for Complementary and Integrative Health has more information about cannabis and CBD.
N3C is a partnership among several NIH Institutes and Centers that aims to use COVID-19 clinical data to answer critical research questions.