David Aronoff, MD, discusses an early study on CBD and on how to address interested patients And in a first that shows CBD’s potential in fighting COVID-19 in people, Americans prescribed high-potency CBD oil showed lower rates of infection, a new study found.
So, Your Patient Just Asked About CBD for COVID-19?
— David Aronoff, MD, discusses an early study on CBD and on how to address interested patients
by Emily Hutto, Associate Video Producer January 28, 2022
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.
New Study: Cannabis Compound CBD May Potentially Prevent, Fight COVID-19 Infection
Smoking marijuana will not protect you from the novel coronavirus, no matter what anyone says and no matter how much certain people want it to be true.
However, if taken in the right way and at the right amount, the cannabis compound CBD might lessen the severity of COVID-19 infection and even prevent the virus’s spread, new research published this week found.
What’s more, new anecdotal evidence suggests that people—not lab mice, and not isolated human cells, but human beings—who were prescribed regular high-potency doses of pharmaceutical-grade CBD were less likely to contract COVID, according to research published Thursday in the journal Science Advances.
“Our research suggest that CBD and its metabolite 7-OH-CBD,” which is a compound produced after the body processes CBD, “can block SARS-Cov-2 infection at early and even later stages of infection,” wrote the researchers, led by academics at the University of Chicago.
LONGMONT, CO. October 10, – Janea Cox, director of the Flowering H.O.P.E. Foundation bottles . [+] high-potency CBD oil.
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Thursday’s findings come on the heels of research published last week that found cannibidiolic acid—or CBD-A, the precursor molecule to CBD, as well as other similar cannabis acids that become the familiar cannabinoids when heated—prevented the entry of the coronavirus into isolated human cells.
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Taken together, these findings are fueling a misconception that smoking cannabis or taking over-the-counter CBD drops are a useful tool against COVID. They’re not.
What the findings may mean that cannabis-derived medicines or preparations might supplement vaccines in the struggle to end the nearly two-year-long COVID-19 pandemic.
But—and researchers cannot stress this enough—what it does not mean is that smoking a joint treats COVID. And your over-the-counter CBD drops won’t, either.
UNITED STATES – SEPTEMBER 6: CBD oil products on display at the Southern Hemp Expo at the Williamson . [+] County Agricultural Exposition Park in Franklin, TN on Friday, Sept. 6, 2019. (Photo By Bill Clark/CQ-Roll Call, Inc via Getty Images)
CQ-Roll Call, Inc via Getty Images
In interviews, researchers highlighted both the potential significance of their work as well as its limitations.
“As a bottom line, what this says is that CBD has the potential to prevent infections, such as breakthrough infections, which might be one of the most useful applications,” as Marsha Rosner, a professor of cancer research at the University of Chicago and a lead study author, said in an interview with VICE’s Motherboard vertical.
However, as the researchers wrote, the findings were limited to just CBD—and just to certain high-grade CBD preparations that deliver a very large dose of the compound.
“Going to your corner bakery and buying some CBD muffins or gummy bears probably won’t do anything,” Rosner said in a news release.
And nothing in the study indicates CBD is a replacement for existing preventative measures, such as masking and vaccinations—both of which the researchers hope people continue to do.
“What we don’t want,” she added, “is people just running out and thinking, ‘I can take CBD, and then I don’t have to get vaccinated or I don’t have to be masked.”
“This is what we really don’t want to see.”
HANOI, VIETNAM – JANUARY 31: People wear face mask while visiting a temple on the seventh day of . [+] Lunar New Year celebration on January 31, 2020 in Hanoi, Vietnam. Vietnam confirmed three new cases of the coronavirus on January 30, making the overall number of reported victims to five. W.H.O. declares the coronavirus outbreak a global health emergency on the same day. (Photo by Linh Pham/Getty Images)
Rosner and her colleagues treated human lung cells with CBD prior to infecting them with the SARS-CoV-2 virus. And they found that “CBD potently inhibited viral replication under non-toxic conditions,” they wrote, adding that other cannabinoids, including “psychoactive THC,” did not do this.
“Remarkably,” they wrote, “only CBD was a potent agent.”
How did CBD do this? The cannabinoid appears to activate a cellular stress response normally triggered in the presence of “viruses or other pathogens,” as Rosner said in a phone interview on Friday. This stress response produces a series of proteins called interferons. And
“CBD induces the production of interferons, and they are the antivirals that will fight the virus,” Rosner said.
CBD also prevented the virus from making other changes to infected host cells.
But cells are cells—they’re not living beings. To test the findings on living beings—something last week’s study did not do—female mice were given two loads of CBD: 20 or 80 mg per kilogram of body weight.
That’s a fairly substantial dose that could be exorbitantly expensive: A 150-pound person would have to take a heroic 5,440 milligrams of CBD to match the mice—and some companies sell 10,000 milligrams, or less than two doses, for $250.
Nevertheless, some will argue that’s money and CBD well spent.
According to the researchers, mice that took 80 milligrams of CBD per kilo of weight saw decreases of viral loads in the lungs and the nose up to “40- and 4.8-fold.”
And, finally, there is some evidence that these mice and test-tube studies will translate to people.
Epidiolex is a CBD-based pharmaceutical drug approved for prescription by the federal Food and Drug Administration for patients with severe seizure disorder.
A review of 1,212 patients in a dataset called the National COVID Cohort Collaborative revealed showed that the COVID infection rate among people with a “medication record” of taking pharmaceutical-grade CBD was 6.2 percent, compared to 8.9 percent for people not taking CBD, the researchers wrote.
But CBD’s preventative potential was even more pronounced for people who took CBD the same day as their COVID-19 tests. For a subset of 531 patients “who were likely taking” 100 milligrams of CBD, their positivity rate was 4.9 percent, compared to rate of 9 percent among a control group not taking the drug.
Going forward, Rosner and her colleagues are hoping that clinical trials with humans can begin—and begin soon, as the pandemic grinds on through historic-high levels of infections and hospitalizations, a dreadful winter spike fueled by the omicron variant.
“We are very eager to see some clinical trials on this subject get off the ground,” Rosner told the University of Chicago’s news service.
“Especially as we are seeing that the pandemic is still nowhere near the end,” she added, “determining whether this generally safe, well-tolerated, and non-psychoactive cannabinoid might have anti-viral effects against COVID-19 is of critical importance.”