Effectiveness of supplementation with quercetin‐type flavonols for treatment of viral lower respiratory tract infections: Systematic review and meta‐analysis of preclinical studies

Brito, Júlio César Moreira; Lima, William Gustavo; Cordeiro, Lídia Pereira B.; da Cruz Nizer, Waleska Stephanie

Viral infections of the lower respiratory tract are considered a public health problem. They affect millions of people worldwide, causing thousands of deaths, and are treated with expensive medicines, such as antivirals or palliative measures. In this study, we conducted a systematic review to describe the use of quercetin‐type flavonols against lower respiratory tract viruses and discussed the preclinical impact of this approach on different signs and clinical mechanisms of infection. The systematic review was performed in PubMed/MEDLINE, Scopus, Scielo, and Biblioteca Virtual de Saúde (BVS). After the database search, 11 relevant studies were identified as eligible. The analysis of these studies showed evidence of antiviral activity of quercetin‐type flavonols with significantly reduced mortality rate (M‐H = 0.19, 95% CI: 0.05 to 0.65, p‐value = 0.008) of infected animals and a reduction in the average viral load (IV = −1.93, 95% CI: −3.54 to −0.31, p‐value = 0.02). Additionally, quercetin and its derivatives reduced the amount of proinflammatory cytokines, chemokines, reactive oxygen species, mucus production, and airway resistance in animals infected with a respiratory virus. Overall, supplementation with quercetin‐type flavonols is a promising strategy for treating viral‐induced lower respiratory tract infections.