Benefits of Nanocurcumin on Mortality in Patients with COVID-19: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background: The Coronavirus disease-2019 (COVID-19) pandemic continues, and the death toll continues to surge. This systematic review and meta-analysis aimed to determine the efficacy of nanocurcumin on mortality in patients with COVID-19. Methods: A systematic search was performed in PubMed, Embase, Cochrane Library, and clinicaltrials.gov up to November 2024, without language restrictions. Inclusion criteria: (1) inclusion of hospitalized patients with COVID-19 who are 18 years or older; (2) polymerase chain reaction positive for severe acute respiratory syndrome coronavirus-2; and (3) use of a randomized controlled design to make a comparison of nanocurcumin with placebo. The Cochrane risk-of-bias tool for randomized trials was used to assess the risk of bias. Studies were pooled to risk ratios (RRs) and standardized mean differences (SMDs), with 95% confidence intervals (CIs). Results: Six trials (enrolling 333 participants) met the inclusion criteria. Nanocurcumin therapy showed significant improvements on mortality (RR 0.47, 95% CI 0.25-0.88; p = 0.02), interleukin-6 (IL-6) (SMD -0.30, 95% CI -0.56 to -0.04; p = 0.02), tumor necrosis factor-α (TNF-α) (SMD -0.63, 95% CI -1.16 to -0.10; p = 0.02), and IL-1β (SMD -0.88, 95% CI -1.37 to -0.39; p = 0.0004). Conclusions: Nanocurcumin significantly reduced mortality, IL-6, TNF-α, and IL-1β in hospitalized patients with COVID-19. Given the lack of safety data and concerns about the risk of bias, the use of nanocurcumin in COVID-19 requires further research.