Echinacea flowers blooming

A Research Study - Traditional Herb, Echinacea purpurea, could aid recovery from COVID

July 27, 2022

Traditional Herb, Echinacea purpurea, could aid recovery from COVID - Press Release from The British Herbal Medicine Association.

  • New research published in “Frontiers in Pharmacology” Special Issue: Pharmacology of Infectious Diseases (April 2022) supports use of Echinacea purpurea for long-term prevention of viral respiratory tract infections (RTIs) including COVID-19 and subsequent variants1
  • In adults treated with the herb, Echinacea purpurea:
    • Reduced RTI risk by 25%
    • Reduced coronavirus risk by 48%
    • Reduced SARS-CoV-2 risk by 63%
    • Reduced overall virus load by at least 99%
    • Reduced viral clearance time by 4.8 days

New research reveals that a traditional cold and influenza herbal medicine containing a fresh herb extract of Echinacea purpurea reduced the incidence of respiratory tract infections (RTIs) and aided recovery from the symptoms of RTIs including COVID-19 (SARS-CoV-2) and its subsequent variants in non-vaccinated and vaccinated adults.

The randomised, controlled clinical study was conducted over a 6-month period (Nov 2020 – May 2021) in Bulgaria, where there was a low uptake of COVID-19 vaccination. From the 120 healthy participants aged between 18 and 75, individuals were randomly assigned to the verum group for treatment with Echinacea purpurea or to the control group; there were 60 participants in each group. Only five individuals in the verum group and seven in the control group had been fully vaccinated by the end of the study.

The verum group were preventatively treated with 2,400 mg Echinacea purpurea extract daily for periods of two months, two months, and one month, interspersed with a one week break between each treatment period. Acute respiratory tract infection events were treated with 4,000 mg Echinacea purpurea extract for up to 10 days and symptom severity assessed via diary entries.

The control group did not receive preventative nor acute treatments but instead were observed in parallel for the same periods.

Naso/oropharyngeal swabs via PCR testing and venous blood samples were routinely collected every month and during acute illnesses for detection and identification of all respiratory viruses, including SARS-CoV-2.

During the total period of prevention treatment, 21 and 29 naso/oropharyngeal samples tested positive for any RTI virus in the treatment and control group respectively, of which 5 and 14 samples tested positive for SARS-CoV-2. Overall, 10 and 14 symptomatic RTI episodes occurred, of which 5 and 8 were COVID-19.

When treated with Echinacea purpurea during acute episodes, the overall virus load reduced significantly by 99 per cent. Treatment with Echinacea also reduced the time until virus clearance by eight days for all viruses, and reduced clearance time by 4.8 days for SARS-CoV-2 in comparison to the control group.

There were no adverse reactions and no COVID-19-related hospitalisations in the verum group, compared to two hospitalisations in the control group.

2/ Traditional herb could aid recovery from COVID

Treatment with Echinacea purpurea reduced the risk of viral RTIs, including SARS-CoV-2. By substantially reducing viral loads in infected subjects, Echinacea purpurea offers a supportive addition to existing treatments such as vaccinations.

Also noteworthy was that the number of smokers, overall co-morbidities, and individuals with hypertension were slightly higher in the treatment group, indicating that Echinacea purpurea may be beneficial to support those more vulnerable to negative RTI and SARS-CoV-2 outcomes or hospitalisation.

A second, in-vitro, paper, newly published in X journal (date), also confirmed the potential mechanism of antiviral action that Echinacea purpurea extract has against all ‘enveloped viruses’, the category of virus to which the coronavirus family belongs. The enveloped viruses tested included SARS-CoV-2 variants: B1.1.7 (Alpha), B.1.351.1 (Beta), P.1 (Gamma), B1.617.2 (Delta), AV.1 (Scottish) and B1.525 (Eta), OC43 (Omicron) and Hu-1 (wild-type Wuhan).

The fresh extract of Echinacea purpurea appears to inhibit virus endocytosis by reducing the ability of a serine protease that exists on the surface of the enveloped coronaviruses, TMPRSS-2, to attach to other ACE2 receptors, a protein on the surface of many cell types. Using the spike-like protein on its surface, the SARS-CoV-2 virus binds to ACE2, like a key being inserted into a lock, prior to entry and infection of host cells.

Chair of the British Herbal Medicines Association (, Dr Chris Etheridge says: “Immunomodulatory alkylamide compounds present in the fresh Echinacea purpurea extract bind to a protein called TMPRSS2, which would usually prepare the enveloped virus spike protein to readily attach to ACE2 receptors, enabling the virus to infect host cells. As the ACE2 receptors act as the cellular doorway to assist coronavirus infection, by partially blocking TMPRSS2, as Echinacea treatment does, it reduces the ease with which the virus spike protein can fit onto the ACE receptor binding site, thus hindering infection.

“There are a multitude of different binding sites within virus entry points into the body such as the nasal cavities, but Echinacea purpurea has a variety of diverse alkylamides which can bind to most of them.

“Despite vaccination rates being high in the UK, COVID-19 rates of infection are also at their highest across the nation since the pandemic started. This study supports the hypothesis that a fresh extract of Echinacea purpurea, a regulated common cold and influenza herbal medicine that is readily available over the counter, has the potential to play a role in supporting the immune system by not only helping to reduce viral load on infection, but also lessen the severity of symptoms experienced and aid recovery; all factors that may also help to reduce hospitalisation rates.

“People in the UK who wish to use Echinacea purpurea to relieve symptoms of respiratory tract infections such as a cough, sore throat or runny nose should look for herbal medicinal products that have been assessed by the Medicines and Healthcare products Regulatory Agency (MHRA) and Health Products Regulatory Authority (HPRA) and display a Traditional Herbal Registration (THR) logo on their pack. This logo assures that they have been assessed for safety and quality and have provided 30 years evidence of traditional use. These products also display an approved traditional use claim on their packs and must include a Patient Information Leaflet in its pack setting out full ingredients, dose and any contraindications.”


  1. The fresh whole plant Echinacea purpurea extract used in the study, EchinaforceTM, was supplied by Swiss herbal medicine manufacturers, A.Vogel.

 About the BHMA

The British Herbal Medicine Association has represented the interests of herbal medicine in the United Kingdom for almost 60 years. It was founded in 1964 at a time of increasing regulatory control, when herbal medicine country faced an uncertain future and played an important role in convincing the government of the day to include provisions for the herbal industry and profession in the Medicines Act 1968. 

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[1] Kolev et al. 2022, "Echinacea purpurea for the Long-term Prevention of Viral Respiratory Tract Infections during Covid-19 Pandemic: A Randomised, Open, Controlled, Exploratory Clinical Study" after only minor revisions of "Frontiers in Pharmacology" Special Issue: Pharmacology of Infectious Diseases

[2] The fresh whole plant Echinacea purpurea extract used in the study, Echinaforce, was supplied by Swiss herbal medicine manufacturers, A.Vogel

[3] Polymerase Chain Reaction tests