The antiviral, immuno-modulatory and anti-inflammatory properties of cannabidiol (CBD) make it a potential candidate for the prevention and treatment of COVID-19.

1. CANNABIDIOL (CBD) AS
POTENTIAL
THERAPEUTIC AGENT
FOR COVID-19
BY
Kevin KF Ng, MD, PhD.
Former Associate Professor of Medicine
Division of Clinical Pharmacology
University of Miami, Miami, FL., USA
Email: kevinng68@gmail.com
A Slide Presentation for HealthCare Providers Dec 2021

2. What is cannabidiol (CBD)?
▪ Cannabidiol is a phytochemical derived from the cannabis plant.
▪ There are more than 144 cannabinoids in the cannabis plant.
▪ Two of the most widely studied cannabinoids are:
▪ Tetrahydrocannabinol (THC)
▪ Cannabidiol (CBD)
Psychoactive Non-Psychoactive
cannabis plant.

3. Difference between Tetrahydrocannabinol (THC) and Cannabidiol (CBD)
▪ Tetrahydrocannabinol (THC) acts on CB1
receptors which are located in the brain
and presynaptic neurons.
▪ Whereas Cannabidiol (CBD) acts on CB2
receptors which are located in the immune
cells

4. Cannabidiol receptors (CB2) in immune cells
Adapted from https://www.news-medical.net/life-sciences/Crystal-Structure-of-the-Human-Cannabinoid-Receptor-CB2.aspx
Receptors
Cannabinoids
cannabinoids

5. Immuno-modulatory and Anti-inflammatory Actions of CBD
▪ Activation of macrophages and T-cells
▪ Inhibition of neutrophil chemotaxis
▪ Inhibition of release of cytokines and chemokines
▪ Inhibition of cyclo-oxygenase, lipoxygenase, and nitric oxide synthase
▪ Inhibition of generation of prostaglandins, leukotrienes and nitric oxide
https://theroc.us/researchlibrary/Cannabidiol%20(CBD)%20and
%20its%20analogs%20a%20review%20of%20their%20effects.pdf

6. Immuno-modulatory and Anti-inflammatory effects of CBD (2018)
https://www.hindawi.com/journals/bmri/2018/1691428/fig2/

7. Bioavailability and half-life of CBD
▪ Oral CBD: Capsules, Oils, and Edibles
▪ oral CBD has the lowest bioavailability of all delivery forms.
▪ Half-lives from 10 to 17 hours have been reported for high dosages between 750 mg and 1500 mg
▪ Inhaled CBD: Vaping and Smoking
▪ Smoking has a bioavailability of 31% and a single CBD cigarette containing about 19 mg of CBD can produce peak
blood levels within 3 minutes
▪ The half-life of smoked CBD averages 31 hours.
▪ Vaping produces similar blood CBD concentrations and pharmacokinetics to smoking. There is some risk of lung
irritation with vaping, though less than smoking.
▪ Nebulizers produce peak blood levels in about 36 minutes
▪ Sublingual Drops
▪ Peak blood levels for this method, which involves placing liquid drops of CBD under your tongue, have been measured
within about 2 hours
▪ Oral Spray
▪ in one study, an oral spray consisting of a 50-50 combination of THC and CBD, produced peak blood levels of CBD
at 3.6 hours for a 5 mg dose of CBD and 4.5 hours for a 15 mg dose of CBD, i.e., a three times greater dose
reached peak blood levels in only 20% more time.
▪ Nasal spray
▪ Absorption through the thin mucous membranes lining the nasal passages is quite rapid — reaching maximum
concentration in the blood in 10 minutes or less [
https://dailycbd.com/en/cbd-bioavailability/

8. Reported Clinical use of CBD
▪ Antioxidant
▪ Anti-inflammatory
▪ Immuno-modulatory
▪ Anticonvulsant
▪ Anti-psychotic
▪ Anti-emetic
▪ Support sleep
▪ Modulates side effects of THC

9. ● CLINICAL CLASSIFICATION OF COVID-19
● CBD STUDY IN VITRO
● EFFECT OF CBD ON COVID-19 PATIENTS

10. Clinical classification of COVID-19
based on oxygen saturation
SARS-COV-2 Host
Mild
COVID-19
Moderate
COVID-19
Severe
COVID-19
Critical
COVID-19
SpO2 levels of 90%–94% in room air
SpO2 levels ≤90% in room air
or patients with ARDS
Endotracheal intubation and
mechanical ventilation
SpO2 levels of 95% or higher

11. COVID-19 death rates depend on age (2020)
SARS-COV-2 Host
Mild
COVID-19
Moderate
COVID-19
Severe
COVID-19
Critical
COVID-19
age

12. COVID-19 death rates depend on underlying health (2020)
https://www.bbc.com/news/health-51674743

13. Therapeutic targets in SARS-COV-2 andCOVID-19
Adapted from https://www.nature.com/articles/s41392-021-00733-x/figures/1

14. Examples of therapeutic agents targeting
SARS-COV-2 and COVID-19
Adapted from https://www.nature.com/articles/s41392-021-00733-x/figures/1
Chloroquine
Remdesivir
Paxlovid
Molnupiravir
Oseltamivir
Corticosteroids
Convalescent plasma
BKT=Bruton’s tyrosine kinase
ACE2=angiotensin converting enzyme-2

15. CBD STUDY IN CELLS AND PATIENTS

16. Cannabidiol (CBD) is a potent inhibitor of SARS-CoV-2
infection in vitro (2021)
https://pubmed.ncbi.nlm.nih.gov/33758843/

17. Limited or no inhibition of SARS-CoV-2 infection by
Cannabinoids other than CBD (2021)
https://pubmed.ncbi.nlm.nih.gov/33758843/

18. CBD blocks entry of SARS-CoV-2 into host cell via ACE2 (2021)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7987002/

19. CBD usage in patients is significantly correlated with a
reduction in COVID-19 positivity (2021)
Adapted from https://pubmed.ncbi.nlm.nih.gov/33758843/
A B C

20. Mechanisim of actions of cannabidiol (CBD)
©DRKEVINKFNG

21. Summary
▪ There are more than 144 cannabinoids in the cannabis
plant.
▪ Cannabidiol (CBD) has been shown to have immuno-
modulatory and anti-inflammatory properties.
▪ The antiviral property of CBD on SARS-COV-2 has
recently been shown in vitro study.
▪ A cohort study also demonstrated that patients who had
CBD prior to covid-19 is less likely to suffer from the
severe disease.
▪ These results need to be confirmed by randomized
controlled trial. Cannabidiol (CBD)

22. ANY QUESTION?
Please contact
Kevin KF Ng, MD, PhD
Email: kevinng68@gmail.com