Medicinal Fungi Evidence Update

A revised medRxiv preprint posted 19 September 2026 — not peer reviewed — reports a dual-site, randomized, double-blind, placebo-controlled phase-I trial in non-hospitalised adults with recently diagnosed mild-to-moderate COVID-19. It predates the last brief and is included now as a correction to the surveillance record. The analysed groups were 26 FoTv and 24 placebo participants; the prespecified primary purpose was safety and feasibility, not definitive efficacy.

Adherence and completion were high, and no hospital, emergency-department or urgent-care visits occurred. Exploratory repeated-measures analyses favoured FoTv for self-reported symptom count and severity. However, nasal SARS-CoV-2 viral load did not differ significantly. Estimated GFR declined within the FoTv group, although between-group levels and transitions to abnormal values did not differ. High-sensitivity troponin-T increased within the FoTv group; its significance is uncertain and deserves follow-up rather than a reassuring reinterpretation.

Allocation concealment and masking were credible. Confidence is nevertheless low because the trial was small, designed for safety, conducted during changing variants and vaccination uptake, and tested many exploratory symptoms, biomarkers and subgroups. The manufacturer supplied and helped fund the study; company-affiliated authors assisted with mycology literature review and writing. The authors declared no competing interests. The findings belong only to this 12 g/day myceliated-rice combination — not to either fungus generally.

No qualifying new systematic review or meta-analysis was identified. A peer-reviewed narrative review on medicinal mushrooms and type 2 diabetes was newly indexed. It is not a systematic review and supplies no new pooled estimate.

Its useful contribution is methodological: it highlights preparation heterogeneity, uncertain dose-response and pharmacokinetics, short trials, incomplete safety evaluation, possible mushroom–drug interactions, liver safety and contaminant screening. Those cautions reinforce the Atlas's existing chain-of-custody framework rather than changing an efficacy conclusion.

Commercial cordycepin of 98% HPLC purity — a purified molecule, not a Cordyceps militaris powder or extract; its manufacturing or fungal source was not specified. Fifty male BALB/c mice were randomized to control, intranasal LPS 3 mg/kg, or LPS followed 24 hours later by oral cordycepin at 20, 40 or 80 mg/kg for three days (n=10/group). There was no established-drug positive control. Parallel MH-S macrophage experiments used 0.1, 1 or 10 micromolar cordycepin after LPS, plus TAK1 knockdown and overexpression.

Cordycepin reduced histological lung injury and several inflammatory measures, generally with stronger effects at higher doses. The cellular perturbation experiments support dependence on TAK1-related signalling. Molecular docking alone does not demonstrate direct physical binding. This is a partial replication of earlier reports that cordycepin reduces LPS lung injury, while adding a proposed TAK1/MAPK/NF-kappaB mechanism.

Strengths include randomized allocation, three doses, n=10/group and genetic pathway perturbation. Limits include no formal prospective power calculation, no stated blinded outcome assessment, males only, a short artificial LPS model, fixed treatment order without cage rotation, and no positive comparator. Public Chinese grants funded the work; no conflicts were declared. The peer-reviewed study was newly indexed 26 September 2026.

A peer-reviewed study administered purified erinacine C at 100 mg/kg/day by gavage for 16 weeks to female APP/PS1 mice. The treatment group contained five mice, with four transgenic vehicle controls and four wild-type controls.

Behavioural and pathology signals were positive, but the extremely small groups, single dose, absent positive comparator and unreported blinding keep it below the high-quality tier. This is evidence about erinacine C, not lion's mane powder, fruiting bodies or mycelial supplements.