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Background Different measures have been taken to treat and control the spread of COVID-19. One of these measures is the use of locally available herbal preparations. Despite their long-time use, still, information on their safety is scarce. Methods This observational cohort study was conducted from February to May 2021 among COVID-19 patients admitted at one of 12 (10 public and two private) health facilities in Tanzania. Participants were grouped into two - those who were using standard care alone and those who reported to be supplementing standard care with herbal preparations for the treatment of COVID-19. A review of medical records and interviews were done to obtain socio-demographic, clinical and laboratory information. All participants were followed up for 14. Results Half of the participants had normal hemoglobin levels at baseline and on day 14. Renal insufficiency was observed more among non-herbal users compared to herbal users (38.5% vs 21.8%) on day 7 (p = 0.04) and 54% vs 49% on day 14. Creatinine levels were significantly raised among non-herbal users than among herbal users at baseline (p = 0.002) and at day 14 (p = 0.045). There was no significant difference in INR level among both groups on day 7, however at day 14, the raise was more among non-herbal compared to herbal users (100% vs 20.5%). Conclusion There were no noticeable haematological, renal or liver parameters derangements among COVID19 patients who used herbal preparations plus standard care compared to those who used standard care alone. [ABSTRACT FROM AUTHOR]