Effect of high-dose Spirulina supplementation on hospitalized adults with COVID-19: a randomized controlled trial
Mohammad Reza Aghasadeghi, Mohammad Ali Zaheri Birgani, Saeedreza Jamalimoghadamsiyahkali, Hadiseh Hosamirudsari, Ali Moradi, Majid Jafari-Sabet, Nooshin Sadigh, Pooneh Rahimi, Rezvan Tavakoli, Mojtaba Hamidi-Fard, Golnaz Bahramali, Zohal Parmoon, Sina Arjmand Hashjin, Ghasem Mirzajani, Reza Kouhkheil, Somayeh Roshangaran, Samineh Khalaf, Mohammad Khademi Nadoushan, Ghazaleh Gholamiyan Yousef Abad, Nima Shahryarpour, Mohammad Izadi, Abolfazl Zendedel, Shayesteh Jahanfar, Omid Dadras, Seyedahmad Seyedalinaghi, Daniel Hackett
Frontiers in Immunology, doi:10.3389/fimmu.2024.1332425
Objective: Spirulina (arthrospira platensis) is a cyanobacterium proven to have anti-inflammatory, antiviral, and antioxidant effects. However, the effect of highdose Spirulina supplementation on hospitalized adults with COVID-19 is currently unclear. This study aimed to evaluate the efficacy and safety of highdose Spirulina platensis for SARS-CoV-2 infection. Study Design: We conducted a randomized, controlled, open-label trial involving 189 patients with COVID-19 who were randomly assigned in a 1:1 ratio to an experimental group that received 15.2g of Spirulina supplement plus standard treatment (44 non-intensive care unit (non-ICU) and 47 ICU), or to a control group that received standard treatment alone (46 non-ICU and 52 ICU). The study was conducted over six days. Immune mediators were monitored on days 1, 3, 5, and 7. The primary outcome of this study was mortality or hospital Frontiers in Immunology frontiersin.org 01
Ethics statement This study is a multicenter, randomized controlled trialapproved by the Research Ethics Committee of Tehran University of Medical Sciences (IR.TUMS.IKHC.REC.1399.481) and the Iranian Registry of Clinical Trials (IRCT) registry team. The s tu dy pro t oco l is re gi stered w ith IRCT u n d e r IRCT20210216050373N1, available at https://irct.ir/trial/54375. All patients gave written informed consent before starting the study.
Author contributions
Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher's note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
Supplementary material The Supplementary Material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fimmu.2024.1332425/ full#supplementary-material
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'abstract': '<jats:sec><jats:title>Objective</jats:title><jats:p><jats:italic>Spirulina</jats:italic> '
'(<jats:italic>arthrospira platensis</jats:italic>) is a cyanobacterium proven to have '
'anti-inflammatory, antiviral, and antioxidant effects. However, the effect of high-dose '
'<jats:italic>Spirulina</jats:italic> supplementation on hospitalized adults with COVID-19 is '
'currently unclear. This study aimed to evaluate the efficacy and safety of high-dose '
'<jats:italic>Spirulina platensis</jats:italic> for SARS-CoV-2 '
'infection.</jats:p></jats:sec><jats:sec><jats:title>Study Design</jats:title><jats:p>We '
'conducted a randomized, controlled, open-label trial involving 189 patients with COVID-19 who '
'were randomly assigned in a 1:1 ratio to an experimental group that received 15.2g of '
'<jats:italic>Spirulina</jats:italic> supplement plus standard treatment (44 non-intensive '
'care unit (non-ICU) and 47 ICU), or to a control group that received standard treatment alone '
'(46 non-ICU and 52 ICU). The study was conducted over six days. Immune mediators were '
'monitored on days 1, 3, 5, and 7. The primary outcome of this study was mortality or hospital '
'discharge within seven days, while the overall discharge or mortality was considered the '
'secondary '
'outcome.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Within seven '
'days, there were no deaths in the <jats:italic>Spirulina</jats:italic> group, while 15 deaths '
'(15.3%) occurred in the control group. Moreover, within seven days, there was a greater '
'number of patients discharged in the <jats:italic>Spirulina</jats:italic> group (97.7%) in '
'non-ICU compared to the control group (39.1%) (HR, 6.52; 95% CI, 3.50 to 12.17). Overall '
'mortality was higher in the control group (8.7% non-ICU, 28.8% ICU) compared to the '
'<jats:italic>Spirulina</jats:italic> group (non-ICU HR, 0.13; 95% CI, 0.02 to 0.97; ICU, HR, '
'0.16; 95% CI, 0.05 to 0.48). In non-ICU, patients who received '
'<jats:italic>Spirulina</jats:italic> showed a significant reduction in the levels of IL-6, '
'TNF-α, IL-10, and IP-10 as intervention time increased. Furthermore, in ICU, patients who '
'received <jats:italic>Spirulina</jats:italic> showed a significant decrease in the levels of '
'MIP-1α and IL-6. IFN-γ levels were significantly higher in the intervention group in both ICU '
'and non-ICU subgroups as intervention time increased. No side effects related to '
'<jats:italic>Spirulina</jats:italic> supplements were observed during the '
'trial.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>High-dose '
'<jats:italic>Spirulina</jats:italic> supplements coupled with the standard treatment of '
'COVID-19 may improve recovery and remarkably reduce mortality in hospitalized patients with '
'COVID-19.</jats:p></jats:sec><jats:sec><jats:title>Clinical Trial '
'Registration</jats:title><jats:p><jats:ext-link>https://irct.ir/trial/54375</jats:ext-link>, '
'Iranian Registry of Clinical Trials number (IRCT20210216050373N1)</jats:p></jats:sec>',
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