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A Randomised, Single Blinded Study Investigating the Role of ' Black Elderberry (Sambucus Nigra) (Sambucol®) in the Treatment, Progression and Reduction of Symptoms in Participants With Coronavirus 19

Evans et al., NCT05489770, BERRY, NCT05489770, May 2022
Early treatmentDouble-blind RCT · NCT05489770 · 204 patients · UK
Elderberry for COVID-19
BERRY Evans et al. NCT05489770 · May 2022
No significant difference in recovery
RCT 204 COVID-19 patients showing no significant differences with Sambucol® black elderberry (Sambucus nigra) treatment. Treatment delay is unknown and may be too late. There was no restriction on the time from symptom onset, patients only needed a positive test result within the last 5 days.
Standard of Care (SOC) for COVID-19 in the study country, the United Kingdom, is very poor with very low average efficacy for approved treatments1. The United Kingdom focused on expensive high-profit treatments, approving only one low-cost early treatment, which required a prescription and had limited adoption. The high-cost prescription treatment strategy reduces the probability of early treatment due to access and cost barriers, and eliminates complementary and synergistic benefits seen with many low-cost treatments.
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OutcomeImprovementEffect · pTreatmentControl
risk of no recovery 1.4% higher · RR 1.01 · p = 0.37 1.4% higherRR 1.01p = 0.37 mean 93.5 (±11.4) n=84 mean 94.8 (±7.1) n=87 mean 93.5 (±11.4) n=84, mean 94.8 (±7.1) n=87day 28
risk of no recovery 2.7% higher · RR 1.03 · p = 0.16 2.7% higherRR 1.03p = 0.16 mean 88.7 (±13.9) n=90 mean 91.1 (±8.8) n=92 mean 88.7 (±13.9) n=90, mean 91.1 (±8.8) n=92day 14
risk of no recovery 2.6% higher · RR 1.03 · p = 0.22 2.6% higherRR 1.03p = 0.22 mean 84.3 (±13.8) n=90 mean 86.5 (±9.9) n=93 mean 84.3 (±13.8) n=90, mean 86.5 (±9.9) n=93day 10
risk of no recovery 1.8% higher · RR 1.02 · p = 0.52 1.8% higherRR 1.02p = 0.52 mean 78.9 (±17.0) n=96 mean 80.3 (±12.7) n=96 mean 78.9 (±17.0) n=96, mean 80.3 (±12.7) n=96day 7

Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates.

Evans et al., 16 May 2022, Double Blind Randomized Controlled Trial, placebo-controlled, United Kingdom, preprint, 1 author, trial NCT05489770 (history) (BERRY). Contact: jane.povey2@nhs.net.
$0 $500 $1,000+ Efficacy vs. cost for COVID-19 treatment protocols c19early.org November 2026 United Kingdom Angola Colombia Kenya Mozambique Myanmar South Africa Peru Philippines USA Brazil France Italy Canada Pakistan Spain Vietnam Japan Nepal Iran Bangladesh Ethiopia Ghana Mexico South Korea Saudi Arabia Algeria Morocco Yemen Poland Uzbekistan India China Venezuela DR Congo Madagascar Thailand Uganda Egypt Nigeria Taiwan Fiji Zambia Bosnia-Herzegovina Dominican Republic Bolivia Côte d'Ivoire Eritrea Togo Iceland New Zealand Mongolia Czechia Belarus Israel Haiti North Macedonia Hong Kong Qatar Panama Serbia The United Kingdom favored high-profit treatments.The average efficacy of treatments was moderate.High-cost protocols reduce early treatment, andforgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
$0 $500 $1,000+ Efficacy vs. cost for COVID-19treatment protocols worldwide c19early.org November 2026 United Kingdom Angola Colombia Kenya Mozambique Myanmar South Africa Peru Philippines USA Brazil France Italy Canada Pakistan Spain Vietnam Japan Iran Bangladesh Ethiopia Ghana Mexico South Korea Saudi Arabia Algeria Morocco Yemen Poland Uzbekistan India China Venezuela DR Congo Madagascar Thailand Uganda Egypt Taiwan Fiji Zambia Dominican Rep. Bolivia Côte d'Ivoire Eritrea Mongolia Czechia Belarus Israel North Macedonia Hong Kong Qatar Panama Serbia The UK favored high-profit treatments.The average efficacy was moderate.High-cost protocols reduce early treatment,and forgo complementary/synergistic benefits. More effective More expensive 75% 50% 25% ≤0%
Elderberry (Sambucus nigra) is an orally administered botanical dietary supplement proposed as potentially beneficial for SARS-CoV-2 via antiviral and immunomodulatory mechanisms.