Standardized Brazilian green propolis extract (EPP-AF®) in COVID-19 outcomes: a randomized double-blind placebo-controlled trial
Marcelo Augusto Duarte Silveira, Matheus De Alencar Menezes, Sergio Pinto De Souza, Erica Batista Dos Santos Galvão, Andresa Aparecida Berretta, Juliana Caldas, Maurício Brito Teixeira, Marcel Miranda Dantas Gomes, Lucas Petri Damiani, Bruno Andrade Bahiense, Julia Barros Cabral, Cicero Wandson Luiz Macedo De Oliveira, Talita Rocha Mascarenhas, Priscila Carvalho Guedes Pinheiro, Milena Souza Alves, Rodrigo Morel Vieira De Melo, Flávia Mendes Leite, Carolina Kymie Vasques Nonaka, Bruno Solano De Freitas Souza, Nathália Ursoli Baptista, Flávio Teles, Suzete Farias Da Guarda, Ana Verena Almeida Mendes, Rogério Da Hora Passos
Scientific Reports, doi:10.1038/s41598-023-43764-w
SARS-CoV-2 and its different variants caused a "wave and wave" pandemic pattern. During the first wave we demonstrated that standardized Brazilian green propolis extract (EPP-AF®) reduces length of hospital stay in adult patients with COVID-19. Afterwards, we decided to evaluate the impact of EPP-AF in hospitalized patients during the third wave of the pandemic. BeeCovid2 was a randomized, double-blind, placebo-controlled clinical trial in hospitalized COVID-19 adult patients. Patients were allocated to receive an oral dose of 900 mg/day of EPP-AF® or placebo for 10 days. The primary outcome was length of hospital stay. Secondary outcomes included safety, secondary infection rate, duration of oxygen therapy dependency, acute kidney injury and need for intensive care. Patients were followed up for 28 days after admission. We enrolled 188 patients; 98 were assigned to the propolis group and 90 to the placebo group. The post-intervention length of hospital stay was of 6.5 ± 6.0 days in the propolis group versus 7.7 ± 7.1 days in the control group (95% CI -0.74 [-1.94 to 0.42]; p = 0.22). Propolis did not have significant impact on the need for oxygen supplementation or frequency of AKI. There was a significant difference in the incidence of secondary infection between groups, with 6.1% in the propolis group versus 18.9% in the control group (95% CI -0.28 [0.1-0.76], p = 0.01). The use of EPP-AF was considered safe and associated with a decrease in secondary infections. The drug was not associated with a significant reduction in length of hospital stay.
ClinicalTrials.gov (NCT04800224). Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a significant concern regarding its global impact on healthcare settings 1 . After the viral replication phase, there is an enormous immunological and inflammatory challenge since both innate and adaptive immunity may be disorderly activated by SARS-CoV-2 infection 2 . The magnitude of OPEN
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Competing interests The authors declare no competing interests.
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Supplementary Information The online version contains supplementary material available at https:// doi. org/ 10. 1038/ s41598-023-43764-w. Correspondence and requests for materials should be addressed to M.A.D.S. Reprints and permissions information is available at www.nature.com/reprints. Publisher's note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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