Discussion
critically ill, chronic kidney disease, fever, coronavirus infection, pain, infection, hemodialysisAcute kidney injury
CRITICALLY ILL, CORONAVIRUS INFECTION, DISEASES, INFECTION, SECONDARY INFECTION
In this randomized, double-blind, placebo-controlled study, the use of standardized Brazilian green propolis extract associated with standard-of-care treatment reduced the length of hospital stay by one day compared to a placebo group among hospitalized adult patients with mild to moderate COVID-19. This trend was more noticeable among non-vaccinated patients despite no statistical significance. On the other hand, the use of propolis was associated with three times fewer secondary infections.A recent analysis in a tertiary hospital has demonstrated that each day of hospitalization costs around US$ 900The first randomized study to use EPP-AF in moderate to severe COVID-19 non-vaccinated patients showed a significant decrease in length of hospital staySARS-CoV-2 infection is more associated with secondary infections when compared to non-infected patientsBeeCovid2 has demonstrated that the use of standardized Brazilian green propolis extract in the dose used is safe, even among critically ill patients, without a single case of hospitalization or readmission to the hospital due to EPP-AF side effects. The safety analysis was performed throughout the entire study period. Previous randomized studies that used EPP-AF had already shown the safety profile of this medication, even in patients with chronic kidney disease undergoing hemodialysisAcute kidney injury may occur in a significant number of COVID-19 patientsOur trial has several limitations. Due to the lack of supplies during the pandemic, glomerular filtration was assessed using creatinine levels calculated by dry chemistry method, which suffers interference by dipyrone (metamizole), drug widely administered to fever and pain controlExperimental data show the potential actions of propolis against viral targets such as TMPRSS2, ACE2 receptor and PAK1, which justifies the experimental use of EPP-AF and results in new perspectives to treat diseases that lead to immuno-inflammatory dysregulationWe therefore conclude that coronavirus infection has a negative impact on people worldwide. This immunological challenge opens a window of opportunity to use propolis, a natural immunomodulator. This is important because propolis may be considered and tested to treat other diseases that cause immunological dysregulations. The present study provides clinical evidence that can be explored by other researchers. In this study, the EPP-AF dose tested was safe to use in adult patients with mild to moderate Covid-19. The use of the medication was not significantly associated with decreases in length of hospital stay. More studies are needed.