Fermented Carica papaya and Morinda citrifolia as Perspective Food Supplements for the Treatment of Post-COVID Symptoms: Randomized Placebo-Controlled Clinical Laboratory Study

Abstract

Food supplements based on fermented Carica papaya and Morinda citrifolia, known for their immune modulating, redox balancing, and anti-inflammatory effects, were added to conventional treatment protocols prescribed to patients recovering after severe and moderate COVID-19 disease in order to alleviate long-lasting post-COVID symptoms. A randomized single-center placebo-controlled clinical laboratory study was designed and performed (total number of participants 188, with delta variant of virus 157, with omicron 31). Clinical statuses were assessed using computer tomography, electrocardiography, a questionnaire, and physical endurance. Plasma cytokines (IL-6, IL-8, IL-17A, and INF-gamma), nitrate/nitrite ratio, antioxidant activity (AOA), and polymorphonuclear leukocyte (PMN) ATP levels were determined before and 20 days following the addition of 28 g of fermented supplements twice per day. The capacity of PMN to phagocyte and the oral-nasal-pharyngeal microbiota were assessed. Clinical symptoms, IL-6, IL-8, and nitric oxide metabolites diminished significantly compared to the placebo group and their background expression. The PMN capacity to phagocyte, AOA, and ATP content remarkably increased. The oral-nasal-pharyngeal microbiota were unchanged. On these grounds, we suggest that fermented tropical fruits could efficiently diminish post-COVID clinical symptoms through several immune-modulating, redox balancing, and pro-energy mechanisms.

Biomolecules of Fermented Tropical Fruits and Fermenting Microbes as Regulators of Human Hair Loss, Hair Quality, and Scalp Microbiota

“…Standardized fermented tropical fruits papaya ( Carica papaya L.) and mangosteen ( Garcinia mangostana Linn.) syrups of food grade [ 50 , 51 , 52 , 53 , 54 ] were used as active ingredients for hair care cosmetic products (they are classified as raw materials for cosmetics by the International Cosmetic Ingredient Index (INCI)). Their concentrations in the experimental lotion were equal to 2.0% w / w for each fermented fruit, and caffeine concentration was 0.5% w / w (lotion’s internal code, MEDENA-1324-HL).…”

“…Fermented tropical fruits, such as papaya, noni, mangosteen, pineapple, berries, etc., seem to be a unique source of both plant-derived low molecular weight biomolecules (secondary metabolites) and fermenting microbe-associated actives with pro- and prebiotic properties [ 47 , 48 , 49 ]. Plant-derived secondary metabolites (polyphenols/terpenes/alkaloids) and microbial exometabolites/membrane components of fermented tropical fruits are known as highly bioavailable biomolecules causing skin and hair improving effects—antioxidant, wound healing, anti-inflammatory antidiabetic, antiacne, skin/hair microbiota balancing, hair growth-promoting, and hair loss-inhibiting [ 50 , 51 , 52 , 53 , 54 ]. The molecular/cellular mechanisms of these health effects have been intensely studied in in vitro and in vivo preclinical experiments.…”

Long COVID: Clinical Framing, Biomarkers, and Therapeutic Approaches

“…In an RCT that enrolled 188 patients and 25 controls, Kharaeva et al showed that the use of Carica papaya and Morinda citrifolia supplements reduced post-COVID symptoms, with increased leukocyte phagocytic capacity, antioxidant activity, and ATP content [ 153 ].…”

The effects of supplementation of noni (Morinda citrifolia L.) fruit polysaccharides-rich extract on antioxidant status and immune function in cashmere goats

“…There are abundant noni germplasm resources in south China. In recent decades, noni fruit has attracted much research attention because of its extensive biological and pharmacological properties including anticancer ( Ma et al, 2020 ), anti-inflammatory ( Kharaeva et al, 2022 ), anti-oxidant ( Wang et al, 2022 ), and immune modulatory effects ( Ezzat et al, 2021 ). Dietary supplementation of noni fruit has been found to strengthen humonal immune response in broiler chickens ( Sunder et al, 2015 ), to enhance the anti-oxidant enzyme activities in serum of calves ( Anantharaj et al, 2017 ), and to counteract the adverse effect of high-fat intake on yellow catfish growth ( Wang et al, 2021 ).…”