Propolis, Bee Honey, and Their Components Protect against Coronavirus Disease 2019 (COVID-19): A Review of In Silico, In Vitro, and Clinical Studies

Abstract

Despite the virulence and high fatality of coronavirus disease 2019 (COVID-19), no specific antiviral treatment exists until the current moment. Natural agents with immune-promoting potentials such as bee products are being explored as possible treatments. Bee honey and propolis are rich in bioactive compounds that express strong antimicrobial, bactericidal, antiviral, anti-inflammatory, immunomodulatory, and antioxidant activities. This review examined the literature for the anti-COVID-19 effects of bee honey and propolis, with the aim of optimizing the use of these handy products as prophylactic or adjuvant treatments for people infected with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). Molecular simulations show that flavonoids in propolis and honey (e.g., rutin, naringin, caffeic acid phenyl ester, luteolin, and artepillin C) may inhibit viral spike fusion in host cells, viral-host interactions that trigger the cytokine storm, and viral replication. Similar to the potent antiviral drug remdesivir, rutin, propolis ethanolic extract, and propolis liposomes inhibited non-structural proteins of SARS-CoV-2 in vitro, and these compounds along with naringin inhibited SARS-CoV-2 infection in Vero E6 cells. Propolis extracts delivered by nanocarriers exhibit better antiviral effects against SARS-CoV-2 than ethanolic extracts. In line, hospitalized COVID-19 patients receiving green Brazilian propolis or a combination of honey and Nigella sativa exhibited earlier viral clearance, symptom recovery, discharge from the hospital as well as less mortality than counterparts receiving standard care alone. Thus, the use of bee products as an adjuvant treatment for COVID-19 may produce beneficial effects. Implications for treatment outcomes and issues to be considered in future studies are discussed.

Approaches to Nutritional Screening in Patients with Coronavirus Disease 2019 (COVID-19)

“…Coronavirus disease 2019 (COVID-19) is a highly infectious viral disease that results from pulmonary invasion by a beta-coronavirus, known as severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) [1]. Even though the disease is asymptomatic in most patients, symptoms of cough, dyspnea, unremitting fever, myalgia, and fatigue commonly occur in specific patient groups; mainly elderly adults and people with chronic disorders such as diabetes mellitus, cardiovascular disorders, obesity, and cancer [2][3][4]. SARS-CoV-2 induces serious adverse effects in these groups including acute respiratory distress syndrome (ARDS), fulminant myocarditis, renal injury, hepatic injury, secondary infections, and mortality [2,[5][6][7].…”

“…SARS-CoV-2 induces serious adverse effects in these groups including acute respiratory distress syndrome (ARDS), fulminant myocarditis, renal injury, hepatic injury, secondary infections, and mortality [2,[5][6][7]. Until now, the global deaths caused by this virus exceeded 2 million [4].…”

“…Tissue damage that contributes to multiple organ failure in severe COVID-19 patients is attributed to defective stimulation of the immune system leading to a condition of sustained inflammation-the cytokine storm, which involves excessive and uncontrollable release of inflammatory cytokines [2][3][4]. Symptomatic COVID-19 patients possibly exhibit a baseline state of inflammation, which allows the virus to escape the immune system and take over cellular processes in human cells to promote its replication [8][9][10].…”

“…Nutritional deficiencies weaken the immune system and increase the invasion, replication, and mutation of viruses [18,21]. Indeed, the pathogenicity of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19) [4,13], is associated with an imbalance in several nutritional elements [5,22,23]. Nutritional deficiencies are common among severe and fatal COVID-19, especially elderly adults and patients with age-related comorbidities such as diabetes and cardiovascular disorders [2,5,6,24].…”

“…Indeed, MNA detected malnutrition and high risk of malnutrition in 14.6% and 65.9% of patients following discharge from ICU [52], in 6.6% and 54.7% of remitting patients attending follow up care [51], and in 5.4% and 57.3% of recovering patients 100 days after discharge from the hospital [50]. Some elements in bioactive foods (e.g., bee products) foster the immune system and interact with SARS-CoV-2 and its related host receptor, resulting in lower viral tropism and decreased viral load [4,86]. Bee products, are reported to counteract anabolic resistance in old age, suppress catabolic genes, and foster anabolism in malnourished old rodents [11].…”