ABSTRACT
Methods: A protocol applying Cochrane rapid review methods was registered with PROSPERO: (CRD42020193847) in July 2020. Four English databases plus preprint servers and trial registries were searched for randomised controlled trials (RCTs). The evidence was appraised using RoB 2.0 and GRADE-approach. Results: 27 results, derived from 9 RCTs, included 674 adults and 781 children. In Hospitalized patients with confirmed SARS-CoV-2 infections, propolis plus usual care compared to usual care alone, reduced the risk of shock, (RR:0.36;95%CI:0.15, 0.88), respiratory failure (RR:0.32;95%CI:0.11, 0.92), and kidney injury (RR:0.36: 95% CI:0.15, 0.88) (all low-certainty) and duration of hospital admission (MD:-3.81 days, 95%CI:-6.19, -1.44) (moderate-certainty). Compared to coffee, honey plus coffee and honey alone, reduced the severity of post-infectious cough of a least 3-weeks duration in adults (MD:-1.40, 95%CI:-1.67, -1.13) (low-certainty) and (MD:-0.40, 95%CI:-0.75, 0.05) (very low-certainty) respectively. Honey was less effective than Guaifenesin in reducing cough severity at 60-minutes in adults with non-specific acute RTIs (MD:0.20 points, 95%CI: 0.05, 0.35) (very low-certainty). Honey compared to placebo reduced the duration of cough in children (MD:-0.71 days 95% CI:-1.15, -0.28) and compared to salbutamol (MD:-0.54 days 95%CI:-0.99, -0.09) (low-certainty);and the global impact of paediatric nocturnal cough was reduced by honey plus usualcare compared to usual-care alone (SMD:-0.80, 95%CI:-1.28, -0.32) (very low-certainty) and pharmaceutical cough medicines (SMD:-0.75 95%CI:-1.13, -0.36) (low-certainty). Background: This rapid review systematically evaluated the effects of honeybee products compared to controls for the duration, severity, and recovery of acute viral respiratory tract infections (RTIs), including SARS-CoV-2, in adults and children. Conclusion: More RCTs are needed to robustly inform the role of honey and propolis for treatment of SARS-CoV-2 and related respiratory infections.