CHALLENGES AND OPPORTUNITIES IN BEEKEEPING AND HONEY PRODUCTION DURING COVID-19 PANDEMIC – A SHORT REVIEW

Honey bees in beekeeping are commonly involved in honey production and as planned pollinators worldwide. However, at the beginning of the covid-19 pandemic, the hardworking little creatures suffered many difficulties. The entire supply chain was blocked. Consequently, the challenges directly affected honey and crop production worldwide. The pandemic issues like travel restrictions and limited access to apiaries had a detrimental influence on beekeepers' activity. Earlier sales decline during the crisis had an economic impact, with some beneficial impacts, like a rise in demand for health-related goods. However, the challenges come with opportunities, which lead to a pointy surge in demand for honey which paved the way for many women entrepreneurs as beekeepers to meet the local demands, which helps the rural economy to be sustained. Another intriguing benefit is that a drastic drop in pollution helped bees get back to their normal routine, which led to a drastic increase in honey production during the pandemic as opposed to what they experienced in normal times. This article briefly outlines such challenges faced by the beekeepers and the honey producers and also focuses on the new opportunities that rendered many values to the producers during the pandemic © Penerbit UMT

The Analysis of Oral and Fecal Virome Detects Multiple Novel Emerging Viruses in Snakes

Wild animals are considered reservoirs for emerging and reemerging viruses, such as the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Previous studies have reported that bats and ticks harbored variable important pathogenic viruses, some of which could cause potential diseases in humans and livestock, while viruses carried by reptiles were rarely reported. Our study first conducted snakes' virome analysis to establish effective surveillance of potential transboundary emerging diseases. Consequently, Adenoviridae, Circoviridae, Retroviridae, and Parvoviridae were identified in oral samples from Protobothrops mucrosquamatus, Elaphe dione, and Gloydius angusticeps based on sequence similarity to existing viruses. Picornaviridae and Adenoviridae were also identified in fecal samples of Protobothrops mucrosquamatus. Notably, the iflavirus and foamy virus were first reported in Protobothrops mucrosquamatus, enriching the transboundary viral diversity in snakes. Furthermore, phylogenetic analysis revealed that both the novel-identified viruses showed low genetic similarity with previously reported viruses. This study provided a basis for our understanding of microbiome diversity and the surveillance and prevention of emerging and unknown viruses in snakes.

Bibliometric approach to trehalulose research trends for its potential health benefits

Trehalulose (1-O-alpha-D-glucopyranosyl-D-fructose) is a naturally occurring disaccharide composed of fructose and glucose. It is a sucrose isomer with a unique alpha-1,1 glycosidic bond that is more stable than the 1,2 glycosidic bond found in sucrose, giving it a lower glycemic index (GI). Trehalulose sugar production is often complicated, and the literature on the production is scarce. However, trehalulose is gaining popularity after a recent study revealed the abundance of this sugar in stingless bee honey (13 to 44 g per 100 g). The current short review discusses the chemical and physiological properties of trehalulose and its potential health benefits based on a bibliometric approach. Furthermore, it evaluates the antidiabetic potential of trehalulose as an emerging alternative sweetener.

Jaya Honey Badger optimization-based deep neuro-fuzzy network structure for detection of (SARS-CoV) Covid-19 disease by using respiratory sound signals

PurposeThe Covid-19 prediction process is more indispensable to handle the spread and death occurred rate because of Covid-19. However early and precise prediction of Covid-19 is more difficult because of different sizes and resolutions of input image. Thus these challenges and problems experienced by traditional Covid-19 detection methods are considered as major motivation to develop JHBO-based DNFN.Design/methodology/approachThe major contribution of this research is to design an effectual Covid-19 detection model using devised JHBO-based DNFN. Here, the audio signal is considered as input for detecting Covid-19. The Gaussian filter is applied to input signal for removing the noises and then feature extraction is performed. The substantial features, like spectral roll-off, spectral bandwidth, Mel-frequency cepstral coefficients (MFCC), spectral flatness, zero crossing rate, spectral centroid, mean square energy and spectral contract are extracted for further processing. Finally, DNFN is applied for detecting Covid-19 and the deep leaning model is trained by designed JHBO algorithm. Accordingly, the developed JHBO method is newly designed by incorporating Honey Badger optimization Algorithm (HBA) and Jaya algorithm.FindingsThe performance of proposed hybrid optimization-based deep learning algorithm is estimated by means of two performance metrics, namely testing accuracy, sensitivity and specificity of 0.9176, 0.9218 and 0.9219.Research limitations/implicationsThe JHBO-based DNFN approach is developed for Covid-19 detection. The developed approach can be extended by including other hybrid optimization algorithms as well as other features can be extracted for further improving the detection performance.Practical implicationsThe proposed Covid-19 detection method is useful in various applications, like medical and so on.Originality/valueDeveloped JHBO-enabled DNFN for Covid-19 detection: An effective Covid-19 detection technique is introduced based on hybrid optimization–driven deep learning model. The DNFN is used for detecting Covid-19, which classifies the feature vector as Covid-19 or non-Covid-19. Moreover, the DNFN is trained by devised JHBO approach, which is introduced by combining HBA and Jaya algorithm.

Changes in the production and foreign trade of honey in Poland vis-a-vis the European Union and the world market

The aim of the article is to show the development of the volume and value of natural honey production, its import and export, and prices in Poland against the background of the situation in other countries in the European Union in the years 2000-2020 and as part of market changes globally. The study used the source of information from the FAOSTAT 2022 database. The production of honey in Poland, in other EU countries and around the world was characterized by an upward trend in the analyzed period. The biggest problem is China, which supplies the market with every fourth kilogram of honey product, while the EU accounts for about 13%. In the top thirty producers of natural honey, there are 11 European countries, including 9 from the EU - Poland is in fourth position. Self sufficiency in terms of honey is 60%, which is why the turnover in foreign trade of honey is dynamically increasing in terms of quantity and value. Overall, the honey trade balance in the EU was negative. The structure of honey exports and imports from and to the EU has changed, which is the result of random factors, i.e. the Covid-19 pandemic, Russia's aggression in Ukraine, and various economic, demographic, social and environmental factors.

Self-medication Practices for COVID-19 Prevention: A Study among Medical Students in Yogyakarta, Indonesia

The corona virus disease 2019 (COVID-19) pandemic has increased the interest in self-care strategies, including self-medication. Medical students, as future health practitioners, learn more about medications than other students. This study aimed to describe self-medication practices for preventing COVID-19 among medical students at Universitas Islam Indonesia. This observational study used a cross-sectional design and was undertaken in November- December 2020. The study sample included 336 undergraduate medical students determined using a consecutive sampling technique based on inclusion and exclusion criteria. Data were collected using an online questionnaire about self-medication practices in the preceding 3 months. Among a total of 336 students, 137 (41%) reported using self-medication intending to prevent COVID-19, and 126 (92%) of these 137 took preventive supplements, mainly vitamins C, D, and E, and omega-3. Seven students reported the use of zinc, mainly in combination with other vitamins. Students who practiced self-medication lived closer to people confirmed with COVID-19, washed their hands more often, and desinfected their belongings more frequently than their counterparts (p<0.05). The mean duration for consuming vitamins was 11-16 days. Forty students (29%) used herbal medicine to prevent COVID-19;ginger, turmeric, honey, black seed, cutcherry, and Curcuma were the most often consumed herbal remedies. Fourteen students (10%) reported taking over-the-counter medications to relieve symptoms related to COVID-19, including antipyretic, analgesic, antiseptic, antihistamine, decongestant, antitussive, and expectorant medications. Most respondents (82%) purchased their medications at pharmacies, and 11 (9%) obtained them from online shops. These findings show the high rate of self-medication using vitamins and herbal remedies for COVID-19 prevention among university medical students. Further studies are needed to explore students' knowledge about the risks of self-medication including the use of herbal medicines.Copyright © 2022 Marmara University Press.

Ensemble deep honey architecture for COVID-19 prediction using CT scan and chest X-ray images.

Recently, the infectious disease COVID-19 remains to have a catastrophic effect on the lives of human beings all over the world. To combat this deadliest disease, it is essential to screen the affected people quickly and least inexpensively. Radiological examination is considered the most feasible step toward attaining this objective; however, chest X-ray (CXR) and computed tomography (CT) are the most easily accessible and inexpensive options. This paper proposes a novel ensemble deep learning-based solution to predict the COVID-19-positive patients using CXR and CT images. The main aim of the proposed model is to provide an effective COVID-19 prediction model with a robust diagnosis and increase the prediction performance. Initially, pre-processing, like image resizing and noise removal, is employed using image scaling and median filtering techniques to enhance the input data for further processing. Various data augmentation styles, such as flipping and rotation, are applied to capable the model to learn the variations during training and attain better results on a small dataset. Finally, a new ensemble deep honey architecture (EDHA) model is introduced to effectively classify the COVID-19-positive and -negative cases. EDHA combines three pre-trained architectures like ShuffleNet, SqueezeNet, and DenseNet-201, to detect the class value. Moreover, a new optimization algorithm, the honey badger algorithm (HBA), is adapted in EDHA to determine the best values for the hyper-parameters of the proposed model. The proposed EDHA is implemented in the Python platform and evaluates the performance in terms of accuracy, sensitivity, specificity, precision, f1-score, AUC, and MCC. The proposed model has utilized the publicly available CXR and CT datasets to test the solution's efficiency. As a result, the simulated outcomes showed that the proposed EDHA had achieved better performance than the existing techniques in terms of Accuracy, Sensitivity, Specificity, Precision, F1-Score, MCC, AUC, and Computation time are 99.1%, 99%, 98.6%, 99.6%, 98.9%, 99.2%, 0.98, and 820 s using the CXR dataset.

Understanding COVID-19 from an exotic honey bee-disease perspective

This article compares the development of the highly infectious COVID-19 disease in humans with infections or infestations in honey bees. The importance of knowledge on the exotic nature of COVID-19 and each of its variants in providing a useful insight as to how it would be expected to develop, and in particular the expected reduction in its virulence over time, is also discussed.

A Comprehensive Review on the Medicinal Benefits of Honey with an Emphasis on Unani Medicine

Background: Honey has been used medicinally in folk medicine since the dawn of civili-zation. It is a necessary component of medicine and food in a wide variety of cultures. It has been used in Unani Medicine for centuries to treat a variety of ailments. Objective(s): This review article aims to explore the medicinal characteristics of honey in view of Unani and modern concepts, highlight its potential in the treatment of the ailments stated in Unani medical literature, and also explore the relevant evidence-based phytochemistry, pharmacological, and clinical data. Method(s): The authors searched classical texts exhaustively for information on the temperament (Mizaj), pharmacological activities, mechanism of action, and therapeutic benefits of honey. Addition-ally, a comprehensive search of internet databases was conducted to compile all available information on the physicochemical, phytochemical, and pharmacological properties of this compound. Result(s): Evidence suggests that honey contains about 180 different types of various compounds, including carbohydrates, proteins, enzymes, flavonoids, and other chemical substances. In Unani classical literature, it exerts important pharmacological actions besides its immense nutritional signifi-cance. Unani physicians advocated many tested/experimented prescriptions and formulations, which still have their relevance in the amelioration of various diseases. Conclusion(s): This analysis concludes that honey has been successfully utilized in Unani medicine for centuries to treat a variety of maladies and is a potential natural source of remedy for a variety of medical disorders. Future research on honey should include a combination of Unani and modern principles.Copyright © 2023 Bentham Science Publishers.

COVID-19: honey as a potential adjuvant treatment

This article sums up the possible impact of honey in the amelioration of COVID-19 induced recognized pathogenesis. The pandemic due to the current outbreak of COVID-19 infected thousands of individuals round the globe. The indicator of COVID-19 infection suggests that increased inflammation, oxidation, and an overstressed immune reaction are key contributor of COVID-19 pathogenesis. This overstressed immune response leads to numerous cytokine production and consequently and led to the development of severe injury in lungs (ALI)/acute respiratory distress disorder and in some conditions becomes reason of death. Honey is formed when honey bees collect nectar from various, and then process it to form the honey. It is a natural remedy to reduce the incidence of various diseases, due to its potential anti-inflammatory, anti-oxidative, immune booster, antiviral, anti-diabetic, antimicrobial, anti-proliferative, cardiovascular, neurological and gastrointestinal diseases and anti-metastatic properties. Honey has been used for the curing of bronchial asthma, throat infections, tuberculosis, thirst, hiccups, fatigue, and hepatitis and also for the ALI/ARDS treatment caused by virus or any other pathogen. Doctors recommend honey as a nutritional supplement to boost the immunity of patients under critical conditions, reducing oxidative stress, inflammation, viral infections that confirm that honey may be used to combat the infection and other complications caused by COVID-19 pandemic. There are many reports which reveal that honey may be used in bacterial and viral infections such as COVID-19, however, further experimental studies are required to validate these speculations.

Raw Honey Of Apiscerana Indica Spp. Induces Transition, In Vitro

On the verge of Covid-19 pandemic accompanied by the vaccination research, proposed research focuses on continuous cell lines which are actually extensively applied as essential as well as economical methods for fundamental scientific analysis, chemical rate of metabolism, analysis about degree of toxicity and formation of biological formula just like vaccines. Mouse spleen cells used are well known to survive only as primary cultures. The availability of non-cancerous long-term cell cultures is scarcely available for in vitro research studies. In order to overcome this limitation, the proposed research attempted to establish a naive, long term-continuous cell culture from Balb/c mouse. This continuous cell culture derived and established from a primary mouse spleen has the potential as a model cell culture for various applications of in vitro testing. This research can be useful for further research in the specified domain.Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Chilblain: a brief history of cold comfort remedies

Chilblain, also known as pernio, has gained publicity in recent years as a result of its association with 'COVID toes' during the COVID-19 pandemic. Long before this, chilblain had left its mark throughout history and literature. The word 'chilblain' has Anglo-Saxon roots. 'Chil' comes from Old English ciele meaning 'chill' or 'frost', while 'blain' comes from the Old English blegen meaning 'inflammatory swelling' or 'sore'. The two words were brought together in the 1540s. The choice of words somehow acknowledges that cold is the aetiological factor that brings on this painful swelling. The Victorian novel Jane Erye, written by Charlotte Bronte in 1847, described the physical hardships that children had to struggle with through the winter at Lowood, the charity school for poor and orphaned girls. Her work masterfully sculptured the essence of chilblain and its effects on the children. Multiple notable figures proposed various remedies to treat the bothersome symptoms of chilblains. Pedanius Dioscorides was a Greek physician and botanist whose monumental work De Materia Medica in the first century AD compiled a list of topical remedies for chilblains, including quince oil, fenugreek oil, frankincense gum, burnt figs in wax, a mixture of gentian, crab ashes and honey, burnt ass hooves, bear grease and decoction of turnip as a warm pack. To cure chilblains, Nicholas Culpeper, an English herbalist, advised grating horseradish and applying it as a mustard plaster. We now know grated horseradish root produces a powerful mustard oil that acts as a rubefacient, which irritates the skin and increases its blood flow. Dr Lewis Johns was a recognized medical officer in the field of medical electricity in charge of the Electrical Department of St Bartholomew's Hospital. He noted a reduced incidence of chilblains in children with poliomyelitis who were treated with a warm electric footbath in 1899. The beneficial effects most likely originated from the warm bath rather than the electricity itself. Sir Thomas Lewis, a British cardiologist, investigated skin responses to injury and vascular reactions of the skin to cold exposure. His careful observations and descriptions of chilblains published in the British Medical Journal in 1941 remain true to this day. Practices such as praying to the statue of St Benignus of Dijon with chilblains, wearing electric patent socks (invented in 1882) and using an electrical vacuum tube in 1922 had also made their way into the lives of sufferers as a potential cure. Despite the epidemiological study of chilblain in over 3000 servicewomen, carried out by the Auxiliary Territorial Service in the winter of 1942, no specific remedy was found. When it comes to chilblain, prevention is better than cure by keeping the hands and feet warm and dry and staying active, and chilblains usually resolve spontaneously within a few weeks.

INTERDISCIPLINARY PROJECTS, FUSING OF STANDARDS IN THE FIELD OF FOOD SCIENCES WITH THE COMPETENCE OF THINKING AND SPEAKING IN PRESCHOOL

On the basis of our thesis stands the importance of the role of curricular projects and the creative didactic work of educators in educational institutions, for the fusion of the fields of standards with the approach based on the competencies of the subject. The Curriculum Framework of Preschool Education in Albania has the status of a political document, with national force. It is in full resonance with the curriculum in public education. The paper is conceived, referring to the basic dimensions of the health growth and education of the children in the age group 3-6 years. Our paper aims through language games in interdisciplinary projects at preschool age children to address the key competencies of the curriculum, fusing the standards of the field of health and nutrition with the competence of thinking and speaking. More precisely, this research treats the interaction of two standards in fields such as: health and food where as a study reference we have honey as a food product of particular importance especially during the pandemic period, as well as the language development, thinking and speech. Based on the curriculum, an informative lecture specified for this value-added organic food product especially during the Covid 19 period was developed alternating with their perceptions towards this product. Our study is extended to 10 schools and 20 kindergartens of public education in the city of Tirana. We collected data from children and educators, with a sample of 500 children and 30 educators participating in the study, where 65% of educators combined language components in the implementation of the interdisciplinary project in preschool education classes, for knowledge of honey through language games. The methodological approach of this paper is based on observation, research, surveys, structured online questionnaires and lectures addressed to educators and children aged 3-6 years to improve knowledge about honey through language games. When structuring methodology, we have relied on the Ministry of Education and Sports literature, in the curriculum and the Strategy of pre-university education, on the draft of organic standards for Honey in Albania but also on many years of personal experiences in the field of education and food sciences. The analysis of the results is performed both in quantitative and qualitative terms. Statistical analysis of data was performed with programs Statistics 7 and Excel. The results showed that the perception of educators and children regarding the knowledge of the organic product (honey) is very optimal, where 100% of them showed that they knew it as a food product, but 55% of them did not have complete information on how to use it, time of use, quantity or perception of its quality. About 60% of the educators did not combine the field of nutrition with the competence of thinking and speaking but formal education added the attributes of these educators to fuse these fields using didactic and linguistic innovations. 41.7% of teachers use the roles of teacher and student during the structuring of the lesson, but in the conditions of the pandemic it became very difficult to realize the diary with competencies because the distance learning made it impossible for them to find the correct activity to adapt with competence. The effect of formal education on the perceptions of educators and children about honey as an organic product with added value especially nowadays, influenced the formation of their clear concepts about the attributes treated for food safety of honey. We suggest University auditors to train capable teachers to implement a new curriculum. © 2023, Consulting and Training Center - KEY. All rights reserved.

Consumption of bee products during the COVID-19 pandemic in Piaui

The aim was to investigate the use of bee products in Piaui state during the COVID-19 pandemic. To that end, data were collected remotely via an online form sent on WhatsApp and Instagram. Sampling was stratified considering the four mesoregions of Piaui and the sex of the participants using the Survey Monkey calculator. After stratification, the study contained 392 participants. A total of 85.46% of the interviewees reported regularly consuming bee products, primarily (24.78%) due to their nutritional potential. During the pandemic, 79.34% used bee products, honey being the most consumed (59.16%), followed by propolis honey (26.04%) and propolis alone (4.82%). With respect to COVID-19-related use, 23.47% and 3.21% of the subjects related consumption for disease prevention and treatment, respectively. In general, there was a 37.24% increase in the consumption of bee products during the pandemic, but most of the participants (52.05%) did not know the extent of the increase.

Exploring the potential therapeutic properties of bee products against COVID-19 (SARS CoV-2)

The new corona virus illness (COVID-19) swept around the world, quickly creating a serious international disaster. For the treatment and prevention of COVID-19, apitherapy appears to be a viable source of pharmacological and nutraceutical medicines. Honey, pollen, propolis, royal jelly, beeswax, and bee venom, for example, have been demonstrated to have significant antiviral action against infections that cause severe respiratory syndromes, including those produced by human corona viruses. Furthermore, many of these natural products are involved in the induction of antibody production, maturation of immune cells, and stimulation of innate and adaptive immunological responses and many of them are involved in the induction of antibody production, maturation of immune cells, and stimulation of innate and adaptive immunological responses.

Screening of honey bee pollen constituents against COVID-19: an emerging hot spot in targeting SARS-CoV-2-ACE-2 interaction.

The attachment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike to angiotensin-converting enzyme 2 (ACE-2) leads the cell fusion process, so spike blockade may be a promising therapy combating COVID-19. Bee pollen bioflavonoids with intrinsic bioactivities are of outmost importance to block SARS-CoV-2-ACE-2 interaction. Herein, we conducted a molecular docking assessment through natural phenolics/non-phenolics of pollen to investigate their affinity against SARS-CoV-2 spike. Finally, kaempferol 3-neohesperidoside 7-O-rhamnoside (compound a), quercetin 7-rhamnoside (compound b), delphinidin-3-O-(6-p-coumaroyl) glucoside (compound c), and luteolin-7-O-6″-malonylglucoside (compound d) showed the lowest binding affinity of -8.1, -7.7, -7.3 and -6.7 kcal/mol. The docking procedure was validated using protein-protein interactions between ACE-2 and SARS-CoV-2 RBD via HADDOCK webserver. MD simulations were fulfilled to investigate different ligands' effects on protein movements. Collectively, compound a may possess the potency to disturb the binding of SARS-CoV-2 spike-ACE-2, which can be on the call for further in vitro and in vivo study to investigate its antiviral potential against SARS-CoV-2.

Effectiveness of antitussives, anticholinergics, and honey versus usual care in adults with uncomplicated acute bronchitis: a multiarm randomized clinical trial.

BACKGROUND: Despite the frequent use of symptomatic therapies in cough, evidence of their benefits is lacking. OBJECTIVE: We compared the effectiveness of 3 symptomatic therapies and usual care in acute bronchitis. METHODS: Multicenter, pragmatic, multiarm parallel group, open randomized trial in primary care (ClinicalTrials.gov, Identifier: NCT03738917) was conducted in Catalonia. Patients ≥18 with uncomplicated acute bronchitis, with cough<3 weeks as the main symptom, scoring ≥4 in either daytime or nocturnal cough (7-point Likert scale), were randomized to usual care, dextromethorphan 15 mg t.i.d., ipratropium bromide inhaler 20 µg 2 puffs t.i.d, or 30 mg of honey t.i.d., all taken for up to 14 days. The main outcome measure was the number of days with moderate-to-severe cough. A symptom diary was given. A second visit was scheduled at days 2-3 for assessing evolution, with 2 more visits at days 15 and 29 for clinical assessment, evaluation of adverse effects, re-attendance, and complications. RESULTS: We failed to achieve the sample size scheduled due to the COVID-19 pandemic. We finally recruited 194 patients. The median number of days with moderate-to-severe cough (score ≥ 3) in the usual care arm was 5 (interquartile range [IQR], 4, 8.75), 5 in the ipratropium bromide arm (IQR, 3, 8), 5 in the dextromethorphan arm (IQR, 4, 9.75), and 6 in the honey arm (IQR, 3.5, 7). The same results were obtained in the Kaplan-Meier survival analysis for the median survival time of each arm with the usual care as the reference group. CONCLUSION: The symptomatic treatment evaluated has shown to be ineffective against cough.

Cough is the most frequent symptom reported by patients with lower respiratory tract infections. Despite being a defense mechanism, cough is unpleasant and negatively affects sleep and overall well-being. Accordingly, many patients with acute cough seek medical help to mitigate symptoms and reduce their duration despite the typically self-limiting nature of the condition. In this randomized clinical trial, we explored the benefit of 3 common symptomatic treatments recommended in some guidelines for relieving this symptom during the course of uncomplicated acute bronchitis, a cough suppressant, an inhaler, and honey intake. Although the total number of patients initially expected could not be achieved due to the disruption caused by the COVID-19 pandemic, the results of our study demonstrate a lack of efficacy of these products as the number of days of severe-to-moderate cough was similar in the 3 arms and comparable to the group of patients allocated to usual care.

Antiviral Activity of Bee Products.

Honey bees provide many products exerting a wide range of benefits to humans. Honey, propolis, royal jelly, beeswax, bee venom, bee pollen and bee bread have been used as natural medicines since ancient times because of their therapeutic effects. These products have demonstrated healing properties against wounds, diabetes, gastrointestinal diseases, cancer, asthma, neurological diseases, bacterial and viral infections. The antibacterial and antibiofilm activity of honey bee products is widely studied, and a huge body of evidence supports it. On the other hand, their antiviral effect has not been extensively studied. However, recent research has demonstrated their potential against various viral infections including SARS-CoV-2. Hence, honey bee products could be alternatives to treat viral diseases, especially when there is no effective treatment available. This narrative review aims to present up-to-date data (including ongoing clinical trials) regarding the antiviral activity of honey bee products, aiming to elucidate how honey bee product supplementation contributes to antiviral treatment.

Honey and Nigella sativa against COVID-19 in Pakistan (HNS-COVID-PK): A multicenter placebo-controlled randomized clinical trial.

Until now, no specific and effective treatment exists for coronavirus disease 2019 (COVID-19). Since honey and Nigella sativa (HNS) have established antiviral, antibacterial, antiinflammatory, antioxidant, and immunomodulatory properties, we tested their efficacy for this disease in a multicenter, placebo-controlled, and randomized clinical trial at four medical care facilities in Pakistan. RT-PCR confirmed COVID-19 adults showing moderate or severe disease were enrolled in the trial. Patients were randomly assigned in a 1:1 ratio to receive either honey (1 g kg-1 day-1 ) and Nigella sativa seeds (80 mg kg-1 day-1 ) or a placebo for up to 13 days along with standard care. The outcomes included symptoms' alleviation, viral clearance, and 30-day mortality in the intention-to-treat population. Three hundred and thirteen patients, 210 with moderate and 103 with severe disease, underwent randomization from April 30 to July 29, 2020. Among the moderate cases, 107 were assigned to HNS, whereas 103 were assigned to the placebo group. Among the severe cases, 50 were given HNS, and 53 were given the placebo. HNS resulted in ~50% reduction in time taken to alleviate symptoms as compared to placebo (moderate cases: 4 vs. 7 days, Hazard Ratio [HR]: 6.11; 95% Confidence Interval [CI]: 4.23-8.84, p < 0.0001 and for severe cases: 6 vs. 13 days, HR: 4.04; 95% CI: 2.46-6.64; p < 0.0001). HNS also cleared the virus earlier than placebo in both moderate cases (6 vs. 10 days, HR: 5.53; 95% CI: 3.76-8.14, p < 0.0001) and severe cases (8.5 vs. 12 days, HR: 4.32; 95% CI: 2.62-7.13, p < 0.0001). HNS further led to a better clinical score on day 6 with normal activity resumption in 63.6% vs. 10.9% among moderate cases (OR: 0.07; 95% CI: 0.03-0.13, p < 0.0001) and hospital discharge in 50% versus 2.8% in severe cases (OR: 0.03; 95% CI: 0.01-0.09, p < 0.0001). In severe cases, the mortality rate was less than 1/4th in the HNS group than in placebo (4% vs. 18.87%, OR: 0.18; 95% CI: 0.02-0.92, p = 0.029). No HNS-related adverse effects were observed. HNS, compared with placebo, significantly improved symptoms, expedited viral load clearance, and reduced mortality in COVID-19 patients. This trial was registered on April 15, 2020 with ClinicalTrials.gov Identifier: NCT04347382.