Honeybee Products for the Treatment and/ or Recovery of COVID-19 and Other Coronavirus-Related Respiratory Tract Infections: A Rapid Systematic Review

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, (RR0.36;95%CI0.15, 0.88), respiratory failure (RR0.32;95%CI0.11, 0.92), and kidney injury (RR0.36 95% CI0.15, 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 (MD0.20 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.