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Covid19Phase 2/3BeeCovid2NCT04800224

Brazilian Green Propolis Extract (EPP-AF) as an Adjunct Treatment for Hospitalized COVID-19 Patients (BeeCovid2)

A Phase 2/3 study testing Standardized Brazilian Green Propolis Extract in people with Covid19 and Inflammation, run by D'Or Institute for Research and Education at 1 site in Brazil.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) promotes challenging immune and inflammatory phenomena. Though various therapeutic possibilities have been tested against coronavirus disease 2019 (COVID-19), the most adequate treatment has not yet been established. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Covid19, Inflammation
What is being tested?
Standardized Brazilian Green Propolis Extract
Type of treatment
Pill or oral medicine
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
200 participants
Where
1 siteBrazil
Study dates
12 Apr 2021to 30 Jul 2021
Phase
Phase 2/3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Older than 18 years;
  • Diagnosis of coronavirus infection confirmed by polymerase chain reaction - reverse transcriptase testing;
  • Symptoms started within 14 days of the randomization date

Who cannot join

  • Pregnant or lactating women;
  • Known hypersensitivity to propolis;
  • Propolis use less than 30 days from the randomization date;
  • Active cancer;
  • Human immunodeficiency virus carriers;
  • Patients undergoing transplantation of solid organs or bone marrow or who were using immunosuppressive medications;
Show all 10Show fewer
  • Bacterial infection at randomization, sepsis or septic shock related to bacterial infection at randomization;
  • Impossibility of using the medication orally or by nasoenteral tube;
  • Known hepatic failure or advanced heart failure (New York Heart Association [NYHA] class III or IV).
  • End Stage Renal Disease (ESRD).

Trial locations and contacts

1 site in 1 country.

Brazil1 site
  • Hospital Sao Rafael

    Salvador, Estado de Bahia, 41820340

Other trials in Brazil

About this study

Official title: The Use of the Standardized Brazilian Green Propolis Extract (EPP-AF) as an Adjunct Treatment for Hospitalized COVID-19 Patients: A Randomized, Double-blind, Placebo-controlled Trial

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) promotes challenging immune and inflammatory phenomena. Though various therapeutic possibilities have been tested against coronavirus disease 2019 (COVID-19), the most adequate treatment has not yet been established. Among candidate adjunct treatment options, propolis, produced by honey bees from bioactive plant exudates, has shown potential against viral targets and has demonstrated immunoregulatory properties.

Read the detailed description

To evaluate the efficacy and safety of oral propolis as an adjunct treatment for SARS-CoV-2 infection, we designed a randomized, double-blind, placebo-controlled trial (Bee-Covid2) (The Use of Brazilian Green Propolis Extract (EPP-AF®) in Patients Affected by COVID-19).

Being tested
Standardized Brazilian Green Propolis Extract, Placebo
Keywords
Propolis, Covid19, Anti-Inflammatory Agents, Immunoregulation
Medical subject headings
COVID-19, Inflammation

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Standardized Brazilian Green Propolis ExtractDrug

    Also called Propolis

    900mg/day of Standardized Brazilian Green Propolis Extract for 10 days.

  • PlaceboDrug

    900mg/day of Placebo for 10 days.

Study groups in NCT04800224
Study groupRoleWhat they receive
PlaceboPlacebo comparatorPatients in the Placebo group will receive an identical number of capsules containing 900 mg / day of placebo (3 capsules of 100 mg each, divided into 3 daily doses); for 10 days.
Receives: Drug: Placebo
PropolisActive comparatorParticipants in the Propolis group will receive propolis EPP-AF at a dose of 900 mg / day (3 capsules of 100 mg each, divided into 3 daily doses); for 10 days.
Receives: Drug: Standardized Brazilian Green Propolis Extract

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Length of hospital stay

    Hospitalization time after randomization (in days)

    Measured: 1-28 days

Secondary outcomes (8)
  1. Percentage of participants with adverse events during the use of propolis or placebo

    We will evaluate the presence or absence of symptoms related to the use of propolis or placebo.

    Measured: 1-28 days

  2. Rate and severity of acute kidney injury during the study

    Assess the degree of acute kidney injury according to KDIGO.

    Measured: 1-28 days

  3. Renal replacement therapy.

    Assess need or not for renal replacement therapy

    Measured: 1-28 days

  4. Rate of need for vasopressor use.

    Describe the time needed for vasopressors in days after randomization.

    Measured: 1-28 days

  5. Intensive care unit (ICU) readmission

    Rate of readmission to the ICU after randomization

    Measured: 1-28 days

  6. Invasive oxygenation time

    Assess the need for mechanical ventilation in days after randomization.

    Measured: 1-28 days

  7. Need for Intra-Aortic Balloon Pump

    Assess the need for Intra-Aortic Balloon Pump in days after randomization.

    Measured: 1-28 days

  8. Need for Extracorporeal Oxygenation Membrane (ECMO)

    Assess the need for Extracorporeal Oxygenation Membrane in days after randomization.

    Measured: 1-28 days

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Mar 2021
  2. Study start12 Apr 2021
  3. Primary completion30 Jul 2021
  4. Study completion30 Jul 2021

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 2/3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
A randomized, double-blind, placebo-controlled trial
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
200 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04800224
Sponsor's protocol ID
31099320.6.0000.0049
Acronym
BeeCovid2
Status last verified
May 2022
First submitted
12 Mar 2021
Last updated
13 May 2022
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: The data presented in this study are available on request from the corresponding author.

Publications

  • Silveira MAD, Capcha JMC, Sanches TR, de Sousa Moreira R, Garnica MS, Shimizu MH, Berretta A, Teles F, Noronha IL, Andrade L. Green propolis extract attenuates acute kidney injury and lung injury in a rat model of sepsis. Sci Rep. 2021 Mar 15;11(1):5925. doi: 10.1038/s41598-021-85124-6.

    PubMed 33723330
  • Silveira MAD, Teles F, Berretta AA, Sanches TR, Rodrigues CE, Seguro AC, Andrade L. Effects of Brazilian green propolis on proteinuria and renal function in patients with chronic kidney disease: a randomized, double-blind, placebo-controlled trial. BMC Nephrol. 2019 Apr 25;20(1):140. doi: 10.1186/s12882-019-1337-7.

    PubMed 31023272
  • MAD Silveira, D De Jong, AA Berretta, et.al. Efficacy of propolis as an adjunct treatment for hospitalized COVID-19 patients: a randomized, controlled clinical trial. MedRxiv preprint doi: https://doi.org/10.1101/2021.01.08.20248932.

  • Berretta AA, Silveira MAD, Condor Capcha JM, De Jong D. Propolis and its potential against SARS-CoV-2 infection mechanisms and COVID-19 disease: Running title: Propolis against SARS-CoV-2 infection and COVID-19. Biomed Pharmacother. 2020 Nov;131:110622. doi: 10.1016/j.biopha.2020.110622. Epub 2020 Aug 17.

    PubMed 32890967
  • Maruta H, He H. PAK1-blockers: Potential Therapeutics against COVID-19. Med Drug Discov. 2020 Jun;6:100039. doi: 10.1016/j.medidd.2020.100039. Epub 2020 Apr 19.

    PubMed 32313880
  • Hoffmann M, Kleine-Weber H, Schroeder S, Kruger N, Herrler T, Erichsen S, Schiergens TS, Herrler G, Wu NH, Nitsche A, Muller MA, Drosten C, Pohlmann S. SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor. Cell. 2020 Apr 16;181(2):271-280.e8. doi: 10.1016/j.cell.2020.02.052. Epub 2020 Mar 5.

    PubMed 32142651
  • Machado JL, Assuncao AK, da Silva MC, Dos Reis AS, Costa GC, Arruda Dde S, Rocha BA, Vaz MM, Paes AM, Guerra RN, Berretta AA, do Nascimento FR. Brazilian green propolis: anti-inflammatory property by an immunomodulatory activity. Evid Based Complement Alternat Med. 2012;2012:157652. doi: 10.1155/2012/157652. Epub 2012 Dec 19.

    PubMed 23320022
  • Shimizu T, Hino A, Tsutsumi A, Park YK, Watanabe W, Kurokawa M. Anti-influenza virus activity of propolis in vitro and its efficacy against influenza infection in mice. Antivir Chem Chemother. 2008;19(1):7-13. doi: 10.1177/095632020801900102.

    PubMed 18610553
  • Ito J, Chang FR, Wang HK, Park YK, Ikegaki M, Kilgore N, Lee KH. Anti-AIDS agents. 48.(1) Anti-HIV activity of moronic acid derivatives and the new melliferone-related triterpenoid isolated from Brazilian propolis. J Nat Prod. 2001 Oct;64(10):1278-81. doi: 10.1021/np010211x.

    PubMed 11678650
  • Berretta AA, Nascimento AP, Bueno PC, Vaz MM, Marchetti JM. Propolis standardized extract (EPP-AF(R)), an innovative chemically and biologically reproducible pharmaceutical compound for treating wounds. Int J Biol Sci. 2012;8(4):512-21. doi: 10.7150/ijbs.3641. Epub 2012 Mar 21.

    PubMed 22457606
  • Silveira MAD, Menezes MA, de Souza SP, Galvao EBDS, Berretta AA, Caldas J, Teixeira MB, Gomes MMD, Damiani LP, Bahiense BA, Cabral JB, De Oliveira CWLM, Mascarenhas TR, Pinheiro PCG, Alves MS, de Melo RMV, Leite FM, Nonaka CKV, Souza BSF, Baptista NU, Teles F, da Guarda SF, Mendes AVA, Passos RDH. Standardized Brazilian green propolis extract (EPP-AF(R)) in COVID-19 outcomes: a randomized double-blind placebo-controlled trial. Sci Rep. 2023 Oct 27;13(1):18405. doi: 10.1038/s41598-023-43764-w.

    PubMed 37891178
  • Silveira MAD, de Souza SP, Dos Santos Galvao EB, Teixeira MB, Gomes MMD, Damiani LP, Bahiense BA, Cabral JB, De Oliveira CWLM, Mascarenhas TR, Pinheiro PCG, Alves MS, de Melo RMV, Berretta AA, Leite FM, Nonaka CKV, de Freitas Souza BS, Mendes AVA, da Guarda SF, da Hora Passos R. The use of standardized Brazilian green propolis extract (EPP-AF) as an adjunct treatment for hospitalized COVID-19 patients (BeeCovid2): a structured summary of a study protocol for a randomized controlled trial. Trials. 2022 Apr 4;23(1):255. doi: 10.1186/s13063-022-06176-1.

    PubMed 35379306

Questions about this trial

What is this clinical trial studying?

A Phase 2/3 study testing Standardized Brazilian Green Propolis Extract in people with Covid19 and Inflammation, run by D'Or Institute for Research and Education at 1 site in Brazil.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 10 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 13 May 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Brazil. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Length of hospital stay (time frame: 1-28 days). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04800224, which also lists 12 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 13 May 2022; AzTrials last refreshed its copy on 5 Nov 2026.

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