Should probiotics, honey, and escin be used in the prevention or treatment of COVID-19?

Abstract

KEY FINDINGS

There is very limited low-quality evidence documenting efficacy of probiotics and no evidence for the use of
honey and escin for COVID-19. Further clinical studies are needed to justify use of these traditional interventions
for COVID-19.

•  Probiotics may prevent upper respiratory tract infection (URTI) among children and ventilator associated
  pneumonia (VAP) among critically ill non-COVID-19 patients. Honey soothes the throat by providing symptomatic
  relief in children with cough. Escin, a dietary supplement from Aesculus hippocastanum or horse chestnut extract,
  had in-vitro activity against SARS virus and Vero E6 cells.
•  One retrospective cohort observational study was found describing 55 COVID-19 patients who were receiving
  a variety of treatment regimens including probiotics. All patients were discharged with no deaths reported.
• We found no completed clinical trials nor systematic reviews studying the efficacy of probiotics, honey or escin
  among COVID-19 patients.
•  The most common adverse effects of probiotics, honey and escin are minor gastrointestinal complaints.
•  We found five registered clinical trials and one observational study investigating the benefits of probiotics,
  one registered trial for honey, and two for escin.
•  WHO Interim guidelines, CDC interim guidelines, Infectious Diseases Society of America COVID-19 treatment
  guidelines, and the American Thoracic Society did not give any recommendation on the use of probiotics,
  honey or escin in patients with COVID-19.