The Effects of Cocoons of Larinus Hedenborgi (Coleoptera: Curculionidae) Extracts on Inflammation and Clinical Outcomes in Patients With Coronavirus Disease 2019: A Double-Blinded Randomized Controlled Clinical Trial

Abstract

Background: Severe acute respiratory syndrome coronavirus 2, the causative agent of coronavirus disease 2019 (COVID-19), is an inflammatory disease that manifests with symptoms including dry cough, fever, myalgia, and even pneumonia. Despite antiviral treatments, no definitive therapy has been proven effective. Trehala manna (TM), the edible cocoon of Larinus hedenborgi (Coleoptera: Curculionidae) weevil, as a natural product, is traditionally used to alleviate respiratory symptoms because of its antibacterial, anti-inflammatory, and antifungal properties. Objective: The current study aimed to determine the effects of TM add-on treatment on inflammatory biomarkers and some clinical outcomes in patients with COVID-19. Methods: The present study was a randomized controlled trial conducted on 60 patients who were randomly allocated to TM (5 g, twice a day) or a placebo for 1 week. The main outcomes of the current study include C-reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), blood urea nitrogen level, creatinine level, fasting blood sugar level, systolic blood pressure, and visual analog scale (VAS) score for cough, which were evaluated at both the beginning and end of the study. Results: Our finding revealed that CRP level, ESR, blood urea nitrogen level, creatinine level, fasting blood sugar level, systolic blood pressure, and VAS score for cough were significantly reduced in the TM group after intervention ( P < 0.05), and CRP level, ESR, VAS score for cough, and fever were significantly reduced in the TM group compared with the control after 7 days ( P < 0.05). Conclusions: Trehala mann is a natural remedy with potential as an adjunctive therapy for reducing inflammatory biomarkers and improving certain clinical symptoms in patients with COVID-19. No adverse effects were observed during the trial. Iranian Registry of Clinical Trials identifier: IRCT20211029052904N1.