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A controlled, randomized clinical trial is proposed to demonstrate the effectiveness of the experimental product in controlling hepato-pulmonary inflammation and neurovascular encephalic inflammation, which may constitute the etiopathogenic basis of persistent COVID. In addition, an individualized training program will be implemented for each participant in order to improve chronic symptoms and, consequently, their quality of life.
Randomized, placebo-controlled, double-blind clinical trial with four parallel arms based on the product consumed (placebo or experimental product) and the performance of physical exercise (exercise or no exercise), designed to analyze the effectiveness of the product under investigation in reducing chronic immune-mediated inflammatory status in subjects who have had SARS-CoV-2 infection and present persistent symptoms 3 months after the onset of the infectious process.
The efficacy of the experimental product, consumed over a period of 4 months, will be determined in terms of reducing chronic inflammation and improving the quality of life of people suffering from this condition.
Clinical manifestations and chronic symptoms, quality of life, response to the individualized physical exercise program, and product safety will be taken into account.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Placebo | Placebo Comparator | Subjects in this group will consume a placebo product (maltodextrin) with the same organoleptic characteristics as the investigational product. |
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| Natural extract | Experimental | Subjects in this group will consume the investigational product (experimental product composed of a combination of six natural extracts: grapefruit extract, apigenin, orange extract, luteolin, yerba mate extract, and olive leaf extract). |
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| Physical exercise and consumption of experimental product | Experimental | During the study, subjects must consume the experimental product and also follow a training program. A multi-component program will be carried out during the 4 months of product consumption. Sessions will last 60 minutes and will be held 2-3 times per week. |
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| Physical exercise and consumption of placebo product | Placebo Comparator | During the study, subjects must consume the placebo product and also follow a training program. A multi-component program will be carried out during the 4 months of product consumption. Sessions will last 60 minutes and will be held 2-3 times per week. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Experimental Product | Dietary Supplement | Supplement consisting of orange extract, apigenin, luteolin, yerba mate extract, grapefruit extract, and olive leaf extract. |
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| Measure | Description | Time Frame |
|---|---|---|
| Immunoinflammatory profile | Antibody assay for molecular biomarkers of the brain-liver-lung axis, blood-brain barrier, immunometabolic pathways, and immune-inflammatory and immuno-angiogenic cardiac remodeling. | Blood samples will be taken twice, once at baseline, at the beginning of the trial and once at the end after 120 days of product intake. |
| Measure | Description | Time Frame |
|---|---|---|
| Clinical signs | The number of clinical manifestations, the type of manifestation, intensity according to the visual analog scale from 0 to 10, and duration of the symptomps. The clinical manifestations will be those felt by the subject. | It will be recorded twice, before starting the consumption of the product and before the end of consumption (120 days) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Francisco Javier López Román | Contact | 968278157 | 157 | jlroman@ucam.edu |
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| UCAM HiTech, Sport & Health Innovation Hub | Murcia | Spain |
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| ID | Term |
|---|---|
| D000094024 | Post-Acute COVID-19 Syndrome |
| D009043 | Motor Activity |
| ID | Term |
|---|---|
| D000086382 | COVID-19 |
| D011024 | Pneumonia, Viral |
| D011014 | Pneumonia |
| D012141 | Respiratory Tract Infections |
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| ID | Term |
|---|---|
| D015444 | Exercise |
| ID | Term |
|---|---|
| D009043 | Motor Activity |
| D009068 | Movement |
| D009142 | Musculoskeletal Physiological Phenomena |
| D055687 | Musculoskeletal and Neural Physiological Phenomena |
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Double-blind study in relation to product consumption. Blinding cannot be performed in relation to physical exercise.
| Control placebo | Dietary Supplement | Product with identical characteristics to the experimental product. |
|
| Physical exercise | Other | During the study, subjects will have to develop a training program. A multicomponent program will be carried out during the 4 months of product consumption. The sessions will last 60 minutes and will be held 2-3 times per week. |
|
| No Physical Exercise | Other | During the study, subjects will only consume the product assigned to them in the randomization. |
|
| Short Form 12 Health Survey | Measured by SF-12 questionnaire. Scale 0-100% | It will be measured twice, once at baseline and at the end of the study after 120 days of consumption. |
| Sleep quality | Measured by Pittsburgh test | Progress will be measured after 120 days of consumption. |
| Sleep efficiency | Measured by accelerometry, with Actigraph wGT3X-BT | Progress will be measured after 120 days of consumption. |
| Fatigue | Measured with Fatigue Severity Scale (FSS). Rated on a 7-point Likert scale (1=strongly disagree, 7=strongly agree), a mean score of \(\ge 4\) typically indicates a moderate to high level of fatigue. | Progress will be measured after 120 days of consumption. |
| Dyspnea | It will be measured with Modified Medical Research Council (mMRC) | Progress will be measured after 120 days of consumption. |
| Depression | It will be measured with Beck Depression Inventory (BDI). Scores are calculated by adding up the responses to 21 items, with a range from 0 to 63, and scores are interpreted by severity levels: 0-13 (minimal), 14-19 (mild), 20-28 (moderate), and 29-63 (severe). | Progress will be measured after 120 days of consumption. |
| Anxiety | It will be measured with the State-Trait Anxiety Inventory (STAI). The STAI (State-Trait Anxiety Inventory) assesses transient (state) and stable (trait) anxiety using 40 items (20 per subscale) with a Likert-type score from 0 to 3. The total score per subscale ranges from 0 to 60, with higher scores indicating greater anxiety. | Progress will be measured after 120 days of consumption. |
| Hospital Anxiety and Depression | Measured with Hospital Anxiety and Depression Scale (HADS). It is a self-administered instrument with 14 items (7 for anxiety, 7 for depression) that is scored from 0 to 3, with a maximum total of 21 points per subscale. A score of 7 or less indicates normality, 8-10 indicates a borderline case, and 11 or above indicates a probable case of anxiety or depression. | Progress will be measured after 120 days of consumption. |
| Stress level | Perceived stress scale (PSS). Measures stress levels over the past month on a scale of 0 to 56. The higher the score, the greater the perceived stress. Typical interpretive ranges include low stress (0-13), moderate stress (14-26), and high stress (27-40+). | Progress will be measured after 120 days of consumption. |
| Cardiorespiratory fitness. | A submaximal test will be performed. | Progress will be measured after 120 days of consumption. |
| The Rate of Force Development | The Rate of Force Development (RFD) measures the speed at which the neuromuscular system generates maximum force in a short period of time (typically in the first 100-200 ms). It is a key indicator of explosive strength and power, vital in fast movements, jumps, sprints, and climbing. | Progress will be measured after 120 days of consumption. |
| Maximum Voluntary Isometric Contraction | Maximum Voluntary Isometric Contraction (MVIC) is the gold standard for measuring muscle strength, involving maximum contraction without joint movement (isometric). It is used to evaluate muscle activation using electromyography, comparing the percentage of effort against the muscle's maximum possible strength. | Progress will be measured after 120 days of consumption. |
| Body composition | It is a control variable. Measured by bioimpedance. | The test will be measured at baseline and after 16 weeks of consumption. |
| Liver safety variables | It is a blood test that measures the presence of some enzymes, proteins and bilirubin in the blood, with the aim of determining if there is any alteration in the liver. Enzyme GPT, GOT, Gamma GT, LDH, alkaline phosphatase and bilirubin (UI/L) | Hematological samples were taken before (day 0) and after consumption of the product (day 120) both in the control group and in the experimental group. |
| Adverse events | It will be evaluated only at the end of the study. | After 16 weeks of consumption. |
| D007239 |
| Infections |
| D014777 | Virus Diseases |
| D018352 | Coronavirus Infections |
| D003333 | Coronaviridae Infections |
| D030341 | Nidovirales Infections |
| D012327 | RNA Virus Infections |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D000094025 | Post-Infectious Disorders |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D001519 | Behavior |