Adjuvant Pomegranate Juice Intake Improves the Inflammatory Status and Clinical Outcomes of Hospitalized COVID-19 Patients: An Exploratory Randomized and Placebo-Controlled Trial​

Background: This study aimed to evaluate the effect of pomegranate juice intake on the inflammatory status and complete blood count in hospitalized Covid-19 patients.Methods: This exploratory randomized, double-blinded placebo-controlled trial included 43 patients with two parallel arms(22+21). In addition to the standard care provided at the hospital, the patients consumed 500mL of whole pomegranate juice(PJ) daily or a placebo for 14 days. Inflammatory markers (C-reactive protein(CRP), interleukin-6(IL-6), erythrocyte sedimentation rate(ESR)) and complete blood count were determined at baseline and after the 14 days of intervention.Results: At the end of the intervention, a significant decreased was observed in Primary outcomes [mean difference (95%CI)] including IL-6 [5.24(0.87 to 9.61)], CRP [23.19(11.93 to 34.44)] and ESR [10.52(1.54 to 19.50)] in the PJ group vs. to before the intervention. In addition, significant changes were also observed in the some of the secondary outcomes, including neutrophils, lymphocytes, platelets, platelets-to-lymphocyte(PLR) and neutrophils-to-lymphocyte (NLR) ratios (p<0.05) in the PJ group compared to before the intervention. At the end of the intervention, the mean change of IL-6 [-7.09(-12.21 to -1.96)], white blood cells [-3.09(-6.14 to -0.05)], neutrophils [-9.12(-18.08 to -0.15)], lymphocyte [7.05(0.17 to 13.92)], platelets [-94.54(-139.33 to -49.75)], PLR [-15.99(-29.31 to -2.67)], blood oxygen saturation [1.75(0.13 to 3.37)] and MCV [0.31(-0.25 to 0.88)] levels were significantly different between groups. While no difference was observed between the two groups in other blood indices.Conclusion: Our results suggest that pomegranate juice intake might slightly improve the inflammatory status and CBC outcomes of COVID-19 patients and may be beneficial.