Table 2.

Summary of antiviral activity of propolis against viral respiratory diseases based on clinical studies.

Type of Virus/Disease	Type of Preparation of Propolis; Dosage and Method of Administration	Population	Effects	Type of Study	Ref.
SARS-CoV-2	Standardized extract of green propolis (Propomax® capsules) Extract of propolis at doses of 400 mg (40 patients) and 800 mg (42 patients) per day for 7 days	Patients with COVID-19 from 18 to 80 years of age, n = 82	Reduction in their hospitalization time; improvement in clinical symptoms of COVID-19	Pilot randomized clinical study	Silveira et al. [48]
SARS-CoV-2	Extract of Iranian green propolis 300 mg of propolis extract in tablets administered three times a day for 14 days	Patients with COVID-19 from 18 to 75 years of age, n = 40	Improvement in clinical symptoms of COVID-19	Randomized, double-blind, placebo-controlled clinical trial	Miryan et al. [49]
SARS-CoV-2	Propolis with extract of Hyoscyamus niger Syrup at dose of 10 mL three times a day for 6 days	Patients with COVID-19 from 18 to 65 years of age, n = 50	Decrease in dry cough, breath score, sore throat and chest pain	Randomized clinical study	Kosari et al. [50]
SARS-CoV-2	Aqueous propolis extract at a dose of 2 mL (50 mg/mL) orally given 3 times a day for 7 days, or at a dose of 1 mL (64 mg/mL) with 1 mL oily perga extract (120 mg/mL) given orally 3 times daily for 7 days	Patients with COVID-19	In progress	Randomized clinical study	NCT04916821 [51]
Mixed etiology: acute otitis media and/or nonstreptococcal pharyngitis	Mixture of propolis-phytosome (Propolisina®) containing 75 mg/sachet of pure propolis	Children over 2 years of age, n = 28	Effective in patients with nonstreptococcal and viral pharyngitis caused by paramyxoviruses, rhinoviruses, adenoviruses. Propolis decreased symptoms such as sore throat, fever and pharyngeal erythema	Open-label, retrospective, controlled clinical study	Di Pierro et al. [73]
Mixed etiology of upper respiratory tract diseases	Herbal preparation of propolis (50 mg/mL), Echinacea (50 mg/mL) and vitamin C (10 mg/mL) at doses of 5.0 mL and 7.5 mL twice daily for 12 weeks	Children from 1 to 5 years of age	55% reduction in the number of illness episodes, 62% reduction in the number of days with fever and decrease in the total number of days with symptoms of respiratory illness	Randomized, double-blind, placebo-controlled study	Cohen et al. [74]
Mixed etiology of upper respiratory tract diseases	Oral spray of propolis (M.E.D.® propolis) at a dose of 2–4 sprays (0.8–1.6 mL of propolis) three times per day (5 days)	Patients from 18 to 77 years of age, n = 58	Remission of symptoms after three days of medication (in 83% of patients)	Randomized, double-blind, placebo-controlled clinical trial	Esposito et al. [72]
Mixed etiology: viral and bacterial tonsillopharyngitis	Complex product containing honey, royal jelly and propolis at a dose of 20–40 mg/kg for 10 days	Patients from 5 to 12 years of age	Effective in the treatment of infections of the upper respiratory tract	Double-blind clinical trial	Seçilmiş, 2020 [3]