Key result
Adjuvant therapy with Xanthohumol significantly reduced the 28-day mortality rate to 20% compared to 48% with placebo in critically ill patients with severe COVID-19.
Why the study?
Does Xanthohumol reduce 28-day mortality in critically ill adult patients treated for COVID-19 with severe respiratory failure?
RCT (n=50)
Double-blind
Randomized
No
Does Xanthohumol reduce 28-day mortality in critically ill adult patients treated for COVID-19 with severe respiratory failure?
Absolute Event Rate: 20% vs 48%
p-value: p=<0.05
Adjuvant therapy with Xanthohumol significantly reduced 28-day mortality and improved inflammatory markers in critically ill patients with severe COVID-19.
Xanthohumol adjunct may reduce mortality and inflammation in severe COVID-19; leaves open confirmation in larger trials before practice change.
Background. The systemic inflammatory response following severe coronavirus infection (COVID-19) is associated with poor outcome. Several anti-inflammatory medications were studied in COVID-19 patients. Xanthohumol (Xn), a natural extract from hop cones, possesses strong anti-inflammatory and antioxidative properties. The aim of this study was to analyse the effect of Xn on the inflammatory response and the clinical outcome of COVID-19 patients. Methods Adult patients treated for acute respiratory failure (PaO2/FiO2 less than 150) were studied. Patients were randomized into two groups: Xn – patients receiving adjuvant treatment with Xn at a daily dose of 4.5 mg/kg body weight for 7 days, and C – controls (patients receiving placebo – NaCl 0.9%). Observations were performed at four time points: immediately after admission to the ICU and on the 3rd, 5th and 7th days of treatment. The inflammatory response was assessed based on the plasma IL-6 concentration, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), C-reactive protein (CRP) and D-dimer levels. The mortality rate was determined 28 days after admission to the ICU. Results Seventy-two patients were eligible for the study, and 50 were included in the final analysis. The mortality rate was significantly lower and the clinical course was shorter in the Xn group compared to controls (20% vs. 48%, p < 0.05, and 9 ± 3 days vs. 22 ± 8 days, p < 0.001). Treatment with Xn decreased plasma IL-6 concentration (p < 0.01), D-dimer levels (p < 0.05) and NLR (p < 0.01) more significantly compared to standard treatment. Conclusion Adjuvant therapy with Xn appears to be a promising anti-inflammatory treatment in COVID-19 patients.
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Dąbrowski et al. (2022) conducted an RCT in Severe COVID-19 with acute respiratory failure (n=50). Xanthohumol vs. Placebo (0.9% NaCl) was evaluated on Mortality rate at 28 days (p=<0.05). Adjuvant therapy with Xanthohumol significantly reduced the 28-day mortality rate to 20% compared to 48% with placebo in critically ill patients with severe COVID-19.
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