The effects of almond porridge, grape extract, and pea syrup on fatigue severity and clinical symptoms of patients with COVID-19: A randomized controlled clinical trial

Background:This study is the first randomized controlled trial assessing the beneficial effects of almond porridge, grape extract, and pea syrup in improving fatigue severity and clinical symptoms in patients with coronavirus disease 2019 (COVID-19) with high levels of fatigue.

Methods:This is a randomized, double-blind, placebo-controlled clinical trial conducted at AJA hospital (Tehran, Iran) from March to December 2022.Patients with COVID-19 were randomly divided into two parallel intervention (almond porridge, grape extract, and pea syrup (AGP mixture)) + routine care and placebo + routine care groups. A mixture of almond porridge and grape extract (containing 25 grams of almonds and 8 ccs of grape extract) was given to the patient at 10 o'clock during the hospital stay. Also, in the snack at 16 o'clock, chickpeas (containing 30 grams of chickpeas) were given during the hospital stay. Patients were assessed at baseline, at discharge, 3 months, and 6 months with the Fatigue Assessment Scale (FAS).

Results: A total of 75 patients in the AGP group and 71 patients in the placebo group completed the 6-month course of the trial. The patients in AGP and placebo groups were comparable based on age, sex, and hospital stay. Patients in two trial groups were comparable based on baseline and discharge FAS scores. However, the AGP group showed a significantly lower FAS score at month 3 (p<0.001) and month 6 (p<0.001) visits. FAS score showed a significantly greater decline in the AGP compared to the placebo group from baseline to month 3 (p<0.001) and 6 (p<0.001). In agreement, repeated measures analysis showed a significant time × treatment interaction effect for AGP on the FAS score (F=13.029; η_p²=0.083; P<0.001).There was no significant between-group difference based on temperature, O2 saturation, presence of cough, productive cough, or diarrhea, and severity of headache and musculoskeletal pain at baseline or discharge.Finally, data showed that patients in the AGP group had significantly lower levels of C-reactive protein (CRP) at discharge (p=0.021).No severe or unforeseen adverse event was reported.

Conclusion:The current study found AGP mixture is effective in reducing fatigue severity in the long-term but not in the short-term, with no side effects. Further studies with larger sample sizes are required to determine the effects of AGP mixture in chronic fatigue post-COVID-19.