D.SAP, a Formulation Derived from Apples, Showed the Potential to

AbstractIntroduction: The SARS-CoV-2 virus is a respiratory virus that causes severe acute respiratory disorder with an unknown mortality rate. It has been reported that excessive inammation in COVID-19-infected patients could lead to unfavorable im-mune reactions such as cytokine storms, which could even cause death. The search for therapeutic strategies to suppress or modulate inammation  in COVID-19 is an important goal not  only for  COVID-19 infection but for other acute respiratory infections. We aimed to evaluate the eects of using an apple-based formulation called Dezhakam sap (D.SAP) in the reduction of COVID-19-associated inammation response of individuals with COVID-19 infection.   Methods: We recruited 210  patients with COVID-19 infection who had used D.SAP for at least 12  months before the viral infection and 350 patients with COVID-19 infection who had not used D.SAP. A matched control healthy group with no his-tory of COVID-19 infection, including 1080 subjects used for comparison with infected groups. Blood samples obtained from all subjects'  RNA were extracted from blood and  cDNA was synthesized  from RNAs. Then all subjects were examined for inammation markers in blood samples using Real-time PCR. Results: Results showed  signicant alterations in  mRNA level  of inammation factor  genes in patients  with D.SAP usage reputation compared to COVID-19-infected subjects without using D.SAP. Conclusion: Results showed  the eectiveness of  specially formulated apple  vinegar  D.SAP as  a natural anti-inammatory agent. It seems that the anti-inammation eects of D.SAP users may related to the antioxidant eects of polyphenolic com-pounds of apples that were maintained  during  the  process  of D.SAP production. Reduction  of inammation  markers  may increase the survival rate in patients with severe reactions of the immune system in COVID-19 infection

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