A Randomized Controlled Trial of the Efficacy of Systemic Enzymes and Probiotics in the Resolution of Post-COVID Fatigue.

Medicines (Basel, Switzerland). 2021;8(9)

Plain language summary

Coronavirus disease-19 (Covid-19) usually lasts for 7-10 days but in a proportion of individuals, long-term symptoms may develop such as fatigue, which can last for at least 12 weeks. Disruptions to the immune system and parts of the cell which produce energy have been observed in these individuals. This randomised control trial of 200 individuals aimed to determine the combined effects of two different multi-enzyme and probiotic supplements; ImmunoSEB and ProbioSEB on Covid-19 induced fatigue. The results showed that supplementation resolved fatigue and lowered fatigue in those who were still fatigued after 14 days compared to taking a placebo. Mental fatigue was also reduced in the supplemented group compared to placebo. It was concluded that 14 days of supplementation with ImmunoSEB and ProbioSEB resolves post-Covid-19 fatigue. This study could be used by health care professionals to recommend the supplementation of ImmunoSEB and ProbioSEB to improve feelings of and in some case resolve fatigue associated with Covid-19.


Muscle fatigue and cognitive disturbances persist in patients after recovery from acute COVID-19 disease. However, there are no specific treatments for post-COVID fatigue. Objective: To evaluate the efficacy and safety of the health supplements ImmunoSEB (systemic enzyme complex) and ProbioSEB CSC3 (probiotic complex) in patients suffering from COVID-19 induced fatigue. A randomized, multicentric, double blind, placebo-controlled trial was conducted in 200 patients with a complaint of post-COVID fatigue. The test arm (n = 100) received the oral supplements for 14 days and the control arm (n = 100) received a placebo. Treatment efficacy was compared using the Chalder Fatigue scale (CFQ-11), at various time points from days 1 to 14. The supplemental treatment resulted in resolution of fatigue in a greater percentage of subjects in the test vs. the control arm (91% vs. 15%) on day 14. Subjects in the test arm showed a significantly greater reduction in total as well as physical and mental fatigue scores at all time points vs. the control arm. The supplements were well tolerated with no adverse events reported. This study demonstrates that a 14 days supplementation of ImmunoSEB + ProbioSEB CSC3 resolves post-COVID-19 fatigue and can improve patients' functional status and quality of life.

Lifestyle medicine

Patient Centred Factors : Triggers/Covid-19 fatigue
Environmental Inputs : Nutrients ; Microorganisms
Personal Lifestyle Factors : Nutrition
Functional Laboratory Testing : Not applicable

Methodological quality

Jadad score : 4
Allocation concealment : No
Publication Type : Journal Article


Nutrition Evidence keywords : Viral infections