Effects of Cacao Flavonoids in Long COVID-19 Patients with Chronic Fatigue: FLALOC, a Placebo-Controlled Randomized Clinical Trial, 2026, Munguía+

Chandelier

Chandelier

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Effects of Cacao Flavonoids in Long COVID-19 Patients with Chronic Fatigue: FLALOC, a Placebo-Controlled Randomized Clinical Trial

Munguía, Levy; Silva, Selene; Villarreal, Francisco; Nájera, Nayelli; Ceballos, Guillermo

Abstract
Background: In the context of long COVID, persistent fatigue is among the most prevalent symptoms that can develop after SARS-CoV-2 infection.
Mitochondrial myopathy and endothelial dysfunction, which are triggers of inflammation, have emerged as prominent causes of long COVID-induced fatigue. Interestingly, the intake of flavanols, particularly (−)-epicatechin (EC), has been associated with the positive modulation of endothelial and mitochondrial structure and function.
Methods: In this work, we conducted a randomized, double-blind, placebo-controlled clinical trial to determine whether an EC-enriched supplement (ECES) improves plasma markers of inflammation, endothelial structure, and fatigue-related endpoints in patients with long COVID-19.
Results: The study included 46 subjects (mean age 52 years) who were instructed to consume two capsules/day for 90 days of either ECES (n = 23) or placebo (n = 23).
Endpoints assessed included mean changes in plasma inflammatory markers (IL-1β, IL-6, and TNF-α) and endothelial dysfunction markers (syndecan-1), handgrip strength, fatigue scale, and quality of life (QoL).
The results showed significant improvements in the ECES group for inflammatory markers, syndecan-1, and fatigue compared with the placebo group.
Conclusions: The results yield intriguing positive findings for EC and open a new avenue for treating long COVID.

Web | DOI | Journal of Clinical Medicine
 
The presentation of the data is horrendous. They’ve made loads of separate bar graphs for each outcome for each group. The hand grip strength data is split between women and men for some reason, but both between group differences are well below the MCID that is usually used of 5 kg.

There is no assessment of the blinding.

Conflicts of Interest​

F.V. and G.C. are stockholders of Epirium Inc. The other authors declare no conflicts of interest
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Epirium Inc has a a drug in development called EB 002, a synthetic form of the flavanol epicatechin, which seems to be either the thing they are testing here, or something very similar to it.
 
Absolutely.

I used to keep hearing on 'educational' programs that you had to roast cocoa beans before you go the flavour at all. But in Colombia I was offered a ripe cocoa pod full of beans to suck out. It was absolutely delicious. It had that mysterious subtle flavour of white chocolate that I think is the real essence of the moreness. The beans were succulent and silky to the tongue. I don't know why peole don't eat them fresh.
 
The data on age and number of COVID-19 infections in Table 1 is mathematically impossible. The mean for the entire sample cannot be less than or greater than the means for both of the groups.

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Typo (I assume) in Table 2, where the total number of patients experiencing headache should be 34, not 36.

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As I understand it, the significant loss to follow-up (~1/3 of the patients that were originally randomised) could introduce bias.

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After an initial assessment, follow-up was performed every 30 days.
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It seems strange to me that they say they performed follow-up every 30 days (making for 3 measures across the 90 day follow-up period) and yet the only data they present in the article is "Before" and "After."

Data Availability Statement: Data is contained within the article.
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Bruh
 
Another one for the nice things are nice list?

I’d be happy to have social prescribing of chocolate given the rise in price of my usual bar of dark Belgian chocolate over the last couple of years!
 
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