1. Home
  2. Home
  3. Blog
  4. Immunity
  5. New, dangerous coronavirus (SARS-CoV-2, COVID-19) Nutritional recommendations when facing coronavirus pandemic.

New, dangerous coronavirus (SARS-CoV-2, COVID-19) Nutritional recommendations when facing coronavirus pandemic.

9493 Views Posted on: 2020-04-04
Posted by: Ireneusz Adamczyk
covid-19While medical science is diligently working on the development of an effective treatment, it may be prudent to learn about some protective measures now, and to become informed concerning potential nutritional therapies.

March 24th, 2020

An article published on February 12, 2020 in Progress in Cardiovascular Diseases proposes the use of nutritional supplements to enhance the body’s type 1 interferon immune response to influenza and coronaviruses, which are among the viruses that have RNA, rather than DNA, as their genetic material.

“Activation of toll-like receptor 7 (TLR7) by single-stranded viral RNA trapped within endosomes provides a key stimulus to type 1 interferon induction by RNA viruses,” authors Mark F. McCarty and James J. DiNicolantonio wrote. “Another key mediator of type 1 interferon response is the mitochondrial antiviral-signaling protein (MAVS).”

Based on this and other research findings, McCarty and DiNicolantonio identified the antioxidant compounds lipoic acid, ferulic acid (which occurs in plant foods such as bran) and sulforaphane (formed from a compound in Brassica family vegetables that include broccoli) as nutrients that may enhance TLR7-mediated induction of type 1 interferon. Spirulina or a protein in spirulina extracts known as phycocyanobilin may also improve this response to RNA viruses and has decreased mortality in mice infected with influenza. N-acetyl-L-cysteine (NAC) increases the production of glutathione (which forms part of the antioxidant enzyme glutathione peroxidase-1) and could help protect TLR7 from damage due to oxidation. Selenium, an element that is present in glutathione peroxidase-1, may also be beneficial. The authors noted that antioxidants in general may be useful due to their ability to dampen excessive lung inflammation induced by viruses.

Another mechanism of type 1 interferon response, activation of mitochondrial antiviral-signaling protein (MAVS), can be upregulated by a relatively high dose of glucosamine, a compound that supports joint health. The addition of glucosamine to the diet of mice infected with influenza significantly improved survival while failing to protect those that were genetically modified to lack MAVS. “This striking new finding points to the possibility that high-dose glucosamine supplementation might aid prevention and control of RNA virus infections,” McCarty and DiNicolantonio remarked.

“Administration of spirulina (or a spirulina extract enriched in phycocyanobilin), a phase 2 inducer (such as ferulic acid, lipoic acid, or sulforaphane), N-acetyl-L-cysteine, selenium, and high-dose glucosamine, in adequate doses, might be expected to help prevent and control RNA virus infections by amplifying the signaling functions of TLR7 and MAVS in evoking type 1 interferon production,” they concluded. They added that beta-glucan from brewer’s yeast, zinc and elderberry (which has an antiviral effect that may be partly mediated by ferulic acid) are further practical nutritional strategies for coping with RNA virus infections.

 “The agents I suggest appear to be overall beneficial for general health - particularly cardiovascular health - and are therefore appropriate for use in primary prevention,” McCarty said. “However, when drug therapies for coronavirus (or other RNA viruses) become available, these nutraceutical measures might be employed as adjuvants.”

Apply What You've Learned: Coronaviruses
  • Coronaviruses have gained recognition during the past few months due to the emergence of COVID-19.  Many people may not know that the coronavirus family is widespread and includes viruses that cause common colds.1
  • Coronaviruses are transmitted between certain animals and humans.2
  • Avoidance of infected individuals or areas in which infections are prevalent, and regular and thorough handwashing are among recommended ways to help prevent contracting coronaviruses. While prudent use of hand sanitizers is helpful, overuse could disrupt the skin’s protective barrier or cause microabrasions.
  • Maintaining a healthy immune system by eating right, sleeping well, exercising, learning to handle stress positively and supplementing with nutrients that support immune function is recommended to help protect against coronavirus and other infectious agents.


Integrative Approaches

covid-19-coronavirusThere are many integrative therapies with well-established antiviral and immune-modulating properties. Details regarding these therapies can be found in Life Extension's Influenza,Pneumonia,Immune Senescence protocols. The interventions described in these protocols, though not necessarily validated as effective specifically for COVID-19, are nevertheless advisable upon onset of symptoms of upper respiratory tract infections.

For upper respiratory tract infections in general, including those caused by some types of coronaviruses, Life Extension has long recommended swift action to help bolster your immune response and mitigate the likelihood of a severe disease course. At the first signs of an upper respiratory tract infection (eg, sneezing, coughing, feeling unwell, mild fever), make an appointment with your doctor then take the following:
 

  1. Zinc Lozenges : Completely dissolve in mouth one lozenge containing 18.75 mg of zinc acetate every two waking hours. Do not exceed 8 lozenges daily, and do not use for more than three consecutive days.
  2. Garlic: Take 9,000‒18,000 mg of a high-allicin garlic supplement each day until symptoms subside. Take with food to minimize stomach irritation.
  3. Vitamin D: If you do not already maintain a blood level of 25-hydroxyvitamin D over 50 ng/mL, then take 50,000 IU of vitamin D the first day and continue for three more days and slowly reduce the dose to around 5,000 IU of vitamin D each day. If you already take around 5,000 IU of vitamin D every day, then you probably do not need to increase your intake.
  4. Cimetidine: Take 800‒1,200 mg a day in divided doses. Cimetidine is a heartburn drug that has potent immune enhancing properties. (It is sold in pharmacies over-the-counter.)
  5. Melatonin: 3‒50 mg at bedtime.


Do not delay implementing the above regimen. Once viruses that cause respiratory infections infect too many cells, they replicate out of control and strategies like zinc lozenges will not be effective. Treatment must be initiated as soon as symptoms manifest. Although this regimen has not been studied specifically in the context of COVID-19, there is little reason not to implement this strategy along with contacting a qualified healthcare provider as soon as possible after onset of upper respiratory tract infection symptoms.

Below are a few additional integrative interventions that have shown beneficial immune-enhancing effects in the context of viral upper respiratory tract infections.

  • Vitamin C. Several studies have shown that vitamin C supplementation, both before and soon after the onset of symptoms of upper respiratory tract infections, may help ease symptom burden and reduce the duration of illness (Gorton 1999; Hemilä 1999; Ran 2018). However, the available evidence does not consistently support the notion that preventive vitamin C supplementation can reduce the risk of acquiring upper respiratory tract infections (Hemilä 2013; Virilhon 2019). Importantly, studies to date have not focused specifically on coronavirus infections but on upper respiratory tract infections in general such as those caused by rhinoviruses, enteroviruses, and influenza viruses.
  • As of March 4th, 2020, a study is slated to take place in Wuhan, China to test the effects of twice-daily 12-gram intravenous vitamin C infusions on outcomes in COVID-19 patients. The primary outcome will assess ventilation-free days, and one of several secondary outcomes will be 28-day mortality (Peng 2020). Previously, a 2017 case report suggested that high-dose intravenous vitamin C may have contributed to the recovery of a 20-year-old patient with acute respiratory distress syndrome (ARDS) due to a viral respiratory tract infection (Fowler 2017).
  • N-acetylcysteine (NAC). N-acetylcysteine (NAC) is an amino acid derivative with mucolytic properties often used in the context of respiratory illnesses (Blasi 2016; Kalyuzhin 2018; Samuni 2013). A meta-analysis published in 2017 found that treatment with NAC led to shorter duration of intensive care unit (ICU) stay compared with control among patients with ARDS (Zhang 2017). In the current COVID-19 pandemic, some Chinese institutions have been using NAC as part of the standard management of patients in the hospital setting (Wu 2020), although clinical trials are needed to specifically assess outcomes in COVID-19 patients treated with NAC. Some researchers have suggested NAC could be a valuable therapeutic in COVID-19 on the basis of its potent antioxidant and mucolytic properties (McCarty 2020).
  • Lactoferrin. Lactoferrin is a glycoprotein involved in immune response and several other functions (Baveye 1999). It is found in secreted fluids and is abundant in milk (breast and cow). Lactoferrin has well-documented antibacterial, antiviral, and antifungal properties (Malaczewska 2019; Wakabayashi 2014; Ishikawa 2013). It appears to exert antiviral effects by activating the antiviral cytokines interferon (IFN)-α/β and boosting natural killer (NK) cell activity and Th1 cytokine responses (Wakabayashi 2014). Some studies suggest that lactoferrin administration may reduce the incidence and severity of common respiratory tract viral infections, like colds and flu (Vitetta 2013; Wakabayashi 2014).
  • In 2005, researchers reported that the gene encoding lactoferrin was highly upregulated in patients affected during the SARS epidemic that emerged in 2003, suggesting that it plays a role in the innate immune response to the infection (Reghunathan 2005). A follow-up study indicated that lactoferrin prevented the 2003 SARS coronavirus from entering host cells (Lang 2011). No data have been published as of March 10th, 2020 directly linking lactoferrin with outcomes in COVID-19 patients.
  • Selenium. Selenium has important antioxidant, anti-inflammatory, and antiviral activities in the body, and deficiency is associated with increased risk of viral infection (Wrobel 2016). In patients with HIV infection, poor selenium status is correlated with increased mortality, and supplementation has been reported to slow progression of immune dysfunction and reduce hospital admissions (Wrobel 2016; Muzembo 2019). Some researchers have proposed that lack of selenium in regional soils may have contributed to the SARS outbreak in 2003 (Harthill 2011).
  • Probiotics. A growing body of evidence shows probiotic supplements with Bifidobacterium and Lactobacillus species can enhance antiviral immune activity and may reduce the occurrence, severity, and duration of viral respiratory tract infections such as influenza (Lenoir-Wijnkoop 2019; Mousa 2017).
  •  Epigallocatechin gallate (EGCG). EGCG is a polyphenol from green tea. Because of its broad antiviral effects, EGCG has been proposed as a promising agent for preventing and treating viral infections such as SARS and MERS (Kaihatsu 2018; Hsu 2015).
Material used with permission of Life Extension. All rights reserved.

“Common Human Coronaviruses.” U. S. Centers for Disease Control. 13 Feb 2020. www.cdc.gov/coronavirus/general-information.html

 “Coronavirus.” World Health Organization. 2020. https://www.who.int/health-topics/coronavirus

Agostini ML, Andres EL, Sims AC, Graham RL, Sheahan TP, Lu X, . . . Denison MR. Coronavirus Susceptibility to the Antiviral Remdesivir (GS-5734) Is Mediated by the Viral Polymerase and the Proofreading Exoribonuclease. mBio. 2018;9(2):e00221-00218.

Alfaraj, S. H., Al-Tawfiq, J. A., Assiri, A. Y., Alzahrani, N. A., Alanazi, A. A., & Memish, Z. A. (2019). Clinical predictors of mortality of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection: A cohort study. Travel medicine and infectious disease, 29, 48-50. doi:10.1016/j.tmaid.2019.03.004

Azhar EI, Hui DSC, Memish ZA, Drosten C, Zumla A. The Middle East Respiratory Syndrome (MERS). Infect Dis Clin North Am. 2019;33(4):891-905.

Baveye S, Elass E, Mazurier J, Spik G, Legrand D. Lactoferrin: a multifunctional glycoprotein involved in the modulation of the inflammatory process. Clinical chemistry and laboratory medicine: CCLM/FESCC. Mar 1999;37(3):281-286.

Blanco N, Eisenberg MC, Stillwell T, Foxman B. What Transmission Precautions Best Control Influenza Spread in a Hospital? Am J Epidemiol. 2016;183(11):1045-1054.

Blasi, F., Page, C., Rossolini, G. M., Pallecchi, L., Matera, M. G., Rogliani, P., & Cazzola, M. (2016). The effect of N-acetylcysteine on biofilms: Implications for the treatment of respiratory tract infections. Respiratory medicine, 117, 190-197. doi:10.1016/j.rmed.2016.06.015

Brown AJ, Won JJ, Graham RL, Dinnon KH, 3rd, Sims AC, Feng JY, . . . Sheahan TP. Broad spectrum antiviral remdesivir inhibits human endemic and zoonotic deltacoronaviruses with a highly divergent RNA dependent RNA polymerase. Antiviral research. 2019;169:104541-104541.

Cao, B., Wang, Y., Wen, D., Liu, W., Wang, J., Fan, G., . . . Wang, C. (2020). A Trial of Lopinavir–Ritonavir in Adults Hospitalized with Severe Covid-19. New England Journal of Medicine. doi:10.1056/NEJMoa2001282

CDC. Center for Disease Control and Prevention. Travelers’ Health: China Traveler View. Available at https://wwwnc.cdc.gov/travel/destinations/traveler/none/china. Last updated 01/27/2020c. Accessed 01/30/2020.

CDC. Centers for Disease Control and Prevention. 2019 Novel Coronavirus (2019-nCoV), Wuhan, China. Available at https://www.cdc.gov/coronavirus/2019-ncov/summary.html. Last undated January 28, 2020b. Accessed January 29, 2020.

CDC. Coronavirus Disease 2019 (COVID-19) Situation Summary https://www.cdc.gov/coronavirus/2019-ncov/summary.html. 02/26/2020a.

CDC. Coronavirus Disease 2019 (COVID-19) Prevention & Treatment. https://www.cdc.gov/coronavirus/2019-ncov/about/prevention-treatment.html. 03/02/2020d.

CDC. Preventing COVID-19 Spread in Communities. https://www.cdc.gov/coronavirus/2019-ncov/community/index.html. Last updated 3/10/2020e.

Chen Y, Liu Q, Guo D. Emerging coronaviruses: genome structure, replication, and pathogenesis. J Med Virol. 2020.

Chu CM, Cheng VC, Hung IF, et al. Role of lopinavir/ritonavir in the treatment of SARS: initial virological and clinical findings. Thorax. 2004;59(3):252-256.

ClinicalTrials.gov. (2020). Active clinical trials for COVID-19 and glucocorticoids. Retrieved from https://clinicaltrials.gov/ct2/results?cond=covid-19&term=glucocorticoids&cntry=&state=&city=&dist=

Corman VM, Muth D, Niemeyer D, Drosten C. Hosts and Sources of Endemic Human Coronaviruses. Adv Virus Res. 2018;100:163-188.

Cortegiani, A., Ingoglia, G., Ippolito, M., Giarratano, A., & Einav, S. (2020). A systematic review on the efficacy and safety of chloroquine for the treatment of COVID-19. J Crit Care. doi:10.1016/j.jcrc.2020.03.005

Dyall J, Gross R, Kindrachuk J, et al. Middle East Respiratory Syndrome and Severe Acute Respiratory Syndrome: Current Therapeutic Options and Potential Targets for Novel Therapies. Drugs. 2017;77(18):1935-1966.

EPA. United States Environmental Protection Agency. List N: Disinfectants for Use Against SARS-CoV-2 https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2 Accessed Mar. 6 2020.

Fauci AS, Lane HC, Redfield RR. Covid-19 — Navigating the Uncharted. New England Journal of Medicine. 2020.

Fowler Iii AA, Kim C, Lepler L, et al. Intravenous vitamin C as adjunctive therapy for enterovirus/rhinovirus induced acute respiratory distress syndrome. World J Crit Care Med. 2017;6(1):85-90.

Frieden J. (2020). FDA to Study Hydroxychloroquine for COVID-19. Retrieved from https://www.medpagetoday.com/infectiousdisease/covid19/85522

Gao J, Tian Z, Yang X. Breakthrough: Chloroquine phosphate has shown apparent efficacy in treatment of COVID-19 associated pneumonia in clinical studies. Bioscience trends. 2020:10.5582/bst.2020.01047.

Gorton HC, Jarvis K. The effectiveness of vitamin C in preventing and relieving the symptoms of virus-induced respiratory infections. J Manipulative Physiol Ther. 1999;22(8):530-533.

Hale C. Quest, LabCorp to launch nationwide coronavirus testing ahead of FDA review https://www.fiercebiotech.com/medtech/quest-diagnostics-to-launch-nationwide-coronavirus-testing-service-ahead-fda

Was this article interesting to you?
Posted in: Immunity, Lactoferrin

Related posts