The pandemic of Coronavirus Disease 2019 (COVID-19) is more than a year old, and hundreds of thousands of new cases are reported every day, making us feel its presence all over the world. Due to Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), pandemics are estimated to be about 10 times higher than reported infections.
Suppressing the spread of SARS-CoV-2 has proven to be difficult because the majority of infections are asymptomatic, the virus is highly contagious, and especially due to the spread by direct contact indoors. ..
New research Dietary Supplement Journal Shows that dietary supplements containing some vitamins and mineral zincs may help prevent infections and reduce the severity of infections.
Vaccination appears to be the only safe and effective route to achieve lasting, global immunity and end the pandemic. Other short-term preventive measures include behavior change and non-pharmaceutical interventions such as wearing masks in public places, social distance, and hand washing.
Secondary prophylaxis includes effective treatments that can prevent the progression of the infection. Treatment options are limited, and remdesivir is one of the few drugs to receive early approval for emergency use with COVID-19. Dexamethasone, tocilizumab, and hydroxychloroquine are among other drugs used on an empirical basis and have varying degrees of efficacy.
Severe COVID-19 odds are higher in people with risk factors such as cardiovascular disease, obesity, diabetes, and lung disease, in addition to aging. Mechanisms of severity that act to increase risk in these conditions range from exaggerated inflammation to airway damage.
The association of severe COVID-19 with inflammatory conditions and weakened or altered immune system suggests that they are inherent in the clinical course.
Since diet and nutritional measurements are associated with significant changes in immunity, many have investigated the effects of major and micronutrients on building protection against the virus. In addition, the nutritional approach is safe and probably effective due to its positive immunity effects.
Old age is associated with immune aging and weakness, which is associated with malnutrition of calcium, vitamin C, vitamin D, folic acid, and zinc. Vitamin B3 deficiency is a precursor to the basic metabolic mediator nicotinamide adenine dinucleotide (NAD) and may also be a key to weakened immunity.
Therefore, some researchers have investigated the possible benefits of using dietary supplements, especially vitamin C, vitamin D, zinc, and B3 vitamins, as part of primary and secondary COVID-19 prevention. ..
Viral infections lead to cell damage and death through a variety of mechanisms. Takeover of cell energy metabolic pathways. Inhibits cell synthesis of biomolecules; competes for ribosomes; competes for transcription factors. When cells detect this process, they react with the innate immune response, ultimately leading to stronger and more specific adaptive immunity.
A study by Linus Pauling has shown that vitamin C may reduce the severity and duration of common colds. This has been confirmed by a meta-analysis of nearly 30 studies. In addition, Vitamin C may reduce or prevent other infections, including those caused by powerful immunomodulators such as bacteria, viruses, and protozoa.
However, the benefits of vitamin C may only be apparent in people who are deficient in vitamin C, children, and people with infections that cause metabolic complications that result in lower levels of vitamin C.
Vitamin C is a very safe molecule. Its antioxidant activity is particularly effective in light of the highly inflammatory and oxidative markers of COVID-19, especially hsCRP. Cytokine storm, This is another marker of oxidative stress.
In one study of patients in the intensive care unit (ICU) and those wearing mechanical ventilation for acute inflammatory lung disease associated with oxidant injury, the use of vitamin C resulted in ICU. The time spent and the outcome of ventilated patients were reduced.
A Chinese study showed that patients with COVID-19 were given high doses of vitamin C by intravenous infusion and repeated high doses in critical cases to improve their oxygenation status. All patients under treatment were discharged home. A controlled trial of vitamin C therapy in patients admitted with severe COVID-19 is underway.
Vitamin D also plays an important role in immunity because its active form interacts with the vitamin D receptor (VDR) in the nucleus of immune cells. It stimulates the production of antimicrobial peptides such as cathelicidin and defensin, and broad-spectrum drugs against various pathogens, enhancing the innate immune response.
On the other hand, it regulates adaptive immune responses, including inflammatory cytokine release. This lowers the cytokine levels of COVID-19 and prevents the cytokine storm that underlies severe COVID-19 symptoms. It also maintains epithelial integrity through tight junctions, gap junctions, and tight junctions, reducing the chance of pathogens passing through underlying tissue.
Vitamin D deficiency is considered to be a risk factor for COVID-19 among the elderly, blacks, people with high obesity index, and smokers. Other immune disorders, including autoimmune diseases such as rheumatoid arthritis, multiple sclerosis (MS), and inflammatory bowel disease, have been shown to be associated with low vitamin D levels.
Again, vitamin D deficiency is more common in areas north of the Earth where solar radiation is relatively weak. MS develops early in such areas, but type I diabetes and inflammatory bowel disease are more common. In addition, a type of MS called relapsing-remitting MS is partially improved by vitamin D supplementation.
The· Case fatality rate In 1918, the influenza pandemic diminished as sunlight increased (specifically, UV B radiation). According to other studies, the number of cases of infectious diseases such as influenza and septic shock varies from season to season.
Recent studies have shown that in people who are deficient in vitamin D, vitamin D supplementation may help reduce the risk of respiratory infections. With COVID-19, the risk of being diagnosed with this condition was 1.8 times higher with vitamin D deficiency compared to the appropriate vitamin D condition. The former group may also have an increased risk of hospitalization.
Vitamin D lowers angiotensin converting enzyme 2 (ACE2) levels. This molecule acts as an invading receptor for SARS-CoV-2 and, at higher levels, may increase its vulnerability to more severe symptoms.
The first outbreak of a pandemic, as well as its spread, occurred during the winter, when vitamin D levels were likely to decline. During the first wave, the higher sacrifices on dark-skinned people in developed countries can be due to their lower vitamin D levels. If so, the inequality is expected to be less obvious as summer begins, and this is certainly happening.
Vitamin D deficiency is also a risk factor for acute respiratory distress syndrome (ARDS), a common fatal complication of serious COVID-19.
Based on these findings, vitamin D intake is recommended in COVID-19 patients to raise serum levels above 40-60 ng / mL. Studies are underway to investigate the role of vitamin D.
Zinc is commonly found in all tissues and metal enzymes in the body, but is deficient in about one-third of humans worldwide. Inadequate zinc intake is associated with many health conditions, including skin disorders and cognitive problems. Immune function is also impaired. Dietary phytates and fiber can reduce zinc absorption, and people on a strictly vegetarian diet are at increased risk of zinc deficiency. This is also seen in some chronic illness conditions.
Zinc is involved in innate and adaptive immune responses, from immune cell development to mucosal integrity. Zinc supplementation has been shown to reduce respiratory infections in children and reduce short colds in one day.
Research is underway to test the effects of zinc supplementation on COVID-19.
Vitamin B3 is a complex of three vitamins, nicotinamide riboside (NR), nicotinamide (NAM), and nicotinic acid (NA), which are precursors of NAD +, which is the central catalyst of metabolism. Since the cell-mediated immune response consumes NAD, depletion of NAD is associated with weakened immunity.
Two components of the cellular response to coronavirus infection are the SIRT and PARP molecules, both of which compete for NAD. Decreased SIRT activation due to PARP overactivation leads to hyperinflammation and cytokine storms with the addition of oxidative stress due to viral activation.
The presence of reactive oxygen species (ROS) causes further oxidative damage to DNA and cell membranes, further activating PARP to advance the repair process. Type I interferon is caused by several viruses and activates CD38. CD38 further consumes NAD and promotes inflammation.
Vitamin B3 deficiency causes pellagra, and its supplementation may help avoid age-related weakness. Coronavirus Encodes an enzyme that opposes activation of the PARP pathway and prevents NAD depletion
Lymphocytopenia is a unique clinical feature of COVID-19 infection, unlike the increase in lymphocyte counts caused by other viral infections. One reason could be high levels of PARP activation during the innate immune response, which depletes NAD and further regulates the adaptive immune response. Indeed, the up-regulation of PARP due to coronavirus infection has been confirmed in a recent treatise.
Therefore, B3 supplementation may enhance both the innate and adaptive immunity of COVID-19. The NR seems to be best suited for this purpose, with better pharmacological properties and a comparable safety profile.
A recent study showed that dietary supplements that combined NR with standard treatment reduced the recovery period for COVID-19 by a third, and these findings require extensive research.
What is the impact?
“”Vitamins B3, C, D, and zinc have been shown to affect the initial innate immune response and / or regulate subsequent downstream processes associated with viral infection... “
The results of these early preclinical and clinical studies form a solid basis for further investigating the potential benefits of supplements for the incidence and severity of COVID-19.
Some important warnings apply. First, supplements are not regulated by the US Food and Drug Administration (FDA) with the same rigor as prescription drugs. They only require that the institution be satisfied with the safety of the new dietary ingredients (NDI, those ingredients marketed since October 1994).
Therefore, there may be quality and safety issues and all claims made by the manufacturer may not be true. Overdose with some supplements can be an issue with over-the-counter status. And third, some conditions and sensitivities may exclude the use of supplements, such as those that thin blood or interact with prescription drugs.
Another set of problems specific to COVID-19 is the difficulty of obtaining data from outpatients due to forced quarantine, which leaves investigator home visits as the only method. Second, funding a nutritional approach can be very expensive, but this method is not a high priority.
The data support a model in which essential nutrients may help cell defense and repair mechanisms and promote recovery and / or control of symptoms of late-stage disease. Such an approach may be as beneficial as medicines. “
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