COVID Tips: For Prevention, Infection & Long Covid!
COVID Tips: For Prevention, Infection & Long COVID!
With the holiday season, we’re seeing another uptick in COVID. As the days get shorter and we’re stuck inside, nasty bugs abound, including COVID-19.
What is COVID exactly?
COVID-19 refers to a viral infection caused by SARS-CoV-2, a severe acute respiratory syndrome coronavirus. The virus consists of replicating RNA enclosed in a lipid or fat membrane. If you are wobbly on the difference between DNA and RNA, think of DNA in the nucleus or center of the cell as holding on to all master copies of protein “recipes”. The RNA carries a translation or copy of each recipe to the ribosomes, where the new proteins are made by the cell.
The COVID-19 virus uses RNA to carry the instructions it needs to duplicate itself and cause human suffering. All it needs to do is enter a vulnerable cell and take over, similar to breaking into a house and forcing the occupants to do your bidding. The outside of the virus membrane contains spike proteins that help it lock onto cell receptors for ACE-2 cells found throughout the body. The spike proteins are the virus’s key to gaining an entryway into the cell.
ACE2 receptors are located all over the body, especially in the lungs, heart, blood vessels, kidneys, liver, and gut as well as the epithelial cells that line many tissues such as the inside of the nose and mouth. One of their primary roles is facilitating the exchange of oxygen and CO2 between the lungs and blood vessels. At the height of the pandemic hospitals filled up with patients unable to breathe unassisted.
Tips to ward off COVID-19.
Use a mask when around sick people or large crowds to prevent the virus from entering the nose or mouth
Consider using an iodine or colloidal silver nasal spray to serve as a barrier
Consider gargling with a diluted povidone-iodine solution (Matsuyma et al. 2022)
Get extra sleep
Follow an anti-viral diet rich in olive oil, garlic, mushrooms, fermented foods, meats containing iron and zinc, and vitamin C-rich foods like citrus and peppers (Constantini n/d) as well as quercetin-rich foods like apples and onions.
Many of the supplements listed below may also help prevent COVID.
Tips to deal with symptoms of acute COVID
If the test comes back positive, here are some evidence-based suggestions to get back on track:
Supplement with zinc!
A recent meta-analysis of zinc supplementation involving five studies and over 1500 participants concluded that zinc supplementation “led to significantly lower risk of mortality” (Tabatabaeizadeh 2022).
Zinc helps support the immune system in numerous ways such as promoting the natural killer cells that destroy many pathogens. Zinc may also block the replication of the virus. A zinc deficiency can suppress the body’s production of an important anti-inflammatory chemical messenger, IL-10. Consider taking a 15 mg zinc lozenge daily for prevention, and then an additional 2-3 lozenges if you get sick.
Consider vitamin D.
Vitamin D is widely touted as helping to improve mortality and reduce symptoms of COVID. It has been noted that there is an association between low vitamin D levels and adverse outcomes of hospitalized COVID patients. In other words, patients with low vitamin D levels tend to fare worse. One problem with this observation is that vitamin D, like albumin, is a negative acute phase reactant, meaning it goes down when the patient is inflamed. Low vitamin D status may therefore be considered a result of inflammation and not the cause. The more relevant piece of information might be to know the patient’s baseline vitamin D status well before they get sick.
In a recent article in Nutrition Reviews, Hadizadeh notes that vitamin D deficiency is associated with an increase in pulmonary infections as well as respiratory viral infections. The highest risk was to hospitalized patients with levels less than 15. In general, supplementing with vitamin D only seemed to help the patient if he or she was truly deficient with levels below 20. However, giving COVID ICU patients very high doses of vitamin D for a short duration did shorten their hospital stay (2021).
The general recommendation is to supplement with between 400 and 2000 IUs of vitamin D. The potential for toxicity is believed to occur at high serum levels, especially above 150. A Danish observational cohort study that looked at 250,000 people over five years found associations with increased mortality at both the higher and lower extremes, although the highest risks were associated with the lowest vitamin D levels (Tabatabaeizadeh 2022).
Another consideration is the possibility that high vitamin D supplementation over time may disrupt other processes within the body, such as calcium and phosphorus regulation, its relationship to other fat-soluble vitamins, or its role as a steroid hormone.
Although vitamin D supplementation is not believed to inhibit viral replication and evidence for its effectiveness is mixed (Tabatabaeizadeh 2022), it is worth considering during an acute COVID-19 infection.
Consider vitamin A.
At the height of the pandemic, it was theorized that vitamin A supplementation would help with COVID-19 because it had already been proven effective in the treatment of pneumonia. It is very supportive of lung tissue. Vitamin A inhibits inflammation and promotes the health of epithelial cells, the cells that line internal organs and body cavities such as the nose, the mouth, the respiratory tract, and the digestive system (Li et al. 2020). Furthermore, vitamin A levels tend to be lower in hospitalized COVID-19 patients (Tepasse et al. 2021).
Don’t forget about known anti-virals such as vitamin C, L-lysine, and a host of botanicals.
If diagnosed with an autoimmune condition, use caution with high doses of vitamin C as well as immune-boosting botanicals because there is a risk of feeling worse by overstimulating an overwrought immune system. That being said, during the height of the pandemic some hospitals in China saw favorable outcomes by administering high doses of vitamin C to COVID-19 patients (Lichtenstein 2020)
Long COVID
While men are more susceptible to complications from an acute (immediate) COVID-19 infection, women are more at risk of long COVID (Takahashi et al. 2020).
Long-haul COVID can have many symptoms including:
Fatigue!!
Cardiovascular symptoms including myocarditis
Brain fog
Pulmonary issues
Organ damage
Microclotting
Cough
GI issues
Hair loss
Headaches
Cataracts
Loss of smell
Increased sensitivity to previously dormant viruses such as Epstein Barr (mono) or herpes family viruses (McCoy 2023 & Klein et al. 2023)
Long COVID seems to have unique properties and should be thought of as having distinct disease states. According to Ikiko Iwasaki, a leading COVID researcher with a focus on Post Viral Fatigue Syndrome, there are four probable causes of long COVID:
Viral remnants or garbage that continue to cause problems (old spike proteins?)
The body’s immune system goes into overdrive triggering an autoimmune reaction
Dormant viruses such as EB and herpes are resuscitated
Tissue damage caused by the initial infection
It is theorized that the spike proteins may lodge in the vascular system and cause microclotting. What is known to date is that severely ill patients experience microclotting that can threaten the lungs, although it appears to be related to the presence of other proteins and not platelets (Matharu et al. 2023). As a nutritionist, I’ve seen several cases of seemingly healthy post-COVID clients with elevated D-dimers – the traditional marker of blood clotting. Often the recommendation is to use specialized proteolytic enzymes designed to break down inflammation in the body.
Allow the body to take out the trash!
Support the many ways the body has of removing cellular or viral debris on its own:
During sleep, autophagy can take place – the process of getting rid of trash.
The lymphatic system (the behind-the-scenes vessels that remove old infection-fighting white blood cells)– consider lymphatic massage!
The glymphatic system (the behind-the-scene vessels that clean up the central nervous system inflammation)
Exercise – both the lymphatic and glymphatic systems require movement of skeletal muscles function properly (McCoy 2023).
Dealing with long COVID can be frustrating. It is a time to focus on listening to the body’s need for extra sleep, healthy food, gentle exercise, as well as strategic supplementation to address specific symptoms. For example, supplementation suggestions for hair loss will differ from those for loss of smell or brain fog.
Two of my favorite supplements for COVID are quercetin and NAC. Quercetin is a plant-derived chemical compound known for its antiviral, antimicrobial, anti-inflammatory, neuroprotective, anti-carcinogenic, and antioxidant properties. It inhibits viral entry into the host cell. It also helps improve COVID symptoms and outcomes with fewer side effectst than synthetic drugs. Quercetin also acts synergistically with other nutrients such as zinc, vitamin C, and especially vitamin D (Gasmi et al. 2022). It is also a natural antihistamine. Quercetin is best absorbed with food.
NAC is a simple amino acid and precursor to the body’s master antioxidant, glutathione. It is also a powerful mucolytic, meaning it breaks down mucus. NAC is best absorbed on an empty stomach.
The good news is that long COVID rates seem to be trending down, perhaps due to milder variants and increased herd immunity. The COVID booster has been shown in numerous studies to reduce the frequency and severity of long COVID (Hall 2023).
To stay on top of the latest information and research concerning long COVID, go to the Yale School of Medicine’s Iwasaki Lab. You should also consult with a licensed nutritionist.
Disclaimer
The included information is not meant to or should not be used to replace or substitute medical treatment, recommendations, or the advice of your physician or health care provider. The information contained within is strictly for educational purposes and is based on evidence-based nutrition. If you believe you have a medical problem or condition, please contact your physician or healthcare provider.
References
Constantini, L. (n/d) Antiviral diet: what is it, how does it support the immune system and more. https://www.osmosis.org/answers/anti-viral-diet?utm_term=&utm_campaign=20397112053&utm_content=&utm_source=google&utm_medium=cpc&campaignid=20397112053&adgroupid=&adid=&gad_source=5&gclid=EAIaIQobChMI04y88uqMgwMVaGpHAR1MeABUEAAYBSAAEgINwfD_BwE
Fatemeh Hadizadeh, Supplementation with vitamin D in the COVID-19 pandemic?, Nutrition Reviews, Volume 79, Issue 2, February 2021, Pages 200–208, https://doi.org/10.1093/nutrit/nuaa081
Gasmi, A., Mujawdiya, P. K., Lysiuk, R., Shanaida, M., Peana, M., Gasmi Benahmed, A., Beley, N., Kovalska, N., & Bjørklund, G. (2022). Quercetin in the Prevention and Treatment of Coronavirus Infections: A Focus on SARS-CoV-2. Pharmaceuticals (Basel, Switzerland), 15(9), 1049. https://doi.org/10.3390/ph15091049
Hall, S (2023) Long COVID rates appear to be decreasing. Scientific American. https://www.scientificamerican.com/article/long-covid-rates-appear-to-be-decreasing/ from Iwasaki Lab, Yale School of Medicine.
Iwaska Lab, Yale School of Medicine (n/d) Immunology of long COVID https://medicine.yale.edu/lab/iwasaki/projects/immunology-long-covid/
Klein, J., Wood, J., Jaycox, J.R., et al. (2023) Distinguishing features of long COVID identified through immune profiling. Nature 623, 139–148 . https://doi.org/10.1038/s41586-023-06651-y
Li, R., Wu, K., Li, Y., Liang, X., Tse, W. K. F., Yang, L., & Lai, K. P. (2020). Revealing the targets and mechanisms of vitamin A in the treatment of COVID-19. Aging, 12(15), 15784–15796. https://doi.org/10.18632/aging.103888
Lichenstein, K., 2020. Can vitamin c prevent and treat coronavirus? Retrieved 3/9/2020 from https://www.medicinenet.com/script/main/art.asp?articlekey=228745
Matharu, S. S., Nordmann, C. S., Ottman, K. R., Akkem, R., Palumbo, D., Cruz, D. R. D., Campbell, K., Sievert, G., Sturgill, J., Porterfield, J. Z., Joshi, S., Alfar, H. R., Peng, C., Pokrovskaya, I. D., Kamykowski, J. A., Wood, J. P., Garvy, B., Aronova, M. A., Whiteheart, S. W., Leapman, R. D., … Storrie, B. (2023). Deep learning, 3D ultrastructural analysis reveals quantitative differences in platelet and organelle packing in COVID-19/SARSCoV2 patient-derived platelets. Platelets, 34(1), 2264978. https://doi.org/10.1080/09537104.2023.2264978
Matsuyama A., Okura, H., Hashimoto, S., & T. Tanaka (2022). A prospective, randomized, open-label trial of early versus late povidone–iodine gargling in patients with COVID-19 https://www.nature.com/articles/s41598-022-24683-8
Tabatabaeizadeh S. A. (2022). Zinc supplementation and COVID-19 mortality: a meta-analysis. European journal of medical research, 27(1), 70.
https://doi.org/10.1186/s40001-022-00694-z
Takahashi, T., Ellingson, M. K., Wong, P., Israelow, B., Lucas, C., Klein, J., Silva, J., Mao, T., Oh, J. E., Tokuyama, M., Lu, P., Venkataraman, A., Park, A., Liu, F., Meir, A., Sun, J., Wang, E. Y., Casanovas-Massana, A., Wyllie, A. L., Vogels, C., … Iwasaki, A. (2020). Sex differences in immune responses that underlie COVID-19 disease outcomes. Nature, 588(7837), 315–320. https://doi.org/10.1038/s41586-020-2700-3
Tepasse, P. R., Vollenberg, R., Fobker, M., Kabar, I., Schmidt, H., Meier, J. A., Nowacki, T., & Hüsing-Kabar, A. (2021). Vitamin A Plasma Levels in COVID-19 Patients: A Prospective Multicenter Study and Hypothesis. Nutrients, 13(7), 2173. https://doi.org/10.3390/nu13072173