Nutraceuticals and COVID-19
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Nutraceuticals and COVID-19

Dr. Sanjay Agrawal

Leading Pharmaceutical consultant and editor-in chief of IJMToday

COVID-19 is a new disease caused by a newly identified and named type of single-stranded, positive-sense RNA corona virus called SARS-CoV-2 that likely jumped from infecting only animal species to infecting humans that, in turn, developed person-to-person transmission that results in respiratory and other problems. The 2019 novel corona virus is related to SARS and MERS corona viruses.

  • This is a new disease, and as more data is gathered and with ongoing research, some of the information will change as more information becomes available.
  • Risk factors for infection with the 2019 novel coronavirus include the following:
    • Recent travel to places where there is an outbreak
    • Close contact with people who are diagnosed with the disease
    • Close contact with anyone who has visited an outbreak zone
    • Contact with secretions or feces from an infected person
    • Eating or handling wild animals native to China (and other countries)
    • Touching surfaces exposed to the virus (door handles/counters)
    • People in nursing homes
    •  Obesity(BMI over 40)
    • Asthma
    • Type 1 and type 2 diabetes
    • Gestational diabetes
    • Older people (over 60-65 years old)
    • Chronic lung disease (for example, COPD, bronchitis, emphysema, idiopathic pulmonary fibrosis, cystic fibrosis, pulmonary hypertension)
    • Serious heart conditions (for example, heart failure, coronary artery disease, cardiomyopathies, congenital heart disease)
    • Chronic kidney disease  (for example, patients with decreased renal function, patients on dialysis)
    • Chronic liver disease (for example, cirrhosis)
    • Immunocompromised patients (for example, patients with cancer treatment, bone marrow or organ transplant, immune deficiencies, HIV with a low CD4 cell count
    • Men have a higher incidence of infections than women
  • Signs and symptoms of COVID-19 infection from the CDC currently include the following:
    • Fever
    • Cough
    • Shortness of breath or difficulty breathing
    • Repeated shaking with chills
    • Muscle pain
    • Headache
    • Sore throat
    • New loss of taste or loss of smell
  • Sometimes people infected with COVID-19 may also experience a runny or stuff nose, aches and pains, tiredness, upset stomach, belly pain, vomiting, diarrhea, and a sore throat. There have been many reported cases where patients infected with the virus have no symptoms.
  • The virus initially spread in an animal species (currently unidentified) and then jumped to humans where it is transferred person to person.
  • There is no antiviral drug or vaccine to treat infected individuals. Treatment is supportive in nature, and it may be necessary for a medical professional to administer treatments in a hospital.
  • Complications may include
    • high fever,
    • severe cough,
    • difficulty breathing,
    • pneumonia,
    • organ failure, and
    • death.
  • People may prevent or lower the risk of this viral infection by good hygiene, avoiding contact with infected people, social distancing, not going into an outbreak area, and by leaving an outbreak zone. There is no vaccine or recommended antiviral compounds specific for treating COVID-19.

COVID-19 Symptoms & Signs

SARS-CoV-2 (2019 novel coronavirus, 2019-nCoV, Wuhan coronavirus) is a new virus that researchers first identified in Wuhan province, China, in late 2019. Infection with SARS-CoV-2 causes an illness called COVID-19. The virus has rapidly spread from China to other countries, including the U.S.

Symptoms of COVID-19 vary in severity. These can include flu-like symptoms such as

  • fever,
  • cough,
  • shaking chills,
  • loss of sense of smell (anosmia) or taste (ageusia),
  • headache,
  • muscle pain,
  • difficulty breathing, and
  • Shortness of breath.

On occasion, people may also have signs and symptoms that include diarrhea, a sore throat, a stuffy or runny nose,

We can protect our self by enhancing our body immunity by consumption of Vit. C and Zinc.

Vitamin C is a water-soluble vitamin and is important in forming collagen- a protein that gives structure to bones, cartilage, muscles, skin and blood vessels.

Vitamin C plays an important role as a component of enzymes involved in the synthesis of collagen and carnitine; it acts as a reducing agent to maintain the enzyme prolyl hydroxylase in an active form, most likely by keeping its iron atom in a reduced state. The hydroxylation of proline and lysine in procollagen is carried out by the enzyme prolyl hydroxylase using Vitamin C as a cofactor.

It also helps maintain capillaries, bones, and teeth and aids in the absorption of iron. Vitamin C is the most potent enhancer of non-heme iron absorption. A study showed that iron absorption from non-heme food sources can be increased significantly with a daily Vitamin C intake of at least 25 mg for each meal (estimated for 3 meals/day).

Vitamin C is a potent antioxidant because it can donate a hydrogen atom and form a relatively stable ascorbyl free radical. As a scavenger of reactive oxygen and nitrogen oxide species, Vitamin C has been shown to be effective against the superoxide radical ion, hydrogen peroxide, the hypochlorous acid and singlet oxygen.

Zinc:

Zinc is an essential trace element for all forms of life.

Numerous aspects of cellular metabolism are zinc-dependent. Zinc plays important role in growth and development, the immune response, neurological function, and reproduction. On the cellular level, the function of zinc can be divided into three categories: 1) catalytic, 2) structural, and 3) regulatory:

– Nearly 100 different enzymes depend on zinc for their ability to catalyze vital chemical reactions. Zinc-dependent enzymes can be found in all known classes of enzymes.

– Zinc plays an important role in the structure of proteins and cell membranes. The structure and function of cell membranes are also affected by zinc. Loss of zinc from biological membranes increases their susceptibility to oxidative damage and impairs their function.

– Zinc finger proteins have been found to regulate gene expression by acting as transcription factors (binding to DNA and influencing the transcription of specific genes). Zinc also plays a role in cell signaling and has been found to influence hormone release and nerve impulse transmission. Recently, zinc has been found to play a role in apoptosis (gene-directed cell death), a critical cellular regulatory process with implications for growth and development, as well as a number of chronic diseases. 

The symptoms of severe zinc deficiency include the slowing or cessation of growth and development, delayed sexual maturation, characteristic skin rashes, chronic and severe diarrhea, immune system deficiencies, impaired wound healing, diminished appetite, impaired taste sensation, night blindness, swelling and clouding of the corneas, and behavioral disturbances. Oral zinc therapy results in the complete remission of symptoms.

It has recently become apparent that milder zinc deficiency contributes to a number of health problems, especially common in children who live in developing countries. Controlled trials of moderate zinc supplementation have demonstrated that mild zinc deficiency contributes to impaired physical and neuropsychological development and increased susceptibility to life-threatening infections in young children.

Significant delays in linear growth and weight gain, known as growth retardation or failure to thrive, are common features of mild zinc deficiency in children. In the 1970s and 1980s, several studies of zinc supplementation in young children with significant growth delays were conducted. Modest zinc supplementation (5.7 mg/day) resulted in increased growth rates compared to placebo.

Low maternal zinc nutritional status has been associated with diminished attention in newborn infants and poorer motor function at six months of age. Zinc supplementation has been associated with improved motor development in very low-birth-weight infants, more vigorous activity in Indian infants and toddlers, and more functional activity in Guatemalan infants and toddlers. Additionally, zinc supplementation was associated with better neuropsychologic functioning (e.g., attention) in Chinese first grade students.

Adequate zinc intake is essential in maintaining the integrity of the immune system, and zinc-deficient individuals are known to experience increased susceptibility to a variety of infectious agents.

Age-related declines in immune function are similar to those associated with zinc deficiency, and the elderly are vulnerable to mild zinc deficiency. Certain aspects of immune function in the elderly have been found to improve with zinc supplementation.

 Zinc deficiency and Pregnancy complications:

It has been estimated that 82% of pregnant women worldwide are likely to have inadequate zinc intakes. Poor maternal zinc nutritional status has been associated with a number of adverse outcomes of pregnancy, including low birth weight, premature delivery, labor and delivery complications, and congenital anomalies. Some studies have found maternal zinc supplementation increases birth weight and decreases the likelihood of premature delivery.

 Age-related macular degeneration:

Zinc is hypothesized to play a role in the development of AMD for several reasons: (1) zinc is found at high concentrations in the part of the retina affected by AMD (2) retinal zinc content has been shown to decline with age, and (3) the activities of some zinc-dependent retinal enzymes have been shown to decline with age.

Zinc and cardiovascular health:

It was observed that the prevalence of CAD, diabetes and glucose intolerancewas significantly higher among subjects consuming lower intakesof dietary zinc. There was a higher prevalence of hypertension,hypertriglyceridemia and low high-density lipoprotein cholesterollevels which showed significant upward trend with lower zincintakes. Serum lipoprotein (a) and 2-hour plasma insulin levelsalso were associated with low zinc intake. It is showed that zincintake and CAD were inversely associated. Lower consumption of dietary zinc and low serumzinc levels were associated with an increased prevalence ofCAD and diabetes and several of their associated risk factorsincluding hypertension, hypertriglyceridemia and other factorssuggestive of mild insulin resistance in urban subjects.

Zinc and skin health:

Zinc is a component of many enzymes, including DNA and RNA polymerases, and it is required for protein synthesis, DNA synthesis, mitosis, and cell proliferation. Approximately 300 enzymes need zinc for proper functioning. Many of these zinc-dependent processes are required for wound healing, such as collagen synthesis and cell division. Studies show that a skin injury site becomes saturated with zinc within 90 minutes of the injury. Zinc levels increase to a peak on approximately the 7th day following the injury and return to normal at about the 14th day. As people age, zinc saturation of an injury does not achieve the same levels as younger skin and overall systemic zinc levels decline. The inability of elderly people to heal quickly or heal completely is most frequently related to inadequate zinc-injury response and low systemic zinc levels.

Zinc is a co-factor in the skin’s production of certain metalloproteinases that remove damaged or mutated tissue. It is a co-factor in the production of adenosine deaminase, which signals T-cells as one of our body’s immune processes. Each of these processes is involved in healing and repair and without adequate zinc levels; the process of skin rejuvenation is slow or simply does not happen.

Shellfish, beef, and other red meats are rich sources of zinc. Nuts and legumes are relatively good plant sources of zinc. Zinc bioavailability is relatively high in meat, eggs, and seafood. 

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