Diagnosis: COVID-19

Updated: Apr 11, 2020

This diagnosis in addition to the diagnosis of cancer or an autoimmune disease is one that puts you at increased mortality regardless of age. In this short post I will outline some key considerations for my patients and their families for immune support that you can employ in addition to hand hygiene, social distancing and, when diagnosed via testing, self isolation and quarantine. There is a lot of information that is and is not accurate and I hesitated to write anything out of concern for accuracy and fact. I favor evidence over conjecture. Now that there is some more information with evidence I am creating a summary below. Feel free to share with friends and family.

1. Testing: here is a link to Nature Biotechnology article - There is a summary table outlining all the test types and where they are stages of development/approval/shipping as of March 23 2020 For a list of testing sites near you please visit your local county health and human services website or go to www.cdc.gov.

2. Take care of your mind. I couldn't agree more about how stressful this is: from planning home schooling, finding groceries, listening to the news on rising numbers of infections in your county, the stress is real. How we handle that stress is even more important. Psychological well-being and immune function are interconnected. In this review article, the authors conclude that a healthy mindset helps with resistance to disease including infectious diseases and bolsters immune function. For support on stress management, search for resources online and apps, call or facetime your family friends for an old-fashioned form of hello, and consider starting a journal in which you can list the things and events and people you are grateful to have in your life. Find and watch positive media such as comedy shows and movies.

3. Stay physically active. For everyone over 18 years of age, that means an average of 150 minutes per week of aerobic activity for substantial health benefits. Aim for 70-80% of your max Heart Rate, which is calculated as 220-your age.

4. Get your sleep and then some. Adequate sleep helps everyone become more resilient to immune challenges and the general stress of life. Sleep is the time when your body is recovering from the previous day and detoxifying and rebuilding. Chronic sleep loss results in inadequate immune function and this is bad for your general and long term health and, in return, can worsen your sleep quality, thus making you more sick. Sleep and your immune function are linked in that they both influence and detract from the other when not in balance.

5. Eat clean. Now is the best time to invest in vegetables and whole foods to support your immune system. Reduce your intake of processed food and aim for a balance of fiber, protein and fat from healthy sources. Additionally, aim for colorful foods - their bioflavonoid content has immune boosting ability. For a comprehensive list go to www.ewg.org for more details on the Dirty Dozen and the Clean Fifteen.

6. Supplements - these are controversial as there is limited human data because human trials are underfunded for supplement research. However there are a few showing promise against coronavirus and they are listed below:

Zinc: Cell culture studies show zinc stops coronavirus replication, and this article discusses a controlled trial of humans were able to reduce common cold duration from 8 days to 4.5 days just by sucking on a 13mg zinc lozenge (in the form of zinc gluconate or citrate) every 2-3 hours while they had cold symptoms. Another benefit is that zinc reduces cytokine production. These are the chemical signals which cause inflammation.

Vitamin D3: current research indicates Vitamin D3 is fine to take without symptoms of Coronavirus infection. When symptoms become present (headache, loss of sense of smell, dry unproductive cough and fever) consult a trained medical professional who is knowledgeable about how Vitamin D influences specifically the levels of macrophage Interleukin 1-b (IL1-b) and COVID-19 infection. Research can change but current research indicates against its use. If you have an inflammatory condition already, this is especially important.

Vitamin C: Early studies have shown the effect of Vitamin C on Neutrophils to reduce lung damage when sepsis occurs. Oral dosing has been indicated to be helpful in preventing the onset of and in reducing severity of viral infections such as the common cold. More studies have recently been approved in China for use of IV vitamin C against Covid-19 infections. For more information about orthomolecular medicine, click on the link here.

Other Supplements for consideration: These are not validated by human clinical trials research but may have cell studies or other information to potentially support their use. Further studies are needed.

- Garlic

- Vitamin A

- Elderberry

- Astragalus

Supplements and Medications to Avoid With a Diagnosis of COVID-19:

- Echinacea this is an article still under peer review - thus is not fully vetted - but discuses potential support for use of echinacea to prevent coronavirus types including the COVID-19 infection, but in prevention only. Use of echinacea during positive/symptomatic illness is not recommended.

- Polysaccharide extracts from medicinal mushrooms becuase they alter the immune system in more than one way which can contribute to furthering COVID-19 if you are tested positive.

- Larch arabinogalactan because the animal studies have not yet found one and propose two possible pathways for it to work, which requires more research. Discontinue if tested positive for COVID-19.

- ACE inhibitors - this study identifies Angiotension Converting Enzyme-2 as a cellular entry point for severe acute respiratory syndrome. There is theoretical, unproven concern that anyone taking an ACE-2 inhibitor for the treatment of hypertension can be increasing their risk of getting and increasing the severity of COVID-19 infection. I suggest you switch to a different blood pressure control drug for the time being to be on the safe side. This may become proven via observational retroscpective research done by autopsy.

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