Antioxidants and Coronavirus - Updates and Reviews in 2020

The novel coronavirus, COVID-19, has infected thousands worldwide, raising fear and anxiety among the general population. In order to reduce your confusion, you need to separate the facts from fiction.

A study published on Feb 24, 2020 in The Journal of the American Medical Association suggested that COVID-19, the disease caused by the new coronavirus that originated in China, appears to get more dangerous with age. This could be related to the weakened immune defence system associated with aging. As there is currently no specific treatment available in the treatment of COVID-19, a few groups of scientists have hypothesized that antioxidants might be a possible treatment option in the treatment of COVID-19.


It's widely accepted that natural antioxidants from fruits and vegetables may help prevent a variety of serious diseases. That said, antioxidant deficiency gets worse with aging.

Here, we have compiled and updated a few important studies and related reviews on Coronavirus treatment with antioxidants.

This list is a work-in-progress list as new evidence might be added from time to time.

Vitamin C (Updated)

As reported by the New York Post, March 24, 2020:

"Seriously sick coronavirus patients in New York state's largest hospital system are being given massive doses of vitamin C … Dr. Andrew G. Weber, a pulmonologist and critical-care specialist affiliated with two Northwell Health facilities on Long Island, said his intensive-care patients with the coronavirus immediately receive 1,500 milligrams of intravenous vitamin C.

Identical amounts of the powerful antioxidant are then re-administered three or four times a day, he said … The regimen is based on experimental treatments administered to people with the coronavirus in Shanghai, China …

'The patients who received vitamin C did significantly better than those who did not get vitamin C,' he said. 'It helps a tremendous amount, but it is not highlighted because it's not a sexy drug' …

Weber … said vitamin C levels in coronavirus patients drop dramatically when they suffer sepsis, an inflammatory response that occurs when their bodies overreact to the infection. 'It makes all the sense in the world to try and maintain this level of vitamin C,' he said."


A commentary article published in The Lancet Respiratory Medicine (March 20, 2020) has also recommended rescue therapy with high-dose vitamin C to be considered.

The CITRIS-ALI randomised trial published in Oct 2019 in JAMA showed a 30% absolute mortality reduction. However,  there was no statistical difference in primary outcomes (based on the clinical trial design) among patients with sepsis treated with vitamin C versus placebo. The difference was in a secondary outcome - 'overall mortality'.



Dr Perry Wilson reviewed the above study and provided a commentary on Medscape:

But basically, this is a pretty low-risk intervention. It's easy for me to sit here and say, "Unless the patient has scurvy, wait for more data." But if a loved one was in the ICU with sepsis, would you ask for vitamin C? After reviewing the literature to prepare for this commentary, I'd be hard-pressed to dismiss it out of hand.

A large review (Jan 2013) of 29 studies in 11,306 people demonstrated that regularly supplementing with vitamin C at an average dose of 1–2 grams per day reduced the duration of colds by 8% in adults and 14% in children (PubMed).

Interestingly, the review also demonstrated that regularly taking vitamin C supplements reduced common cold occurrence in individuals under high physical stress, including marathon runners and soldiers, by up to 50% (PubMed, PubMed).

Additionally, high dose intravenous vitamin C treatment has been shown to significantly improve symptoms in people with severe infections, including sepsis and acute respiratory distress syndrome (ARDS) resulting from viral infections (PubMed, PubMed).

However, note that taking large doses of vitamin C (ascorbic acid) on a regular basis lowers your level of copper, so if you are already deficient in copper and take high doses of vitamin C, you can compromise your immune system.

Buy online: You can purchase liposomal Vitamin C as a dietary supplement online.

Vitamin C Infusion for the Treatment of Severe 2019-nCoV Infected Pneumonia

A major clinical trial in China, registered with the Chinese and the U.S. Clinical Trials Registry. The paragraphs below are the introduction to this trial:

2019 new coronavirus (2019-nCoV) infected pneumonia, namely severe acute respiratory infection (SARI) has caused global concern and emergency. There is a lack of effective targeted antiviral drugs, and symptomatic supportive treatment is still the current main treatment for SARI.

Vitamin C is significant to human body and plays a role in reducing inflammatory response and preventing common cold. In addition, a few studies have shown that vitamin C deficiency is related to the increased risk and severity of influenza infections.

The researchers hypothesise that Vitamin C infusion can help improve the prognosis of patients with SARI. Therefore, it is necessary to study the clinical efficacy and safety of vitamin C for the clinical management of SARI through randomised controlled trials during the current epidemic of SARI.

VICTAS (Vitamin C, Thiamine and Steroids) - A Clinical Trial evaluating the treatment of Sepsis.

Although this is not directly related to the treatment of the novel COVID-19 virus, this treatment protocol could be repurposed as a possible option.

VICTAS is a clinical trial for hospitalized patients with sepsis, a life-threatening condition caused by a severe infection. Sepsis occurs when the body releases so much of certain chemicals into the bloodstream to fight the infection that it causes an overwhelming inflammatory response throughout the body. This reaction then damages major organs and tissues. Someone with sepsis is critically ill and they will commonly have a fever, a fast heart rate, a fast respiration rate and confusion but other symptoms of the infection may also be present. Sepsis is usually treated in an intensive care unit and patients may need oxygen or mechanical ventilation (an artificial lung machine), medications to raise their low blood pressure, or dialysis to remove toxins from their blood. There is a significant risk of death in sepsis patients so new ways of treating it are badly needed.

Sepsis is usually treated with antibiotics and intravenous fluids. Certain medications, such as “anti-inflammatory” steroids like hydrocortisone, have been tested many times. Recently, a researcher reported that a combination of medications may be more effective than any of them by itself. They reported that injecting high doses of vitamin C in combination with thiamine (vitamin B1) and hydrocortisone reduces the damage to major organs and increases the likelihood of surviving a severe episode of sepsis. These therapies are experimental and have not been tested in large numbers of patients nor approved by the Food & Drug Administration (FDA). So, doctors do not know for sure that these therapies work or that they are safe enough to be used in large numbers of people. Early results look promising, but doctors must first perform a type of research called a clinical trial in order to collect data from lots of people before they can know for sure.

VICTAS is a clinical trial to test the combination of Vitamin C, thiamine and hydrocortisone for the treatment of sepsis. It will be conducted across 30 to 40 major academic medical centers in the United States and will enroll at least 500 patients. All patients in the clinical trial will receive the regular best intensive care available for sepsis, and half of the patients will additionally receive vitamin C, thiamine and hydrocortisone. By testing a large number of patients, the doctors can then see if the group of patients that got the combination of medications did better than the group that did not.

Buy online: You can purchase liposomal Vitamin C as a dietary supplement online.


Quercetin

One of the functions of flavonoids such as Quercetin is to act as an antioxidant.

A study published in 2020 by the University of Tennessee and Oak Ridge National Labs used the most powerful IBM supercomputer to model which FDA approved compounds or supplements might interfere with the coronavirus binding to cells. To review, the coronavirus uses the ACE 2 (Angiotensin Converting Enzyme) receptor to enter cells. Once in a cell, the coronavirus virus empties its RNA contents and hijacks the cell to start producing more viruses. So preventing the coronavirus from binding to the ACE 2 receptor is a good thing as it means the virus can’t get into your cells. The study modeled various compounds and at number 5 on the list as those that has the potential to block the virus was Quercetin.

A 2004 study showed that Quercetin blocked the entry of another SARS coronavirus into cells. A 2012 study basically concluded the same thing (PubMed). This coronavirus is called SARS-CoV-2 and is different from the others in its family. So has Quercetin been shown to do anything that prevents this novel virus from entering cells? A lab study in 2020 that has yet to be peer-reviewed, demonstrated that Quercetin and other compounds showed promise in blocking the SARS-CoV-2 novel coronavirus from entering cells.

You can purchase Quercetin as a dietary supplement online at Lazada Malaysia.


Molecular Hydrogen

Molecular hydrogen has been shown to have anti-oxidant and anti-inflammatory properties.  It is 'the one and only' antioxidant that can both penetrate the mitochondria and neutralize the reactive oxygen species (ROS) (Med Gas Res. 2020).

It was discovered and reported in Nature in 2007 by a team in Japan, that inhaled hydrogen gas could act as an antioxidant and protect the brain from free radicals. This sparked the interest in its potential health benefits worldwide and led to many published and on-going clinical research.

A review in 2019 that included 113 references, has also focused on the potential mechanisms of molecular hydrogen against sepsis to provide a theoretical basis for clinical treatment (PubMed).

H2 selectively reduces peroxynitrites and hydroxyl radicals. This gives H2 a significant advantage over other antioxidants such as vitamin C, which act indiscriminately with superoxide and nitric oxide — both of which also have important and beneficial functions. H2 does not interact with either superoxide or nitric oxide. The only thing H2 can react with are the most dangerous ROS (reactive oxygen species) such as peroxynitrites and hydroxyl radicals (Nature in 2007).

Hydrogen Medicine Therapy: An Effective and Promising Novel Treatment for Multiple Organ Dysfunction Syndrome (MODS) Induced by Influenza and Other Viral Infections Diseases?

Although this was published in 2017, the scientific review was published as a response and in anticipation of future similar viral disorders. The review proposed hydrogen therapy as a possible treatment option for SARS (severe acute respiratory syndrome) and MERS (Middle East Respiratory Syndrome) and other forms of viruses that are difficult to manage.

Although the study was not directly related to the treatment of the novel COVID-19 virus, the hypothesis, arguments and basis remain similar as most of these viruses are associated with the increase in oxidative stress and inflammatory response.

hydrogen molecule as a potential therapy for influenza and coronavirus

Until now, numerous studies have indicated cytokine storm and oxidative stress are highly associated with the pathological process when getting infected with these viruses. Although cytokine storm and oxidative stress probably try to eliminate theses viruses, they seem to generate multi-organ damage resulting in lethal clinical symptoms.  Moreover, when inflammation and oxidative stress damage tissue and organs, healing occurs with fibrosis, aggravating persistent multiple organ dysfunction. Therefore, timely elimination of these mass of cytokines and oxidative stress would presumably protect normal organs from the damaging effects of virus infection.

Given the theory that molecular hydrogen can both significantly down regulate expressions of inflammation-related genes and selectively reduce oxidative stress, the authors have reasons to consider that cytokine storm and oxidative stress can be suppressed when getting infected with avian influenza and other severe viruses.

Persistent tissue damage, MODS (Multi Organ Dysfunction Syndrome) and high death rate are highly associated with oxidative stress and cytokine storm induced by influenza and other severe viral infections. Since hydrogen can significantly reduce oxidative stress and restrain excessive production of cytokines, the authors hypothesise that hydrogen can be potentially effective for MODS induced by influenza and other viral infectious diseases.

Buy Online: You can purchase Izumio (Hydrogen Water) from Lazada Malaysia. You can purchase online on a per carton basis (30 packs) or on a per pack basis.



Alpha Lipoic Acid

Lipoic Acid (often called Alpha-lipoic acid) is an organic compound found in all human cells.

It’s made inside the mitochondrion — also known as the powerhouse of cells — where it helps enzymes turn nutrients into energy (PubMed).

Most other antioxidants are either water- or fat-soluble (PubMed). Alpha-lipoic acid is both water- and fat-soluble, which allows it to work in every cell or tissue in the body. Meanwhile,

As of Mar 28, 2020, there were 2 new studies related to Alpha Lipoic Acid for COVID-19 on the Chinese Clinical Trial Registry. One on Mar 8, 2020 and another on Feb 15, 2020.

Other than your local health stores, you can purchase Alpha Lipoic Acid as a dietary supplement online from Amazon.


Melatonin

Melatonin is a versatile molecule, produced not only in the pineal gland, but also in many other organs. Melatonin plays an important physiologic role in sleep and circadian rhythm regulation, immuno-regulation, antioxidant and mitochondrial-protective functions, reproductive control, and regulation of mood. Melatonin has also been reported as effective in combating various bacterial and viral infections.

Melatonin in septic shock, published in The Journal of Critical Care in 2010, further highlights the potential role of melatonin in the treatment of sepsis (blood poisoning), a life-threatening condition triggered by a systemic infection that causes your body to overreact and launch an excessive and highly damaging immune response.

A 2020 rodent study even demonstrated that melatonin can help protect against lung injury caused by mechanical ventilation intervention.

The full therapeutic potential of melatonin in its ability to modulate the immune system, especially the critical function of suppressing cytokine storms to prevent progression of acute respiratory distress syndrome (ARDS) and respiratory failure in infected patients was clearly demonstrated in a study by Huang et al. (2019).

Huang et al. infected rodents with the highly lethal and infectious H1N1 influenza A virus. Co-treatment of these infected rodents with melatonin and an antiviral drug significantly increased their survival rates compared to mice treated only with antivirals alone.

You can purchase melatonin online from Lazada Malaysia.


Conclusion

The dosage could be complicated. Please discuss with your doctor or pharmacist. This list is a work-in-progress list as new evidence might be added from time to time.

Let's not lose to this virus. The virus cannot survive without a human host. If we do get the virus into our bodies, most of us will recover. However, when the infection is active, the virus will try to jump to another host knowing that they will not survive within the human body for long. As long as we do not allow that to happen, that should be the end of Mr COVID-19. Let's battle this virus together!

When it comes to boosting your immune system, there are other means other than antioxidants. Check out Immune Boosting Tips during this Coronavirus Pandemic (Scientifically Referenced).


Related:

Read more: Coronavirus

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