Health care practitioners and the general public must fully understand how the COVID-19 virus affects the well-being and how it transmits. At this time, vaccines for the virus are still not available. Scientists and virologists are still in the process of culturing vaccines to confront the ongoing rise of cases. In the context of inadequate evidence, this article will assess the scientific plausibility and viability of the following recommended interventions to fight the virus.
Moreover, the following recommendations represent the functional medicine approach to the COVID-19 crisis.
Curcumin has been shown to modulate the NLRP3 inflammasome, and a preprint suggests that curcumin can target the COVID-19 main protease to reduce viral replication. Its suggested dose is 500-1,000 mg po bid (of absorption-enhanced curcumin).
EPIGALLOCATECHIN GALLATE (EGCG)
Green tea, in addition to modulating the NLRP3 inflammasome and, based on a preprint, potentially targeting the COVID-19 main protease (Mpro) to reduce viral replication, has also been shown to prevent influenza in healthcare workers. The suggested dose is 4 cups daily or 225 mg po qd.
N-acetylcysteine promotes glutathione production, which has been shown to be protective in rodents infected with influenza. In a little-noticed six-month controlled clinical study enrolling 262 primarily elderly subjects, those receiving 600 mg NAC twice daily, as opposed to those receiving placebo, experienced significantly fewer influenza-like episodes and days of bed confinement. Suggested dose is 600-900 mg po bid.
Resveratrol, a naturally occurring polyphenol, shows many beneficial health effects. It has been shown to modulate the NLRP3 inflammasome. In addition, resveratrol was shown to have in vitro activity against MERS-CoV. Its suggested dose is 100-150 mg po qd.
Activated vitamin D,1,25(OH) D, a steroid hormone, is an immune system modulator that reduces the expression of inflammatory cytokines and increases macrophage function. Vitamin D also stimulates the expression of potent antimicrobial peptides (AMPs), which exist in neutrophils, monocytes, natural killer cells, and epithelial cells of the respiratory tract. Suggested dose is 5,000 IU po qd in the absence of serum levels.
Melatonin has been shown to have an inhibitory effect on the NLRP3 inflammasome. This has not gone unnoticed by the COVID-19 research community, with two recent published papers proposing the use of melatonin as a therapeutic agent in the treatment of patients with COVID-19. Suggested dose is 5-20 mg qd.
Vitamin A is a micronutrient that is crucial for maintaining vision, promoting growth and development, and protecting epithelium and mucus integrity in the body. Vitamin A is known as an anti-inflammation vitamin because of its critical role in enhancing immune function. Its suggested dosage is Up to 10,000-25,000 IU/d.
Elderberry (Sambucus nigra) is seen in many medicinal preparations and has widespread historical use as an anti-viral herb. Based on animal research, elderberry is likely most effective in the prevention of and early infection with respiratory viruses. Suggested dosage is 500 mg po qd (of USP standard of 17% anthocyanosides).
PEA is a naturally occurring anti-inflammatory palmitic acid derivative that interfaces with the endocannabinoid system. There was a significantly favorable outcome in five of six double blind placebo-controlled trials looking at acute respiratory disease due to influenza. Its suggested dosage is 300 mg po bid to prevent infection, 600 mg po tid x two weeks to treat infection.
Vitamin C contributes to immune defense by supporting various cellular functions of both the innate and adaptive immune system. Vitamin C accumulates in phagocytic cells, such as neutrophils, and can enhance chemotaxis, phagocytosis, generation of reactive oxygen species, and ultimately microbial killing. Suggested dose is 1-3 grams po qd.
Zinc contributes to immune defense by supporting various cellular functions of both the innate and adaptive immune system. There is also evidence that it suppresses viral attachment and replication. Zinc deficiency is common, especially in those populations most at risk for severe COVID-19 infections, and it is challenging to accurately diagnosis with laboratory measures. The suggested dose is 30–60 mg daily, in divided doses (Zinc acetate, citrate, picolinate, or glycinate orally, Zinc gluconate as lozenge).