key: cord-0922560-mnpvskuq
authors: Young, Trevor K.; Zampella, John G.
title: Supplements for COVID-19: A modifiable environmental risk
date: 2020-05-15
journal: Clin Immunol
DOI: 10.1016/j.clim.2020.108465
sha: 3df88abc369c80b0f113d09f7f0d535fce39ee43
doc_id: 922560
cord_uid: mnpvskuq

nan

We have read with great interest the review by Gasmi A et al. exploring risk factors associated with disease severity in patients with COVID-19. 1 The authors discuss an individualized patient approach to mitigating risk, especially regarding environmental factors over which patients and providers have some control. We were intrigued by the discussion of herbs with suspected anti-viral properties as a potential therapy for COVID-19. The authors present data regarding possible therapeutic effects of some herbal supplements. Herbal or "natural" supplements are used around the world for a myriad of reasons. Evidence supporting their clinical utility is limited, with a non-insignificant risk of harm. 2 Patient rationale for using supplements is multifactorial and includes a desire for "natural" treatments, cultural traditions, and/or a distrust of conventional medicine. We would like to note that some over the counter supplements may have unrecognized deleterious effects on the host immune and metabolic status, which could negatively alter disease severity of COVID-19.

COVID-19 is the disease caused by the SARS-CoV-2 virus, a novel highly pathogenic coronavirus that most often causes symptoms of upper respiratory infection. While many cases are mild, in some, SARS-CoV-2 is able to infect lower respiratory epithelial cells and induce a pathogenic immune response that can ultimately lead to hypoxic respiratory failure, acute respiratory distress syndrome (ARDS), and death. The underlying pathophysiology surrounding this progression is unknown, and risk factors including hypertension, obesity, and diabetes are currently under investigation. However, rapid worsening of disease severity likely involves an uncontrolled immune

Individual risk management strategy and potential therapeutic options for the COVID-19 pandemic

Patient safety and the widespread use of herbs and supplements

The pathogenesis and treatment of the `Cytokine Storm' in COVID-19

Zn(2+) inhibits coronavirus and arterivirus RNA polymerase activity in vitro and zinc ionophores block the replication of these viruses in cell culture

Echinacea-induced cytokine production by human macrophages

Garlic and ginger extracts modulated broiler chicks innate immune responses and enhanced multidrug resistant Escherichia coli O78 clearance

Immunomodulating activity of Chinese medicinal herbs and Oldenlandia diffusa in particular

Glycyrrhizin, an active component of liquorice roots, and replication of SARS-associated coronavirus