COVID nutrition research

[jimmylegs]

preprint: Evidence Supports a Causal Role for Vitamin D Status in COVID-19 Outcomes (Jun 13)
https://www.medrxiv.org/content/10.1101 ... 20087965v3

...Conclusions: Our novel causal inference analysis of global data verifies that vitamin D status plays a key role in COVID-19 outcomes. The data set size, supporting historical, biomolecular, and emerging clinical research evidence altogether suggest that a very high level of confidence is justified. Vitamin D prophylaxis potentially offers a widely available, low-risk, highly-scalable, and cost-effective pandemic management strategy including the mitigation of local outbreaks and a second wave. Timely implementation of vitamin D supplementation programmes worldwide is critical with initial priority given to those who are at the highest risk, including the elderly, immobile, homebound, BAME and healthcare professionals. Population-wide vitamin D sufficiency could also prevent seasonal respiratory epidemics, decrease our dependence on pharmaceutical solutions, reduce hospitalisations, and thus greatly lower healthcare costs while significantly increasing quality of life.

[jimmylegs]

Zinc as nutritional intervention and prevention measure for COVID–19 disease (Jun 17)
https://nutrition.bmj.com/content/early ... 020-000095

Abstract
The present spread of severe acute respiratory syndrome coronavirus 2, provoking COVID–19 disease, progresses rapidly worldwide. In current absence of a curative treatment and an effective, safe vaccine, there is a pressing need to focus on identifying and correcting deficits in immune function in order to reduce risk of severe progress of the disease and to lower the number of infections and fatalities. This paper evaluates the most recent literature on zinc status related to antiviral immunity and its possible role in COVID–19. It is concluded that zinc is a critical factor for antiviral immunity. There is ample evidence suggesting that zinc depletion, also prevalent in high–income nations, compromises immune functions. Notably, major risk groups for COVID–19, the elderly, men more than women, obese individuals and patients with diabetes are all at risk of zinc deficiency. Moreover, various widely used antihypertensive drugs and statin therapy have been reported to negatively influence zinc status. As zinc depletion impairs antiviral immunity, it is hypothesised to increase susceptibility for COVID–19. Therefore, dietary preventive measures and prompt implementation of zinc supplementation for risk groups should be considered. Large–scale studies are urgently needed to investigate the role of micronutrients and antiviral immunity, in particular drug–micronutrient immunity interaction.

[jimmylegs]

preprint: COVID-19 Outpatients – Early Risk-Stratified Treatment with Zinc Plus Low Dose Hydroxychloroquine and Azithromycin: A Retrospective Case Series Study (Jul 3)
https://www.preprints.org/manuscript/202007.0025/v1

related critique:
www.reddit.com/r/COVID19/comments/hkgj7 ... tratified/

[vesta]

preprint: COVID-19 Outpatients – Early Risk-Stratified Treatment with Zinc Plus Low Dose Hydroxychloroquine and Azithromycin: A Retrospective Case Series Study (Jul 3)
https://www.preprints.org/manuscript/202007.0025/v1

related critique:
www.reddit.com/r/COVID19/comments/hkgj7 ... tratified/

Thanks for finding and posting this.
At present in France Doctors are forbidden to treat Covid 19 with HCQ even though it was an over the counter Medication until mid January. My local country Doctor was very fearful to counter the medical authorities on this matter and Dr Raoult who does treat with HCQ is treated like a pariah. Basically she is ordered to withhold treatment and if I begin to have difficulty breathing, she can send me to the hospital (to die). (She didn't want to hear this.) In the meantime the EU has authorized Remdesivir for hospitalized recovery (Gilead product, US price to be over $3,000 HCQ treatment $20.) The various trials (RECOVERY/ SOLIDARITY/DISCOVERY) do specify studying HCQ for hospitalized patients which is NOT recommended use, so of course it is ineffective. Rather, HCQ should be used on an outpatient basis within 5 days of symptom appearance while the virus is still in the throat. Hospitalization unnecessary. (It is beyond me why cost conscious national health countries should favor the exorbitant cost of intubation - one million dollars in the US) Apparently there is a drive to universal vaccination, but why get a vaccine when an effective, cheap treatment is available.
The RECOVERY trial (WHO, Gates Foundation etc) demonstrates that one is willing to kill the patient in order to discredit HCQ; Zelenko/Raoult dose 400 mg a day (Raoult 600 mg first day), RECOVERY trial 2,400 mg in first 24 hours.
It is frightening to live in a country where powerful interests forbid effective, non toxic treatment.

[jimmylegs]

posted in the natural approach section for the zinc content.

obviously tough to find a COVID study in which an essential nutrient isn't combined with something else, if used at all.

there are other spaces at TiMS to discuss the merit, or lack thereof, of available pharmaceutical trials.

[jimmylegs]

observational, but i will still be interested in these results once they become available

Evaluation of the Relationship Between Zinc Vitamin D and b12 Levels in the Covid-19 Positive Pregnant Women (last update June 23)
https://clinicaltrials.gov/ct2/show/NCT ... w=3&rank=4

[jimmylegs]

interventional, but could be better designed. open label is not the best, obviously. also, i've recently been looking at zinc forms and don't have a great impression of zinc gluconate bioavailability.

Coronavirus 2019 (COVID-19)- Using Ascorbic Acid and Zinc Supplementation (COVIDAtoZ) (last update May 14)
https://clinicaltrials.gov/ct2/show/NCT ... w=2&rank=5

[jimmylegs]

Immune-boosting role of vitamins D, C, E, zinc, selenium and omega-3 fatty acids: Could they help against COVID-19?
fft: https://www.sciencedirect.com/science/a ... 2220303467

"...In this paper, evidence surrounding the role of these dietary components in immunity as well as their specific effect in COVID-19 patients are discussed. In addition, how supplementation of these nutrients may be used as therapeutic modalities potentially to decrease the morbidity and mortality rates of patients with COVID-19 is discussed."

[jimmylegs]

Perspective: Vitamin D deficiency and COVID‐19 severity – plausibly linked by latitude, ethnicity, impacts on cytokines, ACE2 and thrombosis (Jul 2020)
https://pubmed.ncbi.nlm.nih.gov/32613681/

"...Factors associated with worse COVID-19 prognosis include old age, ethnicity, male sex, obesity, diabetes and hypertension and these also associate with deficiency of vitamin D or its response. ...
Conclusions: Substantial evidence supports a link between vitamin D deficiency and COVID-19 severity but it is all indirect. ...Further evidence could come from study of COVID-19 outcomes in large cohorts ... Meanwhile, vitamin D supplementation should be strongly advised for people likely to be deficient."

[jimmylegs]

Analysis of the predictive factors for critical illness of COVID-19 during treatment - Relationship between serum zinc level and critical illness of COVID-19 (sep 7 2020)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476566/

Table 2 Demographic, clinical, and laboratory characteristics of the subgroups of patient with COVID-19
https://www.ncbi.nlm.nih.gov/pmc/articl ... objectonly

oh surprise surprise, high ferritin low zinc.

[jimmylegs]

Coronavirus Disease 2019 (COVID-19) and Nutritional Status: The Missing Link? (sep 25)
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7543263/

"...Host nutritional status plays a pivotal role in the outcome of a variety of different infectious diseases. It is known that the immune system is highly affected by malnutrition, leading to decreased immune responses with consequent augmented risk of infection and disease severity. ... In this review, evidence concerning the impact of nutritional status on viral infection outcomes is discussed."

[jimmylegs]

a start now for larger groups and some controls.

Treatment of SARS-CoV-2 with high dose oral zinc salts: A report on four patients (Oct 2020)
https://www.sciencedirect.com/science/a ... 1220304410

"... The reported efficiency of zinc lozenges for the common cold ranked zinc acetate > zinc gluconate > zinc citrate (Eby, 2004). Patients 1,2 were treated with zinc citrate lozenges (23 mg of elemental zinc); patient 3, zinc citrate/zinc gluconate(23 mg); patient 4, zinc acetate (15 mg). ... They were instructed to take lozenges every 2-4 hours, dissolving lozenges on their tongue over 20 to 30 minutes, but not to exceed 200 mg. ... No side effects from zinc therapy were reported, other than a chalky taste (case 2). ... Short term zinc use at these doses is considered very safe, with occasional gastric distress and metallic taste being the only reported side effects (Prasad et al., 2000)."

COVID-19: Poor outcomes in patients with zinc deficiency (Nov 2020)
https://www.sciencedirect.com/science/a ... 122030730X

[jimmylegs]

Association Between Low Zinc Levels and Severity of Acute Respiratory Distress Syndrome by New Coronavirus SARS‐CoV‐2 (Dec 2020)
https://aspenjournals.onlinelibrary.wil ... /ncp.10612

other than low needing to get right down below 70 before it counted (i would be interested to see more fine-grained analysis than just above or below 70), lots of good info there. i appreciated the considerations detailed in the limitations section.

[jimmylegs]

Supplements for the Treatment of Mild COVID-19—Challenging Health Beliefs With Science From A to Z (Feb 2021)
https://jamanetwork.com/journals/jamane ... ct/2776299

critiquing

Thomas S, Patel D, Bittel B, et al. Effect of high-dose zinc and ascorbic acid supplementation vs usual care on symptom length and reduction among ambulatory patients with SARS-CoV-2 infection: the COVID A to Z randomized clinical trial
https://pubmed.ncbi.nlm.nih.gov/33576820/

"Intervention: Patients were randomized in a 1:1:1:1 allocation ratio to receive either 10 days of zinc gluconate (50 mg), ascorbic acid (8000 mg), both agents, or standard of care.
..
treatment with high-dose zinc gluconate, ascorbic acid, or a combination of the 2 supplements did not significantly decrease the duration of symptoms compared with standard of care."

50mg doesn't actually look very high dose for a short term targeted therapeutic regime (compare 200 above). my 2c, kind of unsurprising that it didn't make much difference - esp if patients happened to have underlying deficiency (tbd). designed to fail?

[jimmylegs]

it works! (but only if *professionals* do it in this more-technical-and-expensive-than-necessary-but-ethical-we-promise fashion)

A pilot double‐blind safety and feasibility randomized controlled trial of high‐dose intravenous zinc in hospitalized COVID‐19 patients (Feb 2021)
https://onlinelibrary.wiley.com/doi/ful ... /jmv.26895

"... We performed a Phase IIa double‐blind, randomized controlled trial to compare HDIVZn to placebo in hospitalized patients with COVID‐19. ... Mean serum zinc on Day 1 in the placebo, and the HDIVZn group was 6.9 ± 1.1 and 7.7 ± 1.6 µmol/l, respectively, consistent with zinc deficiency. HDIVZn, but not placebo, increased serum zinc levels above the deficiency cutoff of 10.7 µmol/l (p < .001) on Day 6. ... Hospitalized COVID‐19 patients demonstrated zinc deficiency. This can be corrected with HDIVZn. Such treatment appears safe, feasible, and only associated with minimal peripheral infusion site irritation. This pilot study justifies further investigation of this treatment in COVID‐19 patients."

Zinc supplementation as an adjunct therapy for COVID-19: challenges and opportunities (March, 2021)
https://bpspubs.onlinelibrary.wiley.com ... /bcp.14826

"... We have initiated a phase IIa pilot double-blind randomised controlled trial (RCT) to determine the feasibility, safety and biological efficacy of HDIVZn in subjects with COVID-19 (Trial registration No ACTRN12620000454976). A detailed clinical trial protocol has been published previously [95]. ..."

the authors spend a lot of time making the case against oral zinc therapy, which is odd considering how readily absorption challenges are overcome, to established toxic effects in excess. caution, yes. iv? i'm not convinced. tbd.