This article takes a quick moment to review COVID-19, and some potential evidenced-based treatments to prevent or treat viral respiratory infections. However, just to be clear, there are no registered evidence-based treatments yet specifically for COVID-19.
The First Outbreak of COVID-19 and CT Findings
The first outbreak of COVID-19 (which stands for Coronavirus Disease 2019) occurred in December 2019 in Wuhan, Hubei Providence, China. Most infected patients were diagnosed with pneumonia and characteristic CT scans, therefore, CT findings are recommended as major evidence to detect early infection and for disease assessment. (1)
Clinical Presentation of COVID-19
Clinical manifestations are nonspecific: runny nose, sore throat, cough, fever, and in severe cases, difficulty breathing. (2)
Transmission of COVID-19
Person-to-person transmission is thought mainly to occur much like that of influenza, that is, via respiratory droplets.
Typical CT Findings
Typical CT findings include ground-glass opacities (GGOs) which are peripherally distributed, with patchy consolidations. And posterior or lower lobe lung involvement is more common. If these GGOs are present in greater numbers or higher density, then it is indicative of disease progression. (3) The preferred type of CT is thin-slice, which is a slice thickness of 0.625 to 1.25 mm with a higher resolution, as opposed to the standard 5 mm CT imaging of the mediastinum and gross lungs. (4)
COVID-19 Viral Genome
Interestingly, the viral genome of the COVID-19 shares 88% sequence identity with two bat-derived severe acute respiratory syndrome (SARS)-like coronaviruses.
Vitamin C and Viral Respiratory Infections
Because COVID-19 is a viral infection with proclivity to infect the respiratory tract, it stands to reason that vitamin C may help to prevent it.
A 1999 prospective, controlled study, from The Journal of Manipulative and Physiological Therapeutics, found that high dose vitamin C decreased the reported cold and flu symptoms of virus-induced respiratory infections by 85%. The treatment group received 1000 mg of vitamin C hourly, for the first six hours, and then three times daily thereafter. (5)
A 2017 review article in the journal, Nutrients, concluded that vitamin C plays a role in preventing and shorting diverse infections. In fact, five controlled trials found that vitamin C had significant benefit in treating pneumonia. (6)
Chinese Medicine and COVID-19
A 2020 guideline, in line with WHO standards, from the journal, Military Medical Research, details some Chinese medicine herbal protocols that might be used specifically for COVID-19 induced pneumonia: (7)
- Clove, fineleaf schizonepeta herb, Perilla frutescens, atractylodes lancea, cinnamon, biond magnolia flower, asarum sieboldii, and Elettaria cardamomum
- Prescription of Chinese herbs for feet bath: vulgaris, carthamus, dried ginger
- Chinese herbs for prophylaxis: Astragalus mongholicus, roasted rhizoma atractylodis macrocephalae, saposhnikovia divaricata, Cyrtomium fortunei, honeysuckle, dried tangerine or orange peel, eupatorium, and licorice
A 2020 Journal of Integrative Medicine in vitro study found 26 Chinese herbs, including licorice and gingko, used to treat viral respiratory infection with anti-COVID-19 properties. (8)
Vitamin D and Immunomodulation During Respiratory Virus Infection
Multiple studies have found that vitamin D has immunomodulatory properties that can improve the response to respiratory viruses. (9) A 2014 randomized controlled trial investigated vitamin D related respiratory disease in preschoolers, making the case that low wintertime vitamin D levels correlate with viral respiratory infections and asthma exacerbations in children. (10) Hence, bolstering up on vitamin D could lower the chances of a respiratory infection, such as COVID-19.
Selenium and Viral Infection
It’s a well known fact that selenium deficiency weakens our defense versus infectious disease agents by reducing selenoprotein expression. (11) As a key part of antioxidant defense, selenium helps to control oxidative stress, which can occur during viral respiratory infections. (12)
Zinc and Lower Respiratory Tract Infections
Zinc is a vital nutrient key to the growth and function of all cells in the human body. According to the WHO, the fifth leading cause of mortality and morbidity in developing nations is zinc deficiency, estimated to affect one-third of the world population and accounting for 16% of lower respiratory tract infections. (13)
In summary, evidence points to vitamins C and D, zinc and selenium supplementation, and the use of Chinese herbal medicine, as possible evidence-based options for COVID-19 prevention and treatment. But it is recommended that these options are implemented only under the guidance of a board certified naturopathic doctor, or other integrative medicine physician. Also, just to reiterate, this article is not recommending treatments specifically for COVID-19, as there are as of yet no officially registered treatments back by evidence based studies.
Zu ZY, Jiang MD, Xu PP, et al. Coronavirus Disease 2019 (COVID-19): A Perspective from China. Radiology. 2020:200490. doi:10.1148/radiol.2020200490.
Raoult D, Zumla A, Locatelli F, Ippolito G, Kroemer G. Coronavirus infections: Epidemiological, clinical and immunological features and hypotheses. Cell Stress. 2020;4(4):66-75. doi:10.15698/cst2020.04.216.
She J, Jiang J, Ye L, Hu L, Bai C, Song Y. 2019 novel coronavirus of pneumonia in Wuhan, China: emerging attack and management strategies. Clinical and Translational Medicine. 2020;9(1). doi:10.1186/s40169-020-00271-z.
- Zu ZY, Jiang MD, Xu PP, et al. Coronavirus Disease 2019 (COVID-19): A Perspective from China. Radiology. 2020:200490. doi:10.1148/radiol.2020200490.
- Gorton H, Jarvis K. The effectiveness of vitamin C in preventing and relieving the symptoms of virus-induced respiratory infections. Journal of Manipulative and Physiological Therapeutics. 1999;22(8):530-533. doi:10.1016/s0161-4754(99)70005-9.
- Hemilä H. Vitamin C and Infections. Nutrients. 2017;9(4):339. doi:10.3390/nu9040339.
- Jin Y-H, Cai L, Cheng Z-S, et al. A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus (2019-nCoV) infected pneumonia (standard version). Military Medical Research. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7003341/. Published February 6, 2020.
- Zhang D-hai, Wu K-lun, Zhang X, Deng S-qiong, Peng B. In silico screening of Chinese herbal medicines with the potential to directly inhibit 2019 novel coronavirus. Journal of Integrative Medicine. Published February 20, 2020.
- Greiller CL, Martineau AR. Modulation of the immune response to respiratory viruses by vitamin D. Nutrients. Published May 29, 2015.
- Maguire JL, Birken CS, Loeb MB, et al. DO IT Trial: vitamin D Outcomes and Interventions in Toddlers – a TARGet Kids! randomized controlled trial. BMC pediatrics. Published February 8, 2014.
- Guillin OM, Vindry C, Ohlmann T, Chavatte L. Selenium, Selenoproteins and Viral Infection. Nutrients. Published September 4, 2019.
- Steinbrenner H, Al-Quraishy S, Dkhil MA, Wunderlich F, Sies H. Dietary selenium in adjuvant therapy of viral and bacterial infections. Advances in nutrition (Bethesda, Md.). Published January 15, 2015. .
Gammoh NZ, Rink L. Zinc in Infection and Inflammation. Nutrients. Published June 17, 2017.