What is COVID-19?

Coronavirus disease 2019 (COVID-19) is an infectious disorder caused by SARS-CoV-2 (Severe Acute Respiratory Syndrome coronavirus.)

SARS-CoV-2 can cause respiratory, intestinal, liver, and neurological diseases.

The vast majority of individuals who contract COVID-19 have mild to moderate symptoms. These symptoms often include fever, dry cough, fatigue, shortness of breath, loss of smell and taste, muscle pain, headache, and flu-like symptoms.

However, a significant minority of people develop critical illness with outcomes of severe pneumonia, respiratory failure, acute respiratory distress syndrome (ARDS), multi-organ dysfunction, and death.

An individual’s immune response to SARS-CoV-2 appears to play a critical role in disease pathogenesis and clinical manifestations. The virus not only activates anti-viral immune responses, but can also cause uncontrolled inflammatory responses.

Medical standard of care

Several different types of treatments for COVID-19 have been developed and include drugs that potentially reduce or stop the virus from multiplying in human cells, and drugs that treat the symptoms of COVID-19.

Medication types include:

  • anti-virals
  • monoclonal antibodies
  • human neutralizing monoclonal antibodies
  • SARS-CoV-2–neutralizing monoclonal antibodies

The current standard of care treatments may reduce rates of hospitalization and improve recovery from COVID-19; however, these treatments are targeted toward high-risk, vulnerable populations, and most are offered after a patient develops symptoms that are likely to progress.

The treatment options for those who are asymptomatic or not considered high-risk for COVID-19 are largely limited. As well, many of these treatment options are not preventative in nature, but help treat COVID-19 when infection has occurred and progressed.

Why consider an orthomolecular approach?

  • The objective of the orthomolecular approach is to promote immunity and health by providing the body with optimal amounts of vitamins and minerals.
  • The immune system REQUIRES adequate amounts of nutrients for the proper functioning of all its complex metabolic processes and components.
  • A healthy, well-functioning immune system offers protection against ALL viruses – including SARS-CoV-2 and its variants.

Most people who have been exposed to SARS-CoV-2 are asymptomatic or have only minor symptoms (Janssen et al., 2021; Cerullo et al., 2020; Wallace, 2020). These people differ from those who experience severe symptoms, largely due to a superior capacity for preventing viral infection and replication, and addressing inflammation and oxidative stress. This capacity results from sufficient amounts of nutrients and a lack of factors that deplete those nutrients.

Immune health is paramount, but ignored

  • Medications can be life-saving in the context of severe COVID-19.  However, full resolution of COVID-19 (or any other virus) is only accomplished with the efforts of a healthy, balanced immune system.
  • Recommendations for supporting immune health with diet, nutrition, and lifestyle in the context of COVID-19 have largely been ignored by government and medical bodies – in spite of a long history of supporting evidence and published research.

Nutrients and immune health

Nutrients and immune health

Nutrients are required for ALL aspects of immune function.

Roles of nutrients in immune function (Adapted from Gombart et al. 2020)

1. Physical barrier integrity (respiratory tract, GI tract, skin)

  • vitamins A, B6, B12, C, D, E, folate
  • iron, zinc

2 .Oxidative burst (to kill pathogens and for immune cell self-protection)

  • vitamins C, E
  • copper, iron, magnesium, selenium, zinc

3. Innate immune cell proliferation, differentiation, function, and movement

  • vitamins A, B6, B12, C, D, E, folate
  • copper, iron, magnesium, selenium, zinc

4. Antimicrobial activity
(complement, interferons)

  • vitamins A, C, D
  • copper, iron, selenium, zinc

5. Regulation of inflammation
(triggered by innate immune cells, pro-inflammatory cytokines)

  • vitamins A, B6, C, E
  • copper, iron, magnesium, selenium, zinc

6. T cell proliferation, differentiation, and function

  • vitamins A, B6, B12, C, D, E
  • copper, iron, selenium, zinc

T-cell inhibitory actions:

  • vitamins B6, D, E

7. Antibody production and function
(TH2, B-cells, antibodies)

  • vitamins A, B6, B12, C, D, E, folate
  • copper, magnesium, selenium, zinc

8. Cell-mediated immunity
(TH1, antigen-presenting cells (dendritic cells, macrophages, B-cells), T-cells)

  • vitamins A, B6, B12, C, D, E, folate
  • copper, iron, selenium, zinc

Nutrition and immune health

In essence, good nutrition creates an environment in which the immune system is able to respond appropriately to challenge, irrespective of the nature of the challenge. Conversely poor nutrition creates an environment in which the immune system cannot respond well” (Calder, 2020).

  • Poor nutrition compromises immunity and increases risk of infection (Gröber & Holick, 2022).
  • Human trials have shown that intakes of some nutrients required for optimal immune function cannot be achieved through diet alone, and supplementation is needed (Calder, 2020).
  • The European Food Safety Authority has identified vitamins A, C, D, B6, B12, and folate, as well as, zinc, copper, iron, and selenium, as being essential for healthy immune function (Galmés et al., 2020).

Poor nutrition is a risk factor in COVID-19

  • Poor nutritional status can increase the severity of COVID-19 outcomes (de Faria Coelho-Ravagnani et al., 2021).
  • Calcium, iron, selenium, and zinc levels were shown to be significantly reduced in COVID-19 patients and associated with increased inflammation, fever, and lung damage (Calder, 2020).

Immune system terminology

Innate immunity:

  • is present at birth
  • has an immediate response to pathogens, first line of defence
  • does not need to be “educated” to fight infections

Innate immunity consists of:

  • physical barriers – skin, mucosa, digestive enzymes, stomach acid, and beneficial intestinal flora
  • complement system, neutrophils, as well as antigen-presenting cells (macrophages, NK (natural killer) cells)

Adaptive immunity:

  • is acquired over lifetime
  • has a delayed response to pathogens
  • is “educated” to identify specific pathogens
  • retains memory of encountered pathogens

Adaptive immunity consists of:

  • T cells, B cells, and antibodies

Humoral versus cell-mediated immunity

  • Humoral immunity acts in body fluids using antibodies.
  • Cell-mediated immunity acts by engulfing pathogens or destroying pathogen-infected cells.
  • Innate and adaptive immunity have both humoral and cell-mediated activity.

TH1 and TH2 cells

In general:

  • TH1 – stimulates cell-mediated responses to pathogens inside cells.
  • TH2 – stimulates humoral immune responses to pathogens outside cells.

Synergy between both the innate and adaptive immune systems, and their components, is vital for an effective and balanced immune response.

Calder, P. C. (2020). Nutrition, immunity and COVID-19. BMJ Nutrition, Prevention & Health, 3(1). 

Cerullo, G., Negro, M., Parimbelli, M., Pecoraro, M., Perna, S., Liguori, G., Rondanelli, M., Cena, H., & D’Antona, G. (2020). The Long History of Vitamin C: From Prevention of the Common Cold to Potential Aid in the Treatment of COVID-19. Frontiers in Immunology, 11. 

de Faria Coelho-Ravagnani, C., Corgosinho, F. C., Sanches, F. L. F. Z., Prado, C. M. M., Laviano, A., & Mota, J. F. (2021). Dietary recommendations during the COVID-19 pandemic. Nutrition Reviews, 79(4), 382–393. 

Galmés, S., Serra, F., & Palou, A. (2020). Current State of Evidence: Influence of Nutritional and Nutrigenetic Factors on Immunity in the COVID-19 Pandemic Framework. Nutrients, 12(9), 2738. 

Gombart, A. F., Pierre, A., & Maggini, S. (2020). A Review of Micronutrients and the Immune System–Working in Harmony to Reduce the Risk of Infection. Nutrients, 12(1), 236. 

Gröber, U., & Holick, M. F. (2022). The coronavirus disease (COVID-19) – A supportive approach      with selected micronutrients. International Journal for Vitamin and Nutrition Research, 92(1), 13–34. 

Janssen, R., Visser, M. P. J., Dofferhoff, A. S. M., Vermeer, C., Janssens, W., & Walk, J. (2021). Vitamin K metabolism as the potential missing link between lung damage and thromboembolism in Coronavirus disease 2019. British Journal of Nutrition, 126(2), 191–198. 

Wallace, T. C. (2020). Combating COVID-19 and Building Immune Resilience: A Potential Role for Magnesium Nutrition? Journal of the American College of Nutrition, 39(8), 685–693.