Can Supplements Help Combat COVID-19?

We don’t know. Here's what researchers have found.

Posted Mar 20, 2020

Photo by CDC on Unsplash. Modified by Nootralize for Educational Purposes.
Coronavirus
Source: Photo by CDC on Unsplash. Modified by Nootralize for Educational Purposes.

What Is COVID-19?

Commonly referred to as the “novel coronavirus” or simply the “coronavirus,” a new virus is causing a respiratory illness known as COVID-19. The infection surfaced in China at the end of 2019, and the virus falls within a subgroup of the corona family of viruses, which gained notoriety for the outbreak of severe acute respiratory syndrome (SARS) in 2003. Given that the novel coronavirus and SARS viruses are closely related, the presentation and duration of symptoms are similar.

Currently, there are no FDA-approved vaccines available for COVID-19. Clinical trials and case reports have yielded moderate results repurposing antiviral therapies used in unrelated viral infections, but further investigation is required. A vaccine candidate is currently being developed, but even with fast-tracking the process, a vaccine will not be available for another 12–18 months due to the vigorous testing required in drug development.

Based on cell studies, here are some candidate substances that could potentially help fight the coronavirus.

None of these are proven as treatments for COVID-19. None of the information here should be taken as medical advice. If you suspect you may have any kind of infection, seek medical help immediately (call first; don’t overwhelm the ERs).

Zinc

Zinc is an essential micronutrient that is critical in a majority of the life-enabling enzymatic processes our bodies rely on. These “zinc-dependent” processes range from aiding neurogenesis and supporting healthy reproduction by ensuring DNA integrity.

Zinc’s fame is primarily due to its ability to regulate the immune system and its innate antimicrobial activity. White blood cells, called lymphocytes, are the body’s main defense against viral infections. Zinc supplementation has been shown to increase white blood cell counts in zinc-deficient patients but also increases the immune response in healthy patients. Additionally, zinc has an intrinsic antiviral activity that extends to the corona family of viruses. In vitro (cell) studies have shown that zinc inhibits corona viral replication by blocking a key viral enzyme utilized for replication in host cells, RNA polymerase.

Glycyrrhizin/Black Licorice

Glycyrrhizin, commonly known as black licorice, is readily utilized for its anti-inflammatory, immune-stimulating, and antiviral properties. In China, glycyrrhizin is used as an adjunct to current antiviral therapy for hepatitis and HIV. When given with standard treatments, patients treated with antivirals and glycyrrhizin demonstrated a decrease in viral expression and replication, and a decrease in liver enzymes, a marker for liver damage and viral infection progression. A similar effect was seen with HIV patients, where glycyrrhizin was associated with reduced viral production and an increase in white blood cells’ ability to recognize and defend against HIV.

In vitro studies have shown that glycyrrhizin inhibits key infectious components of SARS and related coronaviruses. When SARS and corona viral strains were treated with glycyrrhizin, there were significant reductions in viral replication and the activity of viral mechanisms that allow entry into host cells. This antiviral effect, coupled with glycyrrhizin’s added benefit of increasing key components of the immune system, T-lymphocytes and interleukins, makes it a good supplement for enhancing the immune system’s ability to fight viral infections. There is no human research on whether this extends to COVID-19.

Andrographis paniculata

As an adaptogen and a key facet in Ayurveda, andrographis is a supplement used primarily for its immunostimulating properties. Multiple studies have demonstrated its ability to not only reduce the duration of upper respiratory infections but also significantly reduce the severity of symptoms. The properties of andrographis are due to its ability to increase lymphocyte production.

Of note with the spread of COVID-19, a recent publication screened compounds for their ability to inhibit key enzymes of the coronavirus. From the study, it was determined that derivatives of andrographis were able to inhibit several key infectious enzymes, making them candidates to develop drugs to treat COVID-19.

What can I do to protect myself from the coronavirus?

WHO advocates the following precautions for preventing infection/transmission:

  • Regularly wash your hands with soap and water.
  • When unable to use soap and water, use an alcohol-based hand sanitizer that is at least 60 percent alcohol.
  • When possible, maintain at least 3 feet between yourself and anyone who is coughing or sneezing.
  • Cover your mouth and nose with a bent elbow or tissue when coughing or sneezing.
  • Don’t touch your eyes, nose, and mouth

How Did COVID-19 Originate, and How Is It Spread?

COVID-19 is believed to be a zoonotic infection (where animals act as a reservoir for the disease), but the source animal has not yet been determined. Currently, the transmission is believed to happen through respiratory droplets from infected individuals’ coughs or sneezes. The virus is most contagious when patients are symptomatic, but the virus can be spread when patients are not symptomatic. Surfaces contaminated with droplets from sick individuals are also believed to be able to spread the infection, but more research into this topic is needed.

What Are the Symptoms of COVID-19?

The main symptoms of infection are a dry cough, high fever, and lethargy (tiredness). Less common symptoms include nasal congestion, sore throat, or diarrhea. The incubation period of the infection is typically 3–5 days, during which the infected individual may show no overt symptoms. The infection typically lasts 14 days, with usually only supportive care being necessary (hydration, rest, acetaminophen [Tylenol] for fever). Unfortunately for the elderly or for patients with pre-existing conditions, infections can necessitate further medical intervention or hospitalization, especially if pneumonia develops with the infection.

If you suspect you may have any kind of infection, seek medical help immediately.

This article is for educational purposes only. This post was originally written by Nathan Brown, PharmD, and published at nootralize.com. It is not a substitute for professional medical advice, diagnosis, or treatment.

References

Stay updated regarding COVID-19: WHO COVID-19 Dashboard

Information from the World Health Organization (WHO), providing continually updates news and information on protective measures, travel information, and other common questions.

The Lancet COVID-19 Resource Centre

For individuals with medical/scientific background, The Lancet’s Resource Centre provides up to date research, clinical cases, and publications

World Health Organization. Novel Coronavirus (2019-nCoV) technical guidance. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance (Accessed on February 14, 2020).

Centers for Disease Control and Prevention. Interim Clinical Guidance for Management of Patients with Confirmed 2019 Novel Coronavirus (2019-nCoV) Infection

te Velthuis, Aartjan & van den Worm, Sjoerd & Sims, Amy & Baric, Ralph & Snijder, Eric & Hemert, Martijn. (2010). Zn Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture. PLoS pathogens. 6. e1001176. 10.1371/journal.ppat.1001176.

Barnett, J., et al 2020. Effect of Zinc Supplementation On Serum Zinc Concentration And T Cell Proliferation In Nursing Home Elderly: A Randomized, Double-Blind, Placebo-Controlled Trial. Am J Clin Nutr. 2016 Mar;103(3):942-51. doi: 10.3945/ajcn.115.115188. Epub 2016 Jan 27.

Parvataneni, Radhika & Annapurna, A & Rao, S. (2012). Immunostimulant, cerebroprotective & nootropic activities of Andrographis paniculata leaves extract in normal & type 2 diabetic rats. The Indian journal of medical research. 135. 636-41.

Parvataneni, Radhika & Annapurna, A & Rao, S. (2012). Immunostimulant, cerebroprotective & nootropic activities of Andrographis paniculata leaves extract in normal & type 2 diabetic rats. The Indian journal of medical research. 135. 636-41.

Hu X-Y, Wu R-H, Logue M, Blondel C, Lai LYW, Stuart B, et al. (2017) Andrographis paniculata (Chuān Xīn Lián) for symptomatic relief of acute respiratory tract infections in adults and children: A systematic review and meta-analysis. PLoS ONE 12(8): e0181780. https://doi.org/10.1371/journal.pone.0181780

Fiore, C., Eisenhut, M., Krausse, R., Ragazzi, E., Pellati, D., Armanini, D. and Bielenberg, J. (2008), Antiviral effects of Glycyrrhiza species. Phytother. Res., 22: 141-14

Cinatl, J, Morgenstern, B, Bauer, G, Chandra, P, Rabenau, H, Doerr, HW. Glycyrrhizin, an active component of liquorice roots, and replication of SARS-associated coronavirus. The Lancet, Volume 361, Issue 9374, 2045 – 2046.

Canrong Wu, Yang Liu, Yueying Yang, Peng Zhang, Wu Zhong, Yali Wang, Qiqi Wang, Yang Xu, Mingxue Li, Xingzhou Li, Mengzhu Zheng, Lixia Chen, Hua Li, Analysis of therapeutic targets for SARS-CoV-2 and discovery of potential drugs by computational methods, Acta Pharmaceutica Sinica B, 2020,