Denver Fertility Albrecht Women’s Care

COVID-19 Treatment 

How to Treat Covid-19 Infection

Written By Dr. Bruce Albrecht April 9th 2020

At the current time, there are no known effective treatments for a COVID-19 infection.  There are multiple trials of antiviral medications and alternative medications that are being studied, but no treatment has as of yet been shown to be highly effective.

Many people think that the key that opens the door to the total lockdown of our population and the step to getting our economy back on track will be serologic testing.  Serologic testing can measure the viral antibodies in a person's blood.  It is thought that this testing will show definitively who has contracted COVID-19 and has now recovered from the infection and is in theory safe to return to work.  However, for this plan to work, we would need to perform serologic testing on everyone in the whole world.

Serologic testing is different from the PCR viral testing that is currently used to see if a person is actively infected.  PCR viral testing is performed by taking a swab of the throat and nasal passages and looking for viral particles that would be evidence of an active infection.

Serologic testing focuses on finding viral antibodies that show that an individual has had COVID-19 and is now likely to be immune.  Antibodies are one of the key immune responses to viral infections.  Usually in a viral infection, antibodies start to be detectable by a week after the initial infection.  There are two types of antibodies associated with the viral immune response: IgM, which the body produces in the early stages of a viral infection, and IgG, that are produced later during an infection.

This testing could be a huge factor, especially when we are trying to reduce confinement and get the population back to work and normal activities.

Antibody testing is crucial because a large proportion of people with COVID-19 infections may not have shown symptoms of the disease but are now immune to the virus.  Once serologic tests are widely available, they could be used to determine who gets to return to work and exit the "shelter-in-place” lockdown currently being experienced by billions around the world.  The main goal is to allow people to safely return to work as soon as possible.  Workers will probably need to carry a certificate after testing to prove that they can come out of quarantine.

However, there are some caveats to using this testing.  If they are used too early, it is possible that the patient may still be shedding virus and therefore still be a risk to other individuals.  It may be necessary to do the PCR viral test first, and if you do not carry the virus, then have the serologic test to see if you are immune.  This dual testing would obviously be extremely complicated and expensive.

Another potential pitfall is that it not yet known if people who have recovered from COVID-19 are really immune to reinfection.  In a vast majority of infectious diseases, recovery from disease and evidence of a strong immune response would lead to at least a period of immunity from re-occurrence.  This has yet to be determined for COVID-19.

Another issue is that we do not know if the COVID-19 coronavirus will undergo significant and frequent mutation like the influenza virus.  The reason we are continually at risk for influenza is that it mutates so frequently that we never develop complete immunity.  However, persons who have had an influenza infection or have had the influenza vaccine are less likely to become infected or will commonly have a less severe infection.

This points out the importance of developing a vaccine against COVID-19 virus.  We also need to continue to be personally vigilant by improved personal hygiene including hand washing, avoiding touching our eyes nose and mouth and socially distancing ourselves from persons who are sick.  In addition, when we are sick we need to shelter-in-place in order to avoid infecting those around us.  And if an effective vaccine becomes available, we need to get it.  We need to get it along with getting an annual influenza vaccine.  Remember historically influenza has killed far more humans than coronavirus and continues to do so on an annual basis.  Whether COVID-19 surpasses influenza remains to be seen.

Another way that serologic tests will be helpful is allowing us to understand what the denominator is in the equation to calculate a true mortality rate from the infection.  It is suspected that the number of persons who have become infected with COVID-19 is multiple times higher than the number of people who have been documented to have an infection by the PCR viral testing.  The numerator of the equation is the number of deaths documented to be due to COVID-19 infection.  Currently the denominator that is used is the number of patients who have tested positive for the virus.

To give you an idea of why this is important, we only need to look at the fatality rate in Italy versus China.  In Italy scarcity of testing supplies has led to a low rate of testing for COVID-19 infection.  Only patients with significant symptoms are tested.  The Italians have reported a case fatality rate of 7.2% which is is substantially higher than in China (2.3%) where extensive testing has been performed.  And in Korea where a significant portion of the asymptomatic population have had testing, the case fatality rate is even lower (~1%).

In China, the median age of the COVID-19 patients was 59 years, with higher morbidity and mortality among the elderly and among those with coexisting medical conditions (similar to the situation with influenza infections); 56% of the patients were male. Of note, there were no cases in children younger than 15 years of age. Either children are less likely to become infected, which would have important epidemiologic implications, or their symptoms were so mild that their infection escaped detection, which has implications for the size of the denominator of total number of community infections.

On the basis of a case definition requiring a diagnosis of pneumonia, the currently reported worldwide case fatality rate is approximately 2% as reported in the most recent New England Journal of Medicine.  In another article in the Journal, the Chinese reported a mortality of 1.4% among 1099 patients with laboratory-confirmed Covid-19; these patients had a wide spectrum of disease severity.  If one assumes that the number of asymptomatic or minimally symptomatic cases is multiple times higher than the number of reported cases, the case fatality rate may be considerably less than 1%.  

Nevertheless, if we assume the case fatality rate is only 1% and that the 7.5 billion occupants of birth are all highly susceptible to this new virus and that a large percentage of the susceptible population will get all Covid-19, we could expect as many as 75 million deaths.  We could compare this to the 1918 influenza pandemic.  It was estimated that over 500 million people or one third of the world's population became infected with this virus.  The number of deaths was estimated to be at least 50 million worldwide with about 675,000 occurring in the United States.  At that time, United States population was approximately 103 million making the overall mortality for Americans at 0.6% and the estimated case fatality rate at 1.8%.

Vaccination for COVID-19?

As soon as China announced that a novel coronavirus had been identified as the cause of the Wuhan outbreak, several groups began the process of vaxing development and this development is proceeding rapidly.  The first vaccine candidate entered a Phase 1 clinical trial in China on March 16, less than 10 weeks after the first genetic sequences were identified.  A second Phase 1 trial just recently started in the United States with first responders and hospital workers.

There are a lot of steps between a Phase 1 trial and release of a vaccine for general public use.  Vaccine efficacy at producing antibodies needs to be determined as well as the ability of the vaccines to avoid contracting an active infection.  It is important to note that researchers have been unable to develop a vaccine for the most common seasonal coronavirus the common cold.  Moreover, there are a lot of safety issues that will need to be addressed.

Medications for COVID-19

Multiple antiviral medications are in trials with seriously ill patients infected with COVID-19 virus.  Although there have been some hints at benefit, none of these agents have shown a significant advantage to patients.

We all heard the President tout the efficacy of hydroxychloroquine and zinc; however, again the needed studies to confirm benefit have not been performed.

An article just published in Science Advances discusses a completely new antiviral agent.  The researchers successfully engineered a new molecule which is a modified sugar molecule in the cyclodextrin family.  In vitro studies have shown that the drugs work by not by inhibiting viral growth like most current antiviral drugs.  The modified sugar molecules disrupt the outer shell of a virus thereby destroying the infectious particles on contact.  The beauty of this approach is that it will be very difficult for the virus to develop drug resistance.  In many ways, it works similar to virucidal agents, like bleach and alcohol, that are capable of destroying viruses on contact, but these agents are extremely toxic to humans and certainly cannot be taken internally at an appropriate dose without causing severe harm to the human body. Unfortunately, this new family of drugs is a long way away from use in humans.

What Can We Do To Prevent COVID-19 Infection

We do not have a cure for COVID-19 virus infection, which means it is up to each of us to protect ourselves and bolster our own immune system.  There are some things that we can do as well as some things that we should not do.

Alcohol and chlorine solutions are very effective at disinfecting surfaces that may have come into contact with someone actively infected with COVID-19; however, DO NOT spray or wipe your body with alcohol or chlorine to try to kill the virus.  These solutions are to be used on hard surfaces.

For your body use simple soap and water; however, it is important that you wash thoroughly.  Soap affects the surface tension attraction of the virus to your skin and washes away oils and dirt that viruses and bacteria may live in.  Even more importantly, soap disrupts the lipid envelope of a virus thereby destroying the virus.  Proper washing with soap is one of the most effective means available for "decontaminating" your body.

Avoid touching your eyes, nose and mouth.  These are mucous membranes which are very thin and therefore highly susceptible to invasion by viruses.  It has been estimated that the average person touches their face more than 25 times an hour.  If our hands have been touching contaminated surfaces, when we touch our faces, we are inadvertently inoculating our mucous membranes.

Social distancing and shelter-in-place are very important in the prevention of the spread of this disease.  Since it is an airborne disease, the further away you are from an infected individual the lower the likelihood that you will contact sufficient amount of virus to cause an infection.  If you are ill, quarantine is mandatory.  If you are at high risk meaning that you are greater than 65 years old or have coexisting medical conditions particularly lung disease, diabetes, heart disease and hypertension, you should strongly consider shelter in place which will quarantine you from the rest of the world.  Unfortunately, this means that visitors are not welcome to your home.  Every visitor needs to be considered as a potentially infected person who might transmit the disease to you.

Facial masks are controversial primarily because there are so many options available.  N95 is a filtering face respirator designed to filter out at least 95% of very small particles including viruses.  The supply of these masks is very limited and should only be made available to healthcare workers who need protection from potential exposure to airborne COVID-19 virus.  Workers in the emergency room and in the intensive care units are at especially high risk.  First responders are also at high risk.  

All other masks including surgical masks and homemade masks made from towels or T-shirts fall short of providing optimal protection for the wearer of the mask; however, they do provide some protection of the "naked" mucosa being exposed to the virus.  Therefore, it is my belief that we all should be wearing masks.  More importantly, the mask will help prevent an infected person from creating an aerosol of virus when they cough or sneeze that will expose me to their infection.  Moreover, the simple act of talking creates spittle and aerosol and if you are infected with the virus you may expose those around you to the virus.  

Those persons who know they are infected should obviously be in quarantine as well as wearing a mask, but as we have mentioned above, many persons who are actively infected with the COVID-19 virus have minimal or no symptoms and may unintentionally spread the virus.  These are the persons who may unknowingly spread the virus by not practicing social distancing.  If they are wearing a mask, it is thought that the likelihood of spreading their infection is greatly reduced.

So the bottom line is PLEASE wear a mask or some type of mouth cover.  

Potentially Beneficial Alternative Treatments

Heat Treatment

There is still much we do not know about COVID-19, but researchers are starting to paint a picture of the virus.  A recent Chinese investigation suggests COVID-19 is "highly sensitive" to high temperatures and spreads faster in colder climates; its most rapid spread is occurring at a temperature of 20-30°F.  As winter gives way to spring and summer and temperatures are warming up, the stability of the virus could decrease and help break the chain of viral transmission.  However, be cognizant of the large outbreaks in Florida and New Orleans and in the Southern Hemisphere.

You don't have to wait for the arrival of summer to take advantage of the potential benefits of heat.  A core mechanism by which your body fights viral infections is fever.  A fever is your body's way of raising your core body temperature.  Most pathogens do not fare well in high heat.  High body temperature activates heat shock proteins that may prevent viral nucleoproteins from being exported suppressing viral replication.

Could sauna therapy or a steam bath have potential against RNA viruses particularly early on in an infection?  In order to be effective, the core body temperature would need to be increased so that the temperature in the lungs would be hot enough to affect the coronavirus.

Before you dismiss this as a crazy notion, it is important to remember that before the discovery of penicillin, one of the few effective treatments for syphilis was to be infected with malaria.  The high fevers (>104°F) associated with malaria would kill the syphilis spirochetes and cure late stage syphilis.  This discovery was responsible for Julius Wagner-Jauregg winning the Nobel Prize in 1927.  Pyrotherapy (artificial fever) was also used.  The body temperature was raised by placing the patient in a closed chamber and maintaining the temperature at 105°F.  This was a harsh treatment for a harsh disease, and as soon as penicillin became available, it was abandoned.

Saunas create a pseudo fever by raising core body temp.  Most saunas will have a room temperature of 160-180°F.  A number of studies have investigated the antiviral effects of sauna bathing.  A clinical study involving 50 volunteers showed regular sauna bathers had half the rate of common cold compared to non-bathers.   

There is research showing animals placed in a sauna before being injected with influenza virus had suppression of viral replication and dramatically reduced mortality. 

You do not need to elevate the temperature of your body and lung tissue to the temperature of the sauna which is a dangerous 180°F.  You simply could not survive that type of exposure. 

Like the influenza virus, coronaviruses (as a general group) incubate in your sinuses for about three days before moving down into your lungs, and appear to be destroyed by temperatures around 133°F, which is easily achieved in a sauna.  So, provided the virus has not yet reached your lungs, it's quite possible that high heat in your nasal passages could destroy it.

Currently the problem with saunas is accessibility.  Most of us do not have a home sauna and going to a public sauna is something that we should obviously avoid at this time.

The Benefits of Heat-Shock Proteins.  However, it's not the heat itself that provides all the benefit.  By elevating your core temperature by just a few degrees, your body releases heat shock proteins.  Sauna bathing helps reduce viral illness by increasing heat shock protein 70 (Hsp70) and prostaglandins A1 (PGA1).  A 2004 study reported in the Journal of Virology explains how Hsp70 and PGA1 block the replication of influenza viruses.  

Viral nucleoproteins are synthesized in the nucleus, forming a special complex that enables their export from the nucleus and allows them to form complete virions (i.e., active, infective viral forms) on the surface of the cell membrane.  In the nucleus, Hsp70 interferes with the formation of that export complex, thereby trapping the viral nucleoproteins inside the nucleus. Since the viral nucleoprotein is trapped inside the nucleus, it doesn't have the chance to become active and infective.  

Sleep Treatment

Sleep is one of the best and easiest ways to improve your immune defenses.  A good night’s sleep also affects how fast you will recover if you do get sick.  Without enough sleep, your body makes fewer cytokines. These are molecules that target infection and inflammation.  There are many different kinds of cytokines.  Some are beneficial for improving immune defenses and others contribute to abnormal inflammation and cellular/organ damage. 

Beneficial cytokines are both produced and released during sleep, causing double the problem if you do not get enough sleep.  Numerous studies show a good night’s sleep improves the function of immune cells known as T cells.  T cells are a specialized white blood cell that fights intracellular pathogens such asviruses including influenza, HIV and coronavirus. 

In a new study from Germany, researchers compared immune-boosting T cells from volunteers who slept eight hours to those who stayed awake.  They found that the T cells in the study participants who slept were much better equipped to fight off an invading virus than the T cells in than those who were sleep deprived.  

When T cells in your body recognize a cell infected with a virus, they activate something called an integrin.  This is a sticky type of protein that allows the T-cell to attach to and kill infected cells.

Rather than using a prescription sleeping medications such as Lunesta or Ambien, I would recommend a natural sleep agent like melatonin.

Many people feel that melatonin doesn’t work for them.  Dosage can be a big factor.  Many people think that if a little is good a lot is better and take 5 mg or more.  When you take high levels of melatonin, it stops working as a sleep aid.  It turns into a powerful anti-aging supplement.

The ideal dose for sleep can be as little as 200 to 300 micrograms and always 1 mg or less.  If the lower dose is not helping you sleep, increase the dosage by 100 micrograms each night until you find a dose that works for you. Five hundred mcg or less is good for most people.  If you get up to 1 mg and it still does not work, it is likely melatonin is not your best option. 

The best form of melatonin is a spray or drops or a sublingual tablet.  They are better absorbed.  When you take melatonin orally, it breaks down in the liver and most of it never gets into your bloodstream.

Potentially Beneficial Supplements

Both influenza and coronavirus cause an inflammatory storm in the lungs and it is this inflammatory storm that leads to acute respiratory distress, organ failure, and death.  Certain nutraceuticals may help to reduce the inflammation in the lungs from RNA viruses and others may also help boost cytokine type 1 interferon response to these viruses, which is the body's primary way to help create antiviral antibodies to fight off viral infections.

Below is a summary of the nutraceuticals that have animal data and some human studies showing activity against viruses.  Whether these supplements have any effect on COVID-19 viral infection remains to be seen, but when taken in moderation, they are unlikely to cause any adverse side effects.

Quercetin — Known to have antiviral activity.  It showed promise in the SARS epidemic in 2003.  It is now being studied in a clinical trial to evaluate its effectiveness against COVID-19.  

Quercetin's mechanisms of action include the inhibition of lipopolysaccharide (LPS)-induced tumor necrosis factor α (TNF-α) production in macrophages.  TNF-α is a cytokine involved in systemic inflammation, secreted by activated macrophages, a type of immune cell that engulfs and digests foreign substances, microbes and damaged cells.  Quercetin also inhibits the release of proinflammatory cytokines and histamine by modulating calcium influx into the cell. 

In summary, quercetin has been found to limit viral illness via three primary mechanisms. First, it inhibits the virus' ability to infect cells. Second, it inhibits viral replication in already infected cells, and third, it reduces infected cells' resistance to treatment with antiviral medication.

Take 250-500 mg twice daily.

Elderberry extract — Studies have shown that it can shorten influenza duration by two to four days and reduce the severity of the flu.  Elderberry is a very rich source of anthocyanins.  Its impact on viruses might be mediated by ferulic acid, a prominent metabolite that appears in plasma following anthocyanin ingestion.

No dosage of Elderberry extract has been established as there is tremendous difference between products.  Recommended doses are between 500-1500 twice daily.  If you take ferulic acid, 500 mg twice daily.

Glucosamine — Upregulates mitochondrial antiviral-signaling protein (MAVS).  It has been shown to reduce severity of influenza infection severity and lowers influenza mortality in animal studies.

Take 1000-2000 mg twice daily.

Zinc — Zinc has been shown to inhibit coronavirus in vitro and block coronavirus replication in cell culture.  It may work in synergy with the drug hydroxychloroquine.  Hydroxychloroquine and has been shown to improve zinc absorption into the cell. 

Take 30-50 mg twice daily.  Another alternative is to use Zicam lozenges every four hours during waking hours.  Zicam has been shown in studies to shorten the duration of the common cold and reduce the severity of the symptoms.

Vitamin C — Has had a long and checkered history of helping to prevent and treat the common cold.  Nobel Lauralist Linus Pauling was a huge proponent of vitamin C.  He felt that the reason that many of the studies were unable to show benefit had to do with the dosage recommended.  He personally would take as much as 10 g per day.  This dosage is excessive and certainly has the potential to cause diarrhea and other gastrointestinal problems.  In women, it can cause vulvodynia a condition of severe itching and pain of the vaginal/vulvar area.  However, studies do suggest that that in significantly higher doses than the RDA for vitamin C, it may have benefit against viruses.

Vitamin C has two major functions that help explain its potent health benefits.  First, it acts as a powerful antioxidant, and secondly, it also acts as a cofactor for many enzymatic processes. 

During the 2003 SARS pandemic, a Finnish researcher called for an investigation into the use of vitamin C because of research showing that it not only protected chicks against avian coronavirus, but also cut the duration and severity of common cold in humans and significantly lowered the risk of developing pneumonia.

In 2009, IV vitamin C was shown to be a potentially lifesaving treatment for severe swine flu, and based on reports coming out of China with the current COVID-19 epidemic, a pulmonologist in Long Island, New York, is treating intensive care patients with high-dose, IV vitamin C.  Each dose (1500 mg) is more than 16 times the National Institutes of Health’s daily recommended dietary allowance of vitamin C, which is just 90 milligrams for adult men and 75 milligrams for adult women.

It is understandable why both Chinese and American doctors hold hope for vitamin C and COVID-19 patients.  In fact, there is a clinical trial underway in COVID-19 patients using vitamin C. 

take 1000 mg twice daily.

Vitamin D — Another powerful component in the prevention and treatment of influenza is vitamin D.  Although vitamin D does not appear to have a direct effect on the virus itself, it does strengthen immune function, thus allowing the host body to combat the virus more effectively. It also suppresses many inflammatory processes. Taken together with vitamin C, this might make vitamin D quite useful against COVID-19.

Take 4000 units daily.

What Should You Do?

I have tried to summarize the known and unknown and possible treatments for COVID-19 virus.  None of these treatments are a panacea.  Some of them may provide partial benefit.  Nevertheless, we are all at risk for developing a COVID-19 infection in the coming months.

Please stay safe and practice social distancing and personal hygiene.

Below is a summary of the nutraceuticals that have animal data and some human studies showing activity against viruses.  Whether these supplements have any effect on COVID-19 viral infection remains to be seen, but when taken in moderation, they are unlikely to cause any adverse side effects.

Quercetin — Known to have antiviral activity.  It showed promise in the SARS epidemic in 2003.  It is now being studied in a clinical trial to evaluate its effectiveness against COVID-19.  

Quercetin's mechanisms of action include the inhibition of lipopolysaccharide (LPS)-induced tumor necrosis factor α (TNF-α) production in macrophages.  TNF-α is a cytokine involved in systemic inflammation, secreted by activated macrophages, a type of immune cell that engulfs and digests foreign substances, microbes and damaged cells.  Quercetin also inhibits the release of proinflammatory cytokines and histamine by modulating calcium influx into the cell. 

In summary, quercetin has been found to limit viral illness via three primary mechanisms. First, it inhibits the virus' ability to infect cells. Second, it inhibits viral replication in already infected cells, and third, it reduces infected cells' resistance to treatment with antiviral medication.

Take 250-500 mg twice daily.

N-acetylcysteine (NAC) — Encourages glutathione production, a powerful antioxidant, and thins mucus.  It may lower the chances of influenza infection and reduce the risk of developing severe bronchitis.

Take 1200-1800 mg daily.

Elderberry extract — Studies have shown that it can shorten influenza duration by two to four days and reduce the severity of the flu.  Elderberry is a very rich source of anthocyanins.  Its impact on viruses might be mediated by ferulic acid, a prominent metabolite that appears in plasma following anthocyanin ingestion.

No dosage of Elderberry extract has been established as there is tremendous difference between products.  Recommended doses are between 500-1500 twice daily.  If you take ferulic acid, 500 mg twice daily. Lipoic acid can be taken as an alternative (see below).

Spirulina — Reduces severity of influenza infection severity and lowers influenza mortality in animal studies.  In a human trial, spirulina significantly lowered the viral load in patients with HIV infection.

Take 15 g daily.

Beta-glucan — Reduces severity of influenza infection severity and lowers influenza mortality in animal studies.

Take 250-500 mg twice daily.

Glucosamine — Upregulates mitochondrial antiviral-signaling protein (MAVS).  It has been shown to reduce severity of influenza infection severity and lowers influenza mortality in animal studies.

Take 1000-2000 mg twice daily.

Selenium — Selenium is an essential cofactor for certain peroxidases.  Selenium deficiency increases the rate at which viruses can mutate, promoting the evolution of strains that are more pathogenic and capable of evading immune surveillance.

Take 50-100 mg twice daily.

Zinc — Zinc has been shown to inhibit coronavirus in vitro and block coronavirus replication in cell culture.  It may work in synergy with the drug hydroxychloroquine.  Hydroxychloroquine and has been shown to improve zinc absorption into the cell. 

Take 30-50 mg twice daily.  Another alternative is to use Zicam lozenges every four hours during waking hours.  Zicam has been shown in studies to shorten the duration of the common cold and reduce the severity of the symptoms.

Lipoic acid — Helps boost type 1 interferon response.  Type I interferons (IFNs) are polypeptides that are secreted by infected cells.  They activate intracellular antimicrobial programs and have three major functions. 

Firstly, they induce cell-intrinsic antimicrobial states in infected and neighboring cells that limit the spread of infectious agents, particularly viral pathogens.  

Secondly, they modulate innate immune responses in a manner that promotes antigen presentation and natural killer cell functions while restraining pro-inflammatory pathways and cytokine production. 

Thirdly, they activate the adaptive immune system, thus promoting the development of high-affinity antigen-specific T and B cell responses and immunological memory. 

Take 1200-1800 mg twice daily.  This can be taken in place of ferulic acid (see above).  It is easier to find in stores.

Sulforaphane — Helps boost type 1 interferon response.  This is a compound within the isothiocyanate group of organosulfur compounds.  It is naturally obtained from cruciferous vegetables such as broccoli, brussels sprouts, cabbage and kale and is also present in bok choy, collard greens, mustard greens and watercress.

Take 300-400 mg twice daily.

Vitamin C — Has had a long and checkered history of helping to prevent and treat the common cold.  Nobel Lauralist Linus Pauling was a huge proponent of vitamin C.  He felt that the reason that many of the studies were unable to show benefit had to do with the dosage recommended.  He personally would take as much as 10 g per day.  This dosage is perhaps excessive and certainly has the potential to cause diarrhea and other gastrointestinal problems.  In women, it can cause vulvodynia a condition of severe itching and pain of the vaginal/vulvar area.  However, studies do suggest that that in significantly higher doses than the RDA for vitamin C, it may have benefit against viruses.

Vitamin C has two major functions that help explain its potent health benefits.  First, it acts as a powerful antioxidant, and secondly, it also acts as a cofactor for many enzymatic processes. 

During the 2003 SARS pandemic, a Finnish researcher called for an investigation into the use of vitamin C because of research showing that it not only protected chicks against avian coronavirus, but also cut the duration and severity of common cold in humans and significantly lowered the risk of developing pneumonia.

Although the vitamin C protocol is new for COVID-19 treatment, it has been used as a treatment for sepsis.  The sepsis treatment protocol was developed Dr. Paul Marik, a critical care doctor at Sentara Norfolk General Hospital in East Virginia. His retrospective before-after clinical study showed giving patients 200 mg of thiamine intravenous (IV) every 12 hours, 1500 mg of ascorbic acid IV every six hours, and 50 mg of hydrocortisone IV every six hours for two days reduced mortality from 40% to 8.5%.  Unfortunately in double-blind placebo-controlled studies, the benefit is not so striking.  Nevertheless, the treatment has minimal side effects and is inexpensive, readily available and simple to administer to hospitalized patients by IV.

In 2009, IV vitamin C was shown to be a potentially lifesaving treatment for severe swine flu, and based on reports coming out of China with the current COVID-19 epidemic, a pulmonologist in Long Island, New York, is treating intensive care patients with high-dose, IV vitamin C.  This is sort of an adaptation to the sepsis treatment protocol described above.  Each dose (1500 mg) is more than 16 times the National Institutes of Health’s daily recommended dietary allowance of vitamin C, which is just 90 milligrams for adult men and 75 milligrams for adult women.

It is understandable why both Chinese and American doctors hold hope for vitamin C and COVID-19 patients.  In fact, there is a clinical trial underway in COVID-19 patients using vitamin C. 

Another powerful component in the prevention and treatment of influenza is vitamin D.  Although vitamin D does not appear to have a direct effect on the virus itself, it does strengthen immune function, thus allowing the host body to combat the virus more effectively. It also suppresses inflammatory processes. Taken together with vitamin C, this might make vitamin D quite useful against COVID-19.  

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