@duggils
I prefer Sol’s approach in dealing with COVID 19 he looks for evidence and psychological factors to back up many of his claims. For example in a recent update he stated that there was some correlation between Vit D and Covid and that appears to be true. And like him I don't place too much faith in Main Stream media
So lets look at some of the supplements he mentioned
VIt D
Participants were COVID-19 patients of age group 30–60 years admitted during the study period of 6 weeks. Study included either asymptomatic COVID-19 patients (Group A) or severely ill patients requiring ICU admission (Group B). Serum concentration of 25 (OH)D, were measured along with serum IL-6; TNFα and serum ferritin. Standard statistical analysis was performed to analyze the differences. Current Study enrolled 154 patients, 91 in Group A and 63 patients in Group B. The mean level of vitamin D (in ng/mL) was 27.89 ± 6.21 in Group A and 14.35 ± 5.79 in Group B, the difference was highly significant. The prevalence of vitamin D deficiency was 32.96% and 96.82% respectively in Group A and Group B. Out of total 154 patients, 90 patients were found to be deficient in vitamin D (Group A: 29; Group B: 61). Serum level of inflammatory markers was found to be higher in vitamin D deficient COVID-19 patients viz. IL-6 level (in pg/mL) 19.34 ± 6.17 vs 12.18 ± 4.29; Serum ferritin 319.17 ± 38.21 ng/mL vs 186.83 ± 20.18 ng/mL; TNFα level (in pg/mL) 13.26 ± 5.64 vs 11.87 ± 3.15.
The fatality rate was high in vitamin D deficient (21% vs 3.1%). Vitamin D level is markedly low in severe COVID-19 patients. Inflammatory response is high in vitamin D deficient COVID-19 patients. This all translates into increased mortality in vitamin D deficient COVID-19 patients. As per the flexible approach in the current COVID-19 pandemic authors recommend mass administration of vitamin D supplements to population at risk for COVID-19. https://www.nature.com/articles/s41598-020-77093-z
Low levels of vitamin D are also associated with an increase in inflammatory cytokines.
A study of healthy women in the USA found a significant inverse relationship between the serum levels of 25(OH)D and TNF-alpha.8 In another report, the levels of IL6 were found to be increased in those who were vitamin D deficient. In a wide variety of animal studies and in vitro cell models, vitamin D3 has been demonstrated to downregulate the production of inflammatory cytokines, such as TNF-alpha and IL6, while increasing inhibitory cytokines.9 These studies raise the possibility that adequate levels of vitamin D may reduce the incidence of cytokine storm, which can occur in COVID-19.
Thrombotic complications are common in COVID-19 patients.10 Of those with severe disease, over half have been found to have elevated D-dimer levels. Interestingly, vitamin D is also involved in the regulation of thrombotic pathways, and vitamin D deficiency is associated with an increase in thrombotic episodes.11 Vitamin D deficiency has also been found to occur more frequently in patients with obesity and diabetes. These conditions are reported to carry a higher mortality in COVID-19. An increased risk of death with COVID-19 is also observed in black, Asian and minority ethnic (BAME) groups. As melanin reduces the production of vitamin D sociated with exposure to the ultraviolet radiation in sunlight, this may help to explain the observed frequent occurrence of vitamin D deficiency in BAME groups.
One recurring question regarding COVID-19 is whether, once a patient has had the infection, they are unlikely to be re-infected at a later date. The answer to that question is still unknown and depends to some extent on the production, longevity and efficacy of the specific antibodies. However, in the case of influenza A virus (IAV), exposure to the virus results in the production of memory regulatory T cells (mTregs), which persist in the host.12 In mice exposed to influenza A infection, the infusion of mTregs into their tail vein significantly reduces weight loss and lung pathology (particularly the inflammatory infiltrate), relative to the infusion of Tregs that have not previously been exposed to the virus. This study illustrates the potential efficacy of Tregs in combatting viral infection. Given that women have higher levels of Treg cells than men,13 the observation might provide one reason why women have a lower mortality when infected by COVID-19.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7385774/
I think when it comes to dealing with any topic its best to take the observer perspective minus the emotion factor as it helps one focus on the facts and present the information in manner that most individuals find palatable, even the ones that might disagree with your findings.
Zinc
In this perspective, we reviewed the most important literature on the role of zinc homeostasis during viral infections, focusing on the potential benefits of zinc supplementation to prevent and treat SARS-CoV2 infections. Although data specifically on SARS-CoV2 are unfortunately still pending and randomized controlled studies have not been conducted, the enumerated evidence from the literature strongly suggests great benefits of zinc supplementation. Zinc supplementation improves the mucociliary clearance, strengthens the integrity of the epithelium, decreases viral replication, preserves antiviral immunity, attenuates the risk of hyper-inflammation, supports anti-oxidative effects and thus reduces lung damage and minimized secondary infections. Especially older subjects, patients with chronic diseases and most of the remaining COVID-19 risk groups would most likely benefit. Although studies are needed testing the effect of zinc as therapeutic option for established disease, preventive supplementation of subjects from risk groups should begin now, as zinc is a cost-efficient, globally available and simple to use option with little to no side effects. The first clinical trials on zinc supplementation alone and in combination with other drugs such as chloroquine have been registered (124, 160–162). Thus, first results and treatment regimens regarding zinc supplementation for COVID-19 risk groups and patients can be anticipated soon.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7365891/
Lots of data on how vitamins in general could prove to be useful in the battle against COVID
In the absence of a vaccine, the world is eagerly awaiting a panacea of treatment options for COVID-19. In this article, we critically appraised the potential immunomodulatory, antioxidant, and antimicrobial roles of vitamins A to E. Although there is currently no evidence from completed randomized controlled trials to conclusively and specifically demonstrate a role for vitamin supplementation in the fight against COVID-19, there is strong scientific evidence, based on studies of vitamin physiology, pharmacology, and their role in clinical studies of infection and ARDS to indicate a role for vitamins in the battle against this global pandemic. In particular, disease models of a lower vitamin A concentration and increasing host susceptibility to influenza and SARS-CoV have prompted investigation into the relationship between oral supplementation with vitamin A and COVID/COVID-like viruses. Furthermore, computational screening tools is a novel approach revealing promise for targeted drug testing of B vitamins, such as folate and B12, and supplementation if warranted. Vitamin C, owing to its potential role in attenuating upper respiratory tract infections, its antioxidant properties, and use as a high-dose intravenous therapy in ARDS and sepsis, may prove beneficial in COVID-19. The RCTs currently underway might indeed demonstrate a role for this vitamin in the intensive care setting. The Front Line COVID-19 Critical Care (FLCCC) Working Group released the MATH+ protocol in April 2020 and included vitamin C within its multimodal therapeutic strategy. The protocol consists of intravenous methylprednisolone, high-dose intravenous ascorbic acid, full-dose low-molecular-weight heparin and optional treatment components (including thiamine, zinc, and vitamin D) [220]. This is an early intervention protocol directed at suppressing hyperinflammation seen in COVID-19. Anecdotal experience with this regime has shown that early provision (within 6 h of admission) of MATH+ has reduced the need for mechanical ventilation and improved mortality rates within North America and China. The FLCCC working group are reporting 2 deaths in 100 patients treated with the MATH+ protocol; however, they did not compare their results to a control group. These findings are striking, but larger series and tightly defined indications will be required before widespread adoption of this treatment can be advocated. The vitamin receiving the most publicity at present is vitamin D in light of the association between disease severity and populations at risk of vitamin D deficiency, the elderly and black, Asian, and minority ethnic (BAME) populations [221]. There is certainly emerging and existing evidence to postulate a mechanism through which this vitamin might play an essential role in the fight against COVID-19, including its association with the pulmonary renin-angiotensin system. The therapeutic potential of vitamin D has already captured the attention of the scientific and medical communities as evidenced through a number of emerging clinical trials and journal articles. The interest has even percolated through to government [222], with the United Kingdom now advocating the supplementation of vitamin D for individuals in minority ethnic groups, over 65s, and those confined to life indoors [223,224,225,226]. However, UK Biobank analyses of blood calcifediol concentration and COVID-19 risk contradicts existing data and government advice. Despite the calcifediol concentration being lower in BAMEs, the study failed to demonstrate an association between calcifediol and COVID-19 infection after adjusting for potential confounders [227].
It would be unjustified to claim that vitamins are the answer to the coronavirus pandemic, but it would be fair to say that there is emerging evidence that they may play a role in either preventative measures or supportive therapy in established respiratory infections and intensive care settings. The physiology, pharmacology, and basic science behind vitamins A to E does allude to potential benefits that warrant further investigation and completion of the clinical trials, even if this translates to a need for diligent deficiency correction rather than routine mass supplementation.
The current and emerging guidance to supplement at-risk populations with vitamin D is justified given the as of yet unexplained predisposition for the elderly and BAME communities to have the most severe outcomes, potentiated by the fact that an increasing number of individuals will be confined to a life indoors during the lockdown period of the COVID-19 pandemic. Caution must, however, be exercised when recommending vitamin supplementation on a larger scale: The effects of hypervitaminosis can be severe, particularly the fat-soluble vitamins A, D, and E. Of note, hypervitaminosis is almost exclusively a product of ingesting an excess of vitamin supplements, rather than a product of vitamins acquired through normal dietary and physiological means.
The value of maintaining a diet containing a balance of vitamins seems prudent and applicable to the general population during these unprecedented times. We hope in the near future that well-designed clinical trials provide the evidence needed to determine whether the clinical value of vitamins matches the promise of their antioxidative, antimicrobial, and immunomodulatory properties. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7551685/
Methylene Blue
Since the seventies, when I started my intensive care and cardiac surgery duties, I continue with total non-conformity in the face of death, especially when significant battles are lost, for example, against septic shock in young women with gynecological infections, as well as patients who die from anaphylactic shock. Even with the constant and growing commitment to saving lives, like those of the young people mentioned above, we continue to lose the battle for infection/inflammation.
Right now, we are fighting against the COVID-19 pandemic, whose physiopathology surely includes inflammation and the NO-cGMP endothelium-dependent vasoplegic dysfunction. Some well-known observations should be mentioned over and over, based on what has been learned about blocking the NO-cGMP pathway in the treatment of vasoplegic endothelial dysfunction for synthesizing concepts:
The use of methylene blue (MB) does not cause endothelial dysfunction.
The MB effect appears in cases without positive NO regulation.
MB itself is not a vasoconstrictor. By blocking the cGMP pathway, it releases the cAMP pathway, facilitating the vasoconstrictor effect of epinephrine through this “crosstalk” mechanism.
The most used dosage is 2 mg/kg in IV bolus, followed by the same continuous hourly infusion. The plasma concentration declines sharply in the first 40 minutes.
MB has an antioxidant effect.
Based on these concepts, we keep saving lives, and with the certainty that the NO-cGMP pathway blocking by MB has still underestimated at least for more than 100 years. However, many health professionals named MB as a “rescue magic bullet.”
I saw COVID-19 inside this scenario and, last March, I wrote a letter to the Lancet’s Editor-in-Chief entitled “SHOULD METHYLENE BLUE CONSIDERED AS ‘RESCUE MAGIC BULLET’ AGAINST THE NEW CORONAVIRUS?”
The MB/light-based method has been used routinely in Europe for about 17 to 18 years. Plasma units from blood donations are illuminated with visible light in the presence of MB. The MB/light-treated generates singlet oxygen, which leads to the destruction of viral nucleic acids. Emerging groups include severe acute respiratory syndrome coronavirus (SARS-CoV), Crimean-Congo hemorrhagic fever virus (CCHFV) and Nipah virus (NiV), which have been identified by the World Health Organization (WHO) as major infectious threats with the potential to cause a global pandemic[1-3]. Paul Ehrlich, obsessed with structural organic chemistry and dyes, elaborated his theory regarding the discovery of a “magic bullet”. Based on all of his scientific discoveries, he won the Nobel Prize in 1908, with an emphasis on the treatment of malaria with MB. Should MB, a precursor to hydroxychloroquine, be a “rescue magic bullet” against the new coronavirus? If someone chooses to test the idea, I suggest, as a therapeutic test, an initial IV bolus of 1 mg/ kg. In our experience in the treatment of vasoplegic syndrome, the highest dose is 7 mg/kg in continuous IV infusion[4].
The Lancet Global Health, on this occasion, decided not to publish the letter because they believe “the message would be better suited elsewhere”. I agreed with the decision and, during my COVID-19 quarantine, I kept my routine Google consulting “methylene blue and COVID-19”. Suddenly… an explosion of almost three million papers (Figure 1).
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