COVID-19:
Important preventive and adjuvant measures everyone should know

In the following, you will find a variety of hints for useful preventative supplements to strengthen your immune system against viral infections, possible adjuvant or complementary treatment options and hints towards important developments in the context of COVID-19.
Dislcaimer: The following statements have not been reviewed or authorized by the FDA, the BAG or any other medical authority. Please use this resource to research it further for yourself, and before starting any treatment, check with your doctor.

New Insights on COVID-19:

1) Possibly important therapeutic Interventions that are being employed with success

1a) Ozone Therapy applied with success in Hospital in Ibiza, Spain:

https://www.worldhealth.net/news/clinic-becomes-first-use-ozone-therapy-spain/

SUCCESS: Ozone therapy has been used with success at the Nuestra Señora del Rosario Polyclinic Hospital

In a press release the clinic said: “Many patients who were about to be intubated and connected to mechanical ventilation have, thanks to ozone therapy, not only avoided it but improved to the point of not requiring oxygen with just a few treatment sessions.”  Using ozone to disinfect and treat conditions, improve the body’s intake and use of oxygen, and activating the immune system, the therapy has already been trialled on coronavirus patients in Italy and China. At the Santa María della Misericordia University Hospital in Udine, 36 people with pneumonia and respiratory failure were administere with ozone therapy. Only 3% required intubation, compared to the usual 15%, with Dr. De Monte stating that the infusion of ozone helped to strengthen the patients’ response to the effects of the infection.

 Literature:

Rowen RJ, Robins H (2020) A Plausible “Penny” Costing Effective Treatment for Corona Virus – Ozone Therapy. J Infect Dis Epidemiol 6:113. doi.org/10.23937/2474-3658

https://clinmedjournals.org/articles/jide/journal-of-infectious-diseases-and-epidemiology-jide-6-113.php?jid=jide

Bocci VA. Scientific and medical aspects of ozone therapy. State of the art. Arch Med Res. 2006;37(4):425–435. doi:10.1016/j.arcmed.2005.08.006

https://pubmed.ncbi.nlm.nih.gov/16624639/  [Citations: 250]

Elvis AM, Ekta JS. Ozone therapy: A clinical review. J Nat Sci Biol Med. 2011;2(1):66–70. doi:10.4103/0976-9668.82319

https://pubmed.ncbi.nlm.nih.gov/22470237/

Re L, Mawsouf MN, Menéndez S, León OS, Sánchez GM, Hernández F. Ozone therapy: clinical and basic evidence of its therapeutic potential. Arch Med Res. 2008;39(1):17–26. doi:10.1016/j.arcmed.2007.07.005

https://pubmed.ncbi.nlm.nih.gov/18067991/  [Citations: 60]

Mudway IS, Kelly FJ. Ozone and the lung: a sensitive issue. Mol Aspects Med. 2000;21(1-2):1–48. doi:10.1016/s0098-2997(00)00003-0

https://pubmed.ncbi.nlm.nih.gov/10804262/   [Citations: 64]

 

1b) High-Dose Vitamine C Infusion as initial and/or supportive Therapy:

As Vitamine C tends to deplete rapidly in infections like COVID-19, a strong constant supply is extremely important for a functioning immune system.

China is conducting a clinical trial of 24,000 mg/day of intravenous vitamin C to treat patients with coronavirus and severe respiratory complications. Participants will receive IV vitamin C for 7 days straight at Zhongnan Hospital of Wuhan University.

https://clinicaltrials.gov/ct2/show/NCT04264533

At Zhongnan Hospital in Wuhan, China, 24,000 mg of vitamin C will be administered to coronavirus patients, intravenously, each day for 7 days.

To fight a dangerous virus for which there is no existing medical treatment, you must rely on your own immune system. It is well established, in every nutrition textbook ever written, that you need vitamin C to make your immune system work well, or to even work at all.

Anecdotal evidence from a New York hospital confirms this approach:

https://www.newsweek.com/new-york-hospitals-vitamin-c-coronavirus-patients-1494407

 Literature:

Another recent study used this same low 200 mg dose for infants and children under five years of age, with severe pneumonia. The authors concluded that “Vitamin C is effective in reducing duration of severe pneumonia in children less than five years of age. Oxygen saturation was improved in less than one day.” Khan IM et al. J Rawalpindi Med Coll (JRMC); 2014;18(1):55-57 http://www.journalrmc.com/volumes/1405749894.pdf

 Inadequate vitamin C intake is a worldwide problem that can be immediately and economically fixed. With even modest amounts of supplemental vitamin C, deaths will decrease. In one study, a mere 200 mg of vitamin C/day resulted in an 80% decrease in deaths among severely ill, hospitalized respiratory disease patients. [Hunt C et al. Int J Vitam Nutr Res 1994;64:212-19.] http://orthomolecular.org/resources/omns/v16n09.shtml

 Sorice A, Guerriero E, Capone F, Colonna G, Castello G, Costantini S. Ascorbic acid: its role in immune system and chronic inflammation diseases. Mini Rev Med Chem. 2014;14(5):444–452. doi:10.2174/1389557514666140428112602  //  Highly Influental Citations: 2  / Citation Velocity:  11 // https://pubmed.ncbi.nlm.nih.gov/24766384/

Carr AC, Maggini S. Vitamin C and Immune Function. Nutrients. 2017;9(11):1211. Published 2017 Nov 3. doi:10.3390/nu9111211  //  Highly Influental Citations: 6  / Citation Velocity:  22 // https://pubmed.ncbi.nlm.nih.gov/29099763/

Hemilä H. Vitamin C and Infections. Nutrients. 2017;9(4):339. Published 2017 Mar 29. doi:10.3390/nu9040339  //  Highly Influental Citations: 1  / Citation Velocity:  8 // https://pubmed.ncbi.nlm.nih.gov/28353648/

Fisher BJ, Kraskauskas D, Martin EJ, et al. Mechanisms of attenuation of abdominal sepsis induced acute lung injury by ascorbic acid. Am J Physiol Lung Cell Mol Physiol. 2012;303(1):L20–L32. doi:10.1152/ajplung.00300.2011  //  Highly Influental Citations: 7  / Citation Velocity:  9 // https://pubmed.ncbi.nlm.nih.gov/22523283/

 A big compendium on Vitamin C for this is available here, including documentation

http://orthomolecular.org/resources/omns/v16n21.shtml

2) Medications that help to avoid, dampen or manage Cytokine storm

(Alternatives to Corticosteroids that do not impair the immune system as much)

 

2a)  Melatonin  – much more than a sleep hormone:
       an immune-modulatory hormone!

Evidence suggests that excessive inflammation, oxidation, and an exaggerated immune response very likely contribute to COVID-19 pathology. This leads to a cytokine storm and subsequent progression to acute lung injury (ALI)/acute respiratory distress syndrome (ARDS) and often death. Melatonin, a well-known anti-inflammatory and anti-oxidative molecule, is protective against ALI/ARDS caused by viral and other pathogens. Melatonin is effective in critical care patients by reducing vessel permeability, anxiety, sedation use, and improving sleeping quality, which might also be beneficial for better clinical outcomes for COVID-19 patients. Notably, melatonin has a high safety profile. There is significant data showing that melatonin limits virus-related diseases and would also likely be beneficial in COVID-19 patients:

Literature:

Zhang R, Wang X, Ni L, et al. COVID-19: Melatonin as a potential adjuvant treatment [published online ahead of print, 2020 Mar 23]. Life Sci. 2020;250:117583. doi:10.1016/j.lfs.2020.117583  https://pubmed.ncbi.nlm.nih.gov/32217117/  [new paper]

Carrillo-Vico A, Lardone PJ, Alvarez-Sánchez N, Rodríguez-Rodríguez A, Guerrero JM. Melatonin: buffering the immune system. Int J Mol Sci. 2013;14(4):8638–8683. Published 2013 Apr 22. doi:10.3390/ijms14048638  https://pubmed.ncbi.nlm.nih.gov/23609496/  [199 Citations]

An R, Zhao L, Xi C, et al. Melatonin attenuates sepsis-induced cardiac dysfunction via a PI3K/Akt-dependent mechanism. Basic Res Cardiol. 2016;111(1):8. doi:10.1007/s00395-015-0526-1 https://pubmed.ncbi.nlm.nih.gov/26671026/

Zhang Y, Li X, Grailer JJ, et al. Melatonin alleviates acute lung injury through inhibiting the NLRP3 inflammasome. J Pineal Res. 2016;60(4):405-414. doi:10.1111/jpi.12322 https://pubmed.ncbi.nlm.nih.gov/26888116/

Volt H, García JA, Doerrier C, et al. Same molecule but different expression: aging and sepsis trigger NLRP3 inflammasome activation, a target of melatonin. J Pineal Res. 2016;60(2):193-205. doi:10.1111/jpi.12303  https://pubmed.ncbi.nlm.nih.gov/26681113/

Zhang J, Lu X, Liu M, et al. Melatonin inhibits inflammasome-associated activation of endothelium and macrophages attenuating pulmonary arterial hypertension [published online ahead of print, 2019 Nov 27]. Cardiovasc Res. 2019;cvz312. doi:10.1093/cvr/cvz312 https://pubmed.ncbi.nlm.nih.gov/31774487/

2b) Phytotherapeutics with strong anti-inflammatory properties (Triterpenes):

Triterpenes like 1,8-Cineol have been demonstrated to exhibit anti-inflammatory effects similar to Corticosteriods (!), but without the same immune-dampening effects.

Therefore, these could be an adjuvant in very early stages of infection.   Studies by Juergens have shown that 1.8 cineol but also triterpenes, which are found in many plant extracts, inhibit formation of prostaglandin E2, leukotriene B4, and interleukin1  by a very high degree.

Triterpenes are contained in various phytotherapeutic cough medicines like e.g. Bronchipret which are available over the counter (Bionorica).

This proposal comes from Josef Peter Guggenbichler [ https://www.researchgate.net/profile/Josef_Guggenbichler],
a Professor emeritus for Pediatrics and Infectiology (University of Nuremberg and Erlangen, Germany).

He has seen the beneficial effects of these phytothearpeutics confirmed in clinical practice many times.
These phytotherapeutics are freely available in Germany, Austria and Switzerland (without prescription) and are very safe.

It might be worth a trial as a preventative medication e.g. in care homes or similar.

LIterature

Wagner L, Cramer H, Klose P, et al. Herbal Medicine for Cough: a Systematic Review and Meta-Analysis. Forsch Komplementmed. 2015;22(6):359–368. doi:10.1159/000442111   https://pubmed.ncbi.nlm.nih.gov/26840418/    https://www.karger.com/Article/Fulltext/442111  [Citations: 0]

Juergens UR, Dethlefsen U, Steinkamp G, Gillissen A, Repges R, Vetter H. Anti-inflammatory activity of 1.8-cineol (eucalyptol) in bronchial asthma: a double-blind placebo-controlled trial. Respir Med. 2003;97(3):250–256. doi:10.1053/rmed.2003.1432    https://pubmed.ncbi.nlm.nih.gov/12645832/    [Citations: 114]

Treatment of Cough in Respiratory Tract Infections – The Effect of Combining the Natural Active Compounds With Thymol  Schönknecht K, Krauss H, Jambor J, Fal AM. Wiad Lek. 2016;69(6):791–798.    https://pubmed.ncbi.nlm.nih.gov/28214817/   [Citations: 0]

Kemmerich B. Evaluation of efficacy and tolerability of a fixed combination of dry extracts of thyme herb and primrose root in adults suffering from acute bronchitis with productive cough. A prospective, double-blind, placebo-controlled multicentre clinical trial. Arzneimittelforschung. 2007;57(9):607–615. doi:10.1055/s-0031-1296656

https://pubmed.ncbi.nlm.nih.gov/17966760/    [Citations: 20]

Salehi B, Mishra AP, Shukla I, et al. Thymol, thyme, and other plant sources: Health and potential uses. Phytother Res. 2018;32(9):1688–1706. doi:10.1002/ptr.6109

https://pubmed.ncbi.nlm.nih.gov/29785774/     [Citations: 33]

Juergens UR. Anti-inflammatory properties of the monoterpene 1.8-cineole: current evidence for co-medication in inflammatory airway diseases. Drug Res (Stuttg). 2014;64(12):638–646. doi:10.1055/s-0034-1372609   https://pubmed.ncbi.nlm.nih.gov/24831245/

Schinella GR, Tournier HA, Prieto JM, Mordujovich de Buschiazzo P, Ríos JL. Antioxidant activity of anti-inflammatory plant extracts. Life Sci. 2002;70(9):1023–1033. doi:10.1016/s0024-3205(01)01482-5    https://pubmed.ncbi.nlm.nih.gov/11860151/

Ghasemian M, Owlia S, Owlia MB. Review of Anti-Inflammatory Herbal Medicines. Adv Pharmacol Sci. 2016;2016:9130979. doi:10.1155/2016/9130979

https://pubmed.ncbi.nlm.nih.gov/27247570/

Juergens LJ, Worth H, Juergens UR. New Perspectives for Mucolytic, Anti-inflammatory and Adjunctive Therapy with 1,8-Cineole in COPD and Asthma: Review on the New Therapeutic Approach. Adv Ther. 2020 Mar 21.  https://pubmed.ncbi.nlm.nih.gov/32200535/

Juergens UR, Engelen T, Racké K, Stöber M, Gillissen A, Vetter H. Inhibitory activity of 1,8-cineol (eucalyptol) on cytokine production in cultured human lymphocytes and monocytes. Pulm Pharmacol Ther. 2004;17(5):281–287. doi:10.1016/j.pupt.2004.06.002  https://pubmed.ncbi.nlm.nih.gov/15477123/

Juergens UR, Stöber M, Vetter H. Inhibition of cytokine production and arachidonic acid metabolism by eucalyptol (1.8-cineole) in human blood monocytes in vitro.

Eur J Med Res. 1998 Nov 17;3(11):508-10   https://pubmed.ncbi.nlm.nih.gov/9810029/

Juergens UR, Jäger F, Darlath W, Stöber M, Vetter H, Gillissen A  Comparison of in vitro-activity of commonly used topical glucocorticoids on cytokine- and phospholipase inhibition.Eur J Med Res. 2004 Aug 31;9(8):383-90    https://pubmed.ncbi.nlm.nih.gov/15337628/

3) Important but neglected Preventive Measures
    before infection and for early stage of infection

3a) Zinc

Broad-based distribution of Zinc lozenges might be a highly effective adjuvant and/or preventive measure against a viral infections, especially as also the Corona infection seems to very often start in the throat.

Zinc’s absolutely critical function for the immune system is so well known and documented that I list only a few citations here:

Literature

Shankar AH, Prasad AS. Zinc and immune function: the biological basis of altered resistance to infection. Am J Clin Nutr. 1998;68(2 Suppl):447S–463S. doi:10.1093/ajcn/68.2.447S  https://pubmed.ncbi.nlm.nih.gov/9701160/   [Citations: 732]

Hulisz D. Efficacy of zinc against common cold viruses: an overview. J Am Pharm Assoc (2003). 2004;44(5):594–603. doi:10.1331/1544-3191.44.5.594.hulisz  https://pubmed.ncbi.nlm.nih.gov/15496046/   [Citations: 40]

Read SA, Obeid S, Ahlenstiel C, Ahlenstiel G. The Role of Zinc in Antiviral Immunity. Adv Nutr. 2019;10(4):696–710. doi:10.1093/advances/nmz013 https://pubmed.ncbi.nlm.nih.gov/31305906/    [Citations: 2]

3b) Vitamin D+K  (!)

I assume it is well accepted by most people that we need to avoid Vitamin D deficiency in order to be well-defended against viral infections.
Most people who live the Western life (lots of time inside buildings and always with clothes) have a permanent lack of Vitamin D which should be brought up to normal levels to get a better defense up, and might even temporarily mega-dosed at first signs of infection:

Literature

Grant WB, Lahore H, McDonnell SL, et al. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients. 2020;12(4):E988. Published 2020 Apr 2. doi:10.3390/nu12040988  https://pubmed.ncbi.nlm.nih.gov/32252338/

[new paper]

Mora JR, Iwata M, von Andrian UH. Vitamin effects on the immune system: vitamins A and D take centre stage. Nat Rev Immunol. 2008;8(9):685–698. doi:10.1038/nri2378 https://pubmed.ncbi.nlm.nih.gov/19172691/   [621 Citations]

Baeke F, Takiishi T, Korf H, Gysemans C, Mathieu C. Vitamin D: modulator of the immune system. Curr Opin Pharmacol. 2010;10(4):482–496. doi:10.1016/j.coph.2010.04.001 https://pubmed.ncbi.nlm.nih.gov/20427238/   [518 Citations]

Current Topics on Vitamin D. The Effects of Vitamin D on the Immune System]  [Article in Japanese]  Junichi Kikuta  1 , Masaru Ishii   https://pubmed.ncbi.nlm.nih.gov/25716808/

Cannell JJ, Vieth R, Umhau JC, et al. Epidemic influenza and vitamin D. Epidemiol Infect. 2006;134(6):1129–1140. doi:10.1017/S0950268806007175  https://pubmed.ncbi.nlm.nih.gov/16959053/   [437 Citations]

Here is an even more comprehensive collection on Vitamin D and possible uses for prevention and/or early stage Covid-19 infection:
https://docs.google.com/document/d/10peHD1jG-xAGj5Lzu6f43RB7cv5QeePasw05AGZrjKg/edit#heading=h.hkny9ie7oyy8

4) The Perils of Intubation – 
     and New Hypotheses on Pathology

Various clinicians with frontline experience have started to speak out against ventilator use and say they may do more harm than good in many severe cases:  https://www.dailymail.co.uk/news/article-8230775/Is-proof-live-saving-ventilators-actually-deathtraps.html

New York casualty doctor Cameron Kyle-Sidell: “’I fear this misguided treatment will lead to a tremendous amount of harm in a very short time. Covid-19 is not a pneumonia and should not be treated as one.’»

“In New York, which has been hit particularly hard by the virus, 80 per cent of ventilated patients failed to recover. The loss of life in other countries for those on the machines is equally terrifying. Dr David Farcy, the president of the American Academy of Emergency Medicine, warns against using them indiscriminately.»

4a) Important:  COVID-19 does NOT ONLY AFFECT the lung,

but results in systemic Endotheliitis:

COVID-19 was considered to be a lung disease. Up until now, it has been unclear as to why patients are sustaining life-threatening organ failure in organs other than the lungs. An interdisciplinary team from University Hospital Zurich has now shown that SARS-CoV-2 directly elicits inflammation in blood vessels and that this can lead to organ failure and even death.

The first COVID-19 patients with severe progressions of the disease suffered mainly from viral and difficult-to-treat lung inflammations as a complication. This is a typical illness connected to coronaviruses, as they primarily attack respiratory tracts. Doctors realized, however, that an increasing number of patients were displaying cardiovascular problems and multiple organ failure and it was unclear as to whether and to what extent these were connected to the inflammation of the patients’ lungs. As it mainly affected older people, doctors assumed that the strain placed on patients by the virus was triggering cardiovascular problems that are typical for this age group.  

http://www.en.usz.ch/media/press-releases/pages/covid-19-endotheliitis.aspx

Also in that context, it is important to review and further investigate the “Hemotheory” of Covid-19 (which is currently mostly based on Bioinformatics simulations, but sort of reinforced by high ferritin levels in the plasma of severe cases (!):

4b) “The Hemo Hypothesis” – does Covid-19 inhibit oxygen transport?

If this hypothesis (which is rudimentary) should turn out to be true, this virus is much more dangerous than initially thought.

Here is a Bioinformatics paper that points towards this direction:

https://www.researchgate.net/publication/339748594_COVID-19_Disease_ORF8_and_Surface_Glycoprotein_Inhibit_Heme_Metabolism_by_Binding_to_Porphyrin

«The results showed the ORF8 and surface glycoprotein could bind to the porphyrin, respectively, while orf1ab, ORF10 and ORF3a proteins could coordinately attack heme to dissociate the iron to form the porphyrin. The mechanism seriously interfered with the normal heme anabolic pathway of the human body, being expected to result in human disease.»

Here is another a recent pre-pub bioinformatics paper from China that predicts that Covid-19 docks to the Beta-1 Chain of Hemoglobin and Inhibits Oxygen transport:

https://chemrxiv.org/articles/COVID-19_Disease_ORF8_and_Surface_Glycoprotein_Inhibit_Heme_Metabolism_by_Binding_to_Porphyrin/11938173

These two papers hypothesis could be somewhat backed up by the high level of ferritin in many severe Covid-19 cases!

Covid-19: acquired acute porphyria hypothesis

This author argues that Covid-19 has high probability of being more than a disease of pneumonia, and that critical Covid-19 patients may be experiencing a form of acquired acute porphyria. Readily available interventions exist to treat acute porphyria and the position is advanced that urinalysis of critical Covid-19 patients would diagnose this pathology:  https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=15&ved=2ahUKEwjssfmvo_roAhVI6aQKHbfKC744ChAWMAR6BAgHEAE&url=https%3A%2F%2Fosf.io%2F4wkfy%2Fdownload%2F%3Fformat%3Dpdf&usg=AOvVaw2aUKMUoT-E7lUm0WvwqQaj

Equally  interesting in that context is this anecdotal case from Iran which suggests there must be a connection with Erythrocytes:

Hadadi A, Mortezazadeh M, Kolahdouzan K, Alavian G. Does recombinant human Erythropoietin administration in critically ill COVID-19 patients have miraculous therapeutic effects? [published online ahead of print, 2020 Apr 8]. J Med Virol. 2020;10.1002/jmv.25839. doi:10.1002/jmv.25839

https://pubmed.ncbi.nlm.nih.gov/32270515/

«An 80-year-old man with multiple comorbidities presented to the emergency department with tachypnea, tachycardia, fever and critically low O2 saturation and definitive chest CT scan findings in favor of COVID-19 and positive PCR results in 48 h. He received antiviral treatment plus recombinant human Erythropoietin(rhEPO) due to his severe anemia. After 7 days of treatment, he was discharged with miraculous improvement in his symptoms and hemoglobin level.”

All of this makes it necessary to review the actual clinical experiences and get more data regarding this aspect.

If Coronavirus does in fact attack red blood cells, forced respiration will damage the lung as it doesn’t resolve the problem of falling oxygen saturation!

5) Other hints that might be of use

This Professor from Zurich Federal Institute of Technology, Biology Department makes a good case for preventive use of inhalation and salt water gargling:

https://ethz.ch/en/news-and-events/eth-news/news/2020/03/zukunftsblog-viola-vogel-reducing-the-risk-of-infection.html

This new Belgian study advises for far more distance between joggers and other sporties:

https://medium.com/@jurgenthoelen/belgian-dutch-study-why-in-times-of-covid-19-you-can-not-walk-run-bike-close-to-each-other-a5df19c77d08

If disinfectants are sold out:  Soap instead of disinfectants – equally good for non-clinical use as Coronavirus has a lipid hull – and soap dissolves lipids:

https://www.weforum.org/agenda/2020/03/coronavirus-soap-covid-19-virus-hygiene/

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