Boosting the Immune System during the COVID-19 Pandemic

As COVID-19 continues to spread many people are looking for ways to boost their immune system. By keeping an immune system strong our bodies defense systems can be as strong as possible.

So, what does our immune system do?

The immune system is an intricate network of units that come together to fight off invaders, otherwise known as bacteria, virus and other foreign substances. Therefore, it is best to strengthen your immune system so that it may run efficiently to fight off diseases. This can be accomplished with dietary supplements, eating right, reducing stress and maintaining a healthy lifestyle.

It is important to note that the Center for Disease Control (CDC) emphasizes that supplements are not meant to treat or prevent COVID-19, however it may affect the immune system’s ability to fight infections and reduce inflammation.

So, what are some important supplements that may benefit in moderation?

  1. Vitamin D: Is an important immune strengthening nutrient that may potentially reduce the risks of colds and the flu.
  2. Zinc: May help reduce the number of infections and duration of the common cold when taken within 24 hours of onset. It is important to note that high intake of zinc may deplete copper levels. If you are worried about copper levels look for products that contain both copper and zinc.
  3. Vitamin C: There are several studies that suggest vitamin C may help prevent viral, bacterial and other infections shortening the duration of colds and reducing inflammation
  4. Selenium: Is a key nutrient for immune function. It is an antioxidant that strengthens the body’s defenses against bacteria and viruses.
  5. Garlic: may reduce the severity of upper viral respiratory infections and function in preventing viral infections of the common cold.
  6. Probiotics: contain good bacteria that both support gut health and influence the function and regulation of the immune system. They also may decrease the number of respiratory infections especially in children.
  7. Mushrooms: a variety of mushroom species have been shown to help with immune function including Shiitake, Lion’s Mane, Maitake and Reishi. At Rancho pharmacy we carry the Host Defense line for mushrooms.
  8. Honey: May help relive minor pain and inflammation of the mucous membranes. It also has antioxidant properties and some microbial effects. Note that honey is not recommended for children under 1 years old due to the risk of botulism

It is important to note that these supplements are suggestions and more research needs to be done. If you want to try theses, be sure to communicate with your health care provider and take them in moderation or as your doctor recommends.

So, what are other strategies that can be done to strengthen your immune system?

  1. Regular exercise. Many experts recommend at least 150 minutes of moderate exercise per week
  2. Eating a healthy, balanced diet that includes fruits and vegetables
  3. Maintaining a healthy weight
  4. Obtaining adequate quality sleep
  5. Reducing stress: Chronic stress is associated with elevate4d cortisol levels. This can cause immune dysregulation that varies in severity

For more information stop by Rancho Pharmacy to speak to one of our knowledgeable staff members.

 

References:

  1. https://www.covid19treatmentguidelines.nih.gov/supplements/vitamin-c/. Accessed on February 10, 2021
  2. https://pharmacist.therapeuticresearch.com/Content/Segments/PRL/2020/Apr/Treatments-of-Interest-for-COVID-19-S2004008. Accessed on February 3, 2021
  3. https://www.covid19treatmentguidelines.nih.gov/supplements/zinc/. Accessed on February 11 2021
  4. How to boost your immune system. Harvard Health Publishing. https://www.health.harvard.edu/staying-healthy/how-to-boost-your-immune-system. Published 2020. Accessed February 6, 2021
  5. Office of Dietary Supplements – Zinc. NIH Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/Zinc-Consumer/. Published 2019. Accessed February 6, 2021
  6. Boost the Immune System. University of Maryland Medical System. https://www.umms.org/coronavirus/what-to-know/managing-medical-conditions/healthy-habits/boost-immune-system. Accessed February 7, 2021

T-Cell Response vs Antibody Response

The differences between the potential covid-19 vaccines

In July the University of Oxford in collaboration with AstraZeneca released that their potential COVID vaccine produced both a T cell and antibody response in clinical trials. So, what does a T cell and antibody response mean and why does this distinguish the potential vaccine among others?

Well the trial involved 1,077 people who were administered the potential vaccine and resulted in the body making antibodies and T cells to help fight the coronavirus. The vaccine was made from a genetically engineered virus that causes the common cold in chimpanzees. It has been modified by transferring the genetic instructions for the coronavirus “spike protein” to the vaccine, with the hopes that this will teach the body to react against a real infection. This vaccine shows great promise since it induces both an antibody response and T cell response.

So, what does an antibody and t cell response mean?

Initially the focus for COVID treatment and the development of a vaccine has been on the body making antibodies. This is the idea behind convalescent plasma blood donors.

Other companies that are working to develop a COVID-19 vaccine including, Moderna and Biontech/Pfizer, published data demonstrating the body produced neutralizing antibodies, with little said about T cell response. Now we are learning that some of the vaccines in clinical trials are producing both antibodies and T cells raising the questions to which vaccine may produce better immunity.

Antibodies are small proteins made by the immune system that stick onto the surface of the viruses. These proteins can recognize the virus and sometimes be neutralizing antibodies that inactivate the viral particles.

T cells are a type of white blood cell that help coordinate the immune system and are able to spot which of the body’s cells have been infected and destroy them. They can also promote other immune responses, including antibody production.

Nearly all effective vaccines are able to induce both an antibody and a T-cell response. It has also been speculated that specifically to prevent severe COVID-19 infections the body will need to produce a long-lasting effect that will involve both a cellular immunity (T cell ) and humoral immunity (antibody-based).

We still do not have a vaccine on the market for COVID. Vaccines are in clinical trials with promising results. My personal prediction is if any of the vaccines are approved to be effective and safe, we may have multiple vaccines on the market that each work differently.

We strive to keep you posted on the ever-changing topic of COVID-19. Check our webpage daily and subscribe to our newsletter to be the first to know of new information that we post.

References

  1. https://www.bbc.com/news/uk-53469839Accessed on July 26, 2020
  2. https://www.evaluate.com/vantage/articles/news/trial-results/covid-19-vaccine-contest-turns-t-cell-responses. Accessed on July 26, 2020

Famotidine and COVID

Based on preliminary data, famotidine a common heart burn medication that is available both by prescription and over the counter, may play a role in fighting COVID-19. This is based only on a small observation on data from patients in China who had heartburn and contracted COVID-19.  From the study it was observed that 22% of the 1,536 patients who were not on famotidine died or were intubated and put on a ventilator. This was compared to the 84 patients that were on famotidine and 10% died or were put on a ventilator.

 

What is the mechanism behind famotidine?

 

The answer is unclear and needs to be researched further to validate if famotidine is beneficial in COVID-19. Zantac (or ranitidine) which belongs to the same class of medication was not shown to be effective against COVID-19. In addition, computer modeling has shown that the mechanism that famotidine uses to fight heartburn may also help against COVID-19. It does not appear to bind to an enzyme as some had speculated but rather it plays a role with histamine and COVID-19. Additional studies need to be performed before an answer is concluded.

 

There is a study in New York that is being conducted using high doses of famotidine in IV. The researchers will be posting the results as soon the trial ends.  So, should you be using famotidine? There is not enough evidence to indicate to start taking famotidine. If you have heartburn and are concerned about COVID-19 work with your provider and pharmacist.

 

Reference:

  1. https://www.cnn.com/2020/05/09/health/famotidine-covid-19-correlation-study/index.html. Accessed on June 14, 2020
  2. https://blogs.sciencemag.org/pipeline/archives/2020/05/29/famotidine-histamine-and-the-coronavirus. Accessed on June 14, 2020
  3. https://www.drugtopics.com/latest/famotidine-trial-underway-nyc-covid-19-treatment. Accessed on June 14, 2020
  4. https://www.cuimc.columbia.edu/news/heartburn-drug-may-have-potential-against-covid-19. Accessed on June 14, 2020

Concerns about blood pressure medications and COVID-19

COVID-19 binds to the receptor of angiotensin-converting enzyme 2 (ACE2). This receptor is found in various cells throughout the body including the lungs. It is an entry point for the virus and helps the virus gain access to the lungs. This particular receptor also plays a role in blood pressure in which many common blood pressure medications target.

A recent correspondence was published in Lancet by Lei Fang and others about COVID-19 and two classes of blood pressure medications, ACEIs (angiotensin-converting enzyme inhibitors) and ARBs (angiotensin receptor blockers).  Based on the observation patients taking ACEIs and ARBs who have COVID-19 were at increased risk for adverse outcomes. The correspondence was based on 3 studies, with one of the studies involving 1099 patients with confirmed COVID-19 in China. The authors further suggested that patients should be switched from ACEI or ARB to a calcium channel blocker (CCB).

As of now there is no recommendation to stop using these agents. It is crucial to understand that not all patients can be switched to CCBs. This includes diabetes patients utilizing ACEI for kidney protection and congestive heart failure patients who may already be on a CCB and ACEI. If patients stop taking their ACE inhibitor or ARB it may actually worsen cardiovascular or kidney disease and lead to increased mortality.

It is urged that larger clinical trials need to be performed prior to altering life-saving medications within this population. Patients with underlying conditions such as cardiovascular or diabetes need to take precautions and quarantine to avoid others that are infected with COVID-19.  Dr. Diaz, a professor at LSU Health New Orleans School of Public Health stated in an article in Science Daily, “Patients treated with ACEIs and ARBs for cardiovascular diseases should not stop taking their medicine, but should avoid crowds, mass events, ocean cruises, prolonged air travel, and all persons with respiratory illnesses during the current COVID-19 outbreak in order to reduce their risks of infection."

To note, there are two clinical trials set to be launched by the University of Minnesota that will study if losartan can prevent multi-organ failure in hospitalized patients with COVID-19 pneumonia and the second will evaluate if losartan can prevent COVID-19 hospitalizations. The thought is losartan is an angiotensin receptor blocker and this may block the entry-point for the COVID-19 virus. For more details about these clinical trials please log on to clinicaltrials.gov.

If you have concerns and are taking an ACE inhibitor or ARB speak to your doctor.

References:

  1. https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19?source=history_widget#H2110619195. Accessed on March 28, 2020
  2. Receptor Recognition by the Novel Coronavirus from Wuhan: an Analysis Based on Decade-Long Structural Studies of SARS Coronavirus. Yushun Wan, Jian Shang, Rachel Graham, Ralph S. Baric, Fang Li. Journal of Virology Mar 2020, 94 (7) e00127-20; DOI: 10.1128/JVI.00127-20. Accessed on March 28, 2020
  3. Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection? Lancet Respir Med 6 2020; https://doi. org/10.1016/S2213-2600(20)30116-8. Accessed on March 28, 2020
  4. ACE inhibitors and angiotensin receptor blockers may increase the risk of severe COVID-19, paper suggests. https://www.sciencedaily.com/releases/2020/03/200323101354.htm. A possible explanation for the severe lung complications being seen in some people diagnosed with COVID-19 is proposed in a new article. Accessed on March 28, 2020