Could nutritional supplements act as therapeutic adjuvants in COVID-19?

Abstract

Background The role of the immune system and inflammatory response in the pathogenesis of the severe manifestations of coronavirus disease 2019 (COVID-19) is well known. Currently, different therapies active on the immune system are used for the management of COVID-19. The involvement of the immune system also opens the opportunity for the use of nutritional supplements with antimicrobial and immunomodulatory activity. Main aspects Nutritional supplements with antimicrobial and immunomodulatory activity are promising therapeutic adjuvants for the treatment of COVID-19, and also for the prevention of viral spreading. In particular, the role of vitamin D, probiotics, lactoferrin, and zinc is of significant clinical interest, although there are only a few data on their use in COVID-19 patients. Their molecular actions, together with the results of studies performed on other respiratory infections, strongly suggest their potential utility in COVID-19. This article discusses the main properties of these nutritional supplements and their potential applicability in the prevention and treatment of COVID-19. Conclusion The supplementation with vitamin D, probiotics, lactoferrin and zinc could have a role both in preventing SARS-CoV-2 infection and in mitigating the clinical course in infected patients, contributing in the prevention of immune-mediated organ damage.

Natural resources to control COVID-19: could lactoferrin amend SARS-CoV-2 infectivity?

“…LF also stimulated an antiviral host cell response and maintained inhibitory activity in alveolar epithelial cells derived from induced pluripotent stem cells (iPSC), which act as a model for the primary site of infection. Since LF has not been shown to have adverse effects in humans, these findings suggest that this protein can be considered as a readily translatable adjunctive therapy for COVID-19 (Costagliola et al, 2021;Mirabelli et al, 2020). Furthermore, the fermentation of milk and/or LF by gut microbiota releases many active compounds (Cockburn & Koropatkin, 2016) that may directly interact with the viral particles and/or modulate the immune response.…”

“…Figure 2 represents a general scenario of the creation of small metabolites via digestion of the glycosylated LF and/or other whey milk glycoproteins by different microorganisms found in the intestinal microbiota and the effects of these compounds on COVID-19 (Cockburn & Koropatkin, 2016;Karl, 2021;Ren, Cheng & Wang, 2021). The important roles of different type of microbiota (specifically the intestinal microorganisms) in COVID-19 development, severity, and/or recovery have been attracting the increased interest of researchers (Costagliola et al, 2021;Karl, 2021). Currently (as of February 27, 2021), there are at least 32 enrolled clinical trials using microbiota (of different source or form) in .…”

Nutraceuticals in Viral Infections: An Overview of the Immunomodulating Properties

“…A relationship between VD status and the incidence or the severity of respiratory infections in children has been found in many observational studies, and a recent review seems to support the protective role of VD against tuberculosis, otitis media, pharyngotonsillitis, bronchiolitis, and viral wheezing [ 5 , 6 , 7 ]. Even during the recent COVID-19 pandemic, VD and its metabolites were found to be useful both in inducing the antiviral response and in negatively regulating the renin-angiotensin-aldosterone system, including the expression of ACE2, the receptor for SARS-CoV2 [ 8 , 9 ]. The influence of VD status on the clinical outcome of patients with COVID-19 is still undefined, as studies have shown conflicting results [ 10 , 11 , 12 ].…”

“…Studies on the use of zinc in the prevention and treatment of respiratory and gastrointestinal viral infections have shown conflicting results. Indeed, while many studies demonstrated that zinc could reduce the incidence and severity of upper respiratory infections, other authors found no effect, and zinc seems not to influence the prevention and clinical course of lower respiratory infection [ 3 , 9 ].…”

Respiratory delivery of favipiravir-tocilizumab combination through mucoadhesive protein-lipidic nanovesicles: prospective therapeutics against COVID-19

“…RdRp inhibitors like Remdesivir were approved for COVID-19 under Emergency Use authorization [34]. Various studies suggested the clinical significance of Vitamin D and lactoferrin (NCT04427865) [35] in different formulations like liposomal lactoferrin (NCT04475120) [36] as prophylactic treatment as nutritional supplements in the prevention of COVID-19 [37]. These may enhance and boost immunity and therefore protect against viral infection.…”