Natural Supplements for COVID19—Background, Rationale, and Clinical Trials

Abstract

Worldwide, the turmoil of the SARS-CoV-2 (COVID-19) pandemic has generated a burst of research efforts in search of effective prevention and treatment modalities. Current recommendations on natural supplements arise from mostly anecdotal evidence in other viral infections and expert opinion, and many clinical trials are ongoing. Here the authors review the evidence and rationale for the use of natural supplements for prevention and treatment of COVID-19, including those with potential benefit and those with potential harms. Specifically, the authors review probiotics, dietary patterns, micronutrients, antioxidants, polyphenols, melatonin, and cannabinoids. Authors critically evaluated and summarized the biomedical literature published in peer-reviewed journals, preprint servers, and current guidelines recommended by expert scientific governing bodies. Ongoing and future trials registered on clinicaltrials.gov were also recorded, appraised, and considered in conjunction with the literature findings. In light of the controversial issues surrounding the manufacturing and marketing of natural supplements and limited scientific evidence available, the authors assessed the available data and present this review to equip clinicians with the necessary information regarding the evidence for and potential harms of usage to promote open discussions with patients who are considering dietary supplements to prevent and treat COVID-19.

Protective Role of Combined Polyphenols and Micronutrients against Influenza A Virus and SARS-CoV-2 Infection In Vitro

“…Besides their established antioxidant and anti-inflammatory properties, several studies demonstrated their significant protection against viruses and several pathogens, including the Epstein–Barr and herpes simplex viruses [ 5 , 6 , 7 ]. We have already demonstrated the ability of resveratrol in inhibiting the replication of influenza A virus [ 8 ], and recent research in this field demonstrates that various types of polyphenols, such as resveratrol and pterostilbene, are promising antiviral compounds to inhibit SARS-CoV-2 infection [ 9 ]; indeed, other research aligns perfectly with these results [ 10 , 11 ].…”

COVID-19 Vaccination Might Induce Postural Orthostatic Tachycardia Syndrome: A Case Report

“…Current guidelines from The American Autonomic Society for the management of new-onset POTS in patients post-COVID-19 infection recommend conservative strategies as first-line therapies and medications, such as negative chronotropic agents as second-line therapies [ 25 ]. Ongoing research is also evaluating anti-inflammatory dietary supplements for the management of COVID-19 infection [ 19 ]. Consistent with Reddy and Carroll’s prior reports of post-COVID-19-vaccine-associated POTS, our patient was initially managed conservatively with fluids, salt, and compression stockings [ 16 , 17 ].…”

“…She was also recommended to incorporate dietary supplements to support autonomic balance, minimize fatigue, and reduce pain and neuropathy. Our integrative medicine clinical team recommended a series of dietary supplements based on the best available evidence in an effort to reduce burdensome symptoms [ 19 ]. In February 2022, the patient began a daily regimen of dietary supplements based on these recommendations, comprising: 2000 mg Turmeric; 200 mg Vitamin C; 2000 IU Vitamin D3; 400 mg Vitamin B2; 1200 mg Enzogenol (pine bark extract); 800 mg Resveratrol Supreme with Quercetin; 1200 mg Boswellia; and 4800 mg Aged Garlic Extract Reserve Cardiovascular.…”

Mild Coronavirus Disease 2019 (COVID-19) Is Marked by Systemic Oxidative Stress: A Pilot Study

“…Other promising results in COVID-19 were demonstrated with the use of quercetin, a flavonoid derived from plants, as well as N-acetyl-5-methoxytryptamine (also known as melatonin), a tryptophan derivative produced in the pineal gland and immune cells, which both are known to act as a free radical scavenger, in addition to their immunomodulatory and anti-inflammatory actions [ 37 , 38 ]. Finally, several vitamins and minerals have been reported as promising supplementary treatment options in COVID-19 due to their antioxidant properties, including vitamin C, vitamin E, and zinc, among others [ 39 , 40 ]. However, thiol-targeted antioxidants should ideally not unfavorably interfere with the physiological functions of ROS, but rather stay reserved for individuals who demonstrate clear overproduction of ROS [ 41 ].…”