Vitamin E at a high dose as an anti‐ferroptosis drug and not just a supplement for COVID‐19 treatment

Abstract

The novel coronavirus (SARS-CoV-2) was first identified in humans in late 2019. As of January 2021, over 100 million cases of coronavirus disease 2019 were confirmed worldwide, with over 2% of death. It is estimated 30% of the population were to get infected. There are several vaccines with emergency use authorization worldwide. Currently, vaccination started globally, but its longterm effectiveness is still under clinical trial. 1 The critical question is how to treat patients infected with SARS-CoV-2. Initially, everyone thought COVID-19 was a flu-like symptom and after a period of recovery back to normal health, but emerging data showed that SARS-CoV-2 affects the red blood cells (RBC) more than we ever thought possible. It has been reported that hospitalized patients have elevated red blood cell distribution width (RDW) coefficient variation (CV) greater than 15%. 2 However, the elevated and increasing RDW-CV% is associated with an enhanced mortality rate in COVID-19 patients. 2 The high RDW-CV% means that the patients may have small and large or normal and large or normal and small RBC at the same time. In other words, patients have varied RBC volume at the same time. Some studies indicated in the delayed clearance of RBC from the bloodstream makes RBC volume smaller than normal, leading to elevated RDW-CV%. Another possible mechanism behind elevated RDW-CV% is the slowing of RBC turnover in the setting of elevated turnover or production of lymphocytes and platelets in inflammation. There are several controversial studies related to the role of lymphopenia and lymphocytosis as the factors of mortality rate in COVID-19 patients. It has been reported that there is an association of lymphopenia to the mortality rate in COVID-19 patients and also there is an association of severe COVID-19 symptoms with lymphocytosis. Therefore, the hypothesis related to the association of elevated RDW-CV% in the setting of lymphocytosis is controversial in COVID-19 patients. While the increase of platelets is in accordance with the mortality rate in COVID-19 patients and it would be one possibility of elevated RDW-CV%. 2 There are also controversial reports related to the association of mean corpuscular volume (MCV) with COVID-19. Some

Potentiating the Cytotoxic Activity of a Novel Simvastatin-Loaded Cubosome against Breast Cancer Cells: Insights on Dual Cell Death via Ferroptosis and Apoptosis

“…Finally, we investigated the persistence of apoptotic and ferroptotic activities of SIM and SIM-CB in the presence of vitamin E which is a potent antioxidant and a ferroptosis inhibitor. [25][26][27] Clarifying the cytotoxic properties of SIM-loaded cubosome may consequently provide a good opportunity to further optimize the off-label activity of SIM-CB as a promising systemic (intravenous) anticancer agent against persistent breast cancer.…”

Role of Diet and Nutrients in SARS-CoV-2 Infection: Incidence on Oxidative Stress, Inflammatory Status and Viral Production

“…Vitamin E supplementation at 500 mg/kg may act as a treatment drug to inhibit ferroptosis in COVID-19 patients and decline ferroptosis damages to multiple organs, namely the lungs, kidneys, liver, gut, heart and nervous system. It reduces the ferric iron center in 15-lipoxygenase to inactive ferrous (Fe 2+ ), resulting in 15-lipoxygenase inhibition and preventing lipid hydroperoxides formation [ 137 ].…”

COVID-19: A Comprehensive View of Diverse Mitigation Measures, Biomaterials and Outlook

“…This can lead to ferroptosis, a programmed cell death indicated by lipid peroxides and depending on the iron level in the body. Current clinical studies revealed that vitamin E has the potential to inhibit ferroptosis and can be exploited as an anti-ferroptosis drug [196].…”