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Winter Is Coming: The Best Immune Enhancing Diet

October 02, 2023 - Admin

By Steve Blechman

 

Fall is here, and winter will soon be upon us – which means the cold and flu season is approaching. It’s important that we maintain healthy immune function by eating a nutritious diet, along with proper exercise and sleep. Some health experts have warned that COVID-19 cases can increase in the fall during the flu season, especially if a new variant emerges. We need to learn to live with the virus; we can’t let it control our lives.         

It was reported on January 24th, 2022 in the journal Frontiers in Nutrition that “The Mediterranean diet showed a significant protective effect against COVID-19.” The researchers were affiliated with the department of nutrition Harvard T.H. Chan School of Public health, Harvard University and Navarra Institute for Health Research in Pamplona, Spain. The researchers acknowledged, “The Mediterranean diet as a whole seems more important than each of its components in preventing the infection and symptoms of COVID-19.”           

For the past five years U.S. News & World Report convened an expert panel of the country's top specialist in nutrition, diabetes, heart health and weight loss and ranked the Mediterranean diet as the number one overall diet. Also, the best diet for diabetes and best heart-healthy diet. Recent research has shown that obesity and being overweight and having diabetes increase the risk of severe COVID illness. A new exciting study published September 19, 2023 in the journal Frontiers in Nutrition reported that N-acetyl cysteine (NAC) can reduce some of the complications caused by obesity and senescence (biological aging) of visceral adipose tissue, in obese adults. It was a randomized clinical trial on 40 obese adults “who were randomly assigned to receive 600mg of NAC or placebo as a control for 4 weeks.” NAC (600mg daily) reduced “the levels of inflammatory factors including IL-6 and high-sensitivity C-reactive protein (hs-CRP), as well as the level of fasting blood sugar.”†

A study published April 15th, 2021 in the journal Clinical Nutrition concluded that “better adherence to the Mediterranean diet may be associated with a lower risk of COVID-19.” Another prior study published January 2021 in Metabolism was entitled: “Mediterranean Diet as a Nutritional Approach for COVID-19.” The researchers in this study were affiliated with the Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School in Boston, Massachusetts.†           

This report says, “In summary, adherence to the Mediterranean Diet has a favorable impact on cardiovascular diseases and other cardiometabolic disorders, such as diabetes that predispose to COVID-19 infection and related outcomes. The Mediterranean diet, having high antioxidants, anti-inflammatory and potential anti-microbial and immunomodulatory properties, is a promising and relatively easy method to attenuate the severity of COVID-19 infection. Therefore, there is a critical and imminent need for more in vivo studies and well-designed clinical trials to explore the potentially beneficial effects of the Mediterranean diet and or some of its key components, such as nuts, dried fruits and olive oil in preventing COVID-19 infection and or improving disease-related outcomes.”†           

Another study published June 20th, 2021, in the journal Nutrients reported the consumption of coffee and vegetables may boost immunity, offering protection and limit the spread of the coronavirus. Northwestern University Feinberg School of Medicine researchers acknowledged that “a person's nutrition impacts immunity.” They reported that, “Habitual consumption of one or more cups of coffee per day was associated with a 10% decrease in the risk of COVID-19 compared to less than one cup of coffee. Coffee is not only a key source of caffeine but contributes dozens of other constituents; including many implicated in immunity.” Coffee is rich in polyphenols and has “antioxidant and inflamamatory properties. Coffee consumption is associated with lower biomarkers of inflammation such as C-reactive proteins (CRP), interleukin-6 (IL- 6) and tumor necrosis factor (TNF), which are all associated with COVID-19 severity and mortality.”†          

“Coffee consumption has also been associated with lower risk of pneumonia in elderly. Taken together, an immunoprotective effect of coffee against Covid-19 is plausible and merits further investigation.”†        

Also, a study in the British Medical Journal (BMJ Nutrition, Prevention's & Health) on June 7th, 2021 reported that a plant-based diet or a fish diet may lower the severity of COVID-19 infection.†           

The above was a population study, which reported, “In 2,884 front-line health care workers from six countries (France, Germany, Italy, Spain, UK, USA), individuals who reported following plant-based diets and plant-based diets or pescatarian diets that were higher in vegetables, legumes and nuts, and lower in poultry and red and processed meats, had 73% and 59% lower odds of moderate to severe COVID-19, respectively.” The conclusion of the study was that, “individuals following a plant-based diet or pescatarian “fish diet” had lower odds of severe COVID-19 illness.†     

These two studies are believed to be the first studies to examine the role of specific dietary intake in the prevention of COVID-19.†         

The Mediterranean Diet has been shown to lower c-reactive protein (CRP), a measure of inflammation in the body; a simple blood test can be ordered by your physician to measure CRP. The cytokine storm, caused by the coronavirus in some people, not only damages the lungs but also the heart, cardiovascular system, blood vessels, liver, pancreas, intestines, kidneys and brain. And it causes severe blood clots all over the body, increasing the risk of heart attack, stroke and pulmonary embolism. The anti-inflammatory Mediterranean diet is rich in fish and seafood (containing omega-3 fats), extra-virgin olive oil, nuts (rich in monounsaturated fats) and antioxidant-rich fruits and vegetables and red wine, and berries rich in polyphenols.†          

Adequate sleep, 7 to 8 hours daily, and proper nutrition is important for a healthy immune function, which includes fruits and vegetables rich in vitamin C, polyphenols, plus vitamin D and important minerals zinc and selenium.†

TOP 5 IMMUNE HEALTH SUPPLEMENTS†         

As I mentioned above, eating a healthy, nutritious diet such as the Mediterranean diet and getting proper sleep and exercise are the best ways to support healthy immune function.         

There currently are no products or dietary supplements that are scientifically proven to treat or prevent the coronavirus, according to the U.S. Food and Drug Administration (FDA). Still, some unethical supplement companies have promoted fraudulent cures, claims and treatments not based on good science, such as colloidal silver products for the coronavirus. The FDA has cautioned that colloidal silver is not safe or effective for any disease or condition! By law, companies are not allowed on their product labels or ads to make claims intended to diagnose, treat, cure or prevent any disease. Below is a review of what I believe to be the top immune health supplements to help support function of the immune system, based on the latest scientific research.†

  1. ZINC        

Zinc is required for a healthy immune function. Zinc also has anti-viral properties in humans. It has been reported that zinc supplement can lower inflammation. A randomized double-blind placebo trial found that in 40 healthy adults, supplementation with 45mg of zinc daily increased blood levels of zinc and lowered the inflammatory cytokine interleukin-6 and C-reactive protein (American Journal Clinical Nutrition, June 2010). Research has found that “zinc mediates anti-inflammatory and antioxidant pathways” (Clinical Nutrition, May 2020).†

  1. VITAMIN D      

Research has shown that vitamin D deficiency can weaken the immune system. Many Americans are low in vitamin D. 2,000 IUs of vitamin D orally is safe and required to raise blood levels. A new study (Aging, Clinical Experimental Research, May 6, 2020) reported an association and low average levels of vitamin D and high numbers of COVID-19 cases and mortality rates across 20 European countries. Research in the past has reported an association between low levels of vitamin D and respiratory tract infections. Vitamin D has also been shown to lower inflammation and modulate phagocytic-producing white blood cells such as macrophages, neutrophils and other inflammatory cytokines and interleukin-6 (Medical Hypothesis, April 23, 2020.†

3-5. VITAMIN C & POLYPHENOLS, SELENIUM & N-ACETYL CYSTEINE (NAC)          

Research has shown over the years that vitamin C, polyphenols, selenium and N-Acetyl Cysteine (NAC) are important antioxidants in the body that can lower inflammation. When a virus particle enters your body through your nose, mouth or eyes, into your lungs, the immune system recognizes the virus and sends immune-signaling molecules called cytokines such as interleukin-6 (IL-6) and tumor necrosis factor (TNF). Normally these cytokines play a beneficial role by activating our innate immune response and certain white blood cells called macrophage, neutrophils and natural killer cells that destroy and kill certain dangerous pathogens, bacteria and viruses. These white blood cells are like killer, phagocytic Pac-Men that release reactive oxygen species (ROS) free radicals and kill these bacteria and viruses at the same time these ROS free radical species damage normal tissues and can cause inflammation and cell death. So these white blood cells in fact are a two-edged sword – they kill dangerous viruses and bacteria, or they can go haywire, causing severe inflammation, cell damage and organ failure. Antioxidant nutrients such as vitamin C, polyphenols, selenium, and N-Acetyl Cysteine (NAC) have been shown in the scientific literature to be potent scavengers of ROS and free radicals, helping to lower inflammation in the lungs and other organs and tissues.†           

NAC is clearly the most effective and important antioxidant and precursor of glutathione in the lungs! I was the first to launch glutathione and NAC as dietary supplements to the American market over 20 years ago, during my 27 years as Head of Product Development for Twin Laboratories, Inc. (Twinlab). Research has shown that oral glutathione supplements can raise liver glutathione levels in humans. Research has shown that NAC (1,200mg-1,800mg daily) is much more cost effective and efficacious than oral glutathione for raising glutathione in the lungs, liver and other tissues, and therefore the preferred dietary supplement! NAC is best taken with vitamin C as a dietary supplement (1,000mg-2,000mg) because it prevents the oxidation of NAC and acts as a reducing agent, enhancing the stability and function of NAC.†           

Polyphenols such as quercetin and grape skins and grapeseed extract are effective and work synergistically with vitamin C as an antioxidant, having anti-inflammatory and antiviral properties. Quercetin appears to prevent viruses from entry in the cell thereby reducing viral load (Viruses, December 2016). Polyphenols also function as prebiotics and help promote healthy bacteria flora. Curcumin, a polyphenol found in the spice turmeric, has anti-inflammatory properties. There are no studies that demonstrate curcumin prevents or reduces viral infections in humans. One concern is that curcumin may increase the expression of the ACE2 receptor that makes it easier for the virus to enter the cell. This is controversial, and more research is needed to clarify this.†   

The mineral selenium is also an important antioxidant that functions as a co-factor and synthesis of glutathione in the body. It was most recently reported by ScienceDaily on April 29 and published in the April 28 issue of the American Journal of Clinical Nutrition that an “international team of researchers, led by Professor Margaret Rayman at the University of Surrey, has identified a link between COVID-19 cure rate and regional selenium status in China.” This was a very exciting finding! Research has shown that selenium has anti-inflammatory and anti-viral properties. More studies are needed to determine if selenium deficiency can increase the risk of COVID-19. 50 mcg-200mcg of selenium is considered safe daily as a dietary supplement.†           

In conclusion, there is currently no diet or dietary supplement that has proven to treat or cure COVID-19! More well-designed, randomized and controlled trials are needed to establish safety and efficacy. We already know people over age 65 are at the highest risk of severe illness and dying from coronavirus. People who are overweight and obese and have pre-existing diseases such as diabetes, heart disease and hypertension are also at greater risk. A healthy diet and lifestyle changes, such as following the anti-inflammatory Mediterranean diet along with exercise, has been shown in the scientific research to safely prevent and lower the risk of obesity, metabolic syndrome, diabetes, hypertension and cardiovascular disease.†

Bottom line: Eating healthy and improving our metabolic health, along with proper exercise and sleep, is essential for maintaining healthy immune function.†

 

© Copyright 2023 Advanced Research Media

© Reprinted with permission from Advanced Research Media, Inc. 2023

†These statements have not been evaluated by the Food and Drug Administration. These statements are not intended to diagnose, treat, cure or prevent any disease.

 

References:

  1. Mohammad Hassan Sohouli, Ghazaleh Eslamian, et al. Effects of N-acetylcysteine on aging cell and obesity complications in obese adults: a randomized, double-blind clinical trial. Front Nutr, 19 September 2023. https://doi.org/10.3389/fnut.2023.1237869
  2. Perez-Araluce R, Martínez-González MÁ, Gea A, Carlos S. Components of the Mediterranean Diet and Risk of COVID-19. Front Nutr. 2022 Jan 24;8:805533. doi: 10.3389/fnut.2021.805533. PMID: 35141266; PMCID: PMC8819171.
  3. Majumder D, Debnath M, Sharma KN, Shekhawat SS, Prasad GBKS, Maiti D, Ramakrishna S. Olive Oil Consumption can Prevent Non-communicable Diseases and COVID-19: A Review. Curr Pharm Biotechnol. 2022;23(2):261-275. doi: 10.2174/1389201022666210412143553. PMID: 33845735.
  4. Raman B, Bluemke DA, Lüscher TF, Neubauer S. Long COVID: post-acute sequelae of COVID-19 with a cardiovascular focus. Eur Heart J. 2022 Mar 14;43(11):1157-1172. doi: 10.1093/eurheartj/ehac031. PMID: 35176758; PMCID: PMC8903393.
  5. Long COVID: systemic inflammation and obesity as therapeutic targets. Lidiane L Florencio, César Fernández-de-las-Peñas. The Lancet Respiratory Medicine. April 23, 2022 https://doi.org/10.1016/S2213-2600(22)00159-X
  6. Chen C, Haupert SR, Zimmermann L, Shi X, Fritsche LG, Mukherjee B. Global Prevalence of Post COVID-19 Condition or Long COVID: A Meta-Analysis and Systematic Review. J Infect Dis. 2022 Apr 16:jiac136. doi: 10.1093/infdis/jiac136. Epub ahead of print. PMID: 35429399; PMCID: PMC9047189.
  7. PHOSP-COVID Collaborative Group. Clinical characteristics with inflammation profiling of long COVID and association with 1-year recovery following hospitalisation in the UK: a prospective observational study. Lancet Respir Med. 2022 Apr 22:S2213-2600(22)00127-8. doi: 10.1016/S2213-2600(22)00127-8. Epub ahead of print. PMID: 35472304; PMCID: PMC9034855.
  8. Barrea L, Verde L, Grant WB, Frias-Toral E, Sarno G, Vetrani C, Ceriani F, Garcia-Velasquez E, Contreras-Briceño J, Savastano S, Colao A, Muscogiuri G. Vitamin D: A Role Also in Long COVID-19? Nutrients. 2022 Apr 13;14(8):1625. doi: 10.3390/nu14081625. PMID: 35458189; PMCID: PMC9028162.
  9. University of California - Los Angeles Health Sciences. “About 30 percent of COVID patients develop ‘Long COVID,’ research finds.” ScienceDaily. ScienceDaily, 19 April 2022. sciencedaily.com/releases/2022/04/220419092334.htm
  10. Sun M. Yoo, Teresa C. Liu, Yash Motwani, Myung S. Sim, Nisha Viswanathan, Nathan Samras, Felicia Hsu, Neil S. Wenger. Factors Associated with Post-Acute Sequelae of SARS-CoV-2 (PASC) After Diagnosis of Symptomatic COVID-19 in the Inpatient and Outpatient Setting in a Diverse Cohort. Journal of General Internal Medicine, 2022; DOI: 10.1007/s11606-022-07523-3
  11. Chen C, Haupert SR, Zimmermann L, Shi X, Fritsche LG, Mukherjee B. Global Prevalence of Post COVID-19 Condition or Long COVID: A Meta-Analysis and Systematic Review. J Infect Dis. 2022 Apr 16:jiac136. doi: 10.1093/infdis/jiac136. Epub ahead of print. PMID: 35429399; PMCID: PMC9047189.
  12. Sefik E, Qu R, Junqueira C, Kaffe E, Mirza H, Zhao J, Brewer JR, Han A, Steach HR, Israelow B, Blackburn HN, Velazquez S, Chen YG, Halene S, Iwasaki A, Meffre E, Nussenzweig M, Lieberman J, Wilen CB, Kluger Y, Flavell RA. Inflammasome activation in infected macrophages drives COVID-19 pathology. Nature. 2022 Apr 28. doi: 10.1038/s41586-022-04802-1. Epub ahead of print. PMID: 35483404.
  13. Di Marco F, Foti G, Corsico AG. Where are we with the use of N-acetylcysteine as a preventive and adjuvant treatment for COVID-19? Eur Rev Med Pharmacol Sci. 2022 Jan;26(2):715-721. doi: 10.26355/eurrev_202201_27898. PMID: 35113447.
  14. A Study of N-acetylcysteine in Patients with COVID19 Infection. NIH, National Cancer Institute. Memorial Sloan Kettering Cancer Center. Santosha A. Vardhana. https://www.cancer.gov/about-cancer/treatment/clinical-trials/search/v?id=NCI-2020-03373
  15. Model finds COVID-19 deaths among elderly may be due to genetic limit on cell division. By Jake Ellison. University of Washington. Medical Xpress May 7,2022 https://medicalxpress.com/news/2022-05-covid-deaths-elderly-due-genetic.html
  16. Gröber U, Holick MF. The coronavirus disease (COVID-19) - A supportive approach with selected micronutrients. Int J Vitam Nutr Res. 2022 Jan;92(1):13-34. doi: 10.1024/0300-9831/a000693. Epub 2021 Jan 25. PMID: 33487035.
  17. Barrea L, Vetrani C, Caprio M, Cataldi M, Ghoch ME, Elce A, Camajani E, Verde L, Savastano S, Colao A, Muscogiuri G. From the Ketogenic Diet to the Mediterranean Diet: The Potential Dietary Therapy in Patients with Obesity after CoVID-19 Infection (Post CoVID Syndrome). Curr Obes Rep. 2022 May 6:1-22. doi: 10.1007/s13679-022-00475-z. Epub ahead of print. PMID: 35524067; PMCID: PMC9075143.
  18. Agha-Alinejad H, Ahmadi Hekmatikar AH, Ruhee RT, Shamsi MM, Rahmati M, Khoramipour K, Suzuki K. A Guide to Different Intensities of Exercise, Vaccination, and Sports Nutrition in the Course of Preparing Elite Athletes for the Management of Upper Respiratory Infections during the COVID-19 Pandemic: A Narrative Review. Int J Environ Res Public Health. 2022 Feb 8;19(3):1888. doi: 10.3390/ijerph19031888. PMID: 35162910; PMCID: PMC8835175.
  19. Guo X, Franco OH, Laine JE. Accelerated ageing in the COVID-19 pandemic: A dilemma for healthy ageing. Maturitas. 2022 Mar;157:68-69. doi: 10.1016/j.maturitas.2021.12.009. Epub 2021 Dec 27. PMID: 35067379; PMCID: PMC8711135.
  20. Manca R, Bombillar F, Glomski C, Pica A. Obesity and immune system impairment: A global problem during the COVID-19 pandemic. Int J Risk Saf Med. 2022;33(2):193-208. doi: 10.3233/JRS-227007. PMID: 35147561.
  21. Mai K, Cando P, Trasino SE. mTOR1c Activation with the Leucine “Trigger” for Prevention of Sarcopenia in Older Adults During Lockdown. J Med Food. 2022 Feb;25(2):117-120. doi: 10.1089/jmf.2021.0094. Epub 2021 Oct 29. PMID: 34714145.
  22. Calatayud-Sáez FM. The traditional Mediterranean diet is effective in the prevention and treatment of acute and recurrent inflammatory diseases of childhood. Allergol Immunopathol (Madr). 2022 Mar 1;50(2):93-95. doi: 10.15586/aei.v50i2.565. PMID: 35257551.
  23. Study finds Mediterranean diet improves depression symptoms in young men, by University of Technology, Sydney. May 9, 2022. Medical Xpress, https://medicalxpress.com/news/2022-05-mediterranean-diet-depression-symptoms-young.html
  24. Jessica Bayes, Janet Schloss, David Sibbritt, The effect of a Mediterranean diet on the symptoms of depression in young males (the “AMMEND” study): A Randomized Control Trial, The American Journal of Clinical Nutrition, 2022; nqac106, https://doi.org/10.1093/ajcn/nqac106
  25. Perez-Araluce R, Martinez-Gonzalez MA, Fernández-Lázaro CI, Bes-Rastrollo M, Gea A, Carlos S. Mediterranean diet and the risk of COVID-19 in the 'Seguimiento Universidad de Navarra' cohort. Clin Nutr. 2021 Apr 15:S0261-5614(21)00190-4. doi: 10.1016/j.clnu.2021.04.001. Epub ahead of print. PMID: 33934925; PMCID: PMC8047333.
  26. Angelidi AM, Kokkinos A, Katechaki E, Ros E, Mantzoros CS. Mediterranean diet as a nutritional approach for COVID-19. Metabolism. 2021 Jan;114:154407. doi: 10.1016/j.metabol.2020.154407. Epub 2020 Oct 17. PMID: 33080270; PMCID: PMC7833284.
  27. Angelidi AM, Kokkinos A, Katechaki E, Ros E, Mantzoros CS. Mediterranean diet as a nutritional approach for COVID-19. Metabolism. 2021;114:154407. doi:10.1016/j.metabol.2020.154407
  28. University of Illinois at Urbana-Champaign. “Avocados change belly fat distribution in women, controlled study finds.” ScienceDaily. ScienceDaily, 7 September 2021. sciencedaily.com/releases/2021/09/210907110702.htm
  29. Naiman A Khan, Caitlyn G Edwards, Sharon V Thompson, Bridget A Hannon, Sarah K Burke, Anne D M Walk, Richard W A Mackenzie, Ginger E Reeser, Barbara H Fiese, Nicholas A Burd, Hannah D Holscher. Avocado Consumption, Abdominal Adiposity, and Oral Glucose Tolerance Among Persons with Overweight and Obesity. The Journal of Nutrition, 2021; 151 (9): 2513 DOI: 10.1093/jn/nxab187
  30. Naiman A Khan, Caitlyn G Edwards, Sharon V Thompson, Bridget A Hannon, Sarah K Burke, Anne D M Walk, Richard W A Mackenzie, Ginger E Reeser, Barbara H Fiese, Nicholas A Burd, Hannah D Holscher, Avocado Consumption, Abdominal Adiposity, and Oral Glucose Tolerance Among Persons with Overweight and Obesity, The Journal of Nutrition, Volume 151, Issue 9, September 2021, Pages 2513–2521, https://doi.org/10.1093/jn/nxab187
  31. Crous-Bou M, Fung TT, Prescott J, Julin B, Du M, Sun Q, Rexrode KM, Hu FB, De Vivo I. Mediterranean diet and telomere length in Nurses’ Health Study: population based cohort study. BMJ. 2014 Dec 2;349:g6674. doi: 10.1136/bmj.g6674. PMID: 25467028; PMCID: PMC4252824.
  32. Crous-Bou M, Fung TT, Prescott J, Julin B, Du M, Sun Q, Rexrode KM, Hu FB, De Vivo I. Mediterranean diet and telomere length in Nurses' Health Study: population based cohort study. BMJ. 2014 Dec 2;349:g6674. doi: 10.1136/bmj.g6674. PMID: 25467028; PMCID: PMC4252824.
  33. Coffee and Veggies May Protect Against COVID-19 by Mario Paul, Northwestern University. Medical Xpress. July 20, 2021 https://medicalxpress.com/news/2021-07-coffee-veggies-covid-.html
  34. Vu, T.-H.T.; Rydland, K.J.; Achenbach, C.J.; Van Horn, L.; Cornelis, M.C. Dietary Behaviors and Incident COVID-19 in the UK Biobank. Nutrients 2021, 13, 2114. https://doi.org/10.3390/nu13062114
  35. Plant-based and/or fish diets may help lessen severity of COVID-19 infection. British Medical Journal. June 8, 2021 Medical Xpress https://medicalxpress.com/news/2021-06-plant-based-andor-fish-diets-lessen.html
  36. Kim H, Rebholz CM, Hegde S, et alPlant-based diets, pescatarian diets and COVID-19 severity: a population-based case control study in six countries. BMJ Nutrition, Prevention & Health 2021;4:doi: 10.1136/bmjnph-2021-000272
  37. Ismailova A, White JH. Vitamin D, infections and immunity. Rev Endocr Metab Disord. 2021 Jul 29:1–13. doi: 10.1007/s11154-021-09679-5. Epub ahead of print. PMID: 34322844; PMCID: PMC8318777.
  38. Szarpak L, Rafique Z, Gasecka A, Chirico F, Gawel W, Hernik J, Kaminska H, Filipiak KJ, Jaguszewski MJ, Szarpak L. A systematic review and meta-analysis of effect of vitamin D levels on the incidence of COVID-19. Cardiol J. 2021 Jul 26. doi: 10.5603/CJ.a2021.0072. Epub ahead of print. PMID: 34308537.
  39. Inserra F, Tajer C, Antonietti L, Mariani J, Ferder L, Manucha W. Vitamin D supplementation: An alternative to enhance the effectiveness of vaccines against SARS-CoV-2? Vaccine. 2021 Jul 16:S0264-410X(21)00908-7. doi: 10.1016/j.vaccine.2021.07.031. Epub ahead of print. PMID: 34303561; PMCID: PMC8282476.
  40. Fakhrolmobasheri M, Nasr-Esfahany Z, Khanahmad H, Zeinalian M. Selenium supplementation can relieve the clinical complications of COVID-19 and other similar viral infections. Int J Vitam Nutr Res. 2021 Jun;91(3-4):197-199. doi: 10.1024/0300-9831/a000663. Epub 2020 Jun 9. PMID: 32513070.
  41. Zhang HY, Zhang AR, Lu QB, Zhang XA, Zhang ZJ, Guan XG, Che TL, Yang Y, Li H, Liu W, Fang LQ. Association between fatality rate of COVID-19 and selenium deficiency in China. BMC Infect Dis. 2021 May 19;21(1):452. doi: 10.1186/s12879-021-06167-8. PMID: 34011281; PMCID: PMC8132024.
  42. Detopoulou P, Demopoulos CA, Antonopoulou S. Micronutrients, Phytochemicals and Mediterranean Diet: A Potential Protective Role against COVID-19 through Modulation of PAF Actions and Metabolism. Nutrients. 2021 Jan 30;13(2):462. doi: 10.3390/nu13020462. PMID: 33573169; PMCID: PMC7911163.
  43. Khazeei Tabari MA, Iranpanah A, Bahramsoltani R, Rahimi R. Flavonoids as Promising Antiviral Agents against SARS-CoV-2 Infection: A Mechanistic Review. Molecules. 2021 Jun 25;26(13):3900. doi: 10.3390/molecules26133900. PMID: 34202374; PMCID: PMC8271800.
  44. N-Acetylcysteine as Adjuvant Therapy for COVID-19 - A Perspective on the Current State of the Evidence. Kon Ken Wong, Shaun Wen Huey Lee, Kok Pim Kua. https://www.dovepress.com/n-acetylcysteine-as-adjuvant-therapy-for-covid-19--a-perspective-on-th-peer-reviewed-fulltext-article-JIR
  45. N-Acetylcysteine (NAC): Impacts on Human Health. Antioxidants 2021, 10. Tenório, M.C.d.S.;Graciliano, N.G.; Moura, F.A.; Oliveira, A.C.M.d.; Goulart, M.O.F. https://doi.org/10.3390/antiox10060967
  46. Coronavirus Pandemic: Diet and Nutrition Battling the Deadly Cytokine Storm - The Latest Research! Steve Blechman. Advanced Molecular Labs. April 24, 2020 https://advancedmolecularlabs.com/blogs/news/coronavirus-pandemic-diet-and-nutrition-battling-the-deadly-cytokine-storm-the-latest-research
  47. Kate J Claycombe-Larson, Travis Alvine, Dayong Wu, Nishan S Kalupahana, Naima Moustaid-Moussa, James N Roemmich, Nutrients and Immunometabolism: Role of Macrophage NLRP3, The Journal of Nutrition, nxaa085, https://doi.org/10.1093/jn/nxaa085
  48. Calder, P.C.; Carr, A.C.; Gombart, A.F.; Eggersdorfer, M. Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to Protect against Viral Infections. Nutrients 2020, 12, 1181.
  49. Obesity Exacerbates the Cytokine Storm Elicited by Francisella tularensis Infection of Females and Is Associated with Increased Mortality. Mireya G. Ramos Muniz et al. June 26, 2018. Journal of Bio Med Rsch. https://doi.org/10.1155/2018/3412732
  50. Efficacy of glutathione therapy in relieving dyspnea associated with COVID-19 pneumonia: A report of 2 cases. Author links open overlay panel. Richard I.Horowitz. Phyllis R.Freeman. James Bruzzesec. Respiratory Medicine Case Reports. Volume 30, 2020, 101063. https://doi.org/10.1016/j.rmcr.2020.101063
  51. Spanish Ketogenic Mediterranean diet: a healthy cardiovascular diet for weight loss. Nutrition Journal, 2008, Volume 7, Number 1, Page 1. Joaquín Pérez-Guisado, Andrés Muñoz-Serrano, Ángeles Alonso-Moraga
  52. Effect of ketogenic Mediterranean diet with phytoextracts and low carbohydrates/high-protein meals on weight, cardiovascular risk factors, body composition and diet compliance in Italian council employees. Paoli, A., Cenci, L., & Grimaldi, K. A. (2011). Nutrition journal, 10, 112. doi:10.1186/1475-2891-10-112
  53. Mediterranean Diet Reduces Risk of Incident Stroke in a Population With Varying Cardiovascular Disease Risk Profiles. Paterson, K. E., Myint, P. K., Jennings, A., Bain, L., Lentjes, M., Khaw, K. T., & Welch, A. A. (Oct 2018). Stroke, 49 (10), 2415-2420. Advance online publication. doi:10.1161/STROKEAHA.117.020258
  54. Mediterranean Diet Reduces Risk of Incident Stroke in a Population With Varying Cardiovascular Disease Risk Profiles. Paterson, K. E., Myint, P.K., Jennings, A., Bain, L., Lentjes, M., Khaw, K.T., & Welch, A.A. (Oct 2018). Stroke, 49 (10), 2415-2420. Advance online publication. doi:10.1161/STROKEAHA.117.020258
  55. Fish Consumption in Healthy Adults Is Associated with Decreased Circulating Biomarkers of Endothelial Dysfunction and Inflammation during a 6-Year Follow-Up. Bas C. T. van Bussel, Ronald M. A. Henry, Casper G. Schalkwijk, Isabel Ferreira, Edith J. M. Feskens, Martinette T. Streppel, Yvo M. Smulders, Jos W. R. Twisk, Coen D. A. Stehouwer. The Journal of Nutrition, Volume 141, Issue 9, September 2011, Pages 1719-1725, https://doi.org/10.3945/jn.111.139733
  56. University of Surrey. Link identified between dietary selenium and outcome of COVID-19 disease. ScienceDaily, 29 April 2020. sciencedaily.com/releases/2020/04/200429105907.htm
  57. Margaret P Rayman, Ramy Saad, Kate Bennett, Ethan Will Taylor, Jinsong Zhang. Association between regional selenium status and reported outcome of COVID-19 cases in China. The American Journal of Clinical Nutrition, 2020; DOI: 10.1093/ajcn/nqaa095
  58. Calder, P.C.; Carr, A.C.; Gombart, A.F.; Eggersdorfer, M. Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to Protect against Viral Infections. Nutrients2020, 12, 1181.
  59. Ilie PC, Stefanescu S, Smith L. The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality [published online ahead of print, 2020 May 6]. Aging Clin Exp Res. 2020;1‐ doi:10.1007/s40520-020-01570-8
  60. Pilz, S., Zittermann, A., Trummer, C., Theiler-Schwetz, V., Lerchbaum, E., Keppel, M., Grübler, M., März, W., & Pandis, M. (2019). Vitamin D testing and treatment: a narrative review of current evidence, Endocrine Connections, 8(2), R27-R43. Retrieved May 18, 2020, from https://ec.bioscientifica.com/view/journals/ec/8/2/EC-18-0432.xml
  61. Gruber-Bzura BM. Vitamin D and Influenza-Prevention or Therapy? Int J Mol Sci. 2018;19(8):2419. Published 2018 Aug 16. doi:10.3390/ijms19082419
  62. Kate J Claycombe-Larson, Travis Alvine, Dayong Wu, Nishan S Kalupahana, Naima Moustaid-Moussa, James N Roemmich, Nutrients and Immunometabolism: Role of Macrophage NLRP3, The Journal of Nutrition, nxaa085, https://doi.org/10.1093/jn/nxaa085
  63. Ratih Wirapuspita Wisnuwardani, Stefaan De Henauw, Marika Ferrari, Maria Forsner, Frédéric Gottrand, Inge Huybrechts, Antonios G Kafatos, Mathilde Kersting, Viktoria Knaze, Yannis Manios, Ascensión Marcos, Dénes Molnár, Joseph A Rothwell, Azahara Iris Rupérez, Augustin Scalbert, Kurt Widhalm, Luis A Moreno, Nathalie Michels. Total Polyphenol Intake Is Inversely Associated with a Pro/Anti-Inflammatory Biomarker Ratio in European Adolescents of the HELENA Study, The Journal of Nutrition, nxaa064, https://doi.org/10.1093/jn/nxaa064
  64. Bao B, Prasad AS, Beck FW, et al. Zinc decreases C-reactive protein, lipid peroxidation, and inflammatory cytokines in elderly subjects: a potential implication of zinc as an atheroprotective agent. Am J Clin Nutr. 2010;91(6):1634‐ doi:10.3945/ajcn.2009.28836
  65. Mani JS, Johnson JB, Steel JC, et al. Natural product-derived phytochemicals as potential agents against coronaviruses: A review [published online ahead of print, 2020 Apr 30]. Virus Res. 2020;284:197989. doi:10.1016/j.virusres.2020.197989
  66. Silberstein M. Vitamin D: A simpler alternative to tocilizumab for trial in COVID-19? [published online ahead of print, 2020 Apr 23]. Med Hypotheses. 2020;140:109767. doi:10.1016/j.mehy.2020.109767
  67. Aziz, M., Fatima, R. and Assaly, R. (2020), Elevated Interleukin‐6 and Severe COVID‐19: A Meta‐ J Med Virol. Accepted Author Manuscript. doi:10.1002/jmv.25948
  68. Covid-19 in Immune-Mediated Inflammatory Diseases - Case Series from New York. April 29, 2020. DOI: 10.1056/NEJMc2009567.
  69. Giovannini C, Filesi C, D'Archivio M, Scazzocchio B, Santangelo C, Masella R. Polifenoli e difese antiossidanti endogene: effetti sul glutatione e sugli enzimi ad esso correlati [Polyphenols and endogenous antioxidant defences: effects on glutathione and glutathione related enzymes]. Ann Ist Super Sanita. 2006;42(3):336.
  70. Margaret P Rayman, Ramy Saad, Kate Bennett, Ethan Will Taylor, Jinsong Zhang. Association between regional selenium status and reported outcome of COVID-19 cases in China. The American Journal of Clinical Nutrition, 2020; DOI: 10.1093/ajcn/nqaa095
  71. University of Surrey. Link identified between dietary selenium and outcome of COVID-19 disease. ScienceDaily, 29 April 2020. sciencedaily.com/releases/2020/04/200429105907.htm
  72. Jinsong Zhang, Ethan Will Taylor, Kate Bennett, Ramy Saad, Margaret P Rayman, Association between regional selenium status and reported outcome of COVID-19 cases in China, The American Journal of Clinical Nutrition, nqaa095, https://doi.org/10.1093/ajcn/nqaa095
  73. The Possible Role of Vitamin D in Suppressing Cytokine Storm and Associated Mortality in COVID-19 Patients. Ali Daneshkhah, Vasundhara Agrawal, Adam Eshein, Hariharan Subramanian, Hemant Kumar Roy, Vadim Backman. medRxiv 2020.04.08.20058578; doi: https://doi.org/10.1101/2020.04.08.2005857
  74. Santos HO, Teixeira FJ, Schoenfeld BJ. Dietary vs. pharmacological doses of zinc: A clinical review. Clin Nutr. 2020;39(5):1345‐ doi:10.1016/j.clnu.2019.06.024
  75. Zn2+ Inhibits Coronavirus and Arterivirus RNA Polymerase Activity In Vitro and Zinc Ionophores Block the Replication of These Viruses in Cell Culture. Aartjan J. W. te Velthuis, Sjoerd H. E. van den Worm,Amy C. Sims, Ralph S. Baric, Eric J. Snijder , Martijn J. van Hemert Published: November 4, 2010. https://doi.org/10.1371/journal.ppat.10011
  76. Thailand Medical News. BREAKING! COVID-19 Research: Russian Study Indicates That Glutathione Deficiency Affects COVID-19 Susceptibility, NAC Supplements Helps. Apr 26, 2020 https://www.thailandmedical.news/news/breaking-covid-19-research-russian-study-indicates-that-glutathione-deficiency-affects-covid-19-susceptibility,-nac-supplements-helps
  77. Endogenous deficiency of glutathione as the most likely cause of serious manifestations and death in patients with the novel coronavirus infection (COVID-19): a hypothesis based on literature data and own observations. DO - 10.21626/vestnik. Polonikov, Alexey. 2020/04/25. Research Gate
  78. De Flora S, Grassi C, Carati L. Attenuation of influenza-like symptomatology and improvement of cell-mediated immunity with long-term N-acetylcysteine treatment. Eur Respir J. 1997;10(7):1535‐ doi:10.1183/09031936.97.10071535
  79. N-acetylcysteine: A rapid review of the evidence for effectiveness in treating COVID-19 by Dr Oliver Van Hecke, Dr Joseph Lee. CEBM. April 14, 2020 https://www.cebm.net/covid-19/n-acetylcysteine-a-rapid-review-of-the-evidence-for-effectiveness-in-treating-covid-19/
  80. De Rosa SC, Zaretsky MD, Dubs JG, et al. N-acetylcysteine replenishes glutathione in HIV infection. Eur J Clin Invest. 2000;30(10):915‐ doi:10.1046/j.1365-2362.2000.00736.x
  81. Shu Y, Wu M, Yang S, Wang Y, Li H. Association of dietary selenium intake with telomere length in middle-aged and older adults [published online ahead of print, 2020 Jan 31]. Clin Nutr. 2020;S0261-5614(20)30037-6. doi:10.1016/j.clnu.2020.01.014
  82. McCarty MF, DiNicolantonio JJ. Nutraceuticals have potential for boosting the type 1 interferon response to RNA viruses including influenza and coronavirus [published online ahead of print, 2020 Feb 12]. Prog Cardiovasc Dis. 2020;. doi:10.1016/j.pcad.2020.02.007
  83. Ungheri D, Pisani C, Sanson G, et al. Protective effect of n-acetylcysteine in a model of influenza infection in mice. Int J Immunopathol Pharmacol. 2000;13(3):123
  84. Prasad AS, Beck FW, Bao B, et al. Zinc supplementation decreases incidence of infections in the elderly: effect of zinc on generation of cytokines and oxidative stress. Am J Clin Nutr. 2007;85(3):837‐ doi:10.1093/ajcn/85.3.837
  85. Glutathione Fine-Tunes the Innate Immune Response toward Antiviral Pathways in a Macrophage Cell Line Independently of Its Antioxidant Properties. Diotallevi Marina, Checconi Paola et al. Frontiers in Immunology. September 17, 2017 https://www.frontiersin.org/article/10.3389/fimmu.2017.01239
  86. The Role of N-Acetyl Cysteine in Pulmonary Tuberculosis. Resti Yudhawati, Nitya Prasanta. January 2020. Journal of Respiration https://e-journal.unair.ac.id/JR/article/download/17303/9706
  87. Nair MP, Mahajan S, Reynolds JL, et al. The flavonoid quercetin inhibits proinflammatory cytokine (tumor necrosis factor alpha) gene expression in normal peripheral blood mononuclear cells via modulation of the NF-kappa beta system. Clin Vaccine Immunol. 2006;13(3):319‐ doi:10.1128/CVI.13.3.319-328.2006
  88. Leyva-López N, Gutierrez-Grijalva EP, Ambriz-Perez DL, Heredia JB. Flavonoids as Cytokine Modulators: A Possible Therapy for Inflammation-Related Diseases. Int J Mol Sci. 2016;17(6):921. Published 2016 Jun 9. doi:10.3390/ijms17060921
  89. Farzaei, M.H.; Singh, A.K.; Kumar, R.; Croley, C.R.; Pandey, A.K.; Coy-Barrera, E.; Kumar Patra, J.; Das, G.; Kerry, R.G.; Annunziata, G.; Tenore, G.C.; Khan, H.; Micucci, M.; Budriesi, R.; Momtaz, S.; Nabavi, S.M.; Bishayee, A. Targeting Inflammation by Flavonoids: Novel Therapeutic Strategy for Metabolic Disorders. Int. J. Mol. Sci.2019, 20, 4957
  90. Cheng SC, Huang WC, S Pang JH, Wu YH, Cheng CY. Quercetin Inhibits the Production of IL-1beta-Induced Inflammatory Cytokines and Chemokines in ARPE-19 Cells via the MAPK and NF-κB Signaling Pathways. Int J Mol Sci. 2019;20(12):2957. Published 2019 Jun 17. doi:10.3390/ijms20122957
  91. Nair MP, Mahajan S, Reynolds JL, et al. The flavonoid quercetin inhibits proinflammatory cytokine (tumor necrosis factor alpha) gene expression in normal peripheral blood mononuclear cells via modulation of the NF-kappa beta system. Clin Vaccine Immunol. 2006;13(3):319‐ doi:10.1128/CVI.13.3.319-328.2006
  92. Hemilä H, Chalker E. Vitamin C Can Shorten the Length of Stay in the ICU: A Meta-Analysis. Nutrients. 2019;11(4):708. Published 2019 Mar 27. doi:10.3390/nu11040708
  93. Bucca C, Rolla G, Arossa W, et al. Effect of ascorbic acid on increased bronchial responsiveness during upper airway infection. Respiration. 1989;55(4):214‐ doi:10.1159/000195737
  94. N-Acetylcysteine Protection in COPD. Wu, Wenxin et al. CHEST, Volume 145, Issue 1, 193-194. January 2014
  95. Gammoh, N.Z.; Rink, L. Zinc in Infection and Inflammation. Nutrients 2017, 9, 624.
  96. Hirano T, Murakami M, Fukada T, Nishida K, Yamasaki S, Suzuki T. Roles of zinc and zinc signaling in immunity: zinc as an intracellular signaling molecule. Adv Immunol. 2008;97:149‐ doi:10.1016/S0065-2776(08)00003-5
  97. Changes in cytokine production and T cell subpopulations in experimentally induced zinc-deficient humans. F. W. Beck, A. S. Prasad, J. Kaplan, J. T. Fitzgerald, and G. J. Brewer. American Journal of Physiology-Endocrinology and Metabolism 1997 272:6, E1002-E1007
  98. Prasad AS. Effects of zinc deficiency on Th1 and Th2 cytokine shifts. J Infect Dis. 2000;182 Suppl 1:S62‐ doi:10.1086/315916
  99. Shen Y, Cai W, Lei S, Zhang Z. Effect of high/low dose N-acetylcysteine on chronic obstructive pulmonary disease: a systematic review and meta-analysis. COPD. 2014;11(3):351‐ doi:10.3109/15412555.2013.85831
  100. Fowdar K, Chen H, He Z, et al. The effect of N-acetylcysteine on exacerbations of chronic obstructive pulmonary disease: A meta-analysis and systematic review. Heart Lung. 2017;46(2):120‐ doi:10.1016/j.hrtlng.2016.12.004
  101. Cazzola M, Calzetta L, Facciolo F, Rogliani P, Matera MG. Pharmacological investigation on the anti-oxidant and anti-inflammatory activity of N-acetylcysteine in an ex vivo model of COPD exacerbation. Respir Res. 2017;18(1):26. Published 2017 Jan 24. doi:10.1186/s12931-016-0500-y
  102. Santus P, Corsico A, Solidoro P, Braido F, Di Marco F, Scichilone N. Oxidative stress and respiratory system: pharmacological and clinical reappraisal of N-acetylcysteine. COPD. 2014;11(6):705‐ doi:10.3109/15412555.2014.898040
  103. De Backer J, Vos W, Van Holsbeke C, et al. Effect of high-dose N-acetylcysteine on airway geometry, inflammation, and oxidative stress in COPD patients. Int J Chron Obstruct Pulmon Dis. 2013;8:569‐ doi:10.2147/COPD.S49307
  104. Vitamin D reduces respiratory tract infections frequency. Bhutta, Zulfiqar A. The Journal of Pediatrics, Volume 186, 209-212
  105. Jolliffe DA, Greenberg L, Hooper RL, et al. Vitamin D supplementation to prevent asthma exacerbations: a systematic review and meta-analysis of individual participant data [published correction appears in Lancet Respir Med. 2018 Jun;6(6):e27]. Lancet Respir Med. 2017;5(11):881‐ doi:10.1016/S2213-2600(17)30306-5
  106. Martineau AR, James WY, Hooper RL, et al. Vitamin D3 supplementation in patients with chronic obstructive pulmonary disease (ViDiCO): a multicentre, double-blind, randomised controlled trial. Lancet Respir Med. 2015;3(2):120‐ doi:10.1016/S2213-2600(14)70255-3
  107. N-Acetyl-l-cysteine (NAC) inhibit mucin synthesis and pro-inflammatory mediators in alveolar type II epithelial cells infected with influenza virus A and B and with Respiratory Syncytial Virus (RSV) Mata, Manuel, Morcillo, Esteban et al. 2011/05/25. Biochemical pharmacology. 10.1016/j.bcp.2011.05.014
  108. Daglia M. Polyphenols as antimicrobial agents. Curr Opin Biotechnol. 2012;23(2):174‐ doi:10.1016/j.copbio.2011.08.007
  109. Schrauzer GN, Sacher J. Selenium in the maintenance and therapy of HIV-infected patients [published correction appears in Chem Biol Interact 1995 Feb;94(2):167]. Chem Biol Interact. 1994;91(2-3):199‐ doi:10.1016/0009-2797(94)90040-x
  110. N-Acetylcysteine: A New Approach to Anti-HIV Therapy. Mario Roederer, Stephen W. Ela, Frank J.T. Staal, Leonore A. Herzenberg, and Leonard A. Herzenberg. AIDS Research and Human Retroviruses 1992 8:2, 209-217
  111. Kent L. Erickson, Edward A. Medina, Neil E. Hubbard, Micronutrients and Innate Immunity, The Journal of Infectious Diseases, Volume 182, Issue Supplement_1, September 2000, Pages S5–S10, https://doi.org/10.1086/315922
  112. Childs CE, Calder PC, Miles EA. Diet and Immune Function. Nutrients. 2019;11(8):1933. Published 2019 Aug 16. doi:10.3390/nu11081933
  113. Assimakopoulos SF, Marangos M. N-acetyl-cysteine may prevent COVID-19-associated cytokine storm and acute respiratory distress syndrome [published online ahead of print, 2020 Apr 22]. Med Hypotheses. 2020;140:109778. doi:10.1016/j.mehy.2020.109778
  114. Mehta P, McAuley DF, Brown M, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395(10229):1033‐ doi:10.1016/S0140-6736(20)30628-0
  115. The pathogenesis and treatment of the ‘Cytokine Storm’ in COVID-19. Qing Ye, Bili Wang, Jianhua Mao. Journal of Infection. March 24, 2020.
  116. Wu W, Li R, Li X, et al. Quercetin as an Antiviral Agent Inhibits Influenza A Virus (IAV) Entry. Viruses. 2015;8(1):6. Published 2015 Dec 25. doi:10.3390/v8010006
  117. Uchide N, Toyoda H. Antioxidant therapy as a potential approach to severe influenza-associated complications. Molecules. 2011;16(3):2032‐ Published 2011 Feb 28. doi:10.3390/molecules16032032
  118. Hemilä H, Chalker E. Vitamin C may reduce the duration of mechanical ventilation in critically ill patients: a meta-regression analysis. J Intensive Care. 2020;8:15. Published 2020 Feb 7. doi:10.1186/s40560-020-0432-y
  119. University of Virginia Health System. Heart attacks, heart failure, stroke: COVID-19's dangerous cardiovascular complications: ER doctors highlight underappreciated risks, potential drug interactions. ScienceDaily, 15 May 2020. sciencedaily.com/releases/2020/05/200515115644.htm
  120. Brit Long, William J. Brady, Alex Koyfman, Michael Gottlieb. Cardiovascular complications in COVID-19. The American Journal of Emergency Medicine, 2020; DOI: 10.1016/j.ajem.2020.04.048
  121. Anna K E Vadell, Linnea Bärebring, Erik Hulander, Inger Gjertsson, Helen M Lindqvist, Anna Winkvist, Anti-inflammatory Diet In Rheumatoid Arthritis (ADIRA) - a randomized, controlled crossover trial indicating effects on disease activity, The American Journal of Clinical Nutrition, nqaa019, https://doi.org/10.1093/ajcn/nqaa019
  122. Zinc-hydroxychloroquine Found Effective In Some COVID-19 Patients: Study. May 11, 2020. Barrons. Agence France Presse. https://www.barrons.com/news/zinc-hydroxychloroquine-found-effective-in-some-covid-19-patients-study-01589234407?tesla=y
  123. Bernard GR, Wheeler AP, Arons MM, et al. A trial of antioxidants N-acetylcysteine and procysteine in ARDS. The Antioxidant in ARDS Study Group. Chest. 1997;112(1):164‐ doi:10.1378/chest.112.1.164
  124. Hydroxychloroquine and azithromycin plus zinc vs hydroxychloroquine and azithromycin alone: outcomes in hospitalized COVID-19 patients. Philip Carlucci, Tania Ahuja, Christopher M Petrilli, Harish Rajagopalan, Simon Jones, Joseph Rahimian. medRxiv 2020.05.02.20080036; doi: https://doi.org/10.1101/2020.05.02.20080036
  125. Horowitz RI, Freeman PR, Bruzzese J. Efficacy of glutathione therapy in relieving dyspnea associated with COVID-19 pneumonia: A report of 2 cases [published online ahead of print, 2020 Apr 21]. Respir Med Case Rep. 2020;30:101063. doi:10.1016/j.rmcr.2020.101063