Current Knowledge of COVID-19 Treatment and Anti-Inflammatory Approaches

The novel coronavirus disease (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has engulfed the world, affecting more than 180 countries. As a result, there has been considerable economic distress globally and a significant loss of life. Sadly, the vulnerable and immunocompromised in our societies seem to be more susceptible to severe COVID-19 complications. Notably, there are several significant risk factors for severe COVID-19 infection. These include the presence of poor nutritional status and pre-existing noncommunicable diseases (NCDs) such as diabetes mellitus, chronic lung diseases, cardiovascular diseases (CVD), obesity, and various other diseases that render the patient immunocompromised. These diseases are characterized by systemic inflammation, which may be a common feature of these NCDs, affecting patient outcomes against COVID-19. As a result, various antiviral treatments and anti-inflammatory agents are under investigation for their potential therapeutic value. The section presented below originates from the following article ^[1].

the full Encyclopedia entry is here.

Frontiers Research Topic: "Coronavirus Disease (COVID-19): Diet, Inflammation and Nutritional Status"

About Frontiers Research Topics

With their unique mixes of varied contributions from Original Research to Review Articles, Research Topics unify the most influential researchers, the latest key findings and historical advances in a hot research area!

About this Research Topic

COVID-19 is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that has had a significant impact on the way in which we live our lives. Whilst the vast majority of people infected with COVID-19 experience mild symptoms and can recover without the need for hospitalization, it has become increasingly clear that those with pre-existing noncommunicable diseases such as diabetes mellitus, chronic lung diseases, cardiovascular disease and obesity are at increased risk of severe illness and mortality.

The potential for specific foods and nutrients to affect COVID-19 severity and outcomes is gathering increasing interest from the scientific community, as well as the general population and mass media. Given that a common complication in patients with severe COVID-19, and individuals with noncommunicable diseases, is excessive inflammation, foods with anti-inflammatory properties may possess a protective role. Likewise, the role of nutritional status and other nutrients, such as selenium, vitamin D and vitamin C has gathered attention, with vitamin D and selenium deficiency recently linked to COVID-19 severity. Nevertheless, the potential for supplementation of specific foods and nutrients to act as a protective measure against COVID-19 remains a topic of debate.

The goal of this Research Topic is to gather Original Research articles and Reviews which will improve our understanding of diet, specific foods and nutritional status in relation to COVID-19 severity and outcomes. While we expect submissions are likely to be on the preventative role of specific foods and nutrients, submissions on the role of nutrition in treating COVID-19 will also be considered if conducted with scientific rigor.

Welcome subtopics include (but are not limited to):
• Immunological and anti-inflammatory properties of food
• Specific food components and COVID-19 outcomes
• Mechanisms by which specific foods/nutrients may affect COVID-19 severity and outcomes
• Relationship between micronutrient deficiencies and COVID-19
• Nutritional supplementation and COVID-19 outcomes
• Nutritional status and its relationship with COVID-19 severity and outcomes

Due to the exceptional nature of the COVID-19 situation, Frontiers is waiving all article publishing charges for COVID-19 related research in this Research Topic until the 31st of July 2020.

Keywords: COVID-19, Inflammatory, Micronutrients, Selenium, Vitamin

Important Note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review. 

Participating Journals

Manuscripts can be submitted to this Research Topic via the following journals:

Frontiers inNutrition

 

Nutritional Epidemiology

Nutritional Immunology

 

Frontiers inImmunology

 

Nutritional Immunology

The EPA bathing report

This is the Irish Times view on the EPA bathing report and further below are our views.

The Irish Times view on: The EPA bathing report

Ireland in position to get massive post-Covid boost with proper water supplies in place 

 

A ban on bathing at Merrion strand in Dublin Bay was a long time coming; the culmination of five years of failure to meet minimum EU water quality standards. It has the infamous reputation of being the first beach in Ireland to have a permanent ban on swimming.

The EPA’s 2019 bathing water report outlines the causes, particularly two polluted streams whose contents are a result of poor sewerage infrastructure and run-off from roads. Local authorities and Irish Water are trying to find solutions. 

Merrion strand figures prominently in a focus on what is causing ongoing pollution problems in Dublin Bay, including a separate bigger issue of discharges from the often-overloaded Ringsend wastewater treatment works. All told, too much raw or insufficiently treated sewage is being allowed into a much-used amenity and an internationally designated biosphere.

An overall improvement of bathing water quality at locations across Ireland should be acknowledged – 95 per cent of bathing waters (140 of 147) met or exceeded the minimum required standard, up from 94 per cent in 2018.

There are, however, obvious pressure points. Two more beaches are set to meet the same fate as Merrion Strand: Portrane (the Brook) and Ballyloughane in Galway, if they fail to achieve a marked improvement in the coming year.

Irish Water is investing €1.2 billion at 28 locations where raw sewage is being pumped into rivers and seas including the Ringsend plant. But it is encountering delays in Arklow, Athlone, Roscommon and Enniscorthy, which risks substantial EU fines for failing to meet a 30-year-old commitment to end such discharges.

Ireland is in a position to get a massive post-Covid-19 boost from being a genuinely green island, in offering a tourism product demonstrably embracing sustainability, where every sector in the economy is on an accelerated course of decarbonisation. Poor water quality, uncertainty about supplies in the most-populated eastern region and ongoing pollution of lakes, rivers, beaches and bays risks undermining all that.

=  = = = = = = = = = = = = = =  =

Our views 

It’s the same story again and again, as analysed here.

Polluters can not (and are not forced to) self-regulate while monitoring authorities do not monitor competently. Without proper monitoring, they would never be able to impose relevant fines and corrective actions.

People are refused access to water, drinking water (see co Clare problems few weeks ago) or swimming water in this case. 

What needs to be done? 

Well, we do not need to reinvent the wheel!

But just enforcing the law, the “polluter pays principle" and use the power of justice.

At the end of the day it’s about political cost and both Ireland and Greece are small countries where everyone knows every other one, in cases like that, this familiarity might be somehow impending.

There is a great Irish synopsis of all that, just 3 words: Parish Pump Politics  

Ioannis Zabetakis

p.s. further reading

Swimming ban at Dublin's Merrion strand due to poor water quality

 

 

 

NHS England on omega3

these 3 photos are from section 4.11, as per below.

According to NHS England:Omega-3 fatty acid compounds are essential fatty acids which can be obtained from the diet.
 They are licensed for adjunct to diet and statin in hypertriglyceridemia; 
adjunct to diet in type IV hypertriglyceridemia and adjunct in secondary prevention in those who have had a myocardial infarction in the preceding three months.  
Omega-3 fatty acid compounds are available as capsules under the brand name Omacor or Prestylonand can be bought over the counter. There is no good quality data for their use in prevention of dementia, pre-menstrual syndrome, attention-deficit hyperactivity disorder (ADHD), atrial fibrillation, eczema, osteoarthritis or age-related macular degeneration. The
OFFICIAL33inclusion of Omega-3 fatty acid compounds within this consultation is due to there being a lack of robust evidence for clinical effectiveness. 

you have hear the relevant to omega-3 section here (section 4.11, page 32).

Further reading
1. Association Between omega-3 Fatty Acid Supplementation and Risk of Major Cardiovascular Disease Events: A Systematic Review and Meta-Analysis 
(2012)

2. Inflammation and Cardiovascular Disease: Are Marine Phospholipids the Answer?


 (2020)
 

Science and "Conflict of Interest"

this post is about Science and the short paragraph at the end of all scientific publications titled "Conflict of Interest".

Have you seen these paragraphs in papers like?

1. Optimal Nutritional Status for a Well-Functioning Immune System Is an Important Factor to Protect against Viral Infections
  
Conflicts of Interest

P.C.C. has research funding from BASF AS and Bayer Consumer Care; acts as an advisor/consultant to BASF AS, DSM, Cargill, Smartfish, Nutrileads, Bayer Consumer Care, and Pfizer (now GSK) Consumer Healthcare; has received reimbursement for travel and/or speaking from Danone, Fresenius Kabi, Baxter, Pfizer (now GSK) Consumer Healthcare, Abbott, Smartfish, Biogredia and the California Walnut Commission; and is President and member of the Board of Directors of the European Branch of the International Life Sciences Institute. A.C.C. has received research funding from Bayer Consumer Care and travel reimbursement from DSM. M.E. acts as an advisor for DSM and received travel reimbursement from DSM. He is member of the Scientific Board of PM International and President of the Gesellschaft für angewandte Vitaminforschung. A.F.G. has received research funding from Bayer Consumer Care and has acted as an advisor/consultant for and has received reimbursement for travel and/or speaking from Bayer Consumer Care.

2. Rosuvastatin to Prevent Vascular Events in Men and Women with Elevated C-Reactive Protein

Supported by AstraZeneca.

Dr. Ridker reports receiving grant support from AstraZeneca, Novartis, Merck, Abbott, Roche, and Sanofi-Aventis; consulting fees or lecture fees or both from AstraZeneca, Novartis, Merck, Merck–Schering-Plough, Sanofi-Aventis, Isis, Dade Behring, and Vascular Biogenics; and is listed as a coinventor on patents held by Brigham and Women's Hospital that relate to the use of inflammatory biomarkers in cardiovascular disease, including the use of high-sensitivity C-reactive protein in the evaluation of patients' risk of cardiovascular disease. These patents have been licensed to Dade Behring and AstraZeneca. Dr. Fonseca reports receiving research grants, lecture fees, and consulting fees from AstraZeneca, Pfizer, Schering-Plough, Sanofi-Aventis, and Merck; and Dr. Genest, lecture fees from AstraZeneca, Schering-Plough, Merck–Schering-Plough, Pfizer, Novartis, and Sanofi-Aventis and consulting fees from AstraZeneca, Merck, Merck Frosst, Schering-Plough, Pfizer, Novartis, Resverlogix, and Sanofi-Aventis. Dr. Gotto reports receiving consulting fees from Dupont, Novartis, Aegerion, Arisaph, Kowa, Merck, Merck–Schering-Plough, Pfizer, Genentech, Martek, and Reliant; serving as an expert witness; and receiving publication royalties. Dr. Kastelein reports receiving grant support from AstraZeneca, Pfizer, Roche, Novartis, Merck, Merck–Schering-Plough, Isis, Genzyme, and Sanofi-Aventis; lecture fees from AstraZeneca, GlaxoSmithKline, Pfizer, Novartis, Merck–Schering-Plough, Roche, Isis, and Boehringer Ingelheim; and consulting fees from AstraZeneca, Abbott, Pfizer, Isis, Genzyme, Roche, Novartis, Merck, Merck–Schering-Plough, and Sanofi-Aventis. Dr. Koenig reports receiving grant support from AstraZeneca, Roche, Anthera, Dade Behring and GlaxoSmithKline; lecture fees from AstraZeneca, Pfizer, Novartis, GlaxoSmithKline, DiaDexus, Roche, and Boehringer Ingelheim; and consulting fees from GlaxoSmithKline, Medlogix, Anthera, and Roche. Dr. Libby reports receiving lecture fees from Pfizer and lecture or consulting fees from AstraZeneca, Bristol-Myers Squibb, GlaxoSmithKline, Merck, Pfizer, Sanofi-Aventis, VIA Pharmaceuticals, Interleukin Genetics, Kowa Research Institute, Novartis, and Merck–Schering-Plough. Dr. Lorenzatti reports receiving grant support, lecture fees, and consulting fees from AstraZeneca, Takeda, and Novartis; Dr. Nordestgaard, lecture fees from AstraZeneca, Sanofi-Aventis, Pfizer, Boehringer Ingelheim, and Merck and consulting fees from AstraZeneca and BG Medicine; Dr. Shepherd, lecture fees from AstraZeneca, Pfizer, and Merck and consulting fees from AstraZeneca, Merck, Roche, GlaxoSmithKline, Pfizer, Nicox, and Oxford Biosciences; and Dr. Glynn, grant support from AstraZeneca and Bristol-Myers Squibb. No other potential conflict of interest relevant to this article was reported.

= = =

let's talk about Science now:

when the authors themselves explicitly declare these conflicts of interest, could such declarations raise any doubts ?

Let's talk about the data, then.

In relation to CVDs, our team has been studying this field for 20 years.

Our views on omega-3 and statins are presented below in this review paper

 Inflammation and Cardiovascular Disease: Are Marine Phospholipids the Answer?

and this book (chapter 6, on statins may be of some interest)

The Impact of Nutrition and Statins on Cardiovascular Diseases

To conclude: omega-3 and statins do not lower cardiovascular risk. The cholesterol hypothesis can not explain CVDs morbidity; inflammation is the killer, as explained few days ago...

COVID-19: The Inflammation Link and the Role of Nutrition in Potential Mitigation

 

 

Μεσογειακή διατροφή κατά του ιού

Εφημερίδα: Καθημερινή, 23.5.2020

new paper from our team: "COVID-19: The Inflammation Link and the Role of Nutrition in Potential Mitigation "

COVID-19: The Inflammation Link and the Role of Nutrition in Potential Mitigation 

Nutrients 2020, 12(5), 1466; https://doi.org/10.3390/nu12051466 (registering DOI)

 

A reepresentation of the inflammatory molecules involved in infection and how certain dietary components may interact with them. Included are the cytokines, growth factors, and other chemokines that promote the onset and progression of inflammatory manifestations, dysregulation of the immune system, and a diseased state due to the effects of several unmodifiable and modifiable risk factors. Targeted drug treatments and/or healthy lifestyle choices such as balanced diets and physical activity can counterbalance such inflammatory manifestations towards homeostasis.

 

 

by Ioannis Zabetakis ^1,2,*, Ronan Lordan ^2,3, Catherine Norton ^2,4 and Alexandros Tsoupras ^1,2

¹

Department of Biological Sciences, University of Limerick, Limerick V94 T9PX, Ireland

²

Health Research Institute, University of Limerick, Limerick V94 T9PX, Ireland

³

Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104-5158, USA

⁴

Department of Physical Education and Sport Sciences, University of Limerick, Limerick V94 T9PX, Ireland

^*

Author to whom correspondence should be addressed.

Received: 22 April 2020 / Revised: 11 May 2020 / Accepted: 17 May 2020 / Published: 19 May 2020

 

Abstract

The novel coronavirus disease (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has engulfed the world, affecting more than 180 countries. As a result, there has been considerable economic distress globally and a significant loss of life. Sadly, the vulnerable and immunocompromised in our societies seem to be more susceptible to severe COVID-19 complications. 

Global public health bodies and governments have ignited strategies and issued advisories on various handwashing and hygiene guidelines, social distancing strategies, and, in the most extreme cases, some countries have adopted “stay in place” or lockdown protocols to prevent COVID-19 spread. Notably, there are several significant risk factors for severe COVID-19 infection. 

These include the presence of poor nutritional status and pre-existing noncommunicable diseases (NCDs) such as diabetes mellitus, chronic lung diseases, cardiovascular diseases (CVD), obesity, and various other diseases that render the patient immunocompromised. 

These diseases are characterized by systemic inflammation, which may be a common feature of these NCDs, affecting patient outcomes against COVID-19. 

In this review, we discuss some of the anti-inflammatory therapies that are currently under investigation intended to dampen the cytokine storm of severe COVID-19 infections. Furthermore, nutritional status and the role of diet and lifestyle is considered, as it is known to affect patient outcomes in other severe infections and may play a role in COVID-19 infection. 

This review speculates the importance of nutrition as a mitigation strategy to support immune function amid the COVID-19 pandemic, identifying food groups and key nutrients of importance that may affect the outcomes of respiratory infections.

 

 View Full-Text

 

Keywords: coronavirus; COVID-19; SARS-CoV-2; inflammation; infection; anti-inflammatory; nutrition; vitamin C; vitamin D; zinc; noncommunicable diseases

 

The background story of this paper is here. 

 

 

covid-19, NCDs, and food: the missing link?

Last March 30th, I sent an email with a couple of lines to my colleagues, Catherine, Alexandros and Ronan. 

It was a short email: the title of this blogpost with an attached file. The file contained a draft paper, two pages long, titled "Covid-19, Food and Chronic Diseases: the inflammation link".

We have been working on inflammation for a number of years (my first paper on PAF, atherosclerosis and food was published in 2000; it was on ....fried cod; fish and chips was the inspiration - I was lecturing in Leeds then :).

Fast forward to 2018, we (Ronan, Alex) wrote a paper on inflammation and CVDs with a rather radical title. Today, 2 years and few days later, that paper has few downloads and citations. We knew that we were after sth valid...

What about covid-19 though?

On 23rd March, the World Health Organisation (WHO) issued guidelines on the link between COVID-19 and non-communicable diseases (NCDs).

 

The link between non-communicable diseases (NCDs) and COVID-19

It was then when I whispered to myself : hey Yannis, hang on. What's going on here? 

All the discussions  I had with Alex and Ronan at Scholars in UL, with Nikola Tesla watching us, came to mind. So many cappuccinos for me, teas for Ronan and mochas for Alex discussing cardiovascular diseases, platelet aggregation, statins and their non-impact on cardiovascular risk, the vested interests on statins and omega3, cancer, mental disorders, neutral lipids, polar lipids, med diet, food pyramids, obesity etc etc...

And Nikola watching us all the time...

Sometimes, as we were leaving Scholars, I was smiling to Nikola...

That March 30th email was transformed to a review paper that was accepted yesterday and should appear very soon in Nutrients.    

 

"COVID-19: The Inflammation Link and the Role of Nutrition in Potential Mitigation"

 

Received: 22 April 2020; Accepted: 17 May 2020; Published: date

The purpose of this blogpost is double:

a. to thank Catherine, Alexandros and Ronan for all their collective efforts to produce a strong paper in only 23 days under #lockdown and 

b. to remind my spititual children (ie my students) that in Science, there is no parthenogenesis. 

If you work hard on something, good ideas will come.

Ioannis