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 Table of Contents  
Year : 2022  |  Volume : 12  |  Issue : 1  |  Page : 1-3

Do dietary supplements help in boosting the immunity of individuals during the COVID-19 outbreak?

1 Unit of Biochemistry, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur, Malaysia
2 Unit of Pharmacology, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur, Malaysia

Date of Submission30-Oct-2021
Date of Decision05-Nov-2021
Date of Acceptance10-Nov-2021
Date of Web Publication31-Dec-2021

Correspondence Address:
Yasmin Anum Mohd Yusof
Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kem Perdana Sungai Besi, Kuala Lumpur 57000
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/aihb.aihb_157_21

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How to cite this article:
Yusof YA, Haque M. Do dietary supplements help in boosting the immunity of individuals during the COVID-19 outbreak?. Adv Hum Biol 2022;12:1-3

How to cite this URL:
Yusof YA, Haque M. Do dietary supplements help in boosting the immunity of individuals during the COVID-19 outbreak?. Adv Hum Biol [serial online] 2022 [cited 2022 May 23];12:1-3. Available from: https://www.aihbonline.com/text.asp?2022/12/1/1/334568

The recent pandemic COVID-19 has hit hard on the life of a large population throughout the world. The most recent death toll due to COVID-19 infection globally is estimated to be nearing 5 million.[1] People would do whatever they can to prevent being infected with the COVID-19, and consumption of health supplements has been one of the prophylactic measures taken. In a pandemic, the accessibility and availability of preventive substances are crucial. Health supplement sales and consumption have increased dramatically in the wake of COVID-19 from the end of 2019 right through 2021. The wealth of information on the benefit of health supplements against the coronavirus available on media has increased the sales of health supplements globally.[2],[3] Hamulka et al. explored through Google searches and conducted Google Trends analysis in March 2020 to investigate the association between the use of health supplements during the COVID-19 pandemic.[4] They found out that the interests amongst individuals on health supplements were positively correlated with the COVID-19 outbreak. Accessories of interest include Vitamins C and D, zinc, garlic, ginger and turmeric. However, there is contradictory evidence regarding the health benefits of health supplements in preventing and treating COVID-19. Some scientific shreds of evidence on immune-boosting and antiviral properties of health supplements for the treatment of COVID-19 are not convincing.[2],[5]

An online cross-sectional survey was carried out amongst 1678 individuals from four countries in January 2021: Asia (n = 139), America (n = 507), Europe (n = 292) and Turkey (n = 760). The study showed that dietary supplement use increased during the pandemic in all regions before and during the pandemic: Asia (29.5% and 71.9%), America (40.6% and 75.7%), Europe (30.8% and 68.7%) and Turkey (21.3% and 62.2%), respectively. Vitamin C (74.7%), Vitamin D (58.2%) and multivitamins (34.2%), zinc (19.7%), fish oil (17.9%), probiotics (13.4%) and propolis (11.1%) are the most commonly used dietary supplements in all regions.[6]

An app-based community survey conducted in the UK cohort by Louca et al. found that taking probiotics, omega-3 fatty acids, multivitamins or Vitamin D had a lower risk of severe acute respiratory syndrome coronavirus 2 infection by 14%, 12%, 13% and 9%, respectively.[7]

The health benefits of zinc were shown amongst hospitalised patients in several studies.[8],[9],[10] Some reports showed lower zinc levels in non-surviving and surviving COVID-19 patients than their healthy counterparts.[11],[12],[13] A study in Japan showed an association between a low level of serum zinc and the severity of the COVID-19 disease amongst 62 patients.[14] However, it is essential to note that excessive consumption or a high zinc intake may cause side effects such as lethargy, copper deficiency and severe iron-deficiency anaemia.[15] The recommended daily allowance for zinc intake is 40 mg which is considered the tolerable upper intake level and is unlikely to induce toxicity.[16]

The emerging role of Vitamin C in preventing and treating COVID-19 has been investigated extensively and excellently reviewed by Carr and Rowe.[17] Vitamin C has anti-inflammatory and antioxidant activities, which can potentially counteract 'cytokine storm' or the elevated inflammatory markers found in COVID-19 patients.[18] Vitamin C works best when given intravenously to COVID-19 patients who showed decreased serum levels of interleukin-6.[19]

Increased interest in fat-soluble vitamins, including Vitamin D3, is seen during the COVID-19 pandemic.[20],[21],[22] There is a surge in Vitamin D3 amongst healthy individuals and COVID-19 patients. Vitamin D has been associated with lowering the viral replication rates, suppressing inflammation and increasing levels of T-regulatory cells.[23] Similar to the studies on zinc, it was also shown that patients with severe COVID-19 disease also have low Vitamin D levels.[24],[25],[26] COVID-19 patients hospitalised for mild-to-severe symptoms showed faster recovery from cough and gustatory sensory loss when given an oral Vitamin D of 5000 IU daily for 2 weeks.[24]

A study by Demir et al. amongst hospitalised COVID-19 and non-COVID-19 patients found that a deficient level of Vitamin D was more amongst COVID-19 patients (44% with <10 ng/ml) versus non-COVID-19 patients (31%). COVID-19 patients with a high level of Vitamin D (>30 ng/ml) had significantly low C-reactive protein levels, the number of affected lung segments and shorter hospital stays. The study shows that elevated levels of Vitamin D had a protective effect amongst COVID-19 patients.[25] Contradictively, high-dose parenteral Vitamin D3 administration in critical COVID-19 patients with Vitamin D deficiency during admission to the ICU did not reduce the need for intubation, length of hospital stay and in-hospital mortality.[26]

Hypomagnesaemia was also observed amongst C0VID-19 patients. Out of 300 hospitalised patients in France, 48% had abnormally low magnesium levels (<0.75 mmol/L).[27] In addition, an observational study in Iran amongst 459 patients with COVID-19 found that those who died from the disease had lower magnesium levels than those who survived.[28] Low magnesium status is associated with decreased immunity, increased oxidative stress and increased inflammation.[29]

Zinc is a cofactor of many enzymes involved in the metabolism of our body. Its deficiency is associated with elevated levels of pro-inflammatory mediators.[8],[30],[31] A separate observational study in Spain and India found abnormally low zinc levels (<50 mcg/dL) in hospitalised COVID-19 patients. The patients had more severe disease at admission, took longer to recover and had higher mortality rates were associated with low zinc levels.[32],[33]

Interestingly, a few papers published recently have shown the benefit of health supplement black cumin seed, Nigella sativa [the Arabic name is habbatussauda], as adjuvant therapy in combination with honey or zinc along with conventional drugs to manage the patients with COVID-19.[34],[35] Docking studies conducted by Ahmad et al. on the mode of action of one chief constituent in N. sativa, dithymoquinone (DTQ), against S protein angiotensin-converting enzyme 2 receptor of COVID-19 revealed that DTQ exhibited a high affinity for the selected target.[36] They have suggested that if the docking experiment is validated in wet-lab experiments, N. sativa could be used to treat COVID-19 and possibly serve as a lead compound in the future for the development of more effective natural antivirals against COVID-19.

Dietary supplements may protect against infection from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), although scientific pieces of evidence to support such claims are lacking. Nevertheless, sales of nutritional supplements increased dramatically during the COVID-19 pandemic because people hoped that these products might provide some form of protection from SARS-CoV-2 infection and may help reduce the severity of the disease when they are infected.

In conclusion, since there are strong indications to show the association between low COVID-19 infection and less severity of the disease with dietary supplements, more research on this area appears warranted.


The authors and declaration report no conflicts of interest for this work because they have no affiliation or involvement with any organisation financially or association of any entity directly or indirectly with the subject matter or materials that this article presents. This includes expert testimony, honoraria, stocks or options ownership, employment, royalties, grants or patents received or pending.

Financial support and sponsorship

This study was done through self-funding.

Conflicts of interest

There are no conflicts of interest.

  References Top

World Health Organization. WHO Coronavirus (COVID-19) Dashboard; 2021. Available from: https://covid19.who.int/. [Last accessed on 2021 Oct 25].  Back to cited text no. 1
Adams KK, Baker WL, Sobieraj DM. Myth busters: Dietary supplements and COVID-19. Ann Pharmacother 2020;54:820-6.  Back to cited text no. 2
de Faria Coelho-Ravagnani C, Corgosinho FC, Sanches FF, Prado CM, Laviano A, Mota JF. Dietary recommendations during the COVID-19 pandemic. Nutr Rev 2021;79:382-93.  Back to cited text no. 3
Hamulka J, Jeruszka-Bielak M, Górnicka M, Drywień ME, Zielinska-Pukos MA. Dietary supplements during COVID-19 outbreak. Results of Google trends analysis supported by PLifeCOVID-19 online studies. Nutrients 2020;13:54.  Back to cited text no. 4
Calder PC, Carr AC, Gombart AF, Eggersdorfer M. Optimal nutritional status for a well-functioning immune system is an important factor to protect against viral infections. Nutrients 2020;12:1181.  Back to cited text no. 5
Aysin E, Urhan M. Dramatic increase in dietary supplement use during COVID-19. Curr Dev Nutr 2021;5 Suppl 2:207.  Back to cited text no. 6
Louca P, Murray B, Klaser K, Graham MS, Mazidi M, Leeming ER, et al. Modest effects of dietary supplements during the COVID-19 pandemic: Insights from 445 850 users of the COVID-19 symptom study app. BMJ Nutr Prev Health 2021;4:149-57.  Back to cited text no. 7
Wessels I, Rolles B, Rink L. The potential impact of zinc supplementation on COVID-19 pathogenesis. Front Immunol 2020;11:1712.  Back to cited text no. 8
Thomas S, Patel D, Bittel B, Wolski K, Wang Q, Kumar A, et al. Effect of high-dose zinc and ascorbic acid supplementation vs. usual care on symptom length and reduction among ambulatory patients with SARS-CoV-2 infection: The COVID A to Z randomized clinical trial. JAMA Netw Open 2021;4:e210369.  Back to cited text no. 9
Samad N, Sodunke TE, Abubakar AR, Jahan I, Sharma P, Islam S, et al. The implications of zinc therapy in combating the COVID-19 global pandemic. J Inflamm Res 2021;14:527-50.  Back to cited text no. 10
Heller RA, Sun Q, Hackler J, Seelig J, Seibert L, Cherkezov A, et al. Prediction of survival odds in COVID-19 by zinc, age and selenoprotein P as composite biomarker. Redox Biol 2021;38:101764.  Back to cited text no. 11
Razzaque MS. COVID-19 pandemic: Can zinc supplementation provide an additional shield against the infection? Comput Struct Biotechnol J 2021;19:1371-8.  Back to cited text no. 12
Joachimiak MP. Zinc against COVID-19? Symptom surveillance and deficiency risk groups. PLoS Negl Trop Dis 2021;15:e0008895.  Back to cited text no. 13
Yasui Y, Yasui H, Suzuki K, Saitou T, Yamamoto Y, Ishizaka T, et al. Analysis of the predictive factors for a critical illness of COVID-19 during treatment – Relationship between serum zinc level and critical illness of COVID-19. Int J Infect Dis 2020;100:230-6.  Back to cited text no. 14
Agnew UM, Slesinger TL. Zinc toxicity. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2021. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554548/. [Last accessed on 2021 Oct 30; Last updated on 2021 Apr 28].  Back to cited text no. 15
Razzaque MS. COVID-19 pandemic: Can maintaining optimal zinc balance enhance host resistance? Tohoku J Exp Med 2020;251:175-81.  Back to cited text no. 16
Carr AC, Rowe S. The emerging role of vitamin C in the prevention and treatment of COVID-19. Nutrients 2020;12:3286.  Back to cited text no. 17
Kashiouris MG, L'Heureux M, Cable CA, Fisher BJ, Leichtle SW, Fowler AA. The emerging role of vitamin C as a treatment for sepsis. Nutrients 2020;12:292.  Back to cited text no. 18
Zhang J, Rao X, Li Y, Zhu Y, Liu F, Guo G, et al. Pilot trial of high-dose vitamin C in critically ill COVID-19 patients. Ann Intensive Care 2021;11:5.  Back to cited text no. 19
Samad N, Dutta S, Sodunke TE, Fairuz A, Sapkota A, Miftah ZF, et al. Fat-soluble vitamins and the current global pandemic of COVID-19: Evidence-based efficacy from literature review. J Inflamm Res 2021;14:2091-110.  Back to cited text no. 20
Kumar R, Rathi H, Haq A, Wimalawansa SJ, Sharma A. Putative roles of vitamin D in modulating immune response and immunopathology associated with COVID-19. Virus Res 2021;292:198235.  Back to cited text no. 21
Peng MY, Liu WC, Zheng JQ, Lu CL, Hou YC, Zheng CM, et al. Immunological aspects of SARS-CoV-2 infection and the putative beneficial role of vitamin-D. Int J Mol Sci 2021;22:5251.  Back to cited text no. 22
Fakhoury HM, Kvietys PR, Shakir I, Shams H, Grant WB, Alkattan K. Lung-centric inflammation of COVID-19: Potential modulation by vitamin D. Nutrients 2021;13:2216.  Back to cited text no. 23
Sabico S, Enani MA, Sheshah E, Aljohani NJ, Aldisi DA, Alotaibi NH, et al. Effects of a 2-week 5000 IU versus 1000 IU vitamin D3 supplementation on recovery of symptoms in patients with mild to moderate COVID-19: A randomized clinical trial. Nutrients 2021;13:2170.  Back to cited text no. 24
Demir M, Demir F, Aygun H. Vitamin D deficiency is associated with COVID-19 positivity and severity of the disease. J Med Virol 2021;93:2992-9.  Back to cited text no. 25
Güven M, Gültekin H. The effect of high-dose parenteral vitamin D3 on COVID-19-related inhospital mortality in critical COVID-19 patients during intensive care unit admission: An observational cohort study. Eur J Clin Nutr 2021;75:1383-8.  Back to cited text no. 26
Quilliot D, Bonsack O, Jaussaud R, Mazur A. Dysmagnesemia in COVID-19 cohort patients: Prevalence and associated factors. Magnes Res 2020;33:114-22.  Back to cited text no. 27
Alamdari NM, Afaghi S, Rahimi FS, Tarki FE, Tavana S, Zali A, et al. Mortality risk factors among hospitalized COVID-19 patients in a major referral center in Iran. Tohoku J Exp Med 2020;252:73-84.  Back to cited text no. 28
Maier JA, Castiglioni S, Locatelli L, Zocchi M, Mazur A. Magnesium and inflammation: Advances and perspectives. Semin Cell Dev Biol 2021;115:37-44.  Back to cited text no. 29
Olechnowicz J, Tinkov A, Skalny A, Suliburska J. Zinc status is associated with inflammation, oxidative stress, lipid, and glucose metabolism. J Physiol Sci 2018;68:19-31.  Back to cited text no. 30
Gammoh NZ, Rink L. Zinc in infection and inflammation. Nutrients 2017;9:624.  Back to cited text no. 31
Vogel-González M, Talló-Parra M, Herrera-Fernández V, Pérez-Vilaró G, Chillón M, Nogués X, et al. Low zinc levels at admission associates with poor clinical outcomes in SARS-CoV-2 infection. Nutrients 2021;13:562.  Back to cited text no. 32
Jothimani D, Kailasam E, Danielraj S, Nallathambi B, Ramachandran H, Sekar P, et al. COVID-19: Poor outcomes in patients with zinc deficiency. Int J Infect Dis 2020;100:343-9.  Back to cited text no. 33
Maideen NM. Prophetic medicine-nigella sativa (Black cumin seeds) – Potential herb for COVID-19? J Pharmacopuncture 2020;23:62-70.  Back to cited text no. 34
Rahman MT. Potential benefits of combination of Nigella sativa and Zn supplements to treat COVID-19. J Herb Med 2020;23:100382.  Back to cited text no. 35
Ahmad S, Abbasi HW, Shahid S, Gul S, Abbasi SW. Molecular docking, simulation and MM-PBSA studies of nigella sativa compounds: A computational quest to identify potential natural antiviral for COVID-19 treatment. J Biomol Struct Dyn 2021;39:4225-33.  Back to cited text no. 36


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