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 Table of Contents  
INVITED EDITORIAL
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
Malaysia
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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.

Disclosure

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.



 
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