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A proper foundation of immune support for the prevention and easing of COVID-19 infection has been well established and well documented over the last year or so (you can read more about our recommendations here) but with long COVID on the rise many are shifting their focus from the active infection and our initial immune defence to the lingering inflammation that lengthens the recovery and it warrants a different approach.

In Dr Samuel Yanuck’s 2020 paper (Evidence Supporting a Phased Immuno-physical Approach to COVID-19 From Prevention Through Recovery), he and the team (which includes Joseph Pizzorno, Helen Messier and Kara Fitzgerald) considered the evidence to support the different phases of COVID-19 infection and illness. Along with giving evidence-based nutrient suggestions for the key targets for support they looked at the shift from foundation level support and immune support to an approach that is based on antioxidant support and anti-inflammatory support as this can achieve a greater support in the inflammatory and recovery phases of a COVID-19 infection.

Foundation support
As well as a number of dietary and lifestyle recommendations, Dr Yanuck’s team advised a foundation of nutrients that can impact our immune system response to the infection. These include vitamin D, vitamin A, zinc, vitamin C, quercetin, fish oil and melatonin (only available through medical prescription in the UK). Many people are taking a support level of these but increasing levels during an active infection – for example, vitamin C to bowel tolerance can be very useful.

Whilst all of these nutrients work well together quercetin is lesser known but just as effective (find out more here) and additionally can actually act to facilitate the transport of zinc across lipid membranes thus improving the utilization of zinc.

Antioxidant support
The paper looked at the mechanisms behind using antioxidant support, particularly NAC and glutathione. Both are normal components of human biology but glutathione in particular seems to play a role in supporting both the immune surveillance and the antioxidant/anti-inflammatory phases of support. The paper also made a recommendation to consider dual role substances for instance quercetin as previously mentioned is a good foundation nutrient but is also a great antioxidant and anti-inflammatory too.

Escalating inflammation
A characteristic of COVID-19 infections for some is a rise in inflammation that occurs as the disease progresses and this is where the significant proportion of the worse cases occur. If this occurs it is sensible to shift the support from immune regulation to anti-inflammatory support. The emphasis becomes the downregulation of the NLRP3 inflammasome. Dr Yanuck and his team looked at the natural agents that could help with this phase and concluded that curcumin at a high dose as well as bromelain between meals could be particularly useful.

Support for recovery
Considering a phased approach to COVID-19 support that considers the antioxidant and anti-inflammatory support may be particularly useful for those whose illness is severe or lingering. Find out more information on our COVID-19 support resources here. 

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