COVID-19 Update: Mapping the Immune Response & Vitamin C
The world has changed dramatically in the last few weeks since the WHO declared the current coronavirus outbreak as a pandemic on 11th March. In just a matter of weeks, life as we normally know it has been replaced with extensive social distancing and hygiene measures aimed to slow the spread. And as case numbers have risen, so have population levels of worry, fear and anxiety. Since it is a novel virus and there is still a lot that is not yet understood, it is easy to start to feel like everything is out of our control and we are defenceless against whatever life may throw at us.
We are not defenceless and taking positive steps to nurture our health is something which we can take control of in these unsettling times. Our earlier article Supporting you with a better understanding of coronavirus and empowering you with information on immune health provides an overview on coronavirus and key immune supporting nutrients which may be beneficial to include in your diet to support your overall health. It is important to state that there are currently no known natural treatments to prevent or cure Covid-19, there simply isn’t enough evidence yet. What we do have however is lots of information on how you can take action to support your immune and overall health and we will continue to keep you updated on this.
In this article we take a closer look at a new study which has for the first time mapped the immune response of a patient with non-severe COVID-19 and latest research on vitamin C.
Mapping the immune response in COVID-19
The truth is that whilst there is still a lot we don’t yet know about this novel virus and the disease it causes (COVID-19), we are not defenceless. In a recent study published on March 16th in Nature Medicine, Melbourne researchers for the first time provided a detailed report of the broad immune system responses elicited in a patient with a non-severe case of COVID-19.1,2 The patient had mild to moderate symptoms requiring hospital treatment and made a full recovery. During the course of the study, the researchers gained a comprehensive understanding of how the patient’s immune system responded to the virus. They wrote,
“We report the kinetics of immune responses in relation to clinical and virological features of a patient with mild-to-moderate coronavirus disease 2019 (COVID-19) that required hospitalization. Increased antibody-secreting cells (ASCs), follicular helper T cells (TFH cells), activated CD4+ T cells and CD8+ T cells and immunoglobulin M (IgM) and IgG antibodies that bound the COVID-19-causing coronavirus SARS-CoV-2 were detected in blood before symptomatic recovery. These immunological changes persisted for at least 7 d following full resolution of symptoms.”
Here, the Melbourne researchers have mapped a broad spectrum of immune response in a non-severe case of COVID-19 and they hope this study can now be replicated in larger numbers of people with different disease severities to aid further understanding of COVID-19 and support the development of intervention strategies.
Read more about this study from the Melbourne researchers here.
Latest research on vitamin C
Much has been written and talked about vitamin C in the last few months. Vitamin C is a water-soluble nutrient that must be regularly supplied in the diet. Primates (including humans) are in a very small minority of mammals that can’t produce their own vitamin C, hence why it’s important to regularly consume rich dietary sources. In a 2017 review on Vitamin C & Infections, published in Nutrients, the authors commented, “vitamin C levels in white blood cells are tens of times higher than in plasma, which may indicate functional roles of the vitamin in these immune system cells. Vitamin C has been shown to affect the functions of phagocytes, production of interferon, replication of viruses, and maturation of T-lymphocytes, etc. in laboratory studies.”3 In a later 2019 meta-analysis published in Nutrients involving 18 controlled trials and 2004 patients, researchers evaluated the effects of vitamin C on practical outcomes in an intensive care unit (length of stay and duration of mechanical ventilation). They found that vitamin C shortened the length of stay in the intensive care unit and shortened the duration of mechanical ventilation.4
Vitamin C has therefore become of particular scientific interest recently for its possible use in patients with Covid-19:
• Trials are underway to investigate IV vitamin C in Covid-19
Research is now underway in China to investigate the potential role of high dose intravenous vitamin C in patients with COVID-19. One study is a randomised interventional clinical trial involving 140 participants which started on the 14th February this year. The researchers hypothesise that vitamin C infusion can help to improve the prognosis of patients with the 2019 new coronavirus (2019-nCoV) infected pneumonia, namely SARI (Severe Acute Respiratory Infection) and thus aim to study the clinical efficacy and safety of vitamin C for the clinical management of SARI. The estimated completion date for the study is 30 September 2020.5
• Medical team in New York reported to be using IV vitamin C in COVID-19
According to the New York Post, medical teams at Northwell Health have recently been using intravenous vitamin C (1500 mg / 3 - 4 times daily) as a treatment for COVID-19. Dr Andrew Weber, pulmonologist and critical care specialist at Northwell Health (Long Island, NY) commented,
“The vitamin C is administered in addition to medicines such as the anti-malaria drug hydroxychloroquinone, the antibiotic azithromycin, various biologics and blood thinners.”
“The patients who received vitamin C did significantly better than those who did not get vitamin C. It helps a tremendous amount, but it is not highlighted because it’s not a sexy drug.”
“Vitamin C levels in coronavirus patients drop dramatically when they suffer sepsis, an inflammatory response that occurs when their bodies overreact to the infection. It makes all the sense in the world to try and maintain this level of vitamin C.”6
Whilst this newest information has a way to go before it can demonstrate evidence of clinical efficacy of vitamin C against COVID-19, it is promising and encouraging to know that it is being considered and investigated as a potential therapeutic option.
In the meantime, it certainly seems prudent to ensure you are regularly getting optimal levels of vitamin C in your diet, to support immune health, stress resilience and health overall. Rich dietary sources of vitamin C include brightly coloured vegetables and fruits, in particular bell peppers, broccoli, spinach, asparagus, berries, kiwi fruit, citrus fruit, watercress and pineapple.
Information and updates
If you are at all concerned about coronavirus symptoms, it’s vital you phone your GP or call 111.
You can access daily updates from Public Health England and the UK Department of Health and Social Care.
1. Thevarajan I, Nguyen O et al. Breadth of concomitant immune responses prior to patient recovery: a case report of non-severe Covid-19. Nature Medicine 16 March 2020
3. Hemila H. Vitamin C and Infections. Nutrients 2017 Apr; 9(4): 339
4. Hemila H & Chalker E. Vitamin C can shorten the length of stay in the ICU: A meta-analysis. Nutrients 2019 11 (4)
5. ZhiYong Peng. Vitamin C infusion for the treatment of severe 2019-nCoV Infected Pneumonia. Clinical Trials.gov February 11, 2020
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