COVID-19 Information

 An anti-malarial treatment that is also used for autoimmune conditions has been found helpful in many nations to reduce infection severity and mortality rate. Data from many nations shared into a centralized database has been collated and shows significant benefit from early treatment with the medication, hydroxychloroquine and zinc. (C19study.com)

A clinical trial that provided hydroxychloroquine, zinc, and azithromycin early, four days after onset of symptoms of SARS-CoV-2, found reduced severity and mortality of COVID19 with no cardiac side effects. See: Roland Derwand, Martin Scholz, Vladimir Zelenko, COVID-19 outpatients: early risk-stratified treatment with zinc plus low-dose hydroxychloroquine and azithromycin: a retrospective case series study, International Journal of Antimicrobial Agents, 2020,106214,ISSN 0924-8579,https://doi.org/10.1016/j.ijantimicag.2020.106214. (sciencedirect.com)

The Zelenko Protocol with over-the-counter self care and clinician guidance for the medication dosing is available here: Zelenko Protocol. For prevention: Zelenko COVID-19 Prophylaxis Protocol.

The malaria medication hydroxychloroquine is so commonly used for malaria that it is available over the counter in some nations. Side effects were minimal for early use studies and overall showed a 77.4% reduction in mortality rate compared to standard treatment. (hcqtrial.com)

Ivermectin is also a commonly available medication found helpful for treatment of COVID19 either early or during later stages of illness. The U.S. National Institute of Health would like larger clinical trials but has removed opposition to treating COVID19 with Ivermectin as smaller trials have shown safe and positive results. (NIH Statement on Ivermectin, Jan 14, 2021, covid19treatmentguidelines.nih.gov)  

Hydroxychloroquine has not been found helpful during late stage illness, and cardiac risk may be more likely. Always seek a medical professional for individualized treatment and diagnosis.

Zinc Ionophores include chloroquines, Ivermectin, EGCG, and quercetin.
Other foods or supplements might help in a similar way. Zinc is a trace mineral that blocks protein replication, which a virus needs.  The hydroxychloroquine and chloroquine medications are zinc ionophores - they can carry an atom of zinc into a cell, and so are EGCG supplements made from green tea or EGCG is also found in pomegranate products, or quercetin from various foods, citrus peel, or as a supplement. Zinc ionophores can act as carrier chemicals to take zinc into a cell that has more iron content than typical which includes infected or cancerous cells. Green tea and pomegranate juice were found to kill SARS-COV-2 virus in a cell culture study. 

See preprint: Antiviral activity of plant juices and green tea against SARS-CoV-2 and influenza virus in vitro. (pdf)
Also for more information, see:  Eat Food – Antivirals are found in common foods. or Bitter Taste Receptors in the lungs & Hesperidin's Decongestant Properties.

Anemia of Chronic Inflammation, Vitamin C & other Phytonutrients.
Infected cells or cancerous cells, and inflammatory conditions, can cause an increased amount of iron to be in a cell. The body tries to hide it from pathogens who also need it, and the inflammatory signals causes iron to be removed from hemoglobin and it is put it into cell storage. If the shift in iron is significant it will cause symptoms of anemia, with low hemoglobin and elevated ferritin. If it continues to more severe levels the amount of iron in cell storage can become excessive and cause toxic damage - iron oxidizes - it rusts. See: Anemia of Inflammation, IL-6, Hepcidin, Iron & Vitamin C. and  Pomegranate peel catechins – inhibition of NET formation.

T-Cell Immunity & Phytonutrients
Phytonutrients also help modulate immune response - increase T-cells or modulate the balance of inflammatory and anti-inflammatory types. T-cell immunity is proving to be potentially long lasting and helpful against the group of coronavirus. Previous sickness with SARS-1 or colds may provide some immunity against the current SARS-2 pandemic. A variety of phytonutrients and foods help increase immune response and production of T-cells. See: Foods and Phytonutrients that may benefit T-Cells.
Some phytonutrients may help fight the SARS-1 virus in other ways. See: Phytonutrients that may help against COVID19..

Social Distancing may not help indoors - face masks are more protection if risk is air-borne.
Face masks have helped prevent infection spread. Indoor air, especially with an air conditioner, can spread airborne droplets farther than respiratory droplets. Social distancing guidelines of six feet are based on respiratory droplets falling out of the air. Smaller droplets can spread farther through a room. Twenty seven customers were infected in a restaurant setting due to a person sitting near an air conditioner who hadn't begun being symptomatic yet and who tested positive a few days later. The take home point - the face masked waitstaff did not get infected. Social distancing alone was not adequate in an indoor setting.

• "Kim Woo-joo, a professor of infectious medicine at Korea University Medical School, said, "If you wear a mask, the number of bacteria that will enter your mouth will be reduced to one to three. You have to wear a mask unconditionally indoors."" 
• "The WHO officially recognized the possibility of'aerosol transmission' last month, in which virus particles smaller than droplets are mixed & transmitted in the air. If true, there is a possibility of infection just by being in the same space regardless of the presence or absence of an air conditioner or the distance between people." (Google translation from Korean,  손님 27명 감염, 직원은 멀쩡… 파주 스타벅스 미스터리 m.chosuncom)
• News story in English: Starbucks Cafe’s Covid Outbreak Spared Employees Who Wore Masks. (bloomberg)

Wastewater - defective plumbing may be a source of viral spray.
Wastewater from toilet spray (shut the lid if possible first), or a dry U trap that allows sewer fumes to rise upward into the room, may be a source of droplets that may carry live virus from fecal sources. 

• Can Coronavirus spread through defective bathroom sewage pipes?

Outbreaks have been mapped along main sewer lines in some places. The SARS-CoV-2 is also is being tracked from wastewater into larger bodies of water: 

• Early findings indicate the Covid-19 virus can exist in natural bodies of water.

Disclaimer: This information is provided for educational purposes within the guidelines of Fair Use. It is not intended to provide individual guidance. Please seek a health care provider for individualized health care guidance.  

SARS-CoV-2 virus may suppress our immune response allowing cell death leading to organ damage. 

• Immediate Treatment for Early Stage SARS-CoV-2 Infections Recommended To Be Supported Nationally Starting Now,  Authored by Ben Kaplan Singer, M.D.; Daniel Stickler, M.D.; Avery J. Knapp Jr., M.D.; with many contributing doctors.  (googledoc)
• TCM Treatment of COVID-19, based on extensive experience in Chinese hospitals, by Adam Tate, March 20, 2020, updated March 25, 2020. (medicinetraditions.com) — This document includes a description of the progressive or varying stages of COVID19 illness. It includes examples of symptoms that occur in the different stages, and herbal recipes recommended for the specific stage and symptom set. The Chinese medical professionals have found that a combination of the traditional medicinal herb mixtures and modern medicines to be more effective than either alone for treating patients with more severe COVID19 infections. 
• EVMS Critical Care COVID-19 Management Protocol, Developed and updated by Paul Marik, MD (17)
• Thiamine, vitamin B1, may be needed in greater amounts during critical illness.  work of a father with a child with special needs, making him a specialist of sorts regarding the condition. Operation Thiamine – Reducing the Need for Hospitalization of Patients with COVID-19. By Jeffrey Lubell  (googledoc)

Center for Disease Control list of possible symptoms of coronavirus: 

• “Chills, repeated shaking with chills, muscle pain, headache, sore throat and a loss of taste or smell. [...] The CDC previously listed fever, cough and shortness of breath [or difficulty breathing] as symptoms.” 
• “Coronavirus patients can experience a diversity of issues – from mild symptoms to severe illness. These symptoms generally appear 2-14 days after exposure to the virus. Patients may be most infectious in the days before they began showing symptoms, studies show.” (usatoday) 

Digestive symptoms may occur for as many as half of patients who have symptoms with coronavirus infection. Lack of appetite was common, 78%, diarrhea, 34%, vomiting, ~4%, and/or abdominal pain, 2%. (6) 

• “Although most patients presented to the hospital with fever or respiratory symptoms, we found that 103 patients (50.5%) reported a digestive symptom, including lack of appetite (81 [78.6%] cases), diarrhea (35 [34%] cases), vomiting (4 [3.9%] cases), and abdominal pain (2 [1.9%] cases).” (6) 

Many people (~18% in one study) have no symptoms and yet are able to spread the infection. (7) They may have some T-cell immunity against other coronavirus strains of the common cold or even an earlier SARS-CoV-2 infection. Genetic variation in the virus has been found in one case of suspected reinfection (rather than chronic infection that never quite fully healed).  See:  First Case of COVID-19 Reinfection Confirmed — Viral sequence disparity indicates Hong Kong case not simply prolonged infection. (medpagetoday)  This may be good news - the second case was asymptomatic - possibly a T-cell response, and possibly the second strain is a milder virus. It is in a pathogen's survival interest to not kill its host, instead to remain part of the normal microbiome which does include virus. Some help us by preventing inflammation. (Small Molecules inhibiting NF-kB Pathway)

A genetic difference may also be causing the lack of apparent symptoms while lung damage is still continuing and infection of others is still possible - sgp130Fc - surface marker proteins may not be being produced that show the virus is replicating instead of normal protein production - roughly, it is complicated. See: Artemisinin, arteannuin-B, sgp130Fc, and COVID-19.

Skin rashes or toe discoloration that may resemble frostbite may be symptoms in people or children who don’t have any other symptoms of COVID19. (13) (Photo example, COVID Toes)The infection and immune/inflammatory response can increase use of nutrients and deficiency can occur due to the sudden use. “Both vitamin C and thiamine deficiencies are common in septic patients [6,7]” (8)

Low vitamin D levels is being found to be more common among people with symptoms versus asymptomatic in people who test positive for SARS-CoV-2 (16)

• Moderate/RDA amounts vit D before infection~beneficial for reducing risk of respiratory infection, megadose taken after an infection was not found significantly helpful. (ref)

The recommendations by a medical group, (EVMS, listed at the top of this section) are for a moderate-high dose - higher than the RDA but not in the megadose range. (17)

More recent work has linked low levels of several important nutrients to more severe COVID-19 illness. Vitamins A, B1, C, D, E - all with potential benefits as anti-viral, anti-inflammatory antioxidants, and or as immunomodulators - which means they help our immune function have a moderate, appropriate response instead of an under or over active response. Cytokine storm or sepsis shock are two phrases used to describe an dangerously overactive response which is seen in some cases of critical Covid-19 illness. Extra vitamin C and other antioxidants such as vitamin E can help the body to detoxify the inflammatory oxidative stress chemicals. See: Could Vitamins Help in the Fight Against COVID-19? (mdpi)

Reference List & some additional text (googledoc) 

 The phrase Long Covid is being used by some, to describe patients with lingering symptoms following recovery from the worst of the respiratory symptoms of Covid-19. Autoimmune like and other symptoms unique to Covid-19 include a wide range of troublesome symptoms that have left many people disabled compared to their previous normal health. Patient volunteers have collected a large database about the symptoms and people responding to their voluntary survey. While it isn't a randomized study, it is information about a new condition from the patients experiencing the problem.

• What Does COVID-19 Recovery Actually Look Like? An Analysis of the Prolonged COVID-19 Symptoms Survey by Patient-Led Research Team, May 2, 2020,(Document)

Allergic type of over reaction may also be involved in the symptoms of COVID-19 illness or the chronic stage. An over the counter antihistamine medication such as Claritin/loratidine taken daily is safe but do not exceed as it can be damaging to the liver and more is not needed. It is a very tiny tablet, taken once a day .Talk to your health care provider about your health care plan, and pharmacists at the drug store can answer questions about over the counter medications in addition to prescription medications..

Chronic anemia of inflammation, iron, and an anti-malarial called artemisinin.
Chronic anemia of inflammation or infection may be involved in post-recovery symptoms also. Pathogens need iron and the body has a mechanism that removes iron from hemoglobin where it is more easily accessible and puts into cellular storage. If this process continues excessively the person may have too little hemoglobin to carry enough oxygen for normal activity. Feeling out of breath with a racing heart rate might occur with something as easy as walking around a home or going up a flight of stairs. See: Iron and anemia of chronic inflammation.

My own experience as a patient with untested CoV like illness, Feb/March 2020.
My Why?  - why are you writing this? is because I am also a patient, although, untested. I was sick in early March when testing was only available if contact with someone from China. I was quite sick but with my various supplements and nutrient dense foods already in my daily routine, plus an extra orange with the white pith left on, and and extra vitamin C, 100 mg chewable tablet or two, I was able to get better on my own. More about my own symptoms and nutrients are here: Treatment of Cure?.
After I had recovered from the breathless non-productive cough stage, I did have lingering exhaustion and a racing heart rate climbing a flight of stairs. I suspected chronic anemia of infecttion and added the herbal extract artemisinin to my routine, one iam and pm. The medication is available over the counter from herbal supply companies and is used for malaria treatment because it targets iron rich cells. It can help with iron overload conditions. See: Artemisinin, arteannuin-B, sgp130Fc and COVID-19.

Pomegranate Peel
Pomegranate products are anti-inflammatory, and the peel is a source of EGCG and other hydrolyzable tannins that can help intestinal health but can be irritating in excess. Tannins are one the plants' way of telling insects to stop eating them. See the second half of this post for more about foods that can help heal and soothe inflammatory bowel symptoms: ACE2, Diarrhea, & COVID19 – it gets complicated.
Pomegranate peel is very rich in antioxidants and bitter taste in the exterior colorful peel and milder in the white pithy inner membranes. Orange or other citrus peels are similar. The white pith is mild and can be eaten in a 1/4 cup amount while the orange zest acts as a decongestant with just a teaspoon or two.

• Pomegranate preparation and benefits of the fruit and the peel. G13.Pomegranate.
• Citrus peel - a variety of posts.

Citrus Peel
Citrus peel, source of hesperidin, quercetin, rutin and other bioflavonoids. It is called Chen pi in Traditional Chinese Medicine. It is being studied for benefits against obesity, and Metabolic Syndrome:Surprise- we need bitter tastes in our meals to help tell us we are full now. There are bitter taste receptors in a variety of places in the body besides the tongue and they are like little machines that can do things for our cells. Within the intestines they help send signals to the brain to tell us we are satisfied and to stop eating. The food industry has taken the bitter flavor out of most processed foods as it is often perceived as bad or too strong by typical consumers..
Within the lungs bitter taste receptors signal lung tissue to make thinner mucus and to move it out of the lungs,they also lead to more open relaxed airways. Citrus bioflavonoids are being studied for use with asthma and helped me while I was sick and I have continued using it daily. Asthma like symptoms continued to flare up since being sick with untested CoV-19 in March 2020. See: Bitter taste receptors in the lungs & Hesperidin’s decongestant properties.

Mango Peel
Mango peel is also beneficial against inflammation  - making a gently simmered tea, about 20-30 minutes, with mango, citrus, or pomegranate peel retains the medicinal nutrients. Overheating will cause breakdown of the complex chemicals into smaller nonmedicinal  forms. Freezing does not destroy the benefits. A strong tea (which is a water extract) can be used by adding just a couple spoonfuls to any hot beverage or soup. 

I have been making a mixed extract with citrus, mango and pomegranate peel, rosemary, thyme and anise seed (adds flavor and may have respiratory benefits) and some coconut oil to extract fat soluble nutrients. Tea or more concentrated extract could be made. Mild tea would only need a few teaspoons of dry peel and dry herbs in the saucepan of water and would be drank as tea, while the larger amounts given below, steeped in a large sauce pan of water would make a more concentrated extract - and only a few spoonfuls would be added to a hot beverage. Experiment, it is food. It is potent food though, trying smaller amounts at first is cautious and can let you know if it will be a problem for you or a help.

• Approximately zest layer of two-six oranges, peel of one mango, the outer red part of the peel of ½ or less a pomegranate (it is very potent, two tablespoons if using dehydrated), two tablespoons rosemary, thyme and anise seed, one large sauce pan of water, one cup of coconut oil if you also want to make phytonutrient rich oil. 
• First bring it to a boil and then turn off the heat and let the dry ingredients soak for 1-2 hours. Bring it back to a boil with a cup of coconut oil or just a tablespoon and simmer for 20-30 minutes, stir occasionally, if making infused oil, continue to stir occasionally and keep warm for about 2 hours. I then refrigerate the strained oil and tea water in glass jars and the oil rises to the top. 
• One teaspoon of the flavored oil and a couple tablespoons to ¼ cup (depending on how strong the tea is and personal preference) of the tea extract added to a hot beverage adds a nice citrus flavor and may reduce inflammation in the brain and the body - double bonus.
• The ingredients used could vary with what is available and what seems to work for your individual health. The rosemary, outer pomegranate peel, and Star anise, can have a diuretic effect so the tea may be best used early in the day along with adequate water so it isn’t dehydrating and it may help remove toxins without disrupting sleep too much.

People with more flavonoids in their diet over the long term had less risk of Alzheimer's dementia and related dementia's - (Shistar, et al., 2020)

Mango peel could also be dehydrated in a food dehydrator and powdered and might be acceptable added to any food in small amounts. Mango peel is bitter in flavor. (Mango peel powder in an animal based study regarding liver inflammation: Ulla et al, 2016)

Disclaimer: This information is provided for educational purposes within the guidelines of Fair Use. It is not intended to provide individual guidance. Please seek a health care provider for individualized health care guidance.  

• Disclaimer: Opinions are my own and the information is provided for educational purposes within the guidelines of fair use. While I am a Registered Dietitian this information is not intended to provide individual health guidance. Please see a health professional for individual health care purposes.
• The Academy of Nutrition and Dietetics has a service for locating a nutrition counselor near you at the website eatright.org: (eatright.org/find-an-expert)