|LETTER TO THE EDITOR
|Year : 2022 | Volume
| Issue : 3 | Page : 320-321
Complexities of immune- regulation in COVID- 19
Department of Medicine, KG'S Medical University, Lucknow, Uttar Pradesh, India
|Date of Submission||23-Jan-2022|
|Date of Acceptance||21-May-2022|
|Date of Web Publication||17-Sep-2022|
Dr. Harish Gupta
Department of Medicine, KG'S Medical University, Lucknow - 226 003, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Gupta H. Complexities of immune- regulation in COVID- 19. Indian J Health Sci Biomed Res 2022;15:320-1
”Scientific knowledge requires constant probing into the why and wherefore of every little process that you perform.” Mahatma Gandhi, in Mahatma, by D G Tendulkar, Vol 7, 2nd Edn. (1960), Publications Division
Kour and Shrivastava provide nutrition (al) insights in COVID-19 in their Review Article published on September 30, 21 in the Journal. Therein, they classify various nutrients and assess their role for “immunity-enhancement” in such cases. The authors emphasize that macro and micro – both the types of nutrients – need to be balanced if one wants to have escape from infectious diseases. Then, they highlight that gut microbes and proper hydration too play key roles in waging a war against harmful germs. Moreover summarily, the recommendations they make is that adequate supplementation of Vit D, Vit A, Ca, Zn, and folic acid can be considered to fulfill the micronutrient requirements.
Nevertheless, evidence is there that our biological system is too complex to draw such simple conclusions. Thomas et al. at Cleveland Clinic, Ohio, US assessed the effect of high dose Zinc and Ascorbic Acid supplementation versus usual care on symptom length and reduction among ambulatory patients with SARS-CoV-2 infection. Then, they got the results of their randomized clinical trial published. What they discovered in the study is that in patients diagnosed with SARS-CoV-2 infection, treatment with high-dose zinc gluconate, ascorbic acid, or a combination of the two supplements did not significantly decrease the duration of symptoms compared with standard of care. Murai et al. at Sao Paulo, Brazil, discovered the effect of a single high dose of Vitamin D3 on hospital length of stay in patients with moderate-to-severe COVID-19 by conducting a randomized clinical trial. Their study did not support the use of the high dose of the vitamin in this clinical scenario.
Several Indian authors have been stressing that the use of unchecked “immunity boosters” can turn toxic if not consumed under medical supervision. Lakkireddy et al. at Nizam's Institute of Medical Sciences at Hyderabad examined the impact of high-dose oral Vitamin D therapy on the inflammatory markers in patients with COVID-19 disease. They discovered in Telangana that pulse Vitamin D therapy raising the level to 80–100 ng/ml can be added safely to the existing treatment protocols as it reduced inflammatory markers without any side effects. World Health Organization runs its website and there it hosts a page where the global body provides advice for the public. On it, there is a webpage with the title ”Mythbusters.” On this page, it states a fact that Vitamins and mineral supplements cannot cure COVID-19.
Sensing profits and business opportunities, some unscrupulous market forces appeared on the horizon and to counteract them, US Food and Drug Administration informs us about fraudulent coronavirus disease (COVID-19) products. Several proprietary products – a few of Indian origin among those – find a mention here to educate the masses about the nefarious design of misbranding, misrepresenting facts, and other devious tactics adopted by the industrialist to earn profits. Therefore, some useful lessons we can deduce on this aspect is that we need to have realistic expectations from nutritional insights, supplements are likely to work when an individual has a deficiency of it, excess can be harmful, and regimen for making up may need tweaking along with the conduct of the further studies. One– size– fits– all approach is not likely to work when our phenotype and genotypes do not match and the results of well-conducted trials cannot be generalized.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Kour H, Shrivastava R. Nutrition insights in COVID-19. Indian J Health Sci Biomed Res 2021;14:297-301. [Full text]
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.
Murai IH, Fernandes AL, Sales LP, Pinto AJ, Goessler KF, Duran CS, et al.
Effect of a single high dose of vitamin D3 on hospital length of stay in patients with moderate to severe COVID-19: A randomized clinical trial. JAMA 2021;325:1053-60.
Lakkireddy M, Gadiga SG, Malathi RD, Karra ML, Raju IS, Ragini, et al.
Impact of daily high dose oral vitamin D therapy on the inflammatory markers in patients with COVID 19 disease. Sci Rep 2021;11:10641.