Vitamin C is a water-soluble nutrient that cannot be synthesized by humans. Vitamin C acts as an anti-oxidant that can scavenge reactive oxygen species (ROS), thereby protecting bimolecular such as lipids, proteins nucleotides from oxidative dysfunction and damage. During Covid-19 infection, vitamin C that is present in leukocytes is speedily utilized. Balance between antioxidant defenses and oxidant generation can alter multiple signaling pathways It can also involves pro-inflammatory transcription factors, such as nuclear factor кB (NF-кB). Nuclear Factor-кB is involved in inflammatory responses, the pathogenesis of certain viral infection and diseases. Inhibition of Nuclear Factor-кB can be a therapeutic mode against viral infections.
Vitamin C is well known to protective benefit in infectious disease. Supplementation is known to support respiratory defense mechanisms, preventing viral infections, reducing their duration and severity as well as having anti-fungal properties that can improve flu-like symptoms. Patients with acute respiratory infections such as, tuberculosis, pneumonia have decreased plasma vitamin C concentrations. Vitamin C administration reduces the severity and duration of pneumonia in aged patients. This key protective action against infections makes them a target of interests in COVID-19.
For the Treatment and Prevention of viral respiratory tract infections, it is suggested to take 4-6 grams of Vitamin C per day. To those who think that they can get Vitamin C from citrus fruits, they have to understand that they need to consume as many as 20 oranges to get 1g of Vitamin C which is impossible.
Vitamin C levels in white blood cells are ten times higher than in plasma, which shows functional role of the vitamin in these immune cells. Vitamin C has been shown to affect the production of interferon, the functions of phagocytes, maturation of T-lymphocytes and replication of viruses. Vitamin C also protects these blood cells from oxidative damage when they try to clear out viruses, bacteria etc. Many clinical studies have shown that Vitamin C has a positive impact on many infections caused by fungi, viruses, bacteria etc.
Vitamin D is a fat-soluble steroid hormone precursor. That will be arises from ultraviolet B (UVB) radiation exposure of 7-dehydrocholesterol (7-DHC) in the epidermis of the skin. Vitamin D has main role in a wide range of body systems, including in both adaptive and innate immune responses. Vitamin D improves innate cellular immunity through stimulation of expression of anti-microbial peptides, such as cathelicidin and defensins. Defensins maintain gap and tight and junctions, enhance the expression of anti-oxidative genes. Viruses such as influenza damage the integrity of epithelial tight junctions increasing the risk of pulmonary oedema and infection. Vitamin D is known to schedule the integrity of these junctions with low levels of vitamin D receptor expression leading to increased expression of claudin-2 and inflammation. Vitamin D also promotes the differentiation of monocytes to macrophages whilst increasing bacterial destruction, superoxide production and phagocytosis.
Vitamin D supplements are known to reducing the incidence and severity of viral infection. There is an opposite relationship between upper respiratory tract infection and serum 25-hydroxyvitamin D levels. The effects of vitamin D supplementation during covid – 19 infections remain controversial. After, clinical trial it is define better cut offs for vitamin D levels and, finally decide, that dosage is the best. Many human clinical trials have been registered to decide the effect of vitamin D supplementation in COVID-19 patients.
Zinc is involved in many biological processes including immunity. It is vital in both the acquired and innate responses to viral infection. Zinc deficiency significantly increases remodeling of lung tissue and pro-inflammatory cytokines is noted, an effect which was partially countered by zinc supplements.
Due to the anti-viral and immunomodulatory properties of zinc, it has been used in COVID-19 patients. Studied clinical trial of zinc on covid-19 patients have shown that zinc supplementation is able to decrease COVID-19 related symptoms such as lower respiratory tract infection. These effects have been suggested to be due to inhibition of viral replication, uncoating and binding, and may be relevant to COVID-19. A clinical trial registered in Australia will decide the use of intravenous zinc administration COVID-19 positive individuals.
Zinc plays a main role in the recruitment of chemotactic activity and neutrophil granulocytes and. Zinc has positive effects on generation of oxidative burst, NK cells, CD4+ and CD8 + T cells phagocytosis. Zinc has been shown to inhibit the replication, transcription complex and synthesis of corona viruses. It can also interfere directly with therapeutic effects, viral replication, protein synthesis and providing beneficial against viral infections.
Alpha-linolenic acid is an omega-3 fatty acid. It is called “essential” because it is needed for normal human development and growth. It is also found in soybean oil, vegetable oils, canola (rapeseed) oil, in dairy products and red meat, walnuts and other nuts.
ALA(Alpha-lipoic acid) is used in patients with diabetes to treat peripheral neuropathy. We think ALA will have a securely effect against COVID-19 in patients with diabetes by various mechanisms. We will describe the securely effects of ALA against COVID-19 infection in patients with diabetes.
ALA is mainly used in the treatment of diabetic polyneuropathy. It can lowers blood glucose and increases insulin sensitivity. ALA is a potent antioxidant. ALA inhibits activation and reduces oxidative stress of nuclear factor-kappa B. ALA has antiviral effects against some viruses. ALA show antiviral effect by reducing NF-kB activation. ALA increases strengthens and the intracellular glutathione level against the corona virus 229E strain, and inhibits HIV-1 replication. Also, it has been reported that ALA decreases the growth of the vaccinia virus in vitro environment with similar mechanisms, and thus it can be protective against poxviruses. ALA has positive effects such as chelation of metal ions such as cadmium, mercury and lead, redistribution of redox-active divalent metal ions such as copper, and zinc, exogenous antioxidants such as vitamins C and E, and restoration of endogenous. ALA can provide an start up defensive mechanism against COVID-19. The combination of insulin and ALA may be an excellent selection for patients with diabetes.