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Post COVID support and nutritional interventions


Post covid symptoms.


The number of people reporting post-COVID symptoms is increasing and therefore a necessity to look at managing post covid symptoms holistically. Symptoms are wide-ranging and fluctuating, and can include breathlessness, chronic fatigue, “brain fog”, anxiety and stress. Some have reported having a metallic taste in the mouth and being unable to tolerate certain foods or smells. How long this will continue, is different for each individual. However nutritional support and stress reduction techniques can be beneficial in helping the body to heal. As time goes on scientists are learning more about how the virus behaves, in the meantime we can help ourselves by improving our reliance. Viruses have been around for a long time and will continue to be around, not to say that we want a situation such as what we are experiencing now with COVID. However, it is our responsibility to look after our health to enable us to cope better with these challenges that are part of our ecosystem.



It is recognised that many people experiencing ongoing health effects following COVID-19 infection managed their condition independently at home while acutely infected. It is also recognised that not all patients seriously impacted in the longer term were hospitalised or had a positive SARS-CoV-2 test. • The number of patients who need post-COVID syndrome management focusing on recovery and rehabilitation is likely to grow as COVID-19 infection rates continue to rise. (NHS England 2021)


Why does this happen?

Coronaviruses are enveloped single-stranded RNA viruses that are zoonotic in nature and cause symptoms ranging from those similar to the common cold to more severe respiratory, enteric, hepatic, and neurological symptoms.


· Varied and relapsing symptoms of Long Covid can be attributed to elevated peripheral and central cytokines, generated by an abnormal immune response.


· Central Nervous System effects may be due to direct viral invasion or an indirect immune response.


· Dysregulated activation of brain microglia, due to neuroinflammation, can cause centrally mediated symptoms.


There are similarities between long COVID and myalgicencephalomyelitis/chronic fatigue syndrome (ME/CFS) which is also triggered by a post-viral infection. Some may argue that it is due to neuroinflammation, or an overactive immune response. These are all sound hypothesis, the root of all these things may be down to cytokine dysregulation and viral-induced epigenetic changes.


General Support for COVID


Vitamin D-Good levels of Vitamin D levels prior to SARS cov-2 infection have been correlated with a better outcome.


Vitamin C- A powerful antioxidant to help scavenge free radicals. This has little side effect whether it’s taken orally or via intravenous injection. Dr Richard Cheng states there is increased oxidative stress due to the rapid release of free radicals and cytokines are the hallmark of acute respiratory distress syndrome (ARDS) which leads to cellular injury, organ failure and death. A study shows that High-dose intravenous vitamin C (VC) was used successfully in the treatment of 50 moderate to severe COVID-19 patients. (BMJ 2020).

Zinc- is beneficial for the immune system and works synergistically with vitamin C & D to maintain tissue barriers, such as the skin and mucous membranes. Clinicians have also seen a link between Zinc deficiency. We don’t yet know if zinc is beneficial in helping for the recovery of covid, but having optimal zinc levels will help the body and immune system to cope with the viral load more effectively.


Quercetin- is a natural flavonoid found in many vegetables and fruits, and is one of the most important plant molecules, showing pharmacological activity such as antiviral, anti‐atopic, pro‐metabolic, and anti-inflammatory effects. Quercetin effectively inhibits the production of pro-inflammatory cytokines acting as potent immunosuppressive.


Adequate hydration- hydration is essential for all bodily functions to work. It also helps to regulate body temperature, prevent infections and delivers nutrients to cells. This is essential in supporting the body when dealing with the symptoms of long covid.


Rest- rest in general is allows the body to recover. However, when recovering from a virus rest should be prioritised and increased. If the body is able to rest it can focus its energy on the immune system which is working hard





References:


Adhikari, S.P., Meng, S., Wu, Y.J et al. (2020) Epidemiology, causes, clinical manifestation and diagnosis, prevention and control of coronavirus disease (COVID-19) during the early outbreak period: a scoping review. Infectious diseases of poverty, 9(1), pp.1-12.


Aucoin, M., Cooley, K., Saunders, P.R., Cardozo, V., Remy, D., Cramer, H., Abad, C.N. and Hannan, N., 2020. The effect of quercetin on the prevention or treatment of COVID-19 and other respiratory tract infections in humans: A rapid review. Advances in integrative medicine, 7(4), pp.247-251.


Huang, R.Y., Yu, Y.L., Cheng, W.C., OuYang, C.N., Fu, E. and Chu, C.L., 2010. Immunosuppressive effect of quercetin on dendritic cell activation and function. The Journal of Immunology, 184(12), pp.6815-6821.


Low, R.N., Low, R.J. and Akrami, A., 2020. A Cytokine-based model for the pathophysiology of Long COVID symptoms.


RECOVERY trial: the UK covid-19 study resetting expectations for clinical trials


BMJ 2020; 369 (Published 28 April 2020)Cite this as: BMJ 2020;369:m1626

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