Abstract
A scientific interest has emerged to identify pharmaceutical and nutritional strategies in the clinical management of coronavirus disease 2019 (COVID-19). The purpose of this narrative review is to critically assess and discuss pharmaconutrition strategies that, secondary to accepted treatment methods, could be candidates in the current context of COVID-19. Oral medicinal doses of vitamin C (1–3 g/d) and zinc (80 mg/d elemental zinc) could be promising at the first signs and symptoms of COVID-19 as well as for general colds. In critical care situations requiring parenteral nutrition, vitamin C (3–10 g/d) and glutamine (0.3–0.5 g/kg/d) administration could be considered, whereas vitamin D3 administration (100,000 IU administered intramuscularly as a one-time dose) could possess benefits for patients with severe deficiency. Considering the presence of n-3 polyunsaturated fatty acids and arginine in immune-enhancing diets, their co-administration may also occur in clinical conditions where these formulations are recommended. However, despite the use of the aforementioned strategies in prior contexts, there is currently no evidence of the utility of any nutritional strategies in the management of SARS-CoV-2 infection and COVID-19. Nevertheless, ongoing and future clinical research is imperative to determine if any pharmaconutrition strategies can halt the progression of COVID-19.
Highlights
With the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)/coronavirus disease 2019 (COVID-19) worldwide, alongside substantial concern regarding the mortality rates in 2020 [1], extensive biomedical research has been devoted to mitigate this pandemic
Given the more rigorous implementation of pharmaconutrition, and its importance for outpatient and inpatient treatments, we performed a literature review focusing on the use of well-known nutrients possessing pharmacological effects, in critical care environments such as the intensive care unit (ICU), which could possibly be useful in the present COVID-19 pandemic due to their previously established clinical outcomes and safety record [12,13,14]
Evidence was reviewed regarding the administration of vitamin C, vitamin D, zinc, omega-3 (n-3) polyunsaturated fatty acids (PUFA), glutamine, and arginine, as these are nutritional elements with physiological importance for the immune system and may be found within immune-enhancing diets; some of these nutraceutical components possess in vitro antiviral effects [15,16]
Summary
With the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)/coronavirus disease 2019 (COVID-19) worldwide, alongside substantial concern regarding the mortality rates in 2020 [1], extensive biomedical research has been devoted to mitigate this pandemic. In addition to the basic protective measures against the new coronavirus recommended by the World Health Organization (WHO) [2] (e.g., washing hands and social distancing), there is a fervent scientific interest in evaluating effective pharmacotherapy treatment of COVID-19 [3,4]. These endeavors are not limited to pharmaceutical agents, as several recent reports have considered the potential role of nutraceutical agents and proposed dosing regimens for vitamins, minerals, amino acids, and herbal medicines in this context [5,6,7]. Given the more rigorous implementation of pharmaconutrition, and its importance for outpatient and inpatient treatments, we performed a literature review focusing on the use of well-known nutrients possessing pharmacological effects, in critical care environments such as the intensive care unit (ICU), which could possibly be useful in the present COVID-19 pandemic due to their previously established clinical outcomes and safety record [12,13,14]
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