In 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the viral source of coronavirus disease 2019 (COVID-19), spread rapidly. To date, more than 112 million cases have been identified, along with more than 2.4 million deaths reported, wreaking havoc on the human species worldwide.1 In late 2019, the SARS-CoV-2 genome was fully sequenced in China when three bronchoalveolar lavage samples were obtained from a patient with pneumonia.2 Here, it was found that the virus was similar to that of the SARS-like coronavirus strain found in bats (BatCov RaTG13), with a 96 percent match for identity.2 It was also identified to be closely related to SARS-CoV, with a 79.6 percent match.2,3 Because of these similarities, it was quickly recognized that the SARS-CoV-2 virus, like its cousins, shared the same cell entry receptor—angiotensin-converting enzyme II (ACE2).3
ACE2 is mostly expressed in the major organ cells, like those found in the lungs, digestive system, kidneys, heart, bladder and the oral mucosa.4 SARS-CoV-2 enters cells via the ACE2 receptor, inducing COVID-19 infection in the host. Indeed, COVID-19 is associated with low ACE2 expression, and by the virus dominating ACE2 functionality, there is increased risk for negative respiratory, cardiovascular and renal events. Interestingly, this makes perfect sense considering COVID-19 infected patients can develop acute respiratory distress syndrome (ARDS) and, subsequently, organ failure.4 Further, research shows that ACE2 expression is generally lower in older individuals and adult males, making them more susceptible to COVID infection.4
Natural ingredients, such as vitamin D, turmeric and quercetin complement one another to guard the body against foreign invaders, and work in tandem with the body’s natural defense system to optimize respiratory, sinus and immune function by upregulating the expression of ACE2 receptors.4
Vitamin D
Vitamin D is a fat-soluble nutrient required for multiple physiological needs in the body. While it is a nutrient found in many foods, beverages and supplements, vitamin D deficiency is common among Americans. But in actuality, vitamin D is a steroid hormone precursor, and the steroid in its form, 1,25-dihydroxycholecalciferol, is critical for the expression of the specific DNA and RNA sequences that work collectively to support bone/mineral metabolism, the renin-angiotensin-aldosterone system, immune function, the cardiovascular system, muscle metabolism/strength, as well as cellular health.5 The understanding and recognition of vitamin D’s role in health and wellness has raised global awareness of vitamin D sufficiency, and thus, its supplemental use is on the rise.6
In retrospective studies, vitamin D supplementation has been shown to be protective during the COVID-19 pandemic, especially in older, immunocompromised individuals.7 Vitamin D is a steroid hormone that facilitates calcium and phosphorus across the renal tubules for bone metabolism and modulates gene expression by binding to vitamin D receptors (VDRs). Research suggests that vitamin D suppresses renin gene expression and increases the expression of the ACE2 receptor, robbing COVID-19 of the ability to dominate the receptor’s functionality. Due to the increased functionality of the ACE2 receptor through vitamin D supplementation, there is decreased risk of respiratory, cardiovascular and kidney disease events, giving rise to the hypothesis that vitamin D therapy may prevent or even treat COVID-19 infection.8,9 Along with the potential benefits in COVID-19 infection, vitamin D is also beneficial for maintaining physical cell barriers, increasing anti-microbial protein production, and supporting anti-inflammatory responses.4
Turmeric
Turmeric root (Curcuma longa) is a yellow, fragrant spice native to South Asia that belongs to the Zingiberaceae (ginger) family. It has been long documented for its potent medicinal properties in ayurveda (the science of long life), an alternative system of medicine originating in India, for more than 5,000 years. As a result of the various joint, cardiovascular and cellular support applications of turmeric over centuries, it caught the attention of clinical researchers who have found that turmeric possesses potent antioxidant properties.10 Curcuminoids are a group of phenolics present in turmeric and are the active constituents responsible for is physiologic effects in the body. The three main curcuminoids are curcumin (C), desmethoxycurcumin (DMC), and bisdemethoxycurcumin (BDMC).
Curcumin, a polyphenol from turmeric, increases ACE2 receptor expression in animals.10 Researchers reported that the animals, when co-administrated oral curcumin and intravenous injection angiotensin II, did not develop fibrosis in the myocardial muscle, which was attributed to the increased expression of ACE2.10 In other research, using molecular docking with target receptors, curcumin was found to be beneficial in binding with receptors that might be associated with the viral infection, such as SARS-CoV-2 protease, spike glycoprotein-RBD, and PD-ACE2.11 Lastly, curcumin has shown antioxidant, antiviral and anti-inflammatory activity within the body.4
Quercetin
Quercetin is a plant flavonol from the flavonoid group of polyphenols and is found in many fruits, vegetables, grains and leaves. Some foods high in quercetin include capers, radish leaves, dill, cilantro, red onion, cranberries, kale and black plums. Quercetin is one of the most abundant dietary flavonoids, and the average person consumes 10-100 mg/day.12
Being from the flavonoid family, quercetin acts as a powerful antioxidant. Its flavonoid structure contributes to its potent free-radical scavenging capabilities and its ability to protect cells. As for its relationship with COVID-19, quercetin has the capacity to reduce the interaction between the ACE-2 receptor and the SARS-CoV-2 virus.13 While more information is needed, this is considerable since quercetin is also anti-inflammatory and acts as an antiviral, providing multiple protective health benefits when studied in research.4
While SARS-CoV-2 is here to stay, and vaccines are in the post-clinical stage for proven safety and efficacy, the underlying understanding of how foods and nutrients support wellness is critical. By combining all of the tools in our arsenal like our ancestors did, we will persevere. Remember, this too shall pass. VR
References:
1 COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE) at Johns Hopkins University (JHU). Coronavirus Resource Center John Hopkin’s University of Medicine website. https://coronavirus.jhu.edu/map.html (links to external site). Updated daily. Accessed Feb. 17, 2021.
2 Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19) 16-24 February 2020. Geneva: World Health Organization; 2020 (available at www.who.int/docs/default-source/coronavirus/who-china-joint-mission-on-covid-19-final-report.pdf (links to external site).
3 Zhou P, Yang X Lou, Wang XG, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270-273. doi:10.1038/s41586-020-2012-7.
4 Aygun H. Vitamin D can prevent COVID-19 infection-induced multiple organ damage. Naunyn Schmiedebergs Arch Pharmacol. 2020;393(7):1157-1160. doi:10.1007/s00210-020-01911-4.
5 Mozos I, Marginean O. Links between Vitamin D deficiency and cardiovascular diseases. Biomed Res Int. 2015;2015:109275. doi:10.1155/2015/109275.
6 Rooney MR, Harnack L, Michos ED, Ogilvie RP, Sempos CT, Lutsey PL. Trends in use of high-dose vitamin D supplements exceeding 1,000 or 4,000 international units daily, 1999-2014. JAMA. 2017;317(23):2448–2450. doi:https://doi.org/10.1001/jama.2017.4392.
7 Cangiano B, Fatti LM, Danesi L, et al. Mortality in an Italian nursing home during COVID-19 pandemic: correlation with gender, age, ADL, vitamin D supplementation, and limitations of the diagnostic tests. Aging (Albany NY). 2020;12(24):24522-24534. doi:10.18632/aging.202307.
8 Yuan W, Pan W, Kong J, et al. 1,25-Dihydroxyvitamin D3 suppresses renin gene transcription by blocking the activity of the cyclic AMP response element in the renin gene promoter. J Biol Chem. 2007;282(41):29821-29830. doi:10.1074/jbc.M705495200.
9 Bao L, Deng W, Huang B., et al. The pathogenicity of SARS-CoV-2 in hACE2 transgenic mice. Nature. 2020; 583, 830–833. https://doi.org/10.1038/s41586-020-2312-y (links to external site).
10 Pang XF, Zhang LH, Bai F, Wang NP, Garner RE, McKallip RJ, Zhao ZQ. Attenuation of myocardial fibrosis with curcumin is mediated by modulating expression of angiotensin II AT1/AT2 receptors and ACE2 in rats. Drug Des. Dev. Ther. 2015;9:6043–6054. doi: 10.2147/DDDT.S95333.
11 Utomo RY, Ikawati M, Meiyanto E. 2020. Revealing the Potency of Citrus and Galangal Constituents to Halt SARS-CoV-2 Infection.
12 Bischoff SC. Quercetin: potentials in the prevention and therapy of disease. Curr Opin Clin Nutr Metab Care. 2008;11(6):733-740. doi:10.1097/MCO.0b013e32831394b8.
13 Sargiacomo C, Sotgia F, Lisanti MP. COVID-19 and chronological aging: senolytics and other anti-aging drugs for the treatment or prevention of coronavirus infection Aging. 2020;12:6511–6517. doi: 10.18632/aging.103001.
Trisha Sugarek MacDonald holds a Master of Science in nutrition and is also working toward a doctorate in nutrition from Texas Woman’s University. MacDonald has nearly a decade and a half of experience in nutraceutical manufacturing and is currently the senior director of research & development as well as the national educator at Bluebonnet Nutrition, Sugar Land, TX, where she investigates new ingredients, directs the launch of new products, and provides industry training on numerous subjects as it relates to the connection between nutrition and health. She is a frequent editorial contributor and lecturer on the benefits surrounding the responsible use of supplements. For more information, call (800) 580-8866.
