Written by: Sarah Tevis Poteet, DDS (Dallas County Dental Society Member)
We are experiencing a winter surge of the COVID-19 coronavirus pandemic. As health care providers, it important for dentists to find ways to keep ourselves healthy as well as our families. This involves self-care habits, nutrition, exercise, sleep, and stress reducing techniques.
- Reduce exposures: Handwashing, hand sanitizers with at least 60% alcohol, physical distancing, masks, avoid touching eyes, nose, mouth and nose irrigation are all ways to do this.
- Prevent SARS-CoV-2 from invading our cells: Use serum ACE2 as a decoy to prevent SARS from attaching to cells. Ways to increase our serum soluble ACE2 levels include: daily aerobic exercise, sleep, melatonin, vitamin D (see below…you want blood levels to be between 60-80 nmol/L), vitamin A, and curcumin, which inhibits the NF-kB pathway.
- Inhibit viral replications once SARS-CoV-2 enters our cells: Zinc inhibits viral replication of the virus. Quercetin helps zinc enter cells. Elderberry blocks attachment and inhibits viral replication.
- Optimize immune & lung health to prevent pneumonia, neurological problems, GI problems, sepsis & cytokine storms. Antioxidants from fruits and vegetables mop of free radicals to get well faster. Eat the rainbow! Vitamin C prevents pneumonia and decrease risk of sepsis. Glutathione, our “master antioxidant”, protects lungs from injury. Epsom salt baths increase the body’s natural production of glutathione. Omega 3 essential fatty acids and probiotics boost immune support.
- Nourish your body & soul to maintain a healthy immune response. Cut out sugar. Sleep and exercise increase serum ACE2 levels. Optimize vagus nerve function or heart rate variability by meditation, deep breathing, laughter, gratitude, and minimizing stress.
Note that in a retrospective study, the association between vitamin D status and lung involvement and disease severity in COVID-19 was investigated. Focusing on hospitalized patients with a positive COVID-19 diagnosis, study measures included non-contrast lung CT, nasopharyngeal RT-PCR for SARS-CoV-2 and serum 25-OH vitamin D. Major findings include:
- Higher serum 25-OH vitamin D concentration was significantly associated with a lower level of lung involvement (p<0.01).
- A logistic regression analysis showed that one-unit increase of 25-OH vitamin D was associated with a 4-percent reduction in severe lung involvement (p=0.04).
- Serum 25-OH vitamin D concentration was significantly lower in individuals who died of COVID-19 than in survivors (p<0.001).
- For individuals with vitamin D deficiency, the probability of death was 34.6 percent compared to 6.4 percent in individuals who had adequate vitamin D status (p=0.003).
Although this is the first to investigate vitamin D status in relation to disease severity and outcome, previous studies indicate a significant relationship between vitamin D status and the number of cases and mortality rate of COVID-19. The authors note several study limitations, including relatively small sample size (73 participants) and using data from a single facility. However, they state the growing body of evidence surrounding vitamin D and COVID, including the results of this study, could be helpful to public health officials and clinicians in improving patient outcomes against developing more severe forms of disease.
Resources:
Abrishami A, Dalili N, Mohammadi-Torbati P, et al. Possible association of vitamin D status with lung involvement and outcome in patients with COVID-19: a retrospective study. Eur J Nutr 2020;1-9. Access full text here.
Daneshkhah A, Agrawal V, Eshein A, et al. Evidence for possible association of vitamin D status with cytokine storm and unregulated inflammation in COVID-19 patients. Aging Clin Exp Res2020;32(10):2141-2158. Access full text here.
Annweiler G, Corvaisier M, Gautier J, et al. Vitamin D supplementation associated to better survival in hospitalized frail elderly cOVID-19 Patients: The GERIA-COVID Quasi-Experimental Study. Nutrients2020;12(11). Access full text here.