SARS-CoV2 PROPHYLAXIS FOR THE GENERAL POPULATION
ADULT INTERVENTION:
1. All should use products containing the surfactant Sodium Lauryl Ether Sulfate or Sodium Laureth Sulfate. All groups are to be evaluated every Friday during the study period.
2. Zinc Gluconate 50 mgs/day (<150 lbs.) 100 mgs/day (<220 lbs.); 150 mgs/day (>220 lbs.) There is no observable adverse effect for adults up to around 150 mg/day.
3. Vitamin D3 5,000 IU (0.125 mg) (<150 lbs.) 10,000 IU (0.25) (<220 lbs.) 15,000 IU (0.375 mgs) (>220 lbs.)
4. Vitamin C 1 gram/day (<150 lbs.); 2 grams/day (<220 lbs.) 3 grams/day (>220 lbs.)
PEDIATRIC INTERVENTION:
ZINC
Age (years) Tolerable Upper Intake Level (UL) for Zinc
1-3 5 (mg per day)
4-8 10 (mg per day)
9-14 15 (mg per day)
15-19 25 (mg per day)
Doses of 30 mgs/day x 7 days were administered to children 02 – 60 months with Acute Lower Respiratory Tract Infection allowing prompt recovery. No ill effects from Zinc were reported. [PMID: 31214301]
VITAMIN D3
Infants
1 to 15 years old 16 + years old
400-1,000 IU/day 1,000-2,000 IU/day 3,000-5,000 IU/day
VITAMIN C TOLERABLE UPPER INTAKE LEVELS
AGE MALE FEMALE PREGNANT LACTATION
0–6 months 40 mgs 40 mgs
7-12 months 50 mgs 50 mgs
1-3 years 400 mgs 400 mgs
4-8 yeas 650 mgs 650 mgs
9-13 years 1,200 mgs 1,200 mgs
14-18 years 1,800 mgs 1,800 mgs 1,800 mgs 1,800 mgs
19 + years 2,000 mgs 2,000 mgs 2,000 mgs 2,000 mgs
Vitamin C - Health Professional Fact Sheet (nih.gov)
RATIONALE:
1. Exposure to high levels of Cadmium over a long time can lead to kidney failure. The concentration of Cadmium in Zinc-containing supplements can vary as much as 37-fold. Zinc Gluconate has the least Cadmium and equal absorption than Zinc Picolinate Zinc Citrate
2. Zinc Citrate: is as well-absorbed as Zinc Gluconate but has a less bitter, more appealing taste. Median Fractional Absorption of zinc from Zinc Citrate was 61.3% (56.6-71.0) and was not different from that from Zinc Gluconate with 60.9% (50.6-71.7) [https://pubmed.ncbi.nlm.nih.gov/24259556/]
3. Zinc is essential for the function of the immune system. Zinc ions are involved in regulating intracellular signaling pathways in innate and adaptive immune cells. Zinc homeostasis is largely controlled via the expression and action of Zinc Importers (ZIP 1–14), Zinc Exporters (ZnT 1–10), and zinc-binding proteins. Anti-inflammatory and antioxidant properties of zinc have long been documented. [Wessels, I. Zinc as a Gatekeeper of Immune Function. Nutrients. 2017 Dec; 9(12):1286. Doi: 10.3390/ni9121286. PMID: 29186856]
4. Oral Vitamin D3 (cholecalciferol) or oral Vitamin D2 (ergocalciferol) is converted to 25(OH)D in the liver and then to the hormonal metabolite, 1,25(OH)2D (calcitriol), in the kidneys or other organs as needed. To reduce the risk of influenza and/or COVID-19 infection, people at risk should take 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, above 40-60 ng/mL (100-150 nmol/L) followed by 5,000 IU/d. For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful.
5. The Roles of 25(OH)D in immunomodulation, lung, muscle, and cardiovascular function, and infectious disease prevention [Gombart A.F., et al. A Review of Micronutrients and the Immune System-Working in Harmony to Reduce the Risk of Infection. Nutrients. 2020; 12:236. doi: 10.3390/nu12010236; Schwalfenberg G.K. A review of the critical role of vitamin D in the functioning of the immune system and the clinical implications of vitamin D deficiency. Mol. Nutr. Food Res. 2011; 55:96–108. doi: 10.1002/mnfr.201000174; Kast J.I., et al. Respiratory syncytial virus infection influences tight junction integrity. Clin. Exp. Immunol. 2017; 190:351–359. doi: 10.1111/cei.13042; Chen Y., et al. Epidemiological features and time-series analysis of influenza incidence in urban and rural areas of Shenyang, China, 2010–2018. Epidemiol. Infect. 2020;148: e29. doi: 10.1017/S0950268820000151]. Induce cathelicidins and defensins that lower viral replication rates; reduce apoptosis of pneumocytes and stimulate surfactant synthesis in these cells to prevent severe lung injuries (ARDS) [Adams J.S., et al. Vitamin D-directed rheostatic regulation of monocyte antibacterial responses. J. Immunol. 2009; 182:4289–4295. doi: 10.4049/jimmunol.0803736; Laaksi I. Vitamin D and respiratory infection in adults. Proc. Nutr. Soc. 2012; 71:90–97. doi: 10.1017/S0029665111003351]; reduce concentrations of pro-inflammatory cytokines that injures the lining of the lungs, as well as increase the concentrations of anti-inflammatory cytokine. [Huang C., et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. 2020 doi: 10.1016/S0140-6736(20)30183-5; Cantorna M.T. Mechanisms underlying the effect of vitamin D on the immune system. Proc. Nutr. Soc. 2010; 69:286–289. doi: 10.1017/S0029665110001722].
Milton L Pozo MD, FACP.
N/B A CLINICAL PROTOCOL COMPARING THE EFFICACY OF INOSINE PRANOBEX AND HYDROXYCHLOROQUINE PHOSPHATE IN COMBATING THE CURRENT SARS-CoV-2 PANDEMIC
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