How to Keep Your Immune System at Optimum to Against COVID-19

Table of Contents

Highlights
Introduction
What is virus
COVID-19
Air Purifier with HEPA Filter
Treatment Approaches
Optimal Immune System to Defeat COVID-19
Conclusion
References
Authors

Highlights

At present, there are more than 1.3 million people have been infected with COVID-19 coronavirus, more than 47 thousand people are in critical stage, and more than 75 thousand people have died, however, more than 287 thousand people have recovered.
By projections, coronavirus could infect more than 3.85 billion of the global population if unchecked.
No cure for viral infections, need to depend on the body’s immune system ability to fight against the viruses.
The COVID-19 coronavirus has an incubation period up to 24 days and the carriers with asymptomatic could spread the infection, it leads to prevention become tougher to achieve.
Prevention is better than cure, the best approach is to prevent the invasion of viruses to the body.
What if, diagnosed with COVID-19, don’t panic, give the best possible chance to fighting off the viruses by strengthening the immune system.

Introduction

Recently, the most dominates word in the news doubtless is the COVID-19. World Health Organization (WHO) announced the official name of COVID-19 (previously name as 2019-nCoV), CO refers to corona, VI to virus, D to disease and 19 to 2019. This coronavirus has been menacing from the beginning, since the announcement by China on 20th January 2020 until 7rd April, more than 1.3 million people have been infected with COVID-19 in less than three months. Among COVID-19 infected patients, more than 47 thousand people are in critical care and more than 75 thousand people have died. Fortunately, more than 287 thousand people have recovered.

Data and diagram sources

According to current data, coronavirus could infect more than 50% of the global population if unchecked. According to data from the United Nations, the global population in 2019 has reached 7.7 billion people that means coronavirus could infect more than 3.85 billion people worldwide.

No wonder global reaction of panic is rising. In this article, the information will help you to gain a better understanding of the COVID-19. More importantly, everyone would have a chance to understand the reason on no cure for COVID-19 and the approaches to improve an immune system of the body to fight against this tough battle. This article important ideas (as many as possible) with links to medical journals are provided, for those who are interested, can check it out and confirm the information so that misled by false information can be minimized.

What is Virus

First and foremost, we need to understand that microorganisms cause illness when microorganisms invade the body (such as a human body), which known as infection. The most common infectious diseases caused by microorganisms are bacteria and viruses. Although both belong to the category of microorganisms, they are totally different.

Table: Bacteria vs Virus

	Bacteria	Virus
Size	Small, about 0.2-2.0 μm (1x10-6m)	Tiny, about 0.2-0.4 μm (1x10-6m)
Infect	Certain part of the body	Could be infected to the whole body
Benefits	Some bacteria are good for the human body (e.g. good bacteria in the intestine)	Almost all viruses are harmful to the human body
Mutation	Slow	Fast
Treatment	Antibiotic	No cure. Vaccines can be used to prevent viruses from spreading. Antiviral drugs also can be used to suppress the multiplication of the viruses. Ultimately, it still needs to rely on our body’s immune system to defeat the viruses.

From the table above, we are noticed that no drugs or medications can directly attack the viruses for a cure treatment, it is to slow down the viruses rapid development and spread. Hence, the optimal of body’s immune system is still the best defense approach to fighting off viruses.

Frequently, a virus has several subtypes due to high mutation rates of viruses. For example, before outbreaks of COVID-19, H1N1 is previously broke out in Malaysia, is one of the subtypes of influenza A. For example, influenza A viruses are categorized into subtypes based on the type of two proteins on the surface of the virus, named Hemagglutinin (H) and Neuraminidase (N). Currently, 18 types of hemagglutinins (H1-H18) and 11 types of neuraminidases (N1-N11) have been identified. Theoretically, there is a total of 18x11=198 subtypes of influenza A. Fortunately, the mutations of influenza A virus did not reach (yet) all possible combinations of subtypes and not every subtype can be transmitted to a human.

Other than influenza A viruses, there are other species of virus, the COVID-19 virus belongs to the category of coronavirus. Coronaviruses are one of the common pathogens, which responsible for 15-30% of all common colds cases. The main symptoms of common colds include fever, sore throat, cough and etc. Patients with weak immune systems may experience complications such as pneumonia. Currently, seven coronaviruses are known can infect humans and typically affect the respiratory tracts. Three out of seven coronaviruses cause much more severe and sometimes fatal, included SARS outbreaks in 2003, MERS outbreaks in 2012, and this article protagonist, COVID-19.

The diagram below is the outlook of coronavirus.

There are many more species of viruses, such as human immunodeficiency virus (HIV) causes AIDS, hepatitis B virus causes hepatitis, and dengue virus (DENV) causes dengue fever and etc. Although the viruses transmitted differently with various symptoms, the similarity of viral infections is no cure, and needs to depends on the body’s immune system ability to fight against the viruses.

COVID-19

The earliest known case of COVID-19 may trace back to 1st December 2019, the first patient who had been diagnosed with the onset of COVID-19’s symptoms on 8th December 2019. At 9 p.m. on 7th January 2020, the experts had identified a new type of coronavirus, novel coronavirus (2019-nCoV). On 20th January, China’s National Health Commission confirmed that human-to-human transmission cases have occurred. On 30th January, many countries have begun to report confirmed cases of COVID-19. The WHO had announced the outbreak, a global emergency concern towards the spread of COVID-19 coronavirus. On 11th March, the WHO officially declared the outbreak has become a “global pandemic”.

According to the US Centers for Disease Control and Prevention (CDC), the common symptoms of COVID-19 included fever, cough, and breathing difficulty. Undesirably, the COVID-19 coronavirus has an incubation period, in general, the range is 1-14 days. However, the research on 11th February indicated that the incubation period of some patients was up 24 days. During the incubation period, some carriers do not experience any symptoms. The New England Journal of Medicine reported that even carriers are asymptomatic, they also could spread the infection to other people.

Long incubation period with asymptomatic, yet highly contagious, this can be the key reason leads to prevention become tougher to achieve. Consequently, many carriers were unconsciously and unintentionally widely spread the coronavirus in the community.

The wisdom behind the quote of a proverb: “Prevention is better than cure”, especially the optimal body immune system is the only possible approach to fight off the coronavirus, it is a smarter choice to prevent the invasion of the coronavirus from the beginning. The most recommended strategies are washing your hands with soap and water frequently, wear a mask, avoid crowded or high-risk places, avoid direct contact with suspected patients, avoid touching your eyes, nose and mouth before washing your hands, cover your nose and mouth when sneeze or cough, and seek medical assistance as soon as you feel unwell. Besides that, some experts advise to self-quarantine in case you have just returned from high-risk countries, avoid eating raw/undercooked foods, avoid contact with animals, use disinfectant products, use an air purifier with a HEPA filter, and drink enough water.

Some might wonder why an air purifier with a HEPA filter is beneficial to the prevention approach, the function of air purifier with HEPA filter is parallel to a mask, both are beneficial to reduce the risk of coronavirus invasion via our mouth and nose from the air. A mask is to protect us when we go out in public, while an air purifier with HEPA filter is to protect us at home. Particularly for those who are recommended to self-quarantine at home, in order to protect the family/housemate, an air purifier with HEPA filter is much more desirable.

Air Purifier with HEPA Filter

HEPA stands for High-Efficiency Particulate Air, is a highly effective absorbent filter for airborne particles, a technology for the air purifiers. The HEPA filter is able to capture and trap the tiny particles in the air. However, the efficiency of the filtration depends on the features of the filter. The United States Department of Energy has stipulated a standard of HEPA filter is: remove at least 99.97% of airborne particles whose diameter is 0.3 μm.

With the mandatory standard, HEPA filter able to trap most of the bacteria but almost all viruses are too small to be filtered. According to the New England Journal of Medicine, the size of the COVID-19 coronavirus can range from 0.06 μm to 0.14 μm. Although an air purifier with a HEPA filter system is a superior air purifier, attention to the features of the filter is even more crucial to ensure the standard of efficiency of viruses filtration.

The diagram below is the “global pandemic” caused by the microorganisms

Treatment Approaches

What if, diagnosed with COVID-19, don’t panic. According to the present data, the mortality rate of COVID-19 is about 21%. With proper measures, the worst scenario can still be avoided.

Primarily, seek medical attention immediately to confirm the infection of COVID-19. Based on the assessment result and history of a patient, medical doctors will be determined hospital admission or self-quarantine. As of inpatients with confirmed infections, they will be arranged to an isolated area in the hospital to prevent the spread of viruses.

But much about COVID-19 coronavirus is still unclear. One of the possible of most destructive of COVID-19 is the coronavirus infect the white blood cell (immune system), lymphocytes (the “army” in our immune system) of infected patients, facilitating the spread of the disease and lead to the immune system inadvertently helps the virus infect healthy cells. Many infected patients died of respiratory failure, some infected patients died of multiple organ failure due to weakening of the immune system. Medical treatments at hospitals principally intended to preserve our functional status of the body, such as provide oxygen therapy for patients with shortness of breath, provide dialysis for patients with kidney failure and etc., do their best to save lives. The rest of the infected patients can only depend on his or her own immune system to fight off the viruses.

At present, while no vaccine has been developed, a number of antiviral drugs are being tested and established. One of the antiviral drug trials is “Remdesivir”, developed by Gilead Sciences (a company from the US). It was developed as an antiviral drug for viruses of Ebola, SARS and MERS. The laboratory trial of remdesivir exhibited due to the viruses of COVID-19, SARS and MERS are belonging to a similar family of coronaviruses, the result of the trial demonstrated that Remdesivir also could inhibit the replication of COVID-19. Therefore, Gilead Sciences sent the antiviral drug to China for further clinical trials. This antiviral drug also tested in one infected patient in the US with a positive result, but the result not able to determine whether the used of Remdesivir is the key to the recovery of the patient.

Another study is an antiviral drug that targeting on RNA viruses. Some anti-HIV drugs have been used to treat COVID-19 patients as a trial due to both viruses of COVID-19 and HIV are belonging to a similar classification of RNA viruses. In Thailand, the experts from Rajavithi Hospital had successfully improved the condition of several severe patients by using the combination of flu drug Oseltamivir with anti-HIV drugs Lopinavir and Ritonavir. However, all the antiviral drugs treatments are still in the experimental stage, there are no antiviral drugs available for widely used to treat COVID-19—yet. It is due to insufficient data to explain the efficacy and safety of the drugs.

Optimal Immune System to Defeat COVID-19

Since there is currently no confirmation from the medical community of any antiviral drugs or treatment that can cure to fight off COVID-19 coronavirus, we can protect ourselves by strengthening our body immune system as one of the best approaches, combine together with the available medical treatment to increase the chances of recovery. For whatever reason of recovery, fights off the coronavirus ultimately still depending on our own immune system. According to the WHO, while all age groups have a chance to be infected by COVID-19 coronavirus, elderly age groups and infected patients with pre-existing medical conditions faced a higher risk of death. According to the data collected by the National Health Committee of China, 75% of critical or death cases are patients with underlying diseases such as cardiovascular disease, hypertension, diabetes, cancer and etc. Alternatively stated that elderly with pre-existing health conditions are more susceptible to be infected and higher risk of death. This is because they have lower immunity to fight against the virus. Hence, the pivotal approach still is to maintain an optimal of the immune system of the infected patients. There are various recommendations, suggestions and rumors that can be found on the internet, for example, Indian curry cuisine to reduce the risk of COVID-19 infection, vinegar and ginger can help to prevent coronavirus infection, and etc. Nevertheless, all those ideas have not been proven in any form of clinical research.

From a scientific perspective, there are several ways to improve our immune system:
A. Lifestyle Modification:
1. Ensure to get enough sleep. According to the Journal of Experimental Medicine revealed that adequate sleep can improve the immune system of the body.
2. Stay positive emotions especially happiness. Numerous studies displayed that stress leads to decrease in the immune system.
3. Exercise/increase daily physical activity. The relationship between exercise and the immune system is not something new. Many studies confirmed that the improvement of our immune system was highly responsive to exercise. Although not exercising like jogging, swimming or etc., just by brisk walking for 30 minutes daily also can beneficial for the immune system.
4. Defecation. Healthy bowel habits help to improve the immune system of the body.

B. Diet and Nutrition Therapy:
1. A balanced diet. Several studies indicated that deficiency of one nutrient could have negative effects on the immune system. Therefore, we should consume a healthy, varied and balanced diet, containing a variety of fruits and vegetables, simultaneously avoid weight gain with excess body fat (and obesity) is known to impair the immune function.
2. When poor dietary habits and inadequate nutrient intakes from a diet are a concern, consume nutritional supplements may be necessary to achieve adequate nutrient intakes to maintain the optimum immune system.

There are several nutrients help you to maintain a healthy immune system, one of the nutrients is vitamin C. Vice-president of Beijing Chaoyang Hospital, Tong Zhaohui mentioned that vitamin C improves the immune defence during an interview.

Besides that, the Shanghai Municipal Health Commission also listed vitamin C as a nutrient to prevent coronavirus.

In addition, the International Society for Orthomolecular Medicine also had published that vitamin C protects against coronavirus.

Other than vitamin C, there are several nutrients that help to boost the immune system:
1. Garlic. Its nutrient compounds help fight against microbial infections and enhance the functioning of the immune system.
2. Echinacea. Its extracts help to boost the immune system.
3. Protein. Protein helps build and maintain immune cells, is crucial for immune health.
4. Licorice. Several studies demonstrated that licorice had pharmacological activities of antiviral and antimicrobial.

5. Probiotic. Protection from viral infection has been shown as a benefit of probiotic action. Besides, numerous studies also determined that probiotic had significantly improved bowel regularity and stool consistency, it leads to improvement of the immune response.

Conclusion

In summary, indeed, COVID-19 is a non-negligible disease, is a life-threatening infection. Tough the COVID-19 can be deadly, most people with COVID-19 so far have only mild illness and make full recoveries. In the current situation, keeping a healthy immune system in parallel to the medical attention for the infected patients, most of them can be recovered. Therefore, be cautious but not to panic, not to be frightened of COVID-19, also should not trust and believing blindly the unreliable information on the internet. We shall pay attention to cultivate a healthy lifestyle with adequate food and nutritional intake to ensure we have a healthy immune system, we can certainly overcome this pandemic crisis.

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References

Authors

Gan Han Lin, Medical Nutrition Team, Clinical Nutrition Candidate
Gew SP, Medical Nutrition Team, Clinical Nutritionist & IDF Diabetes Educator
Translation By Haylee Lai

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How to Keep Your Immune System at Optimum to Against COVID-19

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