COVID Immune system Lifestyle
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by Abe Rosenberg July 29, 2020

COVID-19 and the immune system: What we know

With no vaccine or effective antiviral treatment available, it’s only natural that some people may search for alternative ways to protect themselves from COVID-19 — tempted by a barrage of online claims touting pills, supplements and concoctions.
 
“I think people are rightfully concerned about how to protect themselves,” said City of Hope hematologist Joseph Alvarnas, M.D., vice president for Government Affairs and senior medical director for Employer Strategy. But he warns, “There are so few reliable sources [of information] and many charlatans who pretend to know.”
 
This is nothing new. Public health challenges have always bred their share of miracle “cures.” Ads for Miller’s Antiseptic Snake Oil (“Don’t fail to have a bottle on hand when the attack comes on!”) promised relief during the 1918 flu pandemic.
 
This time around, much of the interest seems to center on whether those most at risk for COVID-19 — those with weakened immune systems, over 65 or with underlying health conditions —  can do anything to boost their immune systems and improve chances of beating COVID-19 or preventing it altogether.
 
It’s a complex question with a simple answer:
 
Probably not.
 
There’s no shortage of articles touting general immunity-building strategies — from probiotics to antioxidants to every vitamin out there. This genre was popular long before COVID-19 came along. But now, when those stories get recycled to accommodate today’s coronavirus-wary audience, a disclaimer often appears:
 

No Magic Pill

 
“No supplement will cure or prevent disease. With the 2019 coronavirus COVID-19 pandemic, it’s especially important to understand that no supplement, diet or other lifestyle modification other than physical distancing, also known as social distancing, and proper hygiene practices can protect you from COVID-19. Currently, no research supports the use of any supplement to protect against COVID-19 specifically.”
 
And there’s the rub.
 
Yes, it’s always a good idea to take steps to improve your health. Yes, there are scattered studies that say too little sleep depresses the immune system, that exercise helps your T cells and eliminates toxins. Yes, some foods may have certain anti-inflammatory properties. And yes, some people even claim vitamin D fortifies you against respiratory infection and that enhancing your gut microbiome may be a worthwhile goal.
 
But no one has been able to prove that any one of those things has any definitive effect on COVID-19.
 
At this early stage of this new virus, we simply don’t have all of the answers. And that leaves many vulnerable to what Alvarnas describes as “disinformation” about treatments that sound good, even logical, but have no scientific basis when it comes to keeping the coronavirus at bay.
 
“People find many of these things profoundly alluring,” he said. “They seem so simple and without risk. A lot of that is just a reflection of our anxiety.”
 
What’s more, as we continue to learn about COVID-19, inducing one’s immune system to do more may actually be the last thing we want. Because it’s becoming clear that the deadliest cases of COVID-19 are caused not so much by the infection itself but by the immune system’s overreaction to it.
 
It’s called the “cytokine storm.”
 
In some patients, the coronavirus may go unchallenged for days or weeks, but then the body finally fights back with a massive release of cytokine proteins: signaling molecules that activate inflammation and recruit other molecules to join the battle. A snowball effect ensues, causing irreparable and often fatal damage to vital organs, especially the lungs, heart and kidneys.
 
We don’t know why some patients experience a cytokine storm while others don’t. Efforts are underway to find treatments that will regulate an overactive immune system, bringing it back to square one and buying more time for the patient to recover. One strategy, developed by City of Hope’s John J. Rossi, Ph.D., Lidow Family Research Chair of the Department of Molecular and Cellular Biology, employs a drug originally developed to stop liver cancer from spreading by downregulating inflammatory cytokines and upregulating cytokines that can calm the storm.
 
In the meantime, Alvarnas stresses there is no “exotic” or “miracle” potion that will shield us from the effects of COVID-19. We do, however, have weapons at our disposal, and while they may seem mundane by comparison, they do work.
 
“Listen to our health officials,” he pleaded. “Wash your hands. Wear a mask. Practice social distancing. Avoid the magical potions. Nuts and twigs won’t protect you.”
 
And try to be patient. Answers are coming.
 
“Every day, what we know evolves rapidly, and in time we’ll know much more."

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