#053 COVID-19 Q&A #1 with Rhonda Patrick, Ph.D.

Apr 14, 2020 Episode Page ↗
Overview

Dr. Rhonda Patrick answers listener questions about COVID-19, covering topics like its impact on children, potential therapeutics such as hydroxychloroquine and quercetin, blood type influence, vitamin D's role, sauna use, intravenous vitamin C, and melatonin's potential effects on inflammation and oxidative stress.

At a Glance
13 Insights
1h 14m Duration
8 Topics
6 Concepts

Deep Dive Analysis

COVID-19 in Infants, Children, and Pregnant Women

Hydroxychloroquine as a Potential COVID-19 Therapeutic

Quercetin's Role as a Zinc Ionophore

Blood Type Influences on COVID-19 Risk

Vitamin D, ACE2 Receptors, and COVID-19 Susceptibility

Sauna Use and COVID-19 Prevention

High Dose Intravenous Vitamin C for COVID-19 Treatment

Melatonin's Potential Impact on Virus Severity

ACE2 Receptor

The angiotensin-converting enzyme 2 receptor is exploited by SARS-CoV-2 to enter cells. It also plays a crucial role in regulating blood pressure, inflammation, and body fluid homeostasis, and is protective against acute lung injury and acute respiratory distress syndrome.

Zinc Ionophore

A compound that transports positively charged zinc ions across a lipid membrane into cells. This is important because zinc inhibits viral replication (specifically RNA-dependent RNA polymerase), but cannot enter cells on its own.

Renin-Angiotensin System (RAS)

A system involving ACE and ACE2 that regulates blood pressure, inflammation, and fluid balance. Maintaining balance in this system is critical, as an imbalance (e.g., decreased ACE2) can lead to severe lung injury and other conditions.

Cytokine Storm

An excessive and dysregulated inflammatory and immune response, often seen in severe COVID-19, which can lead to extensive cell and tissue damage, multiple organ failure, and acute respiratory distress syndrome.

Heat Shock Proteins (HSPs)

A class of proteins induced by heat stress that maintain cellular homeostasis, protect cells from stress, and activate cellular defense systems. HSPs can stimulate the innate immune response and may directly inhibit viral activity.

NLRP3 Inflammasome

A large intracellular complex that detects and responds to internal and external threats, playing a role in inflammatory disorders. Its activation by viruses like SARS-CoV-1 can trigger NF-kappa B and contribute to a cytokine storm.

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Are children and infants susceptible to COVID-19, and can they spread it?

Children of all ages are susceptible, but generally experience less severe disease than adults, with infants being more vulnerable to severe illness. While they may play a role in community transmission, more research is needed on their impact on viral spread.

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Can hydroxychloroquine treat COVID-19, and how does it work?

Preliminary, low-quality data suggests it might decrease the length of time the virus remains in the respiratory tract. It may work as a zinc ionophore, transporting zinc into cells to inhibit viral replication, and also by interfering with viral entry and reducing inflammation.

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What is quercetin's role as a zinc ionophore in the context of COVID-19?

Quercetin, a flavonoid found in plants, has been shown in in vitro studies to have zinc ionophore activity, meaning it can transport zinc into cells. Zinc then inhibits RNA-dependent RNA polymerase, a key enzyme for RNA virus reproduction.

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Does blood type influence COVID-19 risk?

Preliminary evidence suggests people with blood group A may have a higher risk of acquiring COVID-19, while those with blood type O may have a lower risk. This could be due to type A antibodies (present in type O or B blood) inhibiting the virus's interaction with the ACE2 receptor.

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How does vitamin D influence ACE2 receptors and COVID-19 susceptibility?

Vitamin D is a steroid hormone that helps balance the renin-angiotensin system. While SARS-CoV-2 uses ACE2 to enter cells, ACE2 is crucial for protecting against lung injury. Vitamin D can normalize ACE2 levels in situations where they are downregulated (like in acute lung injury), thereby potentially protecting against severe outcomes.

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Can sauna use help prevent COVID-19?

There is no direct data on sauna use and COVID-19. However, frequent sauna use is associated with a reduced risk of other respiratory illnesses like pneumonia and the common cold, potentially by reducing oxidative stress and inflammation, improving lung function, and modulating the immune system through heat shock proteins.

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Can high-dose intravenous vitamin C help treat COVID-19?

There is no published data on intravenous vitamin C specifically for COVID-19, but a trial is underway. Anecdotal reports from China suggest potential benefits. Published data on sepsis and acute respiratory distress syndrome (complications of severe COVID-19) indicate that intravenous vitamin C can reduce mortality, decrease time in intensive care, and improve organ function, likely by enhancing immune function and generating hydrogen peroxide to kill pathogens.

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How might melatonin impact the severity of COVID-19?

There is no direct data on melatonin for COVID-19. However, melatonin has anti-inflammatory and antioxidant properties, can regulate the immune system (activating or dampening depending on context), and has been shown to be protective against acute lung injury in animal models. It may also modulate inflammasomes and improve sleep, which is vital for immunity.

1. Seek Professional Medical Advice

Do not use the information provided in this podcast to diagnose or treat any medical condition, as it does not constitute medical advice. Always consult a medical doctor for diagnosis and treatment.

2. Prioritize Sleep for Immune Health

Prioritize getting adequate sleep, as it is crucial for regulating the immune system, and lack of sleep can significantly dampen immunity.

3. COVID-19 Breastfeeding Protocol

If a mother has COVID-19, the CDC recommends continuing to breastfeed, but she should wash her hands before touching the infant and wear a face mask, if possible, while feeding at the breast.

4. Avoid Self-Medicating Hydroxychloroquine

Do not take hydroxychloroquine at home without a physician’s guidance due to potential safety concerns like cardiac toxicity and fatal arrhythmias.

5. Sauna Not for COVID-19 Treatment

There is no data to suggest that sauna use or other heat stress modalities have any effect on preventing or treating COVID-19 illness.

6. IV Vitamin C Not for COVID-19

There is no published data on the effect of intravenous vitamin C on COVID-19, so it should not be relied upon as a treatment.

7. Melatonin Not for COVID-19 Treatment

There is no data to suggest that melatonin may prevent or lessen the severity of COVID-19 illness, so it should not be relied upon for this purpose.

8. Test Vitamin D Levels

The best way to determine appropriate vitamin D supplementation is through a baseline blood test, followed by another test a month after starting supplementation.

9. Vitamin D Upper Intake Limit

Be cautious not to take too much vitamin D; the tolerable upper intake for adults is conservatively set at 4,000 IUs per day.

10. Screen for G6PD Before IV Vitamin C

Patients should be pre-screened for glucose-6-phosphate dehydrogenase (G6PD) deficiency before receiving high doses of intravenous vitamin C, as it could lead to hemolysis.

11. Hot Baths for Heat Shock Proteins

Consider taking hot baths (e.g., 140°F from waist down for one hour) as they have been shown to increase heat shock proteins, which play roles in cellular protection and immune response.

12. Avoid Blue Light for Melatonin

To support natural melatonin production, which starts in the evening, avoid blue light exposure as it inhibits melatonin synthesis.

13. Consider Quercetin as Zinc Ionophore

Quercetin, a flavonoid, has shown zinc ionophore activity in vitro, helping zinc enter cells to inhibit viral replication, and has been reported to block SARS-CoV-1 entry.

This is not something people should be taking at home without a physician's guidance.

Rhonda Patrick

When you draw too broad of conclusions from a very isolated interaction that you kind of pull out from a biological system, it can lead to what seems to be a logically consistent conclusion, but it's actually the wrong interpretation.

Rhonda Patrick

It is important to point out that the acute lung injury itself led to a decrease in ACE2, which again I mentioned has been shown to occur with SARS-CoV-1. And this resulted in worse disease outcome.

Rhonda Patrick

While the effect of heat shock proteins on viruses is a bit nuanced, the more important thing is that heat shock proteins activate the innate immune system and sauna use has been shown to increase white blood cell and other monocyte levels.

Rhonda Patrick

While there's no direct evidence that melatonin use could prevent or treat COVID-19, it's plausible that melatonin may possibly have some beneficial role.

Rhonda Patrick

CDC Recommendations for Breastfeeding with COVID-19

Rhonda Patrick (describing CDC recommendations)
  1. Wash hands before touching the infant.
  2. Wear a face mask, if possible, while feeding at the breast.

High-Dose Intravenous Vitamin C Treatment for Severe COVID-19 (China Trial)

Rhonda Patrick (describing a clinical trial)
  1. Administer 12 grams of intravenous vitamin C.
  2. Administer a second 12-gram dose later in the day, for a total of 24 grams per day.
  3. Continue treatment for seven days.
5%
Symptomatic children experiencing severe COVID-19 symptoms Had shortness of breath or low levels of oxygen in the blood.
0.6%
Symptomatic children progressing to ARDS or multi-organ dysfunction Much lower than levels seen in adults.
1 to 5%
Children's proportion of diagnosed COVID-19 cases As of March 18, 2020, based on a meta-analysis of 45 studies.
70%
Hydroxychloroquine-treated patients clearing virus by day six in a small study Compared to 12.5% in the standard of care group.
Three times more potent
Hydroxychloroquine potency against SARS-CoV-2 in cell culture Compared to chloroquine phosphate.
Approximately 70%
US population with vitamin D insufficiency According to NHANES data.
28.9%
US population with vitamin D deficiency According to NHANES data.
Below 20 nanograms per milliliter
Vitamin D deficiency threshold Blood levels of 25-hydroxyvitamin D, according to the Endocrine Society.
Less than 30 nanograms per milliliter
Vitamin D insufficiency threshold Blood levels of 25-hydroxyvitamin D, according to the Endocrine Society.
63% more likely
Increased likelihood of vitamin D deficiency in older adults Compared to young adults, according to NHANES data.
Four times less
Reduction in vitamin D production by age 70 Compared to a 20-year-old.
Greater than 50% less
Reduced bioavailability of vitamin D in obese individuals Compared to non-obese individuals.
Three times higher
Prevalence of vitamin D deficiency in obese adults Compared to non-obese adults.
24.6 times higher
Prevalence of vitamin D deficiency in non-Hispanic blacks Compared to non-Hispanic whites, according to NHANES data.
33%
African Americans' share of COVID-19 hospitalizations Despite constituting 13% of the US population.
45%
White people's share of COVID-19 hospitalizations Despite making up 76% of the US population.
40%
Somali immigrants' share of COVID-19 related deaths in Stockholm, Sweden Despite making up 0.84% of the Stockholm County population.
Around 5 nanograms per mil
Increase in blood 25-hydroxyvitamin D levels per 1,000 IUs of vitamin D supplementation General increase, with genetic factors contributing to variability.
4,000 IUs a day
Tolerable upper intake of vitamin D for adults Set by the Food and Nutrition Board of the Institute of Medicine.
27% less likely
Reduced risk of pneumonia with sauna use (2-3 times weekly) Compared to those using sauna once a week or not at all.
41% less likely
Reduced risk of pneumonia with sauna use (4-7 times weekly) Compared to infrequent sauna users.
Approximately 20 minutes
Average sauna exposure in a Finnish study At 174 degrees Fahrenheit (79 degrees Celsius).
Around 140 degrees Fahrenheit
Typical temperature of far-infrared saunas Lower than typical Finnish saunas, often with longer duration.
Approximately 50%
Increase in heat shock protein levels after sauna use After 30 minutes in a 163 degree Fahrenheit sauna in healthy young men and women.
30 to 70 times higher
Intravenous vitamin C blood level concentration compared to oral administration For the same dose in healthy adults.
885 micromoles per liter
Peak plasma concentration of 1.25 grams intravenous vitamin C In healthy adults.
135 micromoles per liter
Peak plasma concentration of 1.25 grams oral vitamin C In healthy adults.
Approximately 30%
Mortality rate in sepsis/ARDS patients receiving intravenous vitamin C in a clinical trial Compared to more than 46% in the placebo group.
8.5%
Mortality rate in sepsis patients treated with IV vitamin C, steroid, and B1 Compared to 40.4% in a control group receiving standard of care.
50 to 100 times higher
Vitamin C concentration in immune cells (neutrophils and leukocytes) Compared to plasma concentrations.
Around 40 years old
Age at which melatonin production in the pineal gland declines Starts to decline with age.
Up to five times
Increase in melatonin concentration in human lymphoid cells Nocturnal physiological levels in human serum.
6 milligrams per day
Melatonin dosage in a study for diabetes and periodontitis Supplementation for eight weeks.
25 milligrams per day
Melatonin dosage in a study for multiple sclerosis Supplementation for six months.
Up to one gram per day
Melatonin safety at high doses No adverse effects seen for a month in short-term use.