A Promising Approach to Improving COVID-19 Symptoms: Using Antioxidant Supplements

authors:

avatar Sanaz Keshavarz Shahbaz 1 , avatar Yazdan Naderi ORCID 2 , avatar Samaneh Keshavarz-Hedayati 2 , avatar Ehsan Aali 2 , *

Cellular and Molecular Research Center, Research Institute for Prevention of Non-communicable Disease, Qazvin University of Medical Sciences, Qazvin, Iran.
Department of Pharmacology, Faculty of Medicine, Qazvin University of Medical Science, Qazvin, Iran.
Journal of Inflammatory Diseases: Vol.25, issue 2; 105-126
article type: issue_documents_importer

how to cite: Keshavarz Shahbaz S, Naderi Y, Keshavarz-Hedayati S, Aali E. A Promising Approach to Improving COVID-19 Symptoms: Using Antioxidant Supplements. J Inflamm Dis. 2021;25(2):e156283. 

Abstract

Severe Acute Respiratory Syndrome-Coronavirus 2 (SARS-CoV-2) that causes COVID-19 disease could progress to Acute Respiratory Distress Syndrome (ARDS). The immune cells’ migration in response to the virus leads to cell death by releasing oxidizing free radicals. These oxidizing free radicals mediate NF-κB (Nuclear Factor ‘kappa-light-chain-enhancer’ of activated B-cells) activation and induce transcription of cytokine-producing genes that eventually causes cytokine storm and septic shock. The over-expression of oxidative stress and enhancing Reactive Oxygen Species (ROS) and Reactive Nitrogen Species (RNS) production activate transcription factors like NF-κB. So repeating this cycle intensifies the host’s inflammatory responses. In this way, antioxidants as compounds that inhibit oxidation by terminating chain reactions are suggested to alleviate COVID-19 symptoms. In the present review study, the pathogenesis of the virus, the virus immunopathology, and the balance between immune responses and oxidative stress are discussed. Also, in this review, due to the importance of oxidative stress in the pathogenesis of the disease, some of the most important antioxidant agents whose therapeutic effects have been shown in improving many viral infections, ARDS, and acute lung injury, are recommended to improve the patient’s condition infected with SARS-CoV-2. Besides, the recent COVID-19 clinical studies in this field are summarized in this review article. In the present review study, the pathogenesis of the virus, the virus immunopathology, and the balance between immune responses and oxidative stress are discussed. Also, in this review, due to the importance of oxidative stress in the pathogenesis of the disease, some of the most important antioxidant agents whose therapeutic effects have been shown in improving many viral infections, ARDS, and acute lung injury, are recommended to improve the patient’s condition infected with SARS-CoV-2. Besides, the recent COVID-19 clinical studies in this field are summarized in this review article. According to these studies, melatonin through promoting sleep quality, decreasing vascular permeability, reducing anxiety, and regulating blood pressure; vitamin C through decreasing the mortality rates and the requirement for mechanical ventilation; glutathione through decreasing respiratory distress in the pneumonia of COVID-19 patients; and high selenium levels could improve the COVID-19 patients’ clinical outcomes.