COVID-19

by Dr. Noel Peterson, ND, DAAPM

Notice: Based on questions and comments we received, the Patient Advisory written March 24th has led some readers to believe that we were promoting a treatment, prevention or cure for COVID-19 . We sincerely regret this and want to make it clear that there exists no compound for the treatment, prevention or cure for COVID-19 . The only proven method of effective control of COVID-19 are social distancing, sanctuary at home, quarantine, and frequent handwashing with soap and water.

These Patient Advisories are meant to provide information only and not intended to offer medical advice. Medical advice can only be offered in the context of a patient consultation with your physician.

Here’s what we do know: Tho only proven intervention is following all State, local and Federal mandates for social distancing and Stay Home Orders, isolation and quarantine of persons of high risk for exposure, and frequent soap and water hand washing can address the COVID-19 pandemic and flatten the curve of viral infection.. 

What we don’t know: No human clinical studies have been conducted on the efficacy of any natural compounds in the treatment or prevention of any coronavirus infection. No one knows if ionophore induction of Zn++ induced inhibition of viral RNA-dependent RNA-polymerase (RdRp) has an effect on human viral infection.

What you need to know: The FDA has not approved of these statements, or any compound for the treatment or prevention of COVID-19 infection., Medical advice can only be given in the context of a medical consultation. Nothing in the compounds described below have been proven to treat or prevent any disease or malady, nor are these statements intended to provide medical or any other health advice in the treatment or prevention of any disease or malady.  If you suspect exposure to an active case of coronavirus, and/or develop cough, fever chills, and respiratory distress, contact your physician for advice and medical treatment.

What we don’t know: No human clinical studies have been conducted on the efficacy of any natural compounds in the treatment or prevention of any coronavirus infection. No one knows if ionophore induction of Zn++ induced inhibition of viral RNA-dependent RNA-polymerase (RdRp) has an effect on human viral infection.

What you need to know: The FDA has not approved of these statements, or any compound for the treatment or prevention of COVID-19 infection., Medical advice can only be given in the context of a medical consultation. Nothing in the compounds described below have been proven to treat or prevent any disease or malady, nor are these statements intended to provide medical or any other health advice in the treatment or prevention of any disease or malady.  If you suspect exposure to an active case of coronavirus, and/or develop cough, fever chills, and respiratory distress, contact your physician for advice and medical treatment. 

The Covid-19 pandemic is an existential threat to all of us

Clinical experience in China, Korea, and Italy has confirmed that for those of us over 60 years of age, the risk of severe infection and even death is much greater than for younger populations. COVID-19 mortality rates for the overall population are about 6 times that for influenza. According to a recent JAMA Summary of a Report of 72,314 Cases From the Chinese Center for Disease Control and Prevention, the mortality rate for the older population climbs to 14.5% in age 80+ population, 8.0% in age 70-79, and 49% in critical cases (5% of all cases).

In the US, younger patients are getting critically sick

The experience to date in Italy and in the US is that about 50% of COVID-19 cases admitted to the ICU are under 50 yrs, and about 1/3 of new cases admitted to the ICU are aged 20-40 yrs. While the death rate in these younger patients is lower than in the older population, these patients are critically ill and require intubation. No one knows why the younger population is affected more severely in the U.S. compared to China.

Coronaviruses disproportionately target health care workers

The last two epidemics of coronavirus (SARS-1 in 2002, and MERS in 2010) had a devastating effect on the healthcare infrastructure by disproportionately causing critical illness and death in doctors, nurses and hospital personal, which greatly enhanced the death rates in all patients.

Current recommended best practices

The Centers for Disease Control and prevention emphasize social distancing, frequent hand washing and quarantining when necessary. The CDC guidelines are our best hope at stemming the tide of new infections and eventually returning to life as normal.

What about prevention and treatment?

There are currently no drugs, vaccines, nutrients, botanicals or dietary supplements proven to prevent, treat or cure COVID-19. The COVID-19 Central Clinical Task Force, composed of physicians and experts treating confirmed cases across the nation of South Korea, has published its principles of treatment. While the South Korean and Chinese health departments have the most experience with treating the coronavirus COVID-19, their consensus recommendations have as yet not been adopted in the US health care system.

Re-emergence of an ancient remedy?

What we have learned is that one of the promising drugs in the prophylaxis and treatment of coronavirus is an old drug derived from the bark of a Peruvian tree, Cinchona officinalis. This drug, chloroquine, is used in the prevention and treatment of malaria, and in rheumatoid arthritis. Hydroxyquinoline can be highly toxic and is known to cause drug-induced prolongation of the QTc of some people. The QTc is an indicator of the health of the heart’s electrical recharging system. Patients with a dangerously prolonged QTc are at increased risk for potentially life-threatening ventricular rhythm abnormalities that can culminate in sudden cardiac death., causing cardiac arrest in susceptible individuals.

What is really interesting is that hydroxychloroquine targets coronavirus replication through inhibition of the core enzyme that the coronavirus uses to hijack our own cells into making copies of the coronavirus, specifically RNA-dependent RNA-polymerase (RdRp). This coronavirus killing mechanism has been well documented in human cell cultures (in vitro) against the RdRp from a different type of coronavirus, SARS-CoV, and is now a consensus treatment advocated by the Korean health system.

A medication that may help treat COVID-19 is chloroquine derived from the bark of a Peruvian tree, Cinchona officinalis.
One of the promising medications in the prophylaxis and treatment of coronavirus, chloroquine is an old drug derived from the bark of a Peruvian tree, Cinchona officinalis.

Chloroquine’s history goes back thousands of years to Peru (South America), where the indigenous people extracted the bark of the Cinchona trees and used the extract (Chinchona officinalis) to fight chills, fever, and malaria. In 1633 this herbal medicine was introduced in Europe, where it was given the same use and also began to be used against malaria. The quinolone antimalarial drug quinine was isolated from the extract in 1820, and Chloroquine is an analog of quinine.

What is really fascinating is the mechanism of action for Chloroquine

We know that the Zinc ion (Zn++) is a positive ion and therefore does not easily pass through our cell’s bi-lipid membrane, and requires active transport to maintain adequate intracellular levels. It turns out that Chloroquine functions as an ionophore, a compound that opens up cell membranes to allow a hundred-fold increase in the influx of Zinc ions into the infected cell. Intracellular Zn++ must be raised hundreds-fold higher than active transport can provide in order to deactivate the viral RdRp Replicase, effectively shutting down viral replication.

But this does not mean that taking high-dose zinc supplements will help you kill the virus!

In vitro studies have shown an ionophore must be present to increase the uptake of Zinc across the cell membrane; otherwise, Zinc cannot be taken up by cells in high enough concentrations to interfere with RdRp Replicase. By opening the gate, Chloroquine allows a huge hundreds-fold influx of Zn++, enough to stop viral replication through inhibition of RdRp Replicase. Of course, if there is a deficiency of zinc in the environment surrounding the cell, then this mechanism is thwarted. But taking high-dose zinc alone is not sufficient to improve the uptake of zinc into the cells. To increase intracellular zinc to a level high enough for this to work, there must be an ionophore present, like Chloroquine.

Other natural substances have been shown to be effective Zinc ionophores and coronavirus inhibitors

Fortunately, other natural, less toxic substances have been shown to act as zinc ionophores in vitro. Scientists have identified and tested two non-toxic plant-based polyphenols that have potent zinc ionophore effects on live cells, increasing the intracellular concentration of zinc between two-hundred and three-hundred fold, as high as the ionophore effect of Chloroquine. We have read the literature on other plant-derived compounds that have well documented inhibitory effects on other coronavirus infections such as SARS-CoV and MERS CoV based on well designed in vitro studies.

SARS-CoV-2 isolated from a US person infected with OCVID-19.

My prevention and treatment recommendations

We have a rapidly emerging public health catastrophe and little is known about how to prevent the people who have already been exposed from becoming fully symptomatic. Once the virus has hijacked our cells to replicate itself, patients become sick, and if tested, and confirmed, finally are given supportive treatment. Only social distancing and Stay Home Orders, isolation and quarantine of persons of high risk for exposure, and frequent soap and water hand washing can address the COVID-19 pandemic and flatten the curve of viral infection.

Acting on the Best Available Evidence

Under ideal conditions, we would follow the Scientific Method by testing every individual before administering these compounds and track their outcomes. But faced with the reality of a rapid increase in cases, and when the only course of after exposure treatment recommended is self-imposed quarantine, we do what doctors have done for ages in the face of epidemics: we advise, support and treat our patients based on the best available evidence. But this is important for you to understand: there have been no conclusive case studies on the effects of hydroxychloroquine or any other compound on COVID-19.

Here is our three-tiered approach to the management of suspected COVID-19 in addition to CDC guidelines:

  1. Preventive support for: elderly patients who are at risk of exposure; all patients with a comorbidity risk (COPD, respiratory diseases, cardiomyopathy, congestive heart failure, diabetes, frailty); healthcare workers who are at the highest risk of infection; for persons who have been in close proximity and exposed to known COVID-19 positive cases
  2. Active treatment with hydroxychloroquine may be indicated for those who test positive for COVID-19 and are symptomatic (fever, cough, shortness of breath). Only your doctor can make this decision.
  3. Hospitalization for patients who develop symptoms of acute respiratory distress (ARD) or other severe manifestations of COVID-19 infection.

If you would like to consult with us on our protocol for improving your immune response, contact Oregon Regenerative Medicine at (503) 636-2734. We are also currently taking supplement orders and shipping them or placing them outside the clinic door for pickup, providing phone consults, and taking extraordinary sanitizing measures for our patients at ORM. In the meantime, continue to practice exceptional hygiene and handwashing, social distancing, and remember to exercise, eat healthfully and avoid immune compromising sugar intake.


Sources

1.) Expert consensus on chloroquine phosphate for the treatment of novel coronavirus pneumonia]. Multicenter collaboration group of Department of Science and Technology of Guangdong Province and Health Commission of Guangdong Province for chloroquine in the treatment of novel coronavirus pneumonia. Zhonghua Jie He He Hu Xi Za Zhi. 2020 Feb 20;43(0):E019. doi: 10.3760/cma.j.issn.1001-0939.2020.0019. [Epub ahead of print] Chinese. PMID: 32075365

2) J Agric Food Chem. 2014 Aug 13;62(32):8085-93. doi: 10.1021/jf5014633. Epub 2014 Jul 31. Zinc ionophore activity of quercetin and epigallocatechin-gallate: from Hepa 1-6 cells to a liposome model. Dabbagh-Bazarbachi H1, Clergeaud G, Quesada IM, Ortiz M, O’Sullivan CK, Fernández-Larrea JB. https://www.ncbi.nlm.nih.gov/pubmed/25050823

3) Antiviral activity of Sambucus FormosanaNakai ethanol extract and related phenolic acid constituents against human coronavirus NL63. Weng JR, Lin CS, Lai HC, Lin YP, Wang CY, Tsai YC, Wu KC, Huang SH, Lin CW. Virus Res. 2019 Nov;273:197767. doi: 10.1016/j.virusres.2019.197767. Epub 2019 Sep 24. PMID: 31560964 [PubMed – in process]