Inflammation and Covid-19: What to Know!
Elizabeth Jane Hall and Poliana V. Vale, M.D.
COVID 19 is not only an acute, potentially serious viral illness; it is also a chronic disease problem. Indeed, almost 90% of those hospitalized for COVID 19 have pre-existing diseases such as diabetes, hypertension, heart conditions, chronic obstructive lung disease (COPD), liver disease or serious obesity. 1 These diseases significantly elevate the risks for serious complications and dying if one develops COVID 19. Immune suppression is common in diabetes and obesity. COPD lowers the threshold for lung infection. Inflammation is a major player in acute and long-term COVID complications.
The very best way to reduce COVID 19 long-term complications (heart damage and stroke) is not to get the virus! What additional actions can one take to lower their risk for potential long-term complications of COVID 19? These complications may manifest as abnormal clotting, damage to the heart muscle, and stroke. Quelling preexisting inflammation from chronic disease can also be an important preventive strategy for Covid 19 complications!
Inflammation and COVID 19
Complications Unfortunately, smoldering inflammation fuels chronic diseases such as diabetes, hypertension, and obesity. Infections are potential triggers for inflammation inside blood vessels that contributes to abnormal clotting and organ tissue damage. 2
How Are Your Guard Dogs Behaving?
Ideally, the components of your immune system act like a bunch of well-trained guard dogs. They alert us and attack any unwanted invaders, but are friendly to family, friends, and business associates. In immune suppression, these guard dogs are lazy. In autoimmune conditions, they become hyperactive and uncontrollable and attack the body’s tissue and organs. The inflammatory components in our bodies act as one group of immune guard dogs. Almost all pro-inflammatory agents have a dual nature. They benefit us under certain circumstances. When controlled, inflammation is a process that tries to localize and stop the spread of infection or damage. Hopefully, inflammation allows the increased numbers of white blood cells to destroy the bacteria or allergens, and tissue repair follows.
However, if white blood cells are not fully effective and some of the original invaders or irritants remain, more trouble follows, including the development of many chronic and acute disease processes. When the inflammatory process creates a superabundance of pro-inflammatory compounds, we get into even more trouble. Excessive amounts of these cytokines (a category of signaling molecules that regulate immunity and inflammation, among other things) can damage tissues.
COVID 19, Inflammation and Cardiovascular Damage
Obesity, diabetes, high blood pressure, and coronary artery disease are pro-inflammatory diseases. An excessive inflammatory process plays an important role in the severity and complications from Covid 19. On April 17, 2020, the CDC released the following data: Approximately 90% of hospitalized COVID-19 patients had the following underlying conditions: hypertension (49.7%), obesity (48.3%), diabetes (28.3%), and heart disease (27.8%). 3
A Storm that Damages the Heart
During a cytokine storm, the immune system releases excessive amounts of pro-inflammatory cytokines too rapidly into the blood. The inflammatory process escalates quickly and can trigger sudden damage to organs. A cytokine storm often develops into an acute, life-threatening emergency that requires immediate medical and drug intervention to prevent organ damage.
In some cases of severe COVID 19 infection, disproportionate amounts of inflammatory compounds can cause enough damage to the heart muscle to precipitate a heart attack or cause the heart to pump inadequate amounts of blood to the organs. Some COVID patients develop pneumonia and have a low amount of oxygen in the blood. Low levels of oxygen tax the heart. Unfortunately, COVID 19 virus can sometimes elicit severe inflammation in the heart muscle even if a person as no cardiovascular disease and is otherwise healthy. 4
COVID 19, Abnormal Clotting and Strokes
COVID-19 is a pro-inflammatory virus that encourages abnormal clotting with an increased risk of pulmonary embolism (clot in the lungs), deep vein thrombosis, and stroke. Even young adults who experience mild COVID systems may experience a stroke. Again, inflammation can trigger abnormal clotting although it is not necessarily the only factor involved. In seriously ill COVID 19 patients, tiny clots often form in the lungs. 5 Clots can also form in deep veins and travel. Serious infections with accompanying inflammation can destabilize a cholesterol plaque and generate a clotting mechanism. Clots from COVID 19 can also damage the kidneys.
Getting the Inflammatory Watchdogs to Behave
Physiologically, it just makes sense that if one is already in a pro-inflammatory condition from a chronic disease, he has a much lower threshold for both acute and chronic COVID 19 complications. Adopting anti-inflammatory lifestyle interventions that help to eliminate or reduce undesirable inflammation will improve many chronic diseases and may help to lower the threat of serious repercussions if one develops the COVID infection. 6
There is good news! Many of the recommended lifestyle changes below will help to optimize your immune system’s efficiency while helping to quell the undesirable inflammation and reducing your risk for dangerous clots.
Caveat: Please note we are not saying that lifestyle interventions and scientifically validated natural remedies are sufficient by themselves to prevent all the damage caused by fulminating inflammation from a serious COVID cytokine storm. (Fulminating describes a process that occurs suddenly and escalates quickly; is intense and severe to the point of lethality.)
Control Chronic Disease
Keep blood sugar, cholesterol, and blood pressure within normal ranges. Uncontrolled chronic disease generates more free radical damage and inflammation. Work with your doctor to reduce this damage. Learn about lifestyle interventions that can improve your condition.
Optimize Your Gut Health
A healthful diet promotes the proliferation of friendly gut bacteria that produce anti-inflammatory compounds. Unfortunately, the typical Western diet encourages the growth of unfriendly gut bacteria that generates pro-inflammatory compounds that adversely affect the gut, the brain, the liver, the immune system, and so much more. Just a few days of consuming a particular diet shape the gut bacteria. Please note the timing of your meals, regularity of schedule, and sufficient sleep, as they are essential for optimal gut health. 7 Food allergies should be addressed adequately for optimal gut health.
Just an additional observation: The gut is the home to a significant amount of lymphoid tissue that has the ability to generate even more pro-inflammatory compounds.
Avoid Dietary Bloopers
Sugar, saturated and trans fats, and a high salt diet are notorious for promoting inflammation. 8/9 Emphasize whole plant foods instead of the typical Western diet, (high in fats, sugar, refined carbohydrates, animal protein, and low in fiber). The Western diet, especially when combined with a sedentary lifestyle, produces chronic inflammation. 10 Consumption of saturated fats affect the gut microbial balance in an unfavorable manner. A high saturated fat diet can elicit gut inflammation. 11
Deficient or marginal intakes of magnesium, zinc, vitamins C, E, and A, B3, and B6 interfere with the production of anti-inflammatory compounds. Deficient levels of B-12 are linked to increased inflammation 12 and reduced immune responses.
Cultivate a Taste for Green Foods
Eat green vegetables daily. Why? Many of the dark green leafy veggies contain an omega-3 fat (alpha-linolenic) that combats inflammation. Chopped greens are great in soups, pasta, and even in a pizza topping.
Celery contains two dozen analgesic compounds and more than two dozen anti-inflammatory phytochemicals. 13 Don’t like raw celery? Use it liberally in soups, legume dishes, and entrées. A veggie cocktail of half carrot and half celery juice is excellent.
Mast cells play an important role in initiating cytokine storms in influenza and other serious viral infections. We know that the phytochemical sulforaphane in broccoli and kale helps to mitigate some of the inflammatory damage from hyperactive mast cells in allergies. 14 Luteolin, found in celery, artichokes, thyme, and green peppers, has significant anti-inflammatory activity. Both of these phytochemicals work more effectively when eaten together. 15
Caveats: Individuals who have thyroid conditions should cook their green vegetables such as kale, collards, broccoli, and Brussel sprouts.
More Anti-Inflammatory Foods
When consumed regularly, fresh or frozen berries and red grapes provide anti-inflammatory activities. Anthocyanins in any red, purple, or blue fruits have demonstrated anti-inflammatory and anti-oxidative properties. Additionally, anthyocyanins have beneficial effects on blood pressure and other cardiovascular risk factors. Anthocyanin-rich plants also inhibit replication of several viruses and may reduce the risk for undesirable blood clots. 16/17 Apples and citrus also contain anti-inflammatory compounds. In addition, fresh fruits are rich in vitamin C, a natural anti-histamine. Frozen fruits often have higher levels of antioxidants.
Increasing one’s consumption of plant-based omega-3-fats helps to reduce inflammation. Chia seed, flaxseeds, and leafy greens provide anti-inflammatory omega-3 fat. Emphasize whole fats—nuts, seeds, avocados, and olives. Use only cold-pressed oils sparingly. Fried foods increase inflammation.
Vitamin D, Sunlight, and Inflammation
In its active form, vitamin D is generally a marvelous anti-inflammatory, immune-bolstering, and cancer-fighting compound. A new study links vitamin D deficiency to a higher number of COVID 19 cases and mortality. 18/19 Nutritional epidemiologists estimate that 50% of the population in North America and Western Europe has an insufficient or deficient amount of active vitamin D in their bodies. Dark-skinned individuals and the elderly have reduced ability of getting enough vitamin D from skin exposure to sunlight. Since excessive amounts of this fat-soluble vitamin can be toxic, get your vitamin D level checked first before you supplement.
Even if you are taking vitamin D, you still need some sun exposure, preferably in the morning. Sun exposure kills viruses. Through a different mechanism other than vitamin D, sunlight energizes virus-killing T-lymphocytes. 20 Morning sunlight and darkness at night improve melatonin production. This hormone improves immune efficiency and helps to subdue excessive inflammation.
Herbs for Inflammation
Curcumin from turmeric and ginger inhibits inflammation by at least a dozen known pathways. There is early evidence that suggests that curcumin may be useful for viral-causing cytokine storms. 21 Curcumin is fat-soluble and is not easily absorbed. Exposure to light destroys the effectiveness of curcumin. Liposomal formulation improves its absorption. Garlic also inhibits inflammation as well as enhances natural killer cell activities. 22 Both curcumin and garlic have the potential to interact with some medicine. So, always check with your pharmacist before using any medicinal herb to avoid possible herb-drug interactions.
Good News for Obese Individuals!
Excess fat cells generate pro-inflammatory compounds too. Good news! Just a modest weight loss of 5 to 10% can significantly reduce elevated blood sugar and blood fats and reduce inflammatory markers. Australian researchers found that when an obese, pre-diabetic, or diabetic individual loses just a little over 12 pounds, the level of pro-inflammatory chemicals can return to that of lean individuals. 23
Get adequate, good quality sleep. Even reducing a normal sleep time of eight hours by 25% encourages inflammation. Deficient sleep increases inflammation. Losing sleep for even part of one night can trigger one of the major cellular pathways that produce tissue-damaging inflammation. 24 Insufficient sleep can activate your flight-and-fight system and eventually makes one more prone to clots.
Thrive on Exercise
Engage in daily moderate exercise. Sedentary living reduces immune efficiency and encourages undesirable clotting. The exercise does not have to be vigorous or intense to improve immunity or reduce inflammation. Moderate exercise thickens the adrenal gland cortices that produce the anti-inflammatory hormone cortisol. This valuable hormone tightens up the cell membranes making them more resistant to compounds. Just 20 minutes of moderate exercise acts as an anti-inflammatory agent. 25 Regular, moderate exercise also increases anti-inflammatory compounds in the elderly.
Additionally, moderate exercise increases fibrinolysin, an enzyme that breaks apart small clots. Be sure to take additional 5 minute exercise breaks every two hours if you are sedentary.
Develop Sound Mental Health
Depression and chronic anxiety promote inflammation. 26 Loneliness decreases the expression of genes involved in antiviral responses and increases the activity of genes involved in inflammation. 27 Consequently, higher susceptibility to inflammation and viral sickness results.
By cultivating an attitude of gratitude, replacing distorted thought patterns with healthy thoughts, and by accepting our limitations that we cannot change, we reduce our stress.
Presently, we need to take precautions against the COVID 19 virus. Hand-washing and appropriating distancing are essential. Adopting lifestyle strategies that optimize one’s immune system and correcting any preexistent, undesirable inflammation from a chronic disease are useful.
© 2020, Wildwood Sanitarium. All rights reserved. Used with permission.
Disclaimer: The information in this article is educational and general in nature. Neither Wildwood Lifestyle Center, its entities, nor author intend this article as a substitute for medical diagnosis, counsel, or treatment by a qualified health professional.
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