Developing Resilience To COVID-19 Variants
Since the beginning of the Covid-19 pandemic, hospitals, health care workers, nurses, doctors, emergency responders and many others have been overwhelmed and under a great deal of stress. They’ve required our cooperation to limit the spread of Covid-19, prevent unnecessary deaths and to reduce the burden on our health system.
The foremost method of limiting this burden so far has involved social distancing, self-isolation, wearing masks, hand washing and sanitizing surfaces. All of which are valid and important to avoid contact and infection from the virus. But as Covid-19 variants continue to arise and evade vaccination efficacy, it is becoming clear that this virus may be around longer than we would all hope. Is there anything we can do that will reduce our chances of a serious, medical attention requiring, infection and allow us to get back to normalcy?
My hope with this post is to empower and give individuals a more active role in containing the virus and controlling their health by, first, showing the mechanisms of a viral infection and, second, the many ways lifestyle and dietary choices can help or hinder our response to it.
How does a virus work?
The mechanisms of viral infection.
- Implantation of virus at the portal of entry (in the case of COVID-19 this implantation occurs at the mucus membranes found within the mouth, nose and eyes. Specifically the ACE-2 receptors on the epithelial cells of these tissues. 1
- After the virus has implanted, it will begin to replicate
- Then the virus will spread to target organs (COVID-19 seems to affect the lower respiratory tract however there may also be multi-organ involvement. 2
- The virus then begins shedding into the environment and potentially infecting others.3 (For COVID-19 two modes for transmission exist – direct and indirect. The direct method includes transmission via respiratory droplets and aerosols when a person coughs, sneezes, shouts or talks. Indirect modes include transmission via fomites4 (picking up the virus from inanimate objects)
- Transmission through inanimate surfaces appears to be very small, and only in instances where an infected person coughs or sneezes directly on the surface, and someone else touches that surface soon after the cough or sneeze (within 1–2 hours). 5
- Outdoor risk of transmission of Covid-19 is very low. Research continues to suggest that the vast majority of transmission happens in indoor spaces; recent reviews considering data from several countries found very little evidence of outdoor transmission for SARS-CoV-2, influenza or other respiratory viruses.6,7
There are three factors that affect a virus’ ability to infect and a person and make them sick.
- Accessibility of virus to tissue, (How prevalent is the virus in our environment)
- Cellular susceptibility to virus multiplication, and
- Virus susceptibility to host defences. 3
Lockdowns, social distancing, hand washing and wearing masks, prevents our contact with the virus and reduces our risk of encountering the virus.
But what happens if we do encounter the virus? Is there a way to make our cells less susceptible to viral hijacking or ensuring our host defences (immune system) protects us more effectively?
It turns out that through our lifestyle and dietary choices we have a great deal of control in ensuring a COVID-19 infection doesn’t result in serious or critical outcome. 8
Covid-19 infection can present in a spectrum ranging from mild, moderate to severe illness. In severe cases of COVID-19 the respiratory distress comes not just from how the virus harms the infected, but from an exaggerated response of the individuals own immune system. The pneumonia which accompanies COVID-19 is not directly caused by the virus but rather through fibrosis caused by runaway cytokine storms within the respiratory system. 9
What is a cytokine storm?
Cytokines are a group of proteins that provide intercellular signaling and communication, which controls cell proliferation and differentiation alongside immune and inflammatory responses. The immune system, under normal circumstances, will respond to a pathogen with a regulated and proportionate amount of cytokines to remove the pathogen and restore homeostasis.
Failures in the body’s own feedback and regulatory processes are responsible for excessive cytokine production and can result in systemic damage that often outstrips the benefit from a ‘typical’ immune response. 8
The leading cause of death in patients infected with Covid-19 is acute respiratory distress syndrome or ARDS. It is now known that several proinflammatory cytokines will contribute to the occurrence of ARDS. 10
Risk factors for a severe infection
Poor nutritional status as well as pre-existing noncommunicable diseases (NCDs) such as diabetes mellitus, chronic lung diseases, cardiovascular diseases (CVD), obesity, and various other diseases that compromise immune function can increase the likelihood of a severe and fatal infection from Covid-19.
These diseases are characterized by systemic inflammation, leaving an individual pre-inflamed prior to viral infection. The inflammation caused by infection from the virus combined with this systemic inflammation can make a severe and medical attention requiring reaction more likely. 11
How to maintain a healthy well-functioning immune system
The good news is, adoption of healthy lifestyle, and dietary habits can have a considerable effect on improving nutrition status, reducing inflammation and preventing and even improving pre-existing conditions which can consequently safeguard us from severe viral infections.
Vaccines also appear to be more effective in individuals who fall into the normal/healthy body mass index (BMI) range for their body weight and height. 12
Below are some easy and effective strategies.
Adopt an anti-inflammatory diet
There is nothing complex or new about an anti-inflammatory diet. You don’t need to eat a variety of expensive and exotic superfoods or take a briefcase full of supplements. An anti-inflammatory diet is simply choosing whole foods consisting of whole vegetables, fruits, nuts, seeds and grains, healthy fats and oils, good quality protein sources, and small amounts of healthy treats. This combined with reducing consumption of refined and processed foods, including highly
processed sugar laden foods and beverages, processed meats, refined oils and deep-fried foods will be a huge step in the right direction.
A good example is found in this anti-inflammatory food pyramid.
Reduce your consumption of sugar
Poor blood sugar control, not only in people with diabetes, worsens the prognosis and increases the seriousness of COVID-19 infection.
- because a spike in blood sugar is accompanied by a large increase in inflammatory mediators.
- glycosylation – a process that can be caused by a spike in blood sugar, is needed by the virus to link onto a cellular receptor – this can favor the cellular intrusion of Covid-19, leading to higher severity of symptoms experienced.
Individuals with well-regulated blood sugar (like those who regularly exercise and eat plenty of whole vegetables and fruits) are less likely to have high levels of inflammation and reduced binding capacity for the virus. 13
Supplement with Vitamin D
Two separate systematic reviews looking at the effects of vitamin D and Covid-19 show that a vitamin D deficiency is associated with increased severity and complications from Covid-19 infection and that optimal levels can reduce inflammatory markers and the negative immunomodul
ation of the inflammatory cytokine storm caused by COVID-19. Both studies recommend acquiring optimal blood levels of vitamin D through supplementation and/or sunlight exposure in order to reduce the severity of Covid-19 infection.14, 15
Make sure you’re getting enough Omega 3
There are various benefits of omega-3 fatty acids and taking it as a supplement might be associated with the prevention of the viral entry by changing the composition of fats in the membrane of our cells. Omega-3 fatty acids, such as DHA and EPA, perform their role by being incorporated in the cell membrane and affecting the clumping of toll-like receptors and thus preventing signals that activate nuclear factor kappa B (NF-κB) a regulator of innate immunity, and help to reduce the complications of COVID-19 by producing fewer pro-inflammatory mediators.16 17
Being physically inactive greatly increases the risk for severe Covid-19 outcomes, including greater risk of hospitalization, admission to the ICU, and death for adults compared to individuals constantly meeting physical activity guidelines. 18
Respiratory viral infections, such as SARS-CoV-2, cause a systemic inflammatory response that places increased demand and substantial burden on the cardiopulmonary system.
Regular use of exercise positively affects the cardiorespiratory system allowing for greater cardiopulmonary capacity to deal with a respiratory infection and has been shown to diminish the risk for adverse outcomes. Routine exercise has also been shown to improve immune function, reduce the risk of respiratory infections and lower chronic low-grade inflammation. 19
The benefits to exercise don’t stop there. Exercise also helps you;
- Sleep better 20
- Manage blood sugar more effectively 21
- Reduce chronic pain 22
- Reduce the risk of dementia 23
Exercise doesn’t have to be going to the gym and lifting weights or going to spin class three times a week. Exercise in its most sustainable form can be doing any form of physical activity that you enjoy, such as dancing, gardening, hiking, swimming, cleaning, playing with kids or any kind of hobby that gets you moving.
Try meditating or start a gratitude journal.
In a time where our immune systems need to be functioning optimally the news and information being given by media outlets and our government institutions has been a driver for fear, stress and included instructions (social isolation) that are known to, unfortunately, reduce immune function.24
Meditation, visualization and gratitude practices can be extremely helpful at reducing the stress and fear associated with a global pandemic as well as help combat the negative effects of social isolation.
The isolation caused by repeated and prolonged lockdowns are an unfortunate consequence of the medical community’s strategy to control the virus. Fortunately the negative immune system effects of loneliness and isolation have been proven to be improved by specific meditative practices.25
Meditation has been shown to counteract at least 60% of the inflammatory mechanisms that COVID-19 triggers. This could lower the likelihood and severity of the body’s inflammatory load, diminishing the damage the body takes and accelerating the clearing of the virus.26
Improving the resilience and recovery rates of the sick in quarantine reduces the duration of their stay in the hospital and improving the immune efficiency of the healthy in isolation can reduce their likelihood of requiring hospitalization in the first place.
There are many helpful mediation/visualization apps and programs to be discovered – check out a couple of the options below
Get enough sleep
Sleep provides essential support to the immune system. Getting sufficient hours of high-quality sleep enables a well-balanced immune defense that features strong innate and adaptive immunity.
Sleep plays a role in promoting inflammatory homeostasis through its effects on several inflammatory mediators, such as cytokines. Prolonged sleep deficiency can lead to chronic, systemic low-grade inflammation and is associated with inflammatory diseases, like diabetes, atherosclerosis, and neurodegeneration.27
Immune function works in a synergistic manner with our circadian rhythm and sleep/wake cycles, where differentiated immune cells with immediate functions, peak during the wake period and undifferentiated or less differentiated cells peak during the night, when the more slowly evolving adaptive immune response is initiated.28
Implementing new behaviours and changing dietary patterns can be challenging, so start out small. Many small changes can amount to a big shift in your wellbeing.
If you would like more information on how to implement these strategies or have a health concern, contact Beachealth today.
Written by: Jared Cox
- Lu C wei, Liu X fen, Jia Z fang. 2019-nCoV transmission through the ocular surface must not be ignored. Lancet. 2020;395(10224). doi:10.1016/S0140-6736(20)30313-5
- Gavriatopoulou M, Korompoki E, Fotiou D, et al. Organ-specific manifestations of COVID-19 infection. Clin Exp Med. 2020;20(4). doi:10.1007/s10238-020-00648-x
- Samuel Baron MF and TA. Viral Pathogenesis. Med Microbiol Bookshelf ID NBK8149. Published online 1996.
- Harrison AG, Lin T, Wang P. Mechanisms of SARS-CoV-2 Transmission and Pathogenesis. Trends Immunol. 2020;41(12). doi:10.1016/j.it.2020.10.004
- Goldman E. Exaggerated risk of transmission of COVID-19 by fomites. Lancet Infect Dis. 2020;20(8). doi:10.1016/S1473-3099(20)30561-2
- Bulfone TC, Malekinejad M, Rutherford GW, Razani N. Outdoor Transmission of SARS-CoV-2 and Other Respiratory Viruses: A Systematic Review. J Infect Dis. 2021;223(4). doi:10.1093/infdis/jiaa742
- Weed M, Foad A. Protocol for a rapid scoping review of evidence of outdoor transmission of COVID-19. medRxiv. Published online 2020. doi:10.1101/2020.08.07.20170373
- Arena R, Bond S, Calvo IR, et al. Shelter from the cytokine storm: Healthy living is a vital preventative strategy in the COVID-19 era. Prog Cardiovasc Dis. Published online June 2021. doi:10.1016/j.pcad.2021.06.008
- Cascella M, Rajnik M, Cuomo A, Dulebohn SC, Di Napoli R. Features, Evaluation and Treatment Coronavirus (COVID-19) – StatPearls – NCBI Bookshelf.; 2020.
- Ye Q, Wang B, Mao J. The pathogenesis and treatment of the `Cytokine Storm’ in COVID-19. J Infect. 2020;80(6). doi:10.1016/j.jinf.2020.03.037
- Zabetakis I, Lordan R, Norton C, Tsoupras A. Covid-19: The inflammation link and the role of nutrition in potential mitigation. Nutrients. 2020;12(5). doi:10.3390/nu12051466
- Painter SD, Ovsyannikova IG, Poland GA. The weight of obesity on the human immune response to vaccination. Vaccine. 2015;33(36). doi:10.1016/j.vaccine.2015.06.101
- Ceriello A. Hyperglycemia and the worse prognosis of COVID-19. Why a fast blood glucose control should be mandatory. Diabetes Res Clin Pract. 2020;163. doi:10.1016/j.diabres.2020.108186
- Pereira M, Dantas Damascena A, Galvão Azevedo LM, de Almeida Oliveira T, da Mota Santana J. Vitamin D deficiency aggravates COVID-19: systematic review and meta-analysis. Crit Rev Food Sci Nutr. Published online 2020. doi:10.1080/10408398.2020.1841090
- Yisak H, Ewunetei A, Kefale B, et al. Effects of vitamin d on covid-19 infection and prognosis: A systematic review. Risk Manag Healthc Policy. 2021;14. doi:10.2147/RMHP.S291584
- Hathaway D, Pandav K, Patel M, et al. Omega 3 fatty acids and COVID-19: A comprehensive review. Infect Chemother. 2020;52(4). doi:10.3947/IC.2020.52.4.478
- Hariharan A, Hakeem AR, Radhakrishnan S, Reddy MS, Rela M. The Role and Therapeutic Potential of NF-kappa-B Pathway in Severe COVID-19 Patients. Inflammopharmacology. 2021;29(1). doi:10.1007/s10787-020-00773-9
- Sallis R, Young DR, Tartof SY, et al. Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients. Br J Sports Med. Published online 2021. doi:10.1136/bjsports-2021-104080
- Brawner CA, Ehrman JK, Bole S, et al. Inverse Relationship of Maximal Exercise Capacity to Hospitalization Secondary to Coronavirus Disease 2019. Mayo Clin Proc. 2021;96(1). doi:10.1016/j.mayocp.2020.10.003
- Banno M, Harada Y, Taniguchi M, et al. Exercise can improve sleep quality: A systematic review and meta-analysis. PeerJ. 2018;2018(7). doi:10.7717/peerj.5172
- Buresh R. Exercise and glucose control. J Sports Med Phys Fitness. 2014;54(4).
- Leung A, Gregory NS, Allen LAH, Sluka KA. Regular physical activity prevents chronic pain by altering resident muscle macrophage phenotype and increasing interleukin-10 in mice. Pain. 2016;157(1). doi:10.1097/j.pain.0000000000000312
- Ahlskog JE, Geda YE, Graff-Radford NR, Petersen RC. Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. Mayo Clin Proc. 2011;86(9). doi:10.4065/mcp.2011.0252
- Campagne DM. Stress and perceived social isolation (loneliness). Arch Gerontol Geriatr. 2019;82. doi:10.1016/j.archger.2019.02.007
- Pandya SP. Meditation program mitigates loneliness and promotes wellbeing, life satisfaction and contentment among retired older adults: a two-year follow-up study in four South Asian cities. Aging Ment Heal. 2021;25(2). doi:10.1080/13607863.2019.1691143
- Black DS, Slavich GM. Mindfulness meditation and the immune system: a systematic review of randomized controlled trials. Ann N Y Acad Sci. 2016;1373(1). doi:10.1111/nyas.12998
- Besedovsky L, Lange T, Haack M. The sleep-immune crosstalk in health and disease. Physiol Rev. 2019;99(3). doi:10.1152/physrev.00010.2018
- Besedovsky L, Lange T, Born J. Sleep and immune function. Pflugers Arch Eur J Physiol. 2012;463(1). doi:10.1007/s00424-011-1044-0