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Drinking lemon in warm water has been claimed to prevent COVID-19 by increasing vitamin C levels

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Proposed Expert: Dr. DR Rai, MAMS, FCGP, IBMS
Internal Medicine Specialist, Hon. Prof. of College of Medical Practitioners, Kota

This is true. Lemon water contains copious amounts of Vitamin C and it has been shown to prevent COVID-19 symptoms. COVID-19 pneumonia and its progression to respiratory failure appear to be driven by an immune hyperreaction in which IL-6 and ET-1 play an important role. Vitamin C can reduce these (and other) inflammatory mediators in various inflammatory conditions, and is clinically beneficial in (non-COVID-19) hypertensive and/or diabetic obese adult patients. Considering the weight of the evidence and because vitamin C is cheap and safe, an oral low dose (1–2 g/d) may be useful prophylactically, and in cases of severe COVID-19, a (very) high-dose regimen may be beneficial.1

Many recent cases revealed that the novel COVID-19 leads to lower respiratory tract infections, and therefore, taking vitamin C could be an effective player in the treatment and prevention against this virus.2In support of this, according to a report by China and the USA, vitamin C supplementation has shown improvement in the conditions of patients suffering from COVID-19.3 It has also been reported that vitamin C has an inhibitory effect against various other viruses including influenza, HIV, rabies virus, avian RNA tumour viruses, herpesviruses and paramyxoviruses, parvovirus, and human lymphotropic virus type 1.

Studies have shown high doses of vitamin C to induce immunosuppression in hyper-activated immune effector cells which led to lung damage in COVID-19 patients.4 High-dose IV vitamin C at different dosages between 10 g and 20 g daily during 8–10 h was also successfully used for the treatment of moderate to severe cases of COVID-19 in China.5Therefore, moderate doses of vitamin C supplementation may be considered to prevent/treat COVID-19 symptoms as well.6

Because the development of efficacious vaccines and antiviral drugs takes time, vitamin C and other antioxidants are among currently available agents to mitigate COVID-19 associated acute respiratory distress syndrome.7 Given the fact that high-dose vitamin C is safe, healthcare professionals should take a close look at this opportunity.

Source:

1 Feyaerts AF, et al. Nutrition. 2020; 79: 110948.doi: 10.1016/j.nut.2020.110948
2 BudhwarS, et al. CurrNutr Rep. 2020:1–10.doi: 10.1007/s13668-020-00325-1
3 Rodríguez L,et al. Int J Environ Res Public Health. 2011; 8(4):1174-205.
4 Erol A. 2020. CrossRef fromA Sahebnasagh, et al.Eur J Pharmacol.2020;887:173530.
5 Downing D, et al. Orthomolecular Medicine
6 NewsService. 2020 http://orthomolecular.org/resources/omns/v16n14.shtml
7 Wang L, et al. Int. J. Antimicrob. Agents. 2020;105948
8 Cheng RZ. Med Drug Discov. 2020;5:100028. doi: 10.1016/j.medidd.2020.100028

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Coronavirus

Will the vaccine really help?

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The combination of getting vaccinated and following the guidelines to protect yourself and others will offer the best protection from COVID-19.

It is advisable to get the COVID-19 vaccination because it will help keep you from getting COVID-19. In fact, according to the Advisory Committee on Immunization Practices (ACIP)1, the independent committee that advises the Centers for Disease Control and Prevention (CDC) on how best to control vaccine-preventable diseases in the US, even a previous COVID-19 infection should NOT rule out a person from getting the vaccine. In a report2 from the CDC meeting on December 12, the committee noted that data from clinical trials suggests that vaccination is “safe and likely efficacious” in people who have previously been infected with COVID-19, whether they displayed symptoms or not.

Based on the knowledge we have regarding vaccines for other diseases and early data from clinical trials, experts believe that getting a COVID-19 vaccine may also help keep you from getting seriously ill even if you do get COVID-19.Getting vaccinated yourself may also protect people around you, particularly people at increased risk for severe illness from COVID-19, such as elderly and people with medical conditions. Experts continue to conduct more studies about the effect of COVID-19 vaccination on severity of illness from COVID-19, as well as its ability to keep people from spreading the virus that causes COVID-19.

COVID-19 vaccination is a safer way to help build protection and it is much needed given that currently, all reports suggest COVID-19 can have serious, life-threatening complications,  and there is no way to know how COVID-19 will affect you. And if you get sick, you could spread the disease to friends, family, and others around you.

Getting COVID-19 may offer some natural protection, known as immunity. Current evidence suggests that reinfection with the virus that causes COVID-19 is uncommon in the 90 days after initial infection. However, experts don’t know for sure how long this protection lasts, and the risk of severe illness and death from COVID-19 far outweighs any benefits of natural immunity. COVID-19 vaccination will help protect you by creating an antibody (immune system) response without having to experience sickness.

Most importantly, if we are to defeat this virus and come out of this pandemic with flying colors, COVID-19 vaccination will be an important tool to help stop the pandemic. Wearing masks, good hand hygiene and social distancing help reduce your chances of being exposed to the virus or spreading it to others, but as we are aware, these measures alone have not been enough. Vaccines will work with your immune system so it will be ready to fight the virus if you are exposed.

Add – gap of 28 days between two doses of COVID-19 vaccine and its effectiveness will begin 14 days after the second dose. So, preventive measures need to be continued and strictly adhered to.

Source

1 https://www.health.com/condition/infectious-diseases/coronavirus/if-you-already-had-covid-do-you-need-vaccine
2 https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2020-12/slides-12-12/COVID-03-Mbaeyi.pdf

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Coronavirus

Children’s immune system can evade COVID

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A growing body of evidence is suggesting that children’s immune systems are better equipped to handle the Coronavirus, than adults. A recent report1 published in a leading medical journal, Nature, analyzed this. The report says that young children account for only a small percentage of COVID-19 infections2 and this data has perplexed scientists across the globe.

According to eminent immunologist, Dr. Donna Farber, “Children are very much adapted to respond — and very well equipped to respond — to new viruses and even when they are infected with SARS-CoV-2, children are most likely to experience mild or asymptomatic illness”.3 Both resistance to infection and resistance to disease appear to be much stronger in children than in adults. The apparent resistance to infection might actually reflect a more rapid clearance of the virus so that the chance to detect cases is diminished.4

Another indication that children’s response to the virus differs from that of adults is that some children develop COVID-19 symptoms and antibodies specific to SARS-CoV-2 but never test positive for the virus on a standard RT-PCR test. For e.g., in a study4 of three children under the age of 10, from the same family who developed SARS-CoV-2 antibodies— and two of them even experienced mild symptoms — but none tested positive on RT-PCR, despite being tested 11 times over 28 days while in close contact with their parents, who had tested positive.

Studies5-7 report that even in children who experienced the severe but rare complication in response to SARS-CoV-2 infection, the rate of positive results on RT-PCR ranged from just 29-50%.

Another recent study8of 32 adults and 47 children aged 18 years or younger, found that children mostly produced antibodies aimed at the SARS-CoV-2 spike protein, which the virus uses to enter cells, while adults generated similar antibodies, but also developed antibodies against the protein that is essential for viral replication. Since children lack this protein that supports viral replication, they are not experiencing widespread infection. The study inferred that children’s immune responses seem to be able to eliminate the virus before it replicates in large numbers, which is why they may be able to evade COVID-19 or at least be affected only mildly.

Source

1 Nogrady B. Nature 2020;588:382
2 Wu Z, et al. J Am Med Assoc. 2020;323:1239–42.
3 Dong, Y, et al. Pediatrics 2020;145:e20200702.
4 Fisher A. Mucos Immunol. 2020;13:563-65.
5 Tosif S, et al. Nature Commun. 2020;11:5703.
6 Dufort EM, et al. N Engl J Med. 2020;383:347–58.
7 Feldstein LR, et al. NEngl J Med. 2020;383:334–46.
8 Whittaker ED, et al. J Am Med Assoc. 2020;324:259-69.
9 Weisberg SP, et al. Nature Immunol. 2020;https://doi.org/10.1038/s41590-020-00826-9

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Coronavirus

If I have already had COVID-19 and recovered, do I still need to get vaccinated with a COVID-19 vaccine?

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Health Patrol has carried out numerous reports on the possibility of reinfection and severe health risks associated with COVID-19.1Due to these health risks associated with COVID-19 and the fact that re-infection with COVID-19 is possible, you should take the vaccine irrespective of whether you already had COVID-19 infection.

At this time, experts do not know how long someone is protected from getting sick again after recovering from COVID-19—which is also because the immunity someone gains from having an infection, called natural immunity, varies from person to person. Some early evidence suggests natural immunity may not last very long. As the system learns to fight back the infection, it develops COVID antibodies. Right now, from what studies have shown, it has been suggested that antibodies may last anywhere between 3-6 months for a person, after which they can start to wane. Asymptomatic persons and those with milder cases of infection are thought to have lower immunity than others.

A recently discussed publication in this regard has been the one by Harvey et al. that concluded that antibody positivity to SARS-CoV-2 is associated with a decreased risk of future infection. The study, currently unpublished, states that using real-world data from more than 3 million people, National Cancer Institute researchers have found that people who have had evidence of a prior infection with the deadly Coronavirus, appear to have some degree of protection against being reinfected with the virus.2

Another recent study3 published on January 06, 2021 in the journal Science, reports COVID-19 patients who recovered from the disease still have robust immunity from the coronavirus up to eight months after infection. The result is an encouraging sign that the study authors interpret to mean immunity to the virus probably lasts for many years, and it should alleviate fears that the COVID-19 vaccine would require repeated booster shots to protect against the disease and finally get the pandemic under control.

We still do not know how long immunity produced by vaccination lasts until we have more data on how well the vaccines work. Both natural immunity and vaccine-induced immunity are important aspects of COVID-19 that experts are trying to learn more about, and we at Health Patrol will keep you updated, as new evidence becomes available.

Source

1 https://healthpatrol.in/2020/10/22/is-there-a-possibility-of-reinfection-in-covid-patients/
2 Harvey RA, Rassen JA, Kabelac CA, et al. doi: https://doi.org/10.1101/2020.12.18.20248336
3 Dan JM, Mateus J, Kato Y, et al. Immunological memory to SARS-CoV-2 assessed for up to 8 months after infection. Science 06 Jan 2021: eabf4063. DOI: 10.1126/science.abf4063

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Coronavirus

Vaccine is safe for women desirous of getting pregnant

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Earlier this week, Health Patrol published a report on vaccines being safe for pregnant women.1 Since then, we have received a few queries from women in their reproductive age desirous of getting pregnant and whether they should get the vaccine once it is available for them. The answer is YES.

However, it is pertinent to be aware of the usual body responses to the COVID-19 vaccine. Studies have shown that COVID-19 vaccination can cause fever in some patients (up to 16% of those vaccinated and mostly after the second dose); however, the study further reiterates that this risk should not be a concern when deciding whether to vaccinate a patient desiring pregnancy. Additionally, the most common symptom of COVID-19 infection itself is fever (83-99% of affected patients). Patients who experience fever following vaccination should take an antipyretic medication, such as acetaminophen pr paracetamol.2

According to the December 2020 Update3 from the American Society for Reproductive Medicine (ASRM) Patient Management and Clinical Recommendations During the Coronavirus (COVID-19) Pandemic, patients who conceive in the window between the first and second dose of the vaccine should be offered the second dose of the vaccine at the appropriate interval.

The CDC4 has also added to this information saying that, “Routine testing for pregnancy before COVID-19 vaccination is not recommended. Women who are trying to become pregnant do not need to avoid pregnancy after receiving an mRNA COVID-19 vaccine.”

Source

1 https://healthpatrol.in/2021/01/11/covid-vaccines-are-safe-for-pregnant-women/
2 Polack FP, et al. Safety and Efficacy of the BNT162b2 mRNA COVID-19 Vaccine. New Engl J Med. Dec. 10, 2020 (DOI: 10.1056/NEJMoa2034577).
3 Update 11. December 16, 2020. https://www.asrm.org/globalassets/asrm/asrm-content/news-and-publications/covid-19/covidtaskforceupdate11.pdf
4 https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.html#:~:text=Routine%20testing%20and%20pregnancy,an%20mRNA%20COVID%2D19%20vaccine.

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Coronavirus

Headache is a common symptom in COVID-19

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After the emergence of a novel coronavirus, COVID-19 was initially characterized by fever, sore throat, cough, and dyspnea, mainly manifestations of respiratory system.1 However, other manifestations such as headache, abdominal pain, diarrhea, loss of taste and smell were added to the clinical spectrum, during the course of the COVID-19 pandemic. Headache here, leads the charts as the reports on the neurological findings are increasing rapidly.2 Headache was reported in 11-34% of the hospitalized COVID-19 patients, but clinical features of these headaches were totally missing in available publications for any reference points for the treating clinicians of healthcare staff.

Thankfully, a lot of research is being done on the subject and studies show that bilateral, long-lasting headaches, resistance to analgesics and having male gender were more frequent in people with COVID-19 in conjunction with anosmia/ageusia and gastrointestinal complaints. These features may be helpful for diagnosing the headache related to COVID-19 during the pandemic.3

A study published in the journal Headache noted, “The headaches had migraine-like features, including throbbing and/or pressing nature in almost all patients, aggravation with routine movements and bending over, sensory disturbances such as photophobia and/or phonophobia, nausea, and recovery within several days.”However, the headaches also had some unusual features, including new unrelenting pain, rapid onset, higher intensity, and association with anosmia/ageusia, diarrhea, reduced appetite, and weight loss. Study researchers observed a partial response or temporary recovery lasting hours following use of analgesics, mainly paracetamol or nonsteroidal anti-inflammatory drugs.4

Another study5 by Seth, et al. published in the journal Headache reported the case of a young male patient who went with a headache to the emergency room. He had increased intracranial pressure and tested positive for SARS-CoV-2, suggesting new headaches during the pandemic should not be ignored and any change in the character of chronic headache should prompt testing for COVID‐19. 

Bottomline is, clinicians and patients should not overlook headache, which is a common non-respiratory symptom of COVID-19, and its characteristics should be recorded with scrutiny.

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