A review on existing COVID-19 treatments published by researchers at New York Medical College in the journal Antioxidants theorized that multiple natural remedies could potentially have clinical efficacy as secondary treatments in helping people who suffer from the effects of cytokine storms, an immune response which causes systemic inflammation after the body produces an over-abundance of cytokines too early. The review summarized a number of additional pharmaceutical treatment options, including antivirals, cytokine inhibitors, antiretrovirals, monoclonal antibodies, convalescent plasma, and corticosteroids, although a “vaccine is the only magic bullet,” they wrote.
 
The authors of the study posit that antivirals and natural ingredients may play a role in preventing cytokine storms by upregulating heme oxygenase 1 (HO-1), an enzyme which reduces oxidation, and is known to be depleted during the onset of a severe systemic inflammatory reaction as heme levels increase. The chronic inflammatory state of obesity also intensifies this effect, the researchers said, noting that the role any natural products known to upregulate HO-1 would be most significant in obese patients, particularly as a secondary treatment to antivirals.
 
The specific natural remedy that the researchers said warrants investigation is a combination of thymoquinone, the active compound found in black seed oil, and omega-3 fatty acids, a combination of ingredients evidenced to protect against oxidative stress induced by obesity, improve insulin sensitivity, and, in animal models, convert white fat to brown fat (a function which improves energy homeostasis among other benefits). Specifically, they cited a study which made these claims while evaluating the clinical efficacy of TriNutra’s Thymoquin and VivoMega omega-3 fish oil, which was published this year.
 
The authors also looked at other natural products and drugs derived from natural sources shown to upregulate HO-1, which include pomegranate seed oil, resveratrol, curcumin, statins, and aspirin.
 
“Obese individuals have many more ACE-2 receptors on the surface of white necrotic adipocytes and have many more white adipocytes in total than the number of brown adipocytes of their lean counterparts,” the authors concluded. “COVID-19 causes severe systemic inflammation and downregulation of HO-1, already downregulated in the chronic inflammatory state of obesity. The clinical course of the disease has been challenged by the interaction of three genetic polymorphisms, the first is the CYP2D6 enzyme system, second is the HO-1 anti-inflammatory gene, and third the ACE and ACE-2 enzyme systems. Effective therapy must include anti-viral drugs to halt viral replication. The second must involve the upregulation of the heme oxygenase system to reduce ROS and the severe inflammation caused by the cytokine excess. The anti-inflammatory and antioxidant approach should be essential to our armamentarium until we have an effective vaccine.”
 
“There is still so much we have to learn, but our studies continue to help us progress as we search for methods to improve our health and fight against cytokine storms,” Dr. Nader Abraham, Professor of Medicine and Pharmacology at The New York Medical College and lead author of the study, said, indicating that the review is a good sign that some natural products can contribute to a number of processes associated with a decreased risk of cytokine storms.