COVID-19 UPDATE for Wednesday April 15
About the author: Stephen Cherniske taught Clinical Nutrition at two southern California universities and directed the first FDA-licensed clinical lab specializing in nutrition and immunology. You can follow him on FaceBook and My2048.com
We know that the majority of people infected with the COVID-19 have only mild symptoms while others require hospitalization, intensive care and more than 22,000 have died. So there is an obvious urgent need to see if there are modifiable factors that can help reduce risk for serious illness.
The word modifiable is important. Clearly, age is the # 1 risk factor in this pandemic. That’s been the case in every study in every country. But I’ve been calling for widespread analysis of nutrition, diet, lifestyle, blood chemistry and body composition. On Monday, a study out of NYU identified obesity as the most important risk factor after age.  Obesity is modifiable, but only in the long term. There is no pill or potion that can make you thin in 60 days. So we still need to look for things that we can alter or improve in the short term. What can we learn from the people who recover from COVID-19 infection, other than they are not obese?
The NYU study points to inflammation as a starting point, because we’ve known for decades that adipose tissue fundamentally alters the cytokine balance in the body, producing a state of chronic inflammation. So is the short-term treatment anti-inflammatory drugs like NSAIDS or corticosteroids? Clearly not, because while those are great at reducing inflammation, they also suppress immunity. In this case, we need to look at the natural products arena. And there we find a treasure trove of foods and plant-based compounds that reduce inflammation without suppressing immunity.
Food first. An anti-inflammatory diet includes green leafy vegetables, fatty fish or fish oil, brightly colored vegetables and fruits like organic strawberries, cherries, blueberries and oranges. It’s also important to reduce or eliminate the foods that cause inflammation: highly processed carbohydrates (most snack foods), French fries and other fried foods, soft drinks and other sweetened beverages, and processed meats.
Aside from these mostly obvious choices, a number of plant-based anti-inflammatory compounds have been identified, tested and proven effective. I was fortunate to work with the foremost research group in that area, in terms of published studies and patents. Unigen Pharmaceuticals created the world’s largest medicinal plant library, and then used high throughput genomic technologies to screen for compounds that could balance inflammation. The operative word there is balance. Shutting down inflammation caused the Vioxx disaster. Think of it as the difference between using a hammer (powerful drug) vs a screwdriver. In addition to Unigen’s compounds derived from Morus alba, Scutellaria bicalensis and Acacia catechu, we have boswellia from Boswellia serrata and curcumin from Curcuma longa species. Look for these compounds in joint care products.
IMPORTANT NOTE: There are times when a hammer is needed, especially when COVID-19 patients are experiencing extreme levels of inflammation – known as cytokine storm – in the second stage of infection. But for prevention, the plant-based approach makes more sense.
The next modifiable risk factor, common in obesity and invariably present in people over 65, is low levels of DHEA. Production of this hormone peaks around age 25 and then declines, leaving the average 70 year-old with only 10 to 15% of what they produced in their 20’s. Since DHEA is the most comprehensive repair signal in the human body and brain, that decline can only be seen as catastrophic.
Low DHEA is a modifiable risk factor because it is safe (The FDA classified it as a nutritional supplement in 1994) widely available, and blood levels can be monitored by routine blood chemistry. There are four ways that restoring DHEA to optimum levels can mitigate the obesity risk factor.
1. DHEA is an immune modulator. High levels are associated with improved mucosal immunity. [2,3] This translates to lower risk of infection by all pathogens that enter through the nose and mouth.
2. DHEA has anti-obesity effects, both short-term and long term. It rapidly improves blood sugar balance.  and over time, promotes fat loss and muscle gains. [5-9]3. DHEA has anti-inflammatory effects in multiple tissues, including the lungs and brain. [10,11]4. DHEA improves anti-viral immune competence. [12-14]
You are right to wonder why low DHEA is not mentioned in the medical news regarding this pandemic, when it is a primary modifiable risk factor. It’s not for lack of evidence. Since I wrote The DHEA Breakthrough in 1996, there have been over 10,000 additional studies published on DHEA, including scores of human clinical trials. I believe the omission is simply part of the “drugs only” approach of conventional medicine. If you would like to help your doctor understand the importance of DHEA in health and disease, you can download my e-book, The Case For DHEA for free at My2048.com.
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Dehydroepiandrosterone and multiple measures of functional immunity in young adults. Prall SP, Muehlenbein MP.
[ 3] The role of dehydroepiandrosterone on functional innate immune responses to acute stress. Stress Health. 2017 Dec;33(5):656-664. Prall SP, Larson EE, Muehlenbein MP.
 Fat-reducing effects of DHEA involve upregulation of ATGL and HSL expression, and stimulation of lipolysis in adipose tissue. Steroids. 2012 Nov;77(13):1359-65. Karbowska J, Kochan Z.
 Dehydroepiandrosterone (DHEA) replacement decreases insulin resistance and lowers inflammatory cytokines in aging humans. Aging, 2011 May; 3(5): 533–542. Edward P. Weiss, Dennis T. Villareal, John O. Holloszy.
 DHEA enhances effects of weight training on muscle mass and strength in elderly women and men. Am J. Physiol Endocrinol Metab 291: E1003–E1008, 2006. Dennis T. Villareal and John O. Holloszy
 Dehydroepiandrosterone supplementation improves endothelial function and insulin sensitivity in men. J Clin Endocrinol Metab. 2003 Jul;88(7):3190-5. Kawano H, Yasue H, Kitagawa A, et al.
 Effects of DHEA replacement on bone mineral density and body composition in elderly women and men. Clin Endocrinol (Oxf) 2000 Nov; 53(5):561-8/ Villareal DT, Holloszy JO, Kohrt WM.
 Effects of DHEA on metabolic and endocrine functions of adipose tissue. Horm Mol Biol Clin Investig. 2013 Aug;14(2):65-74. Karbowska J, Kochan Z.
 Androgens are effective bronchodilators with anti-inflammatory properties: A potential alternative for asthma therapy. Steroids. 2020 Jan;153:108509. Montaño LM, Flores-Soto E, et al.
 Dehydroepiandrosterone (DHEA): hypes and hopes. Drugs. 2014 Jul;74(11):1195-207. Rutkowski K1, Sowa P, et al.
 Beta-androstenes and resistance to viral and bacterial infections. Neuroimmunomodulation. 2009;16(2):88-95. Loria RM.
 Neurosteroid-mediated regulation of brain innate immunity in HIV/AIDS: DHEA-S suppresses neurovirulence. FASEB J. 2013 Feb;27(2):725-37. Maingat FG, Polyak MJ, et al.
 The inhibitory effect of DHEA and its derivatives against influenza A virus in vitro and in vivo. Arch Virol. 2016 Nov;161(11):3061-72. Yang Q, Mao Q, et al.