Explaining Cytokine Storm in More Severe COVID-19 Cases

by Dr. Susan Tanner, MD

It is generally believed, as we move forward in our understanding of the COVID-19 virus, that most health complications from this disease are from complete dysregulation of the immune system leading to a process called cytokine storm. But what does this term mean?

Cytokine Storm Simplified

To start, a brief and extremely simplified explanation of cytokine storm starts with the immune response. When a foreign cell enters the bloodstream, and in the case of Coronavirus, this is likely through the respiratory system, there is a release of specific substances or cytokines within the white blood cells. These cytokines are meant to protect the body from this foreign invader. The release of cytokines is inflammatory, and again, in the case of Coronavirus, they are HIGHLY inflammatory.   Part of the reason for this is that this is a new virus in humans. We have no pre-existing cells that recognize it in any way; so, the immune response is extra forceful. It can be illustrated by thinking of how forcefully you would yell at a stranger to “GET OUT!” of your house, versus the force with which you would yell the same command at an annoying sibling. One is a life or death exclamation of force, while the other is probably quite loud, but is not everything you’ve got.

As the diagram above suggests, the release of this inflammation causes widespread damage. Smooth linings of blood vessels are attacked, allowing leakage of essential water and salts into spaces outside of the cells. This leakage also occurs in the lining of the respiratory passages in the lungs. Then, to correct the inflammation, the body lays a protective layer of fibrous-like substances in place and pulmonary fibrosis or scarring of the lungs can occur which makes the tissue stiff and breathing more labored and difficult. In turn, the fibrosis can lead to respiratory failure.

If a patient progresses to this stage in the illness, the need for ventilator placement becomes essential to sustain life. Furthering the seriousness of the issue is the fact that, as we have seen in the news, ventilators are becoming in short supply, because the virus is spreading very rapidly. Additionally, the damage to blood vessels affects certain blood clotting mechanisms, allowing free bleeding into organs and tissues. The bleeding can lead to further infection and even sepsis. Kidney function becomes affected by this huge storm of inflammation as well, and the body’s ability to clear wastes is compromised. In other words, the cytokine release caused by the virus has created a storm of inflammation throughout the body that continues to increase and shut everything down.

What Can We Do?

This all sounds like scary stuff, and it is. Containment of the spread of the virus by avoiding contact and sheltering in place is essential. Following all the good hygiene specifics such as hand washing, not touching your face, mouth, eyes, or ears before washing your hands, avoiding crowds, and getting plenty of fresh air and sunshine are all also helpful. One additional thing that I must mention here is that if you smoke or vape you MUST STOP NOW. Lung tissue is made much more vulnerable by these habits and allows a feeding frenzy of the corona-induced cytokine storm. Also worth mentioning because of its seriousness is mold. If you are in a home with a mold issue or high mold counts in the breathing air, you are also more vulnerable. The mold toxins can ignite a different, but equally as damaging cytokine storm that causes a steady, inflammatory cascade affecting every system in the body. When the body feels threatened by the constant toxic exposure, immunity to other pathogens and the ability to heal and recover are significantly diminished. Exposure to something like COVID-19 could be catastrophic. Thus, is it important to do the things needed to get the air quality in your home right or to get yourself to a mold-free space, so that you are protected and strong.

Added Viral Protection or Dangerous Supplements?

For added protection, we have discussed in previous articles the use of probiotics, Vitamin D, Vitamin C, Quercetin, and trace minerals, such as zinc and selenium as preventive agents that are shown to be quite helpful in viral deterrence. There are other immune stimulating or boosting agents and combinations that have been controversial such as elderberry, beta glucan and echinacea. These supplements can stimulate more immune cell production. Generally, this immune stimulation is indicated to be helpful in prevention. However, there has been the question of whether these supplements would accelerate cytokine storm in a Coronavirus patient due to the increase in immune cells.   After reviewing a few papers on this, though, I think most of this concern may be overblown. There are no studies or even reports of patients currently ill with COVID-19 having been on these preventatives vs. those who have not, and the efficacious use of most of these in other viral illnesses is well documented.

As more and more people are looking at preventive measures, the supplies of some of the higher-quality supplements have become as scarce as toilet paper. In my previous articles, I had referred to several products that could be found on the portal, wellevate.com   If you attempted to find the recommended products there and found them on back order an additional source is NuMedica. You can go in and register with the code 40568 and you can find the following:

  • Liposomal C
  • Seasonal shield, which contains quercetin, zinc, selenium, and NAC all helpful support in prevention as well as dealing with the pollen issues we have now
  • Vitamin D3 5000
  • Pro Flora probiotic
  • Immuno PRP spray

Keep Calm and Carry On

Most importantly, do everything in your power to avoid exposure to the virus. Continue to follow the basic guidelines for social distancing and for sheltering in place laid forth for the community by our local and national leaders. When you must go out into public places, wear a mask, follow the sanitizing, disinfecting, and cleaning guidelines. Doing those things will help to shield you from the virus, which is still your best defense. Also, and I know this sounds overly simple, but be reasonable. Please, don’t panic. Take proper precautions but also remember to enjoy your time at home with less activities and obligations. Worry only adds to your stress levels.  You should instead feel secure in the fact that you are doing what you need to do to stay health. This doesn’t mean that you shouldn’t also take this seriously. Coronavirus is a serious threat to our world, and we must all do our part–not because you need to be fearful, but because we may be dealing with this virus for some time yet. You may need your strength, ingenuity, and focus to carry you through.

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