Long Covid: Ursachen sprechen für den therapeutischen Einsatz von Antioxidantien

Zusammenfassung

Hyperinflammation und oxidativer Stress spielen nicht nur bei akuter Covid-19-Erkrankung, sondern auch bei Long Covid eine wichtige pathophysiologische Rolle. Bei Covid-19 wurde ein Vitamin-C-Mangel nachgewiesen und der Benefit von supportiven Vitamin-C-Infusionen bereits untersucht. Bei Long Covid sind die überschießende Entzündung und reaktive Sauerstoffverbindungen ebenfalls Mitauslöser für Fibrosen, Thrombosen, Immun-Dysregulation (Autoimmunphänomene und Virenpersistenz), Fatigue, kognitive Beeinträchtigungen und Störungen des autonomen Nervensystems. Der Benefit von Vitamin-C-Infusionen – wie die Linderung von Fatigue, kognitiven Störungen und Schmerzen – ist bereits bei anderen Grunderkrankungen gut untersucht. Vitamin C ist eines der effektivsten Antioxidantien, Kofaktor relevanter Stoffwechselwege und ein wichtiger Immunmodulator. Der therapeutische Einsatz bei Long Covid ist deshalb sehr plausibel und wird durch praktische Erfahrung bestätigt.

Abstract

Hyperinflammation and oxidative stress play an important pathophysiological role not only in acute COVID-19 disease but also in Long-COVID. In COVID-19, vitamin C deficiency has been demonstrated and the benefit of supportive vitamin C infusions has already been investigated. In Long-COVID, excessive inflammation and reactive oxygen species are co-triggers for fibrosis, thrombosis, immune dysregulation (autoimmune phenomena and viral persistence), fatigue, cognitive impairment and autonomic nervous system dysfunction. The benefits of vitamin C infusions – such as alleviation of fatigue, cognitive impairment and pain – have already been widely studied in other underlying diseases. Vitamin C is one of the most effective antioxidants, co-factor of relevant metabolic pathways and an important immune modulator. The therapeutic use in Long-COVID is therefore very plausible and is confirmed by practical experience.

Schlüsselwörter

Long Covid - Post-Covid-19-Syndrom - Vitamin C - Immunmodulation - oxidativer Stress - Antioxidantien

Keywords

Long COVID - post COVID-19 syndrome - vitamin C - immune modulation - oxidative stress - antioxidants

• Literatur

• 1 Lopez-Leon S, Wegman-Ostrosky T, Perelman C. et al. More than 50 long-term effects of COVID-19: A systematic review and meta-analysis. Sci Rep 2021; 11 (01) 16144
• 2 Crook H, Raza S, Nowell J. et al. Long covid-mechanisms, risk factors, and management. BMJ 2021; 374: n1648
• 3 Boldrini M, Canoll PD, Klein RS. How COVID-19 affects the brain. JAMA Psy 2021; 78 (06) 682-683
• 4 Vollbracht C, Guendling PW. Immunmodulation mit Vitamin C. EHK 2017; 66: 36-43
• 5 Vollbracht C, Kraft K. Oxidative stress and hyper-inflammation as major drivers of severe COVID-19 and long COVID: Implications for the benefit of high-dose intravenous vitamin C. Front Pharmacol 2022; 13: 899198
• 6 Carr AC, Maggini S. Vitamin C and immune function. Nutrients 2017; 9 (11) 1211
• 7 Ang A, Pullar JM, Currie MJ. et al. Vitamin C and immune cell function in inflammation and cancer. Biochem Soc Trans 2018; 46 (05) 1147-1159
• 8 Lee Chong T, Ahearn EL, Cimmino L. Reprogramming the epigenome with vitamin C. Front Cell Dev Biol 2019; 7: 128
• 9 Mousavi S, Bereswill S, Heimesaat MM. Immunomodulatory and antimicrobial effects of vitamin C. Eur J Microbiol Immunol (Bp) 2019; 9 (03) 73-79
• 10 Su Y, Yuan D, Chen DG. et al. Multiple early factors anticipate post-acute COVID-19 sequelae. Cell Physiol Biochem 2022; 185 (05) 881-895.e20
• 11 Cervia C, Zurbuchen Y, Taeschler P. et al. Immunoglobulin signature predicts risk of post-acute COVID-19 syndrome. Nat Commun 2022; 13 (01) 446
• 12 Magnusdottir I, Lovik A, Unnarsdottir AB. et al. Acute COVID-19 severity and mental health morbidity trajectories in patient populations of six nations: An observational study. Lancet Public Health 2022; 7 (05) e406-e416
• 13 Holford P, Carr AC, Zawari M. et al. Vitamin C intervention for critical COVID-19: A pragmatic review of the current level of evidence. Life 2021; 11: 1166
• 14 Alzoubi KH, Shatnawi AF, Al-Qudah MA. et al. Vitamin C attenuates memory loss induced by post-traumatic stress like behavior in a rat model. Behav Brain Res 2020; 379: 112350
• 15 Vollbracht C, Kraft K. Feasibility of vitamin C in the treatment of post viral fatigue with focus on long COVID, based on a systematic review of IV vitamin C on fatigue. Nutrients 2021; 13 (04) 1154