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Resveratrol
Resveratrol, a naturally occurring polyphenol, shows resveratrol was shown to have in vitro activity against
many beneficial health effects. It has been shown to MERS-CoV. 43
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modulate the NLRP3 inflammasome. In addition,
5

Intervention Resveratrol
Suggested dose 100–150 mg po qd
Mechanism(s) of action against Favorably modulate viral-induced pathological cellular processes
non-COVID-19 viruses • Modulation of NLRP3 inflammasome activation 5
Outcomes data supporting their MERS-CoV 43
mitigating effects on illness from Influenza 44,45
other viral strains
Strength of evidence Conditional
Risk of harm 46-53 Mimimal

Vitamin D
Activated vitamin D,1,25(OH) D, a steroid hormone, is vitamin D supplementation may prevent upper respiratory
an immune system modulator that reduces the expression infections. However, there is some controversy as to
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of inflammatory cytokines and increases macrophage whether it should be used and the laboratory value that
function. Vitamin D also stimulates the expression of should be achieved. Research suggests that concerns about
potent antimicrobial peptides (AMPs), which exist in vitamin D (increased IL-1beta in cell culture) are not seen
neutrophils, monocytes, natural killer cells, and epithelial clinically. The guidance we suggest is that a laboratory range
cells of the respiratory tract. Vitamin D increases of >50 and < 80ng/mL serum 25-hydroxy vitamin D may
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anti-pathogen peptides through defensins and has a dual help to mitigate morbidity from COVID-19 infection.
effect due to suppressing superinfection. Evidence suggests

Intervention Vitamin D
Suggested dose 5,000 IU po qd in the absence of serum levels
Mechanism(s) of action against Favorably modulate cellular defense and repair mechanisms:
non-COVID-19 viruses 55-78 • Activation of macrophages
• Stimulation of anti-microbial peptides
• Modulation of defensins
• Modulation of TH17 cells
Favorably modulate viral-induced pathological cellular processes:
• Reduction in cytokine expression
• Modulation of TGF beta
Outcomes data supporting their Reduce progression from colonization to illness
mitigating effects on illness from Reduce the severity and duration of acute symptoms and complications
other viral strains
Strength of evidence Limited
Risk of harm 79-82 Mimimal

Evans—Virus-Specific Nutraceutical and Botanical Agents Integrative Medicine • Vol. 19, No. S1 • Epub Ahead of Print 37