– By Heidi Skolnik, MS, CDN, FACSM

Scientists and doctors have gained significant knowledge regarding the mechanisms and methods of howSARS-CoV-2attacks cells and invades the body. Our understanding continues to evolve quickly. We now know, for example, that the virus can cause a runaway inflammatory response in the body that can overwhelm organs. “Cytokine storm” is the phrase being used to describe this rush of inflammatory cytokines.

The invading virus and the accompanying inflammation can exert a significant toll on the body, causing it to work extremely hard to combat the infection and repair damaged organs. A patient who has been seriously ill may have also taken powerful drugs likeRemdesvirorHydroxychloroquine, or other experimental therapies, which can also contribute to greater than normal stress on the body. The net toll can be significant, with recovery lasting anywhere from a few days to many months. From infection to complete recovery, we know there can bemuscle atrophy and loss, organ damage, and a severely compromised immune system.

It is essential to employ proactive nutrition strategies designed specifically to support the recovered patient’s restoration to full health. We’ve spoken to some of the leading hospitals in New York and they agree thatbetter nutrition is key. Nutrition, combined with physical therapy is the best approach to restoring health and strength. These leading hospitals are recommending nutrition programs to patients infected by COVID-19.

Below we discuss some of the key nutrients and dosages, recommended for daily consumption, as part of a post-recovery program from COVID-19.The nutrients should be used for at least six (6) weeks and should be done so after consulting with your physician. Your MD and/or hospital nutrition staff may have a different protocol for you to follow. If you are not advised on nutrition, you can follow the below guidelines in consultation with your doctor.

The essential groups of nutrients:

• Protein:Bed rest, disuse and lack of mobility can all contribute to the loss of muscle which can result in a loss of strength, balance and muscular endurance. To help support the return of muscular health, it is recommended to increase protein intake to 1 gram per / lb of body-weight during recovery. Protein is best consumed evenly at each meal versus all at once and you should include protein with each snack. Using a protein supplement can be helpful to many who may find it challenging to eat enough.
• Glutamine:An amino acid that is an energy source of the immune system; glutamine becomes needed in higher quantities during trauma and illness. It is recommended that consuming 5 to 10 grams of glutamine per day may help support the health of the immune system.
• BCAAs:Branched Chain Amino Acids, a combination of three essential amino acids, Valine, Leucine and Isoleucine, are recommended to promote maximum muscle regeneration, protein synthesis and increased muscle mass. It is recommended to consume 5 grams of BCAA’s in the correct 2:1:1ratio(3 grams of leucine, and over 1 gram each of isoleucine and valine).
• B Vitamins:B Vitamins are important for making sure the body’s cells are functioning properly. They help the body convert food into energy (metabolism), create new blood cells, and maintain healthy body tissues. It is advisable to take a b-complex.
• Vitamin C:Known as a powerful antioxidant, Vitamin C can help neutralize free radicals and support the health of the immune system. For adults, the daily recommended value of Vitamin C is 65 to 90 milligrams, however during the recovery period, many hospitals are using megadoses (therapeutic amounts utilized in hospitals is quite different than daily use recommendations). It is safe and may provide benefits to increase Vitamin C above daily recommended levels, but not to exceed 1000 milligrams.
• Vitamin D:Being stuck indoors is causing many of us to become deficient in Vitamin D. CDC recommends Vitamin D supplementation during this indoor time. There continues to be a lot of debate about the right amount of Vitamin D to take daily but the current consensus is around 400 to 800 IU. A recovered patient shouldn’t hesitate to take higher than this range, perhaps as high as 1000 IU for a period of weeks or months. Your doctor may measure your Vitamin D level and adjust recommended amounts accordingly.
• Iron:A mineral important to the functioning of the immune system, it is recommended to take 10 milligrams per day during the 6 week recovery period.
• Vitamin E: Fat-soluble antioxidant that is involved in immune function and has shown to regulate other metabolic processes. The recommended daily intake is 15 milligrams.

Additions to support muscle protein synthesis and help you return to full strength:

• HMB:A metabolite of leucine, HMB inhibits protein degradation, promotes muscle growth and prevents muscle breakdown. Studies have shown good benefits at 1.5 grams of HMB twice a day.
• Digestive Enzymes/Prebiotics:We are increasingly learning of the role of healthy gut in supporting a strong immune system. The drugs taken for COVID-19 can wreak havoc on friendly gut bacteria. We recommend a combination ofprobiotics and prebiotics.