Toxicity of Food Supplements as An Adjuvant for COVID-19 Treatment or Prevention

Commercially available food supplements, especially vitamins and minerals,are be-coming increasingly popular in the era of COVID-19 pandemic. Sales of food sup-plements increased dynamicallybecause of the belief that they could be more effec-tive than conventional antiviral or corticosteroid drugs as well as missing the specific medical therapy for preventing or treating this disease.The greatest interest is asso-ciated with immune-related nutrients and antioxidant agents, including vitamin C, vitamin D, vitamin E, selenium(Se),and zinc(Zn). These are currently under clini-cal investigation for possible application in the prevention and management of COVID-19. This review summarizes postulated mechanisms of commonly used sup-plements suggested reducingthe duration and severity of viral infections by improv-ing immune response. Their toxicity in thecontext of potential adverse effects is also discussed. Whether these molecules and theamount could hurt patients with COVID-19 are research questions worth evaluating. Considering both efficacy and safety, evidence supporting larger intakes of specific nutrients with immune-boost-ing and/or antioxidant properties needs further research. Until relevant responses are provided, age and gender related tolerable upper intake levels for vitamins and min-erals should be considered to avoid weight gainingas an additional risk factor of developing complications during the disease course, besidesthe risk of inappropriate doses associated with toxicity.Herein, high-quality information respecting specific nutrients proposed to have positive effect against COVID-19 is disseminated and certain research gaps are addressed, requiring the research on the health effects of supplements to be tightly correlated to age, nutritional status, wellbeing and partic-ular to existing co-morbidities.