COVID-19

COVID-19: Hidden Coinfections and Chain Reactions Parasitic Infectious Relationships within Us

By SIMON YU, MD, COL, USA (Ret)

Dr. Tom Frieden, former director of the Centers for Disease Control and Prevention (CDC), opened up a new front in the Coronavirus War by saying we don’t just need to treat the acute disease, we need to treat the underlying conditions that make people more susceptible to serious disease progression. He focused on heart disease, and managing mitigating risk factors such as CVD, diabetes, hypertension and smoking in order to increase people’s odds for recovery. The initial focus has been pneumonia and acute respiratory distress syndrome (ARDS), with risk factors including asthma, chronic obstructive pulmonary disease, and emphysema.

Dr. Frieden calls for better management of people’s underlying health problems to help mitigate the impact of COVID-19. I would take this one step further and say we need to go beyond managing chronic diseases, and find and treat the pathogens that underlie and fuel their pathologies. Why?

In 2001, my work as an Army Reserve medical officer took me to Bolivia to treat 10,000 Andes Indians with parasite medications. Not only did this resolve their parasite problems, but many reported it helped them overcome a range of additional chronic health problems. When I returned to St. Louis, I began to dig deeper with my chronic disease and “mystery disease” patients and treat some of them for parasite problems, and saw many improve. I expanded this “search and destroy” mission with my patients to fungal and dental infections, as I learned many such infections – often overlooked in medicine today – are overlapping, synergistic, and can present as chronic illness.

The more I learned about the importance of a healthy biological terrain and the importance of a healthy immune system, the more I began to apply military thinking and strategy to medicine, and paradoxically, help the body find peace within itself. Sun Tzu wrote, “The supreme art of war is to subdue the enemy without fighting,” in his classic, The Art of War. I learned the best way to do that is strengthen the immune system, by focusing on such basics as nutrition, exercise, sleep, and emotional balance. When it comes to chronic illnesses, my belief is that we should not fight symptoms, a diagnosis or a syndrome, but improve the biological terrain, and counter the underlying asymmetric threats.

The importance of a multipronged effort to strengthen the immune system and treat the multiple pathogens that lead to an inflammatory cascade is underscored by new CDC data on COVID-19 in the U.S. Of 7,162 cases from mid-February to late March with complete information, the CDC found that 78 percent of people requiring admission to an intensive care unit (ICU) had at least one underlying health condition. Of people hospitalized but not requiring ICU admission, 71 percent had at least one such condition, compared with just 27 percent of people who didn’t need to be hospitalized. The biggest risk factors contributing to hospitalization and ICU admission were diabetes, lung disease and CVD.

In addition to preexisting heart, lung and metabolic conditions, another major risk factor is an overactive immune system – a “cytokine storm.” According to Dr. Randy Cron of the University of Alabama at Birmingham, in as much as 15 percent of people battling any serious infection, “the immune system keeps raging long after the virus is no longer a threat. It continues to release cytokines that keep the body on an exhausting full alert. In their misguided bid to keep the body safe, these cytokines attack multiple organs including the lungs and liver, and may eventually lead to death.” This may be the turning point from a mild to miserable respiratory illness into life-threatening organ failure.

TABLE 1. Reported outcomes among COVID-19 patients of all ages, by hospitalization status, underlying health condition, and risk factor for severe outcome from respiratory infection — U.S. February 12–March 28, 2020
Underlying health condition/ Risk factor for severe outcomes Not hospitalized Hospitalized, non-ICU ICU admission Hospitalization status unknown
(top three conditions listed below) (number, percent with condition)
Total w/ complete information (7,162) 5,143 1,037 457 525
One or more conditions (2,692, 38%) 1,388 (27%) 732 (71%) 358 (78%) 214 (41%)
Diabetes mellitus (784, 11%) 331 (6%) 251 (24%) 148 (32%) 54 (10%)
Chronic lung disease (656, 9%) 363 (7%) 152 (15%) 94 (21%) 47 (9%)
Cardiovascular disease (647, 9%) 239 (5%) 242 (23%) 132 (29%) 34 (6%)

Source: http://dx.doi.org/10.15585/mmwr.mm6913e2

What have I learned in my years of medical practice as a regional HMO director, 25 years in the US Army Reserve Medical Corps, and as director of Prevention and Healing, Inc. in St. Louis? The asymmetric threats most often overlooked are parasites, fungal infections, and dental problems. Viruses are technically parasites, a gray area between living and nonliving: they cannot replicate on their own but do so in living cells. They have been evolving with us and some of them are encoded as a part of our genetic code from the point of evolution of biological life. They are unique and complex, composed of a protein coat surrounding RNA or DNA core genetic materials. They can stay dormant for many years or be active seasonally, and are capable of growth and multiplication only in living cells as unwanted guests, just like parasites. Parasites have their own parasites, fungi, mycoplasma, bacteria and many types of viruses. The slide below is part of my lecture explaining the evolution of life and parasites, coinfections and parasitic relationships from a universal, simplified perspective.

FIGURE 1. The Kingdoms of Life: Creation, Evolution and Co-Creation

The coronavirus is deceptive and creates a hidden chain reaction. COVID-19 will attack aggressively already vulnerable aging populations and immune-compromised, chronically ill patients, young or old. Many patients are nutritionally depleted and cannot support their immune system, so rapidly succumb to the viral infection. By the time one develops pneumonia, COVID-19 may activate dormant, inactivated bacteria, fungi, mycobacteria and parasites that were previously under the surveillance of the immune system. COVID-19 pneumonia patients may be fighting more than viral infection but also bacterial, mycobacterium-TB like infection, fungi and reactivated parasites, including dental infections. Prevotella have been found in lungs of COVID patients in three Asian studies; it is often found in dental infections.

Coinfections might explain why some patients respond to hydroxychloroquine, an antimalarial parasite medication, and azithromycin, an antibiotic for pneumonia, one of numerous treatment strategies now being tested. Hydroxychloroquine facilitates uptake of zinc into cells, which interrupts viral replication. Another repurposed medication being tested is losartan, an angiotensin-converting enzyme (ACE) inhibitor blood pressure medication. ACE-2 is the host cell receptor responsible for mediating infection by SARS-CoV-2, the novel coronavirus responsible for coronavirus disease 2019 (COVID-19). Treatment with anti-ACE-2 antibodies disrupts the interaction between virus and receptor.

Physicians in Shanghai report help from using high and frequent dose IV Vitamin C. A clinical trial using Vitamin C for coronavirus is underway in China, and it is also in use in some New York City hospitals. While pharma companies are eager to fund trials of costly patented drugs, we also need to test combinations of existing drugs and nutrients to find more accessible, affordable solutions.

For prevention and prophylactic measures, I recommend extra vitamin C up to 10,000mg/day, 10,000 IU of vitamin D3, vitamin K2, selenium, zinc, boron, and herbal and homeopathic remedies for viral respiratory illnesses, such as elderberry extract. Glutathione can be used for general immune support. I am not saying this will prevent or stop COVID-19, but help you be in a stronger position to fight it.

In the face of the coronavirus pandemic ravaging the US, the FDA has rapidly issued a series of Emergency Use Authorization (EUA) Updates for Coronavirus Disease (COVID-19) which cover In Vitro Diagnostic Products, Personal Protective Equipment, Other Medical Devices, and Therapeutics. In addition, FDA approved two new treatments being used overseas in late March: convalescent plasma therapy, and hydroxychloroquine, an antiparasitic used for malaria, lupus, and rheumatoid arthritis. Both of these have a long history of successful use for other diseases, side effects are understood and should be monitored, and clinical trials are being initiated.

The Food and Drug Administration (FDA) has created a special emergency program for possible therapies, the Coronavirus Treatment Acceleration Program (CTAP). As of this writing, there are 10 therapeutic agents in active trials, and another 15 in planning stages. FDA invites new requests for product development for proposed COVID-19 uses and drug development submissions at COVID19-productdevelopment@fda.hhs.gov

There is a good deal of controversy in medical circles about whether the FDA is moving too fast, or too slowly, in clinical trials and drug approval. Given the gravity of the challenges we face, it is time to put aside intellectual biases, and be open to new strategies. It is time for “all hands on deck.”

Just as public health strategies of isolation, quarantine and containment play a vital role in pandemics in addition to emergency medicine and targeted therapeutics there is an important role for preventive and integrative medicine. We need to treat the whole body and strengthen the biological terrain to be ready to confront both novel viruses and longstanding pathogens that contest for living among, within, and off of us. We need extra help in the face of the asymmetric threats we confront in the challenging months ahead in our families, our nation, and our stressed and overstretched healthcare system.

Simon Yu, MD, Col (Ret), practices internal and integrative medicine at Prevention and Healing, Inc. in St. Louis; his latest book is, AcciDental Blow Up in Medicine: Battle Plan for Your Life.

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7 replies »

  1. I live in California. I’ve been under the worst stress I’ve ever experienced in my 52yrs of life during shelter in place. Everything bad that could happen has affected me mentally & now physically. I went to urgent care because I was seeing white bulb at the base of my hair follicles from head, face, ears, eyes brows ect… Dr said your just having a nervous breakdown. I said maybe but there are bug crawling all over. I sent samples to the lab Patiently waiting. A nurse friend says I think you have white Piedra them another says Demodex. Now I’m infested, I’ve taken pix more samples everyday of these parasites. I’m extremely clean , been using tea tree oil which helps . I find your article so interesting with parasites & Covid. I also have arthritis in my fingers. The inflammation is horrific. . I wish more doctors were educated like you are. Hopefully I can get a prescription soon . What do you think about Ivermectin?

  2. Thank you, Dr. Yu, for an insightful piece noting not only the importance of dental health, but other issues such as fungal issues, and the immune system. I addressed a good deal of this in my book, Diagnosing and Treating Chronic Heavy Metal Toxicity: Patient Guide to Regaining Health, because I spent my life ill and only recently put the right pieces together to make significant progress in health (such as finally being able to reverse obesity, diabetes type 2, reduce hypothyroidism, etc.). Still a work in progress, but continuing to share valuable information such as your article because the lifestyle changes are essential for health and if we take care of those, working with our physicians, we will be able to improve our health.

  3. This is extremely important and lifesaving information and the general population is not very well educated of aware of this domino effect or even what cytokines are and do within the body. It explains why patients seem to level off with what presents as mild symptoms but after a week or so suddenly get much much worse. I am a former immune-compromised individual and had similar experiences in my battle with lupus. I would contract a cold of upper-respiratory infection, my body would fight it off and I would start to feel better, then crash and burn badly for the next several weeks in utter exhaustion and pain. I turned that awful cycle around after years of experimenting with different natural protocols and nutritional regimens with the help of an Integrated Holistic physician-pharmacist that treated my immune system instead of suppressing it to combat Symptoms. Treating the host and not the virus or pathogen can make a significant difference in how a deadly disease manifests in the body. I had essentially given up on living at the age of 38, with his drug-free protocols. By 40, my Immune system was restored and my quality of life completely improved. At the age I am now,66, which according to the rheumatologist’s diagnosis was not attainable, I know more about auto-immune dis-orders, than most of the average physicians and it has kept me strong and healthy for the most part. I am very wary of the current treatments they are using on the COVID patients. They are using the immune-suppressing instead of supporting drugs and approaches and that can actually be as bad as the virus itself, which in turn overwhelms an already maxed out body. I see that there has been some success within the Alternative Medical community with Ozone shots and IV therapy to oxygenate the blood of exposed patients with a high rate of reversal in symptoms, even with severe cases. I know that is what I would request as my first line of defense if it became a reality for me to fight off this invisible enemy. I pray that a more holistic approach becomes part of the weapon used to defeat this new Disease and we have enough data and proof of the efficacy of a multi-defense approach to curing be working with the body’s own defenses, not just trying to subdue the invader, but also weakening and sometimes killing the host in the process.

  4. Thank you for making an important point. While not technically so, I consider environmental toxins and diet, exercise, lifestyle, and lack of access to health and dental care as “pathogenic” in the broad sense of being specific causative agents – and also as increasing the odds of opportunistic infections of all kinds. You will find that in my work, practice and writing.

  5. “we need to go beyond managing chronic diseases, and find and treat the pathogens that underlie and fuel their pathologies.”

    How does that explain the terrible covid outcomes in the African American community? Overweight, hypertension, lack of exercise, diabetes, poor diet, poor access to health care. Maybe even asthma from pollution and other maladies from industrial chemical toxins close to the neighborhoods they live.

    That’s where I think the “pathogens” develop.

  6. Thank you for your response. For more of my thoughts on this, please see my latest book, AcciDental Blow Up in Medicine: Battle Plan for Your Life.

  7. Thank you Dr. Yu, very interesting piece. Regarding dental issues, I’ve often wondered what role dental issues might play in overall patient health, and whether the strange quirk of history that caused us to treat dental health on a completely separate, parallel track of providers, institutions, and payers, has been a detriment.

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