As of August 2020, in the United States there have been more than four million COVID-19 cases confirmed through testing, state a press release from Health Testing Centers. To help in these uncertain times, the organization has narrowed down the top six clinical markers for COVID-19 preparedness that patients should be aware of based on the latest research and data.
Vitamin D Testing for COVID-19 Risk Assessment
No longer a matter of mere speculation, the clinical evidence from the field now clearly indicates that Vitamin D levels are deeply correlated to patient outcome following a COVID-19 infection. This is a major concern as vitamin D deficiency affects about one billion people worldwide including 35% of adults and 61% of the elderly population in the United States.
Even after controlling for factors such as age and healthcare quality, a Northwestern University research team concluded that COVID-19 patients who have "severe Vitamin D deficiencies" (defined as less than ten nanograms per milliliter of blood, or >10ng/mL) are twice as likely to develop life-threatening complications after exposure to the virus.
Based on the available research, the following groups are most at-risk of developing a clinical Vitamin D deficiency that will compromise their ability to neutralize the COVID-19 virus:
· People with darker skin pigmentations
· The elderly
· Office workers
· Obese individuals (BMI above 25)
· People with liver or kidney disease
· Patients taking certain pharmaceutical drugs like anti-seizure medications and HIV/AIDS therapeutics
Simple lab work can ascertain the presence and extent of a Vitamin D deficiency in a patient by drawing a blood sample to evaluate the concentration of 25-hydroxyvitamin D. The clinical gold standard for detecting Vitamin D deficiencies is the 25-OH Vitamin D test. This is the preferred diagnostic tool of healthcare professionals because it paints a broad picture of total Vitamin D levels stored throughout the body.
Blood Sugar Tests (A1C) for COVID-19 Risk Assessment
In addition to Vitamin D levels, preliminary data indicates better outcomes for patients who control their blood sugar levels – an especially important consideration for pre-diabetic and diabetic patients.
The evidence so far, in fact, is shocking: half of COVID-19 patients that require hospitalization are hyperglycemic, meaning that their blood sugar levels remain dangerously elevated. Many patients suffering from this serious health condition may be unaware of it.
COVID-19 Mortality Rate by Blood Sugar Levels
Understanding your own blood-sugar measurements and taking necessary steps to reduce blood-sugar concentrations, therefore, is a critical component of COVID preparedness.
The emerging data regarding the correlation between blood sugar and COVID-19 outcomes squares with the well-established science behind how sugar impairs immune function. Sugar in the blood acts as an immunosuppressant, potentially crippling the immune system's ability to subdue the viral threat when COVID-19 enters the body.
A1C tests are the industry standard for assessing blood sugar concentrations over time. Because blood sugar fluctuates naturally on an hour-to-hour basis depending on when and what we eat, a test that measures blood sugar over extended periods is needed to fully understand the health implications related to COVID-19. A1C tests reveal overall blood sugar levels over the previous several months by measuring the amount of glucose (sugar) coating the red blood cells.
C-Reactive Protein Tests for COVID-19 Risk Assessment
Inflammation is a natural and necessary biological function that catalyzes the immune system into action. When inflammation levels run amok, though, serious and often-fatal complications can follow.
Arguably the single most important (and woefully overlooked) medical revelation in the past 50 years is that inflammation drives nearly all chronic disease. It has been linked to diabetes, cancer, autoimmune disorders, heart disease, and every other major chronic illness that affects Americans by the millions each year.
Regarding COVID-19, the evidence is clear that uncontrolled inflammation hinders the immune system's ability to effectively neutralize the invading pathogen. Specifically, in COVID-19 cases, unchecked inflammation can lead to a deadly cytokine storm. Understanding your current system-wide inflammation levels is critical for assessing your overall risk of complications from COVID-19 in the event that you become infected.
C-reactive protein screening is the ideal test as a baseline assessment of inflammation levels. It is generally used to diagnose and monitor a wide range of illnesses associated with chronic inflammation such as heart disease and inflammatory bowel disease (IBD). C-reactive protein tests are also useful for predicting how efficiently the immune system will respond to an invading pathogen – especially one like COVID-19 that often outmaneuvers our innate immune systems.
Zinc Level Tests for COVID-19 Risk Assessment
Of all the nutrients typically sourced from food, researchers increasingly recognize zinc as one of the most reliable predictors of COVID-19 mortality among infected patients.
As much as 25% of the population may suffer from a zinc deficiency with many being unaware of their immune system "blind spot." Zinc has long been recognized as an important tool in the body's frontline defenses against pathogens. Zinc is believed to primarily aid the immune response by halting viral replication, cutting off the viral infection's spread at the source.
Considering, zinc deficiency in the population and its important immunomodulatory role, self- and prescribed intervention in high risk groups such as the elderly is highly recommended. A blood test can measure the level of zinc in your body and determine if you have a zinc deficiency. If you have a zinc deficiency based on the results, the next step is to fortify your immune system with the zinc it needs through immune-boosting zinc supplementation.
Iron Level Tests for COVID-19 Risk Assessment
Iron is another dietary nutrient that plays a critical role in fortifying the immune system. Next to zinc, it is arguably the second-most important nutritional piece of the COVID-19 puzzle. Iron plays an essential role in generating new red blood cells and is a key component of hemoglobin that helps carry oxygen throughout your body.
Ferritin is a protein that stockpiles iron so that the body has enough of a supply when new iron-rich red blood cells must be produced. As such, ferritin levels serve as an accurate gauge of how much iron the body has on hand.
The research indicates that elevated ferritin levels (common in diabetic patients or others with auto-immune disorders) represent a substantial risk factor for hospitalized COVID-19 patients. Individuals with abnormally high ferritin levels experience the disastrous complications associated with COVID-19 infections, most notably the dreaded cytokine storm response, at substantially greater rates than patients with normal iron readings.
Another study, interestingly, found a negative correlation between COVID-19 severity and iron levels in the blood, meaning that as iron levels dropped, the likelihood of experiencing life-threatening inflammation (particularly in the lungs) increased.
Patients and providers who suspect sub-optimal iron levels can order a serum iron test and ferritin test. A serum iron test may help detect decreased or elevated iron levels. It may also help detect iron-deficiency anemia or hemochromatosis (an iron overload that makes it harder for your body to remove excess iron). Iron levels fluctuate throughout the day and may also vary depending on your diet or supplement intake.
Ferritin tests are commonly ordered with serum iron tests and are used to measure the amount of iron stored in your body. Most iron that is absorbed by the body is incorporated into the hemoglobin of red blood cells. Levels for hemoglobin are routinely checked in a complete blood cell count. As mentioned previously, hemoglobin is responsible for transporting oxygen through the body.
The majority of the remaining iron is then stored in ferritin in the body. Elevated ferritin levels may be seen in the body's inflammatory response or in chronic illnesses which is why this test may also be used as an inflammatory marker in certain individuals. Normal ferritin levels range between 20-80 ng/mL. Respective figures below or above those thresholds are cause for concern.
As the studies above indicate, iron levels that are either lacking or dangerously elevated represent key COVID-19 risk factors that call for clinical intervention through either iron supplementation or iron chelation therapy.
IL-6 and Other Genetic Markers of COVID-19 Susceptibility
Genetic testing, an exciting and rapidly developing field in the healthcare technology sector, enables providers and patients to gauge specific genetic factors that inform how you might respond to a COVID-19 infection. For example, some patients have a genetic predisposition for abnormally upregulated interleukin-6 (IL-6) cell activity. In this case, IL-6 cells are pro-inflammatory components of the immune system. With this type of immune response, an infection with a virus such as COVID-19 may increase levels of IL-6.
Higher levels of IL-6 in the blood are closely linked to the deadly cytokine storm response to COVID-19 seen in many severely ill patients. Elevated levels or over production of IL-6 may contribute to the systemic inflammatory process in the body. Due to this inflammatory response produced by the body’s immune system while fighting COVID-19, both elevated IL- 6 and Ferritin levels have been noted. Lab tests can be performed to both:
Genetically measure the body's natural, baseline production of IL-6 cells
If a genetic predisposition to excessive IL-6 production is detected through lab work, then IL-6 inhibitors may be indicated to slow the inflammatory cells' activity in the event of a COVID-19 infection.
