認識新冠肺炎與Omicorn共存 醫：提升免疫力7大營養素
新冠肺炎疫情在全世界已蔓延三年，病毒的不斷變種也增加其傳染力，但其高度傳染力仍需大家小心提防。以下介紹COVID-19的演化、預防，以及如何維持好的免疫力進而防止中、重症。
什麼是COVID 19？COVID 19的演化進程
2019年年底起新型冠狀病毒SARS-CoV-2開始肆虐全球，以極快的速度遍及全球各國，世界衛生組織(World Health Organization, WHO)於2020年1月30日公布此為一公共衛生緊急事件，2月11日將此新型冠狀病毒所造成的疾病稱為COVID-19 (Coronavirus Disease-2019)，國際病毒學分類學會則將此病毒學名定為SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2)(1)。
新型冠狀病毒SARS-CoV-2屬冠狀病毒科(Coronavirinae)之beta亞科(betacoronavirus)。從疫情發生迄今，新型冠狀病毒隨著大量的傳播後已歷經多次突變，而出現不同的變異株，其中曾流行的新型冠狀變種病毒包含alpha、delta以及現在全世界主要流行的omicron變異株(2)(3)。
| 主要變異株 | Alpha (B.1.1.7) | Beta (B.1.351) | Gamma (P.1) | Delta (B.1.617.2) | Omicron (B.1.1.529) |
| 最早發現地區 | 英國 | 南非 | 巴西、日本(巴西移入) | 印度 | 南非、波札那 |
| 棘蛋白突變點(數量) | 11 | 10 | 12 | 10 | 32 |
據研究顯示，感染omicron變異株所導致的重症比例比起delta顯著較低，而施打疫苗追加劑仍能提供omicron突破性感染者70%以上的重症保護力(4)。
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疫情至今已過了數年，目前世界各國皆逐步放寬防疫限制，邁向與病毒共存的時代，如此一來，完整接種疫苗、提高個人免疫力與平時的防護措施都顯得更為重要。疫情時代中，建議所有民眾仍應維持運動習慣、攝取均衡飲食、放鬆心情、補足所有營養，才能健康迎向後疫情生活。
參考資料：https://www.dha.tw
1、衛生福利部疾病管制署 – 嚴重特殊傳染性肺炎 疾病介紹
2、Centers for Disease Control and Prevention - SARS-CoV-2 Variant Classifications and Definitions
3、衛生福利部疾病管制署 – COVID-19疫苗與Omicron病毒變異株
4、Tommy Nyberg, Neil M Ferguson, Sophie G Nash, Harriet H Webster, Seth Flaxman, Nick Andrews, Wes Hinsley, Jamie Lopez Bernal, Meaghan Kall, Samir Bhatt, Paula Blomquist, Asad Zaidi, Erik Volz, Nurin Abdul Aziz, Katie Harman, Sebastian Funk, Sam Abbott, COVID-19 Genomics UK (COG-UK) consortium; Russell Hope, Andre Charlett, Meera Chand, Azra C Ghani 6, Shaun R Seaman, Gavin Dabrera , Daniela De Angelis, Anne M Presanis, Simon Thelwall. Comparative analysis of the risks of hospitalisation and death associated with SARS-CoV-2 omicron (B.1.1.529) and delta (B.1.617.2) variants in England: a cohort study. Lancet. 2022 Apr 2;399(10332):1303-1312. doi: 10.1016/S0140-6736(22)00462-7. Epub 2022 Mar 16. PMID: 35305296
5、Centers for Disease Control and Prevention - Symptoms of COVID-19
6、衛生福利部疾病管制署 – COVID-19 確診個案，居家照護期間警示症狀評估與注意事項
7、衛生福利部疾病管制署 – COVID-19 兒童確診個案，居家照護期間症狀評估與注意事項
8、衛生福利部疾病管制署 – 3+4居家隔離
9、Hira Shakoor, Jack Feehan, Kathleen Mikkelsen, Ayesha S Al Dhaheri, Habiba I Ali, Carine Platat, Leila Cheikh Ismail, Lily Stojanovska, Vasso Apostolopoulos. Be well: A potential role for vitamin B in COVID-19. Maturitas. 2021 Feb;144:108-111. doi: 10.1016/j.maturitas.2020.08.007. Epub 2020 Aug 15. PMID: 32829981
10、Michele C.A., Angel B., Valeria L., Teresa M., Giuseppe C., Giovanni M., Ernestina P., Mario B. Vitamin supplements in the era of SARS-Cov2 pandemic. GSC Biol. Pharm. Sci. 2020;11(2):007–019 doi: 10.30574/gscbps.2020.11.2.0114
11、Zhang L., Liu Y. Potential interventions for novel coronavirus in China: a systematic review. J. Med. Virol. 2020;92(5):479–490. doi: 10.1002/jmv.25707. Epub 2020 Mar 3. PMID: 32052466
12、Anitra C Carr, Silvia Maggini. Vitamin C and Immune Function. Nutrients. 2017 Nov 3;9(11):1211. doi: 10.3390/nu9111211. PMID: 29099763
13、Harri Hemilä, Elizabeth Chalker. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2013 Jan 31;2013(1):CD000980. doi: 10.1002/14651858.CD000980.pub4. PMID: 23440782
14、García L.F. Immune response, inflammation, and the clinical spectrum of COVID-19. Front. Immunol. 2020;11:1441. doi: 10.3389/fimmu.2020.01441. PMID: 32612615
15、Hiedra R., Lo K.B., Elbashabsheh M., Gul F., Wright R.M., Albano J., Azmaiparashvili Z., Patarroyo Aponte G. The use of IV vitamin C for patients with COVID-19: A case series. Expert Rev. Anti-Infect. Ther. 2020;1:1–3. doi: 10.1080/14787210.2020.1794819. PMID: 32662690
16、Mayte Medrano, Estrella Carrillo-Cruz, Isabel Montero, and Jose A Perez-Simon. Vitamin D: Effect on Haematopoiesis and Immune System and Clinical Applications. Int J Mol Sci. 2018 Sep; 19(9): 2663.Published online 2018 Sep 8. doi: 10.3390/ijms19092663. PMID: 30205552
17、Mradul Mohan, Jerin Jose Cherian, Amit Sharma. Exploring links between vitamin D deficiency and COVID-19. PLoS Pathog. 2020 Sep 18;16(9):e1008874. doi: 10.1371/journal.ppat.1008874. eCollection 2020 Sep. PMID: 32946517
18、Minkyung Bae and Hyeyoung Kim. The Role of Vitamin C, Vitamin D, and Selenium in Immune System against COVID-19. Molecules. 2020 Nov; 25(22): 5346.Published online 2020 Nov 16. doi: 10.3390/molecules25225346. PMID: 33207753
19、Ananda S Prasad. Zinc in Human Health: Effect of Zinc on Immune Cells. Mol Med. 2008 May-Jun; 14(5-6): 353–357.Published online 2008 Apr 3. doi: 10.2119/2008-00033.Prasad. PMID: 18385818
20、te Velthuis AJ, van den Worm SH, Sims AC, Baric RS, Snijder EJ, van Hemert MJ. Zn(2+) inhibits coronavirus and arterivirus RNA polymerase activity in vitro and zinc ionophores block the replication of these viruses in cell culture. PLoS Pathog. 2010;6(11):e1001176. doi: 10.1371/journal.ppat.1001176. PMID: 21079686
21、National Institutes of Health (NIH) - COVID-19 Treatment Guidelines - Zinc
22、Moghaddam A., Heller R.A., Sun Q., Seelig J., Cherkezov A., Seibert L., Hackler J., Seemann P., Diegmann J., Pilz M., et al. Selenium deficiency is associated with mortality risk from COVID-19. Nutrients. 2020;12:2098. doi: 10.3390/nu12072098. PMID: 32708526
23、Zhang J., Taylor E.W., Bennett K., Saad R., Rayman M.P. Association between regional selenium status and reported outcome of COVID-19 cases in China. Am. J. Clin. Nutr. 2020;111:1297–1299. doi: 10.1093/ajcn/nqaa095. PMID: 32342979
24、Louca P, Murray B, Klaser K, et al. Modest effects of dietary supplements during the COVID-19 pandemic: insights from 445 850 users of the COVID-19 Symptom Study app. BMJ Nutr Prev Health. 2021;4(1):149-157. Published 2021 Apr 19. doi:10.1136/bmjnph-2021-000250
25、Doaei S, Gholami S, Rastgoo S, Gholamalizadeh M, Bourbour F, Bagheri SE, Samipoor F, Akbari ME, Shadnoush M, Ghorat F, Mosavi Jarrahi SA, Ashouri Mirsadeghi N, Hajipour A, Joola P, Moslem A, Goodarzi MO. The effect of omega-3 fatty acid supplementation on clinical and biochemical parameters of critically ill patients with COVID-19: a randomized clinical trial. J Transl Med. 2021 Mar 29;19(1):128. doi: 10.1186/s12967-021-02795-5. PMID: 33781275; PMCID: PMC8006115.
26、Barazzoni R., Bischoff S.C., Krznaric Z., Pirlich M., Singer P. Elsevier; 2020. ESPEN Expert Statements and Practical Guidance for Nutritional Management of Individuals With SARS-CoV-2 Infection; pp. 1631–1638. doi: 10.1016/j.clnu.2020.03.022. Epub 2020 Mar 31. PMID: 32305181
27、L Susan Wieland, Vanessa Piechotta, Termeh Feinberg, Emilie Ludeman, Brian Hutton, Salmaan Kanji, Dugald Seely, Chantelle Garritty. Elderberry for prevention and treatment of viral respiratory illnesses: a systematic review. BMC Complement Med Ther. 2021 Apr 7;21(1):112. doi: 10.1186/s12906-021-03283-5. PMID: 33827515
28、Weng JR, Lin CS, Lai HC, et al. Antiviral activity of Sambucus FormosanaNakai ethanol extract and related phenolic acid constituents against human coronavirus NL63. Virus Res. 2019;273:197767. doi:10.1016/j.virusres.2019.197767. PMID: 31560964
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