We are nearing year two of the pandemic. COVID-19 is probably here to stay with us. Understanding COVID-19 pathogenesis and how this virus affects COVID-19 patients is critical to reducing your risk of complications and severe COVID-19. 

Emerging research suggests that the COVID-19 can seriously impact your mitochondrial function. Mitochondrial damage from COVID-19 may determine disease severity and outcomes. Supporting your mitochondrial health may be critical for reducing severe symptoms and hospitalization.

In this article, I want to go over the COVID-19 pathogenesis, how it affects your mitochondrial function, and how you can support your mitochondrial health.

What Is the Mitochondria

Your mitochondria are specialized structures inside your cells that serve as a powerhouse. They are the batteries that serve as an energy factory for your body. They are responsible for the production of about 90 percent of cellular energy in the form of adenosine (ATP). 

The mitochondria power a variety of bodily functions. Two of their main roles are cellular respiration and energy production. Your mitochondria are the reason you need to breathe and eat. Besides cellular respiration and cellular energy production, your mitochondria are critical for cell growth and multiplication, cell death of old, injured, and damaged cells, calcium homeostasis, nerve function, organ metabolism, heat production, synthesizing biomolecules, and other functions (1, 2).

COVID-19 and the Mitochondria

As with other viral infections, COVID-19 may affect your mitochondrial health. A 2021 review published in Frontiers in Aging Neuroscience has discussed the potential impact of COVID-19 on your mitochondria that may play a crucial role in COVID-19 pathogenesis, severe COVID-19, complications, and mortality (3). Increasing research evidence suggests that once your body is infected, COVID-19 takes over the mitochondria of your immune cells. Once it’s inside your mitochondrial structures, it will start to replicate, damage your mitochondrial function, and increase the risk of cell death.

As you know, your mitochondria are critical for your cellular homeostasis and immune health. The mitochondria of impacted cells become compromised and the cells become highly vulnerable to further damage. Unfortunately, the vulnerability of your mitochondria can increase with age which may explain why the older population is more impacted by the virus (3, 4).

Inflammatory Response and Cytokine Storm

Once the COVID-19 or SARS-CoV-2 virus is inside your cells, it will provoke a major inflammatory immune response. This will lead to the release of various cytokines, such as TNF-α, INF-γ, and interleukin-10, causing an increase in mitochondrial reactive oxygen species (mROS). Mitochondrial ROS are highly reactive chemicals generated during mitochondrial oxidative metabolism. They play a role in infections, such as COVID-19, aging, and DNA. In COVID-19, mitochondrial ROS can trigger the further release of pro-inflammatory cytokines. This may increase the risk of a cytokine storm, which can cause serious symptoms, health complications, or even death (3, 5).

In order to produce ROS, your mitochondria may have to take some energy away from ATP energy production, which can cause membrane permeabilization (i.e. leakiness), apoptosis (i.e. cell death), and severe mitochondria damage. The problem is that if damaged mitochondria have to dump their content into the liquid inside your cells, called the cytosolic space, it may lead to even more cytokine production. This may, of course, only further trigger COVID-19 and inflammation (3).

Iron Overload

Beyond the increased risk of a cytokine storm, ferritin may also play a role in the potential poor outcome of COVID-19. Ferritin is a measurement of iron stores in the body.  When healthy, a baseline ferritin can help understand one’s risk of iron overload, and therefore I order it in many of my patients.  Healthy mitochondria use iron to store mitochondrial ferritin. Problems may occur if there is too much iron, as iron overload can cause oxidative stress. It may also interfere with the oxygen intake of your mitochondria and therefore compromise mitochondrial health and function (3). 

Damaged mitochondria may not be able to metabolize iron effectively, which may increase ferritin build-up and cell death. Ferritin overload may also interfere with glucose tolerance in affected cells, which can cause issues in those with diabetes. Diabetes is one of the major risk factors for complications with COVID-19 and ferritin overload may play a role in some cases (3).

Platelet Count and Coagulation

COVID-19 may also affect your platelet count and coagulation. Lower platelet counts and increased coagulation may interfere with mitophagy, which is the selective removal of damaged mitochondria through autophagy. Without mitophagy, your platelets may experience apoptosis, which can increase the risk of blood clots. Blood clots are one of the potential consequences of COVID-19. Their risk factor is particularly high for those with diabetes who are also experiencing oxidative stress or mitochondrial damage (3).

Increased Risk of Mitochondrial Dysfunction and Complications from COVID-19

Aging and age-related diseases may increase the risk of mitochondrial issues and COVID-19 complications. However, chronic inflammation, increased oxidative stress, obesity, diabetes, metabolic disease, gut health issues, and neurological diseases are all risk factors regardless of your age (3, 4, 7, 8).

How to Support Mitochondrial Function

Supporting your mitochondrial function was critical even before the pandemic. It’s even more important now to reduce the risk of complications from COVID-19.

To support your mitochondrial health, I recommend the following strategies:

  • Follow an antioxidant-rich, anti-inflammatory, nutrient-dense diet. Stay away from refined sugar, highly processed grains, refined oil, highly processed foods, and junk food. These only fuel inflammation, oxidative stress, and mitochondrial dysfunction. Eat plenty of greens, vegetables, herbs, fruits, nuts, seeds, and pasture-raised animal protein (9). 
  • Try intermittent fasting. Intermittent fasting is a dietary strategy that cycles between a window of fasting (not eating) and a window reserved for eating within a day. Intermittent fasting can increase autophagy and mitophagy that helps to maintain mitochondrial health. Intermittent fasting may also reduce oxidative stress, decrease inflammation, and support immune function (10, 11).
  • Sleep plenty and move your body. Aim for 7 to 9 hours of sleep at night. Move your body regularly and exercise 20 to 30 minutes at least 5 times a week. Focus on cardiovascular exercises, such as walking, biking, running, or high-intensity interval training for heart health (12, 13, 14).
  • Lower your stress levels. Try meditation, breathwork, gratitude practice, journaling, and positive affirmations to lower your stress levels and learn to respond to stress better (15).
  • Reduce exposure to toxins. If you are a smoker, stop smoking. Avoid secondhand smoke as much as possible as cigarette smoking can compromise mitochondrial structure and function. Reduce your exposure to air pollution, contaminated water, mold, and other environmental toxins. Choose organic whenever possible and available (16, 17).
  • Try red-light therapy. RLT may stimulate mitochondrial health and allow your mitochondria to create more energy (18, 19, 20, 21).
  • Try some anti-inflammatory and antioxidant-rich supplements. You may benefit from supplementing vitamin omega-3 fatty acids, vitamin C and E, N-acetylcysteine (NAC), coenzyme Q10, and a-lipoic acid (22, 23, 24, 25, 26, 27).

To learn more about my recommendations for improving your immune system, supporting your body through a SARS-COV-2 infection, and supporting your recovery from long hauler syndrome, I recommend reading this and this article.

Next Steps

If you are experiencing symptoms of mitochondrial dysfunction, currently dealing with a COVID-19 infection, or simply want to improve your health to reduce your health risks, I welcome you to start a personalized functional medicine consultation with me for further personalized guidance to improve your health. You may book your consultation here. 

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