Best to not encounter Covid-19 at all, next best would be to somehow prevent its harmful effects. At the very least, you may want to make sure you have sufficient levels of NAD (Nicotinamide Adenine Dinucleotide) to increase your chances to survive it.
New research suggests that the method by which Covid-19 damages lung tissue includes NAD depletion, so many people ask whether Vitamin B3-based NAD precursors, like NMN (Nicotinamide Mononucleotide), which replenish NAD, might protect against the harm caused by Covid-19?
There’re 2 most famous precursors to NAD, both of B3 Vitamin family: Niacin and NMN (Nicotinamide Mononucleotide). NMN got more popular today as a better, probably the foremost effective NAD+ booster. Niacin fame came earlier, as it was identified before as a cure for the very nasty disease Pellagra, which was quite common within the 1st half of the 20th century. Today Pellagra is rare, partly because the flour and cereals that we eat are enriched with Niacin.
Now we all know that Vitamin B3 can do far more than simply prevent Pellagra, so supplementing at a better level might be smart, no matter what the science may show about Covid-19.
Here is what the emerging science has on Covid-19, and why it points toward the potential of NAD precursors. It creates so called "Cytokine Storms" consistent with this study: "It has been widely accepted that" excessive inflammation and cytokine storms"greatly contribute to the severity and lethality of Covid-19."
Cytokines are small proteins released by the system. When the Covid-19 coronavirus enters the lungs, cytokines are released, causing inflammation. But in some patients too many cytokines are released - an uncontrolled storm. This severe overreaction can cause deadly levels of inflammation. Cytokine storms are more likely to occur in older patients, who have both well-developed immune systems and diminished levels of NAD.
Last year, a 21-day placebo-controlled, randomized, double-blind, crossover human study showed that increase in NAD levels "depressed levels of circulating inflammatory cytokines."
This Editorial published in Nature Magazine on March 23, 2020, says,"We propose some simple, but largely ignored, approaches to the treatment of Covid-19 patients...Since Vitamin B3 is highly lung protective, it should be used as soon as coughing begins…”
But why even wait for coughing to start, why not start protecting your body and immune system right now?
That fact may be enough by itself for some people to act. As usual, the best NAD precursor, NMN, is the most expensive, but certainly is less expensive than Covid treatments, let alone treatment of any long-term damage it may cause in a patient’s respiratory system.
But let's go deeper and check out to why Vitamin B3 is recommended.
This preprint manuscript says that in the "pathology pathway of Covid-19, almost all procedures lead to or originate from NAD+ depletion." Specifically, SIRT1 regulates cytokines to modulate inflammation, and the depletion of NAD prevents the operation of SIRT1, and thus cytokine storms can develop.
This is an oversimplification of the "pathology pathway," which is more completely expressed in the paper: "NAD is consumed in large scale by PARP and its depletion inhibits the activity of other protective protein like SIRT1 and CD38. Expression of NFkB and cytokines and blood and immune cell defects are the consequences of SIRT1 and CD38 inhibition respectively."
But the bottom line is to suggest therapeutic approaches that can prevent or respond to NAD depletion. Or, as the authors say, "In conclusion, it seems interruption of the explained lethal circles may convert Covid-19 to a simple common cold."
That again may be enough to suggest for some people Nicotinamide Mononucleotide (NMN), Nicotinamide (NAM), or Nicotinamide Riboside (NR) supplementation as a prophylactic, with NMN, as evidence suggests, being the most efficient of them all.
If you want to go even deeper into the mechanisms involved, the science gets complex. For example, the study says that normally PARP-1 functions as an antiviral agent by removing a ribose from the cell's NAD and then attaching it to the virus, which inhibits the virus's function. But coronaviruses like Covid-19 code for PARG, which removes ribosides. As a result, “Excessive activation of PARP occurs to compensate ADP-ribose hydrolyzation of PARG which is associated with catalytic consumption of NAD+ followed by ATP reduction leading to depletion of energy and cell death."
Or, as one online commenter helpfully explained, "PARP1 tries to inhibit viral replication by breaking ribose off NAD and attaching it to the viral RNA. But the virus encodes PARG which whips that ribose right off. So PARP1 and PARG are fighting over ribosylation of the viral genome, all the while burning through the cell’s supply of NAD. Fiendish."
In the end, it nonetheless appears that Covid-19 causes NAD depletion, which successively triggers a cascade of troubles which may, among other things, end in lung damage. We await further details on the mechanisms.
Even before Covid-19, researchers were noting NAD repletion as a way of preventing lung damage from inflammation. For instance, during this ongoing study that began before the Covid-19 outbreak, the researchers noted that "supplementing mice with the unique NAD+ precursor" reduced both age-related and induced fibrosis, and therefore the researchers hypothesized that attempts to "boost NAD+ bioavailability will restore SIRT activity and limit fibrosis" including in inflammation-dependent models of systemic sclerosis. That study may be focused on effect on mice, it is not complete yet, and their method of NAD repletion is to inhibit CD38 (because CD38 also depletes NAD). But the overall concept that excess inflammation may result in NAD depletion, which in turn can cause lung damage, which in turn can often be prevented by replenishing NAD, predates Covid-19. Covid-19 is simply the foremost recent example of an NAD-depleting illness that would potentially be addressed with NAD-replenishing strategies.
The journal Aging notes that “Covid-19 patients may benefit tremendously from [NAD boosters like NMN], as SARS-CoV-2-infected patients have increased levels of [the NAD+-consuming enzyme] CD38+, and NAD has been shown to enhance DNA repair via PARP pathways."
In summary, few ways of preventing NAD depletion exist, including replenishment of NAD using one or more of the Vitamin B3 NAD precursors, like Nicotinamide Mononucleotide (NMN), Niacin (NA), Nicotinamide (NAM), or Nicotinamide Riboside (NR). And these methods might indeed be effective.
A word of caution: it must be noted of course that there’s no evidence that a vitamin can prevent Covid-19 infection. But there's emerging science that suggests that preventing NAD depletion could be a crucial strategy in mitigating the consequences of Covid-19 infection. NAD replenishment by any method will not treat or cure the disease, but evidence only suggests that B3 vitamins like Nicotinamide Mononucleotide are safe and effective at replenishing NAD. The effect of that replenishment in humans remains being tested as human trials continue. But so far, in animal studies, we see NAD replenishment having a positive effect on physical conditions involving NAD depletion.