Implications for Systemic Approaches to COVID-19: Effect Sizes of Remdesivir, Tocilizumab, Melatonin, Vitamin D3, and Meditation

Ryan D Castle; Michelle A Williams; William C Bushell; J Adam Rindfleisch; Christine Tara Peterson; James Marzolf; Kimberly Brouwer; Paul J Mills

doi:10.2147/JIR.S323356

Implications for Systemic Approaches to COVID-19: Effect Sizes of Remdesivir, Tocilizumab, Melatonin, Vitamin D3, and Meditation

J Inflamm Res. 2021 Sep 22:14:4859-4876. doi: 10.2147/JIR.S323356. eCollection 2021.

Authors

Ryan D Castle¹, Michelle A Williams², William C Bushell³, J Adam Rindfleisch⁴, Christine Tara Peterson⁵, James Marzolf⁶, Kimberly Brouwer⁷, Paul J Mills⁸

Affiliations

¹ Science Division, Whole Health Institute, Bentonville, AR, USA.
² Harvard T.H. Chan School of Public Health, Department of Global Health and Population, Harvard University, Boston, MA, USA.
³ Science Division, Whole Health Institute, New York, NY, USA.
⁴ Education Department, Whole Health School of Medicine and Health Sciences, Bentonville, AR, USA.
⁵ Center of Excellence for Research and Training in Integrative Health, Department of Family Medicine, School of Medicine, University of California, San Diego, CA, USA.
⁶ Health Sector Finance & Policy, Whole Health Institute, Bentonville, AR, USA.
⁷ Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, CA, USA.
⁸ Herbert Wertheim School of Public Health and Human Longevity Science, Center of Excellence for Research and Training in Integrative Health, University of California, San Diego, CA, USA.

Abstract

Introduction: COVID-19 poses a chronic threat to inflammatory systems, reinforcing the need for efficient anti-inflammatory strategies. The purpose of this review and analysis was to determine the efficacy of various interventions upon the inflammatory markers most affected by COVID-19. The focus was on the markers associated with COVID-19, not the etiology of the virus itself.

Methods: Based on 27 reviewed papers, information was extracted on the effects of COVID-19 upon inflammatory markers, then the effects of standard treatments (Remdesivir, Tocilizumab) and adjunctive interventions (vitamin D₃, melatonin, and meditation) were extracted for those markers. These data were used to approximate effect sizes for the disease or interventions via standardized mean differences (SMD).

Results: The data that were available indicated that adjunctive interventions affected 68.4% of the inflammatory markers impacted by COVID-19, while standard pharmaceutical medication affected 26.3%.

Discussion: Nonstandard adjunctive care appeared to have comparable or superior effects in comparison to Remdesivir and Tocilizumab on the inflammatory markers most impacted by COVID-19. Alongside standards of care, melatonin, vitamin D₃, and meditation should be considered for treatment of SARS-COV-2 infection and COVID-19 disease.

Keywords: COVID-19; antivirals; corticosteroids; cytokine storm; effect size; inflammation; meditation; melatonin; vitamin D; whole health.