COVID-19: Proposing a Ketone-Based Metabolic Therapy as a Treatment to Blunt the Cytokine Storm

This hypothesis paper proposes a ketone-based metabolic therapy to blunt the cytokine storm in severe SARS-CoV-2 infection. It reasons that increasing (R)-beta-hydroxybutyrate through a ketogenic diet or exogenous ketones could restore energy metabolism and redox state, and hypothesizes that a moderately high-fat diet plus exogenous ketones at the first signs of respiratory distress would bypass the block at the pyruvate dehydrogenase complex. It lists limitations: it is unknown whether human immune and lung cell function is enhanced by ketosis, ketoacidosis risk must be assessed, and permissive fat and carbohydrate levels are not established.