COVID-19 AND NUTRITION
DOI:
https://doi.org/10.11603/bmbr.2706-6290.2021.2.12345Keywords:
COVID-19, viral infection, nutrition, chronic disordersAbstract
Summary. Currently Covid-19 pandemic is a leading challenge across the globe. It is mandatory to attain and maintain good nutritional status to fight against virus. Nutritional status of individual is affected by several factors such as age, sex, health status, life style and medications. Nutritional status of individuals has been used as resilience towards destabilization during this COVID-19 pandemic. Optimal nutrition and dietary nutrient intake impact the immune system, therefore the only sustainable way to survive in current context is to strengthen the immune system. There is no evidence found that supplement can cure the immune system except Vit C, which is one of the best way to improve immune system. A proper diet can ensure that the body is in proper state to defeat the virus. However along with the dietary management guidelines the food safety management and good food practices is compulsory. This article explores the importance of nutrition to boost immunity and gives some professional and authentic dietary guidelines about nutrition and food safety to withstand COVID-19.
The aim of the study – to analyze and systematize the literature data about the influence of nutrition on the manifestation of COVID-19 infection.
Materials and Methods. The study uses publications of the world scientific literature on COVID-19 infection, in particular the causes and mechanisms of its development, treatment, complications and its consequences as well as the influence of different nutrients and nutrasuticals on the course of COVID-19. This review highlights the nutritional interventions to increase the immune response in the body during viral infections, especially considering the novel coronavirus pandemic. Due to their beneficial effects on general healthcare and disease prophylaxis, nutraceuticals have been gaining more and more importance lately.
Results. During the COVID-19 pandemic, the nutritional status of individuals has been used as a measure of resilience toward destabilization. Optimal nutrition and dietary nutrient intake impact the immune system through gene expression, cell activation, and signaling molecules modification. In addition, various dietary ingredients are determinants of gut microbial composition and subsequently shape the immune responses in the body. Therefore the existing evidence suggests that the only sustainable way to survive in the current situation is to strengthen the immune system. An adequate intake of zinc, iron, and vitamins A, B 12, B6, C, and E is essential for the maintenance of immune function. In the current scenario, COVID-19 has imposed a new set of challenges for the individual to maintain a healthy diet. The state of self-isolation, lockdown, and social distancing are important measures to flattening the curve of the disease, although these measures have severe repercussions on an individual’s life. The act of confining to one’s home has significant impacts on one’s health, including changes in eating patterns, sleeping habits, and physical activity. It would promote sedentary behaviors that affect mental and physical health and lead to an increased risk of obesity. Fear and anxiety may also cause changes in dietary habits leading to unhealthy dietary patterns and less desire to eat or with lessened enjoyment during eating. Micronutrients are dietary components that may contribute substantially to a robust immune system. Essential micronutrients like vitamins A, D, E, C, B6, B12, and folate and trace elements such as iron, zinc, and selenium, available in a variety of fresh animal- and plant-based foods, aid the body’s ability to fight infections.
Conclusions. COVID-19 became the most challenging pandemic influencing all countries worldwide. A proper and healthy diet can ensure a robust immune system that can resist any onslaught by the virus. A certain amount of particular nutrient saturates into cells and prevents any kind of nutritional deficiency. Individuals consuming well-balanced diets appear to be safer with better immune systems and lower incidence of chronic diseases and infections.
References
Zhang L, Liu Y. Potential interventions for novel coronavirus in China: A systematic review. J Med Virol. 2020;92(5): 479-90. DOI:10.1002/jmv.25707
Schoeman D, Fielding BC. Coronavirus envelope protein: current knowledge. Virol J. 2019;16: 69 10.1186/s12985-019-1182-0
Zhang N, Wang L, Deng X, et al. Recent advances in the detection of respiratory virus infection in humans. J Med Virol. 2020;92(4): 408-17. 10.1002/jmv.25674
Leung WK, To KF, Chan PK, Chan HL, Wu AK, Lee N, et al. Enteric involvement of severe acute respiratory syndrome-associated coronavirus infection. Gastroenterology. 2003;125: 1011-7. DOI: 10.1016/S0016-5085(03)01215-0
To KK, Tsang OT, Yip CCY, Chan KH, Wu TC, Chan JMC, et al. Consistent detection of 2019 novel coronavirus in saliva. Clin Infect Dis. 2020;71: 841-3. DOI: 10.1093/cid/ciaa149
Lu R, Zhao X, Li J, Niu P, Yang B, Wu H, et al. Genomic characterisation and epidemiology of 2019 novel coronavirus, implications for virus origins and receptor binding. Lancet. 2020;395: 565-74. DOI: 10.1016/S0140-6736(20)30251-8
Gu J, Han B, Wang J. COVID-19: gastrointestinal manifestations and potential fecal–oral transmission. Gastroenterology. 2020;158: 1518-9. DOI: 10.1053/j.gastro.2020.02.054
Chau TN, Lee KC, Yao H, Tsang TY, Chow TC, Yeung YC, et al. SARS-associated viral hepatitis caused by a novel coronavirus, report of three cases. Hepatology. 2004;39: 302-10. DOI: 10.1002/hep.20111
Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579: 270-3. DOI: 10.1038/s41586-020-2012-7
Nasri H, Baradaran A, Shirzad H, Rafieian-Kopaei M. New concepts in nutraceuticals as alternative for pharmaceuticals. Int J Prev Med. 2014;5: 1487-99.
World Health Organisation. Nutrition. Nutrition advice for adults during the COVID-19 outbreak. Available from: http://www.emro.who.int/nutrition/nutrition-infocus/nutrition-advice-for-adults-during-the-covid-19-outbreak.html[last accessed 26 April 2020].
Childs CE, Calder PC, Miles EA. Diet and immune function. Nutrients. 2019;11: 1933.
Elmadfa I, Meyer AL. The role of the status of selected micronutrients in shaping the immune function. Endocr Metab Immune Disord Drug Targets. 2019;19: 1100-15.
Chaplin DD. Overview of the immune response. J Allergy Clin Immunol. 2010;125(2 suppl 2): S3-S23. DOI: 10.1016/j.jaci.2009.12.980
Romagnani S. T-cell subsets (Th1 versus Th2). Ann Allergy Asthma Immunol. 2000;85: 9-18.
Gombart AF, Pierre A, Maggini S. A review of micronutrients and the immune system-working in harmony to reduce the risk of infection. Nutrients. 2020;12: 236. DOI:10.3390/nu12010236
Chandra RK. Nutrition and the immune system from birth to old age. Eur J Clin Nutr. 2002;56(suppl 3): S73-S76.
Alpert PT. The role of vitamins and minerals on the immune system. Home Health Care Manag Pract. 2017;29: 199-202.
Milner JJ, Beck MA.. The impact of obesity on the immune response to infection. Proc Nutr Soc. 2012;71: 298-306.
Diwakar BT, Finch ER, Liao C, et al.The role of selenoproteins in resolution of inflammation In: Hatfield DL, Schweizer U, Tsuji PA, Gladyshev VN, eds. Selenium: Its Molecular Biology and Role in Human Health. 4th ed.Springer International Publishing; 2016.
Haryanto B, Suksmasari T, Wintergerst E, et al. Multivitamin supplementation supports immune function and ameliorates conditions triggered by reduced air quality. Vitam Miner. 2015;4: 2-15. DOI:10.4172/2376-1318.1000128
McClung JP, Peterson DG. Trace elements and immune function In: Watson RR, Zibadi S, Preedy VR, Eds. Dietary Components and Immune Function. Humana Press; 2010: 253-62.
Saeed F, Nadeem M, Ahmed RS, et al.Studying the impact of nutritional immunology underlying the modulation of immune responses by nutritional compounds – a review. Food Agric Immunol. 2016;27: 205-29.
Weiss G. Iron and immunity: a double-edged sword. Eur J Clin Invest. 2002;32(suppl 1): 70-8.
Xu Y, Sherwood JA, Lackey KH, et al.The responses of immune cells to iron oxide nanoparticles. J Appl Toxicol. 2016;36: 543-53.
Wintergerst ES, Maggini S, Hornig DH.. Immune-enhancing role of vitamin C and zinc and effect on clinical conditions. Ann Nutr Metab. 2006;50: 85-94.
Maares M, Haase H.. Zinc and immunity: an essential interrelation. Arch Biochem Biophys. 2016;611: 58-65.
Maggini S, Wintergerst ES, Beveridge S, et al.Selected vitamins and trace elements support immune function by strengthening epithelial barriers and cellular and humoral immune responses. Br J Nutr. 2007;98(suppl 1): 29-S35.
Avery JC, Hoffmann PR.. Selenium, selenoproteins, and immunity. Nutrients. 2018;10: 1203. DOI:10.3390/nu10091203
Ivory K, Prieto E, Spinks C, et al.Selenium supplementation has beneficial and detrimental effects on immunity to influenza vaccine in older adults. Clin Nutr. 2017;36: 407-15.
A phase 2 trial of high-dose ascorbate in glioblastoma multiforme. ClinicalTrials.gov identifier: NCT02344355. https://clinicaltrials.gov/ct2/show/NCT02344355. Updated April 7, 2020. Accessed May 12, 2020.
Hydroxychloroquine and zinc with either azithromycin or doxycycline for treatment of COVID-19 in outpatient setting. ClinicalTrials.gov identifier: NCT04370782. https://clinicaltrials.gov/ct2/show/NCT04370782?term=NCT04370782&draw=2&rank=1. Updated May 18, 2020. Accessed May 12, 2020.
TET2 mutations in myelodysplastic syndromes and acute myeloid leukemia with azacitidine + ascorbic acid. ClinicalTrials.gov identifier: NCT03397173. https://clinicaltrials.gov/ct2/show/NCT03397173?term=NCT03397173&draw=2&rank=1. Updated January 21, 2020. Accessed May 12, 2020.
Hagag AA, El Frargy MS, Houdeeb HA.. Therapeutic value of vitamin D as an adjuvant therapy in neonates with sepsis [published online June 25, 2019]. Infect Disord Drug Targets. DOI:10.2174/1871526519666190626141859 [PubMed] [CrossRef] [Google Scholar]
Kim W-Y, Jo E-J, Eom JS, et al.Combined vitamin C, hydrocortisone, and thiamine therapy for patients with severe pneumonia who were admitted to the intensive care unit: propensity score–based analysis of a before–after cohort study. J Crit Care. 2018;47: 211-8. [PubMed] [Google Scholar]
Sánchez-Armendáriz K, García-Gil A, Romero CA, et al.Oral vitamin D3 5000 IU/day as an adjuvant in the treatment of atopic dermatitis: a randomized control trial. Int J Dermatol. 2018;57: 1516-20. [PubMed] [Google Scholar]
Gonçalves D, Lima C, Ferreira P, et al.Orange juice as dietary source of antioxidants for patients with hepatitis C under antiviral therapy. Food Nutr Res. 2017;61: 1296675. DOI:10.1080/16546628.2017.1296675 [PMC free article] [PubMed] [CrossRef] [Google Scholar]
Bhattacharjee A, Basu A, Biswas J, et al. Chemoprotective and chemosensitizing properties of selenium nanoparticle (Nano-Se) during adjuvant therapy with cyclophosphamide in tumor-bearing mice. Mol Cell Biochem. 2017;424: 13-33. [PubMed] [Google Scholar]
Kaya H, Koç AK, Sayın İ, et al.Vitamins A, C, and E and selenium in the treatment of idiopathic sudden sensorineural hearing loss. Eur Arch Otorhinolaryngol. 2015;272: 1119-25. [PubMed] [Google Scholar]
Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395: 1054-62.
Barazzoni R, Bischoff SC, Breda J, et al.ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. Clin Nutr. 2020;39: P1631-8. DOI:10.1016/j.clnu.2020.03.022
Li T, Zhang Y, Gong C, et al.Prevalence of malnutrition and analysis of related factors in elderly patients with COVID-19 in Wuhan, China [published online April 22, 2020]. Eur J Clin Nutr. 2020;74: 871-5. DOI:10.1038/s41430-020-0642-3
Kinney JM. Nutritional frailty, sarcopenia and falls in the elderly. Curr Opin Clin Nutr Metab Care. 2004;7: 15-20
Barazzoni R, Bischoff SC, Breda J, et al.ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection. Clin Nutr. 2020;39: P1631-8. DOI:10.1016/j.clnu.2020.03.022
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Bulletin of Medical and Biological Research

This work is licensed under a Creative Commons Attribution 4.0 International License.