Nutritional perspectives for the prevention and mitigation of COVID-19

Akhtar, Saeed; Das, Jai K; Ismail, Tariq; Wahid, Muqeet; Saeed, Wisha; Bhutta, Zulfiqar Ahmed

doi:10.1093/nutrit/nuaa063

Cited by 79 publications

(90 citation statements)

References 134 publications

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“…Adequate intake of all micronutrients seems important for a balanced and appropriate immune response [ 21 , 22 ]. Specifically, there are already several published reports that have linked vitamin D deficiency with different harmful outcomes of COVID-19, and they speculate as well on the potential benefits of supplementation, pending of the results of sufficiently powered randomized trials [ 23 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Mediterranean diet and the risk of COVID-19 in the ‘Seguimiento Universidad de Navarra’ cohort

et al. 2022

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Background & aims A potential protection against COVID-19 infection by a high-quality dietary pattern is to be expected given the biological plausibility supporting the beneficial effects of adequate nutrition on the immune system. However, knowledge on the relationship between long-term maintained healthy dietary patterns, such as the Mediterranean diet, and the risk of SARS-2-Cov infection is still sparse. We longitudinally assessed this association in a well-known Mediterranean cohort. Methods We assessed 9677 participants from the SUN Project, a prospective cohort of middle-aged university graduates in Spain. We inquired about a positive result in a COVID-19 diagnostic test during the months of February to December 2020. After excluding health professionals (HP), 5194 participants were included in the statistical analyses (mean age: 52.6, SD: 12.4; 55.2% women). Food habits were assessed at baseline using a previously validated semiquantitative 136-item food frequency questionnaire. Adherence to the Mediterranean diet (cumulative average of 2 repeated measurements separated 10 years apart) was assessed using the 0-to-9 Mediterranean Diet Score (MDS). We used multivariable logistic regression models to estimate odds ratios and 95% confidence intervals for incident COVID-19 according to the MDS. Results Among 5194 non-HP participants, 122 reported to have received a diagnosis of COVID-19 based on a specific diagnostic test. Participants with intermediate adherence to the Mediterranean diet (MDS ≥4 & <7) had a significantly lower odds of developing COVID-19 (multivariable-adjusted OR = 0.50, 95% CI, 0.34–0.73), and those with the highest adherence (MDS ≥ 7) exhibited the lowest risk (multivariable-adjusted OR = 0.36, 0.16–0.84, p for trend < 0.001) as compared with participants with MDS ≤3. This inverse association remained robust within subgroups and in sensitivity analyses. Notwithstanding, no significant associations were observed for health professionals (p for interaction = 0.06). Conclusion In conclusion, better adherence to the Mediterranean diet may be associated with a lower risk of COVID-19. Our results are applicable only to persons who are not health professionals.

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Section: Discussionmentioning

confidence: 99%

Mediterranean diet and the risk of COVID-19 in the ‘Seguimiento Universidad de Navarra’ cohort

et al. 2022

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“…The ferritin levels in the non-survivor group of patients were significantly higher than those found in the survivors. On the other hand, Akhtar et al (2021) have reviewed the role of nutrition in preventing and reducing the severity of COVID-19, with a focus on various micronutrients. With respect to iron, it was considered that its role in innate immunity would be to regulate production of cytokines and to improve phagocytosis, while in adaptative immunity, it increases T-cell proliferation and improves cytotoxic T-cell function.…”

Section: Essential Trace Elements and Covid-19mentioning

confidence: 99%

The effects of some essential and toxic metals/metalloids in COVID-19: A review

Domingo

Marquès

2021

Food and Chemical Toxicology

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Thousands of studies have been conducted in order to understand in depth the characteristics of the novel coronavirus SARS-CoV-2, its infectivity and ways of transmission, and very especially everything related to the clinical and severity of the COVID-19, as well as the potential treatments. In this sense, the role that essential and toxic metals/metalloids have in the development and course of this disease is being studied. Metals/metalloids such as arsenic, cadmium, lead, mercury or vanadium, are elements with known toxic effects in mammals, while trace elements such as cobalt, copper, iron, manganese, selenium and zinc are considered essential. Given the importance of metals/metalloids in nutrition and human health, the present review was aimed at assessing the relationship between various essential and toxic metals/metalloids and the health outcomes related with the COVID-19. We are in the position to conclude that particular attention must be paid to the load/levels of essential trace elements in COVID-19 patients, mainly zinc and selenium. On the other hand, the exposure to air pollutants in general, and toxic metal/metalloids in particular, should be avoided as much as possible to reduce the possibilities of viral infections, including SARS-CoV-2.

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Section: Overviewmentioning

confidence: 99%

“…Numerous nutrients are necessary for proper immune functioning [11,12,[18][19][20]. Nutritional deficiencies weaken the immune system and increase the invasion, replication, and mutation of viruses [18,21]. Indeed, the pathogenicity of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19) [4,13], is associated with an imbalance in several nutritional elements [5,22,23].…”

Section: Overviewmentioning

confidence: 99%

Approaches to Nutritional Screening in Patients with Coronavirus Disease 2019 (COVID-19)

Ali

Kunugi

2021

IJERPH

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Malnutrition is common among severe patients with coronavirus disease 2019 (COVID-19), mainly elderly adults and patients with comorbidities. It is also associated with atypical presentation of the disease. Despite the possible contribution of malnutrition to the acquisition and severity of COVID-19, it is not clear which nutritional screening measures may best diagnose malnutrition in these patients at early stages. This is of crucial importance given the urgency and rapid progression of the disease in vulnerable groups. Accordingly, this review examines the available literature for different nutritional screening approaches implemented among COVID-19 patients, with a special focus on elderly adults. After a literature search, we selected and scrutinized 14 studies assessing malnutrition among COVID-19 patients. The Nutrition Risk Screening 2002 (NRS-2002) has demonstrated superior sensitivity to other traditional screening measures. The controlling nutritional status (CONUT) score, which comprises serum albumin level, cholesterol level, and lymphocytes count, as well as a combined CONUT-lactate dehydrogenase-C-reactive protein score expressed a predictive capacity even superior to that of NRS-2002 (0.81% and 0.92% vs. 0.79%) in midlife and elder COVID-19 patients. Therefore, simple measures based on routinely conducted laboratory investigations such as the CONUT score may be timely, cheap, and valuable alternatives for identifying COVID-19 patients with high nutritional risk. Mini Nutritional Assessment (MNA) was the only measure used to detect residual malnutrition and high malnutrition risk in remitting patients—MNA scores correlated with hypoalbuminemia, hypercytokinemia, and weight loss. Older males with severe inflammation, gastrointestinal symptoms, and pre-existing comorbidities (diabetes, obesity, or hypertension) are more prone to malnutrition and subsequently poor COVID-19 prognosis both during the acute phase and during convalescence. Thus, they are in need of frequent nutritional monitoring and support while detecting and treating malnutrition in the general public might be necessary to increase resilience against COVID-19.

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Nutritional perspectives for the prevention and mitigation of COVID-19

Cited by 79 publications

References 134 publications

Mediterranean diet and the risk of COVID-19 in the ‘Seguimiento Universidad de Navarra’ cohort

Mediterranean diet and the risk of COVID-19 in the ‘Seguimiento Universidad de Navarra’ cohort

The effects of some essential and toxic metals/metalloids in COVID-19: A review

Approaches to Nutritional Screening in Patients with Coronavirus Disease 2019 (COVID-19)

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