Obesity, malnutrition, and trace element deficiency in the coronavirus disease (COVID-19) pandemic: An overview

Abstract

The world is currently facing the coronavirus disease (COVID-19) pandemic which places great pressure on health care systems and workers, often presents with severe clinical features, and sometimes requires admission into intensive care units. Derangements in nutritional status, both for obesity and malnutrition, are relevant for the clinical outcome in acute illness. Systemic inflammation, immune system impairment, sarcopenia, and preexisting associated conditions, such as respiratory, cardiovascular, and metabolic diseases related to obesity, could act as crucial factors linking nutritional status and the course and outcome of COVID-19. Nevertheless, vitamins and trace elements play an essential role in modulating immune response and inflammatory status. Overall, evaluation of the patient's nutritional status is not negligible for its implications on susceptibility, course, severity, and responsiveness to therapies, in order to perform a tailored nutritional intervention as an integral part of the treatment of patients with COVID-19. The aim of this study was to review the current data on the relevance of nutritional status, including trace elements and vitamin status, in influencing the course and outcome of the disease 3 mo after the World Health Organization's declaration of COVID-19 as a pandemic.

Poor nutritional status, risk of sarcopenia and nutrition related complaints are prevalent in COVID-19 patients during and after hospital admission

“…Finally, patients in this study were included based on a dietetic consultation and may not represent all COVID-19 patients admitted to hospital. However, the included patient group is comparable to hospital COVID-19 populations described by others for sex, age, prevalence of overweight and obesity (BMI), and comorbidities [28]. The in-hospital mortality at the ICU was 28%, which corresponds to reported COVID-19 ICU mortality [29].…”

Prevalence of vitamin D is not associated with the COVID-19 epidemic in Europe. A critical update of the existing evidence

“…"State level" parameters include diverse factors, such as a country's preparedness, actions of the governments, health infrastructure, timing of lockdown, rapid border closures, implementation of social distancing and socioeconomic status, 3 while the "individual level" includes the sociodemographic factors and other determinants of health status such as sex, age, chronic diseases, obesity, and malnutrition. 4,5 It is well known that malnutrition constitutes a risk factor for increased mortality and morbidity of several diseases. 6 Protein and energy malnutrition, and other specific micronutrient deficiencies have been shown to manifest adverse effects in immunity and thereby exhibit poor prognosis of viral infections.…”

“…“State level” parameters include diverse factors, such as a country’s preparedness, actions of the governments, health infrastructure, timing of lockdown, rapid border closures, implementation of social distancing and socioeconomic status, 3 while the “individual level” includes the sociodemographic factors and other determinants of health status such as sex, age, chronic diseases, obesity, and malnutrition. 4,5…”

COVID-19 and Alzheimer’s disease: how one crisis worsens the other

“…In a cross-sectional study, over one-fourth of the COVID-19 patients were at risk of malnutrition and more than half of the COVID-19 patients were in a state of malnutrition in China [109]. Malnutrition is associated with the length of hospital stay and the in-hospital mortality [110,111]. For instance, the incidence of diabetes and other comorbidities is also significantly altered in COVID-19 patients with risk of malnutrition or in malnutrition [109].…”