Suboptimal Consumption of Relevant Immune System Micronutrients Is Associated with a Worse Impact of COVID-19 in Spanish Populations

Abstract

Coronavirus disease 2019 (COVID-19) has caused a global health crisis and the factors behind its differential impact on COVID-19 among populations are still being known. Geographical differences in nutrient profile could be a relevant factor, especially considering that scientific evidence supports that 10 micronutrients are essential for proper immune system function. This study aims to evaluate these micronutrient intakes in the territories of Spain and to analyze their relationship with epidemiological indicators of COVID-19 from the first two waves of COVID-19, when neither specific vaccines nor drugs had yet come into play. Results showed that vitamin D, A, B9, and zinc intakes were particularly insufficient in Spain. The joint intake of these four micronutrients was lower in regions with the highest COVID-19 incidence and mortality, and of particular importance, was the insufficient intake of vitamin D. A pattern of food consumption associated with lower COVID-19 impact was observed. In conclusion, the results show the relevance of the optimal consumption of foods rich in essential nutrients for the immune system. Therefore, this assessment could serve to launch specific dietary recommendations to strengthen the immune system in Spanish territories to better face potential new COVID-19 variants and/or further infectious diseases.

Could Selenium Supplementation Prevent COVID-19? A Comprehensive Review of Available Studies

“…The Spanish group of Prof. Francisca Serra submitted, in July 2020, a “current state of evidence” review dealing with the nutritional and nutrigenetic factors that affect immunity; it included a compilation of COVID-19 epidemiological data that were available at the time (May 2020) in 10 European countries, showing a non-significant inverse correlation between the suboptimal estimated status of selenium and COVID-19 incidence [ 27 ]. Later, the same group focused on the estimated selenium intake in Spain and did not find any significant association with the epidemiological indicators of COVID-19 [ 28 ].…”

Susceptibility to COVID-19 Nutrition Misinformation and Eating Behavior Change during Lockdowns: An International Web-Based Survey

“…Vitamins C and D, alongside other essential nutrients, can help with the ‘maintenance of functions of the immune system’ (European Food Safety Authority, EFSA) [ 57 ]; thus, mitigating deficiency risks for these during the early stages of the novel coronavirus pandemic was emphasized [ 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 ]. Research on vitamin C and vitamin D status remains ongoing on the grounds that their deficiency may be associated with increased susceptibility to COVID-19 infection and to potentially more severe or prolonged symptoms once infected [ 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 ]. Because medical prescription is not needed for their procurement, misinformed assurances with silent contraindications about vitamin supplements could lead to harmful intakes, unsafe combinations, and misuse by the public, as seen in hypervitaminosis and intoxication case reports during the global pandemic [ 36 , 83 , 84 , 85 , 86 , 87 , 88 , 89 ].…”

The association between nutrients and occurrence of COVID‐19 outcomes in the population of Western Iran: A cohort study

“…The results of various studies showed that this vitamin could affect the reduction in the activity of various infectious viruses, especially the coronavirus, and increase the body's immunity 28 . Also, published evidences around the worlds, showed that various diets and different micronutrients play a role in the immune system and COVID‐19 patients 29–32 …”

“…28 Also, published evidences around the worlds, showed that various diets and different micronutrients play a role in the immune system and COVID-19 patients. [29][30][31][32] This research was the first study in Iran with this comprehensiveness and a high sample size in order to determine the association between important macronutrients (such as proteins, fats, carbohydrates, and fiber), micronutrients (such as vitamins and antioxidants), the infection of COVID-19, and hospitalization due to it, which, of course, had several limitations. Among these limitations, we can point out the presence of various confounding factors related to different food and diets, which could not be controlled in the present study.…”

“… 28 Also, published evidences around the worlds, showed that various diets and different micronutrients play a role in the immune system and COVID‐19 patients. 29 , 30 , 31 , 32 …”