Potential roles of micronutrient deficiency and immune system dysfunction in the coronavirus disease 2019 (COVID-19) pandemic

Gorji, Ali; Ghadiri, Maryam Khaleghi

doi:10.1016/j.nut.2020.111047

Cited by 65 publications

(48 citation statements)

References 137 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 scientific rationale backing the supposed efficacy of micronutrient supplementation to prevent or treat COVID-19 have been documented [ 13 , 14 ], but primary evidence on it remains sparse. Vitamin C administered orally (2–8 g/day) may reduce incidence and length of respiratory infections.…”

Section: Discussionmentioning

confidence: 99%

“…Vitamin C and D supplementation or micronutrient sufficiency have been shown to reduce acute respiratory tract infections incidence, including that of influenza, and cold duration, but these observations remain inconsistent [ 8 , 9 , 10 , 11 , 12 ]. Nonetheless, there is sound rationale backing micronutrient supplementation for the prevention of COVID-19 and management of clinical manifestation [ 13 , 14 ]. For instance, vitamin D preserves tight junctions of respiratory cells, kills enveloped virus, and reduces cytokine storm risk, amongst other functions.…”

Section: Introductionmentioning

confidence: 99%

Micronutrients Deficiency, Supplementation and Novel Coronavirus Infections—A Systematic Review and Meta-Analysis

2021

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Background: Micronutrients play roles in strengthening and maintaining immune function, but their supplementation and/or deficiency effects on respiratory tract infections are inconclusive. This review aims to systematically assess the associations between micronutrient supplementation or deficiency, with novel coronavirus incidence and disease severity. Methods: Systematic literature searches conducted in five electronic databases identified 751 unique studies, of which 33 studies (five supplementation studies, one supplementation and deficiency study, and 27 deficiency studies) were eventually included in this review. Proportions of incidence and severity outcomes in each group, and adjusted summary statistics with their relevant 95% confidence intervaIs (CI) were extracted. Data from 19 studies were pooled in meta-analysis using the generic inverse variance method. Findings: A total of 360,346 patients across 16 countries, with a mean age between 32 and 87.7 years, were involved across 33 studies. All studies were on COVID-19 infections. In individuals without micronutrient deficiency, there was a significant reduction on odds of COVID-19 incidence (pooled OR: 0.37, 95% CI: 0.18, 0.78), and ICU admissions or severe/critical disease onset when combined as a severity outcome (pooled OR: 0.26, 95% CI: 0.08, 0.89). Insignificant protective effects were observed on other outcome measures, namely mortality, ICU admission, progression to respiratory-related complications, severe/critical disease onset or requiring respiratory support and hospitalization rate. Conclusion: The absence of micronutrient deficiency significantly reduced COVID-19 incidence and clinical deterioration in hospitalized patients. Usage of micronutrients as prophylaxis and complementary supplement in therapeutic management of COVID-19 patients may be a promising and cost-effective approach warranting in-depth investigation.

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“…Micronutrients, such as nutritionally essential vitamins and minerals, influence and support each stage of the immune response. Micronutrient deficiency can affect both innate and adaptive immunity, causing immunosuppression and thus increasing susceptibility to infection [15].…”

Section: Discussionmentioning

confidence: 99%

Beneficial Effects of Oral Administration of a Nutritional Supplement in Asymptomatic and Symptomatic COVID-19 Patients

Pasquale¹,

Francesco²,

Anna³

et al. 2021

JFNS

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As the 2019 coronavirus disease (COVID-19) pandemic rages, there is an urgent need to identify clinical and laboratory predictors for progression to severe and fatal forms of this disease. In this study, we aimed to evaluate the potential ability of a nutritional supplement to normalize certain hematological, biochemical and immunological biomarkers in patients with and without symptoms of COVID-19. Micronutrients, such as nutritionally essential vitamins and minerals, influence and support every step of the immune response. This investigation was performed by administering a dietary supplement rich in calciferol (vitamin D3), ascorbic acid (vitamin C), folic acid (vitamin B9) and pantothenic acid (vitamin B5) to the enrolled patients for 120 days. All essential elements for a complete physiological enzymatic process. The reported results appear promising from the point of view of the experimental approach adopted. In particular, the scheduled administration of the nutritional supplement rich in micronutrients to asymptomatic and mild to moderate COVID-19 patients has led, in general, to the normalization of the values of some critical biochemical and immunological parameters found to be altered. This nutritional approach, although it does not resolve the disease and therefore does not represent a cure, can improve the quality of life of COVID-19 patients.

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Potential roles of micronutrient deficiency and immune system dysfunction in the coronavirus disease 2019 (COVID-19) pandemic

Cited by 65 publications

References 137 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

Micronutrients Deficiency, Supplementation and Novel Coronavirus Infections—A Systematic Review and Meta-Analysis

Beneficial Effects of Oral Administration of a Nutritional Supplement in Asymptomatic and Symptomatic COVID-19 Patients

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