The Impact of Polyphenols-Based Diet on the Inflammatory Profile in COVID-19 Elderly and Obese Patients

Abstract

The World Health Organization declared the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-associated disease (coronavirus disease 2019 – COVID-19) as a pandemic in March 2020. COVID-19 is characterized by cytokine storm, acute respiratory distress syndrome (ARDS), and systemic inflammation–related pathology and already kills more than 1.5 million of people worldwide. Since aged and obese COVID-19 patients exhibit an enhanced inflammatory status, they represent a high-risk cluster for rapidly progressive clinical deterioration. These individuals present comorbid disorders and immunosenescence that may promote viral-induced cytokine storm and expression of molecules acting as virus receptor as angiotensin I converting enzyme 2 (ACE2) and CD26 (dipeptidyl-peptidase 4), resulting in respiratory failure and increased morbidity and mortality. A better knowledge of SARS-CoV-2 infection in inflammatory-associated high-risk population is essential in order to develop the therapies needed to combat or prevent severe COVID-19. Here, we review the pathogenesis and clinical implications of inflammatory disorders and disease markers associated to senescence in COVID-19 patients and the emerging evidence to argue that a high intake of polyphenols may have a protective effect on SARS-CoV-2 illness severity.

Impact of Zinc, Glutathione, and Polyphenols as Antioxidants in the Immune Response against SARS-CoV-2

“…Slow the recovery time of patients [58,84] Polyphenols Balance the Th1/Th2 cytokine response pattern Reducing inflammation Modifying senescence markers [85] Further research is needed and clinical trials are currently under development to investigate how these antioxidants help minimize the distress and mortality associated with SARS-CoV-2 infection. We expect that our research provides a novel perspective that contribute to the design of clinical or nutritional targets for the prevention of this pandemic.…”

Molecular Mechanisms of Possible Action of Phenolic Compounds in COVID-19 Protection and Prevention

“…Several recent reviews recognized and presented different aspects of potential use of polyphenols against COVID-19 by assessing the effects of polyphenols on COVID-19 drug targets [5]; the underlying mechanism of polyphenols antiviral and immune-regulation activities in COVID-19 [23]; the possibility to use polyphenols for the development of novel natural approaches against COVID-19 [6,24]; polyphenols potential in strengthening antioxidant defenses and upregulating the immune systems; and in prevention, replication, and spreading of the SARS-CoV-2 [25]. Similarly, the role of key medicinal/nutritional antioxidants, including polyphenols, in the antiviral immune response in COVID-19 [26], mechanism of polyphenol action in COVID-19 in comparison to other acute infectious diseases [27], potential of polyphenols in reducing COVID-19 cytokine storm [28,29], and potential of polyphenols in tuning of autophagy and ubiquitin-proteasome system pathways in COVID-19 [30] were reviewed. The use of tea polyphenols in prophylaxis and treatment of COVID-19 [31,32]; polyphenol potential for modulating the expression of host microRNAs that play role in SARS-CoV-2 infection [33]; and beneficial effects of polyphenols against the COVID-19-induced lung damage and associated systemic effects based on predictive, preventive, and personalized medicine (3PM) were also critically studied [34].…”

“…An update on completed or recruiting clinical trials based on plants, their isolated products, and functional foods against COVID-19 is summarized in an article by Alam et al (2021) [133]. The protective effects of polyphenols against acute lung injury are highlighted in a review paper by He et al (2021) [134], while a review of clinical trials data by Santos et al (2021) [29] reinforces the potency of polyphenols in the treatment of COVID-19. Physiological func- Polyphenols, strong antioxidants, can neutralize the harmful reactivity of undesired or overproduced reactive oxygen and nitrogen species (ROS and RNS) that arise during metabolic processes in the organism.…”

“…By alleviating chronic disturbances and impairments, polyphenols also act as antiaging agents. Many of them have been found to exterminate senescent cells as well, therefore adjusting the inflammaging and immunosenescence [29]. Polyphenols have been confirmed as antimicrobial agents, affecting various levels of defense mechanisms against pathogen invasion.…”

Accumulation of CD28null Senescent T-Cells Is Associated with Poorer Outcomes in COVID19 Patients

“…Since senolytics are not specific for CD28 null senescent T-cells, their drug effects may act directly on these cells or through clearing other senescent cells. Several clinical trials are investigating potential benefit of senolytics on senescence-associated severe COVID-19 [139].…”