bims-covind Biomed News
on COVID-19 and Immunology: nutrition and diet
Issue of 2021‒01‒03
twenty-four papers selected by
Aimee Cook
Newcastle University


  1. Front Nutr. 2020 ;7 606398
    Name JJ, Souza ACR, Vasconcelos AR, Prado PS, Pereira CPM.
      Some nutrients play key roles in maintaining the integrity and function of the immune system, presenting synergistic actions in steps determinant for the immune response. Among these elements, zinc and vitamins C and D stand out for having immunomodulatory functions and for playing roles in preserving physical tissue barriers. Considering the COVID-19 pandemic, nutrients that can optimize the immune system to prevent or lower the risk of severe progression and prognosis of this viral infection become relevant. Thus, the present review aims to provide a comprehensive overview of the roles of zinc and vitamins C and D in the immune response to viral infections, focusing on the synergistic action of these nutrients in the maintenance of physical tissue barriers, such as the skin and mucous membranes. The evidence found in the literature shows that deficiency of one or more of these three elements compromises the immune response, making an individual more vulnerable to viral infections and to a worse disease prognosis. Thus, during the COVID-19 pandemic, the adequate intake of zinc and vitamins C and D may represent a promising pharmacological tool due to the high demand for these nutrients in the case of contact with the virus and onset of the inflammatory process. Ongoing clinical trials will help to clarify the role of these nutrients for COVID-19 management.
    Keywords:  COVID-19; immunity; junctional complex; nutrients; vitamin C; vitamin D; zinc
    DOI:  https://doi.org/10.3389/fnut.2020.606398
  2. Nutrients. 2020 Dec 27. pii: E54. [Epub ahead of print]13(1):
    Hamulka J, Jeruszka-Bielak M, Górnicka M, Drywień ME, Zielinska-Pukos MA.
      The use of dietary supplements (DSs) has been steadily increasing all over the world and additionally, the sales of DSs have dynamical increased in the wake of coronavirus disease 2019 (COVID-19) in most of the countries. We investigated DSs phenomenon in 2020 through (1) exploration of Google searches worldwide and in Poland (with Google Trends (GT) tool), and (2) analyses of results of PLifeCOVID-19 Online Studies conducted during the first and second wave of the pandemic. The conducted GT analysis and cross-sectional studies revealed that during the COVID-19 outbreak in March 2020, the interest in immune-related compounds and foods like vitamins C and D, zinc, omega-3, garlic, ginger, or turmeric, as well as their consumption increased. Improving immunity was the main reason behind the supplementation and changes in consumption of pro-healthy foods. GT analysis has shown these interests were positively correlated with the interest in COVID-19, but adversely with cumulative cases or deaths. Respondents tended to start supplementation during the first COVID-19 wave rather than the second one. Except for the role of vitamins D and C, zinc, and selenium in patients with deficiencies of those nutrients, there are no clear and convincing studies that support the role of DSs use in COVID-19 prevention and treatment in healthy, well-nourished individuals. Moreover, as the risk of elevated intake of some nutrients due to the popularity of DSs exists, effective education of consumers in rationale use of DSs and health-protecting behaviors against COVID-19 should be developed.
    Keywords:  COVID-19; Google Trends; bioactive compounds; dietary supplements; fatty acids; immunity; internet; nutrients; vitamin C; vitamin D; zinc
    DOI:  https://doi.org/10.3390/nu13010054
  3. Endocr Res. 2020 Dec 30. 1-8
    Szeto B, Zucker JE, LaSota ED, Rubin MR, Walker MD, Yin MT, Cohen A.
      Context: Populations severely affected by COVID-19 are also at risk for vitamin D deficiency. Common risk factors include older age, chronic illness, obesity, and non-Caucasian race. Vitamin D deficiency has been associated with risk for respiratory infections and failure, susceptibility and response to therapy for enveloped virus infection, and immune-mediated inflammatory reaction. Objective: To test the hypothesis that 25-hydroxyvitamin D[25(OH)D] deficiency is a risk factor for severity of COVID-19 respiratory and inflammatory complications. Design: We examined the relationship between prehospitalization 25(OH)D levels (obtained 1-365 days prior to admission) and COVID-19 clinical outcomes in 700 COVID-19 positive hospitalized patients. Primary Outcomes: Discharge status, mortality, length of stay, intubation status, renal replacement. Secondary Outcomes: Inflammatory markers. Results: 25(OH)D levels were available in 93 patients [25(OH)D:25(IQR:17-33)ng/mL]. Compared to those without 25(OH)D levels, those with measurements did not differ in age, BMI or distribution of sex and race, but were more likely to have comorbidities. Those with 25(OH)D < 20 ng/mL (n = 35) did not differ from those with 25(OH)D ≥ 20 ng/mL in terms of age, sex, race, BMI, or comorbidities. Low 25(OH)D tended to be associated with younger age and lower frequency of preexisting pulmonary disease. There were no significant between-group differences in any outcome. Results were similar in those ≥50 years, in male/female-only cohorts, and when differing 25(OH)D thresholds were used (<15 ng/mL and <30 ng/mL). There was no relationship between 25(OH)D as a continuous variable and any outcome, even after controlling for age and pulmonary disease. Conclusions: These preliminary data do not support a relationship between prehospitalization vitamin D status and COVID-19 clinical outcomes.
    Keywords:  COVID-19; hospital discharge; inflammatory markers; intubation; mortality; vitamin D
    DOI:  https://doi.org/10.1080/07435800.2020.1867162
  4. Explore (NY). 2020 Dec 23. pii: S1550-8307(20)30417-1. [Epub ahead of print]
    Alschuler L, Chiasson AM, Horwitz R, Sternberg E, Crocker R, Weil A, Maizes V.
      The majority of individuals infected with SARS-CoV-2 have mild-to-moderate COVID-19 disease. Convalescence from mild-to-moderate (MtoM) COVID-19 disease may be supported by integrative medicine strategies. Integrative Medicine (IM) is defined as healing-oriented medicine that takes account of the whole person, including all aspects of lifestyle. Integrative medicine strategies that may support recovery from MtoM COVID-19 are proposed given their clinically studied effects in related conditions. Adoption of an anti-inflammatory diet, supplementation with vitamin D, glutathione, melatonin, Cordyceps, Astragalus and garlic have potential utility. Osteopathic manipulation, Qigong, breathing exercises and aerobic exercise may support pulmonary recovery. Stress reduction, environmental optimization, creative expression and aromatherapy can provide healing support and minimize enduring trauma. These modalities would benefit from clinical trials in people recovering from COVID-19 infection.
    Keywords:  Aromatherapy; COVID-19; Creative expression; Diet; Exercise; Immune; Integrative medicine; Osteopathic manipulation; Qigong; Stress reduction; Supplements
    DOI:  https://doi.org/10.1016/j.explore.2020.12.005
  5. RMD Open. 2020 12;pii: e001454. [Epub ahead of print]6(3):
    Cutolo M, Paolino S, Smith V.
      
    Keywords:  COVID-19; cytokines; glucocorticoids; inflammation; pulmonary fibrosis
    DOI:  https://doi.org/10.1136/rmdopen-2020-001454
  6. Nutrients. 2020 Dec 11. pii: E3799. [Epub ahead of print]12(12):
    Ling SF, Broad E, Murphy R, Pappachan JM, Pardesi-Newton S, Kong MF, Jude EB.
      The worldwide pandemic of 2019 novel coronavirus disease (COVID-19) has posed the most substantial and severe public health issue for several generations, and therapeutic options have not yet been optimised. Vitamin D (in its "parent" form, cholecalciferol) has been proposed in the pharmacological management of COVID-19 by various sources. We aimed to determine whether COVID-19 mortality was affected by serum 25-hydroxyvitamin D (25(OH)D) levels, vitamin D status, or cholecalciferol therapy, and to elucidate any other predictors of COVID-19 mortality. Patients hospitalised with COVID-19 were opportunistically recruited from three UK hospitals, and their data were collected retrospectively. Logistic regression was used to determine any relationships between COVID-19 mortality and potential predictors, including 25(OH)D levels and cholecalciferol booster therapy. A total of 986 participants with COVID-19 were studied, of whom 151 (16.0%) received cholecalciferol booster therapy. In the primary cohort of 444 patients, cholecalciferol booster therapy was associated with a reduced risk of COVID-19 mortality, following adjustment for potential confounders (ORadj 0.13, 95% CI 0.05-0.35, p < 0.001). This finding was replicated in a validation cohort of 541 patients (ORadj 0.38, 95% CI 0.17-0.84, p = 0.018). In this observational study, treatment with cholecalciferol booster therapy, regardless of baseline serum 25(OH)D levels, appears to be associated with a reduced risk of mortality in acute in-patients admitted with COVID-19. Further work with large population studies needs to be carried out to determine adequate serum 25(OH)D levels, as well as multi-dose clinical trials of cholecalciferol therapy to assess maximum efficacy.
    Keywords:  25-hydroxyvitamin D; COVID-19; SARS-CoV-2; cholecalciferol; mortality; novel coronavirus 2019; vitamin D; vitamin D treatment
    DOI:  https://doi.org/10.3390/nu12123799
  7. Cell Immunol. 2020 Dec 16. pii: S0008-8749(20)30419-6. [Epub ahead of print]360 104259
    Kloc M, Ghobrial RM, Lipińska-Opałka A, Wawrzyniak A, Zdanowski R, Kalicki B, Kubiak JZ.
      Vitamin D regulates homeostasis, anti-microbial response, and inflammation. The vitamin D receptors are expressed in the macrophages and other immune cells, regulating the transcription of many different genes, including those coding the anti-microbial peptides. One of the most severe complications of the SARS-CoV-2 infection is the acute respiratory distress syndrome (ARDS) caused by the hyperinflammatory response (commonly called cytokine storm) of the lung macrophages. Studies showed that Vitamin D deficiency increases the severity of the ARDS in COVID-19 infection. We discuss here how the vitamin D supplementation may influence macrophage and myeloid-derived suppressor cells (MDSCs) inflammatory response, subdue the hyperinflammatory response, and lessen the ARDS in COVID-19 patients.
    Keywords:  COVID-19; Hyperinflammatory response; Macrophages; Myeloid-derived suppressor cells (MDSCs); SARS-CoV-2; Vitamin D; Vitamin D receptor
    DOI:  https://doi.org/10.1016/j.cellimm.2020.104259
  8. Phytother Res. 2020 Dec 22.
    El-Missiry MA, Fekri A, Kesar LA, Othman AI.
      The newly emerging severe acute respiratory syndrome, coronavirus-2 (SARS-CoV-2) is a dangerous pathogen that causes global health problems. It causes a disease called coronavirus disease 2019 (COVID-19) with high morbidity and mortality rates. In SARS-Cov-2-infected patients, elevated oxidative stress and upsurge of inflammatory cytokines are the main pathophysiological events that contribute to the severity and progression of symptoms and death. The polyphenols are natural compounds abundant in fruits and vegetables that are characterized by their high antioxidant and anti-inflammatory effects. Polyphenols have potential as an intervention for preventing respiratory virus infection. The beneficial effects of polyphenols on COVID-19 might be due to multiple mechanisms. Polyphenols can strengthen the body's anti-inflammatory and antioxidant defenses against viral infection. Targeting virus proteins and/or blocking cellular receptors are other plausible antiviral approaches to prevent the entry of the virus and its replication in the host cells. The results on the antiviral effects of various polyphenols, especially on SARS-CoV-2, are promising. The aim of this review is to clarify the role of polyphenols in strengthening antioxidant defenses and upregulating the immune systems of COVID-19 patients and to prevent replication and spreading of the virus.
    Keywords:  COVID-19; SARS-CoV-2; inflammation; oxidative stress; polyphenols; respiratory virus
    DOI:  https://doi.org/10.1002/ptr.6992
  9. Front Immunol. 2020 ;11 590459
    Ahmed F.
      Background: SARS-CoV-2 causes ongoing pandemic coronavirus disease of 2019 (COVID-19), infects the cells of the lower respiratory tract that leads to a cytokine storm in a significant number of patients resulting in severe pneumonia, shortness of breathing, respiratory and organ failure. Extensive studies suggested the role of Vitamin D in suppressing cytokine storm in COVID-19 and reducing viral infection; however, the precise molecular mechanism is not clearly known. In this work, bioinformatics and systems biology approaches were used to understand SARS-CoV-2 induced cytokine pathways and the potential mechanism of Vitamin D in suppressing cytokine storm and enhancing antiviral response.Results: This study used transcriptome data and identified 108 differentially expressed host genes (DEHGs) in SARS-CoV-2 infected normal human bronchial epithelial (NHBE) cells compared to control. Then, the DEHGs was integrated with the human protein-protein interaction data to generate a SARS-CoV-2 induced host gene regulatory network (SiHgrn). Analysis of SiHgrn identified a sub-network "Cluster 1" with the highest MCODE score, 31 up-regulated genes, and predominantly associated immune and inflammatory response. Interestingly, the iRegulone tool identified that "Cluster 1" is under the regulation of transcription factors STAT1, STAT2, STAT3, POU2F2, and NFkB1, collectively referred to as "host response signature network". Functional enrichment analysis with NDEx revealed that the "host response signature network" is predominantly associated with critical pathways, including "cytokines and inflammatory response", "non-genomic action of Vitamin D", "the human immune response to tuberculosis", and "lung fibrosis". Finally, in-depth analysis and literature mining revealed that Vitamin D binds with its receptor and could work through two different pathways: (i) it inhibits the expression of pro-inflammatory cytokines through blocking the TNF induced NFkB1 signaling pathway; and (ii) it initiates the expression of interferon-stimulating genes (ISGs) for antiviral defense program through activating the IFN-α induced Jak-STAT signaling pathway.
    Conclusion: This comprehensive study identified the pathways associated with cytokine storm in SARS-CoV-2 infection. The proposed underlying mechanism of Vitamin D could be promising in suppressing the cytokine storm and inducing a robust antiviral response in severe COVID-19 patients. The finding in this study urgently needs further experimental validations for the suitability of Vitamin D in combination with IFN-α to control severe COVID-19.
    Keywords:  COVID-19; RNA sequencing; SARS-CoV-2; bioinformatics; cytokine storm; lung fibrosis; regulatory network; vitamin D
    DOI:  https://doi.org/10.3389/fimmu.2020.590459
  10. Asian J Psychiatr. 2020 Dec 25. pii: S1876-2018(20)30636-5. [Epub ahead of print]55 102523
    Mehta A, Soni VK, Sharma K, Ratre YK, Shukla D, Singh AK, Vishvakarma NK.
      
    Keywords:  Amino Acids; COVID-19; Neurotransmitters; Psychiatric illness; Vitamin D
    DOI:  https://doi.org/10.1016/j.ajp.2020.102523
  11. Rev Med Virol. 2020 Dec 31. e2204
    Midha IK, Kumar N, Kumar A, Madan T.
      Of all the nutrients, vitamin A has been the most extensively evaluated for its impact on immunity. There are three main forms of vitamin A, retinol, retinal and retinoic acid (RA) with the latter being most biologically active and all-trans-RA (ATRA) its main derivative. Vitamin A is a key regulator of the functions of various innate and adaptive immune cells and promotes immune-homeostasis. Importantly, it augments the interferon-based innate immune response to RNA viruses decreasing RNA virus replication. Several clinical trials report decreased mortality in measles and Ebola with vitamin A supplementation.During the Covid-19 pandemic interventions such as convalescent plasma, antivirals, monoclonal antibodies and immunomodulator drugs have been tried but most of them are difficult to implement in resource-limited settings. The current review explores the possibility of mega dose vitamin A as an affordable adjunct therapy for Covid-19 illness with minimal reversible side effects. Insight is provided into the effect of vitamin A on ACE-2 expression in the respiratory tract and its association with the prognosis of Covid-19 patients. Vitamin A supplementation may aid the generation of protective immune response to Covid-19 vaccines. An overview of the dosage and safety profile of vitamin A is presented along with recommended doses for prophylactic/therapeutic use in randomised controlled trials in Covid-19 patients.
    DOI:  https://doi.org/10.1002/rmv.2204
  12. Phytother Res. 2020 Dec 29.
    Brendler T, Al-Harrasi A, Bauer R, Gafner S, Hardy ML, Heinrich M, Hosseinzadeh H, Izzo AA, Michaelis M, Nassiri-Asl M, Panossian A, Wasser SP, Williamson EM.
      In times of health crisis, including the current COVID-19 pandemic, the potential benefit of botanical drugs and supplements emerges as a focus of attention, although controversial efficacy claims are rightly a concern. Phytotherapy has an established role in everyday self-care and health care, but, since botanical preparations contain many chemical constituents rather than single compounds, challenges arise in demonstrating efficacy and safety. However, there is ample traditional, empirical, and clinical evidence that botanicals can offer some protection and alleviation of disease symptoms as well as promoting general well-being. Newly emerging viral infections, specifically COVID-19, represent a unique challenge in their novelty and absence of established antiviral treatment or immunization. We discuss here the roles and limitations of phytotherapy in helping to prevent and address viral infections, especially regarding their effects on immune response. Botanicals with a documented immunomodulatory, immunostimulatory, and antiinflammatory effects include adaptogens, Boswellia spp., Curcuma longa, Echinacea spp., Glycyrrhiza spp., medicinal fungi, Pelargonium sidoides, salicylate-yielding herbs, and Sambucus spp. We further provide a clinical perspective on applications and safety of these herbs in prevention, onset, progression, and convalescence from respiratory viral infections.
    Keywords:  Boswellia; COVID-19; Curcuma; Echinacea; Glycyrrhiza; Pelargonium; Sambucus; adaptogens; herbal medicine; medicinal fungi; phytotherapy; salicylate
    DOI:  https://doi.org/10.1002/ptr.7008
  13. APMIS. 2020 Dec 23.
    Kolberg ES, Wickstrøm K, Tonby K, Dyrhol-Riise AM, Holten AR, Amundsen EK.
      We have earlier proposed that serum ACE (s-ACE) could be used as a biomarker for severity in COVID-19 due to an assumed inverse relationship between ACE and ACE2. High s-ACE could indicate lower ACE2 activity and therefore more widespread and severe SARS-CoV2 infection, owing to virally mediated downregulation of ACE2 (1). Dysregulation of the Renin-Angiotensin-Aldosterone system (RAAS) are found in comorbidities known as risk factors for increased morbidity and mortality, such as hypertension and cardiovascular disease (2).
    Keywords:  COVID-19; RAAS; SARS-CoV-2; biomarker
    DOI:  https://doi.org/10.1111/apm.13108
  14. Chin J Nat Med. 2020 Dec;pii: S1875-5364(20)60031-0. [Epub ahead of print]18(12): 881-889
    Dai YJ, Wan SY, Gong SS, Liu JC, Li F, Kou JP.
      Coronavirus disease-2019 (COVID-19) is a new highly infectious disease caused by a novel coronavirus. Recently, the number of new cases infected pneumonia in the world continues to increase, which has aroused great concern from the international community. At present, there are no small-molecule specific anti-viral drugs for the treatment. The high mortality rate seriously threatens human health. Traditional Chinese medicine (TCM) is a unique health resource in China. The combination of TCM and Western medicine has played a positive and important role in combating COVID-19 in China. In this review, through literature mining and analysis, it was found that TCM has the potential to prevent and treat the COVID-19. Then, the network pharmacological studies demonstrated that TCM played roles of anti-virus, anti-inflammation and immunoregulation in the management of COVID-19 via multiple components acting on multiple targets and multiple pathways. Finally, clinical researches also confirmed the beneficial effects of TCM on the treatment of patients. This review may provide meaningful and useful information on further drug development of COVID-19 and other viral infectious diseases.
    Keywords:  Active ingredients of traditional Chinese medicine; Novel coronavirus pneumonia; Prescription of traditional Chinese medicine; Single Chinese herb; Viral infection
    DOI:  https://doi.org/10.1016/S1875-5364(20)60031-0
  15. Chin J Nat Med. 2020 Dec;pii: S1875-5364(20)60038-3. [Epub ahead of print]18(12): 941-951
    Xing Y, Hua YR, Shang J, Ge WH, Liao J.
      As a representative drug for the treatment of severe community-acquired pneumonia and sepsis, Xuebijing (XBJ) injection is also one of the recommended drugs for the prevention and treatment of coronavirus disease 2019 (COVID-19), but its treatment mechanism for COVID-19 is still unclear. Therefore, this study aims to explore the potential mechanism of XBJ injection in the treatment of COVID-19 employing network pharmacology and molecular docking methods. The corresponding target genes of 45 main active ingredients in XBJ injection and COVID-19 were obtained by using multiple database retrieval and literature mining. 102 overlapping targets of them were screened as the core targets for analysis. Then built the PPI network, TCM-compound-target-disease, and disease-target-pathway networks with the help of Cytoscape 3.6.1 software. After that, utilized DAVID to perform gene ontology (GO) function enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis to predict the action mechanism of overlapping targets. Finally, by applying molecular docking technology, all compounds were docked with COVID-19 3 CL protease(3CLpro), spike protein (S protein), and angiotensin-converting enzyme II (ACE2). The results indicated that quercetin, luteolin, apigenin and other compounds in XBJ injection could affect TNF, MAPK1, IL6 and other overlapping targets. Meanwhile, anhydrosafflor yellow B (AHSYB), salvianolic acid B (SAB), and rutin could combine with COVID-19 crucial proteins, and then played the role of anti-inflammatory, antiviral and immune response to treat COVID-19. This study revealed the multiple active components, multiple targets, and multiple pathways of XBJ injection in the treatment of COVID-19, which provided a new perspective for the study of the mechanism of traditional Chinese medicine (TCM) in the treatment of COVID-19.
    Keywords:  COVID-19; Molecular docking; Network pharmacology; Xuebijing injection
    DOI:  https://doi.org/10.1016/S1875-5364(20)60038-3
  16. Aging (Albany NY). 2020 Dec 22. 12
    Cangiano B, Fatti LM, Danesi L, Gazzano G, Croci M, Vitale G, Gilardini L, Bonadonna S, Chiodini I, Caparello CF, Conti A, Persani L, Stramba-Badiale M, Bonomi M.
      INTRODUCTION: The COVID-19 pandemic caused an increased mortality in nursing homes due to its quick spread and the age-related high lethality.RESULTS: We observed a two-month mortality of 40%, compared to 6.4% in the previous year. This increase was seen in both COVID-19 positive (43%) and negative (24%) residents, but 8 patients among those testing negative on the swab, tested positive on serological tests. Increased mortality was associated with male gender, older age, no previous vitamin D supplementation and worse "activities of daily living (ADL)" scores, such as Barthel index, Tinetti scale and S.OS.I.A.
    CLASSIFICATION:
    CONCLUSION: Our data confirms a higher geriatric mortality due to COVID-19. Negative residents also had higher mortality, which we suspect is secondary to preanalytical error and a low sensitivity of the swab test in poorly compliant subjects. Male gender, older age and low scores on ADL scales (probably due to immobility) are risk factors for COVID-19 related mortality. Finally, mortality was inversely associated with vitamin D supplementation.
    DESIGN: In this observational study, we described the two-month mortality among the 157 residents (age 60-100) of a nursing home after Sars-CoV-2 spreading, reporting the factors associated with the outcome. We also compared the diagnostic tests for Sars-CoV-2.
    Keywords:  COVID-19; activities of daily living; hydroxychloroquine; nasopharyngeal swab; sensitivity and specificity; serology
    DOI:  https://doi.org/10.18632/aging.202307
  17. Soins. 2020 Oct;pii: S0038-0814(20)30247-4. [Epub ahead of print]65(849): 59-62
    Ferrer MH, Leveque LB, Ogier M, Vermech N, Lefort H.
      Our social environment shapes our eating habits, notably our consumption of fruit and vegetables rich in micronutrients (vitamins and trace elements), essential for regulating the immune system. Ensuring a balanced intake of micronutrients could prove to be particularly beneficial for patients with severe forms of COVID-19 suffering from critical immune dysregulation.
    Keywords:  COVID-19; Covid-19; infection; inflammation; nutrition; oligoélément; trace element; vitamin; vitamine
    DOI:  https://doi.org/10.1016/S0038-0814(20)30247-4
  18. J Immunoassay Immunochem. 2020 Dec 26. 1-24
    Grigore A, Cord D, Tanase C, Albulescu R.
      At present, specific therapies for COVID-19 are not well established, being certain only that the immune system plays a decisive role in the initiation and progression of the disease. Plants have given and continue to give compounds with great efficiency and low toxicity, some of them being a starting point for extremely effective synthetic substances. Although herbal remedies are used mainly for preventive purposes, there are also guidelines issued by some countries that indicate the use of traditional remedies for different stages of COVID-19 disease.Europe has a long and strong tradition of using medicinal plants for therapeutic purposes, but clinical trials for this type of approach are scarce, compared to Asia. In this regard, a bridge between tradition and science, would have a strong impact on the capacity for prevention and treatment of COVID-19. The paper reviews compounds of plant origin that have previously proven effective in counteracting some coronaviruses but also some of their major effects - direct action on virus replicative apparatus (viral entry or replication, action on the viral enzymatic system), collateral action of natural compounds on the immune system and also the contribution of herbal medicine as vaccine adjuvants are tackled.
    Keywords:  Medicinal plants; immune system; inflammation; traditional
    DOI:  https://doi.org/10.1080/15321819.2020.1862867
  19. Biomed Pharmacother. 2020 Dec 16. pii: S0753-3322(20)31336-6. [Epub ahead of print]134 111143
    Amaral-Machado L, Oliveira WN, Rodrigues VM, Albuquerque NA, Alencar ÉN, Egito EST.
      BACKGROUND: The ARDS (Acute Respiratory Distress Syndrome) is a severe respiratory syndrome that was recently associated as the main death cause in the COVID-19 pandemic outbreak. Hence, in order to prevent ARDS, the pulmonary function maintenance has been the target of several pharmacological approaches. However, there is a lack of reports regarding the use of effective pharmaceutical active natural products (PANPs) for early treatment and prevention of COVID-19-related ARDS. Therefore, the aim of this work was to conduct a systematic review regarding the PANPs that could be further studied as alternatives to prevent ARDS. Consequently, this work can pave the way to spread the use of PANPs on the prevention of ARDS in COVID-19-confirmed or -suspected patients.METHODS: The search strategy included scientific studies published in English from 2015 to 2020 that promoted the elucidation of anti-inflammatory pathways targeting ARDS by in vitro and/or in vivo experiments using PANPs. Then, 74 studies regarding PANPs, able to maintain or improve the pulmonary function, were reported.
    CONCLUSIONS: The PANPs may present different pulmonary anti-inflammatory pathways, wherein (i) reduction/attenuation of pro-inflammatory cytokines, (ii) increase of the anti-inflammatory mediators' levels, (iii) pulmonary edema inhibition and (iv) attenuation of lung injury were the most observed biological effects of such products in in vitro experiments or in clinical studies. Finally, this work highlighted the PANPs with promising potential to be used on respiratory syndromes, allowing their possible use as alternative treatment at the prevention of ARDS in COVID-19-infected or -suspected patients.
    Keywords:  ARDS prevention; COVID-19; Immunomodulation; Natural products
    DOI:  https://doi.org/10.1016/j.biopha.2020.111143
  20. Molecules. 2020 Dec 12. pii: E5888. [Epub ahead of print]25(24):
    Giovinazzo G, Gerardi C, Uberti-Foppa C, Lopalco L.
      SARS-CoV-2 first emerged in China during late 2019 and rapidly spread all over the world. Alterations in the inflammatory cytokines pathway represent a strong signature during SARS-COV-2 infection and correlate with poor prognosis and severity of the illness. The hyper-activation of the immune system results in an acute severe systemic inflammatory response named cytokine release syndrome (CRS). No effective prophylactic or post-exposure treatments are available, although some anti-inflammatory compounds are currently in clinical trials. Studies of plant extracts and natural compounds show that polyphenols can play a beneficial role in the prevention and the progress of chronic diseases related to inflammation. The aim of this manuscript is to review the published background on the possible effectiveness of polyphenols to fight SARS-COV-2 infection, contributing to the reduction of inflammation. Here, some of the anti-inflammatory therapies are discussed and although great progress has been made though this year, there is no proven cytokine blocking agents for COVID currently used in clinical practice. In this regard, bioactive phytochemicals such as polyphenols may become promising tools to be used as adjuvants in the treatment of SARS-CoV-2 infection. Such nutrients, with anti-inflammatory and antioxidant properties, associated to classical anti-inflammatory drugs, could help in reducing the inflammation in patients with COVID-19.
    Keywords:  COVID-19; SARS-CoV-2; cytokines; inflammation; polyphenols
    DOI:  https://doi.org/10.3390/molecules25245888
  21. Public Health Nutr. 2020 Dec 28. 1-22
    Kamarli Altun H, Karacil Ermumcu MS, Seremet Kurklu N.
      OBJECTIVE: This study was conducted to evaluate the dietary habits of the dietitians who had a leading role in this regard during the pandemic and their use of dietary supplements, functional food, and herbal medicines.DESIGN: A cross-sectional study. An online questionnaire was used as a data collection tool to identify the participants' socio-demographic characteristics, health statuses and dietary habits, and their use of dietary supplements, functional foods, and herbal medicines.
    SETTING: Turkey.
    PARTICIPANTS: The study population was 550 dietitians.
    RESULTS: In this study, the participants' average age was 30.6 ± 9.1 years, and most of them (88.2%) were women. More than half of the participants (88.9%) thought that adequate and balanced nutrition would positively affect the course of COVID-19. To avoid COVID-19, 94.5% of the dietitians used dietary supplements, 46.1% herbal medicines, and 34.9% functional foods during the pandemic. The most commonly used dietary supplement was fish oil (81.9%), functional food was vegetables and fruits (80.5%), and the herbal medicine was cinnamon (63.5%). Women's consumption of functional foods was approximately twice higher compared to men (95% Cl: 1.048-4.165; p<0.05). The findings showed that the longer the dietitians were in their careers, the more functional foods and herbal medicines they used.
    CONCLUSION: During the pandemic, dietitians' use of foods with protective effects against diseases increased depending on their academic knowledge and experience in nutrition. The findings obtained in this study suggest that an expert's opinion should be obtained before using dietary supplements and herbal medicines.
    Keywords:  COVID-19; dietary supplements; dietitians; functional foods; herbal medicine
    DOI:  https://doi.org/10.1017/S1368980020005297
  22. Nutr Metab Cardiovasc Dis. 2020 Oct 21. pii: S0939-4753(20)30452-X. [Epub ahead of print]
    Savarese M, Castellini G, Morelli L, Graffigna G.
      BACKGROUND AND AIMS: In Italy, the spread of the novel coronavirus (SARS-Cov-2) required lifestyle changes that have affected food choices and people's health condition. We explore people's perception of the role of food consumption as a preventive measure and how it reconfigures consumption habits.METHOD AND RESULTS: We conducted an online survey of a representative sample of 1004 Italian citizens. Around 40% of the population perceive that strengthening the immune defences through nutrition is not important to reduce the risk of coronavirus disease 2019 (COVID-19) infection. People with lower levels of perceived importance are slightly younger and have a less healthy lifestyle. They are less worried about the emergency. During the last months, they have bought less food supplements and also intend to decrease their purchase in the next 6 months.
    CONCLUSION: In COVID-19 pandemic, scholars underline the importance of having a strong immune system. However, the Italians who attribute less importance to food that helps the immune system seem to differ negatively in their psychological attitude towards the emergency and food consumption. Today, Italians are asked to engage in preventive food practices to protect against possible chronic diseases; exploring their perceptions is important to orient them towards this change.
    Keywords:  Behavioural change; COVID-19; Disease preventions; Food psychology; Healthy diets
    DOI:  https://doi.org/10.1016/j.numecd.2020.10.013
  23. Soins. 2020 Oct;pii: S0038-0814(20)30249-8. [Epub ahead of print]65(849): 66-69
    Leveque LB, Zaïre M, Maire D, Lefort H, Ferrer MH.
      Eating habits are evolving. In a public health context, guidelines are regularly updated according to the nutritional status and health of the French population, but some of these recommendations go unheeded. In the context of the current epidemic, nutritional care must be provided to high risk populations as well as to patients presenting, or having presented, COVID-19, in order to favour immunity and recovery.
    Keywords:  COVID-19; Covid-19; guideline; micronutrient; micronutriment; nutrition; oligoélément; recommandation; trace element; vitamine
    DOI:  https://doi.org/10.1016/S0038-0814(20)30249-8