bims-covind Biomed News
on COVID-19 and Immunology: nutrition and diet
Issue of 2021‒01‒10
sixteen papers selected by
Aimee Cook
Newcastle University


  1. Int J Mol Med. 2020 Nov 30.
    Sidiropoulou P, Docea AO, Nikolaou V, Katsarou MS, Spandidos DA, Tsatsakis A, Calina D, Drakoulis N.
      As the coronavirus disease 2019 (COVID‑19) continues to spread worldwide, it has become evident that the morbidity and mortality rates clearly vary across nations. Although several factors may account for this disparity, striking differences within and between populations indicate that ethnicity might impact COVID‑19 clinical outcomes, reflecting the 'color of disease'. Therefore, the role of key biological variables that could interplay with viral spreading and severity indices has attracted increasing attention, particularly among non‑Caucasian populations. Although the links between vitamin D status and the incidence and severity of COVID-19 remain elusive, several lines of emerging evidence suggest that vitamin D signaling, targeting several immune‑mediated pathways, may offer potential benefits at different stages of SARS-CoV-2 infection. Given that the vitamin D status is modulated by several intrinsic and extrinsic factors, including skin type (pigmentation), melanin polymers may also play a role in variable COVID‑19 outcomes among diverse population settings. Moreover, apart from the well‑known limiting effects of melanin on the endogenous production of vitamin D, the potential crosstalk between the pigmentary and immune system may also require special attention concerning the current pandemic. The present review article aimed to shed light on a range of mostly overlooked host factors, such as vitamin D status and melanin pigments, that may influence the course and outcome of COVID‑19.
    DOI:  https://doi.org/10.3892/ijmm.2020.4802
  2. Front Pharmacol. 2020 ;11 604579
    Boulkrane MS, Ilina V, Melchakov R, Fedotova J, Drago F, Gozzo L, Das UN, Abd El-Aty AM, Baranenko D.
      Novel coronavirus disease (COVID-19) pandemic caused by SARS-CoV-2, for which there is no effective treatment except employing prevention strategies, has already instituted significant number of deaths. In this review, we provide a scientific view on the potential role of vitamin D in SARS-CoV-2 virus/COVID-19 disease. Vitamin D is well-known to play a significant role in maintaining the immune health of an individual. Moreover, it induces antimicrobial peptide expression that can decrease viral replication and regulate the levels of pro-inflammatory/anti-inflammatory cytokines. Therefore, supplementation of vitamin D has the potential to reduce the incidence, severity and the risk of death from pneumonia resulting from the cytokine storm of many viral infections including COVID-19. We suggest that supplementation of subjects at high risk of COVID-19 with vitamin D (1.000 to 3.000 IU) to maintain its optimum serum concentrations may be of significant benefit for both in the prevention and treatment of the COVID-19.
    Keywords:  COVID 19; SARS-CoV-2; respiratory tract infection; vitamin D3; vitamin D3 receptor
    DOI:  https://doi.org/10.3389/fphar.2020.604579
  3. Ir J Med Sci. 2021 Jan 06.
    Farid N, Rola N, Koch EAT, Nakhoul N.
      SARS-CoV-2, causing the lethal disease COVid-19, is a public health emergency in the 2020 global pandemic. The outbreak and fast spreading of SARS-CoV-2 have a high morbidity and mortality specifically in elder patients with chronic diseases such as diabetes mellitus, arterial hypertension, chronic kidney disease, and organ transplanted patients with immunosuppressive therapy. Preliminary results support different treatments such as chloroquine and convalescent plasma infusion in severe cases, with good outcome. On the other hand, the efficacy of supplementation with active vitamin D, an immunomodulator hormone with antiinflammatory and antimicrobial effects, is unproven. A recent study reported that vitamin D attains antiviral effects, via blocking viral replication directly. SARS-CoV-2 primarily uses the immune evasion process during infection via the envelope spike glycoprotein, which is followed by a cytokine storm, causing severe acute respiratory disease syndrome and death. SARS-CoV-2, by using the well-known angiotensin-converting enzyme 2 by the protein spike, as the host receptor to enter into alveolar, myocardial, and renal epithelial cells, can be disrupted by vitamin D. However, the correlation between vitamin D levels and COVID-19 deaths in previous studies was insignificant. Retrospective studies demonstrated a correlation between vitamin D status and COVID-19 severity and mortality, while other studies did not find this correlation. Studies have shown that, vitamin D reduces the risk of acute viral respiratory tract infections and pneumonia via direct inhibition of viral replication, antiinflammatory and immunomodulatory effects. The data available today regarding the beneficial protective effect of vitamin D is unclear and with conflicting results. Large randomized control trials are necessary to test this hypothesis. In this review, we will explain the cross talk between the active vitamin D and the angiotensin-converting enzyme 2, and summarize the data from the literature.
    Keywords:  Angiotensin converting enzyme 2; COVID-19; Renin; SARS-CoV-2; Vitamin D
    DOI:  https://doi.org/10.1007/s11845-020-02452-8
  4. Nutrition. 2020 Dec 04. pii: S0899-9007(20)30389-0. [Epub ahead of print]84 111106
    Katz J, Yue S, Xue W.
      OBJECTIVE: The 2019 coronavirus disease (COVID-19) pandemic has disproportionally affected a variety of patients with underlying risk factors such as respiratory and cardiovascular diseases, diabetes, obesity, and black race. Vitamin D deficiency, which can result in a compromised immune response, has been also linked to increased risk and increased morbidities associated with COVID-19. In the absence of large-scale longitudinal studies to determine the strength of association between vitamin deficiency and COVID-19, cross-sectional studies of large patient cohorts can be used.METHODS: We used the i2b2 patient's registry platform at the University of Florida Health Center to generate a count of patients using the international classification of diseases (ICD)-10 diagnosis codes for the period of October 1, 2015, through June 30, 2020. Logistic regression of the aggregates was used for the analysis.
    RESULTS: Patients with vitamin D deficiency were 4.6 times more likely to be positive for COVID-19 (indicated by the ICD-10 diagnostic code COVID19) than patients with no deficiency (P < 0.001). The association decreased slightly after adjusting for sex (odds ratio [OR] = 4.58; P < 0.001) and malabsorption (OR = 4.46; P < 0.001), respectively. The association decreased significantly but remained robust (P < 0.001) after adjusting for race (OR = 3.76; P < 0.001), periodontal disease status (OR = 3.64; P < 0.001), diabetes (OR = 3.28; P < 0.001), and obesity (OR = 2.27; P < 0.001), respectively. In addition, patients with vitamin D deficiency were 5 times more likely to be infected with COVID-19 than patients with no deficiency after adjusting for age groups (OR = 5.155; P < 0.001).
    CONCLUSIONS: Vitamin D deficiency is significantly associated with increased risk for COVID-19.
    Keywords:  COVID-19; corona virus 19; dental disease; odds ratio; vitamin D
    DOI:  https://doi.org/10.1016/j.nut.2020.111106
  5. Indian J Microbiol. 2020 Dec 30. 1-6
    Nile SH, Kai G.
      The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing potentially fatal coronavirus disease-19 (COVID-19), with a significant health and economic burden around the globe. Currently many clinical studies are undergoing but still there is no any specific approved therapy or drug established for effective treatment of COVID-19. This review aimed to analyses various clinical studies which have been registered in www.clinicaltrials.gov and http://www.chictr.org.cn were registered with natural plant-based medicines and Traditional Chinese medicine (TCM) for discovering effective treatment and prevention of COVID-19. Total 46 and 64 natural drug and TCM interventions were identified which mainly determined the preventive strategies and possible treatments for COVID-19 infection. We identified that most of the clinical trial undergoing on natural compound like heparin and vitamin C as therapeutic agents and immune boosters for against COVID-19. Traditional Chinese medicines and herbal medicines can be effectively used as a preventive therapy against COVID-19 and after successful clinical trials and these potential therapies can be promoted by countries around the world.Supplementary Information: The online version contains supplementary material available at (10.1007/s12088-020-00919-x).
    Keywords:  COVID-19; Clinical trials; Natural products; SARS-CoV-2; TCM
    DOI:  https://doi.org/10.1007/s12088-020-00919-x
  6. Am J Physiol Endocrinol Metab. 2021 Jan 06.
    Lohia P, Nguyen P, Patel N, Kapur S.
      Background The immunomodulating role of vitamin D might play a role in COVID-19 disease. Objective To study the association between vitamin D and clinical outcomes in COVID-19 patients. Methods Retrospective cohort study on COVID-19 patients with documented vitamin D levels within the last year. Vitamin D levels were grouped as ≥ 20 ng/mL or <20 ng/mL. Main outcomes were mortality, need for mechanical ventilation, new DVT or pulmonary embolism, and ICU admission. Results A total of 270 patients (mean (SD) age, 63.81 (14.69) years); 117 (43.3%) males; 216 (80%) African Americans; 139 (51.5%) in 65 and older age group were included. Vitamin D levels were less than 20 ng/ml in 95 (35.2%) patients. During admission, 72 patients (26.7%) died, 59 (21.9%) needed mechanical ventilation, and 87 (32.2%) required ICU. Vitamin D levels showed no significant association with mortality (OR=0.69; 95% CI, 0.39 - 1.24; p=0.21), need for mechanical ventilation (OR=1.23; 95% CI, 0.68 - 2.24; p=0.49), new DVT or PE(OR= 0.92; 95% CI, 0.16- 5.11; p=1.00) or ICU admission (OR=1.38; 95% CI, 0.81 - 2.34; p=0.23). Conclusion We did not find any significant association of vitamin D levels with mortality, the need for mechanical ventilation, ICU admission and the development of thromboembolism in COVID-19 patients.
    Keywords:  Critical care; Mechanical Ventilation; Mortality; Thromboembolism; Vitamin D
    DOI:  https://doi.org/10.1152/ajpendo.00517.2020
  7. Reprod Sci. 2021 Jan 07.
    Sethuram R, Bai D, Abu-Soud HM.
      COVID-19 (coronavirus disease 2019) is the current world health crisis, producing extensive morbidity and mortality across all age groups. Given the established roles of zinc in combating oxidative damage and viral infections, zinc is being trialed as a treatment modality against COVID-19. Zinc also has confirmed roles in both male and female reproduction. The possible depletion of zinc with the oxidative events of COVID-19 is especially relevant to the fertility of affected couples. This review aims to present the pathophysiology of COVID-19, especially in relation to reproductive function; the role of zinc in the COVID-19 disease process; and how zinc depletion in concert with cytokine storm and reactive oxygen species production could affect reproduction. It also highlights research areas to better the understanding of COVID-19 and its impact on fertility and potential ways to mitigate the impact.
    Keywords:  Coronavirus; Covid-19; Infertility; Reactive oxygen species; Zinc
    DOI:  https://doi.org/10.1007/s43032-020-00400-6
  8. Mov Disord. 2020 09;35(9): 1497
    Speeckaert MM, Speeckaert R, Delanghe JR.
      
    Keywords:  COVID‐19; Parkinson's disease; standardization; vitamin D
    DOI:  https://doi.org/10.1002/mds.28213
  9. Cureus. 2020 Nov 30. 12(11): e11779
    Kumari P, Dembra S, Dembra P, Bhawna F, Gul A, Ali B, Sohail H, Kumar B, Memon MK, Rizwan A.
      Background and objective The anti-inflammatory properties of vitamin C (VC) and the promising results it has shown in the treatment for common cold have prompted clinicians to use it as adjuvant therapy in the treatment of COVID-19. The purpose of this study was to find out the role of VC as adjunctive therapy in coronavirus disease 2019 (COVID-19). Methodology This study was conducted from March to July 2020 in the COVID-19 unit of a tertiary care hospital in Karachi. In this randomized controlled trial (RCT), one group received the intervention [50 mg/kg/day of intravenous (IV) VC] along with the standard therapy, and the other group received standard therapy only. Data such as age, gender, vitals, and biochemical values as well as outcomes including the number of days required for treatment, hospital stay, need for ventilation, and mortality were compared between the two groups and recorded using a self-structured questionnaire. Results COVID-19 patients who received IV VC became symptom-free earlier (7.1 ± 1.8 vs. 9.6 ± 2.1 days, p-value: <0.0001) and spent fewer days in the hospital (8.1 ± 1.8 vs. 10.7 ± 2.2 days, p-value: <0.0001) compared to those who received standard therapy only. However, there was no significant difference in the need for mechanical ventilation (p-value: 0.406) and mortality (p-value: 0.31) between the two groups. Conclusion VC can significantly improve clinical symptoms in patients affected with COVID-19; however, it had no impact on mortality and the need for mechanical ventilation. More large-scale studies are required to further assess the role of VC in the treatment of COVID-19.
    Keywords:  covid-19; intravenous vitamin c; pakistan
    DOI:  https://doi.org/10.7759/cureus.11779
  10. Int J Infect Dis. 2021 Jan 02. pii: S1201-9712(20)32600-X. [Epub ahead of print]
    Liu N, Sun J, Wang X, Zhang T, Zhao M, Li H.
      BACKGROUND: Observational studies suggest that the risk and clinical prognosis of coronavirus disease 2019 (COVID-19) are related to low vitamin D status; however, the data are inconsistent.OBJECTIVES: We conducted a systematic review and meta-analysis to assess the association between low vitamin D status and COVID-19.
    METHODS: The systematic search was conducted with PubMed, Embase, and the Cochrane Library from database inception to September 25, 2020. The standardized mean difference (SMD) or odds ratio (OR) and corresponding 95% confidence interval (CI) were applied to estimate pooled results. Random - or fixed - effect models based on heterogeneity were used for the meta-analysis. Funnel plots and Egger regression tests were used to assess publication bias.
    RESULTS: A total of 10 articles with 361, 934 participants were selected for meta-analysis. Overall, the pooled OR in the fixed-effect model showed that vitamin D deficiency or insufficiency was associated with an increased risk of COVID-19 (OR = 1.43, 95% CI 1.00 to 2.05). In addition, COVID-19-positive individuals had lower vitamin D levels than those with COVID-19-negative individuals (SMD = -0.37, 95% CI = -0.52 to -0.21). Significant heterogeneity existed in both endpoints. Funnel plots and Egger regression tests revealed significant publication bias.
    CONCLUSIONS: This systematic review and meta-analysis indicated that low vitamin D status may be associated with an increased risk of COVID-19 infection. Further studies are needed to evaluate the impact of vitamin D supplementation on the clinical severity and prognosis in patients with COVID-19.
    SYSTEMATIC REVIEW REGISTRATION: PROSPERO registration no: CRD42020216740.
    Keywords:  25-hydroxyvitamin D; Coronavirus disease 2019; Low vitamin D status; Meta-analysis; Vitamin D
    DOI:  https://doi.org/10.1016/j.ijid.2020.12.077
  11. Chin J Integr Med. 2021 Jan;27(1): 3-6
    Li JG, Xu H.
      Covid-19 pandemic has caused hundreds of thousands deaths and millions of infections and continued spreading violently. Although researchers are racing to find or develop effective drugs or vaccines, no drugs from modern medical system have been proven effective and the high mutant rates of the virus may lead it resistant to whatever drugs or vaccines developed following modern drug development procedure. Current evidence has demonstrated impressive healing effects of several Chinese medicines (CMs) for Covid-19, which urges us to reflect on the role of CM in the era of modern medicine. Undoubtedly, CM could be promising resources for developing drug candidates for the treatment of Covid-19 in a way similar to the development of artemisinin. But the theory that builds CM, like the emphasis of driving away exogenous pathogen (virus, etc.) by restoring self-healing capacity rather than killing the pathogen directly from the inside and the 'black-box' mode of diagnosing and treating patients, is as important, yet often ignored, an treasure as CM herbs and should be incorporated into modern medicine for future advancement and innovation of medical science.
    Keywords:  Chinese medicine; Covid-19; SARS-CoV-2; coronavirus; herbal medicine
    DOI:  https://doi.org/10.1007/s11655-020-2860-x
  12. Nutrition. 2020 Nov 21. pii: S0899-9007(20)30372-5. [Epub ahead of print]83 111089
    Ratha SK, Renuka N, Rawat I, Bux F.
      The outbreak of the coronavirus disease of 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 that has created huge trepidation worldwide, has a mortality rate of 0.5% to 1% and is growing incessantly. There are currently no therapies and/or vaccines that may help abate this viral disease, but the use of masks and social distancing can limit the spread. Boosting immunity has been a simple way to resist viral infection and limit fatalities. In this context, the use of nutraceuticals appears to be a potential panacea. The ability of algae-based nutraceuticals, mainly Spirulina, to boost immunity against viral diseases has already been reported clinically. Spirulina-based nutraceuticals boost the adaptive and innate immunity, and bioactive compounds, such as angiotensin-converting enzyme (ACE) inhibitor peptides, phycobiliproteins, sulfated polysaccharides, and calcium-Spirulan, can serve as antiviral agents. The presence of these molecules indicates its potential role in resisting infection and COVID-19 disease progression. This review focuses on the potential role of algal nutraceuticals as immune boosters to combat the human coronavirus and other viral diseases. The potential use of Spirulina-based nutraceuticals for combating COVID-19, its mechanism, and future directions have also been discussed.
    Keywords:  Algae; Antiviral; COVID-19; Coronavirus; Immune-booster; Nutraceuticals
    DOI:  https://doi.org/10.1016/j.nut.2020.111089
  13. PLoS Negl Trop Dis. 2021 01;15(1): e0008895
    Joachimiak MP.
      A wide variety of symptoms is associated with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, and these symptoms can overlap with other conditions and diseases. Knowing the distribution of symptoms across diseases and individuals can support clinical actions on timelines shorter than those for drug and vaccine development. Here, we focus on zinc deficiency symptoms, symptom overlap with other conditions, as well as zinc effects on immune health and mechanistic zinc deficiency risk groups. There are well-studied beneficial effects of zinc on the immune system including a decreased susceptibility to and improved clinical outcomes for infectious pathogens including multiple viruses. Zinc is also an anti-inflammatory and anti-oxidative stress agent, relevant to some severe Coronavirus Disease 2019 (COVID-19) symptoms. Unfortunately, zinc deficiency is common worldwide and not exclusive to the developing world. Lifestyle choices and preexisting conditions alone can result in zinc deficiency, and we compile zinc risk groups based on a review of the literature. It is also important to distinguish chronic zinc deficiency from deficiency acquired upon viral infection and immune response and their different supplementation strategies. Zinc is being considered as prophylactic or adjunct therapy for COVID-19, with 12 clinical trials underway, highlighting the relevance of this trace element for global pandemics. Using the example of zinc, we show that there is a critical need for a deeper understanding of essential trace elements in human health, and the resulting deficiency symptoms and their overlap with other conditions. This knowledge will directly support human immune health for decreasing susceptibility, shortening illness duration, and preventing progression to severe cases in the current and future pandemics.
    DOI:  https://doi.org/10.1371/journal.pntd.0008895