bims-covind Biomed News
on COVID-19 and Immunology: nutrition and diet
Issue of 2021‒01‒31
nineteen papers selected by
Aimee Cook
Newcastle University


  1. Int J Vitam Nutr Res. 2021 Jan 25. 1-22
    Gröber U, Holick MF.
       Worldwide the pandemic of COVID-19 spreads rapidly and has had an enormous public health impact with substantial morbidity and mortality especially in high-risk groups, such as older people and patients with comorbidities like diabetes, dementia or cancer. In the absence of a vaccine against COVID-19 there is an urgent need to find supportive therapies that can stabilize the immune system and can help to deal with the infection, especially for vulnerable groups such as the elderly. This is especially relevant for our geriatric institutions and nursing homes. A major potential contributing factor for elderly is due to their high incidence of malnutrition: up to 80% among the hospitalized elderly. Malnutrition results when adequate macronutrients and micronutrients are lacking in the diet. Often missing in public health discussions around preventing and treating COVID-19 patients are nutritional strategies to support optimal function of their immune system. This is surprising, given the importance that nutrients play a significant role for immune function. Several micronutrients, such as vitamin D, retinol, vitamin C, selenium and zinc are of special importance supporting both the adaptive and innate immune systems. As suboptimal status or deficiencies in these immune-relevant micronutrients impair immune function and reduces the resistance to infections, micronutrient deficiencies should therefore be corrected as soon as possible, especially in the elderly and other vulnerable groups. According to epidemiological, experimental and observational studies, some case reports and a few intervention studies the supplementation of vitamin D and/or zinc are promising. The multiple anti-inflammatory and immunomodulatory effects of Vitamin D could explain its protective role against immune hyper reaction and cytokine storm in patients with severe COVID-19. A randomized, placebo-controlled intervention study even shows that high dose vitamin D supplementation promotes viral clearance in asymptomatic and mildly symptomatic SARS-CoV-2 positive individuals. Besides, the data of a recent prospective study with COVID-19 patients reveal that a significant number of them were zinc deficient. The zinc deficient patients had more complications and the deficiency was associated with a prolonged hospital stay and increased mortality. Thus, immune-relevant micronutrients may help to increase the physiological resilience against COVID-19.
    Keywords:  COVID-19; elderly; malnutrition; retinol; selenium; vitamin C; vitamin D; zinc
    DOI:  https://doi.org/10.1024/0300-9831/a000693
  2. J Nutr Health Aging. 2021 ;25(2): 189-196
    Karahan S, Katkat F.
      BACKGROUND: Because of the lack of sufficient data, we aimed to investigate the role of serum 25(OH) vitamin D level on COVID severity and related mortality.METHODS: This was a retrospective observational study. Data, including sociodemographic features, clinical characteristics, and laboratory data, and 25(OH) vitamin D levels were recorded for each study participant. Patients were stratified into different vitamin D groups; Normal (Serum 25(OH) vitamin D level >30 ng/mL), Vitamin D insufficiency (21-29 ng/mL), and deficiency (<20 ng/mL). The severity of COVID was classified according to the Chinese Clinical Guideline for classification of COVID-19 severity. Mortality data were determined for participants. Univariate and multivariate Logistic regression analysis was performed to determine independent predictors of in-hospital mortality.
    RESULTS: Overall, 149 COVID-19 patients (females 45.6%, mean age 63.5 ± 15.3 (range 24-90 years) years) were included. Forty-seven patients (31.5%) had moderate COVID-19, whereas 102 patients (68.5%) had severe-critical COVID-19. The mean 25(OH) vitamin D level was 15.2 ± 10.3 ng/mL. Thirty-four (22.8%) and 103 (69.1%) patients had vitamin D insufficiency and deficiency, respectively. Mean serum 25(OH) vitamin D level was significantly lower in patients with severe-critical COVID-19 compared with moderate COVID-19 (10.1 ± 6.2 vs. 26.3 ± 8.4 ng/mL, respectively, p<0.001). Vitamin D insufficiency was present in 93.1% of the patients with severe-critical COVID-19. Multivariate logistic regression analysis revealed that only lymphocyte count, white blood cell count, serum albumin and, 25(OH) vitamin D level were independent predictors of mortality.
    CONCLUSION: Serum 25(OH) vitamin D was independently associated with mortality in COVID-19 patients.
    Keywords:  COVID-19; mortality; prognosis; vitamin D
    DOI:  https://doi.org/10.1007/s12603-020-1479-0
  3. BMJ Mil Health. 2021 Jan 27. pii: bmjmilitary-2020-001686. [Epub ahead of print]
    Parsons IT, Gifford RM, Stacey MJ, Lamb LE, O'Shea MK, Woods DR.
      For most individuals residing in Northwestern Europe, maintaining replete vitamin D status throughout the year is unlikely without vitamin D supplementation and deficiency remains common. Military studies have investigated the association with vitamin D status, and subsequent supplementation, with the risk of stress fractures particularly during recruit training. The expression of nuclear vitamin D receptors and vitamin D metabolic enzymes in immune cells additionally provides a rationale for the potential role of vitamin D in maintaining immune homeostasis. One particular area of interest has been in the prevention of acute respiratory tract infections (ARTIs). The aims of this review were to consider the evidence of vitamin D supplementation in military populations in the prevention of ARTIs, including SARS-CoV-2 infection and consequent COVID-19 illness. The occupational/organisational importance of reducing transmission of SARS-CoV-2, especially where infected young adults may be asymptomatic, presymptomatic or paucisymptomatic, is also discussed.
    Keywords:  infectious diseases; internal medicine; occupational & industrial medicine; preventive medicinE; public health; respiratory infections
    DOI:  https://doi.org/10.1136/bmjmilitary-2020-001686
  4. R Soc Open Sci. 2020 Dec;7(12): 201912
    Griffin G, Hewison M, Hopkin J, Kenny R, Quinton R, Rhodes J, Subramanian S, Thickett D.
      Vitamin D is a hormone that acts on many genes expressed by immune cells. Evidence linking vitamin D deficiency with COVID-19 severity is circumstantial but considerable-links with ethnicity, obesity, institutionalization; latitude and ultraviolet exposure; increased lung damage in experimental models; associations with COVID-19 severity in hospitalized patients. Vitamin D deficiency is common but readily preventable by supplementation that is very safe and cheap. A target blood level of at least 50 nmol l-1, as indicated by the US National Academy of Medicine and by the European Food Safety Authority, is supported by evidence. This would require supplementation with 800 IU/day (not 400 IU/day as currently recommended in UK) to bring most people up to target. Randomized placebo-controlled trials of vitamin D in the community are unlikely to complete until spring 2021-although we note the positive results from Spain of a randomized trial of 25-hydroxyvitamin D3 (25(OH)D3 or calcifediol) in hospitalized patients. We urge UK and other governments to recommend vitamin D supplementation at 800-1000 IU/day for all, making it clear that this is to help optimize immune health and not solely for bone and muscle health. This should be mandated for prescription in care homes, prisons and other institutions where people are likely to have been indoors for much of the summer. Adults likely to be deficient should consider taking a higher dose, e.g. 4000 IU/day for the first four weeks before reducing to 800 IU-1000 IU/day. People admitted to the hospital with COVID-19 should have their vitamin D status checked and/or supplemented and consideration should be given to testing high-dose calcifediol in the RECOVERY trial. We feel this should be pursued with great urgency. Vitamin D levels in the UK will be falling from October onwards as we head into winter. There seems nothing to lose and potentially much to gain.
    Keywords:  COVID-19; immunology; vitamin D
    DOI:  https://doi.org/10.1098/rsos.201912
  5. Eur J Public Health. 2021 Jan 28. pii: ckab004. [Epub ahead of print]
    Lippi G, Ferrari A, Targher G.
      All vitamin D tests carried out for outpatients aged 18 years or older during the last three years at an Italian University Hospital were reviewed. The serum vitamin D concentrations measured since the Italian COVID-19 lockdown to present did not significantly differ from the previous two years (78 vs. 77 nmol/L; p = 0.277), whilst the prevalence of vitamin D deficiency was found to be even marginally lower in 2020 (16.0% vs. 17.9%; p = 0.003). These results suggest that vitamin D deficiency in our province has not increased during the Italian COVID-19 outbreak or in correspondence with the nationwide lockdown.
    Keywords:  1,25-dihydroxycholecalciferol; COVID-19; Coronavirus; vitamin D
    DOI:  https://doi.org/10.1093/eurpub/ckab004
  6. J Reprod Immunol. 2021 Jan 08. pii: S0165-0378(21)00001-2. [Epub ahead of print]144 103271
    Bezerra Espinola MS, Bertelli M, Bizzarri M, Unfer V, Laganà AS, Visconti B, Aragona C.
      In late 2019, the new Coronavirus has been identified in the city of Wuhan then COVID-19 spreads like wildfire in the rest of the world. Pregnant women represent a risk category for increased abortion rates and vertical transmission with adverse events on the newborns has been recently confirmed. The scientific world is struggling for finding an effective cure for counteracting symptomatology. Today, there are many therapeutic proposes but none of them can effectively counteract the infection. Moreover, many of these compounds show important side effects not justifying their use. Scientific literature reports an immune system over-reaction through interleukins-6 activation. In this regard, the possibility to control the immune system represents a possible strategy for counteracting the onset of COVID-19 symptomatology. Vitamin D deficiency shows increased susceptibility to acute viral respiratory infections. Moreover, Vitamin D seems involved in host protection from different virus species by modulating activation and release of cytokines. Myo-inositol down-regulates the expression of IL-6 by phosphatidyl-inositol-3-kinase (PI3K) pathway. Furthermore, myo-inositol is the precursor of phospholipids in the surfactant and it is applied for inducing surfactant synthesis in infants for treating respiratory distress syndrome (RDS). This review aims to summarize the evidence about COVID-19 infection in pregnant women and to encourage the scientific community to investigate the use of Vitamin D and Myo-inositol which could represent a possible preventive treatment for pregnant women or women undergoing assisted reproductive technologies (ART).
    Keywords:  COVID-19; Myo-inositol; Pregnancy; SARS-CoV-2; Vitamin D
    DOI:  https://doi.org/10.1016/j.jri.2021.103271
  7. Am J Clin Nutr. 2021 Jan 29. pii: nqaa381. [Epub ahead of print]
    Ma H, Zhou T, Heianza Y, Qi L.
      BACKGROUND: Previous studies have related vitamin D supplementation to a lower risk of acute respiratory tract infection. Emerging evidence suggests that vitamin D insufficiency is related to a higher risk of coronavirus disease 2019 (COVID-19) infection.OBJECTIVES: We aimed to investigate the prospective association between habitual use of vitamin D supplements and risk of COVID-19 infection, and assess whether such an association differed according to the different levels of circulating and genetically predicted vitamin D.
    METHODS: This study included 8297 adults who have records of COVID-19 test results from UK Biobank (from 16 March 2020 to 29 June 2020). The use of vitamin D supplements, circulating vitamin D levels, and main covariates were measured at baseline (2006-2010). Genetically predicted vitamin D levels were evaluated by genetic risk score.
    RESULTS: After adjustment for covariates, the habitual use of vitamin D supplements was significantly associated with a 34% lower risk of COVID-19 infection (OR, 0.66; 95% CI, 0.45-0.97; P = 0.034). Circulating vitamin D levels at baseline or genetically predicted vitamin D levels were not associated with the risk of COVID-19 infection. The association between the use of vitamin D supplements and the risk of COVID-19 infection did not vary according to the different levels of circulating or genetically predicted vitamin D (P-interactions = 0.75 and 0.74, respectively).
    CONCLUSIONS: Our findings suggest that habitual use of vitamin D supplements is related to a lower risk of COVID-19 infection, although we cannot rule out the possibility that the inverse association is due to residual confounding or selection bias. Further clinical trials are needed to verify these results.
    Keywords:  COVID-19; SARS-CoV-2; circulating vitamin D level; genetic risk score; vitamin D supplement
    DOI:  https://doi.org/10.1093/ajcn/nqaa381
  8. J Med Virol. 2021 Jan 29.
    Demir M, Demir F, Aygun H.
      OBJECTIVE: The present study examined the relationship between PCR test positivity and clinical outcomes of vitamin D levels measured within the six months before the PCR test in COVID-19 positive patients.MATERIALS AND METHODS: In this retrospective cohort study,COVID-19(227) and non-COVID-19 patients(260) were divided into four groups according to their vitamin D levels: Group I (0-10 ng/ml), Group II (10-20 ng/ml),Group III (20-30 ng/ml),and Group IV(Vitamin D>30ng/ml).Laboratory test results and the radiological findings were evaluated. In addition,for comparative purposes,medical records of 1200 patients who had hospital visit in 1 November 2019-1 November 2020 period for complaints due to reasons not related to COVID-19 were investigated for the availability of vitamin D measurements.This search yielded 260 patients with tested vitamin D levels.
    RESULTS: Vitamin D levels were below 30 ng/ml in 94.27% of 227 COVID-19 positive patients [average age:46.32±1.24 years (range:20-80years) and 56.54% women] while 93.07% of 260 non-COVID-19 patients [average age:44.63±1.30 years (range:18-75years) and 59.50% women] had vitamin D levels below 30 ng/ml.Nevertheless,very severe vitamin D deficiency (<10 ng/ml) was considerably more common in COVID-19 patients (44%) [average age:44.15±1.89 years (range:23-80years) and 57.57% women] than in non-COVID-19 ones (31%) [average age:46.50±2.21 years (range:20-75) and 62.5% women].Among COVID-19 positive patients,the group with vitamin D levels of >30 ng/ml had significantly lower D-dimer and CRP levels,number of affected lung segments and shorter hospital stays.No difference was found among the groups in terms of age and gender distribution.
    CONCLUSION: Elevated vitamin D levels could decrease COVID-19 PCR positivity,D-dimer and CRP levels and the number of affected lung segments in COVID-19 positive patients,thereby shortening duration of hospital stays and alleviating the intensity of COVID-19. This article is protected by copyright. All rights reserved.
    Keywords:  COVID-19; CRP; Computed tomography; D-dimer; PCR testing; Vitamin D
    DOI:  https://doi.org/10.1002/jmv.26832
  9. Int J Environ Res Public Health. 2021 01 21. pii: 904. [Epub ahead of print]18(3):
    Scudiero O, Lombardo B, Brancaccio M, Mennitti C, Cesaro A, Fimiani F, Gentile L, Moscarella E, Amodio F, Ranieri A, Gragnano F, Laneri S, Mazzaccara C, Di Micco P, Caiazza M, D'Alicandro G, Limongelli G, Calabrò P, Pero R, Frisso G.
      Coronaviruses (CoVs) represent a large family of RNA viruses that can infect different living species, posing a global threat to human health. CoVs can evade the immune response, replicate within the host, and cause a rapid immune compromise culminating in severe acute respiratory syndrome. In humans, the immune system functions are influenced by physical activity, nutrition, and the absence of respiratory or cardiovascular diseases. This review provides an in-depth study between the interactions of the immune system and coronaviruses in the host to defend against CoVs disease.
    Keywords:  cardiovascular disorders; coronavirus; immune system; nutrition; physical exercise; respiratory infection
    DOI:  https://doi.org/10.3390/ijerph18030904
  10. Front Vet Sci. 2020 ;7 570748
    Alagawany M, Attia YA, Farag MR, Elnesr SS, Nagadi SA, Shafi ME, Khafaga AF, Ohran H, Alaqil AA, Abd El-Hack ME.
      The novel coronavirus (SARS-CoV-2) infection (COVID-19) has raised considerable concern on the entire planet. On March 11, 2020, COVID-19 was categorized by the World Health Organization (WHO) as a pandemic infection, and by March 18, 2020, it has spread to 146 countries. The first internal defense line against numerous diseases is personalized immunity. Although it cannot be claimed that personalized nutrition will have an immediate impact on a global pandemic, as the nutritional interventions required a long time to induce beneficial outcomes on immunity development, nutritional strategies are still able to clarify and have a beneficial influence on the interplay between physiology and diet, which could make a positive contribution to the condition in the next period. As such, a specific goal for every practitioner is to evaluate different tests to perceive the status of the patient, such as markers of inflammation, insulin regulation, and nutrient status, and to detect possible imbalances or deficiencies. During the process of disease development, the supplementation and addition of different nutrients and nutraceuticals can influence not only the viral replication but also the cellular mechanisms. It is essential to understand that every patient has its individual needs. Even though many nutrients, nutraceuticals, and drugs have beneficial effects on the immune response and can prevent or ameliorate viral infections, it is essential to detect at what stage in COVID-19 progression the patient is at the moment and decide what kind of nutrition intervention is necessary. Furthermore, understanding the pathogenesis of coronavirus infection is critical to make proper recommendations.
    Keywords:  COVID-19; SARS—CoV-2; minerals; probiotics; vitamins
    DOI:  https://doi.org/10.3389/fvets.2020.570748
  11. Food Biosci. 2021 Jan 20. 100891
    Mehany T, Khalifa I, Barakat H, Althwab SA, Alharbi YM, El-Sohaimy S.
      Currently, antiviral drugs and/or vaccines are not yet available to treat or prevent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this review, we narrated the available data, from credible publishers, regarding the possible role of polyphenols and natural extracts-containing polyphenols in the prevention of coronavirus disease 2019 (COVID-19), and their immune-boosting properties. It was revealed that polyphenols could be considered as promising biologically active substances for the prevention of COVID-19. The underlying potential mechanism behind this action is mostly due to the antiviral activities and the immune-regulation functions of polyphenols against COVID-19-infections. Antivirus polyphenolic-based medications can mitigate SARS-CoV-2-enzymes, which are vital for virus duplication and infection. It was also found that triterpenoid, anthraquinone, flavonoids, and tannins are possible keys to scheming antiviral therapies for inhibiting SARS-CoV-2-proteases. The identified pharmacophore structures of polyphenols could be utilized in the explanation of novel anti-COVID-19 designs. The advantage of using mixtures containing polyphenols is related to the high-safety profile without having major side-effects, but further randomized controlled trials are required in the upcoming studies.
    Keywords:  Boosting immune functions; COVID-19, Coronavirus disease 2019; CoVs, Coronaviruses; Functional foods; MERS-CoV, Middle East Respiratory Syndrome; Polyphenols; SARS-CoV, Severe observation of acute respiratory syndrome; SARS-CoV-2, Severe acute respiratory syndrome coronavirus 2; SARS-CoV2
    DOI:  https://doi.org/10.1016/j.fbio.2021.100891
  12. Phytomedicine. 2020 Oct 03. pii: S0944-7113(20)30192-6. [Epub ahead of print] 153361
    Khanna K, Kohli SK, Kaur R, Bhardwaj A, Bhardwaj V, Ohri P, Sharma A, Ahmad A, Bhardwaj R, Ahmad P.
      Current scenario depicts that world has been clenched by COVID-19 pandemic. Inevitably, public health and safety measures could be undertaken in order to dwindle the infection threat and mortality. Moreover, to overcome the global menace and drawing out world from moribund stage, there is an exigency for social distancing and quarantines. Since December, 2019, coronavirus, SARS-CoV-2 (COVID-19) have came into existence and up till now world is still in the state of shock.At this point of time, COVID-19 has entered perilous phase, creating havoc among individuals, and this has been directly implied due to enhanced globalisation and ability of the virus to acclimatize at all conditions. The unabated transmission is due to lack of drugs, vaccines and therapeutics against this viral outbreak. But research is still underway to formulate the vaccines or drugs by this means, as scientific communities are continuously working to unravel the pharmacologically active compounds that might offer a new insight for curbing infections and pandemics. Therefore, the topical COVID-19 situation highlights an immediate need for effective therapeutics against SARS-CoV-2. Towards this effort, the present review discusses the vital concepts related to COVID-19, in terms of its origin, transmission, clinical aspects and diagnosis. However, here, we have formulated the novel concept hitherto, ancient means of traditional medicines or herbal plants to beat this pandemic.
    Keywords:  Herbal plants; Immune-System Rebooting; Natural therapeutics; PAK-1 Blockers; SARS-CoV-2; Traditional medicine
    DOI:  https://doi.org/10.1016/j.phymed.2020.153361
  13. World J Gastroenterol. 2021 Jan 07. 27(1): 37-54
    Koriem KMM.
      The term lipidome is mentioned to the total amount of the lipids inside the biological cells. The lipid enters the human gastrointestinal tract through external source and internal source. The absorption pathway of lipids in the gastrointestinal tract has many ways; the 1st way, the lipid molecules are digested in the lumen before go through the enterocytes, digested products are re-esterified into complex lipid molecules. The 2nd way, the intracellular lipids are accumulated into lipoproteins (chylomicrons) which transport lipids throughout the whole body. The lipids are re-synthesis again inside the human body where the gastrointestinal lipids are: (1) Transferred into the endoplasmic reticulum; (2) Collected as lipoproteins such as chylomicrons; or (3) Stored as lipid droplets in the cytosol. The lipids play an important role in many stages of the viral replication cycle. The specific lipid change occurs during viral infection in advanced viral replication cycle. There are 47 lipids within 11 lipid classes were significantly disturbed after viral infection. The virus connects with blood-borne lipoproteins and apolipoprotein E to change viral infectivity. The viral interest is cholesterol- and lipid raft-dependent molecules. In conclusion, lipidome is important in gastrointestinal fat absorption and coronavirus disease 2019 (COVID-19) infection so lipidome is basic in gut metabolism and in COVID-19 infection success.
    Keywords:  COVID-19; Fat metabolism; Future therapy; Gastrointestinal tract; Lipidome; Viral infection
    DOI:  https://doi.org/10.3748/wjg.v27.i1.37
  14. Phytother Res. 2021 Jan 29.
    Singh NA, Kumar P, Jyoti , Kumar N.
      A severe acute respiratory syndrome is an unusual type of contagious pneumonia that is caused by SARS coronavirus. At present, the whole world is trying to combat this coronavirus disease and scientific communities are putting rigorous efforts to develop vaccines. However, there are only a few specific medical treatments for SARS-CoV-2. Apart from other public health measures taken to prevent this virus, we can boost our immunity with natural products. In this article, we have highlighted the potential of common spices and herbs as antiviral agents and immunity boosters. A questionnaire-based online survey has been conducted on home remedies during COVID-19 among a wide range of peoples (n-531) of different age groups (13-68 years) from various countries. According to the survey, 71.8% of people are taking kadha for combating infection and boosting immunity. Most people (86.1%) think that there is no side effect of kadha while 13.9% think vice versa. A total of 93.6% of people think that spices are helpful in curing coronavirus or other viral infection as well as boosting immunity. Most people are using tulsi drops, vitamin C, and chyawanprash for boosting their immunity. Therefore, we conclude from the survey and available literature that spices and herbs play a significant role against viral infections.
    Keywords:  SARS-CoV-2; antiviral; bioactive compounds; coronavirus; herbs; immunity boosters; spices
    DOI:  https://doi.org/10.1002/ptr.7019
  15. Front Nutr. 2020 ;7 613928
    Ceccarelli G, Borrazzo C, Pinacchio C, Santinelli L, Innocenti GP, Cavallari EN, Celani L, Marazzato M, Alessandri F, Ruberto F, Pugliese F, Venditti M, Mastroianni CM, d'Ettorre G.
      Background: Mounting evidence suggests SARS-CoV-2 may impact on host microbiota and gut inflammation, infecting intestinal epithelial cells. This possible link and its implications can be investigated by observing the effects of modulation of the microbial flora in patients with COVID-19. The aim of this study was to compare the rate of mortality, the need of ICU hospitalization and the length of hospitalization in patients with severe COVID-19 pneumonia who received the best available therapy (BAT) vs. patients treated with BAT and supplemented with oral bacteriotherapy. Methods: This retrospective, observational cohort study included 200 adults with severe COVID-19 pneumonia. All patients received therapeutic regimens including low molecular weight heparin plus one or more between hydroxychloroquine, azithromycin, antivirals, and Tocilizumab. Oral bacteriotherapy was used as complementary treatment. Results: Out of the 200 patients, 112 received BAT without oral bacteriotherapy, and 88 BAT with oral bacteriotherapy. Crude mortality was 22%. Eleven percent died in the group of patients treated with BAT plus oral bacteriotherapy vs. 30% subjects in the group of patients managed only with BAT (p < 0.001). By multivariate analysis, the age >65 years, CRP >41.8 mg/L, Platelets <150.000 mmc, and cardiovascular events were associated with the increased risk of mortality. Oral bacteriotherapy was an independent variable associated with a reduced risk for death. Despite large prospective trials are needed, this study highlights a possible role for oral bacteriotherapy in the management of patients hospitalized for COVID-19 pneumonia.
    Keywords:  COVID-19; gut; microbiota; oral bacteriotherapy; pneumonia
    DOI:  https://doi.org/10.3389/fnut.2020.613928
  16. Diabetes Metab Syndr. 2021 Jan 13. pii: S1871-4021(20)30535-X. [Epub ahead of print]15(1): 295-301
    Santacroce L, Inchingolo F, Topi S, Del Prete R, Di Cosola M, Charitos IA, Montagnani M.
      BACKGROUND AND AIMS: Probiotics can support the body's systems in fighting viral infections. This review is aimed to focus current knowledge about the use of probiotics as adjuvant therapy for COVID-19 patients.METHODS: We performed an extensive research using the PubMed-LitCovid, Cochrane Library, Embase databases, and conducting manual searches on Google Scholar, Elsevier Connect, Web of Science about this issue.
    RESULTS: We have found several papers reporting data about the potential role of probiotics as well as contrasting experimental data about it.
    CONCLUSIONS: Most data show good results demonstrating that probiotics can play a significant role in fighting SARS-CoV-2 infection, also compared with their use in the past for various diseases. They seem effective in lowering inflammatory status, moreover in patients with chronic comorbidities such as cancer and diabetes, improving clinical outcomes.
    Keywords:  Dysbiosis; Human microbiota; Pharmacological effects; Probiotics; SARS-Cov-2
    DOI:  https://doi.org/10.1016/j.dsx.2020.12.040
  17. Biomed Pharmacother. 2021 Jan 14. pii: S0753-3322(21)00052-4. [Epub ahead of print]137 111267
    An X, Zhang Y, Duan L, Jin , Zhao S, Zhou R, Duan Y, Lian F, Tong X.
      Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the third coronavirus causing serious human disease to spread across the world in the past 20 years, after SARS and Middle East respiratory syndrome. As of mid-September 2020, more than 200 countries and territories have reported 30 million cases of coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2, including 950,000 deaths. Supportive treatment remains the mainstay of therapy for COVID-19. The World Health Organization reported that four candidate drugs, including remdesivir, are ineffective or have little effect on COVID-19. According to China News, 90 % of Chinese patients with COVID-19 use traditional Chinese medicine (TCM), with an effectiveness rate of 80 %, and no deterioration in patient condition. We have compiled the direct evidence of TCM treatment for COVID-19 as of December 31, 2020. We describe the advantages of TCM in the treatment of COVID-19 based on clinical evidence and the required methods for its clinical use. TCM can inhibit virus replication and transcription, prevent the combination of SARS-CoV-2 and the host, and attenuate the cytokine storm and immune deficiency caused by the virus infection. The cooperation of many countries is required to establish international guidelines regarding the use of TCM in patients with severe COVID-19 from other regions and of different ethnicities. Studies on the psychological abnormalities in patients with COVID-19, and medical staff, is lacking; it is necessary to provide a complete chain of evidence to determine the efficacy of TCM in the related prevention, treatment, and recovery. This study aims to provide a reference for the rational use of TCM in the treatment of COVID-19.
    Keywords:  COVID-19; Direct evidence; Efficacy advantage; Mechanism; SARS-CoV-2; Traditional Chinese medicine
    DOI:  https://doi.org/10.1016/j.biopha.2021.111267
  18. Panminerva Med. 2021 Jan 25.
    Barassi A, Pezzilli R, Mondoni M, Rinaldo RF, DavÌ M, Cozzolino M, Melzi D'Eril GV, Centanni S.
      BACKGROUND: Vitamin D (VitD) deficiency has been reported to be associated with respiratory tract infection. In this work we evaluated the concentration of VitD in COVID-19 patients experiencing acute respiratory infections of different levels of severity excluding those who underwent invasive respiratory support.METHODS: The levels of serum VitD and C-reactive protein (CRP) were analyzed in 118 consecutive hospitalized COVID-19 patients (74M, 44F), confirmed with rRT-PCR. Of these patients with ventilation support 52 (44.1%) received oxygen via nasal cannula, oxygen mask or an oxygen mask with a reservoir, 48 (40.7%) were on a continuous positive airway pressure device (CPAP) and 18 (15,3%) on non-invasive mechanical ventilation (NIMV).
    RESULTS: The median values (range) of VitD and of CRP were 15.1 ng/mL (1.3-73.3) and 14.2 mg/L (5.0-151.2), respectively. A negative correlation from VitD levels and those of CRP (correlation coefficient - 0.259: P=0.005) was observed. VitD levels in O2 support patients were significantly higher than in both CPAP and NIMV patients. No statistical differences were found for CRP levels (P=0.834) among the three type of oxygen support. Fewer patients with O2 support had VitD <30 ng/mL and <20 ng/mL than CPAP and NIMV patients. There were no relationships between VitD and the three classes of IgM (P=0.419) and of IgG (P=0.862) SARS-CoV-2 antibodies values. The behavior was the same for CRP.
    CONCLUSIONS: Our study shows that a significant proportion of COVID-19 patients have a VitD deficiency and that this condition is more frequent in CPAP and in NIMV patients.
    DOI:  https://doi.org/10.23736/S0031-0808.21.04277-4