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Jose J, Ndang K, Chethana MB, Chinmayi CS, Afrana K, Gopan G, Parambi DGT, Munjal K, Chopra H, Dhyani A, Kamal MA. Opportunities and Regulatory Challenges of Functional Foods and
Nutraceuticals During COVID-19 Pandemic. CURRENT NUTRITION & FOOD SCIENCE 2024; 20:1252-1271. [DOI: 10.2174/0115734013276165231129102513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 01/04/2025]
Abstract
:
The novel Coronavirus has brought global mortality, disruption, and a significant loss
of life. A compromised immune system is a known risk factor for all viral influenza infections.
Due to the perceived “immune-boosting” properties of nutraceutical products, sales of dietary supplements have grown globally. In recent years, consumers have increasingly demanded nutraceutical products rather than curative synthetic medicines for preventive therapies for the coronavirus
disease outbreak of 2019 (COVID-19). Healthy foods and nutraceuticals have become daily diet
plans for consumers. Although there has been an increase in demand, there is no such regulation
and harmonized process, which stands as a barrier to the approval of these products. Therefore,
many misbranded and spurious products are entering the market, which may harm consumers.
This article focuses on the role of functional foods and nutraceutical in the management of
COVID-19 also focuses on the different nutraceutical regulations in each country and compare the
similarities and differences of the following countries: India, the USA (United States of America),
the EU (European Union), and China. The comparative study of nutraceutical regulations in India,
the USA, Europe, and China shows that there is a difference regarding the nutraceutical regulations; however, despite the differences, it is observed that it has the same underlying objective,
i.e., ensuring the safety of the consumers by maintaining the product quality.
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Affiliation(s)
- Jobin Jose
- Department of Pharmaceutics and Pharmaceutical Regulatory Affairs, NITTE Deemed-to-be University, NGSM Institute of Pharmaceutical Sciences, Mangalore 575018, India
| | - Keyidaule Ndang
- Department of Pharmaceutics and Pharmaceutical Regulatory Affairs, NITTE Deemed-to-be University, NGSM Institute of Pharmaceutical Sciences, Mangalore 575018, India
| | - Madhusoodhana Ballakkuraya Chethana
- Department of Pharmaceutics and Pharmaceutical Regulatory Affairs, NITTE Deemed-to-be University, NGSM Institute of Pharmaceutical Sciences, Mangalore 575018, India
| | - Chikmagalur Srinath Chinmayi
- Department of Pharmaceutics and Pharmaceutical Regulatory Affairs, NITTE Deemed-to-be University, NGSM Institute of Pharmaceutical Sciences, Mangalore 575018, India
| | - Khatheeja Afrana
- Department of Pharmaceutics and Pharmaceutical Regulatory Affairs, NITTE Deemed-to-be University, NGSM Institute of Pharmaceutical Sciences, Mangalore 575018, India
| | - Gopika Gopan
- Department of Pharmaceutics and Pharmaceutical Regulatory Affairs, NITTE Deemed-to-be University, NGSM Institute of Pharmaceutical Sciences, Mangalore 575018, India
| | - Della Grace Thomas Parambi
- Department of Pharmaceutical Chemistry, College of
Pharmacy, Jouf University, Sakaka, Al Jouf 72341, Saudi Arabia
| | - Kavita Munjal
- Department of Pharmacy, Amity Institute of Pharmacy, Amity University, Noida, Uttar Pradesh, India
| | - Hitesh Chopra
- Department of Biosciences, Saveetha School of Engineering,
Saveetha Institute of Medical and Technical Sciences, Chennai, 602105, Tamil Nadu, India
| | - Archana Dhyani
- School of Pharmacy,
Graphic Era Hill University, Dehradun, India
| | - Mohammad Amjad Kamal
- Institutes for Systems Genetics, Frontiers Science Center for Disease-
related Molecular Network, West China Hospital, Sichuan University, Sichuan, China
- King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Pharmacy, Faculty of Allied Health
Sciences, Daffodil International University, Dhaka, Bangladesh
- Enzymoics, 7 Peterlee place, Hebersham, NSW
2770; Novel Global Community Educational Foundation, Australia
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Park DJ, Baik SM, Lee H, Park H, Lee JM. Impact of nutrition-related laboratory tests on mortality of patients who are critically ill using artificial intelligence: A focus on trace elements, vitamins, and cholesterol. Nutr Clin Pract 2024. [PMID: 39450866 DOI: 10.1002/ncp.11238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2024] [Revised: 09/12/2024] [Accepted: 09/30/2024] [Indexed: 10/26/2024] Open
Abstract
BACKGROUND This study aimed to understand the collective impact of trace elements, vitamins, cholesterol, and prealbumin on patient outcomes in the intensive care unit (ICU) using an advanced artificial intelligence (AI) model for mortality prediction. METHODS Data from ICU patients (December 2016 to December 2021), including serum levels of trace elements, vitamins, cholesterol, and prealbumin, were retrospectively analyzed using AI models. Models employed included category boosting (CatBoost), extreme gradient boosting (XGBoost), light gradient boosting machine (LGBM), and multilayer perceptron (MLP). Performance was evaluated using area under the receiver operating characteristic curve (AUROC), accuracy, precision, recall, and F1-score. The performance was evaluated using 10-fold crossvalidation. The SHapley Additive exPlanations (SHAP) method provided interpretability. RESULTS CatBoost emerged as the top-performing individual AI model with an AUROC of 0.756, closely followed by LGBM, MLP, and XGBoost. Furthermore, the ensemble model combining these four models achieved the highest AUROC of 0.776 and more balanced metrics, outperforming all models. SHAP analysis indicated significant influences of prealbumin, Acute Physiology and Chronic Health Evaluation II score, and age on predictions. Notably, the ratios of selenium to age and low-density lipoprotein to total cholesterol also had a notable impact on the models' output. CONCLUSION The study underscores the critical role of nutrition-related parameters in ICU patient outcomes. Advanced AI models, particularly in an ensemble approach, demonstrated improved predictive accuracy. SHAP analysis offered insights into specific factors influencing patient survival, highlighting the need for broader consideration of these biomarkers in critical care management.
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Affiliation(s)
- Dong Jin Park
- Department of Laboratory Medicine, College of Medicine, Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea
| | - Seung Min Baik
- Department of Surgery, Division of Critical Care Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University College of Medicine, Seoul, Korea
- Department of Surgery, Korea University College of Medicine, Seoul, Korea
| | - Hanyoung Lee
- Department of Surgery, Division of Acute Care Surgery, Korea University Anam Hospital, Seoul, Korea
| | - Hoonsung Park
- Department of Surgery, Division of Acute Care Surgery, Korea University Anam Hospital, Seoul, Korea
| | - Jae-Myeong Lee
- Department of Surgery, Division of Acute Care Surgery, Korea University Anam Hospital, Seoul, Korea
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Halim Z, Huang Y, Lee ZY, Lew CCH. New randomized controlled trials on micronutrients in critical care nutrition: A narrative review. Nutr Clin Pract 2024; 39:1119-1149. [PMID: 39119820 DOI: 10.1002/ncp.11195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 05/14/2024] [Accepted: 07/02/2024] [Indexed: 08/10/2024] Open
Abstract
There has been increasing interest in the role of micronutrient supplementation in critical care. This narrative review summarizes the recent studies on micronutrients in critically ill patients. We searched two databases for primary randomized controlled trials that investigated the effects of micronutrient supplementation in patients with critical illness published from January 2021 to August 2023. Personal files, reference lists of included studies, and previous reviews were also screened. Twelve studies reported on vitamin C, four studies on vitamin D, three studies on thiamin, two studies on multivitamins, and one study on cobalamin. The therapeutic effects of vitamin C appear mixed, although vitamin C monotherapy appears more promising than vitamin C combination therapy. Intramuscular administration of vitamin D appeared to lower mortality, mechanical ventilation duration, and intensive care unit stay, whereas enteral administration showed limited clinical benefits. Intravenous thiamin was not associated with improved outcomes in patients with septic shock or hypophosphatemia. Preliminary evidence suggests reduced vasopressor dose with cobalamin. Decreased disease severity and hospital stay in patients with COVID-19 with vitamins A-E requires further investigation, whereas providing solely B-group vitamins did not demonstrate therapeutic effects. It is currently premature to endorse the provision of high-dose micronutrients in critical illness to improve clinical outcomes. This review may help to inform the design of future trials that will help better elucidate the optimal dosage and form of micronutrients, methods of administration, and subgroups of patients with critical illness who may most benefit.
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Affiliation(s)
- Zakiah Halim
- Department of Dietetics, Changi General Hospital, Singapore, Singapore
| | - Yingxiao Huang
- Department of Dietetics, Changi General Hospital, Singapore, Singapore
| | - Zheng-Yii Lee
- Department of Anaesthesiology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Department of Cardiac Anesthesiology & Intensive Care Medicine, Charité Berlin, Germany
| | - Charles Chin Han Lew
- Department of Dietetics & Nutrition, Ng Teng Fong General Hospital, Singapore, Singapore
- Faculty of Health and Social Sciences, Singapore Institute of Technology, Singapore, Singapore
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Sinopoli A, Sciurti A, Isonne C, Santoro MM, Baccolini V. The Efficacy of Multivitamin, Vitamin A, Vitamin B, Vitamin C, and Vitamin D Supplements in the Prevention and Management of COVID-19 and Long-COVID: An Updated Systematic Review and Meta-Analysis of Randomized Clinical Trials. Nutrients 2024; 16:1345. [PMID: 38732592 PMCID: PMC11085542 DOI: 10.3390/nu16091345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 04/26/2024] [Accepted: 04/26/2024] [Indexed: 05/13/2024] Open
Abstract
This review aims to evaluate the efficacy of any vitamin administration(s) in preventing and managing COVID-19 and/or long-COVID. Databases were searched up to May 2023 to identify randomized clinical trials comparing data on the effects of vitamin supplementation(s) versus placebo or standard of care on the two conditions of interest. Inverse-variance random-effects meta-analyses were conducted to estimate pooled risk ratios (RRs) and 95% confidence intervals (CIs) for all-cause mortality between supplemented and non-supplemented individuals. Overall, 37 articles were included: two regarded COVID-19 and long-COVID prevention and 35 records the COVID-19 management. The effects of vitamin D in preventing COVID-19 and long-COVID were contrasting. Similarly, no conclusion could be drawn on the efficacy of multivitamins, vitamin A, and vitamin B in COVID-19 management. A few positive findings were reported in some vitamin C trials but results were inconsistent in most outcomes, excluding all-cause mortality (RR = 0.84; 95% CI: 0.72-0.97). Vitamin D results were mixed in most aspects, including mortality, in which benefits were observed in regular administrations only (RR = 0.67; 95% CI: 0.49-0.91). Despite some benefits, results were mostly contradictory. Variety in recruitment and treatment protocols might explain this heterogeneity. Better-designed studies are needed to clarify these vitamins' potential effects against SARS-CoV-2.
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Affiliation(s)
| | - Antonio Sciurti
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Claudia Isonne
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Maria Mercedes Santoro
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy
| | - Valentina Baccolini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
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Zifko U, Guendling K, Seet R, Kasper S. Management of cognitive impairment associated with post-COVID-19 syndrome: recommendations for primary care. Front Pharmacol 2024; 15:1338235. [PMID: 38711990 PMCID: PMC11072190 DOI: 10.3389/fphar.2024.1338235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 03/22/2024] [Indexed: 05/08/2024] Open
Abstract
Introduction: Although post-COVID-19 syndrome (PCS) with cognitive impairment is increasingly encountered in primary care, evidence-based recommendations for its appropriate management are lacking. Methods: A systematic literature search evaluating the diagnosis and treatment of cognitive impairment associated with PCS was conducted. Practical recommendations for the management of PCS-associated cognitive impairment in primary care are summarized, based on an evaluation of pharmacological plausibility and clinical applications. Results: Currently, the pathology of cognitive impairment associated with PCS remains unclear with no high-quality data to support targeted interventions. Existing treatment approaches are directed towards symptom relief where counseling on the chronicity of the disease and regular reassessments at 4- to 8-week intervals is considered reasonable. Patients should be informed and encouraged to adopt a healthy lifestyle that centers around balanced nutrition and appropriate physical activities. They may also benefit from the intake of vitamins, micronutrients, and probiotics. The administration of Ginkgo biloba extract could offer a safe and potentially beneficial treatment option. Other non-pharmacological measures include physiotherapy, digitally supported cognitive training, and, if indicated, ergotherapy or speech therapy. In most patients, symptoms improve within 8 weeks. If serious, ambiguous, or when new symptoms occur, specialized diagnostic measures such as comprehensive neurocognitive testing or neuroimaging should be initiated. Very few patients would require inpatient rehabilitation. Conclusion: PCS with cognitive impairment is a debilitating condition that could affect daily functioning and reduce work productivity. Management in primary care should adopt a multidisciplinary approach, centering around physical, cognitive, and pharmacological therapies.
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Affiliation(s)
- Udo Zifko
- Rudolfinerhaus private clinic GmbH, Rudolfinerhaus, Vienna, Austria
| | | | - Raymond Seet
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Siegfried Kasper
- Center for Brain Research, Department of Molecular Neuroscience, Medical University of Vienna, Vienna, Austria
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Akasov RA, Chepikova OE, Pallaeva TN, Gorokhovets NV, Siniavin AE, Gushchin VA, Savvateeva LV, Vinokurov IA, Khochenkov DA, Zamyatnin AA, Khaydukov EV. Evaluation of molecular mechanisms of riboflavin anti-COVID-19 action reveals anti-inflammatory efficacy rather than antiviral activity. Biochim Biophys Acta Gen Subj 2024; 1868:130582. [PMID: 38340879 DOI: 10.1016/j.bbagen.2024.130582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 01/03/2024] [Accepted: 02/06/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Riboflavin (vitamin B2) is one of the most important water-soluble vitamins and a coenzyme involved in many biochemical processes. It has previously been shown that adjuvant therapy with flavin mononucleotide (a water-soluble form of riboflavin) correlates with normalization of clinically relevant immune markers in patients with COVID-19, but the mechanism of this effect remains unclear. Here, the antiviral and anti-inflammatory effects of riboflavin were investigated to elucidate the molecular mechanisms underlying the riboflavin-induced effects. METHODS Riboflavin was evaluated for recombinant SARS-CoV-2 PLpro inhibition in an enzyme kinetic assay and for direct inhibition of SARS-CoV-2 replication in Vero E6 cells, as well as for anti-inflammatory activity in polysaccharide-induced inflammation models, including endothelial cells in vitro and acute lung inflammation in vivo. RESULTS For the first time, the ability of riboflavin at high concentrations (above 50 μM) to inhibit SARS-CoV-2 PLpro protease in vitro was demonstrated; however, no inhibition of viral replication in Vero E6 cells in vitro was found. At the same time, riboflavin exerted a pronounced anti-inflammatory effect in the polysaccharide-induced inflammation model, both in vitro, preventing polysaccharide-induced cell death, and in vivo, reducing inflammatory markers (IL-1β, IL-6, and TNF-α) and normalizing lung histology. CONCLUSIONS It is concluded that riboflavin reveals anti-inflammatory rather than antiviral activity for SARS-CoV-2 infection. GENERAL SIGNIFICANCE Riboflavin could be suggested as a promising compound for the therapy of inflammatory diseases of broad origin.
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Affiliation(s)
- Roman A Akasov
- Federal Scientific Research Center "Crystallography and Photonics" of the Russian Academy of Sciences, Moscow 119333, Russia; Institute of Molecular Theranostics, Sechenov First Moscow State Medical University, Moscow 119991, Russia; Moscow State Pedagogical University, Moscow 119435, Russia.
| | - Olga E Chepikova
- Institute of Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University, Moscow 119991, Russia; Research Center for Translational Medicine, Sirius University of Science and Technology, Sochi 354340, Russia
| | - Tatiana N Pallaeva
- Federal Scientific Research Center "Crystallography and Photonics" of the Russian Academy of Sciences, Moscow 119333, Russia; Research Center for Translational Medicine, Sirius University of Science and Technology, Sochi 354340, Russia
| | - Neonila V Gorokhovets
- Institute of Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University, Moscow 119991, Russia
| | - Andrei E Siniavin
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow 123098, Russia; Department of Molecular Neuroimmune Signalling, Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow 117997, Russia
| | - Vladimir A Gushchin
- Federal State Budget Institution "National Research Centre for Epidemiology and Microbiology Named after Honorary Academician N F Gamaleya" of the Ministry of Health of the Russian Federation, Moscow 123098, Russia; Department of Virology, Biological Faculty, Lomonosov Moscow State University, Moscow 119991, Russia
| | - Lyudmila V Savvateeva
- Institute of Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University, Moscow 119991, Russia
| | - Ivan A Vinokurov
- Petrovsky National Research Center of Surgery, Moscow 119991, Russia
| | - Dmitry A Khochenkov
- N.N. Blokhin National Medical Research Center of Oncology, Moscow 115478, Russia; Togliatti State University, Togliatti 445020, Russia
| | - Andrey A Zamyatnin
- Research Center for Translational Medicine, Sirius University of Science and Technology, Sochi 354340, Russia; Faculty of Bioengineering and Bioinformatics, Lomonosov Moscow State University, Moscow 119234, Russia; Belozersky Institute of Physico-Chemical Biology, Lomonosov Moscow State University, Moscow 119992, Russia
| | - Evgeny V Khaydukov
- Federal Scientific Research Center "Crystallography and Photonics" of the Russian Academy of Sciences, Moscow 119333, Russia; Moscow State Pedagogical University, Moscow 119435, Russia
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He KY, Lei XY, Zhang L, Wu DH, Li JQ, Lu LY, Laila UE, Cui CY, Xu ZX, Jian YP. Development and management of gastrointestinal symptoms in long-term COVID-19. Front Microbiol 2023; 14:1278479. [PMID: 38156008 PMCID: PMC10752947 DOI: 10.3389/fmicb.2023.1278479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/20/2023] [Indexed: 12/30/2023] Open
Abstract
Background Emerging evidence reveals that SARS-CoV-2 possesses the capability to disrupt the gastrointestinal (GI) homeostasis, resulting in the long-term symptoms such as loss of appetite, diarrhea, gastroesophageal reflux, and nausea. In the current review, we summarized recent reports regarding the long-term effects of COVID-19 (long COVID) on the gastrointestine. Objective To provide a narrative review of abundant clinical evidence regarding the development and management of long-term GI symptoms in COVID-19 patients. Results Long-term persistent digestive symptoms are exhibited in a majority of long-COVID patients. SARS-CoV-2 infection of intestinal epithelial cells, cytokine storm, gut dysbiosis, therapeutic drugs, psychological factors and exacerbation of primary underlying diseases lead to long-term GI symptoms in COVID-19 patients. Interventions like probiotics, prebiotics, fecal microbiota transplantation, and antibiotics are proved to be beneficial in preserving intestinal microecological homeostasis and alleviating GI symptoms. Conclusion Timely diagnosis and treatment of GI symptoms in long-COVID patients hold great significance as they may contribute to the mitigation of severe conditions and ultimately lead to the improvement of outcomes of the patients.
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Affiliation(s)
- Kai-Yue He
- School of Life Sciences, Henan University, Kaifeng, China
| | - Xin-Yuan Lei
- School of Life Sciences, Henan University, Kaifeng, China
| | - Lei Zhang
- School of Life Sciences, Henan University, Kaifeng, China
| | - Dan-Hui Wu
- School of Life Sciences, Henan University, Kaifeng, China
| | - Jun-Qi Li
- School of Life Sciences, Henan University, Kaifeng, China
| | - Li-Yuan Lu
- School of Life Sciences, Henan University, Kaifeng, China
| | - Umm E. Laila
- School of Life Sciences, Henan University, Kaifeng, China
| | - Cui-Yun Cui
- Department of Blood Transfusion, Henan Provincial People’s Hospital, Zhengzhou, Henan, China
| | - Zhi-Xiang Xu
- School of Life Sciences, Henan University, Kaifeng, China
| | - Yong-Ping Jian
- School of Life Sciences, Henan University, Kaifeng, China
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Barania Adabi S, Daneghian S, Khalkhali H, Nejadrahim R, Shivappa N. The association between inflammatory and immune system biomarkers and the dietary inflammatory index in patients with COVID-19. Front Nutr 2023; 10:1075061. [PMID: 37063325 PMCID: PMC10103612 DOI: 10.3389/fnut.2023.1075061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/07/2023] [Indexed: 04/03/2023] Open
Abstract
BackgroundInflammation and cytokine storm have been reported to be the main cause of acute symptoms of coronavirus disease (COVID-19). Diet-induced inflammation may affect the condition of patients with COVID-19. Therefore, this study aimed to investigate the relationship between disease severity, inflammatory and immune system biomarkers, and the dietary inflammatory index (DII) in patients with COVID-19.MethodsThis cross-sectional study was conducted on 500 adult patients with COVID-19. Patients were divided into mild, moderate, and severe conditions based on clinical and laboratory evidence. A validated food frequency questionnaire (FFQ) was used to determine DII and energy-adjusted DII (E-DII) scores. The serum C-reactive protein (CRP) level and blood cell count were measured for all patients. Multiple linear regression was used to explore the association between DII and E-DII and CRP, blood cell counts, and hospitalization in patients with COVID-19.ResultsCoronavirus disease (COVID-19) patients with higher DII had higher consumption of fat and carbohydrate and lower intakes of protein, anti-inflammatory nutrients, garlic, caffeine, tea, onion, and fiber (P < 0.05). There was a positive association between DII and CRP (β = 1.024, P < 0.001), hospitalization (β = 1.062, P < 0.001), WBC count (β = 0.486, P < 0.009), neutrophil count (β = 0.565, P < 0.001), and neutrophil-to-lymphocyte ratio (β = 0.538, P < 0.001) and a negative association between DII and the lymphocyte count (β = −0.569, P < 0.001). There was a positive association between E-DII and hospitalization (β = 1.645, P < 0.001), WBC count (β = 0.417, P < 0.02), and neutrophil-to-lymphocyte ratio (β = 0.35, P < 0.03).ConclusionThere is a positive correlation between DII and inflammation, immune hyperactivation, and length of hospital stay in patients with COVID-19. Further longitudinal studies are necessary.
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Affiliation(s)
- Somayyeh Barania Adabi
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
- Department of Nutrition, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Sevana Daneghian
- Department of Nutrition, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
- Food and Beverages Safety Research Center, Urmia University of Medical Sciences, Urmia, Iran
- *Correspondence: Sevana Daneghian
| | | | - Rahim Nejadrahim
- Department of Infectious Diseases and Dermatology, Urmia University of Medical Sciences, Urmia, Iran
| | - Nitin Shivappa
- Cancer Prevention and Control Program, Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, United States
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