The prognostic role of micronutrient status and supplements in COVID-19 outcomes: A systematic review

Evmorfia Pechlivanidou; Dimitrios Vlachakis; Konstantinos Tsarouhas; Dimitris Panidis; Christina Tsitsimpikou; Christina Darviri; Dimitrios Kouretas; Flora Bacopoulou

doi:10.1016/j.fct.2022.112901

The prognostic role of micronutrient status and supplements in COVID-19 outcomes: A systematic review

Food Chem Toxicol. 2022 Apr:162:112901. doi: 10.1016/j.fct.2022.112901. Epub 2022 Feb 25.

Authors

Evmorfia Pechlivanidou¹, Dimitrios Vlachakis², Konstantinos Tsarouhas³, Dimitris Panidis⁴, Christina Tsitsimpikou⁵, Christina Darviri⁶, Dimitrios Kouretas⁷, Flora Bacopoulou⁸

Affiliations

¹ Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, 11527, Greece.
² Laboratory of Genetics, Department of Biotechnology, School of Applied Biology and Biotechnology, Agricultural University of Athens, Athens, 11855, Greece.
³ Department of Cardiology, University Hospital of Larissa, Mezourlo, Larissa, 41110, Greece.
⁴ European Commission, Joint Research Centre (JRC), Ispra, Italy.
⁵ General Chemical State Laboratory of Greece, 16, An. Tsocha Str., Athens, 11521, Greece.
⁶ Postgraduate Program "The Science of Stress and Health Promotion", School of Medicine, National and Kapodistrian University of Athens, 4 Soranou Ephessiou Street, 11527, Athens, Greece.
⁷ Department of Biochemistry and Biotechnology, University of Thessaly, Larissa, Greece.
⁸ Center for Adolescent Medicine and UNESCO Chair in Adolescent Health Care, First Department of Pediatrics, School of Medicine, National and Kapodistrian University of Athens, Aghia Sophia Children's Hospital, Athens, 11527, Greece; Postgraduate Program "The Science of Stress and Health Promotion", School of Medicine, National and Kapodistrian University of Athens, 4 Soranou Ephessiou Street, 11527, Athens, Greece. Electronic address: fbacopoulou@med.uoa.gr.

Abstract

Micronutrients constitute an adjuvant treatment for respiratory viral infections. Since there is no effective antiviral therapy for COVID-19 yet, adjuvant intervention for the survival of critically ill patients may be significant. Search of the PubMed, CINAHL and Cochrane databases was carried out to find human studies investigating the prognostic role of micronutrient status and the effects of micronutrient supplementation intervention in COVID-19 outcomes of adult patients. Patients with certain comorbidities (diabetes mellitus type 2, obesity, renal failure, liver dysfunction etc.) or pregnant women were excluded. 31 studies (27 observational studies and 4 clinical trials) spanning the years 2020-2021, pertaining to 8624 COVID-19 patients (mean age±SD, 61 ± 9 years) were included in this systematic review. Few studies provided direct evidence on the association of serum levels of vitamin D, calcium, zinc, magnesium, phosphorus and selenium to patients' survival or death. Vitamin D and calcium were the most studied micronutrients and those with a probable promising favorable impact on patients. This review highlights the importance of a balanced nutritional status for a favorable outcome in COVID-19. Micronutrients' deficiency on admission to hospital seems to be related to a high risk for ICU admission, intubation and even death. Nevertheless, evidence for intervention remains unclear.

Keywords: COVID-19; Coronavirus; Micronutrients; Pandemic; Supplements; Vitamin.

Publication types

Review