Association between dietary antioxidant quality score and severity of coronavirus infection: a case-control study

Mobina Aghajani; Alexei Wong; Mehdi Azimi; Shadmehr Mirdar Harijani

doi:10.3389/fnut.2023.1174113

Association between dietary antioxidant quality score and severity of coronavirus infection: a case-control study

Front Nutr. 2023 Jul 6:10:1174113. doi: 10.3389/fnut.2023.1174113. eCollection 2023.

Authors

Mobina Aghajani¹, Alexei Wong², Mehdi Azimi³, Shadmehr Mirdar Harijani^{1

4}

Affiliations

¹ Department of Exercise Physiology, Faculty of Sport Sciences, University of Mazandaran, Babolsar, Iran.
² Department of Health and Human Performance, Marymount University, Arlington, TX, United States.
³ Department of Internal Medicine, School of Medicine, Firoozgar General Hospital, Iran University of Medical Sciences, Tehran, Iran.
⁴ Athletic Performance and Health Research Center, University of Mazandaran, Babolsar, Iran.

Abstract

The purpose of this study was to examine the association between the dietary antioxidant quality score (DAQS) and the severity of Coronavirus disease 2019 (COVID-19). The present case-control study was carried out on 295 patients diagnosed with COVID-19 (≥18 years old), including 104 critical patients (Intensive care unit [ICU] admission) and 191 COVID-19 patients without severe complications (Non-intensive care unit [Non-ICU] patients) as cases. Dietary intake was assessed by a 147-item, semi-quantitative food frequency questionnaire (FFQ). Logistic regression was performed to calculate the odds ratio (OR) and 95% confidence interval (CI) for the considered risk factors. Our outcomes (after multivariate adjustment) suggested that higher adherence to DAQS was significantly associated with a decreased risk of COVID-19 infection severity (OR = 0.12; 95% CI: 0.04-0.29, p < 0.001). Similar results were seen when analyzed by sex [men (OR = 0.02; 95% CI: 0.002-0.15, p < 0.001) and women (OR = 0.21; 95% CI: 0.06-0.68, p = 0.012)]. A significant association between vitamin D3 intake and decreased risk of COVID-19 severity (OR = 0.91; 95% CI: 0.89-0.94, p < 0.001) was also observed. Moreover, multivariate results revealed that there were no significant associations between vitamin C (OR = 1.00; 95% CI: 0.99-1.00, p = 0.067), vitamin E (OR = 0.98; 95% CI: 0.86-1.11, p = 0.798), zinc (OR = 1.02; 95% CI: 0.86-1.20, p = 0.805), and selenium (OR = 0.99; 95% CI: 0.99-1.00, p = 0.077) intakes with the risk of COVID-19 severity. However, subgroup analyses by sex suggested a significant association between vitamin C intake and the risk of COVID-19 infection severity in women (OR = 1.00; 95% CI: 1.00-1.00, p = 0.028). Our findings showed a negative association between DAQS adherence and the risk of COVID-19 infection severity. Our results may be used to develop potential dietary therapies to decrease COVID-19 severity.

Keywords: COVID-19; DAQS; ICU; antioxidant; diet.