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Review
. 2020 Aug 10;9(8):2589.
doi: 10.3390/jcm9082589.

Key Aspects in Nutritional Management of COVID-19 Patients

Alfredo Fernández-Quintela  1   2   3 , Iñaki Milton-Laskibar  1   2   3 , Jenifer Trepiana  1   2   3 , Saioa Gómez-Zorita  1   2   3 , Naroa Kajarabille  1   2   3 , Asier Léniz  1   3   4 , Marcela González  5 , María P Portillo  1   2   3
Affiliations
Review

Key Aspects in Nutritional Management of COVID-19 Patients

Alfredo Fernández-Quintela et al. J Clin Med. .

Abstract

This review deals with the relationship among nutrition, the immune system, and coronavirus disease 2019 (COVID-19). The influence of nutrients and bioactive molecules present in foodstuffs on immune system activity, the influence of COVID-19 on the nutritional status of the patients, and the dietary recommendations for hospitalized patients are addressed. Deficient nutritional status is probably due to anorexia, nausea, vomiting, diarrhea, hypoalbuminemia, hypermetabolism, and excessive nitrogen loss. There is limited knowledge regarding the nutritional support during hospital stay of COVID-19 patients. However, nutritional therapy appears as first-line treatment and should be implemented into standard practice. Optimal intake of all nutrients, mainly those playing crucial roles in immune system, should be assured through a diverse and well-balanced diet. Nevertheless, in order to reduce the risk and consequences of infections, the intakes for some micronutrients may exceed the recommended dietary allowances since infections and other stressors can reduce micronutrient status. In the case of critically ill patients, recently published guidelines are available for their nutritional management. Further, several natural bioactive compounds interact with the angiotensin-converting enzyme 2 (ACE2) receptor, the gateway for severe acute respiratory syndrome (SARS) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Natural bioactive compounds can also reduce the inflammatory response induced by SARS-CoV-2. These compounds are potential beneficial tools in the nutritional management of COVID-19 patients.

Keywords: COVID-19; SARS-CoV-2; bioactive compounds; malnutrition; nutrition; nutritional support.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus uses the angiotensin-converting enzyme 2 (ACE2) receptor to enter the host cell and the transmembrane protease serine 2 (TMPRSS2) for Spike (S) protein priming.
Figure 2
Figure 2
Effects of several nutrients on aspects of COVID-19 infection. ↑: increase, ↓: decrease.
Figure 3
Figure 3
Anti-inflammatory effect of bioactive compounds present in foodstuffs. PPAR: peroxisome proliferator-activated receptor, TNF: tumor necrosis factor, IL: interleukin, ↓: decrease.
Figure 4
Figure 4
Anti-inflammatory activity of celastrol. NF-κB: nuclear factor kappa B, TMPRSS2: transmembrane protease serine 2, ↓: decrease.
See this image and copyright information in PMC

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