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Meta-Analysis
. 2024 Feb 20;23(1):21.
doi: 10.1186/s12937-024-00927-3.

Association of dietary inflammatory index and the SARS-CoV-2 infection incidence, severity and mortality of COVID-19: a systematic review and dose-response meta-analysis

Xuanyu Hao #  1 , Shiwen Li #  2 , Yanmin Yang  3 , Huixu Dai  4 , Yumeng Yan  5 , Dongyang Li  6
Affiliations
Meta-Analysis

Association of dietary inflammatory index and the SARS-CoV-2 infection incidence, severity and mortality of COVID-19: a systematic review and dose-response meta-analysis

Xuanyu Hao et al. Nutr J. .

Abstract

Background: Several studies have reported the association between dietary inflammatory index (DII) and the SARS-CoV-2 infection risk, severity or mortality of COVID-19, however, the outcomes remain controversial.

Objective: We sought to examine whether a dose-response association of DII and SARS-CoV-2 infection exists.

Design: A dose-response meta-analysis was performed to investigate the association of DII and SARS-CoV-2 infection. We conducted a systematic search of PubMed, Embase and Web of Science up to March 15th, 2023. The odds ratios (OR) of DII and COVID-19 risk and severity were computed.

Results: Totally, 5 studies were included (1 from UK and 4 from Iran), consisting of 197,929 participants with 12,081 COVID-19 cases. Although there was heterogeneity among studies, the results indicated that higher DII was independently related to higher SARS-CoV-2 infection incidence (OR = 1.57, 95% CI: 1.14, 2.17) and COVID-19 severity (OR = 1.11, 95% CI: 1.07, 1.15) but not COVID-19 mortality (risk ratio = 1.13, 95% CI: 1.00, 1.27). The incidence of SARS-CoV-2 infection increased by 31% for each 1-point increase in the E-DII (OR = 1.31, 95% CI: 1.20, 1.43).

Conclusions: This meta-analysis suggests that an elevated DII score is associated with increased SARS-CoV-2 infectious risk and severity of COVID-19. There were not enough studies on COVID-19 mortality. Further large prospective studies in different countries are warranted to validate our results.

Keywords: COVID-19; Dietary inflammatory index; Incidence; Mortality; Severity.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Flow chart of literature search and study selection
Fig. 2
Fig. 2
Forest plots of pooled ORs for DII and COVID-19 incidence (A) and severity (B) OR: odds ratio
Fig. 3
Fig. 3
Forest plots of pooled ORs for DII and COVID-19 risk in Asian countries (A), case-control studies (B), DII subgroup (C), energy-adjusted DII group (D) OR: odds ratio
Fig. 4
Fig. 4
Dose-response analysis plots of energy adjusted DII (E-DII) and COVID-19 incidence. Full line: estimated odds ratio; dashed line: 95% confidence interval of odds ratio
Fig. 5
Fig. 5
Sensitivity analysis of included studies
Fig. 6
Fig. 6
Plots of Egger’s test (A) and Begg’s test (B)
See this image and copyright information in PMC

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