Major dietary patterns in relation to disease severity, symptoms, and inflammatory markers in patients recovered from COVID-19

The association between dietary fat quality and quantity and hospitalization duration in COVID-19 in Iranian patients: a cross-sectional study

Background

The global impact of Coronavirus Disease 2019 (COVID-19 (has highlighted the necessity of understanding factors influencing its severity and hospitalization duration. While a balanced diet is crucial for immune support, the role of dietary fats in this context has not been well understood. This study explored associations between the quality and quantity of fatty acids and severity and the length of hospitalization in COVID-19 patients in 2022.

Method

This cross-sectional study included 107 COVID-19 patients aged 20-60 years who were hospitalized at Amir Alam Hospital in Tehran, Iran. Dietary fat intake was assessed using 24 h food recall. Data on symptoms were collected using a demographic questionnaire and verified against their hospital records. Linear and binary logistic regressions were employed for statistical analysis.

Result

A higher omega 6/omega 3(N6/N3) ratio was linked to increased odds of respiratory distress syndrome (RDS) and elevated D-dimer levels, while correlating with lower odds of fever. While RDS odds increased over Vit E/polyunsaturated fatty acid (PUFA) ratio tertiles, chills decreased. [PUFA + monounsaturated fatty acid (MUFA)]/saturated fatty acid (SFA) ratio was associated with reduced odds of chest pain, duration of hospitalization (DH) time, c-reactive protein (CRP), and D-dimer levels. Furthermore, PUFA intake was negatively associated with odds of poor appetite, RDS, and headaches, whereas SFA intake was positively associated with odds of fever. Additionally, there was a positive correlation between cholesterol-saturated index (CSI) levels and DH time (P < 0.7).

Conclusion

Our findings indicate that higher N6/N3 and VitE/PUFA ratios were associated with increased RDS and D-dimer levels, while the VitE/PUFA ratio was linked to reduced chills. Higher (PUFA + MUFA)/SFA ratios were associated with lower chest pain, DH, CRP, and D-dimer levels. While higher PUFA intake was related to reduced poor appetite, RDS, and headache, higher SFA intake was linked to increased fever. Additionally, there was a positive association between CSI levels and DH. Current findings indicate that the quality and balance of dietary fats may play a crucial role in modulating inflammatory responses and clinical outcomes.

The association between nutrient patterns and hospital stay duration and symptoms in COVID-19 in Iranian patients: cross-sectional study

Background

An excessively reactive immune system results in the cytokine storm COVID-19. A healthy diet is essential to maintain the balance between the immune system and inflammatory and oxidative stress. Associations between single foods and nutrients and COVID-19 have been examined. However, no prior study has examined associations between nutrient patterns and COVID-19. This study assessed the link between nutrient patterns and the COVID-19 severity and length of hospital stay in Iranian adults.

Methods

This cross-sectional study included 107 Iranian adults aged 20-60 years, who were admitted to Amir Alam Hospital in Tehran, Iran, due to COVID-19. Data on their symptoms were collected through a demographic questionnaire and verified against their hospital records. Three non-consecutive 24-h dietary recalls were used to collect participants' food and beverage intake. Principal component analysis (PCA) was used to derive nutrient patterns.

Result

A total of 95 Covid patients with a mean age of 46.2 years were included. Four major dietary patterns were identified using the Scree Plot chart, including high carbohydrate and high minerals pattern; high protein and high vitamins pattern; high fat pattern; and poor nutrient pattern. Adherence to the poor nutrient patterns was associated with a higher number of hospitalization days and lower appetite (p < 0.05). The poor dietary patterns were associated with an increased likelihood of headache, fever, and respiratory distress syndrome (RDS). Also, headaches were more common with adherence to the high-fat pattern (p < 0.05).

Conclusion

The findings of this study show that a poor nutrient pattern is related to longer hospital stays and reduced appetite. It also connected to an increased likelihood of symptoms including headaches, fever, and respiratory distress syndrome. A strong association was found between respiratory distress syndrome, headaches, and a high-fat diet was found. Further studies with prospective designs are needed to better understand and validate these findings.

The Association between Lifestyle Factors and COVID-19: Findings from Qatar Biobank

Coronavirus Disease 2019 (COVID-19) manifestations range from mild to severe life-threatening symptoms, including death. COVID-19 susceptibility has been associated with various factors, but studies in Qatar are limited. The objective of this study was to investigate the correlation between COVID-19 susceptibility and various sociodemographic and lifestyle factors, including age, gender, body mass index, smoking status, education level, dietary patterns, supplement usage, physical activity, a history of bariatric surgery, diabetes, and hypertension. We utilized logistic regression to analyze these associations, using the data of 10,000 adult participants, aged from 18 to 79, from Qatar Biobank. In total, 10.5% (n = 1045) of the participants had COVID-19. Compared to non-smokers, current and ex-smokers had lower odds of having COVID-19 (odds ratio [OR] = 0.55; 95% CI: 0.44-0.68 and OR = 0.70; 95% CI: 0.57-0.86, respectively). Vitamin D supplement use was associated with an 18% reduction in the likelihood of contracting COVID-19 (OR = 0.82; 95% CI: 0.69-0.97). Obesity (BMI ≥ 30 kg/m2), a history of bariatric surgery, and higher adherence to the modern dietary pattern-characterized by the consumption of foods high in saturated fat and refined carbohydrates-were positively associated with COVID-19. Our findings indicate that adopting a healthy lifestyle may be helpful in the prevention of COVID-19 infection.

Association of major dietary patterns with socioeconomic status, obesity, and contracting COVID-19 among Iranian adults

Background

The coronavirus disease 2019 (COVID-19) pandemic clearly affected the lifestyle and dietary habits of millions of people worldwide. The purpose of this study was to evaluate the association of major dietary patterns with socioeconomic status, obesity, and contracting COVID-19.

Methods

We conducted a cross-sectional study using an online survey for data collection with a total of 1,187 participants (over the age of 18 years) who reported their sociodemographic details, anthropometric index (weight and height), and dietary intake. Multivariable logistic regression models were applied to assess the association between major dietary patterns and study outcomes.

Results

A total of 1,106 adults were included in the current analysis. We identified three major dietary patterns (plant-based, meat, and Western dietary patterns). The mean age of participants was significantly higher in the upper tertile of plant-based dietary patterns (DPs) compared to the first tertile, while it was lower in the top tertile of meat and Western DPs. The percentage of participants who lived in urban areas was significantly higher in the third tertile of meat DP than in the first tertile (p < 0.001). Moderate adherence to Western DP was significantly associated with increased odds of obesity (OR: 1.79; 95% CI: 1.17, 2.74). In addition, high adherence to Western DP was significantly related to increased odds of obesity after controlling for confounders. Subjects in the second tertile of the Western DP had higher odds (95% Cl: 1.04, 1.92) for COVID-19 infection than the first tertile.

Conclusion

This study showed that moderate and high adherence to a Western dietary pattern was associated with a higher risk of obesity and COVID-19 infection during the pandemic. Future studies are needed to confirm these findings.

Development and management of gastrointestinal symptoms in long-term COVID-19

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.

The Intersection Between COVID-19, Cardiovascular Disease, and Diet: a Review

PURPOSE OF REVIEW

Cardiovascular disease (CVD) is one of the top comorbidities associated with COVID-19-both pre- and post-infection. This review examines the relationships between COVID-19 infection and cardiovascular health, with a specific focus on diet as an important modifiable risk factor.

RECENT FINDINGS

Pandemic era studies of individuals battling and recovering from COVID-19 infection suggest a strong link between metabolic diseases, such as CVD, and SARS-CoV-2 infection susceptibility and severity. Other studies also demonstrate how COVID-19 lockdown policies and quarantine recommendations led to drastic lifestyle changes associated with increased CVD risk, such as reduced physical activity and lower diet quality. At the same time, new research is emerging that plant-based diets, which have previously been associated with lower CVD risk, may lower COVID-19 infection rates and severity of symptoms. Diet, COVID-19, and CVD intersect through complex biological mechanisms and related behavioral factors evidenced by clinical trials and epidemiological studies. Diet may be a critical tool for modifying risk of communicable and non-communicable conditions in the post-pandemic world.

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

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.

The association between inflammatory and immune system biomarkers and the dietary inflammatory index in patients with COVID-19

Background

Inflammation 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.

Methods

This 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.

Results

Coronavirus 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 &lt; 0.05). There was a positive association between DII and CRP (β = 1.024, P &lt; 0.001), hospitalization (β = 1.062, P &lt; 0.001), WBC count (β = 0.486, P &lt; 0.009), neutrophil count (β = 0.565, P &lt; 0.001), and neutrophil-to-lymphocyte ratio (β = 0.538, P &lt; 0.001) and a negative association between DII and the lymphocyte count (β = −0.569, P &lt; 0.001). There was a positive association between E-DII and hospitalization (β = 1.645, P &lt; 0.001), WBC count (β = 0.417, P &lt; 0.02), and neutrophil-to-lymphocyte ratio (β = 0.35, P &lt; 0.03).

Conclusion

There 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.