Potential of macronutrients and probiotics to boost immunity in patients with SARS-COV-2: a narrative review

The dynamic linkage between covid-19 and nutrition: a review from a probiotics perspective using machine learning and bibliometric analysis

Introduction

The pandemic crisis is now a memorable milestone in the history of science, not only for the impacts on the population's health but also for the effort of the medical community to find immediate solutions amid the pandemic so that appropriate therapeutic means can be provided. Diet and nutrition could not fail to be studied in the context of combating the side effects of COVID-19. This study attempts to detect the relationship between dietary patterns and the disease of COVID-19 and emphasizes research on probiotics by mapping the knowledge produced during the pandemic until 2024.

Methods

In addition to bibliometrics, a machine-learning framework, ASReview, was used to structure the literature search. With this method, 2,309 articles were collected from the PubMed database, with 599 constituting inputs into bibliometric software and further analysis.

Results

Food choices, dietary patterns, vitamins and their role (vitamin D), obesity, and probiotics were keywords that attracted global research attention. Dietary supplements also constituted a field of study regarding the evolution of the disease and the impact they could have after the first pandemic wave.

Discussion

Probiotics were considered an adjunct therapeutic intervention not only during the period before the development of vaccines but also alongside other therapeutic solutions. Whether used preventively or during the treatment phase, probiotics were studied to combat COVID-19 due to their potential role in immunomodulation and ability to regulate gut microbiota during respiratory infections.

Estimation of Anti-SARS-CoV-2 IgM/IgG Seroprevalence Among Non-Vaccinated and Vaccinated University Students: A Cross-Sectional Egyptian Study

It is essential to comprehend the humoral immune response to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and its vaccines to maximize the effectiveness of anti-SARSCoV-2 community immunization efforts. The aim of this cross-sectional study was to determine the seroprevalence of anti-SARS-CoV-2 IgM/IgG among newcomer students at Kafr Elsheikh University in Egypt, whether they had been vaccinated or not. Blood samples from 400 healthy newcomer students (200 non-vaccinated and 200 vaccinated) were evaluated for the presence of anti-SARS-CoV-2 IgM/IgG using colloidal gold immunochromatography lateral flow immunoassay cards, and then the results were confirmed by using specific ELISA tests. The prevalence of anti-SARS-CoV-2 antibodies among the participants (n = 400) was 56.3% for IgG and 13.3% for IgM. Regarding the non-vaccinated participants, 55.0% were females, the mean age was 18.2 years, and the mean BMI was 25.35. Regarding the vaccinated participants, 58.5% were females, the mean age was 18.1 years, and the mean BMI was 25.3. There were statistically non-significant correlations (p ˃ 0.05) between gender, BMI, and each of IgM- or IgG-positivity in both vaccinated and non-vaccinated groups. In total, 41.5% and 48.5% of the anti-SARS-CoV-2 IgM-positive and anti-SARS-CoV-2 IgG-positive participants were non-vaccinated, respectively. Furthermore, 58.5% and 51.5% of the anti-SARS-CoV-2 IgM-positive and anti-SARS-CoV-2 IgG-positive participants were vaccinated, respectively. No statistically significant association (p ˃ 0.05) in immunoglobulins positivity between the anti-SARS-CoV-2 non-vaccinated, and vaccinated groups. The anti-SARS-CoV-2 immunological response of nonsmokers, people who exercise regularly, and those who take vitamin supplements, eat a balanced diet, and use certain herbs is noteworthy. Among the vaccinated subjects, 96.6%, 25.0%, 31.9%, 45.7%, and 7.8% of the IgG-positive group, versus 97.2%, 60.6%, 64.2%, 52.3%, and 6.4% of the IgG-positive non-vaccinated group, were nonsmokers, exercisers, and those taking vitamin supplements, eating a balanced diet, and using herbs, respectively. Furthermore, 93.5%, 32.3%, 35.5%, 48.4%, and 6.5% of the IgM-positive vaccinated group, versus 100.0%, 63.6%, 81.8%, 45.5%, and 4.5% of the IgM-positive non-vaccinated participants, were nonsmokers, physical exercisers, vitamin supplement users, balanced eaters, and herbalists, respectively. Persons who are free from comorbidities, young, non-obese, non-smokers, engage in physical exercise, take vitamins, eat a balanced diet, and use certain immunostimulant herbal supplements, all have a strong anti-SARS-CoV-2 humoral immune response, even if they were not vaccinated. During pandemics, vaccination of this group should not be a priority to preserve vaccine doses for high-risk vulnerable people. Even if there is a lockdown during an anticipated future epidemic or pandemic, we should prioritize healthy eating and lifestyle choices, along with increasing physical activity.

Associations Between Dietary Patterns and the Occurrence of Hospitalization and Gastrointestinal Disorders-A Retrospective Study of COVID-19 Patients

During the COVID-19 pandemic, dietary habits in the population changed and sometimes deviated from healthy eating patterns, such as the Mediterranean diet. Based on reports on the quality of the diet of respondents to studies conducted at the beginning of the pandemic, it could be concluded that these new dietary habits are unfavorable for a good prognosis and the course of any disease and its severity of symptoms. This study decided to confront these assumptions with the results of people who had COVID-19. Background/Objectives: This study aimed to assess the associations between dietary patterns and the occurrence of hospitalization and gastrointestinal disorders among patients diagnosed with COVID-19. Methods: This study included 550 respondents who completed a survey up to 8 months after being diagnosed with COVID-19. The survey included 62 items from the FFQ-6®, GSRS, PAC-SYM and FACT-G7 standardized questionnaires. Results: Two dietary patterns (DPs) were identified: 'Processed high fat/sugar/salt/meat/dairy/potatoes' and 'Semi-vegetarian'. Higher adherence to the 'Processed' DP was associated with higher odds of hospitalization due to COVID-19, a more severe course of the disease, and the highest intensity of gastrointestinal symptoms. Higher adherence to the 'Semi-vegetarian' DP was associated with lower odds of hospitalization due to COVID-19, a less severe course of the disease, and the lowest intensity of gastrointestinal symptoms. Conclusions: This study showed a strong harmful effect of high adherence to a processed dietary pattern on an increased incidence of hospitalization and gastrointestinal disorders among northwestern Polish adults during the COVID-19 pandemic, emphasizing the importance of a healthy diet.

Alterations in microbiota of patients with COVID-19: implications for therapeutic interventions

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) recently caused a global pandemic, resulting in more than 702 million people being infected and over 6.9 million deaths. Patients with coronavirus disease (COVID-19) may suffer from diarrhea, sleep disorders, depression, and even cognitive impairment, which is associated with long COVID during recovery. However, there remains no consensus on effective treatment methods. Studies have found that patients with COVID-19 have alterations in microbiota and their metabolites, particularly in the gut, which may be involved in the regulation of immune responses. Consumption of probiotics may alleviate the discomfort caused by inflammation and oxidative stress. However, the pathophysiological process underlying the alleviation of COVID-19-related symptoms and complications by targeting the microbiota remains unclear. In the current study, we summarize the latest research and evidence on the COVID-19 pandemic, together with symptoms of SARS-CoV-2 and vaccine use, with a focus on the relationship between microbiota alterations and COVID-19-related symptoms and vaccine use. This work provides evidence that probiotic-based interventions may improve COVID-19 symptoms by regulating gut microbiota and systemic immunity. Probiotics may also be used as adjuvants to improve vaccine efficacy.

Causal effects between gut microbiota and pulmonary arterial hypertension: A bidirectional Mendelian randomization study

BACKGROUND

Multiple studies have highlighted a potential link between gut microbes and the onset of Pulmonary Arterial Hypertension (PAH). Nonetheless, the precise cause-and-effect relationship remains uncertain.

OBJECTIVES

In this investigation, we utilized a two-sample Mendelian randomization (TSMR) approach to probe the presence of a causal connection between gut microbiota and PAH.

METHODS

Genome-wide association (GWAS) data for gut microbiota and PAH were sourced from MiBioGen and FinnGen research, respectively. Inverse variance weighting (IVW) was used as the primary method to explore the causal effect between gut flora and PAH, supplemented by MR-Egger, weighted median (WM). Sensitivity analyses examined the robustness of the MR results. Reverse MR analysis was used to rule out the effect of reverse causality on the results.

RESULTS

The results indicate that Genus Ruminococcaceae UCG004 (OR = 0.407, P = 0.031) and Family Alcaligenaceae (OR = 0.244, P = 0.014) were protective factors for PAH. Meanwhile Genus Lactobacillus (OR = 2.446, P = 0.013), Class Melainabacteria (OR = 2.061, P = 0.034), Phylum Actinobacteria (OR = 3.406, P = 0.010), Genus Victivallis (OR = 1.980, P = 0.010), Genus Dorea (OR = 3.834, P = 0.024) and Genus Slackia (OR = 2.622, P = 0.039) were associated with an increased Prevalence of PAH. Heterogeneity and pleiotropy were not detected by sensitivity analyses, while there was no reverse causality for these nine specific gut microorganisms.

CONCLUSIONS

This study explores the causal effects of eight gut microbial taxa on PAH and provides new ideas for early prevention of PAH.

The effect of a web-based lifestyle intervention on nutritional status and physical activity on prevention of COVID-19: a randomized controlled trial in women's empowerment

Background

Healthy dietary intake and physical activity affect the immune systems. The present study aimed to investigate the effects of a web-based lifestyle intervention on nutritional status, physical activity, and prevention of COVID-19.

Methods

Three hundred-three women (30-60 years old), who did not have COVID-19 in the City of Ardabil, participated in this study. Participants were randomized into an intervention (n = 152) or control group (n = 151). The intervention group received eight online educational sessions focusing on a healthy diet and physical activity via the website. There was no educational session for the control group during the intervention, but they were placed on the waiting list to receive the intervention and given access to the website and educational content after the follow-up. Outcomes were nutritional status, physical activity, immunoglobulin G (IgG), and immunoglobulin M (Ig M) antibody titers against the virus. They were evaluated at the baseline, after 4 and 12 weeks.

Results

Significant improvements in weight (P < 0.001), BMI (P < 0.001), total energy (P = 0.006), carbohydrate (P = 0.001), protein (P = 0.001), and fat (P < 0.001) were found for the intervention group compared to the control group during the study. MET-min/week for moderate physical activity increased during the time for the intervention and control groups (P < 0.001 and P = 0.007, respectively). MET-min/week for walking activity rose in the post-intervention and follow-up compared to that in the baseline in the groups (P < 0.001 for both groups). Total physical activity was increased during the study (P < 0.001) for both groups. The mean of serum IgG and IgM titers against the virus were increased during the study in both groups in time effect (P < 0.001). There was a significant time x group interaction for carbohydrate and fat intakes (P = 0.005 and P = 0.004, respectively).

Conclusion

The web-based lifestyle intervention may improve nutritional status and physical activity, and have the potential to reduce the risk of contracting a COVID-19 infection.

COVID-19 and Gastrointestinal Tract: From Pathophysiology to Clinical Manifestations

Background: Since its first report in Wuhan, China, in December 2019, COVID-19 has become a pandemic, affecting millions of people worldwide. Although the virus primarily affects the respiratory tract, gastrointestinal symptoms are also common. The aim of this narrative review is to provide an overview of the pathophysiology and clinical manifestations of gastrointestinal COVID-19. Methods: We conducted a systematic electronic search of English literature up to January 2023 using Medline, Scopus, and the Cochrane Library, focusing on papers that analyzed the role of SARS-CoV-2 in the gastrointestinal tract. Results: Our review highlights that SARS-CoV-2 directly infects the gastrointestinal tract and can cause symptoms such as diarrhea, nausea/vomiting, abdominal pain, anorexia, loss of taste, and increased liver enzymes. These symptoms result from mucosal barrier damage, inflammation, and changes in the microbiota composition. The exact mechanism of how the virus overcomes the acid gastric environment and leads to the intestinal damage is still being studied. Conclusions: Although vaccination has increased the prevalence of less severe symptoms, the long-term interaction with SARS-CoV-2 remains a concern. Understanding the interplay between SARS-CoV-2 and the gastrointestinal tract is essential for future management of the virus.

Role of micronutrients in the modulation of immune system and platelet activating factor in patients with COVID-19; a narrative review

Background

Dietary micronutrients may play important roles in the improvement of the immune responses against SARS-CoV-2. This study aimed to assess the effect of micronutrients on platelet activating factor (PAF) and immunity with a special focus on the coronavirus disease 2019 (COVID-19).

Methods

All paper published in English on the effects of micronutrients including fat soluble vitamins, water soluble vitamins, and minerals on PAF, immunity, and COVID-19 were collected from online valid databases.

Results

Vitamin A may modulate the expression of PAF-receptor gene in patients with COVID-19. Vitamin D may modulate inflammatory response through influencing PAF pathway. Vitamin E may improve COVID-19 related heart injuries by exert anti-PAF activities. Vitamin C status may have PAF related anti-inflammatory and micro-thrombotic effects in SARS-CoV-2 patients. Furthermore, some trace elements such as copper, selenium, and iron may have key roles in strengthens immunity by inactivate PAF acetyl hydrolase.

Conclusion

This narrative review study highlighted the importance of micronutrients in the improvement of immune function through modulation of PAF in patients with COVID-19. Further longitudinal studies are warranted.