Combating COVID-19 and the Role of Nutrition

COVID-19 Background
In December 2019, the viral pandemic of respiratory illness caused by COVID-19, otherwise known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), from Wuhan, China began sweeping its way across the globe. While COVID-19 has been shown to affect all groups, severe pathology and mortality is disproportionately high among the elderly, underrepresented minorities, and those with underlying comorbidities.
Scientists have long recognized the intricate link between nutrition, immune system function, and the risk and severity of infections. Obesity and type-2 diabetes, two prominent risk factors for severe COVID-19, may underlie the health disparity observed in these populations. The high prevalence of these two risk factors, worldwide, but especially in the U.S. and other developed countries, is likely driven by increased consumption of the typical Western diet consisting of high amounts of saturated fat, refined carbohydrates and sugars, and low levels of fiber, unsaturated fats, and antioxidants. Poorly nourished individuals are at a greater risk of COVID-19 infections. Conversely, viral infections can lead to nutritional deficits that “snowball” or worsen the nutritional status and severity of illness in those affected by the virus. Therefore, it is critical for all of us to pay attention to our diet and nutritional status during this ongoing pandemic.
Nutritional care is critical and if not promptly and adequately implemented, malnutrition will negatively impact patients with the infection. Profound metabolic changes occur post-infection due to the actions of pro-inflammatory cytokines, including but not limited to TNF-α, IL-1, IL-6, IL-8, and CRP, all of which seem to be drastically elevated in moderate to severe COVID-19 cases. These changes have long been documented to influence energy, fat, carbohydrate, protein, and micronutrient metabolism. At the same time, the body’s antioxidant defenses become depleted in response to the elevated cytokines, resulting in upregulation of the inflammatory process and localized tissue damage. The immune response exerts a high metabolic and nutritional cost upon the body. Multiple micronutrients (e.g., vitamins C, D, and E, magnesium, copper, selenium, zinc, thiamin, carnitine and others), protein and fluid balance are likely all involved in mitigating and treating the inflammatory response induced by COVID-19.
Our Ongoing Research
The RESTORE Study
In partnership with the Academy of Nutrition and Dietetics and George Mason University our team has launched the “The RESTORE Study: Nutrition Care Practices and Status of SARS-CoV-2 Patients” to assess standard nutrition care practices that show the greatest potential in influencing the burden of disease in patients admitted to the ICU. This nationwide multicenter study includes a 6-month period of data collection within the Academy of Nutrition and Dietetics Health Informatics Infrastructure (ANDHII).
Magnesium Status and Incidence of COVID-19 Infection
In Partnership with Indiana University School of Medicine, we are assessing if magnesium status (among other nutritional markers) can influence the risk of contracting COVID-19 using electronic medial records (EMRs) from over 7,000 patients in the Indiana University Health System Consortium.
Publications
The Magnesium Global Network (MaGNet) to Promote Research on Magnesium in Diseases Focusing on COVID-19
2021. Magnesium Research
Combating COVID-19 and Building Immune Resilience: A Potential Role for Magnesium Nutrition?
2020. Journal of the American College of Nutrition
Nutrition Care Practice Patterns for Patients with COVID-19 – A Preliminary Report
2021. Journal of Parenteral and Enteral Nutrition

Additional COVID-19 Resources
The Role of Nutrition in Supporting the Immune System Relative to Coronavirus (COVID-19)
American Society for Nutrition
Coronavirus (COVID-19)
Academy of Nutrition and Dietetics
Personalized Nutrition & the COVID-19 Era
American Nutrition Association
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