Abstract
Food insecurity in the United States has been exacerbated due to the socioeconomic strain of the coronavirus disease 2019 (COVID-19) pandemic. Populations experiencing poverty and, as a consequence, food insecurity in the United States are disproportionately affected by obesity, which was identified early in the pandemic as a major risk factor for increased susceptibility to COVID-19 infection and mortality. Given the focus on obesity and its role in immune dysregulation, it is also important to note the role of micronutrient deficiency, another sequalae of food insecurity. Micronutrients play an important role in the ability of the immune system to mount an appropriate response. Moreover, OBESE individuals are more likely to be micronutrient deficient. This review will explore the role of micronutrients, vitamin A, vitamin D, vitamin C, and zinc in respiratory immunity and COVID-19 and how micronutrient deficiency may be a possible confounder in obesity’s association with severe outcomes. By illuminating the role of micronutrients in COVID-19, this paper expands the discussion from food insecurity and obesity to include micronutrient deficiency and how all of these interact in respiratory illnesses such as COVID-19.
Highlights
We describe below the potential associations between commonly cited micronutrient deficiencies, vitamin A, vitamin D, vitamin C, and zinc and their relationship with obesity in patients with COVID-19
Chronic conditions linked to food insecurity, including diabetes, hypertension, chronic kidney and pulmonary diseases, high cholesterol, and even depression, are associated with increased oxidative stress and immune dysregulation, which may be worsened in the presence of obesity and micronutrient deficiency [103,104]
Obesity may be associated with increased risk of COVID-19 infection and complications due to its role in mediating a pro-inflammatory state, which can lead to sub-optimal immune responses via immune system dysregulation [7]
Summary
Res. Public Health 2022, 19, 1125 or obese, defined as an increased body mass index (BMI ≥ 25 kg/m2 or ≥30 kg/m2 ), have a nearly two-fold increased likelihood of having COVID-19 infection or complications [5,6,7]. Among the developed nations, the US has one of the highest rates of poverty, it has the worst index of social and health problems when assessed as a function of income inequality [19] Both inequities in wealth and rates of poverty in the US vary by race and ethnicity, with most racial and ethnic minority groups having twice the prevalence of poverty, as well as obesity and COVID-19 infections and complications [20]. We describe below the potential associations between commonly cited micronutrient deficiencies, vitamin A, vitamin D, vitamin C, and zinc and their relationship with obesity in patients with COVID-19
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