Abstract

BackgroundThe enormous health impact of the COVID-19 pandemic has refocused attention on measures to optimize immune function and vaccine response. Dietary deficiencies of micronutrients can weaken adaptive immunity. The aim of this review was to examine links between micronutrients, immune function and COVID-19 infection, with a focus on nutritional risks in subgroups of the Swiss population.MethodsScoping review on the associations between selected micronutrients (vitamins D and C, iron, selenium, zinc, and n-3 PUFAs) and immunity, with particular reference to the Swiss population. These nutrients were chosen because previous EFSA reviews have concluded they play a key role in immunity.ResultsThe review discusses the available knowledge on links between sufficient nutrient status, optimal immune function, and prevention of respiratory tract infections. Because of the rapid spread of the COVID-19 pandemic, controlled intervention studies of micronutrients in the context of COVID-19 infection are now underway, but evidence is not yet available to draw conclusions. The anti-inflammatory properties of n-3 PUFAs are well established. In Switzerland, several subgroups of the population are at clear risk of nutrient deficiencies; e.g., older adults, multiple comorbidities, obesity, pregnancy, and institutionalized. Low intakes of n-3 PUFA are present in a large proportion of the population.ConclusionThere are clear and strong relationships between micronutrient and n-3 PUFA status and immune function, and subgroups of the Swiss population are at risk for deficient intakes. Therefore, during the COVID-19 pandemic, as a complement to a healthy and balanced diet, it may be prudent to consider supplementation with a combination of moderate doses of Vitamins C and D, as well as of Se, Zn and n-3 PUFA, in risk groups.

Highlights

  • Viral infection outbreaks have been and will remain a regular challenge all along human evolution

  • This paper aims to summarize the role of selected nutrients on the immune system, pointing to specific nutritional risks in the Swiss population related to immunity: the review is not aimed at therapy but rather on prevention

  • The aim of this review is to provide a summary of observational and intervention trials linking nutrition status and intake of specific micronutrients to outcomes of viral infections, COVID-19

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Summary

Introduction

Viral infection outbreaks have been and will remain a regular challenge all along human evolution. Nutritional reinforcement of the host immunity enabling fighting the virus has been mostly ignored [4] This low interest occurred despite the fact that it is scientifically well established and endorsed by expert authorities that selected nutrients, including several micronutrients (we use this term hereafter for vitamins and trace elements) and nutrients such as omega-3 polyunsaturated fatty acids (PUFA), support our immune response [5]. It is likely, that depletion of these nutrients is detrimental on the risk of acquiring an infection and on the recovery. As a rapid scoping review, we did not perform a formal systematic search, but relied our data sources on PubMed, Medline, and the Cochrane library

Coronavirus pandemic and the situation in Switzerland
Nutrition and immune response
Vitamin D
Vitamin C
Omega-3 polyunsaturated fatty acids
Long-term multi-micronutrient administration
Dietary intake and nutritional status of the Swiss population
Summary of micronutrients at risk in the Swiss population and recommendations
Conclusion
Findings
Declaration of competing interest
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