Nutrition, the digestive system and immunity in COVID-19 infection
Gastroenterology and Hepatology from Bed to Bench,
20 September 2020
The aim of this review is to synthesise literature on the complex relationship between food consumption and nutritional status, including the digestive system, in order to consider the relationship to immunity and potential responses to COVID-19 infection. The aim is to help to inform the many healthcare professionals working with patients with COVID-19. A literature search was performed on PubMed, Scopus and EMBASE databases. Hand searches were also undertaken using Google and reference lists to identify recent evidence. Studies were critically appraised, and the findings were analysed by narrative synthesis. Nutritional status can impact on immunity in several ways (including affecting susceptibility to infection, severity of disease and recovery time) and is therefore a significant consideration in the management of COVID-19. COVID-19 can also impact on digestive function which can further impact nutritional status. There is recognition of the role of Vitamin D deficiency in vulnerability to severe respiratory infections including COVID-19, and it may have a role in treatment where deficiency is indicated. Healthcare professionals should be aware that obesity may be accompanied by micronutrient malnutrition including vitamin D deficiency and also alterations in the microbiome and inflammatory responses which can further impact on immunity and severity of disease. Multidisciplinary team working is recommended in the management of patients with COVID-19 and approaches should include a consideration of nutritional status (both macronutrients and micronutrients), body weight as well as of gastrointestinal signs and symptoms.
- obesity, COVID-19, nutritional status, vitamin D, microbiome, multidisciplinary, supplementation, practice.
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