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Association between dietary antioxidant quality score and severity of coronavirus infection: a case–control study

Aghajani et al., Frontiers in Nutrition, doi:10.3389/fnut.2023.1174113
Jul 2023  
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Severe case 88% Improvement Relative Risk Diet for COVID-19  Aghajani et al.  Prophylaxis Is a healthy diet beneficial for COVID-19? Retrospective 295 patients in Iran (April - August 2022) Lower severe cases with healthier diets (p=0.000033) c19early.org Aghajani et al., Frontiers in Nutrition, Jul 2023 Favorshealthy diet Favorscontrol 0 0.5 1 1.5 2+
Diet for COVID-19
22nd treatment shown to reduce risk in June 2021
 
*, now with p < 0.00000000001 from 28 studies.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,400+ studies for 79 treatments. c19early.org
Case control study of 295 COVID-19 patients in Iran, showing lower risk of severe cases with higher dietary antioxidant quality scores, and with higher intake of vitamin D.
Study covers vitamin D and diet.
risk of severe case, 88.0% lower, OR 0.12, p < 0.001, higher quality diet 96, lower quality diet 85, adjusted per study, case control OR, DAQS tertile 3 vs. tertile 1, multivariable, model 3.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Aghajani et al., 6 Jul 2023, retrospective, Iran, peer-reviewed, 4 authors, study period April 2022 - August 2022. Contact: shadmehr.mirdar@gmail.com.
This PaperDietAll
Association between dietary antioxidant quality score and severity of coronavirus infection: a case–control study
Mobina Aghajani, Alexei Wong, Mehdi Azimi, Shadmehr Mirdar Harijani
Frontiers in Nutrition, doi:10.3389/fnut.2023.1174113
The purpose of this study was to examine the association between the dietary antioxidant quality score (DAQS) and the severity of Coronavirus disease 2019 . The present case-control study was carried out on 295 patients diagnosed with COVID-19 (≥18 years old), including 104 critical patients (Intensive care unit [ICU] admission) and 191 COVID-19 patients without severe complications (Non-intensive care unit [Non-ICU] patients) as cases. Dietary intake was assessed by a 147-item, semi-quantitative food frequency questionnaire (FFQ). Logistic regression was performed to calculate the odds ratio (OR) and 95% confidence interval (CI) for the considered risk factors. Our outcomes (after multivariate adjustment) suggested that higher adherence to DAQS was significantly associated with a decreased risk of COVID-19 infection severity (OR = 0.12; 95% CI: 0.04-0.29, p < 0.001). Similar results were seen when analyzed by sex [men (OR = 0.02; 95% CI: 0.002-0.15, p < 0.001) and women (OR = 0.21; 95% CI: 0.06-0.68, p = 0.012)]. A significant association between vitamin D3 intake and decreased risk of COVID-19 severity (OR = 0.91; 95% CI: 0.89-0.94, p < 0.001) was also observed. Moreover, multivariate results revealed that there were no significant associations between vitamin C (OR = 1.00; 95% CI: 0.99-1.00, p = 0.067), vitamin E (OR = 0.98; 95% CI: 0.86-1.11, p = 0.798), zinc (OR = 1.02; 95% CI: 0.86-1.20, p = 0.805), and selenium (OR = 0.99; 95% CI: 0.99-1.00, p = 0.077) intakes with the risk of COVID-19 severity. However, subgroup analyses by sex suggested a significant association between vitamin C intake and the risk of COVID-19 infection severity in women (OR = 1.00; 95% CI: 1.00-1.00, p = 0.028). Our findings showed a negative association between DAQS adherence and the risk of COVID-19 infection severity. Our results may be used to develop potential dietary therapies to decrease COVID-19 severity.
Ethics statement All participants signed an informed consent prior to partaking in this research. This work was approved by the local ethics committee of Mazandaran University (Ethic ID: IR.UMZ.REC.1401.001) and performed according to the Declaration of Helsinki. The patients/ participants provided their written informed consent to participate in this study. Author contributions MoA and SH: concept and design, acquisition, analysis, interpretation of data, and statistical analysis. MoA, AW, MeA, and SH: drafting of the manuscript. SH: supervision. All authors contributed to critical revision of the manuscript for important intellectual content, and read and approved the final manuscript. Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Publisher's note All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. Supplementary material The Supplementary material for this article can be found online at: https://www.frontiersin.org/articles/10.3389/fnut.2023.1174113/ full#supplementary-material
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' 'Dietary intake was assessed by a 147-item, semi-quantitative food frequency questionnaire ' '(FFQ). Logistic regression was performed to calculate the odds ratio (OR) and 95% confidence ' 'interval (CI) for the considered risk factors. Our outcomes (after multivariate adjustment) ' 'suggested that higher adherence to DAQS was significantly associated with a decreased risk of ' 'COVID-19 infection severity (OR\u2009=\u20090.12; 95% CI: 0.04–0.29, ' '<jats:italic>p</jats:italic> &amp;lt; 0.001). Similar results were seen when analyzed by sex ' '[men (OR\u2009=\u20090.02; 95% CI: 0.002–0.15, <jats:italic>p</jats:italic> &amp;lt; 0.001) ' 'and women (OR\u2009=\u20090.21; 95% CI: 0.06–0.68, <jats:italic>p</jats:italic> = 0.012)]. A ' 'significant association between vitamin D3 intake and decreased risk of COVID-19 severity ' '(OR\u2009=\u20090.91; 95% CI: 0.89–0.94, <jats:italic>p</jats:italic> &amp;lt; 0.001) was ' 'also observed. Moreover, multivariate results revealed that there were no significant ' 'associations between vitamin C (OR\u2009=\u20091.00; 95% CI: 0.99–1.00, ' '<jats:italic>p</jats:italic> = 0.067), vitamin E (OR\u2009=\u20090.98; 95% CI: 0.86–1.11, ' '<jats:italic>p</jats:italic> = 0.798), zinc (OR\u2009=\u20091.02; 95% CI: 0.86–1.20, ' '<jats:italic>p</jats:italic> = 0.805), and selenium (OR\u2009=\u20090.99; 95% CI: 0.99–1.00, ' '<jats:italic>p</jats:italic> = 0.077) intakes with the risk of COVID-19 severity. However, ' 'subgroup analyses by sex suggested a significant association between vitamin C intake and the ' 'risk of COVID-19 infection severity in women (OR\u2009=\u20091.00; 95% CI: 1.00–1.00, ' '<jats:italic>p</jats:italic> = 0.028). Our findings showed a negative association between ' 'DAQS adherence and the risk of COVID-19 infection severity. Our results may be used to ' 'develop potential dietary therapies to decrease COVID-19 severity.</jats:p>', 'DOI': '10.3389/fnut.2023.1174113', 'type': 'journal-article', 'created': {'date-parts': [[2023, 7, 6]], 'date-time': '2023-07-06T14:11:55Z', 'timestamp': 1688652715000}, 'update-policy': 'http://dx.doi.org/10.3389/crossmark-policy', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Association between dietary antioxidant quality score and severity of coronavirus infection: a ' 'case–control study', 'prefix': '10.3389', 'volume': '10', 'author': [ {'given': 'Mobina', 'family': 'Aghajani', 'sequence': 'first', 'affiliation': []}, {'given': 'Alexei', 'family': 'Wong', 'sequence': 'additional', 'affiliation': []}, {'given': 'Mehdi', 'family': 'Azimi', 'sequence': 'additional', 'affiliation': []}, { 'given': 'Shadmehr Mirdar', 'family': 'Harijani', 'sequence': 'additional', 'affiliation': []}], 'member': '1965', 'published-online': {'date-parts': [[2023, 7, 6]]}, 'reference': [ { 'key': 'ref1', 'doi-asserted-by': 'publisher', 'first-page': '695', 'DOI': '10.3122/jabfm.2022.04.210529', 'article-title': 'A pilot of a randomized control trial of melatonin and vitamin C for ' 'mild-to-moderate COVID-19', 'volume': '35', 'author': 'Fogleman', 'year': '2022', 'journal-title': 'J Am Board Family Med'}, { 'key': 'ref2', 'doi-asserted-by': 'publisher', 'first-page': '2255', 'DOI': '10.1056/NEJMra2026131', 'article-title': 'Cytokine storm', 'volume': '383', 'author': 'Fajgenbaum', 'year': '2020', 'journal-title': 'N Engl J Med'}, { 'key': 'ref3', 'doi-asserted-by': 'publisher', 'first-page': '1543', 'DOI': '10.1134/S0006297920120068', 'article-title': 'COVID-19 and oxidative stress', 'volume': '85', 'author': 'Chernyak', 'year': '2020', 'journal-title': 'Biochemistry (Mosc)'}, { 'key': 'ref4', 'doi-asserted-by': 'publisher', 'first-page': '1', 'DOI': '10.1186/s12879-021-06536-3', 'article-title': 'Mortality-related risk factors of COVID-19: a systematic review and ' 'meta-analysis of 42 studies and 423,117 patients', 'volume': '21', 'author': 'Dessie', 'year': '2021', 'journal-title': 'BMC Infect Dis'}, { 'key': 'ref5', 'doi-asserted-by': 'publisher', 'first-page': '757', 'DOI': '10.2147/CIA.S158513', 'article-title': 'Oxidative stress, aging, and diseases', 'volume': '13', 'author': 'Liguori', 'year': '2018', 'journal-title': 'Clin Interv Aging'}, { 'key': 'ref6', 'doi-asserted-by': 'publisher', 'first-page': '175', 'DOI': '10.2165/00151829-200504030-00003', 'article-title': 'The role of oxidative stress in the pathogenesis of COPD: implications ' 'for therapy', 'volume': '4', 'author': 'Rahman', 'year': '2005', 'journal-title': 'Treat Respir Med'}, { 'key': 'ref7', 'doi-asserted-by': 'publisher', 'DOI': '10.3390/ijms18071544', 'article-title': 'Correlation between oxidative stress, nutrition, and cancer initiation', 'volume': '18', 'author': 'Saha', 'year': '2017', 'journal-title': 'Int J Mol Sci'}, { 'key': 'ref8', 'doi-asserted-by': 'publisher', 'first-page': '105051', 'DOI': '10.1016/j.phrs.2020.105051', 'article-title': 'Targeting inflammation and cytokine storm in COVID-19', 'volume': '159', 'author': 'Huang', 'year': '2020', 'journal-title': 'Pharmacol Res'}, { 'key': 'ref9', 'doi-asserted-by': 'publisher', 'DOI': '10.11604/pamj.supp.2020.35.2.22877', 'article-title': 'COVID-19 infection and oxidative stress: an under-explored approach for ' 'prevention and treatment?', 'volume': '35', 'author': 'Ntyonga-Pono', 'year': '2020', 'journal-title': 'Pan Afr Med J'}, { 'key': 'ref10', 'doi-asserted-by': 'publisher', 'DOI': '10.1177/2050312121991246', 'article-title': 'Deficiency of antioxidants and increased oxidative stress in COVID-19 ' 'patients: a cross-sectional comparative study in Jigawa, Northwestern ' 'Nigeria', 'volume': '9', 'author': 'Muhammad', 'year': '2021', 'journal-title': 'SAGE Open Med'}, { 'key': 'ref11', 'doi-asserted-by': 'publisher', 'first-page': '193', 'DOI': '10.1007/s12291-022-01059-3', 'article-title': 'Role of matrix degradation, oxidative stress, inflammation & trace ' 'elements in COVID-19 patients: a multivariate study from India', 'volume': '38', 'author': 'Singh', 'year': '2022', 'journal-title': 'Indian J Clin Biochem'}, { 'key': 'ref12', 'doi-asserted-by': 'publisher', 'first-page': '100064', 'DOI': '10.1016/j.arres.2023.100064', 'article-title': 'Strong dual antipolymerase/antiexonuclease actions of some ' 'aminothiadiazole antioxidants: a promising in-silico/in-vitro ' 'repurposing research study against the COVID-19 omicron virus (B. 1.1. 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Nutr.', 'published': {'date-parts': [[2023, 7, 6]]}}
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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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