Nutritional risk factors for SARS-CoV-2 infection: a prospective study within the NutriNet-Santé cohort

DOI record: { "DOI": "10.1186/s12916-021-02168-1", "ISSN": [ "1741-7015" ], "URL": "http://dx.doi.org/10.1186/s12916-021-02168-1", "abstract": "<jats:title>Abstract</jats:title><jats:sec>\n <jats:title>Background</jats:title>\n <jats:p>Nutritional factors are essential for the functioning of the immune system and could therefore play a role in COVID-19 but evidence is needed. Our objective was to study the associations between diet and the risk of SARS-CoV-2 infection in a large population-based sample.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Methods</jats:title>\n <jats:p>Our analyses were conducted in the French prospective NutriNet-Santé cohort study (2009–2020). Seroprevalence of anti-SARS-CoV-2 antibodies was assessed by ELISA on dried blood spots. Dietary intakes were derived from repeated 24 h dietary records (at least 6) in the two years preceding the start of the COVID-19 pandemic in France (February 2020). Multi-adjusted logistic regression models were computed.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Results</jats:title>\n <jats:p>A total of 7766 adults (70.3% women, mean age: 60.3 years) were included, among which 311 were positive for anti-SARS-CoV-2 antibodies. Dietary intakes of vitamin C (OR for 1 SD=0.86 (0.75–0.98), <jats:italic>P</jats:italic>=0.02), vitamin B9 (OR=0.84 (0.72–0.98), <jats:italic>P</jats:italic>=0.02), vitamin K (OR=0.86 (0.74–0.99), <jats:italic>P</jats:italic>=0.04), fibers (OR=0.84 (0.72–0.98), <jats:italic>P</jats:italic>=0.02), and fruit and vegetables (OR=0.85 (0.74–0.97), <jats:italic>P</jats:italic>=0.02) were associated to a decreased probability of SARS-CoV-2 infection while dietary intakes of calcium (OR=1.16 (1.01–1.35), <jats:italic>P</jats:italic>=0.04) and dairy products (OR=1.19 (1.06–1.33), <jats:italic>P</jats:italic>=0.002) associated to increased odds. No association was detected with other food groups or nutrients or with the overall diet quality.</jats:p>\n </jats:sec><jats:sec>\n <jats:title>Conclusions</jats:title>\n <jats:p>Higher dietary intakes of fruit and vegetables and, consistently, of vitamin C, folate, vitamin K and fibers were associated with a lower susceptibility to SARS-CoV-2 infection. Beyond its established role in the prevention of non-communicable diseases, diet could therefore also contribute to prevent some infectious diseases such as COVID-19.</jats:p>\n </jats:sec>", "alternative-id": [ "2168" ], "article-number": "290", "assertion": [ { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Received", "name": "received", "order": 1, "value": "21 July 2021" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "Accepted", "name": "accepted", "order": 2, "value": "21 October 2021" }, { "group": { "label": "Article History", "name": "ArticleHistory" }, "label": "First Online", "name": "first_online", "order": 3, "value": "30 November 2021" }, { "group": { "label": "Declarations", "name": "EthicsHeading" }, "name": "Ethics", "order": 1 }, { "group": { "label": "Ethics approval and consent to participate", "name": "EthicsHeading" }, "name": "Ethics", "order": 2, "value": "The NutriNet-Santé study is conducted in accordance with the Declaration of Helsinki, and all procedures were approved by the Institutional Review Board of the French Institute for Health and Medical Research (IRB INSERM #0000388FWA00005831) and by the National Commission on Informatics and Liberty (CNIL #908,450 and #909,216). All participants provided informed consent and an electronic signature. The study is registered at ExternalRef removed (#NCT03335644). The SAPRIS protocol was approved by the Inserm ethics committee (approval #20-672 dated March 30, 2020). The SAPRIS-SERO study was approved by the Sud-Mediterranée III ethics committee (approval #20.04.22.74247) and electronic informed consent was obtained from all participants for dried-blood spot testing." }, { "group": { "label": "Consent for publication", "name": "EthicsHeading" }, "name": "Ethics", "order": 3, "value": "Not applicable" }, { "group": { "label": "Competing interests", "name": "EthicsHeading" }, "name": "Ethics", "order": 4, "value": "Prof Fabrice Carrat reports personal fees from Imaxio and Sanofi, outside the submitted work. All other authors declare no competing interest." } ], "author": [ { "affiliation": [], "family": "Deschasaux-Tanguy", "given": "Mélanie", "sequence": "first" }, { "ORCID": "http://orcid.org/0000-0002-1277-3380", "affiliation": [], "authenticated-orcid": false, "family": "Srour", "given": "Bernard", "sequence": "additional" }, { "affiliation": [], "family": "Bourhis", "given": "Laurent", "sequence": "additional" }, { "affiliation": [], "family": "Arnault", "given": "Nathalie", "sequence": "additional" }, { "affiliation": [], "family": "Druesne-Pecollo", "given": "Nathalie", "sequence": "additional" }, { "affiliation": [], "family": "Esseddik", "given": "Younes", "sequence": "additional" }, { "affiliation": [], "family": "de Edelenyi", "given": "Fabien Szabo", "sequence": "additional" }, { "affiliation": [], "family": "Allègre", "given": "Julien", "sequence": "additional" }, { "affiliation": [], "family": "Allès", "given": "Benjamin", "sequence": "additional" }, { "affiliation": [], 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