Current State of Evidence: Influence of Nutritional and Nutrigenetic Factors on Immunity in the COVID-19 Pandemic Framework
Galmés et al.
, Current State of Evidence: Influence of Nutritional and Nutrigenetic Factors on Immunity in the COVID-19..
, Nutrients, doi:10.3390/nu12092738
Ecological study of European countries analyzing 10 vitamins and minerals endorsed by the European Food Safety Authority as having sufficient evidence for a causal relationship between intake and optimal immune system function: vitamins D, A, C, B6, B9, B12, zinc, copper, iron, and selenium.
Intake levels of all 10 showed an inverse correlation with the relative mortality rate, while all except vitamin B6 and selenium showed an inverse correlation with incidence and mortality. Most individual correlations did not reach statistical significance. Authors note greater association in populations genetically predisposed towards lower micronutrient status.
Galmés et al., 8 Sep 2020, retrospective, peer-reviewed, 3 authors.
firstname.lastname@example.org (corresponding author), email@example.com, firstname.lastname@example.org.
Current State of Evidence: Influence of Nutritional
and Nutrigenetic Factors on Immunity in the
COVID-19 Pandemic Framework
Sebastià Galmés 1,2,3,4 , Francisca Serra 1,2,3,4, *
and Andreu Palou 1,2,3
Laboratory of Molecular Biology, Nutrition and Biotechnology, NUO Group, Universitat de les Illes Balears,
07122 Palma, Spain; email@example.com (S.G.); firstname.lastname@example.org (A.P.)
CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), 28029 Madrid, Spain
Institut d’Investigació Sanitària Illes Balears (IdISBa), 07120 Palma, Spain
Alimentómica S.L., Spin-off n.1 of the University of the Balearic Islands, 07121 Palma, Spain
Correspondence: email@example.com; Tel.: +34-971-173-051
Received: 31 July 2020; Accepted: 4 September 2020; Published: 8 September 2020
Abstract: The pandemic caused by the new coronavirus has caused shock waves in many countries,
producing a global health crisis worldwide. Lack of knowledge of the biological mechanisms of
viruses, plus the absence of effective treatments against the disease (COVID-19) and/or vaccines have
pulled factors that can compromise the proper functioning of the immune system to fight against
infectious diseases into the spotlight. The optimal status of specific nutrients is considered crucial to
keeping immune components within their normal activity, helping to avoid and overcome infections.
Specifically, the European Food Safety Authority (EFSA) evaluated and deems six vitamins (D, A, C,
Folate, B6 , B12 ) and four minerals (zinc, iron, copper and selenium) to be essential for the normal
functioning of the immune system, due to the scientific evidence collected so far. In this report, an
update on the evidence of the contribution of nutritional factors as immune-enhancing aspects, factors
that could reduce their bioavailability, and the role of the optimal status of these nutrients within the
COVID-19 pandemic context was carried out. First, a non-systematic review of the current state of
knowledge regarding the impact of an optimal nutritional status of these nutrients on the proper
functioning of the immune system as well as their potential role in COVID-19 prevention/treatment
was carried out by searching for available scientific evidence in PubMed and LitCovid databases.
Second, a compilation from published sources and an analysis of nutritional data from 10 European
countries was performed, and the relationship between country nutritional status and epidemiological
COVID-19 data (available in the Worldometers database) was evaluated following an ecological
study design. Furthermore, the potential effect of genetics was considered through the selection of
genetic variants previously identified in Genome-Wide Association studies (GWAs) as influencing
the nutritional status of these 10 considered nutrients. Therefore, access to genetic information in
accessible databases (1000genomes, by Ensembl) of individuals from European populations enabled
an approximation that countries might present a greater risk of suboptimal status of the nutrients
studied. Results from the review approach show the importance of maintaining a correct nutritional
status of these 10 nutrients analyzed for the health of the immune system, highlighting the importance
of Vitamin D and iron in the context of COVID-19. Besides, the ecological study demonstrates
that intake levels of relevant micronutrients—especially Vitamins D, C, B12 , and iron—are..
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