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Association of dietary inflammatory index and the SARS-CoV-2 infection incidence, severity and mortality of COVID-19: a systematic review and dose-response meta-analysis

Hao et al., Nutrition Journal, doi:10.1186/s12937-024-00927-3, PROSPERO CRD42023407410
Feb 2024  
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Diet for COVID-19
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*, now known with p < 0.00000000001 from 28 studies.
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Systematic review and dose-response meta-analysis of 5 studies with 197,929 participants showing higher SARS-CoV-2 infection risk and COVID-19 severity with higher Dietary Inflammatory Index (DII) scores. The odds of COVID-19 increased 31% per 1-point rise in E-DII.
2 meta analyses show significant improvements with diet for hospitalization Rahmati, severity Hao, and cases Hao, Rahmati.
Currently there are 28 diet for COVID-19 studies, showing 20% lower mortality [-15‑44%], 99% lower ICU admission [79‑100%], 72% lower hospitalization [57‑82%], and 35% fewer cases [25‑43%].
Hao et al., 20 Feb 2024, peer-reviewed, 6 authors, trial PROSPERO CRD42023407410. Contact:
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Association of dietary inflammatory index and the SARS-CoV-2 infection incidence, severity and mortality of COVID-19: a systematic review and dose-response meta-analysis
Xuanyu Hao, Shiwen Li, Yanmin Yang, Huixu Dai, Yumeng Yan, Dongyang Li
Nutrition Journal, doi:10.1186/s12937-024-00927-3
Background Several studies have reported the association between dietary inflammatory index (DII) and the SARS-CoV-2 infection risk, severity or mortality of COVID-19, however, the outcomes remain controversial. Objective We sought to examine whether a dose-response association of DII and SARS-CoV-2 infection exists. Design A dose-response meta-analysis was performed to investigate the association of DII and SARS-CoV-2 infection. We conducted a systematic search of PubMed, Embase and Web of Science up to March 15th, 2023. The odds ratios (OR) of DII and COVID-19 risk and severity were computed. Results Totally, 5 studies were included (1 from UK and 4 from Iran), consisting of 197,929 participants with 12,081 COVID-19 cases. Although there was heterogeneity among studies, the results indicated that higher DII was independently related to higher SARS-CoV-2 infection incidence (OR = 1.57, 95% CI: 1.14, 2.17) and COVID-19 severity (OR = 1.11, 95% CI: 1.07, 1.15) but not COVID-19 mortality (risk ratio = 1.13, 95% CI: 1.00, 1.27). The incidence of SARS-CoV-2 infection increased by 31% for each 1-point increase in the E-DII (OR = 1.31, 95% CI: 1.20, 1.43). Conclusions This meta-analysis suggests that an elevated DII score is associated with increased SARS-CoV-2 infectious risk and severity of COVID-19. There were not enough studies on COVID-19 mortality. Further large prospective studies in different countries are warranted to validate our results.
Supplementary Information The online version contains supplementary material available at https://doi. org/10.1186/s12937-024-00927-3. Supplementary Material 1 Declarations Ethical approval Not applicable. Consent to publication Not applicable. Competing interests The authors declare no competing interests. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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