Abstract: International Journal of Environmental Research and Public Health Article Effect of a Nutritional Support System to Increase Survival and Reduce Mortality in Patients with COVID-19 in Stage III and Comorbidities: A Blinded Randomized Controlled Clinical Trial Fernando Leal-Martínez 1, *, Lorena Abarca-Bernal 1 , Alejandra García-Pérez 1 , Dinnaru González-Tolosa 1 , Georgina Cruz-Cázares 1 , Marco Montell-García 2 and Antonio Ibarra 1 1 2 *



 Citation: Leal-Martínez, F.; Abarca-Bernal, L.; García-Pérez, A.; González-Tolosa, D.; Cruz-Cázares, G.; Montell-García, M.; Ibarra, A. Effect of a Nutritional Support System to Increase Survival and Reduce Mortality in Patients with COVID-19 in Stage III and Comorbidities: A Blinded Randomized Controlled Clinical Trial. Int. J. Environ. Res. Public Health 2022, 19, 1172. https://doi.org/10.3390/ Centro de Investigación en Ciencias de la Salud (CICSA), Facultad de Ciencias de la Salud (FCS), Universidad Anáhuac México Norte, Mexico City 52786, Mexico; lore19.ab@gmail.com (L.A.-B.); alejandragp_@hotmail.com (A.G.-P.); din.tolosa@gmail.com (D.G.-T.); georgina.crucaz@hotmail.com (G.C.-C.); jose.ibarra@anahuac.mx (A.I.) Centro Médico ISSEMyM (CMI) Toluca “Lic. Arturo Montiel Rojas”, Toluca City 52170, Mexico; cazabichos@yahoo.com Correspondence: ferman5@hotmail.com; Tel.: +52-5521094339 Abstract: The COVID-19 evolution depends on immunological capacity. The global hospital mortality rate is 15–20%, but in México it is 46%. There are several therapeutic protocols, however, integral nutrition is not considered. In this study, a Nutritional Support System (NSS) was employed to increase survival and reduce mortality in patients with stage III COVID-19. A randomized, blinded, controlled clinical trial was performed. Eighty patients (aged 30 to 75 years, both sexes) were assigned to (1) “Control Group” (CG) hospital diet and medical treatment or (2) “Intervention Group” (IG) hospital diet, medical treatment, and the NSS (vitamins, minerals, fiber, omega-3, amino acids, Bcomplex, and probiotics). IG significantly increased survival and reduced mortality compared to CG (p = 0.027). IG decreased progression to Mechanical Ventilation Assistance (MVA) by 10%, reduced the intubation period by 15 days, and increased survival in intubated patients by 38% compared to CG. IG showed improvement compared to CG in decrease in supplemental oxygen (p = 0.014), the qSOFA test (p = 0.040), constipation (p = 0.014), the PHQ-9 test (p = 0.003), and in the follow-up, saturation with oxygen (p = 0.030). The NSS increases survival and decreases mortality in patients with stage III COVID-19. ijerph19031172 Academic Editor: Paul B. Tchounwou Keywords: COVID-19; SARS-CoV-2; nutritional support; NSS; nutrition; supplementation; probiotics; pneumonia; survival; mortality Received: 13 November 2021 Accepted: 31 December 2021 Published: 21 January 2022 Publisher’s Note: MDPI stays neutral