What is the role of micronutrients in recovery from COVID-19?

In a recent study published in International Journal of Molecular Sciencesresearchers evaluated the function of micronutrients and metabolites derived from gut microflora in the recovery of coronavirus disease 2019 (COVID-19).

The availability of sufficient amounts of micronutrients and the gut flora in homeostasis are two of the many positive health benefits of a balanced diet. Vitamins and minerals ensure immunoregulatory function and participate in biochemical reactions as cofactors and coenzymes; in contrast, the gut microbiota and its metabolites control the cellular response directly and indirectly through their interactions with host receptors. The likely causes of this susceptibility are diet and the composition of the intestinal microflora. Its supplementation can help restore microbial balance and enhance the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and recovery.

The role of micronutrients in the infection and consequences of COVID-19

This study investigated how micronutrients and microbiomes influence the risk of COVID-19 infection, disease severity, and outcomes.

Through changes in T-cell and antibody-mediated immunological responses, micronutrient deficiency inhibits the immune response. In respiratory disease, vitamins decrease cellular load and viral antigen expression, decrease mitochondrial antiviral signaling (MAVS) and interferon regulatory factor 3 (IRF3) gene expression, and increase nuclear factor-κB (NF-κB) expression. However, adequate vitamin intake controls immune responses and, under certain circumstances, reduces the risk of infections by inhibiting the production of pro-inflammatory cytokines such as tumor necrosis factor alpha (TNF-α).

Interleukin 6 (IL-6) and interferon (IFN) can also reduce the frequency, severity and risk of death from infections such as COVID-19. The severity of the disease is determined by the rapid response of the immune system to this infection; as such, micronutrients function as immunoregulators and are associated with the immune system’s response to COVID-19 infection.

Vitamins D, C, and B, as well as some minerals such as zinc, are micronutrient supplements that have beneficial effects on respiratory disease, sepsis, and even COVID-19. Consequently, the therapy of these patients must include a nutritional monitoring strategy and a specific diet to cope with micronutrient deficits after COVID-19.

Water soluble vitamins

Depending on the body’s requirements, serum vitamin C concentrations can drop rapidly during infections. High intravenous doses reduce the severity of respiratory tract infections caused by COVID-19 in individuals when supplemented. In particular, ascorbic acid can control how SARS-CoV-2 enters its target cells because it can reduce the production of angiotensin-converting enzyme-2 (ACE-2) in alveolar epithelial cells. In addition, vitamin C deficiency has been linked to symptoms in patients with COVID-19, such as fatigue, pain, cognitive problems, and depression. Intravenous vitamin C supplementation improves, minimizes, and alleviates symptoms of COVID-19 and post-COVID-19, although more research is needed to precisely determine the benefits and required doses.

Fat-soluble vitamins

Like vitamin C, the supply of retinoic acid is rapidly depleted in response to viral load, leading to fever. No research has been done on the effect of vitamin A on patients with COVID-19 or post-COVID syndrome, despite claims of how well it modulates the immune system and viral replication. Vitamin D deficiency allows SARS-CoV-2 to persist and replicate in the host. Additionally, compared to mild symptoms of COVID-19, severe symptoms of COVID-19 were associated with vitamin D deficiency.

Recent studies have shown that patients with severe COVID-19 disease with vitamin D deficiency have altered cytokine storms due to changes in the synthesis of cytokines such as IL-6, IL-8, IL-12, TNF-alpha, and IFN-gamma . Vitamin E may be a key regulator of this disease as it has the ability to efficiently reduce reactive species during active SARS-CoV-2 infection.

Imbalance of water and electrolytes

Dehydration, diarrhea, and vomiting are risk factors associated with fluid distribution and electrolyte imbalance and are often present in most patients with COVID-19. In addition, chest pain and palpitations are the two predominant cardiovascular symptoms reported by COVID-19 patients. The researchers discovered a significant relationship between the two diseases, as cardiovascular disease (CVD) is commonly reported by people with COVID-19.

The association could be explained by the main route by which SARS-CoV-2 enters the human host, the ACE-2 receptor, a component of the renin-angiotensin-aldosterone system (RAAS). In addition, one of the main causes of heart failure is the RAAS. Consequently, it is plausible to say that COVID-19 exacerbates and accelerates early-onset CVD. Additionally, patients who have already experienced CVD may acquire a more severe form of COVID-19, which would significantly negatively impact their ability to recover from post-COVID-19 syndrome.

Gut microbiota during infection and consequences of COVID-19

The team also found that people infected with SARS-CoV-2 have higher opportunistic infections such as Actinomyces, Streptococcus and Rothia. A negative link was found between Faecalibacterium prausnitzii and Bifidobacterium bifidum, which also has immunomodulatory potential and significant anti-inflammatory abilities supporting host defense. Opportunistic pathogens such as Collinsella, Coriobacteriaceae, Enterococcaceae and Staphylococcaceae are observed in the gut microbiota of critical patients with COVID-19. These pathogens are associated with better health because they produce short-chain fatty acids, but their production is significantly reduced in patients with COVID-19. Due to their natural resistance to various drugs and their rapid adaptability to chemotherapy, this huge number of microorganisms can have an impact on the clinical condition of patients.

Overall, the study demonstrated the importance of micronutrients in controlling the immune system against viral infections, especially SARS-CoV-2, and showed their importance as a therapeutic support tool.