Volume 6, Issue 7, July – 2021 International Journal of Innovative Science and Research Technology

ISSN No:-2456-2165

Nutritional Status of Covid-19 Positive Patients

Stefania Pellino, Department of Prevention, Azienda Sanitaria Locale (ASL) Benevento, Benevento, Italy.
Margherita Luciano, Department of Prevention, Azienda Sanitaria Locale (ASL) Benevento, Benevento, Italy.
Rosamaria Luciano, Department of Prevention, Azienda Sanitaria Locale (ASL) Benevento, Benevento, Italy.
Erika Mancini, Department of Prevention, Azienda Sanitaria Locale (ASL) Benevento, Benevento, Italy.
Maria Concetta Conte, Health Direction, Azienda Sanitaria Locale (ASL) Benevento, Benevento, Italy.
Gennaro Volpe, General Direction, Azienda Sanitaria Locale (ASL) Benevento, Benevento, Italy.
Tommaso Zerella, Department of Prevention, Azienda Sanitaria Locale (ASL) Benevento, Benevento, Italy.

Abstract:- A good nutritional status has a beneficial Microbiota is the set of microorganisms that colonize
influence on immune system. Nutritional status is the intestine and play a fundamental role in anti-
determined by healthy food consumption, vitamins and inflammatory response against pathogens. 70-80% of the
microelements have an important role in supporting the immune cells of our body are found in the intestine and,
immune system. Therefore, their deficiency could therefore, the efficiency of this activity depends on the
increase susceptibility to infections such as Covid-19 variety of foods and the quality of the nutrients that we
disease. The purpose of this study is to highlight how introduce daily with food.
nutritional status affects the effectiveness of the immune
response in Covid-19 positive patients. Micronutrients, including vitamins (vitamins A, C, D,
E) and trace elements (zinc, selenium, iron, magnesium),
The study was conducted from March 2020 to June have an important role in supporting the immune system,
2020 at Health Prevention Department in Benevento therefore, their deficiency could increase susceptibility to
(Campania Region, South Italy). 133 patients accepted infections.
the questionnaire in the form of telephone interview.
Statistical test result using Odd test Ratio: 0,027 (IC For example, vitamin A is essential because it
95%: 0,009- 0,082). The patients with a good nutritional maintains the integrity of the skin and mucous membranes,
status have 0,027 times to be asymptomatic compared to which are the first barrier to external pathogens and some
others with insufficient nutritional status. orange-colored foods such as carrots, pumpkin, apricots, egg
yolk are rich of it.
Keywords:- Covid-19, Nutritional Status, Immune System.
Vitamin C cannot be synthesized by humans, so it is
I. INTRODUCTION important to take it in the diet and it supports various cell
defense mechanisms. A good vitamin C status counteracts
At the end of 2019 a new type of coronavirus was common viral infections such as respiratory diseases and
identified as the cause of a cluster of pneumonia cases in avoids the development of complications.
Wuhan, a city in the Hubei Province of China. It rapidly
spread, resulting in an epidemic throughout China, followed Vitamin D can modulate the innate and adaptive
by a global pandemic that was officially declared by the immune responses. Deficiency in vitamin D is associated
World Health Organization on the 11th of March 2020. with increased autoimmunity as well as an increased
susceptibility to infection. Good sources of vitamin D are:
Coronavirus Disease (COVID-19) is asymptomatic or oily fish (such as salmon, sardines, herring, mackerel) and
presents with mild/ moderate symptoms (fever, dry cough, egg yolks.
fatigue, anosmia/dysgeusia) and heals without
hospitalization but, in some patients, can cause bilateral Zinc is an essential mineral found in all organs, tissues
interstitial pneumonia, respiratory distress syndrome up to and body fluids and is the second most abundant trace
death. Clinical features are determined above all by the mineral after iron. A deficiency has been associated with
underlying pathologies of the infected: the elderly and those many pathological conditions, including colds and
who are already suffering from other diseases are certainly pneumonia. Zinc is found in legumes, pine nuts, walnuts,
at greater risk of developing severe forms. Infection can almonds and hazelnuts.
have a different impact on the immune system, paving the
way for a more or less serious form of Covid-19. The Finally, magnesium is the cofactor of over 300 cellular
different course of the disease, regardless of the initial enzymes and its deficiency is associated with a state of
conditions of the infected, seems also guided by the immune chronic inflammation.
response that is triggered in each patient. Therefore, in
addition to strict compliance with the anti-contagion rules, is The aim of this study is to highlight how nutritional
essential try to strengthen our immune system, which is status affects the effectiveness of the immune response in
closely linked to the intestinal microbiota. Covid-19 positive patients.

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Volume 6, Issue 7, July – 2021 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
II. MATERIALS AND METHODS patients consumed only one of these and 5 patients totaled a
score of 0.
This study was conducted on 133 patients, 60 females
(45,1%) and 73 males (54,9%) with Sars-Cov-2 infection In the group of pauci-symptomatic patients, only 3
during the first wave of Covid-19 pandemic in Benevento, a patients got a score of 7.5, the same for score of 5, only one
city of Campania Region (South Italy). We proposed a got a score of 10. 2 patients not consumed nothing about anti-
questionnaire in the form of telephone interview to a group inflammatory foods groups. The remaining 14 declared that
of 192 Covid-19 positive patients treated by Health they regularly consume only one of the categories of food
Prevention Department. Only 133 patients accepted the indicated (score 2.5).
interview.
Of the 13 patients with mild-moderate symptoms, 9 got
Non- respondents (59 patients) had severe symptoms a score of 0. Only one patient scored 2.5 and another totaled
or they were hospitalized. Interview was conducted from 10/10 score. 2 patients declared that they consume two
March 2020 to June 2020. The age of 133 patients ranged categories of anti-inflammatory foods. Nobody scored 7.5
from 3 years to 91 years (Table 1); under-18 patients score (Table 2).
answered with parentals authorization. The patients, non-
hospitalized, were classified into three groups: Also, 80% of patients declared that they are
asymptomatic; paucisymptomatic (patients with anosmia overweight.
and/or dysgeusia and/or asthenia and/or low-grade fever
and/or headache and/or myalgia); mild-moderate Asymptomatic Paucisymptomatic Symptomatic
symptomatic (TB > 37,5 C° and/or cough and/or dyspnea).
Patients answered questions about their eating practices and, score 10/10 65 (67%) 1 (4%) 1 (8%)
in particular, about their habits of consuming: fruits and score 7.5/10 18 (19%) 3 (13%) 0 (0%)
vegetables (sources of vitamins and minerals), oily fish, nuts score 5/10 7 (7%) 3 (13%) 2 (15%)
and seeds (sources of omega-3 and vitamin D), yogurt
(sources of probiotics), wholegrain cereals (sources of fibers score 2.5/10 2 (2%) 14 (61%) 1 (8%)
and B vitamins). Each of the four categories of anti- score 0/10 5 (5%) 2 (9%) 9 (69%)
inflammatory foods is assigned a value of 2,5. Overall score Table 2. Distribution of Nutritional Survey Score.
is equal to 10 for patients who regularly consume these
products. Score is equal to 7,5 for patients who consume The results of statistic test using Odd test Ratio are:
three of four foods categories. Score of 5 is assigned to 0,027 (IC 95%: 0,009- 0,082). A good nutritional status have
patients who consume two groups of anti-inflammatory 0,027 times to be asymptomatic compared with patients with
foods and score of 2,5 is for patients who consume only one insufficient nutritional status (Table 3). Nutritional status of
of these groups. In addition, patients should indicate whether Covid-19 patients is unknown but these results suggest that a
they are taking vitamin supplements. deficiency of vitamins and minerals may decrease the
immune defenses against Covid-19. However, more precise
Age Male Female Total studies are needed.
0-9 1 0 1
10 - 19 6 6 12 Nutritional Status Symptomatic Asymptomatic
20 - 29 12 9 21 Good 5 (3,8%) 83 (62,4%)
30 - 39 10 4 14 Insufficient 31 (23,3%) 14 (10,5%)
40 - 49 10 15 25 Total 36 (27,1%) 97 (72,9%)
50 - 59 17 17 34 Table 3. Analysis of nutritional status in Covid-19 positive
60 - 69 11 5 16 patients from March 2020 to June 2020).
70 - 79 1 1 2
This study had several limitations that are worth noting.
80 - 89 4 3 7
First, it was a study conducted at a single province with a
90 + 1 0 1 relatively small number of patients. Second, in this study
Total 73 60 133 many indicators of nutritional status were not measurable
Table 1. Characteristic of Covid-19 positive patients. such as vitamin D level or minerals level. Third, this study
not included patients with several symptoms.
III. RESULTS
IV. DISCUSSION
133 patients were interviewed: 97 (73%) were
asymptomatic, 23 (17%) pauci-symptomatic, 13 (10%) with Nutritional status can affect the body's immune
symptoms mild- moderate. Among asymptomatic patients, 65 response to viral infections.
said they regularly consume each category of foods totaling
(score 10/10). 18 patients totaled a score of 7.5 (3 food The ingestion of meals with a high energy content (fats
categories of 4 consumed habitually), 7 patients reported and sugars) is able to trigger a metabolic and immune
consuming two categories of anti-inflammatory foods, 2 response in the body and over time to determine a chronic

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Volume 6, Issue 7, July – 2021 International Journal of Innovative Science and Research Technology
ISSN No:-2456-2165
inflammatory status. Adipose tissue, in particular adipose Conflict of Interest
visceral tissue, causes an increase in the cytokines involved
in the inflammatory pathways (TNFα. MCP-1, IL6, leptin, The authors have nothing to disclose.
resistin, adiponectin, etc). Conversely, a diet rich in vitamins,
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