Introduction
On December 12, 2019 a new coronavirus (SARS-CoV-2) emerged in Wuhan, China, triggering a pandemic of severe acute respiratory syndrome in humans (COVID-19).1 Although, the pandemic has affected all the groups, severe pathology and mortality is disproportionately highest in the elderly, underrepresented minorities (blacks/African Americans and Latinos), and/or in those with underlying comorbidities.2 Thus, the scientific community across the world is putting uni-directional efforts to develop therapy and prevention strategies from the available resources to defeat COVID-19. In this regards, these communities have unanimous view that immune-nutrition can play a pivotal role in improving immune responses against viral infections.
Initially, when the pandemic hit the world, it was difficult to identify the risk factors and etiology of COVID-19, further, making it difficult for the scientists for disease prevention. With the passage of time, it has been found that obesity represents a significant risk factor both for COVID-19 susceptibility and prognosis.3 Around 13% of the world population is obese, therefore, immune-nutrition can be an effective prophylactic measure to lower the burden of COVID-19 disease.4
Inflammation plays a fundamental role in the pathogenesis and progression of COVID-19, ranging from common colds to fatal cases of pneumonia due to the cytokine release syndrome (CRS) that affected patients, determining the severe conditions.5 Infectious diseases, like COVID-19, are characterized by an increased production of adiponectin. 6 It seems interesting the possibility to improve the action of adiponectin through diet intervention.7 An optimal nutritional status guarantees the main modulating processes of inflammatory and oxidative stress, both connected to the immune system. A balanced diet, rich in some foods, is associated with anti-inflammatory and immunomodulatory compounds, including vitamins (C, D, and E) and minerals (zinc and selenium), and may influence human nutritional status.8
Prebiotic from fruits and vegetables is well-established to modulate the gut microbiota and numerous benefits have been reported in chronic inflammatory and metabolic conditions.9 Moreover, increased dietary fiber consumption is linked to reduced mortality rates in respiratory-related diseases and improved lung function. Thus, plant-based diets, functional foods, and supplements present a promising strategy for protecting against respiratory infections.10
Therefore, it can be concluded that personalized immune-nutrition for obese patients should be the first therapeutic choice to reduce the risk of infections and the disease course in COVID-19 patient. Immuno-nutrition can decrease the risk of infections, reducing characteristic inflammation state. In addition, immune-nutrition would be fundamental to support the immune response and protein synthesis in severe phase of COVID-19.
