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Published in: Italian Journal of Pediatrics 1/2021

Open Access 01-12-2021 | Probiotics | Debate

Could nutritional supplements act as therapeutic adjuvants in COVID-19?

Authors: Giorgio Costagliola, Erika Spada, Pasquale Comberiati, Diego G. Peroni

Published in: Italian Journal of Pediatrics | Issue 1/2021

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Abstract

Background

The role of the immune system and inflammatory response in the pathogenesis of the severe manifestations of coronavirus disease 2019 (COVID-19) is well known. Currently, different therapies active on the immune system are used for the management of COVID-19. The involvement of the immune system also opens the opportunity for the use of nutritional supplements with antimicrobial and immunomodulatory activity.

Main aspects

Nutritional supplements with antimicrobial and immunomodulatory activity are promising therapeutic adjuvants for the treatment of COVID-19, and also for the prevention of viral spreading. In particular, the role of vitamin D, probiotics, lactoferrin, and zinc is of significant clinical interest, although there are only a few data on their use in COVID-19 patients. Their molecular actions, together with the results of studies performed on other respiratory infections, strongly suggest their potential utility in COVID-19. This article discusses the main properties of these nutritional supplements and their potential applicability in the prevention and treatment of COVID-19.

Conclusion

The supplementation with vitamin D, probiotics, lactoferrin and zinc could have a role both in preventing SARS-CoV-2 infection and in mitigating the clinical course in infected patients, contributing in the prevention of immune-mediated organ damage.
Literature
2.
go back to reference Feldstein LR, Rose EB, Horwitz SM, Collins JP, Newhams MM, Son MBF, et al. Multisystem Inflammatory Syndrome in U.S. Children and Adolescents. N Engl J Med. 2020 Jul 23;383(4):334–346. doi: https://doi.org/10.1056/NEJMoa2021680. Epub 2020 Jun 29. PMID: 32598831; PMCID: PMC7346765. Feldstein LR, Rose EB, Horwitz SM, Collins JP, Newhams MM, Son MBF, et al. Multisystem Inflammatory Syndrome in U.S. Children and Adolescents. N Engl J Med. 2020 Jul 23;383(4):334–346. doi: https://​doi.​org/​10.​1056/​NEJMoa2021680. Epub 2020 Jun 29. PMID: 32598831; PMCID: PMC7346765.
3.
go back to reference Bousquet J, Cristol JP, Czarlewski W, Anto JM, Martineau A, Haahtela T, et al. Nrf2-interacting nutrients and COVID-19: time for research to develop adaptation strategies. Clin Transl Allergy. 2020 Dec 3;10(1):58. doi: https://doi.org/10.1186/s13601-020-00362-7. PMID: 33292691; PMCID: PMC7711617. Bousquet J, Cristol JP, Czarlewski W, Anto JM, Martineau A, Haahtela T, et al. Nrf2-interacting nutrients and COVID-19: time for research to develop adaptation strategies. Clin Transl Allergy. 2020 Dec 3;10(1):58. doi: https://​doi.​org/​10.​1186/​s13601-020-00362-7. PMID: 33292691; PMCID: PMC7711617.
6.
go back to reference Pecora F, Persico F, Argentiero A, Neglia C, Esposito S. The Role of Micronutrients in Support of the Immune Response against Viral Infections. Nutrients. 2020 Oct 20;12(10):3198. doi: https://doi.org/10.3390/nu12103198. PMID: 33092041; PMCID: PMC7589163. Pecora F, Persico F, Argentiero A, Neglia C, Esposito S. The Role of Micronutrients in Support of the Immune Response against Viral Infections. Nutrients. 2020 Oct 20;12(10):3198. doi: https://​doi.​org/​10.​3390/​nu12103198. PMID: 33092041; PMCID: PMC7589163.
7.
go back to reference Carpagnano GE, Di Lecce V, Quaranta VN, Zito A, Buonamico E, Capozza E, et al. Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19. J Endocrinol Invest. 2020 Aug 9:1–7. doi: https://doi.org/10.1007/s40618-020-01370-x. Epub ahead of print. PMID: 32772324; PMCID: PMC7415009. Carpagnano GE, Di Lecce V, Quaranta VN, Zito A, Buonamico E, Capozza E, et al. Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19. J Endocrinol Invest. 2020 Aug 9:1–7. doi: https://​doi.​org/​10.​1007/​s40618-020-01370-x. Epub ahead of print. PMID: 32772324; PMCID: PMC7415009.
9.
go back to reference Dankers W, Colin EM, van Hamburg JP, Lubberts E. Vitamin D in autoimmunity: molecular mechanisms and therapeutic potential. Front Immunol. 2016;7:697.PubMed Dankers W, Colin EM, van Hamburg JP, Lubberts E. Vitamin D in autoimmunity: molecular mechanisms and therapeutic potential. Front Immunol. 2016;7:697.PubMed
12.
go back to reference Legitimo A, Bertini V, Costagliola G, Baroncelli GI, Morganti R, Valetto A, Consolini R. Vitamin D status and the immune assessment in 22q11.2 deletion syndrome. Clin Exp Immunol. 2020 Jun;200(3):272–286. doi: https://doi.org/10.1111/cei.13429. Epub 2020 Apr 16. PMID: 32149392; PMCID: PMC7231997. Legitimo A, Bertini V, Costagliola G, Baroncelli GI, Morganti R, Valetto A, Consolini R. Vitamin D status and the immune assessment in 22q11.2 deletion syndrome. Clin Exp Immunol. 2020 Jun;200(3):272–286. doi: https://​doi.​org/​10.​1111/​cei.​13429. Epub 2020 Apr 16. PMID: 32149392; PMCID: PMC7231997.
13.
go back to reference Martineau AR, Jolliffe DA, Hooper RL, Greenberg L, Aloia JF, Bergman P, et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 2017 Feb 15;356:i6583. doi: https://doi.org/10.1136/bmj.i6583. PMID: 28202713; PMCID: PMC5310969. Martineau AR, Jolliffe DA, Hooper RL, Greenberg L, Aloia JF, Bergman P, et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 2017 Feb 15;356:i6583. doi: https://​doi.​org/​10.​1136/​bmj.​i6583. PMID: 28202713; PMCID: PMC5310969.
21.
go back to reference Wang Y, Li X, Ge T, Xiao Y, Liao Y, Cui Y, et al. Probiotics for prevention and treatment of respiratory tract infections in children: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2016 Aug;95(31):e4509. doi: https://doi.org/10.1097/MD.0000000000004509. PMID: 27495104; PMCID: PMC4979858. Wang Y, Li X, Ge T, Xiao Y, Liao Y, Cui Y, et al. Probiotics for prevention and treatment of respiratory tract infections in children: A systematic review and meta-analysis of randomized controlled trials. Medicine (Baltimore). 2016 Aug;95(31):e4509. doi: https://​doi.​org/​10.​1097/​MD.​0000000000004509​. PMID: 27495104; PMCID: PMC4979858.
25.
go back to reference Lang J, Yang N, Deng J, Liu K, Yang P, Zhang G, Jiang C. Inhibition of SARS pseudovirus cell entry by lactoferrin binding to heparan sulfate proteoglycans. PLoS One. 2011;6(8):e23710.CrossRef Lang J, Yang N, Deng J, Liu K, Yang P, Zhang G, Jiang C. Inhibition of SARS pseudovirus cell entry by lactoferrin binding to heparan sulfate proteoglycans. PLoS One. 2011;6(8):e23710.CrossRef
27.
go back to reference Peroni DG. Viral infections: lactoferrin, a further arrow in the quiver of prevention. J Pediat Neonatal Individualized Med (JPNIM). 2020;9(1):e090142. Peroni DG. Viral infections: lactoferrin, a further arrow in the quiver of prevention. J Pediat Neonatal Individualized Med (JPNIM). 2020;9(1):e090142.
30.
go back to reference Siqueiros-Cendón T, Arévalo-Gallegos S, Iglesias-Figueroa BF, García-Montoya IA, Salazar-Martínez J, Rascón-Cruz Q. Immunomodulatory effects of lactoferrin. Acta Pharmacol Sin. 2014 May;35(5):557–66. doi: https://doi.org/10.1038/aps.2013.200. PMID: 24786230; PMCID: PMC4814036. Siqueiros-Cendón T, Arévalo-Gallegos S, Iglesias-Figueroa BF, García-Montoya IA, Salazar-Martínez J, Rascón-Cruz Q. Immunomodulatory effects of lactoferrin. Acta Pharmacol Sin. 2014 May;35(5):557–66. doi: https://​doi.​org/​10.​1038/​aps.​2013.​200. PMID: 24786230; PMCID: PMC4814036.
35.
go back to reference Shittu MO, Afolami OI. Improving the efficacy of Chloroquine and Hydroxychloroquine against SARS-CoV-2 may require zinc additives - a better synergy for future COVID-19 clinical trials. Infez Med. 2020;28(2):192–7.PubMed Shittu MO, Afolami OI. Improving the efficacy of Chloroquine and Hydroxychloroquine against SARS-CoV-2 may require zinc additives - a better synergy for future COVID-19 clinical trials. Infez Med. 2020;28(2):192–7.PubMed
Metadata
Title
Could nutritional supplements act as therapeutic adjuvants in COVID-19?
Authors
Giorgio Costagliola
Erika Spada
Pasquale Comberiati
Diego G. Peroni
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Italian Journal of Pediatrics / Issue 1/2021
Electronic ISSN: 1824-7288
DOI
https://doi.org/10.1186/s13052-021-00990-0

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