Early oral nutritional supplement improves COVID-19 outcomes among hospitalized older patients during the Omicron wave.

OBJECTIVES: The effect of and optimal timing for initiating an oral nutritional supplement(ONS) in hospitalized older patients with the Omicron variant infection remain unclear. The aim of this study was to explore the associations between the ONS and clinical outcomes. METHODS: This study used a retrospective cohort design as primary analysis and a case-control design as sensitivity analysis. We collected data from patients with confirmed coronavirus disease 2019 (COVID-19) between April 2022 and June 2022 at Shanghai Fourth People's Hospital, one of the designated medical centers for COVID-19 in Shanghai, China. Patients were identified as ONS users or non-ONS users, with the former defined as early ONS (ONS initiated within 48 h from hospital admission), and late ONS (ONS initiated after 48 h) users. RESULTS: The study included 1181 hospitalized patients ≥60 y of age. The mean age of the cohort was 78 y, and most patients were women (57.7%). Mortalities after propensity-score matching were 1.2% and 4.3% in the ONS group and non-ONS groups, respectively (P = 0.032). Subgroup analysis results showed that median (IQR) hospital length of stay and the median (IQR) length from symptom onset to viral clearance were shorter for the early ONS than for the late ONS group (9 [6-13] d versus 14 [11 -18] d; P < 0.001, and 11 [8-17] d versus 17 [13-22] d; P < 0.001, respectively). The findings from the case-control analysis supported those from the primary analysis. CONCLUSIONS: Early ONS might have significantly lowered risk for in-hospital death, as well as reduce hospital length of stay and days of viral clearance in older patients with COVID-19 during the Omicron wave.

Body Fat Reduction Effect of Bifidobacterium breve B-3: A Randomized, Double-Blind, Placebo Comparative Clinical Trial.

This double-blind, randomized clinical trial aimed to evaluate the efficacy and safety of Bifidobacterium breve B-3 (BB-3) for reducing body fat. Healthy individuals were randomized into the BB-3 or placebo group (1:1). Dual-energy X-ray absorptiometry was used to evaluate body fat reduction objectively. In the BB-3 group, body weight was lower than before BB-3 ingestion. Regarding waist circumference, hip circumference, and waist/hip circumference ratio, waist circumference and hip circumference were lower in the BB-3 group than in the placebo group at 12 weeks; the waist/hip circumference ratio was found to decrease at each visit in the BB-3 group, although there was no significant difference in the amount of change after 12 weeks. BB-3 did not cause any severe adverse reactions. Body fat was significantly lower in the BB-3 group than in the placebo group. In conclusion, ingesting BB-3 significantly reduces body weight, waist circumference, and hip circumference. Thus, BB-3 is safe and effective for reducing body fat.

Effectiveness of Nutritional Supplements for Attenuating the Side Effects of SARS-CoV-2 Vaccines.

Supplementation is known to enhance the immune response and reduce infection. Therefore, the association between immune nutrients and vaccine side effects needs to be investigated. Our aim was to analyze the relationship between vaccination side effects and supplement intake among the Italian population. The study included a questionnaire asking for personal data, anthropometric information, COVID-19 infection and immunity response, and COVID-19 vaccination and supplementation. The survey was conducted from 8 February to 15 June 2022. In the study, 776 respondents were included, aged between 18 and 86 (71.3% females). We observed a statistically significant correlation between supplement consumption and side effects at the end of the vaccination cycle (p = 0.000), which was also confirmed by logistic regression (p = 0.02). Significant associations were observed between supplement intake and side effects of diarrhea and nausea at the end of the vaccination cycle (p = 0.001; p = 0.04, respectively). Significant associations were observed between side effects and omega-3 and mineral supplementation at the start of the vaccination cycle (p = 0.02; p = 0.001, respectively), and between side effects and vitamin supplementation at the end of the vaccination cycle (p = 0.005). In conclusion, our study shows a positive impact of supplementation on vaccination response, increasing host immune defenses, and reducing side effects.

Supplementation use and diet changes during COVID-19 pandemic according to anxiety level and Mediterranean diet adherence.

Aim; This study was planned and conducted to examine the change in food consumption and nutritional supplement use during the COVID-19 pandemic according to individuals' status of anxiety and Mediterranean diet adherence. Methods; This prospective, cross-sectional research was completed online with the participation of 949 people (66.4% women). The Mediterranean Diet Adherence Screener Scale (MEDAS) and Coronavirus Anxiety Scale (CAS) were applied. After this section of the questionnaire was completed, the participants were tasked with answering questions regarding changes in food consumption and use of nutritional supplements during the pandemic. Results; While 50.8% of the participants had low adherence to the Mediterranean diet, 18.2% were considered to have a high adherence. It was observed that legume (p = 0.001), milk and dairy (p = 0.01), and fruit (p < 0.001) consumption of participants with high adherence to the Mediterranean diet increased during the pandemic, and packaged food (p < 0.001) consumption decreased. The increase in the consumption of fruit (p < 0.001) and vegetables (p = 0.018) were significantly higher in the group with anxiety. Age, sex, educational status, positive COVID-19 test, place of residence, CAS score and MEDAS score affect the use of dietary supplements according to binary logistic regression (R2 = 0.106 p < 0.001). The three most commonly used supplements were identified as vitamins C, D and B12. Conclusions: These results can shed light on how to prepare for possible future pandemics when it comes to dealing with anxiety through diet.

TGF-beta 2 enriched formula as oral nutritional supplement in patients hospitalized for COVID-19: A preliminary observational study

BACKGROUND: SARS-COV 2 turned in a global epidemic since January 2020. It is able to directly stimulate the release of proinflammatory cytokines (cytokine storm) and, affecting enterocytis, dysregulates intestinal permeability likewise Inflammatory Bowel Diseases. According to Guidelines, nutritional support in COVID-19 patients is relevant in a perspective of a fast recovery. Aim of this study is to propose in SARS-COV2 patients an early nutritional support using a polymeric-TGF-beta2 containing formula, with immunoregulatory properties specific for bowel disease, evaluating its effects on systemic inflammation and protein energy malnutrition. METHOD(S): COVID-19 patients hospitalized in Santa Maria Hospital of Terni and in Madonna delle Grazie Hospital of Matera (March-December 2020) were enrolled. The protocol consists in supplying 150 gr of nutritional formula powder (750 kcal/day). Values of serum prealbumin, transferrin, C-reactive protein and Lymphocyte count were collected at baseline and every week. Data were compared to a untreated sample of inpatients. RESULT(S): TGF-beta2 containing formula use seems to be associated to a lower needing and longer time free from steroid therapy, increasing of prealbumin and transferrin values and overall with a better outcome in exposed patients;higher values of serum prealbumin seemed to be associated with lower CRP. It does not induce gastrointestinal discomfort or worsen gastrointestinal symptoms. CONCLUSION(S): TGF-beta2 containing formula represents a valid nutritional support in COVID-19, preventing sarcopenia associated to hypercatabolic status and modulating inflammatory response probably thanks to specific properties of its nutritional components. This is only a preliminary observation: further investigations are on-going, involving several Italian Centers. Copyright © 2022-IOS Press. All rights reserved.

Assessment of dietary habits and use of nutritional supplements in COVID-19: A cross-sectional study.

Objective: Determine nutritional status and use of food supplements during COVID-19. Methods: Sample of individuals aged 18-65 participated in study voluntarily. Patients with COVID-19 or individuals with contact were not included. Questionnaire form was prepared based on literature on food supplements and included questions adapted to COVID-19 pandemic. Results: 488 participants completed the study. Participants' mean age was 26.28 ± 7.64, %82.0 were female, 88.3% were high educated. During COVID-19, 33.6% exercise less than 150 min/day, 55.1% evaluate their eating habits as good/very good, and number of meals did not change compared to before pandemic (41.8%). 34.2% of participants consume 5-7 cups of water daily during pandemic. Consumption of pastry (54.7%) and green leafy vegetables (49.6%) increased. 78.7% of participants did not use any nutritional supplement, and 51.1% stated that they did not need nutritional supplements. Multivitamin and mineral (16.5%), vitamin D (15.3%), and vitamin C (11.4%) are used the most, and 56.7% have been using these products for 1-3 months. Use of nutritional supplements was recommended mostly by doctors (39.4%). 43.1% stated that they used these products to maintain good health, 21.9% because they felt tired, 13.8% because they did not have adequate and balanced nutrition. 51.0% of those using nutritional supplements benefited, 30.8% had no effect. Conclusions: Participants did not make significant changes in their eating habits compared to before pandemic, the use of nutritional supplements increased to maintain good health.

Pharmaceutical and nutraceutical potential of natural bioactive pigment: astaxanthin.

Astaxanthin (3,3'-dihydroxy-ß,ß-carotene-4,4'-dione) is an orange-red, lipophilic keto-carotenoid pigment. It is majorly found in marine ecosystems particularly in aquatic animals such as salmon, shrimp, trout, krill, crayfish, and so on. It is also synthesized in microalgae Heamatococcus pluvialis, Chlorococcum, Chlorella zofingiensis, red yeast Phaffia rhodozyma and bacterium Paracoccus carotinifaciens. Some aquatic and terrestrial creatures regarded as a primary and secondary sources of the astaxanthin producing and accumulating it through their metabolic pathways. Astaxanthin is the powerful antioxidant, nutritional supplement as well as promising therapeutic compound, observed to have activities against different ravaging diseases and disorders. Researchers have reported remarkable bioactivities of astaxanthin against major non-communicable chronic diseases such as cardiovascular diseases, cancer, diabetes, neurodegenerative, and immune disorders. The current review discusses some structural aspects of astaxanthin. It further elaborates its multiple potencies such as antioxidant, anti-inflammatory, anti-proliferative, anti-cancer, anti-obese, anti-diabetic, anti-ageing, anti-TB, anti-viral, anti-COVID 19, neuro-protective, nephro-protective, and fertility-enhancing properties. These potencies make it a more precious entity in the preventions as well as treatments of prevalent systematic diseases and/or disorders. Also, the review is acknowledging and documenting its powerful bioactivities in relation with the pharmaceutical as well as nutraceutical applicability.

The Role of Nutrients in Prevention, Treatment and Post-Coronavirus Disease-2019 (COVID-19).

SARS-CoV-2 virus, infecting human cells via its spike protein, causes Coronavirus disease 2019 (COVID-19). COVID-19 is characterized by shortness of breath, fever, and pneumonia and is sometimes fatal. Unfortunately, to date, there is still no definite therapy to treat COVID-19. Therefore, the World Health Organization (WHO) approved only supportive care. During the COVID-19 pandemic, the need to maintain a correct intake of nutrients to support very weakened patients in overcoming disease arose. The literature available on nutrient intake for COVID-19 is mainly focused on prevention. However, the safe intake of micro- and/or macro-nutrients can be useful either for preventing infection and supporting the immune response during COVID-19, as well as in the post-acute phase, i.e., "long COVID", that is sometimes characterized by the onset of various long lasting and disabling symptoms. The aim of this review is to focus on the role of nutrient intake during all the different phases of the disease, including prevention, the acute phase, and finally long COVID.

Computer Evaluation of the Potential of Protein from Arachis hypogaea as A Nutritional Supplement during COVID-19 Pandemic

The potential of Arachis hypogaea protein as a nutritional supplement during the pandemic of COVID-19 was studied. First of all, the classification of Arachis hypogaea proteins was briefly reviewed, and the representative Arachis hypogaea proteins (Ara h1, Ara h2, Ara h3, Ara h6, conarachin A and conarachin B) were selected. At the same time, six common Arachis hypogaea proteins were hydrolyzed by computer-simulated gastrointestinal protease, and a large number of active peptides were obtained. Then, the active peptides were docked with SARS-CoV-2 Mpro to evaluate their binding ability of the six Arachis hypogaea proteins. Results showed that the degree of hydrolysis of the six Arachis hypogaea proteins ranged from 34.97% to 38.11%, and Ara h2 possessed the best binding effect with SARS-CoV-2 Mpro (F>6.67%), followed by Ara h6 (F=4.73%). In addition, oligopeptides PCAQR, CQSQL, PCEQH and IQQGR were proved to possess good binding effect with SARS-CoV-2 Mpro (docking fraction≤-140). In summary, supplementation of Arachis hypogaea protein during COVID-19 pandemic may be helpful for potential SARS-CoV-2 infection, and the identified oligopeptides have the potential to become inhibitors of SARS-CoV-2. © 2021, Editorial Board of Modern Food Science and Technology. All right reserved.

Observational study on the benefit of a nutritional supplement, supporting immune function and energy metabolism, on chronic fatigue associated with the SARS-CoV-2 post-infection progress.

BACKGROUND & AIMS: Recent studies have verified that the SARS-CoV-2 infection (from December 2019 has affected 123 million people throughout the world and more than 3 million people in Italy), can have medium-term and long-term effects, collectively referred to as "post-Covid syndrome" or "long-Covid" characterized by chronic fatigue, followed by muscle weakness, dyspnea and headache. Chronic fatigue or chronic tiredness is a persistent symptom both in patients who have experienced a severe infection and in those who have experienced a mild form of infection. Studies conducted on both patients discharged from hospital and patients managed at home showed that there was no association between the severity of the Coronavirus disease (Covid-19) and the subsequent chronic fatigue symptom. The aim of this study was to evaluate the ability of a nutritional supplement based on vitamins, minerals, amino acids and plant extracts (Apportal®) intake, to ameliorate the general health status in particular the chronic fatigue symptom in subjects after SARS-CoV-2 negativity. METHODS: Participants were advised to take one sachet daily of Apportal® for 28 consecutive days. At the beginning (T0), after 14 days (T1) and after 28 days (T2) of supplementation, general fatigue, mental fatigue and Quality of Life indexes were evaluated through specific questionnaires. The assessment of quality of life and health status were measured through the EuroQoL-5D questionnaire, chronic fatigue using the FACIT-Fatigue questionnaire and mental fatigue using the modified Chalder questionnaire. RESULTS: 201 subjects were enrolled for the study; results showed a significant improvement in all indexes analyzed after 14 and 28 days of supplementation. The main significant improvement was observed after the first 14 days and it was further confirmed at 28 days as well. The RTE (Relative Treatment Effect) trend about quality of life, health status, FACIT-Fatigue and mental fatigue in the three questionnaires was statistically significant (Wald Statistic, p < 0.0001). The data of FACIT-questionnaire showed an improvement of at least 1 unit in 76.62% of subjects after 14 days and in 90.05% of subjects after 28 days. An improvement of 10-unit was found in about one third of subjects after 14 days and in half of the subjects after 28 days. CONCLUSIONS: This study shows that Apportal® can reduce chronic fatigue and improve quality of life and health status in subjects after SARS-CoV-2 negativity due to the synergistic effect of its components.

Recovery Focused Nutritional Therapy across the Continuum of Care: Learning from COVID-19.

Targeted nutritional therapy should be started early in severe illness and sustained through to recovery if clinical and patient-centred outcomes are to be optimised. The coronavirus disease 2019 (COVID-19) pandemic has shone a light on this need. The literature on nutrition and COVID-19 mainly focuses on the importance of nutrition to preserve life and prevent clinical deterioration during the acute phase of illness. However, there is a lack of information guiding practice across the whole patient journey (e.g., hospital to home) with a focus on targeting recovery (e.g., long COVID). This review paper is of relevance to doctors and other healthcare professionals in acute care and primary care worldwide, since it addresses early, multi-modal individualised nutrition interventions across the continuum of care to improve COVID-19 patient outcomes. It is of relevance to nutrition experts and non-nutrition experts and can be used to promote inter-professional and inter-organisational knowledge transfer on the topic. The primary goal is to prevent complications and support recovery to enable COVID-19 patients to achieve the best possible nutritional, physical, functional and mental health status and to apply the learning to date from the COVID-19 pandemic to other patient groups experiencing acute severe illness.

Ocoxin oral solution demonstrates antiviral properties in cellular models.

Ocoxin Oral Solution (OOS) and Viusid (VS) are nutritional supplements that include several natural products which affect different cellular functions, such as proliferation or the redox status. In addition, some of their constituent components have been described to exert an antiviral effect. Considering this, it was hypothesized that treatment with OOS and VS could protect from viral infections. In order to evaluate the impact of OOS and VS on viral infection, lentivirus and retrovirus whose genomes coded for green fluorescent protein were used. In addition, and as a second approach to measure viral infection, a hemagglutinin-tagged form of the mitogen-activated protein kinase ERK5 was also inserted in the retroviral vector. Viral particles produced in 293T cells were used to infect HeLa cells in the presence or absence of OOS or VS. It was observed that VS had a minimal effect on the capacity of either lentivirus or retrovirus to infect HeLa cells. However, OOS significantly reduced the infection of HeLa cells with both of these viruses. The effect was dose-dependent, reaching a maximum at a 1:100 dilution of OOS. These results suggested that, in addition to its well-known antitumoral properties, OOS may also inhibit infection with viruses. This effect is relevant since patients receiving oncological therapies are more susceptible to viral infections, and nutritional supplements such as OOS may help in reducing the severity of these potential pathogenic infections.

Modulation of Hb-O2 affinity to improve hypoxemia in COVID-19 patients.

This opinion paper aims at discussing the potential impact of modulating the Hb-O2 affinity by the nutritional supplement 5-HMF on patients affected by COVID-19. The paper describes the critical role of the oxygen affinity in hypoxemic COVID-19 patients and the potential positive effect of 5-HMF, a compound shown to increase the Hb-O2 affinity.

Nutritional therapy for patients with coronavirus disease 2019 (COVID-19): Practical protocol from a single center highly affected by an outbreak of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.

OBJECTIVES: Coronavirus disease 2019 (COVID-19) carries a high risk for malnutrition owing to the state of debilitation that results from acute respiratory failure symptoms. The aim of this study was to provide an approach to reduce the risk for malnutrition and improve patients' clinical outcomes. METHODS: Short age-adjusted Nutritional Risk Screening was performed with 94 non-intensive care unit (ICU) patients admitted to the Giovanni Borea Civil Hospital in Sanremo. Forty-nine patients in the ICU were considered at risk for malnutrition without screening and were fed with enteral nutrition plus supplemental parenteral nutrition. In the non-ICU setting, patients underwent a personalized nutritional protocol, considering their conditions, which consisted of a high-protein and high-calorie pureed diet, oral nutritional supplements, and/or artificial nutrition or other personalized nutritional path. RESULTS: The nutritional treatment was well tolerated by the patients. Of the non-ICU patients, 19.1% died. They were mainly women, with higher body mass indices and older in age. Of the patients in the ICU, 53.1% died. Of the 94 non-ICU patients, 72 scored positive on at least one nutritional risk screening item (excluding age). Of the 94 non-ICU patients, 68 were >70 y of age. Non-ICU patients whose energy and protein needs were not met were older (P = 0.01) and had a higher death rate than patients whose needs were met (P < 0.001). CONCLUSIONS: This protocol should not be considered as a guideline; rather, it is intended to report the clinical experience of a nutrition team in an Italian reference center for the treatment of patients with COVID-19. Nutritional strategies should be implemented to prevent worsening of clinical outcomes.

Role of Immune Dysregulation in Increased Mortality Among a Specific Subset of COVID-19 Patients and Immune-Enhancement Strategies for Combatting Through Nutritional Supplements.

Background: The COVID-19 pandemic has been causing varying severities of illness. Some are asymptomatic and some develop severe disease leading to mortality across ages. This contrast triggered us explore the causes, with the background that a vaccine for effective immunization or a drug to tackle COVID-19 is not too close to reality. We have discussed strategies to combat COVID-19 through immune enhancement, using simple measures including nutritional supplements. Discussion: A literature search on mortality-related comorbid conditions was performed. For those conditions, we analyzed the pro-inflammatory cytokines, which could cause the draining of the immune reservoir. We also analyzed the immune markers necessary for the defense mechanism/immune surveillance against COVID-19, especially through simple means including immune enhancing nutritional supplement consumption, and we suggest strategies to combat COVID-19. Major comorbid conditions associated with increased mortality include cardiovascular disease (CVD), diabetes, being immunocompromised by cancer, and severe kidney disease with a senile immune system. Consumption of Aureobasidium pullulans strain (AFO-202) beta 1,3-1,6 glucan supported enhanced IL-8, sFAS macrophage activity, and NK cells' cytotoxicity, which are major defense mechanisms against viral infection. Conclusion: People with co-morbid conditions who are more prone to COVID-19-related deaths due to immune dysregulation are likely to benefit from consuming nutritional supplements that enhance the immune system. We recommend clinical studies to validate AFO-202 beta glucan in COVID-19 patients to prove its efficacy in overcoming a hyper-inflammation status, thus reducing the mortality, until a definite vaccine is made available.