McAuliffe Shane, Ray Sumantra, Fallon Emily, Bradfield James, Eden Timothy, Kohlmeier Martin
NNEdPro Global Centre for Nutrition and Health, St John's Innovation Centre, Cambridge, UK.
School of Biomedical Sciences, Ulster University at Coleraine, Coleraine, Northern Ireland.
BMJ Nutr Prev Health. 2020 Jun 18;3(1):93-99. doi: 10.1136/bmjnph-2020-000100. eCollection 2020.
Existing micronutrient deficiencies, even if only a single micronutrient, can impair immune function and increase susceptibility to infectious disease. Certain population groups are more likely to have micronutrient deficiencies, while certain disease pathologies and treatment practices also exacerbate risk, meaning these groups tend to suffer increased morbidity and mortality from infectious diseases. Optimisation of overall nutritional status, including micronutrients, can be effective in reducing incidence of infectious disease. Micronutrient deficiencies are rarely recognised but are prevalent in the UK, as well as much more widely, particularly in high-risk groups susceptible to COVID-19. Practitioners should be aware of this fact and should make it a consideration for the screening process in COVID-19, or when screening may be difficult or impractical, to ensure blanket treatment as per the best practice guidelines. Correction of established micronutrient deficiencies, or in some cases assumed suboptimal status, has the potential to help support immune function and mitigate risk of infection. The effects of and immune response to COVID-19 share common characteristics with more well-characterised severe acute respiratory infections. Correction of micronutrient deficiencies has proven effective in several infectious diseases and has been shown to promote favourable clinical outcomes. Micronutrients appear to play key roles in mediating the inflammatory response and such effects may be enhanced through correction of deficiencies. Many of those at highest risk during the COVID-19 pandemic are also populations at highest risk of micronutrient deficiencies and poorer overall nutrition. Correction of micronutrient deficiencies in established COVID-19 infection may contribute to supporting immune response to infection in those at highest risk. There is a need for further research to establish optimal public health practice and clinical intervention regimens.
现有的微量营养素缺乏，即使只是单一的微量营养素缺乏，也会损害免疫功能并增加感染传染病的易感性。某些人群更有可能存在微量营养素缺乏，而某些疾病病理和治疗方法也会加剧这种风险，这意味着这些人群往往因传染病而发病率和死亡率增加。优化包括微量营养素在内的整体营养状况，可有效降低传染病的发病率。微量营养素缺乏很少被认识到，但在英国以及更广泛的地区普遍存在，尤其是在易感染新冠病毒的高危人群中。从业者应意识到这一事实，并应将其纳入新冠病毒筛查过程的考虑因素，或者在筛查可能困难或不切实际时，确保按照最佳实践指南进行全面治疗。纠正已确定的微量营养素缺乏，或在某些情况下纠正假定的次优状态，有可能有助于支持免疫功能并降低感染风险。新冠病毒感染的影响和免疫反应与特征更明确的严重急性呼吸道感染有共同特征。在几种传染病中，纠正微量营养素缺乏已被证明是有效的，并且已显示可促进良好的临床结果。微量营养素似乎在介导炎症反应中起关键作用，通过纠正缺乏可能会增强这种作用。在新冠疫情期间风险最高的许多人群，也是微量营养素缺乏风险最高且整体营养较差的人群。在已确诊的新冠病毒感染中纠正微量营养素缺乏，可能有助于支持高危人群对感染的免疫反应。需要进一步研究以确定最佳的公共卫生实践和临床干预方案。
