Group for Nutritional Biochemistry and Dietology, Centre of Research Excellence in Nutrition and Metabolism, National Institute for Medical Research, University of Belgrade, Belgrade 11129, Serbia.
World J Gastroenterol. 2021 Sep 14;27(34):5682-5699. doi: 10.3748/wjg.v27.i34.5682.
Varying degrees of liver injuries have been reported in patients infected with the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). In general, oxidative stress is actively involved in initiation and progression of liver damage. The liver metabolizes various compounds that produce free radicals. Maintaining the oxidative/antioxidative balance is important in coronavirus disease 2019 (COVID-19) patients. Antioxidant vitamins, essential trace elements and food compounds, such as polyphenols, appear to be promising agents, with effects in oxidative burst. Deficiency of these nutrients suppresses immune function and increases susceptibility to COVID-19. Daily micronutrient intake is necessary to support anti-inflammatory and antioxidative effects but for immune function may be higher than current recommended dietary intake. Antioxidant supplements (β-carotene, vitamin A, vitamin C, vitamin E, and selenium) could have a potential role in patients with liver damage. Available evidence suggests that supplementing the diet with a combination of micronutrients may help to optimize immune function and reduce the risk of infection. Clinical trials based on the associations of diet and SARS-CoV-2 infection are lacking. Unfortunately, it is not possible to definitively determine the dose, route of administration and best timing to intervene with antioxidants in COVID-19 patients because clinical trials are still ongoing. Until then, hopefully, this review will enable clinicians to understand the impact of micronutrient dietary intake and liver status assessment in COVID-19 patients.
据报道,感染严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2)的患者存在不同程度的肝损伤。一般来说,氧化应激积极参与肝损伤的启动和进展。肝脏代谢产生自由基的各种化合物。在 2019 冠状病毒病(COVID-19)患者中,维持氧化/抗氧化平衡很重要。抗氧化维生素、必需微量元素和食物化合物,如多酚,似乎是有前途的药物,具有氧化爆发的作用。这些营养素的缺乏会抑制免疫功能,增加 COVID-19 的易感性。每天摄入微量营养素对于支持抗炎和抗氧化作用是必要的,但对于免疫功能来说,可能高于目前推荐的膳食摄入量。抗氧化补充剂(β-胡萝卜素、维生素 A、维生素 C、维生素 E 和硒)在肝损伤患者中可能具有潜在作用。现有证据表明,用多种微量营养素补充饮食可能有助于优化免疫功能,降低感染风险。缺乏基于饮食与 SARS-CoV-2 感染关联的临床试验。不幸的是,由于临床试验仍在进行中,目前还不可能确定在 COVID-19 患者中用抗氧化剂进行干预的剂量、给药途径和最佳时机。在那之前,希望这篇综述能使临床医生了解 COVID-19 患者的微量营养素饮食摄入和肝脏状况评估的影响。
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