Estrategias nutricionales para la disminución de Long COVID-19. Una Revisión de la literatura
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jul 4, 2024
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https://doi.org/10.36677/medicinainvestigacion.v12i2.22433
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Claudia Nelly Orozco González
http://orcid.org/0000-0002-8885-5198
Betsy Corina Sosa Garcia
http://orcid.org/0000-0002-1545-4190
Adrina Garduño Alanis
http://orcid.org/0000-0002-9660-2799
Yizel Becerril Alarcon
http://orcid.org/0000-0001-6219-7361
Ruth Berenice Morales Díaz
http://orcid.org/0009-0008-9907-4865
http://orcid.org/0000-0002-8885-5198
Betsy Corina Sosa Garcia
http://orcid.org/0000-0002-1545-4190
Adrina Garduño Alanis
http://orcid.org/0000-0002-9660-2799
Yizel Becerril Alarcon
http://orcid.org/0000-0001-6219-7361
Ruth Berenice Morales Díaz
http://orcid.org/0009-0008-9907-4865
Resumen
Introducción:
La pandemia por la COVID-19, se originó por el virus SARS-CoV-2, afectando a más personas con comorbilidades preexistentes, baja actividad física y estilos de vida no saludables. Se conoce que antes de la pandemia, la alimentación de las personas era deficiente, por lo que existe una gran necesidad de seguir estrategias nutricionales para la prevención de infecciones por Long COVID-19.
Objetivo:
Identificar las estrategias nutricionales para la disminución de Long COVID.
Material y métodos:
Se hizo una búsqueda exhaustiva de fuentes de datos electrónicos en PubMed, Web of Science, RedAlyC, Google Scholar, Biblioteca Cochrane, y Scopus, publicados en el periodo de 2020- 2023, utilizando términos MeSH “nutrición” “estrategias nutricionales” “COVID-19”, “pautas nutricionales y “recomendaciones nutricionales” No se aplicaron restricciones de idioma siguiendo las directrices en la norma PRISMA.
Resultados:
Se seleccionaron 19 estudios publicados en el periodo 2020 y 2023, de tipo cohorte, ensayo clínico, transversal y prospectivo. Al analizar la información, se identificó tres temas relacionados con el efecto de la nutrición y Long COVID: i) adherencia a la dieta mediterránea, ii) calidad de dieta y iii) intervención nutricional con suplementación de componentes no energéticos. La dieta mediterránea fue la terapia nutricional más recomendada debido a la calidad de alimentos y los beneficios en la enfermedad cardiovascular, sensibilidad a la insulina y perfil de lípidos, y disminución de la inflamación, siendo el sexo femenino reporta mayor adherencia del 77% teniendo como resultado niveles más bajos de triglicéridos, IMC, perímetro abdominal y citocinas proinflamatorias.
Conclusiones:
Una nutrición adecuada para todas las células del sistema inmunológico tendrá una función homeostáticamente, esto a través del seguimiento y cumplimiento de estrategias que propicien un estilo de vida saludable.
Article Details
Como citar
OROZCO GONZÁLEZ, Claudia Nelly et al.
Estrategias nutricionales para la disminución de Long COVID-19. Una Revisión de la literatura.
Medicina e Investigación Universidad Autónoma del Estado de México, [S.l.], v. 12, n. 2, p. 97-108, jul. 2024.
ISSN 2594-0600.
Disponible en: <https://medicinainvestigacion.uaemex.mx/article/view/22433>. Fecha de acceso: 10 oct. 2024
doi: https://doi.org/10.36677/medicinainvestigacion.v12i2.22433.
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Esta obra está bajo licencia internacional Creative Commons Reconocimiento-NoComercial-SinObrasDerivadas 4.0.
Citas
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Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of corona- virus disease (COVID-19) outbreak. J Autoimmun. 2020; 109: 102433.
López-Sampalo A, Bernal-López MR, Gómez-Huelgas R. Persistent COVID-19 syndrome. A narrative review. Rev Clin Esp. 2022; 222 (4): 241-50.
Huang Y, Ting M, Hsu B, Tsai J. Demonstration of reserved anterior pituitary function among patients with amenorrhea after postpartum hemorrhage. Gynecol Endocrinol Off J Int Soc Gynecol Endocrinol. 2000; 14 (2): 99-104.
Xu X, Chen P, Wang J, Feng J, Zhou H, Li X, et al. Evolution of the novel coronavirus from the ongoing Wuhan outbreak and modeling of its spike protein for risk of human transmission. Sci China Life Sci. 2020; 63 (3): 457-60.
Disser NP, De Micheli AJ, Schonk MM, Konnaris MA, Piacentini AN, Edon DL, et al. Musculoskeletal Consequences of COVID-19. J Bone Jt Surg. 2020; 102 (14): 1197-204.
Tramontana F, Napoli N, El-Hajj Fuleihan G, Strollo R. The D-side of COVID-19: musculoskeletal benefits of vitamin D and beyond. Endocrine. 2020; 69 (2): 237-40.
Zhao Z, Li Y, Zhou L, Zhou X, Xie B, Zhang W, et al. Prevention and treatment of COVID-19 using Traditional Chinese Medicine: A review. Phytomed- icine. 2021; 85: 153308.
Arkin N, Krishnan K, Chang MG, Bittner EA. Nutrition in critically ill patients with COVID-19: Challenges and special considerations. Clin Nutr Edinb Scotl. 2020; 39 (7): 2327-8.
Chaplin DD. Overview of the immune response. J Allergy Clin Immunol. 2010; 125 (2): S3-23.
Gombart AF, Pierre A, Maggini S. A Review of Micronutrients and the Immune System–Working in Harmony to Reduce the Risk of Infection. Nutri- ents. 2020; 12 (1): 236.
Berger MM, Shenkin A, Schweinlin A, Amrein K, Augsburger M, Biesalski HK, et al. ESPEN micronutrient guideline. Clin Nutr. 2022; 41 (6): 1357-424.
Maggini S, Pierre A, Calder P. Immune Function and Micronutrient Require- ments Change over the Life Course. Nutrients. 2018; 10 (10): 1531.
Yang F, Zhang Y, Tariq A, Jiang X, Ahmed Z, Zhihao Z, et al. Food as medicine: A possible preventive measure against coronavirus disease (COVID-19). Phytother Res PTR. 2020; 34 (12): 3124-36.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. Declaración PRISMA 2020: una guía actualizada para la publicación de revisiones sistemáticas. Rev Esp Cardiol. 2021; 74 (9): 790-9.
AHA. a American Heart Association (AHA) avala los 14 puntos de dieta mediterránea del estudio PREDIMED [Internet]. 2021 [citado 11 de octubre de 2023]. Disponible en: https://cardioalianza.org/la-american-heart-associa- tion-aha-avala-los-14-puntos-de-dieta-mediterranea-del-estudio-predimed/#:~:text=%E2%80%9CLa%20dieta%20mediterr%C3%A1nea%20fue%20elegida,la%20AHA%E2%80%9D%20declara%20el%20Dr.
Farrugia F, Refalo D, Bonello D, Cuschieri S. The impact of the COVID-19 pandemic on Mediterranean diet adherence: A narrative systematic review. Nutr Health. 2023; 02601060231187511.
Mieziene B, Burkaite G, Emeljanovas A, Tilindiene I, Novak D, Kawachi I. Adherence to Mediterranean diet among Lithuanian and Croatian students during COVID-19 pandemic and its health behavior correlates. Front Public
Health. 2022; 10: 1000161.
Tárraga López PJ, Panisello Royo JM, Carbayo Herencia J, Carro A, Rosich N, Panisello M, et al. Changes in adherence to the Mediterranean diet observed in a Spanish population during confinement for the SARS-CoV-2 pandemic. Nutr Hosp. 2020; 18 (10): 109-20.
Perez-Araluce R, Martinez-Gonzalez MA, Fernández-Lázaro CI, Bes-Rastrollo M, Gea A, Carlos S. Mediterranean diet and the risk of COVID-19 in the ‘Seguimiento Universidad de Navarra’ cohort. Clin Nutr. 2022; 41 (12): 3061-8.
Gomes DL, da Silva ECB, Reis AL, Carvalhal MM de L, Kikuchi JLD, Uliana GC, et al. Adherence to Online Nutritional Monitoring Was Associated with Better Food Habits in People with T1DM during the COVID-19 Pandemic in Brazil. Nutrients. 2023; 15 (9): 2121.
Alfonso Viguria U, Casamitjana N. Early Interventions and Impact of COVID-19 in Spain. Int J Environ Res Public Health. 2021; 18 (8): 4026.
Gerini F, Fantechi T, Contini C, Casini L, Scozzafava G. Adherence to the Mediterranean Diet and COVID-19: A Segmentation Analysis of Italian and US Consumers. Sustainability. 2022; 14 (7): 3823.
Fitzgibbon M, Blumstein L, Schiffer L, Antonic MA, McLeod A, Dakers R, et al. Adapting to the COVID-19 pandemic on Building Research in Diet and Cognition (BRIDGE) trial. Trials. 2021; 22 (1): 459.
Merino J, Dashti HS, Li SX, Sarnowski C, Justice AE, Graff M, et al. Genome-wide meta-analysis of macronutrient intake of 91,114 European ancestry participants from the cohorts for heart and aging research in genomic epidemiology consortium. Mol Psychiatry. 2019; 24 (12): 1920-32.
Nakamura M, Shirai Y, Sakuma M. Dietary Changes during the COVID-19 Pandemic: A Longitudinal Study Using Objective Sequential Diet Records from an Electronic Purchase System in a Workplace Cafeteria in Japan. Nutrients. 2021; 13 (5): 1606.
Doaei S, Gholami S, Rastgoo S, Gholamalizadeh M, Bourbour F, Bagheri SE, et al. The effect of omega-3 fatty acid supplementation on clinical and bio-chemical parameters of critically ill patients with COVID-19: a randomized clinical trial. J Transl Med. 2021; 19 (1): 128.
Beigmohammadi MT, Bitarafan S, Hoseindokht A, Abdollahi A, Amoozadeh L, Soltani D. The effect of supplementation with vitamins A, B, C, D, and E on disease severity and inflammatory responses in patients with COVID-19: a randomized clinical trial. Trials. 2021; 22 (1): 802.
Hansen KS, Mogensen TH, Agergaard J, Schiøttz-Christensen B, Østergaard L, Vibholm LK, et al. High-dose coenzyme Q10 therapy versus placebo in patients with post COVID-19 condition: a randomized, phase 2, crossover trial. Lancet Reg Health - Eur. 2023; 24: 100539.
Wilson D, Driller M, Winwood P, Johnston B, Gill N. The Effects of a Brief Lifestyle Intervention on the Health of Overweight Airline Pilots during COVID-19: A 12-Month Follow-Up Study. Nutrients. 2021; 13 (12): 4288.
Li Q, Cheng F, Xu Q, Su Y, Cai X, Zeng F, et al. The role of probiotics in coronavirus disease-19 infection in Wuhan: A retrospective study of 311 severe patients. Int Immunopharmacol. 2021; 95: 107531.
de Faria Coelho-Ravagnani C, Corgosinho FC, Sanches FLFZ, Prado CMM, Laviano A, Mota JF. Dietary recommendations during the COVID-19 pan- demic. Nutr Rev. 2021; 79 (4): 382-93.
Che Abdul Rahim N, Manjit Singh JS, Pardi M, Zainuddin AA, Salleh R. Anal- ysis of Available Nutrition Recommendations to Combat COVID-19: A Scop- ing Review. Malays J Med Sci. 2021; 28 (3): 18-45.
Sharma S, Di Castelnuovo A, Cerletti C, Donati MB, de Gaetano G, Iacoviello L, et al. Diet Quality and Risk of SARS-CoV-2 Infection or COVID-19: A Systematic Review of Observational Studies. Adv Nutr. 2023; S2161831323013790.
Butler-Laporte G, Nakanishi T, Mooser V, Morrison DR, Abdullah T, Adeleye O, et al. Vitamin D and COVID-19 susceptibility and severity in the COVID-19 Host Genetics Initiative: A Mendelian randomization study. Minelli C, editor. PLOS Med. 18 (6): e1003605.
Muffone ARMC, de Oliveira Lübke PDP, Rabito EI. Mediterranean diet and infertility: a systematic review with meta-analysis of cohort studies. Nutr Rev. 2023; 81 (7): 775-89.
Hou YC, Su WL, Chao YC. COVID-19 Illness Severity in the Elderly in Relation to Vegetarian and Non-vegetarian Diets: A Single-Center Experience. Front Nutr. 2022; 9: 837458.
Morales Camacho WJ, Osma Zambrano SE, Morales Camacho MA, Herrera Contreras AC, Rangel Acevedo A, Duarte Valencia EJ, et al. Nutritional status and high adherence to the Mediterranean diet in Colombian school children and teenagers during the COVID-19 pandemic according to sex. J Nutr Sci. 2021; 10: 1-7.
Cauwenberghs N, Prunicki M, Sabovčik F, Perelman D, Contrepois K, Li X, et al. Temporal changes in soluble angiotensin-converting enzyme 2 associated with metabolic health, body composition, and proteome dynamics during a weight loss diet intervention: a randomized trial with implications for the COVID-19 pandemic. Am J Clin Nutr. 2021; 114 (5): 1655-65.
Chatzinikola C, Papavasileiou V, Koutelidakis A. Mediterranean Diet Adherence and Physical Activity Level in AdolescentsDuring the Lockdown in the COVID-19 Pandemic: A Cross-sectionalStudy in Greek Island of Rhodes. Curr Nutr Food Sci. 2023; 19 (4): 469-77.
Doğan G, Özyildirim C, Yabanci Ayhan N. Supplementation use and diet changes during COVID-19 pandemic according to anxiety level and Mediterranean diet adherence. Clin Nutr ESPEN. 2023; 54: 122-9.
GołębiowskaJ,Zimny-ZającA,MakuchS,DróżdżM,DudekK,ŻórawskaJ,etal. The Impact of Different Types of Diet on the Prevention of Diseases among Pol- ish Inhabitants, Including COVID-19 Disease. Nutrients. 2023; 15 (18): 3947.
Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A Novel Coronavirus from Patients with Pneumonia in China, 2019. N Engl J Med. 2020; 382 (8): 727-33.
Rothan HA, Byrareddy SN. The epidemiology and pathogenesis of corona- virus disease (COVID-19) outbreak. J Autoimmun. 2020; 109: 102433.
López-Sampalo A, Bernal-López MR, Gómez-Huelgas R. Persistent COVID-19 syndrome. A narrative review. Rev Clin Esp. 2022; 222 (4): 241-50.
Huang Y, Ting M, Hsu B, Tsai J. Demonstration of reserved anterior pituitary function among patients with amenorrhea after postpartum hemorrhage. Gynecol Endocrinol Off J Int Soc Gynecol Endocrinol. 2000; 14 (2): 99-104.
Xu X, Chen P, Wang J, Feng J, Zhou H, Li X, et al. Evolution of the novel coronavirus from the ongoing Wuhan outbreak and modeling of its spike protein for risk of human transmission. Sci China Life Sci. 2020; 63 (3): 457-60.
Disser NP, De Micheli AJ, Schonk MM, Konnaris MA, Piacentini AN, Edon DL, et al. Musculoskeletal Consequences of COVID-19. J Bone Jt Surg. 2020; 102 (14): 1197-204.
Tramontana F, Napoli N, El-Hajj Fuleihan G, Strollo R. The D-side of COVID-19: musculoskeletal benefits of vitamin D and beyond. Endocrine. 2020; 69 (2): 237-40.
Zhao Z, Li Y, Zhou L, Zhou X, Xie B, Zhang W, et al. Prevention and treatment of COVID-19 using Traditional Chinese Medicine: A review. Phytomed- icine. 2021; 85: 153308.
Arkin N, Krishnan K, Chang MG, Bittner EA. Nutrition in critically ill patients with COVID-19: Challenges and special considerations. Clin Nutr Edinb Scotl. 2020; 39 (7): 2327-8.
Chaplin DD. Overview of the immune response. J Allergy Clin Immunol. 2010; 125 (2): S3-23.
Gombart AF, Pierre A, Maggini S. A Review of Micronutrients and the Immune System–Working in Harmony to Reduce the Risk of Infection. Nutri- ents. 2020; 12 (1): 236.
Berger MM, Shenkin A, Schweinlin A, Amrein K, Augsburger M, Biesalski HK, et al. ESPEN micronutrient guideline. Clin Nutr. 2022; 41 (6): 1357-424.
Maggini S, Pierre A, Calder P. Immune Function and Micronutrient Require- ments Change over the Life Course. Nutrients. 2018; 10 (10): 1531.
Yang F, Zhang Y, Tariq A, Jiang X, Ahmed Z, Zhihao Z, et al. Food as medicine: A possible preventive measure against coronavirus disease (COVID-19). Phytother Res PTR. 2020; 34 (12): 3124-36.
Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. Declaración PRISMA 2020: una guía actualizada para la publicación de revisiones sistemáticas. Rev Esp Cardiol. 2021; 74 (9): 790-9.
AHA. a American Heart Association (AHA) avala los 14 puntos de dieta mediterránea del estudio PREDIMED [Internet]. 2021 [citado 11 de octubre de 2023]. Disponible en: https://cardioalianza.org/la-american-heart-associa- tion-aha-avala-los-14-puntos-de-dieta-mediterranea-del-estudio-predimed/#:~:text=%E2%80%9CLa%20dieta%20mediterr%C3%A1nea%20fue%20elegida,la%20AHA%E2%80%9D%20declara%20el%20Dr.
Farrugia F, Refalo D, Bonello D, Cuschieri S. The impact of the COVID-19 pandemic on Mediterranean diet adherence: A narrative systematic review. Nutr Health. 2023; 02601060231187511.
Mieziene B, Burkaite G, Emeljanovas A, Tilindiene I, Novak D, Kawachi I. Adherence to Mediterranean diet among Lithuanian and Croatian students during COVID-19 pandemic and its health behavior correlates. Front Public
Health. 2022; 10: 1000161.
Tárraga López PJ, Panisello Royo JM, Carbayo Herencia J, Carro A, Rosich N, Panisello M, et al. Changes in adherence to the Mediterranean diet observed in a Spanish population during confinement for the SARS-CoV-2 pandemic. Nutr Hosp. 2020; 18 (10): 109-20.
Perez-Araluce R, Martinez-Gonzalez MA, Fernández-Lázaro CI, Bes-Rastrollo M, Gea A, Carlos S. Mediterranean diet and the risk of COVID-19 in the ‘Seguimiento Universidad de Navarra’ cohort. Clin Nutr. 2022; 41 (12): 3061-8.
Gomes DL, da Silva ECB, Reis AL, Carvalhal MM de L, Kikuchi JLD, Uliana GC, et al. Adherence to Online Nutritional Monitoring Was Associated with Better Food Habits in People with T1DM during the COVID-19 Pandemic in Brazil. Nutrients. 2023; 15 (9): 2121.
Alfonso Viguria U, Casamitjana N. Early Interventions and Impact of COVID-19 in Spain. Int J Environ Res Public Health. 2021; 18 (8): 4026.
Gerini F, Fantechi T, Contini C, Casini L, Scozzafava G. Adherence to the Mediterranean Diet and COVID-19: A Segmentation Analysis of Italian and US Consumers. Sustainability. 2022; 14 (7): 3823.
Fitzgibbon M, Blumstein L, Schiffer L, Antonic MA, McLeod A, Dakers R, et al. Adapting to the COVID-19 pandemic on Building Research in Diet and Cognition (BRIDGE) trial. Trials. 2021; 22 (1): 459.
Merino J, Dashti HS, Li SX, Sarnowski C, Justice AE, Graff M, et al. Genome-wide meta-analysis of macronutrient intake of 91,114 European ancestry participants from the cohorts for heart and aging research in genomic epidemiology consortium. Mol Psychiatry. 2019; 24 (12): 1920-32.
Nakamura M, Shirai Y, Sakuma M. Dietary Changes during the COVID-19 Pandemic: A Longitudinal Study Using Objective Sequential Diet Records from an Electronic Purchase System in a Workplace Cafeteria in Japan. Nutrients. 2021; 13 (5): 1606.
Doaei S, Gholami S, Rastgoo S, Gholamalizadeh M, Bourbour F, Bagheri SE, et al. The effect of omega-3 fatty acid supplementation on clinical and bio-chemical parameters of critically ill patients with COVID-19: a randomized clinical trial. J Transl Med. 2021; 19 (1): 128.
Beigmohammadi MT, Bitarafan S, Hoseindokht A, Abdollahi A, Amoozadeh L, Soltani D. The effect of supplementation with vitamins A, B, C, D, and E on disease severity and inflammatory responses in patients with COVID-19: a randomized clinical trial. Trials. 2021; 22 (1): 802.
Hansen KS, Mogensen TH, Agergaard J, Schiøttz-Christensen B, Østergaard L, Vibholm LK, et al. High-dose coenzyme Q10 therapy versus placebo in patients with post COVID-19 condition: a randomized, phase 2, crossover trial. Lancet Reg Health - Eur. 2023; 24: 100539.
Wilson D, Driller M, Winwood P, Johnston B, Gill N. The Effects of a Brief Lifestyle Intervention on the Health of Overweight Airline Pilots during COVID-19: A 12-Month Follow-Up Study. Nutrients. 2021; 13 (12): 4288.
Li Q, Cheng F, Xu Q, Su Y, Cai X, Zeng F, et al. The role of probiotics in coronavirus disease-19 infection in Wuhan: A retrospective study of 311 severe patients. Int Immunopharmacol. 2021; 95: 107531.
de Faria Coelho-Ravagnani C, Corgosinho FC, Sanches FLFZ, Prado CMM, Laviano A, Mota JF. Dietary recommendations during the COVID-19 pan- demic. Nutr Rev. 2021; 79 (4): 382-93.
Che Abdul Rahim N, Manjit Singh JS, Pardi M, Zainuddin AA, Salleh R. Anal- ysis of Available Nutrition Recommendations to Combat COVID-19: A Scop- ing Review. Malays J Med Sci. 2021; 28 (3): 18-45.
Sharma S, Di Castelnuovo A, Cerletti C, Donati MB, de Gaetano G, Iacoviello L, et al. Diet Quality and Risk of SARS-CoV-2 Infection or COVID-19: A Systematic Review of Observational Studies. Adv Nutr. 2023; S2161831323013790.
Butler-Laporte G, Nakanishi T, Mooser V, Morrison DR, Abdullah T, Adeleye O, et al. Vitamin D and COVID-19 susceptibility and severity in the COVID-19 Host Genetics Initiative: A Mendelian randomization study. Minelli C, editor. PLOS Med. 18 (6): e1003605.
Muffone ARMC, de Oliveira Lübke PDP, Rabito EI. Mediterranean diet and infertility: a systematic review with meta-analysis of cohort studies. Nutr Rev. 2023; 81 (7): 775-89.
Hou YC, Su WL, Chao YC. COVID-19 Illness Severity in the Elderly in Relation to Vegetarian and Non-vegetarian Diets: A Single-Center Experience. Front Nutr. 2022; 9: 837458.
Morales Camacho WJ, Osma Zambrano SE, Morales Camacho MA, Herrera Contreras AC, Rangel Acevedo A, Duarte Valencia EJ, et al. Nutritional status and high adherence to the Mediterranean diet in Colombian school children and teenagers during the COVID-19 pandemic according to sex. J Nutr Sci. 2021; 10: 1-7.
Cauwenberghs N, Prunicki M, Sabovčik F, Perelman D, Contrepois K, Li X, et al. Temporal changes in soluble angiotensin-converting enzyme 2 associated with metabolic health, body composition, and proteome dynamics during a weight loss diet intervention: a randomized trial with implications for the COVID-19 pandemic. Am J Clin Nutr. 2021; 114 (5): 1655-65.
Chatzinikola C, Papavasileiou V, Koutelidakis A. Mediterranean Diet Adherence and Physical Activity Level in AdolescentsDuring the Lockdown in the COVID-19 Pandemic: A Cross-sectionalStudy in Greek Island of Rhodes. Curr Nutr Food Sci. 2023; 19 (4): 469-77.
Doğan G, Özyildirim C, Yabanci Ayhan N. Supplementation use and diet changes during COVID-19 pandemic according to anxiety level and Mediterranean diet adherence. Clin Nutr ESPEN. 2023; 54: 122-9.
GołębiowskaJ,Zimny-ZającA,MakuchS,DróżdżM,DudekK,ŻórawskaJ,etal. The Impact of Different Types of Diet on the Prevention of Diseases among Pol- ish Inhabitants, Including COVID-19 Disease. Nutrients. 2023; 15 (18): 3947.