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      Micronutrients and Bioactive Substances: Their Potential Roles in Combating COVID-19

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          Highlights

          • COVID-19 pandemic has been overwhelmingly affecting public health and setting huge economic crises across the world.

          • Despite the absence of specific drugs, there is a need for alternative nutritional approaches

          • Micronutrients and bioactive substances can be considered in alternative nutritional approaches as they:

            • have great potentials to interfere with spike glycoproteins, angiotensin converting enzyme 2 receptors and transmembrane protease serine 2 at the entry site of SARS-CoV-2;

            • inhibit proteases such as Papain-Like protease, 3 Chymotrypsin-Like protease and RNA dependent RNA polymerase;

            • have anti-inflammatory, antioxidant and antiviral properties;

            • can bolster immune system and help to mitigate clinical features

          Abstract

          Objective

          COVID-19 pandemic has been seriously threatening public health and setting huge economic crises across the world. In absence of specific drugs to COVID-19, there is an urgent need to look for alternative approaches. Therefore, the aim of this paper was to review the roles of micronutrients and bioactive substances as potential alternative approaches in combating COVID-19.

          Methods

          This review was based on literature identified using electronic searches in different databases.

          Results

          Vitamins (A, B, C, D and E), minerals (selenium and zinc) and bioactive substances from curcumin, echinacea, propolis, garlic, soybean, green tea, and other polyphenols were identified for having potential roles in interfering with spike glycoproteins, angiotensin converting enzyme 2 and transmembrane protease serine 2 (TMPRSS2) at the entry site; and inhibiting activities of Papain-Like protease (PLpro), 3 Chymotrypsin-Like protease (3CLpro) and RNA dependent RNA polymerase (RdRp) in the replication cycle of SARS-CoV-2. Having immunomodulating, anti-inflammatory, antioxidant and antiviral properties, such micronutrients and bioactive substances are consequently the promising alterative nutritional approaches to combat COVID-19.

          Conclusion

          To put in nutshell, the roles of micronutrients and bioactive substances in COVID-19 are exciting research areas and thus, this review may guide researchers to undertake further studies.

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          Most cited references173

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          Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

          Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
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            Clinical Characteristics of Coronavirus Disease 2019 in China

            Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)
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              SARS-CoV-2 Cell Entry Depends on ACE2 and TMPRSS2 and Is Blocked by a Clinically Proven Protease Inhibitor

              Summary The recent emergence of the novel, pathogenic SARS-coronavirus 2 (SARS-CoV-2) in China and its rapid national and international spread pose a global health emergency. Cell entry of coronaviruses depends on binding of the viral spike (S) proteins to cellular receptors and on S protein priming by host cell proteases. Unravelling which cellular factors are used by SARS-CoV-2 for entry might provide insights into viral transmission and reveal therapeutic targets. Here, we demonstrate that SARS-CoV-2 uses the SARS-CoV receptor ACE2 for entry and the serine protease TMPRSS2 for S protein priming. A TMPRSS2 inhibitor approved for clinical use blocked entry and might constitute a treatment option. Finally, we show that the sera from convalescent SARS patients cross-neutralized SARS-2-S-driven entry. Our results reveal important commonalities between SARS-CoV-2 and SARS-CoV infection and identify a potential target for antiviral intervention.
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                Author and article information

                Journal
                Nutrition
                Nutrition
                Nutrition (Burbank, Los Angeles County, Calif.)
                Elsevier Inc.
                0899-9007
                1873-1244
                4 December 2020
                4 December 2020
                : 111103
                Affiliations
                [1 ]70599 Stuttgart, Germany
                [2 ]Institute of Nutritional Sciences, University of Hohenheim, Wolgrasweg 47, 70593 Stuttgart, Germany
                Author notes
                [* ]Corresponding author: Dr. Tibebeselassie Seyoum Keflie, +4917658995469.
                Article
                S0899-9007(20)30386-5 111103
                10.1016/j.nut.2020.111103
                7717879
                33450678
                08b44861-743a-4205-a367-7123f7c2115b
                © 2020 Elsevier Inc. All rights reserved.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 13 September 2020
                : 11 November 2020
                : 30 November 2020
                Categories
                Review

                Nutrition & Dietetics
                covid-19,sars-cov-2,cytokine storms,lung injury,micronutrients,bioactive substances

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