Effects of multi-nutrient supplementation on COVID-19 severity in elderly patients

In a recent study posted to the medRxiv* pre-print server, a team of researchers analyzed the effects of multi-nutrient supplementation on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine efficacy and the overall improvement of respiratory and muscle function in elderly coronavirus disease 2019 (COVID-19) patients.

Introduction

Many studies have reported that older adults are more susceptible to coronavirus disease 2019 (COVID-19) -related hospitalizations. This vulnerability of the elderly was attributed to risk factors like low vitamin D, low serum levels, poor respiratory and muscular function, malnutrition, immunosenescence, limited mobility, and comorbidities.  

About the study

The present Pomerium study assessed the role of multi-nutrient supplements in improving immune responses and reducing the number and severity of COVID-19-related cases in the elderly.

A single-blinded randomized controlled trial (RCT) was conducted among 160 older adults who were sarcopenic aged-care residents of ages 75 and above. These individuals might or might not be vaccinated against SARS-CoV-2 or seasonal influenza infections. The study group was randomly treated with multi-nutrient supplements given in two doses daily 220 ml bottles, or, treated with usual care. 

The effects of the supplements were assessed 12 weeks after the treatment was terminated. An evaluation was performed at baseline for changes in immune response, serum levels, respiratory function, muscle-related measures, and quality of life (QoL), at week 4 for immune response and serum level changes, and at week 12 for changes in immunity, serum levels, and other measures.

Events were recorded 12 weeks after the supplementation was ceased. Physical function was assessed using testing procedures that measured handgrip strength, gait speed, and short physical performance battery (SPPB).  

The primary outcomes of the study included T-cell subsets measured at baseline, at week 4, and week 12. The secondary outcomes included serum vitamin D and albumin levels estimated at weeks 4 and 12, multiple immunosenescence markers at baseline, week 4, and week 12; and measures of handgrip strength, SPPB, body composition, respiratory function, and QoL.

Results

The results of this Pomerium study showed that nutritional supplements enhanced T-cell subsets and improved the individual’s immune response against SARS-CoV-2. It was also found that multi-nutrient supplements improved immunity and clinical outcomes in aged adults. Anti-viral resistance against SARS-CoV-2 was enhanced on treatment with zinc, vitamin D, protein, and selenium. Serum levels above 50 nmol/L were noted in 19% of patients in intensive care units while the same was observed in 39% of patients in general medical wards.

Vitamin D supplementation enhanced the TGFβ plasma level in response to viral infections. Furthermore, it was noted that daily vitamin D consumption improved QoL and respiratory function while reducing the risk of obstructive lung disease in adult patients. The reduced risk for acute exacerbations of respiratory diseases, pneumonia, and lung function in older adults was also observed with the supplementation of vitamin D.

The study demonstrated the benefit of regular protein intake in the improved muscle mass and function observed in sarcopenic adults and reduced mobility impairment. Regular calcium intake and an increase in daily protein intake from 0.9g/kg body weight to 1.1g/kg body weight enabled better maintenance of appendicular muscle mass. Furthermore, analysis of protein intake showed it has a direct-acting inhibitory action against SARS-CoV-2 infection and replication.

Calcium β-hydroxy-β-methyl butyrate (CaHMB) supplementation helped in the protection of muscle mass and the prevention of muscle atrophy in older adults. Treatment with CaHMB along with amino acid supplementation reduced viral infection in the elderly infected with human immunodeficiency virus (HIV). Trace elements like Selenium were noted to increase IFN-γ levels, especially when consumed after vaccination, leading to improved immune responses against viral infections like SARS-CoV-2 infections. 

Conclusion

The study findings showed that cellular immunity in aged adults was significantly improved by treatment with multi-nutrient supplements. Supplementation with CaHMB, vitamin D, and protein in sarcopenic older adults enhanced muscle mass and function. Selenium supplementation was shown to be safe as an adjuvant therapy against viral infections including COVID-19. Improved immune responses, reduced inflammation, and reduced immunity dysfunction were observed with the inclusion of zinc in nutritional supplements.  

These observations regarding the treatment of older COVID-19 patients with multi-nutritional supplements can also be utilized to reduce the impact of viruses other than SARS-CoV-2 on the health, immunity, and QoL of the patients. Taken together, the findings show that scalable and practical clinical care can be provided to elderly patients based on evidence-based dietary plans to reduce the infection and severity of viral infections like COVID-19.

*Important notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Written by

Susha Cheriyedath

Susha has a Bachelor of Science (B.Sc.) degree in Chemistry and Master of Science (M.Sc) degree in Biochemistry from the University of Calicut, India. She always had a keen interest in medical and health science. As part of her masters degree, she specialized in Biochemistry, with an emphasis on Microbiology, Physiology, Biotechnology, and Nutrition. In her spare time, she loves to cook up a storm in the kitchen with her super-messy baking experiments.