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Cited by 42Gut microbiota and healthSARS-CoV-2 and COVID-19 ResearchNutritional Studies and Diet

The microbiota-mediated dietary and nutritional interventions for COVID-19

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Gasmi, Amin, Tippairote, Torsak, Mujawdiya, Pavan Kumar, Peana, Massimiliano, Menzel, Alain, Dadar, Maryam, Gasmi Benahmed, Asma, Bjørklund, Geir·2021·Clinical Immunology
DOI 10.1016/j.clim.2021.108725PMC PMC8032598
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Abstract

Worldwide, scientists are looking for specific treatment for COVID-19. Apart from the antiviral approach, the interventions to support healthy immune responses to the virus are feasible through diet, nutrition, and lifestyle approaches. This narrative review explores the recent studies on dietary, nutritional, and lifestyle interventions that influence the microbiota-mediated immunomodulatory effects against viral infections. Cumulative studies reported that the airway microbiota and SARS-CoV-2 leverage each other and determine the pathogen-microbiota-host responses. Cigarette smoking can disrupt microbiota abundance. The composition and diversification of intestinal microbiota influence the airway microbiota and the innate and adaptive immunity, which require supports from the balance of macro- and micronutrients from the diet. Colorful vegetables supplied fermentable prebiotics and anti-inflammatory, antioxidant phytonutrients. Fermented foods and beverages support intestinal microbiota. In sensitive individuals, the avoidance of the high immunoreactive food antigens contributes to antiviral immunity. This review suggests associations between airway and intestinal microbiota, antiviral host immunity, and the influences of dietary, nutritional, and lifestyle interventions to prevent the clinical course toward severe COVID-19.

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  • Probiotics and synbiotics can mediate the balance and diversity of the gut microbiota, which plays a significant role in the host's response to many viral infections.

    “Probiotics and synbiotics can mediate the balance and diversity of the gut microbiota, which plays a significant role in the host's response to many viral infections, either by promoting the attachment of viruses to host cells or by supporting antiviral immunity (such as interferons and innate immune activation).”

    From Comparative effectiveness of oral nutritional supplements in preventing respiratory tract infections among adults: a systematic review and network meta-analysis (2025) · cites this paper as [6]

    The Probiotics section says probiotics may mediate intestinal microbiome balance and diversification and augment antiviral immunity. The section on microbiota and SARS-CoV-2 infections says microbiota can affect responses to many viruses through viral attachment or antiviral immunity. The paper does not make the same balance-and-diversity claim for synbiotics; no page numbers are available in our copy. (LLM, conf=0.86)

    Experimental — accuracy not yet measured

  • Supplementing with micronutrients (including vitamins A, C, D, E, zinc, selenium, iron) and plant-based antioxidants (such as flavonoids and polyphenols) can reduce the risk of RTI by activating the immune system, reducing oxidative stress, providing anti-inflammatory effects, and maintaining respiratory tract barrier function.

    “Supplementing with micronutrients (including vitamins A, C, D, E, zinc, selenium, iron, etc.) and plant-based antioxidants (such as flavonoids and polyphenols) can reduce the risk of RTI by activating the immune system, reducing oxidative stress, providing anti-inflammatory effects, and maintaining respiratory tract barrier function.”

    From Comparative effectiveness of oral nutritional supplements in preventing respiratory tract infections among adults: a systematic review and network meta-analysis (2025) · cites this paper as [6]

    The General aspects section says vitamin D, zinc and selenium deficiencies can compromise antiviral responses and that supplementation may benefit people with those deficiencies. It also says antioxidant, anti-inflammatory phytonutrients may support responses to SARS-CoV-2. It does not establish that the full listed set of supplements reduces respiratory tract infection risk, or that maintaining respiratory tract barrier function is a mechanism. Page numbers are unavailable in our copy. (LLM, conf=0.87)

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Authors
Gasmi, A., Tippairote, T., Mujawdiya, P. K., Peana, M., Menzel, A., Dadar, M., Gasmi Benahmed, A., & Bjørklund, G.
Affiliations
  • Société Francophone de Nutrithérapie et de Nutrigénétique Appliquée (FR)
  • Mahidol University (TH)
  • Birla Institute of Technology and Science, Pilani (IN)
  • University of Sassari (IT)
  • Razi Vaccine and Serum Research Institute (IR)
  • Council for Nutritional and Environmental Medicine (NO)
Corresponding author
Bjørklund, Geir
ORCID
Venue
Clinical Immunology
Publisher
Elsevier BV
Published
2021-05
Volume
226
Pages
108725
ISSN
1521-6616 (ISSN-L)
DOI
10.1016/j.clim.2021.108725
PMC
PMC8032598
OpenAlex
W3155330492
Cited by
42
References
123
Citations by year
2025: 5 · 2024: 5 · 2023: 11 · 2022: 14 · 2021: 7
FWCI
0.97
Type
journal article
Language
en
Open access
Licence
Locations
  • Clinical Immunology (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • UnissResearch (Università degli Studi di Sassari) (submittedVersion)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Health Sciences › Medicine › Infectious Diseases › SARS-CoV-2 and COVID-19 Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Nutritional Studies and Diet
Keywords
COVID-19 pandemic, SARS-CoV-2, gut microbiota, airway microbiome, dietary intervention, lifestyle intervention, immunomodulation, cigarette smoking, prebiotics, fermented foods, phytochemicals, innate and adaptive immunity, severe COVID-19 prevention
MeSH terms
Gastrointestinal Microbiome, Host Microbial Interactions, COVID-19, SARS-CoV-2, Anti-Inflammatory Agents, Antioxidants, Humans, Immunity, Innate, Life Style, Lung, Probiotics, Prebiotics, Adaptive Immunity

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