Coronavirus Disease 2019 (COVID-19) and Nutritional Status: The Missing Link?

Adv Nutr. 2021 Jun 1;12(3):682-692. doi: 10.1093/advances/nmaa125.


Coronavirus disease 2019 (COVID-19) is an emerging disease that has reached pandemic status by rapidly spreading worldwide. Elderly individuals and patients with comorbidities such as obesity, diabetes, and hypertension show a higher risk of hospitalization, severe disease, and mortality by acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. These patients frequently show exacerbated secretion of proinflammatory cytokines associated with an overreaction of the immune system, the so-called cytokine storm. Host nutritional status plays a pivotal role in the outcome of a variety of different infectious diseases. It is known that the immune system is highly affected by malnutrition, leading to decreased immune responses with consequent augmented risk of infection and disease severity. Body composition, especially low lean mass and high adiposity, has consistently been linked to worsened prognosis in many different diseases. In this review, evidence concerning the impact of nutritional status on viral infection outcomes is discussed.

Keywords: BMI; COVID-19; SARS-CoV-2; immune system; obesity; sarcopenia; undernutrition.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aged
  • COVID-19*
  • Cytokine Release Syndrome
  • Humans
  • Malnutrition* / complications
  • Nutritional Status
  • SARS-CoV-2