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

Clin Immunol. 2021 May:226:108725. doi: 10.1016/j.clim.2021.108725. Epub 2021 Apr 9.


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.

Keywords: COVID-19; Gut-lung axis; Microbiota; Prebiotics; Probiotics; SARS-CoV-2.

Publication types

  • Review

MeSH terms

  • Adaptive Immunity
  • Anti-Inflammatory Agents / pharmacology
  • Antioxidants / pharmacology
  • COVID-19 / diet therapy*
  • COVID-19 / immunology*
  • COVID-19 / microbiology
  • COVID-19 / prevention & control
  • Gastrointestinal Microbiome / immunology*
  • Host Microbial Interactions / immunology*
  • Humans
  • Immunity, Innate
  • Life Style
  • Lung / immunology*
  • Lung / microbiology
  • Lung / pathology
  • Lung / virology
  • Prebiotics / administration & dosage
  • Probiotics / pharmacology
  • Probiotics / therapeutic use
  • SARS-CoV-2 / pathogenicity


  • Anti-Inflammatory Agents
  • Antioxidants
  • Prebiotics