Effect of immunonutrition on serum levels of C-reactive protein and lymphocytes in patients with COVID-19: a randomized, controlled, double-blind clinical trial

• Published in: Nutrición hospitalaria : organo oficial de la Sociedad Española de Nutrición Parenteral y Enteral Vol. 39; no. 1; pp. 20 - 26
• Main Authors: Pimentel, Rodrigo Fernandes Weyll, Silva, Arthur Pinto, Santana, Amália Ivine Costa, Silva, Douglas de Souza E, Ramos, Mariângela de Souza, Souza, Márcio Costa de, Suen, Vivian Marques Miguel, Maduro, Isolda Padro de Negreiros Nogueira, Ribas Filho, Durval, D'Oliveira Júnior, Argemiro, da Silva, Dandara Almeida Reis, Coelho, Julita Maria Freitas, Gomes, Antonio Marcos Tosoli, Machado, Paulo Roberto Lima, Merces, Magno Conceição das
• Format: Journal Article
• Language: English
• Published: Spain Grupo Arán 09-02-2022
• Subjects: Adult; C-Reactive Protein; COVID-19; Dietary Supplements; Double-Blind Method; Female; Humans; Lymphocytes; Nutrition & Dietetics; SARS-CoV-2; Infecciones por coronavirus. Terapia nutricional. Arginina. Omega-3. Proteína C-reactiva; Arginina; Infecciones por coronavirus; Coronavirus infection; C-reactive protein; Terapia nutricional; Arginine; Proteína C-reactiva; Omega-3; Nutrition therapy
• ISSN: 0212-1611; 1699-5198; 1699-5198
• DOI: 10.20960/nh.03847

Introduction: patients with COVID-19 undergo changes in leukocyte count, respiratory disorders, and an increase in inflammatory substances. To improve the inflammatory condition, some nutrients can be used, including arginine, omega-3 fatty acids and nucleotides. This study aims to evaluate how oral immunonutrient supplements affects serum C-reactive protein (CRP) levels and lymphocyte count in patients with COVID-19. Methods: in this double-blind clinical trial, we randomized 43 adult patients with COVID-19 to receive a standard high-protein normocaloric supplement (control) or an immunonutrient-enriched supplement (experiment) for 7 days. The primary outcome was to evaluate changes in total lymphocyte count and serum level of CRP. The assessment of risk and nutritional status of these patients was also performed. Results: forty-three patients with mean age of 41.5 (± 1.8) years were followed up, 39.5 % of them women. The mean body mass index was 27.6 (± 0.8) kg/m² and 58.1 % had low nutritional risk. In the experiment group, there was a CRP reduction of 23.6 (± 7.5) mg/L, while in the control branch the decrease was 14.8 (± 12.1) mg/L (p = 0.002). There was an increase in lymphocytes in the experiment group (+367.5 ± 401.8 cells/mm³) and a reduction in the control group (-282.8 ± 327.8 cells/mm³), although there was no statistical significance (p = 0.369). Relative risk (RR) of treatment in reducing CRP by 30 % or more was 4.45 (p < 0.001; 95 % CI, 1.79-11.07). RR in increasing lymphocyte count by 30 % or more was 1.28 (p = 0.327; 95 % CI, 0.67-2.45). Conclusion: we conclude that immunonutrient supplements seem to reduce CRP levels more than standard high-protein normocaloric supplements.