Published online Sep 14, 2021. doi: 10.3748/wjg.v27.i34.5682
Peer-review started: January 29, 2021
First decision: March 29, 2021
Revised: April 11, 2021
Accepted: August 17, 2021
Article in press: August 17, 2021
Published online: September 14, 2021
Processing time: 223 Days and 13.1 Hours
Varying degrees of liver injuries have been reported in patients infected with the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). In general, oxidative stress is actively involved in initiation and progression of liver damage. The liver metabolizes various compounds that produce free radicals. Maintaining the oxidative/antioxidative balance is important in coronavirus disease 2019 (COVID-19) patients. Antioxidant vitamins, essential trace elements and food compounds, such as polyphenols, appear to be promising agents, with effects in oxidative burst. Deficiency of these nutrients suppresses immune function and increases susceptibility to COVID-19. Daily micronutrient intake is necessary to support anti-inflammatory and antioxidative effects but for immune function may be higher than current recommended dietary intake. Antioxidant supplements (β-carotene, vitamin A, vitamin C, vitamin E, and selenium) could have a potential role in patients with liver damage. Available evidence suggests that supplementing the diet with a combination of micronutrients may help to optimize immune function and reduce the risk of infection. Clinical trials based on the associations of diet and SARS-CoV-2 infection are lacking. Unfortunately, it is not possible to definitively determine the dose, route of administration and best timing to intervene with antioxidants in COVID-19 patients because clinical trials are still ongoing. Until then, hopefully, this review will enable clinicians to understand the impact of micronutrient dietary intake and liver status assessment in COVID-19 patients.
Core Tip: In this review, we highlight the importance of an optimal micronutrient intake and status to boost the immune system, providing special emphasis on liver injury during the coronavirus disease 2019 (commonly known as COVID-19) crisis and focusing on the most relevant nutrients that reduce oxidative stress.