Title:SARS-CoV-2 Infection, Inflammation, Immunonutrition, and Pathogenesis
of COVID-19
Volume: 30
Issue: 39
Author(s): Ligen Yu*, Mohd Khanapi Abd Ghani, Alessio Aghemo, Debmalya Barh, Matteo Bassetti, Fausto Catena, Gaetano Gallo, Ali Gholamrezanezhad, Mohammad Amjad Kamal, Amos Lal, Kamal Kant Sahu, Shailendra K. Saxena, Ugo Elmore, Farid Rahimi, Chiara Robba, Yuanlin Song, Zhengyuan Xia and Boxuan Yu
Affiliation:
- Talent Recruitment and Career Support (TRACS) Office, Nanyang Technological University, N2.1 B4-01, 76 Nanyang Drive,
637331, Singapore
Keywords:
COVID-19, cytokine storm, immunity, inflammatory response, malnutrition, phagocytosis, restrictive diet, self-limiting infection.
Abstract: The COVID-19 pandemic, caused by the coronavirus, SARS-CoV-2, has
claimed millions of lives worldwide in the past two years. Fatalities among the elderly
with underlying cardiovascular disease, lung disease, and diabetes have particularly been
high. A bibliometrics analysis on author’s keywords was carried out, and searched for
possible links between various coronavirus studies over the past 50 years, and integrated
them. We found keywords like immune system, immunity, nutrition, malnutrition, micronutrients,
exercise, inflammation, and hyperinflammation were highly related to each
other. Based on these findings, we hypothesized that the human immune system is a multilevel
super complex system, which employs multiple strategies to contain microorganism
infections and restore homeostasis. It was also found that the behavior of the immune
system is not able to be described by a single immunological theory. However, one
main strategy is “self-destroy and rebuild”, which consists of a series of inflammatory responses:
1) active self-destruction of damaged/dysfunctional somatic cells; 2) removal of
debris and cells; 3) rebuilding tissues. Thus, invading microorganisms’ clearance could
be only a passive bystander response to this destroy-rebuild process. Microbial infections
could be self-limiting and promoted as an indispensable essential nutrition for the vast
number of genes existing in the microorganisms. The transient nutrition surge resulting
from the degradation of the self-destroyed cell debris coupled with the existing nutrition
state in the patient may play an important role in the pathogenesis of COVID-19. Finally,
a few possible coping strategies to mitigate COVID-19, including vaccination, are discussed.