Nutrition and Covid-19 epidemic


  • Tanja PAJK ŽONTAR University of Ljubljana, Biotechnical Faculty, Slovenia
  • Rajko VIDRIH University of Ljubljana, Biotechnical Faculty, Slovenia



nutrition, Covid-19, immune system, nutrients, vitamins, elements, antioxidants, omega-3 polyunsaturated fatty acids


Proper nutrition is an essential part of an individual’s defence against numerous diseases including coronavirus disease SARS-CoV-2 (Covid-19). Nutritional status of individual is affected by several factors such as age, sex, health status, physical activity, life style and medications. Optimal nutrition and dietary nutrient intake impact the immune system, therefore the sustainable way to survive in current context is to strengthen the immune system. Inadequate intake of energy, protein, and specific micronutrients are associated with depressed immune function and increased susceptibility to infection. Predominantly vital for the encouraging of immune function are elements selenium, iron and zinc and vitamins A, D, C, E, B6, B9 (folate) and B12 as well as omega-3 polyunsaturated fatty acids. Thus, during this time it is important to take care of nutritional habits, following a healthy and balanced nutritional pattern containing a high amount of elements, antioxidants and vitamins. It is also recommended, that individuals should be mindful of physical activity, known to be associated with all-cause mortality. Regular physical activity also improves mental health and overall feelings of wellbeing. Thus, now in the time of epidemic, more than ever, wider access to healthy foods should be a top priority for governments around the world


Acosta-Elias, J., & Espinosa-Tanguma, R. (2020). The folate concentration and/or folic acid metabolites in plasma as factor for COVID-19 infection. Frontiers in pharmacology, 11, 1062.

Alis, R., Romagnoli, M., Primo-Carrau, C., Pareja-Galeano, H., Blesa, J. R. & Sanchis-Gomar, F. (2015). Effect of exhaustive running exercise on red blood cell distribution width. Clinical Chemistry and Laboratory Medicine (CCLM), 53(2), e29-e31.

Aman, F., & Masood, S. (2020). How Nutrition can help to fight against COVID-19 Pandemic. Pakistan Journal of Medical Sciences, 36(COVID19-S4), S121-S123.

Antonio, S. G., Matteo, M., Achille, C., Enrica, V., Valentina, G., Salvatore, S., … Edoardo, M. (2020). Are diabetes and its medications risk factors for the development of COVID-19? Data from a population-based study in Sicily. Nutrition, Metabolism and Cardiovascular Diseases, 31(2), 396-398.

Barazzoni, R., Bischoff, S. C., Breda, J., Wickramasinghe, K., Krznaric, Z., Nitzan, D., … Singer, P. (2020). ESPEN expert statements and practical guidance for nutritional management of individuals with SARS-CoV-2 infection, Clinical Nutrition, 39(6), 1631-1638.

Batool, S., Wang, Q., Qureshi, S. & Chua, E. (2013). The red cell diameter width distribution, the forgotten haematological parameter for anaemia in the older person. European Geriatric Medicine, 4, 1-4.

Borné, Y., Smith, J. G., Melander, O., Hedblad, B. & Engström, G. (2011). Red cell distribution width and risk for first hospitalization due to heart failure: a population‐based cohort study. European Journal of Heart Failure, 13(12), 1355-1361.

Butler, M. J., & Barrientos, R. M. (2020). The impact of nutrition on COVID-19 susceptibility and long-term consequences. Brain, Behavior, and Immunity, 87, 53-54.

Emans, M. E., van der Putten, K., van Rooijen, K. L., Kraaijenhagen, R. J., Swinkels, D., van Solinge, W. W., … Gaillard, C. A. (2011). Determinants of red cell distribution width (RDW) in cardiorenal patients: RDW is not related to erythropoietin resistance. Journal of Cardiac Failure, 17(8), 626-633.

FAO. (2020). 7 healthy eating tip to face the COVID 19 crisis. Retrived from

Ferrucci, L., & Fabbri, E. (2018). Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty. Nature reviews. Cardiology, 15(9), 505-522.

Finzi, E. (2020). Treatment of SARS-CoV-2 with high dose oral zinc salts: A report on four patients. International Journal of Infectious Diseases, 99, 307-309.

Foy, B. H., Carlson, J. C., Reinertsen, E., Valls, R. P. I., Lopez, R. P., Palanques-Tost, E., … Higgins, J. M. (2020). Association of red blood cell distribution with mortality risk in hospitalized adults with SARS-CoV-2 infection. JAMA Network Open, 3(9), e2022058-e2022058. https://doi:10.1001/jamanetworkopen.2020.22058

Global Nutrition Report. (2020). 2020 Global Nutrition Report. Retrived from

Hiedra, R., Lo, K. B., Elbashabsheh, M., Gul, F., Wright, R. M., Albano, J., …Aponte, G. P. (2020). The use of IV vitamin C for patients with COVID-19: a single center observational study. Expert Review of Anti-Infective Therapy, 18(12), 1259–1261.

Holt, R. R., & Uriu-Adams J. Y., & Keen C. L. (2012). Zinc. In J. W. Erdman & I. A. Macdonald & S. H. Zeisel (Eds.), Present knowledge in Nutrition (pp. 521 – 539). Hong Kong, A John Wiley & Sons, Ltd., Publication.

Hunt, C., Chakravorty, N., Annan, G., Habibzadeh, N. & Schorah, C. (1994). The clinical effects of vitamin C supplementation in elderly hospitalised patients with acute respiratory infections. International Journal for Vitamin and Nutrition Research, 64(3), 212-219.

Im, J. H., Je, Y. S., Baek, J., Chung, M.-H., Kwon, H. Y. & Lee, J.-S. (2020). Nutritional status of patients with COVID-19. International Journal of Infectious Diseases, 100, 390-393.

Itelman, E., Wasserstrum, Y., Segev, A., Avaky, C., Negru, L., Cohen, D., … Lasman, N. (2020). Clinical characterization of 162 COVID-19 patients in Israel: preliminary report from a large tertiary center. The Israel Medical Association Journal: IMAJ, 22(5), 271-274.

Jaggers, G. K., Watkins, B. A. & Rodriguez, R. L. (2020). COVID-19: repositioning nutrition research for the next pandemic. Nutrition Research (New York, NY), 81, 1-6. https://doi: 10.1016/j.nutres.2020.07.005

Liu, M., Wallin, R., Wallmon, A. & Saldeen, T. (2002). Mixed tocopherols have a stronger inhibitory effect on lipid peroxidation than α-tocopherol alone. Journal of Cardiovascular Pharmacology, 39(5), 714-721.

Loprinzi, P. D., & Hall, M. E. (2015). Physical activity and dietary behavior with red blood cell distribution width. Physiology & Behavior, 149, 35-38.

Muscogiuri, G., Barrea, L., Savastano, S. & Colao, A. (2020). Nutritional recommendations for CoVID-19 quarantine. European Journal of Clinical Nutrition, 74, 850-851.

Naik, S. R., Gupta, P., Khaitan, T. & Shukla, A. K. (2020). Reduced levels of serum vitamin B12 in symptomatic cases of oral lichen planus: A cross-sectional study. Journal of Oral Biology and Craniofacial Research, 10(4), 578-582.

NIJZ. (2020). Referenčne vrednosti za energijski vnos ter vnos hranil. Retrived from

Rogero, M. M., Leão, M. d. C., Santana, T. M., de MB Pimentel, M. V., Carlini, G. C., da Silveira, T. F., … Castro, I. A. (2020). Potential benefits and risks of omega-3 fatty acids supplementation to patients with COVID-19. Free Radical Biology and Medicine, 156, 190-199.

Shakoor, H., Feehan, J., Al Dhaheri, A. S., Ali, H. I., Platat, C., Ismail, L. C., … Stojanovska, L. (2020). Immune-boosting role of vitamins D, C, E, zinc, selenium and omega-3 fatty acids: Could they help against COVID-19? Maturitas, 143, 1-9.

Solomons, N. W. (2012). Vitamin A. In J. W. Erdman & I. A. Macdonald & S. H. Zeisel (Eds.), Present knowledge in Nutrition (pp. 149 – 184). Hong Kong, A John Wiley & Sons, Ltd., Publication.

Tan, C. W., Ho, L. P., Kalimuddin, S., Cherng, B. P. Z., Teh, Y. E., Thien, S. Y., … Nagarajan, C. (2020). A cohort study to evaluate the effect of combination Vitamin D, Magnesium and Vitamin B12 (DMB) on progression to severe outcome in older COVID-19 patients. Nutrition, 79-80, 111017.

Terry, E. N., & Diamond A. M. (2012). Selenium. In J. W. Erdman & I. A. Macdonald & S. H. Zeisel (Eds.), Present knowledge in Nutrition (pp. 521 – 539). Hong Kong, A John Wiley & Sons, Ltd., Publication.

Te Velthuis, A. J., van den Worm, S. H., Sims, A. C., Baric, R. S., Snijder, E. J. & van Hemert, M. J. (2010). Zn2+ inhibits coronavirus and arterivirus RNA polymerase activity in vitro and zinc ionophores block the replication of these viruses in cell culture. PLOS pathogens, 6(11), e1001176.

Wiltshire, E., Peña, A. S., MacKenzie, K., Shaw, G. & Couper, J. (2020). High dose folic acid is a potential treatment for pulmonary hypertension, including when associated with COVID-19 pneumonia. Medical Hypotheses, 143, 110142.

WHO. (2020a). Nutrition advice for adults during the COVID-19 outbreak. Retrived from:

WHO. (2020b). Coronavirus disease (COVID-19): Food safety and nutrition. Retrived from

Wu, D., & Meydani, S. N. (2019). Vitamin E, Immune Function, and Protection Against Infection. Vitamin E in Human Health, In: Weber P., Birringer M., Blumberg J., Eggersdorfer M., Frank J. (Eds) Vitamin E in Human Health. Nutrition and Health. Humana Press pp. 371-384. Humana Press, Cham.

Zhang, J., Taylor, E. W., Bennett, K., Saad, R. & Rayman, M. P. (2020). Association between regional selenium status and reported outcome of COVID-19 cases in China. The American Journal of Clinical Nutrition, 111(6), 1297-1299.

Zhou, Y.-F., Luo, B.-A. & Qin, L.-L. (2019). The association between vitamin D deficiency and community-acquired pneumonia: A meta-analysis of observational studies. Medicine, 98(38), e17252. https://doi: 10.1097/MD.0000000000017252



14. 07. 2021



Review Article

How to Cite

PAJK ŽONTAR, T., & VIDRIH, R. (2021). Nutrition and Covid-19 epidemic. Acta Agriculturae Slovenica, 117(2), 1–7.

Similar Articles

1-10 of 451

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)