The whole world is currently reeling under the impact of a pandemic, a viral infection caused by the COVID-19 or more commonly known as the coronavirus infection. Infected persons usually show respiratory or flu-like symptoms such as cough, fever, shortness of breath, and so on, within 2–14 days after exposure to the virus. The good news is that most patients usually experience mild to moderate severity of the illness and recover without requiring special treatment. However, older patients and patients with pre-existing medical problems like cardiovascular disease, diabetes, chronic respiratory disease, and cancer are more likely to manifest serious symptoms and the disease may even prove fatal. The COVID-19 virus spreads primarily through droplets of saliva or discharge from the nose when an infected person coughs or sneezes. As there are no specific vaccines or treatments available currently, the only ways to reduce the spread of the disease are practising respiratory etiquette, observing social distancing, maintaining hygiene, washing hands thoroughly, and so on.
As researchers around the world desperately try to develop the vaccine for the infection and develop the prophylaxis for it, governments have been working on a war footing to control the spread of the virus and minimize the number of fatalities resulting from it. Although too early to confirm, the virus shares certain similarities with other virus strains such as severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome coronavirus (MERS-CoV). As scientists are still working on the exact nature of the similarities, certain common precautionary measures have been advised to the general public.
However, it would be noteworthy to assess the status of malnutrition and susceptibility to viral infections through the lens of other similar viral diseases/ epidemic/endemic case studies. As the COVID-19 is a newly discovered virus, confirmed information available about the virus is limited; a study of similar experiences with previous episodes of infections would help develop possible measures to ensure preparedness for the future.
Malnutrition and Immunodeficiency
Malnutrition is a major factor responsible for increased morbidity and mortality burden in a population. Malnutrition usually results from disordered nutrient assimilation or recurrent infections and chronic inflammation, which could be the result of an underlying immune defect. Studies have shown that immune dysfunction can be both a cause and a consequence of malnutrition. Immune dysfunction can directly drive pathological processes in malnutrition, including mal-absorption, increased metabolic demand, dysregulation of the growth hormone, and greater susceptibility to infection. Malnutrition is not just a result of inadequate food intake but also improper nutrient intake and poor diets leading to consequences such as obesity and diabetes. Characterizing pathogenesis across the spectrum of malnutrition is essential to underpin novel therapeutic approaches to support international goals to improve nutrition, health, and well-being. Even common infections could be fatal to undernourished children implying that mortality is related to underlying immunodeficiency even in mild forms of undernutrition. Infections are also more common and more severe in people with obesity. Immune dysfunction can also arise before birth via developmental pathways, compounded by environmental and behavioural factors, particularly those experienced during early life.
Co-relation Between Micronutrient Deficiencies and Susceptibility to Infections
Malnutrition can be a consequence of energy deficit (protein-energy malnutrition or PEM) or a micronutrient deficiency and in both cases is still a major burden in developing countries and is considered the most relevant risk factor for illness and death, affecting particularly hundreds of millions of pregnant women and young children.
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