Virus Infection

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    Viral infections, including lower respiratory tract infections (LRTIs) and COVID-19, pose significant health risks worldwide. The immune system plays a critical role in combating these infections. Adequate nutrition, particularly the intake of specific micronutrients such as vitamins A, C, D, zinc, and omega-3 fatty acids, is essential for the maintenance and enhancement of immune function. Current research underscores the importance of these micronutrients in supporting the immune system. This article reviews the impact of these specific micronutrients on the immune system and discusses the potential of supplementation as a supportive strategy against viral infections.[1]

    Importance of Micronutrients in Immune Response

    The immune response can be broadly classified into two types: the inflammatory and innate immune response, and the adaptive immune response.

    • The inflammatory and innate immune response is the body's first line of defense, providing an immediate but non-specific response to pathogens. This includes physical barriers such as skin and mucous membranes, as well as immune cells that recognize and attack invaders. Key components of this response are the innate cells like natural killer (NK) cells and macrophages, which act quickly to prevent the spread of infections.
    • In contrast, the adaptive immune response is highly specific and involves the body's ability to recognize and remember specific pathogens for a faster response upon subsequent exposures. This branch of the immune system includes B cells, which produce antibodies, and T cells, which can directly kill infected cells or help coordinate other parts of the immune system.

    Micronutrients play a pivotal role in supporting both types of immune responses. Adequate intake of certain vitamins and minerals is crucial for the maintenance and enhancement of immune function. Below is a summary of key micronutrients and their contributions to both the inflammatory and innate, as well as the adaptive immune responses.

    Micronutrient Inflammatory and Innate Immune Response Adaptive Immune Response
    Vitamin A
    • Integrity of epithelia
    • Differentiation and function of NK cells
    • Promotion of Foxp3+ Treg generation
    • Inhibition of Th1/Th17 generation
    • Phagocytic and oxidative burst activity of macrophages
    • Secretion of the pro-inflammatory cytokines IL-12 and IL-23
    • Growth and differentiation of B cells
    • Production of antibodies
    • Immunoregulatory function of Treg cells
    Vitamin C
    • Barrier integrity
    • Scavenger of ROS
    • Chemotactic ability and antibacterial activity of neutrophils
    • Apoptotic process of neutrophils
    • Reduction of formation of neutrophil extracellular traps
    • Differentiation and proliferation of B- and T-cells
    • Immunostimulator of antibody production (IgM and IgG)
    • T-cell maturation via epigenetic mechanisms
    Vitamin D
    • Production of antimicrobial peptides
    • Modulation of macrophages/monocytes and dendritic cells functions
    • Limits overproduction of pro-inflammatory cytokines from macrophages (IL1, TNFα)
    • Limits overproduction of pro-inflammatory cytokines from T cells (IFNγ, IL2, IL8, IL6)
    • Th1 to Th2 shift, increases Th2 cytokines (IL4, IL10)
    • Induces differentiation of Treg
    • Reduces excessive antibody production
    • Maintenance of membrane barrier integrity
    • Direct antiviral effects
    • Decreases oxidative stress
    • Limits excessive release of pro-inflammatory cytokines (IL2, IL6, and TNF-α)
    • Enhances the number of Treg
    Omega 3 Fatty Acids
    • Structures of cell membranes
    • Inhibition of cytokine production
    • Inhibiting neutrophil migration
    • Clearance of polymorphonuclear leukocytes
    • Specialized pro-resolving mediators (SPMs)
    • Treg cells formation
    • B cells activation
    • Upregulate CCR5 expression

    Each micronutrient listed in the table above contributes to the immune system in unique ways, supporting various cells and functions within the inflammatory and innate, and adaptive immune responses. Vitamins such as A, C, and D, minerals like zinc, and fatty acids like omega-3 are instrumental in ensuring that the immune system operates effectively to protect the body against infections.

    Supplementation as a Supportive Measure

    Supplementation with these micronutrients is seen as a safe, cost-effective way to bolster the immune system. It is recommended to supplement these nutrients in addition to maintaining a balanced diet, adhering to the upper safety limits set by health authorities.

    While individual micronutrients contribute to immune health, their synergistic effects require further investigation. Current research suggests that combinations of these nutrients might enhance the overall immune response more effectively.

    It is crucial to note that supplementation is not a cure or guaranteed prevention for infections. Instead, it may help reduce symptoms and facilitate recovery from viral infections.


    Implementing an optimal nutrition strategy, including a balanced diet and appropriate supplementation of key micronutrients, can be a beneficial approach to reducing the burden of infectious diseases worldwide, including COVID-19. However, this should be viewed as part of a broader strategy that includes other public health measures.


    1. Pecora F et al.: The Role of Micronutrients in Support of the Immune Response against Viral Infections. Nutrients 2020. (PMID 33092041) [PubMed] [DOI] [Full text] Viral infections are a leading cause of morbidity and mortality worldwide, and the importance of public health practices including handwashing and vaccinations in reducing their spread is well established. Furthermore, it is well known that proper nutrition can help support optimal immune function, reducing the impact of infections. Several vitamins and trace elements play an important role in supporting the cells of the immune system, thus increasing the resistance to infections. Other nutrients, such as omega-3 fatty acids, help sustain optimal function of the immune system. The main aim of this manuscript is to discuss of the potential role of micronutrients supplementation in supporting immunity, particularly against respiratory virus infections. Literature analysis showed that in vitro and observational studies, and clinical trials, highlight the important role of vitamins A, C, and D, omega-3 fatty acids, and zinc in modulating the immune response. Supplementation with vitamins, omega 3 fatty acids and zinc appears to be a safe and low-cost way to support optimal function of the immune system, with the potential to reduce the risk and consequences of infection, including viral respiratory infections. Supplementation should be in addition to a healthy diet and fall within recommended upper safety limits set by scientific expert bodies. Therefore, implementing an optimal nutrition, with micronutrients and omega-3 fatty acids supplementation, might be a cost-effective, underestimated strategy to help reduce the burden of infectious diseases worldwide, including coronavirus disease 2019 (COVID-19).