Efeitos da imunonutrição nos níveis séricos de albumina, TNF-α e IL-6 em pacientes com COVID-19: ensaio duplo-cego randomizado controlado

Abstract

Background and Objectives: Many specialized immunonutrient formulas are available, with an emphasis on combining arginine, omega 3 fatty acids, and nucleotides. These nutrients can reduce the inflammatory pattern, with an increased contribution to resolving infections. Considering the inflammatory catharsis resulting from COVID-19, this study aimed to evaluate the effect of immunonutrition on serum albumin, IL-6, and TNF-α levels in patients with COVID-19. Materials and Methods: a randomized double-blind clinical trial conducted in 2020 in Salvador, Bahia, Brazil. Adult patients diagnosed with COVID-19 were randomized to receive a standard hyperproteic normocaloric supplement (control) or a supplement enriched with immunonutrients (experiment) for a period of 07 days. The participants were monitored for a period of 08 days, including the assessment of risk and nutritional status, and collection of blood samples to evaluate albumin, IL-6, and TNF-α. 44 Results: 70 patients were included in the study. 64 were randomly allocated to receive an immunonutrient diet or a standard control diet. The nutritional diagnosis was 27.6 (±0.8) kg/m² and the nutritional risk was 41.9%. In the experiment group, there was an average increase in albumin to 0.84 (±0.65) mg/dL, while in the control group this increase was of 0.21 (±0.52) mg/dL. Regarding the IL-6 doses, there was a reduction both in the experiment group (-257.27 ± 448.89 pg/ml) and in the control group (-142.75 ± 253.29 pg/ml). When comparing the difference in TNF-α levels, a reduction was observed in the experiment group (-3.72 ± 5.98 pg/ml), while an increase in the control group (5.33 ± 10.48 pg/ml) was observed. Conclusions: the use of an oral supplement enriched with immunonutrients seems to be able to reduce the IL-6 and TNF-α serum levels and increase serum albumin levels.