The association between nutrient patterns and hospital stay duration and symptoms in COVID-19 in Iranian patients: cross-sectional study

Atieh Mirzababaei ^1,2* Farideh Shiraseb ² Azam Mohamamdi ² Mahya MehriHajmir ³ Sara Ebrahimi ^4* Zeinab Zarrinvafa ⁵ Elham Kazemian ⁶ Amir Mehrvar ^7* khadijeh mirzaei ^2*

• ¹ Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Alborz, Iran
• ² Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Alborz, Iran
• ³ Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington, D.C., District of Columbia, United States
• ⁴ Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia
• ⁵ Science and Research Branch, Islamic Azad University, Tehran, Iran
• ⁶ Department of Psychiatry, Alborz University of Medical Sciences, Karaj, Iran, Karaj, Alborz, Iran
• ⁷ Department of Psychiatry, Taleghani Hospital, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Alborz, Iran

Background: An excessively reactive immune system results in the cytokine storm COVID-19 .A healthy diet is essential to maintain the balance between the immune system and inflammatory and oxidative stress. Associations between single foods and nutrients and COVID-19 have been examined. However, no prior study has examined associations between nutrient patterns and COVID-19. This study assessed the link between nutrient patterns and the COVID-19 severity and length of hospital stay in Iranian adults Methods: This cross-sectional study included 107 Iranian adults aged 20-60 years, who were admitted to Amir Alam Hospital in Tehran, Iran, due to COVID-19. Data on their symptoms were collected through a demographic questionnaire and verified against their hospital records. Three non-consecutive 24-hour dietary recalls were used to collect participants' food and beverage intake. Principal component analysis (PCA) was used to derive nutrient patterns.Result: A total of 95 Covid patients with a mean age of 46.2 years were included. Four major dietary patterns were identified using the Scree Plot chart, including high carbohydrate and high minerals pattern; high protein and high vitamins pattern; high fat pattern; and poor nutrient pattern.Adherence to the poor nutrient patterns was associated with a higher number of hospitalization days and lower appetite (p <0.05). The poor dietary patterns were associated with an increased likelihood of headache, fever, and respiratory distress syndrome (RDS). Also, headaches were more common with adherence to the high-fat pattern (p<0.05).The findings of this study show that a poor nutrient pattern is related to longer hospital stays and reduced appetite. It also connected to an increased likelihood of symptoms including headaches, fever, and respiratory distress syndrome. A strong association was found between 4 respiratory distress syndrome, headaches, and a high-fat diet was found. Further studies with prospective designs are needed to better understand and validate these findings.