LAUSR

Simple Summary COVID-19 related symptoms and severity of infection vary greatly among individuals and althoμgh various factors including age, gender, obesity, and underlying co-morbidities are sμggested to be the confounding variables that affect the severity of disease, a small percentage of apparently healthy and young people also succumb to disease, this was especially true before the COVID-19 vaccines were developed. Recently, few studies have sμggested that COVID-19 severity is lower in individuals who followed a plant based and pescatarian diet. Aim of the current study was to examine whether symptoms experienced by COVID-19 patients can be predictive of mild and long-term disease pre-vaccination and if the intake of specific nutrients as well as serum 25(OH)D concentrations are related to the severity of symptoms experienced by individuals. Additionally, we performed longitudinal and cross-sectional analysis on antibodies against SARS-CoV-2 to examine the duration and degree of protection conferred by natural immunity after SARS-CoV-2 infection. We found several nutrients such as vitamin E, poly-unsaturated fatty acids, and fibre amongst others to be possibly linked to a reduced COVID-19 severity. Abstract The heterogeneity of the severity of symptoms of COVID-19 experienced by the young and healthy individuals is poorly understood. The present study was undertaken to mainly examine whether the respective diets and the type of symptoms experienced by patients are predictive of having long COVID-19. Disease severity was assessed with a symptomatology questionnaire and used to group 55 participants in asymptomatic (AS), mild symptoms (S) and long COVID (LC). We found that experiencing a higher number of symptoms as well as fatigue were predictors of developing LC whereas those who experienced rhinorrhea were less likely to develop LC. Blood samples were also taken to measure vitamin D [25(OH)D] concentrations and duration of spike IgG antibodies. In this study, serum 25(OH)D was not significantly different between 3 symptom groups with median (IQR) ng/mL levels of 22.0 (12.3) in the AS, 22.3 (7.5) in S, and 24.9 (9.4) in the LC group (p ≥ 0.05). The duration of IgG antibody response was found to vary greatly, with some individuals showing raised IgG over a year after infection. To examine whether dietary factors can influence the severity of symptoms, diet was analysed using 4–7-day food diaries as well as a Food Frequency Questionnaire (FFQ). Some nutrients such as vitamin E, polyunsaturated fatty acids, fibre, and iron were associated with lower severity of COVID-19. Lower intake of vitamin E was associated with having LC with a median (IQR) intake of 6.2 mg (3.8) seen in LC vs. 8.6 mg (7.2) in the AS group (p = 0.047). This pilot study has highlighted a few differences in the number and type of symptoms experienced by the young non-hospitalised individuals with mild and long COVID-19 and identified a few dietary components for their potential protective role against long COVID-19, however, the findings need to be confirmed with further large scale studies.