Coronavirus outbreak is one of the worst pandemic affecting the lives of almost everyone. Doctors, medical experts, nurses and other medical staff are working relentlessly to protect and save the lives of people suffering from COVID-19. This viral disease affects our respiratory system and other organs, which exerts a big toll on our immune system in fighting this disease. Therefore, the immune system has to be stronger to survive the treatment and better recovery.

Treatment therapy involves medicinal support as per the patient needs, along with nutrition playing a very vital role in support of immune health. Appropriate nutritional intervention is mandatory, which involves careful monitoring of the timing, food selection and source of nutrition. 

To maintain weight and prevent weight loss, energy needs vary from 25-30 Kcal per kg body weight per day. The goal should be to meet the daily energy needs with selecting foods from all food groups to reap the benefits of its nutrients. The carbohydrates and fats ratio needs to be maintained, as they are the prime energy providers in the body. Most people who are on ventilators are given nutrition via tube feedings. It has been observed that the 70:30 ratio of carbohydrates to fats can be administered to the patients. But if the person exhibits symptoms of hyperglycemia or high blood sugar levels then the ratio can be adjusted to 60:40 or 50:50. Regular monitoring of all biochemical parameters is the key. 

If the patient has mild symptoms and can consume a normal diet orally then meals should be small and frequent. One big meal with a big portion size is a big no-no. Warm water and clear soups should be given to prevent dehydration and meet the daily fluid needs. Intake of fruits and vegetables should be encouraged to provide vitamins, minerals and antioxidants. Nutrition supplements like curcumin can also be used to boost immunity. 

Protein intake must be adequate to prevent muscle loss, anaemia and building of antibodies. 1-1.5 grams protein per kg body weight can be given, but requirements might vary in the presence of any underlying medical condition like renal disorders, dialysis, etc. Protein from good quality sources should be preferred. 

COVID-19 has shown to affect our pulmonary system primarily causing increased production of mucous. If the sputum production is high, then foods naturally rich in histamines like tomatoes, spinach, mushrooms, brinjal, yoghurt and vinegar should be avoided. Elevated levels of histamine in the body mean high sputum production. 

Patients suffering from COVID-19 are found to be iron and vitamin D deficient. Hence, vitamin D supplementation is necessary and requirements may range from 10-100 micrograms per day. Vitamin D is required for the activation of naive cells to killer immune cells. In addition, iron-rich foods like dark green leafy vegetables along with supplements are essential to prevent anaemia. To enhance iron absorption and augment immunity, vitamin C is another critical essential micronutrient that should not be overlooked. Vitamin A has also been observed to show promising benefits during the treatment of coronavirus and lung patients because it is essentially required by our immune cells to fight against illness and infections. Therefore, vitamin A rich foods like carrot, pumpkin, papaya, sweet potato and spinach should be given.  

To sum up, a well-balanced diet should be planned carefully to meet the needs of all macro and micro-nutrients. The focus should be on immunity-boosting foods and nutrients. The patient should refrain from consuming alcohol, caffeine and excess sugar. People who are at risk of developing micronutrients deficiency might aid from taking a multivitamin supplement. Plenty of fluids should be consumed unless there are any fluid restrictions. Patients with other co-morbidities should be handled accordingly. 

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