Affiliations 

  • 1 Talent Recruitment and Career Support (TRACS) Office, Nanyang Technological University, N2.1 B4-01, 76 Nanyang Drive, 637331, Singapore
  • 2 Biomedical Computing and Engineering Technologies (BIOCORE) Applied Research Group, Faculty of Information and Communication Technology, Universiti Teknikal Malaysia Melaka, Durian Tunggal, 76100, Melaka, Malaysia
  • 3 Humanitas Research Hospital IRCCS, Rozzano, Italy
  • 4 Institute of Integrative Omics and Applied Biotechnology, Nonakuri, Purba Medinipur WB, India
  • 5 Infectious Diseases Clinic, Department of Health Sciences, University of Genoa and Policlinico San Martino Hospital - IRCCS, Genoa, Italy
  • 6 Azienda Ospedaliero - Universitaria di Parma, Parma, Italy
  • 7 University of Catanzaro, Catanzaro, Italy
  • 8 Keck School of Medicine, University of Southern California (USC), Los Angeles, California, USA
  • 9 7 Peterlee Place, Hebersham, NSW2770, Australia
  • 10 Department of Medicine, Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, 55902, USA
  • 11 Huntsman Cancer Centre, University of Utah, USA
  • 12 Center for Advanced Research, King George's Medical University (KGMU), Lucknow-226003, India
  • 13 Department of Gastrointestinal Surgery, IRCCS San Raffaele Scientific Institute, San Raffaele Vita-Salute University, Milan, Italy
  • 14 Division of Biomedical Science and Biochemistry, Research School of Biology, The Australian National University, Ngunnawal and Ngambri Country, Canberra, ACT 2600, Australia
  • 15 Anesthesia and Intensive Care, Policlinico San Martino, Largo Rosanna Benzi 15, 16100 Genova, Italy
  • 16 Department of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, 200032, P.R. China
  • 17 Department of Anesthesiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
  • 18 School of Computer Science and Engineering, Nanyang Technological University, 50 Nanyang Avenue, 639798, Singapore
Curr Med Chem, 2023;30(39):4390-4408.
PMID: 36998130 DOI: 10.2174/0929867330666230330092725

Abstract

The COVID-19 pandemic, caused by the coronavirus, SARS-CoV-2, has claimed millions of lives worldwide in the past two years. Fatalities among the elderly with underlying cardiovascular disease, lung disease, and diabetes have particularly been high. A bibliometrics analysis on author's keywords was carried out, and searched for possible links between various coronavirus studies over the past 50 years, and integrated them. We found keywords like immune system, immunity, nutrition, malnutrition, micronutrients, exercise, inflammation, and hyperinflammation were highly related to each other. Based on these findings, we hypothesized that the human immune system is a multilevel super complex system, which employs multiple strategies to contain microorganism infections and restore homeostasis. It was also found that the behavior of the immune system is not able to be described by a single immunological theory. However, one main strategy is "self-destroy and rebuild", which consists of a series of inflammatory responses: 1) active self-destruction of damaged/dysfunctional somatic cells; 2) removal of debris and cells; 3) rebuilding tissues. Thus, invading microorganisms' clearance could be only a passive bystander response to this destroy-rebuild process. Microbial infections could be self-limiting and promoted as an indispensable essential nutrition for the vast number of genes existing in the microorganisms. The transient nutrition surge resulting from the degradation of the self-destroyed cell debris coupled with the existing nutrition state in the patient may play an important role in the pathogenesis of COVID-19. Finally, a few possible coping strategies to mitigate COVID-19, including vaccination, are discussed.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.