Liver disorders in COVID-19,nutritional approaches and the use of phytochemicals

Coronavirus disease 2019(COVID-19),which is caused by severe acute respiratory syndrome-coronavirus-2(SARS-CoV-2),has affected millions of people globally.It was declared a pandemic by the World Health Organization in March 2020.The hyperinflammatory response to the entry of SARS-CoV-2 into the host through angiotensin-converting enzyme 2 is the result of a“cytokine storm”and the high oxidative stress responsible for the associated symptomatology.Not only respiratory symptoms are reported,but gastrointestinal symptoms(diarrhea,vomiting,and nausea)and liver abnormalities(high levels of aspartate aminotransferase,alanine aminotransferase transaminases,and bilirubin)are observed in at least 30%of patients.Reduced food intake and a delay in medical services may lead to malnutrition,which increases mortality and poor outcomes.This review provides some strategies to identify malnutrition and establishes nutritional approaches for the management of COVID-19 and liver injury,taking energy and nutrient requirements and their impact on the immune response into account.The roles of certain phytochemicals in the prevention of the disease or as promising target drugs in the treatment of this disease are also considered.