Symptom Severity and Duration of COVID-19 Are Correlated with the Healthy Eating Index (HEI) Among Hospitalized...

Coronaviruses belong to a broad group of viruses that can infect both humans and animals, leading to a range of illnesses. To protect the host from pathogenic agents, it is essential to enhance the immune system's efficiency. Proper nutrition of patients reduces the risk of secondary bacterial infections. Therefore, our research aimed to investigate the relationship between the Healthy Eating Index and the severity of symptoms and disease duration in older adults with coronavirus disease 2019 (COVID-19).

This cross-sectional study was conducted among 200 elderly patients with COVID-19 who were hospitalized at a hospital affiliated with the Social Security Organization in Iran. For patients, the consent form, demographic information, disease-related information, and Food Frequency Questionnaire (FFQ) questionnaire were completed, and diet quality was calculated based on the Healthy Eating Index. Disease symptom severity was also assessed using visual analog scale questionnaires. Descriptive statistics, t tests, chi-square tests, and ordinal logistic regression were used to analyze the data in SPSS 22.0, with P < 0.05 indicating statistical significance.

The average age of the study population was 70.3 ± 7.38 years, including 93 women and 107 men. Higher Healthy Eating Index (HEI) scores were significantly associated with greater weight, body mass index (BMI), and nutrient intake, including energy, protein, vitamin D, and riboflavin (P < 0.05 for all). Symptom severity varied across HEI quartiles, with significant differences observed in dry cough, sore throat, and headaches (P < 0.05). Participants in the highest HEI quartile (Q4) experienced more extended hospitalizations (P = 0.018). A sore throat was correlated with weight, BMI, and body circumferences (P < 0.05).

Our study found that HEI scores in elderly COVID-19 patients were associated with increased body weight, BMI, and waist circumference, as well as more severe symptoms and longer hospitalizations. This "paradoxical relationship" refers to the unexpected association where better diet quality, despite its known benefits for overall health, was linked to worse COVID-19 outcomes, suggesting that diet quality alone may not mitigate the adverse effects of factors such as obesity and metabolic health in this population.