Effect of natural products use prior to infection with COVID-19 on disease severity and hospitalization: A self-reported cross-sectional survey study
Refat M Nimer, Omar F Khabour, Samer F Swedan, Hassan M Kofahi
F1000Research, doi:10.12688/f1000research.121933.1
Background: Managing coronavirus disease 2019 (COVID-19) using available resources is essential to reduce the health burden of disease. The severity of COVID-19 is affected by nutritional status. In this study the effect of natural product use prior to infection with COVID-19 on disease severity and hospitalization was explored. Methods: This was a cross-sectional study. Between March and July 2021, a self-administered survey was conducted in Jordan. Individuals who recovered from COVID-19 and were ≥18 years old were the study population. Study measures included the use of natural products, COVID-19 severity, and hospitalization status. A multivariate regression model was used for statistical analysis. Results: The mean age (mean ± SD) of the study sample (n=2,148) was 40.25 ± 15.58 years old. Multivariate logistic regression showed that the regular intake of carnation (OR [0.56], CI [0.37-0.85]), onion (OR [0.69], CI [0.52-0.92]), lemon (OR [0.68], CI [0.51-0.90]), and citrus fruits (OR [0.66], CI [0.50-0.89]) before infection were associated with a substantial reduction in COVID-19 severity (P<0.01). Also, the consumption of carnation (OR [0.55], CI [0.34-0.88]), lemon (OR [0.57], CI [0.42-0.78]), and citrus fruits (OR [0.61], CI [0.44-0.84]) were associated with a significant decrease in the frequency of COVID-19induced hospitalization (P<0.01). Conclusions: Regular consumption of carnation, lemon, and citrus fruits before infection was associated with better outcomes for COVID-19. Studies on other populations are required to confirm these findings.
Summary: The study explored the association between using specific natural products prior to COVID-19 infection and the severity of the disease and hospitalization status in a sample of Jordanian adults. Title: This is a retrospective study, the study design included a survey about prior COVID-19 infection and natural products consumption prior to infection.
Methods: -Recruitment method is not clear, how the investigators reached out to the potential participants is not stated. The study suggests that only people who were previously infected with COVID-19 were included in the study. This assumption should be discussed in the inclusion criteria. -Calculation of the study sample assumed that the total population is the number of COVID-19 infected people as reported by the end of July 2021. Does this report include only adults or total confirmed cases? As the survey targeted only adults, the authors should identify precisely the study population as a reference for sample size calculation.
Results: -Why is lemon considered a separate category from citrus? I suggest including all citrus fruit, including lemon as one category. -In table 1, the results were expressed in a different format, I suggest having all the results expressed as N (%). For this purpose, age can be categorized into 2-3 categories, and same for BMI. -In the multivariate logistic regression, the authors mentioned that after controlling for covariate, the findings... What are the covariates? The authors should..
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