A review published at the end of March analysed eight studies from different countries on nutritional status and the supply of biofactors such as vitamins and minerals in older people with COVID-19. “The strength of this systematic analysis is that this is the first study to examine the nutritional status and nutrient deficiencies in relation to the severity of the course of the disease in older patients with COVID-19,” the authors’ statement said.¹
With regard to the general nutritional status of the senior citizens, it was found that the prevalence of malnutrition in elderly patients with COVID-19 is high and linked to negative health outcomes – including stays in intensive care units and deaths in hospital.
Five studies also provided scientific data on the biofactor supply and the course of COVID-19 disease in the senior citizens studied. Both the vitamin D₃ and the magnesium and vitamin B₁₂ status were associated with malnutrition, oxygen therapy and/or the intensive care of patients and the survival rate after COVID-19 disease.

Experts recommend:
Pay attention to the biofactor supply in senior citizens
“The results of the studies analysed can be considered to be rele-vant and are also in line with the well-documented knowledge that elderly people in general can suffer more frequently from a deficiency of the biofactors vitamin D₃, vitamin B₁₂ and magnesium,” emphasises Prof. Hans-Georg Classen, Chairman of the Society for Biofactors (GfB).
Almost 62% of the population have insufficient serum concentrations of vitamin D₃.² Senior citizens are particularly affected by a vitamin D₃ deficiency, as in addition to insufficient alimentary intake from the age of 60 onwards, the body’s own vitamin D₃ synthesis decreases. On the one hand, the content of the vitamin D precursor 7-dehydrocholesterol in the skin is reduced, while on the other hand the capacity of the liver and kidneys to produce active vitamin D₃, calcitriol (1,25(OH)2D3) diminishes. Furthermore, elderly people often require nursing and are immobile, as a result of which they spend less time outdoors, which further reduces synthesis via the skin.³
Around one third of people over the age of 65 are also affected by vitamin B₁₂ deficiency, with this figure rising to 37.6% among those over 85⁴ and even up to 40% of senior citizens in inpatient nursing homes.⁵ And according to the results of the ErnSTES study – a multicentre study on the nutrition of elderly people in in-patient facilities – the magnesium supply of senior citizens is also often considered insufficient.⁶
“Therefore, attention should be paid as a general principle to the supply of the three biofactors in all senior citizens and – in accordance with the above-mentioned connection between malnutrition and biofactor deficiency and the course of COVID-19 disease – especially in elderly patients with a SARS-CoV-2 infection,” is the clear recommendation of the Society for Biofactors (GfB).

Bibliography:

1. Damayanthi HDWT et al.: Nutritional determinants and COVID-19 outcomes of older patients with COVID-19: A systematic review. Arch Gerontol Geriatr. 2021 Juli-August; 95: 104411. Online veröffentlicht 2021 31. März doi:  10.1016 / j.archger.2021.104411
2. Rabenberg M et al.: Journal of Health Monitoring 2016, 1(2). Robert Koch-Institut, Berlin. DOI 10.17886/RKI-GBE-2016-036
3. Biesalski HK: Ernährungsmedizin 2018, Stuttgart: Thieme Verlag, S. 177
4. Conzade R et al.: Prevalence and predictors of subclinical micronutrient deficiency in german older adults: results from the population-based KORA-Age Study. Nutrients 2017, 9: 1276
5. Andrès E et al.: Vitamin B12 deficiency in elderly patients. CMAJ 2004, 171(3): 251-259
6. Heseker H et al.: ErnSTES-Studie, in DGE: Ernährungsbericht 2008, 157-204