Mechanisms By Which Malnutrition Magnified COVID-19 Impact

​Nidhi Ghildayal, PhD

Over the last several decades, public health researchers have been exploring the various ways malnutrition might worsen health among those experiencing an infectious disease. According to the World Health Organization (WHO), malnutrition is the state of too little, or too much, consumption of energy or nutrients. During the COVID-19 pandemic, the effects of malnutrition and inadequate access to healthy foods have been paramount, and were particularly prominent in children and communities of color.

The state of emergency caused by widespread contagion increased food insecurity compared to the year prior the pandemic. The number of people experiencing food insecurity in the United States tripled in households that included children, and doubled in households overall. The resulting malnutrition may have increased vulnerability to effects of COVID-19 as well as other negative health outcomes that can be affected by poor nutrition: including muscle, cardiorespiratory, and/or gastrointestinal function. People who have obesity also have been vulnerable to worse outcomes with COVID-19, including higher rates of hospitalization, need for a ventilator, or death.
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Malnutrition can be a double-edged sword, making people more vulnerable to infectious diseases, and infections also decreasing appetite and inability to properly absorb the nutrients needed for good health, creating a cycle of potential negative health consequences. In this case, malnutrition may both coincide with and amplify the effect of infectious disease impact.

​The relationship between malnutrition and COVID-19 is much more complex than can be distilled down to a few paragraphs. Continued research on the cyclic effect of each on the other would be beneficial, including investigation of specific nutritional deficiencies that may worsen response to infection. However, it is certainly clear that greater access to healthy foods may have lessened the burden of this pandemic.