COVID-19: Ketone bodies ensure a fit immune system | Knowledge & Environment | DW

Why is COVID-19 hitting some people so much harder than others? While some hardly feel anything, others have to stay in bed for weeks, possibly even in the hospital. There are probably several answers to this question. Christoph Wilhelm and Christian Bode from the University of Bonn believe they have found one of them.

Christian Bode is an intensive care physician and was already treating seriously ill COVID-19 patients in the intensive care unit of the University Hospital in Bonn at the beginning of the pandemic. However, he did not observe the cytokine storm, an excessive reaction of the immune system, which leads to multiple inflammations in the body. There had to be another explanation for the severe, often fatal courses.

Bode therefore teamed up with the immunologist Christoph Wilhelm. They have one in common Study conducted in which they wanted to compare the change in metabolism of patients who had COVID-19 with that of people who had influenza.

The two scientists discovered a difference that seems to have an enormous impact on the effectiveness of the immune system.

Ketone bodies feed T cells

Anyone who has ever been really ill knows it: No appetite, zero. That’s not a problem at first, because the human body has a plan for this case. If we eat little or nothing and therefore lack carbohydrates as the main source of energy for our body, the metabolism changes.

“An inflammatory reaction always consumes a lot of energy, and it has to come from somewhere,” explains Christoph Wilhelm. Therefore, in a starvation situation, the body begins to burn fat. This creates so-called ketone bodies, which are so rich in energy that they replace missing carbohydrates. One of these ketone bodies is beta-hydroxybutyrate, or BHB for short.

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The scientists observed that those suffering from influenza formed large amounts of ketone bodies. The COVID-19 sufferers, on the other hand, did not show a significant increase in ketone bodies.

In the further course of their investigation, the researchers also found that the missing ketone bodies apparently have a direct impact on the fitness of the immune system – and thus help to determine how severe a disease is.

Both the T killer cells and T helper cellstwo essential components of the immune system, showed signs of exhaustion in COVID-19 sufferers – apparently because the ketone bodies as energy suppliers were missing.

Wilhelm and Bode cannot yet answer why the ketone body level in COVID-19 patients does not increase sufficiently and thus paralyzes the immune system. However, they have a few suspicions: it could have something to do with the nutritional status of those affected before the infection, for example.

How great the influence of nutrition on the immune system and thus on the course of diseases is known Nutritionist Hans Hauner from the Technical University of Munich. There he is director of the chair for nutritional medicine.

“Diet plays a major role in diseases and infections,” says Hauner. “We know from large observational studies, especially from England, that people who are overweight or obese have performed worse and worse with COVID-19. Both the complication rate and the mortality rate were significantly higher.”

The nutritionist also finds the work of the Bonn scientific colleagues very exciting because it makes a chronically neglected part of medicine clearly visible: what we eat and what we don’t can have very concrete effects on our health. However, nutrition can not only make you ill, it can also prevent and even heal.

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Christoph Wilhelm and Christian Bode tried this out on mice. Weak, exhausted immune cells recover when they are supplied with sufficient ketone bodies. For example, through a targeted change in diet that is very high in fat and low in carbohydrates. Also known as the keto diet.

The animals nursed in this way recovered from their SARS-CoV-2 infection, and the death rate fell significantly compared to the control group.

avocado and almonds

A ketogenic diet is high in fat and low in carbohydrates. But beware! The keto diet is not a panacea.

Food for a healthy immune system

Nevertheless, all three experts advise against conducting experiments with ketogenic nutrition on your own. That’s not even necessary. “A plant-based, healthy diet with little meat also offers the best protection against infectious diseases,” says nutritionist Hauner.

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