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Thrombosis and COVID-19: A potential role for tomatoes

15/10/2020 - Sophie Colvine - CoViD-19
A review article entitled ‘Thrombosis and COVID-19: The Potential Role of Nutrition’ has recently been published in the Frontiers in Nutrition journal, discussing the role of nutrition in combatting the thrombotic complications of COVID-19.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for the coronavirus disease (COVID-19), is a contagion that has rapidly spread around the globe. While the disease is predominantly characterized by respiratory symptoms initially, it is clear that other systems including the cardiovascular and neurological systems are also involved. Several thrombotic complications are reported including venous thrombosis, vasculitis, cardiomyopathy, and stroke. Thrombosis and inflammation are implicated in various non-communicable diseases. This is of significant concern as people with pre-existing conditions such as cardiovascular disorders, renal disorders, obesity, metabolic syndrome, and diabetes are at greater risk of severe COVID-19 infection. 
Consequently, the research surrounding the use of anticoagulants, antiplatelet, and antithrombotic strategies for prophylaxis and treatment of COVID-19 is of critical importance. The adoption of a healthy diet, physical exercise, and lifestyle choices can reduce the risk factors associated with non-communicable diseases and the thrombo-inflammatory complications. 
These thrombotic complications and potential foods, nutraceuticals, and the antithrombotic constituents within that may prevent the onset of severe thrombotic complications as a result of infection are discussed in the review. 
The authors write that “generally, only a limited number of food-derived compounds have been investigated for their antiplatelet effects clinically as of yet, whereby fish oils are synonymous. However, there has been some success in developing antiplatelet nutraceuticals. One such product is a water-soluble tomato-based nutraceutical given the trademarked name Fruitflow®. Fruitflow is now recognized as a functional product by the European Food Safety Authority (EFSA) with a recognized health claim that states that Fruitflow® “helps maintain normal platelet aggregation, which contributes to healthy blood flow”. A 3 g dose (containing 65 mg of antiplatelet components) of Fruitflow® recently demonstrated antiplatelet effects that were approximately one-third the effect of 75 mg of aspirin in a double-blinded randomized clinical trial of 47 healthy subjects. Nutraceuticals such as these may serve as a safe antiplatelet prophylactic treatment for those at high risk of COVID-19 who may also be at increased risk of thrombotic complications and an alternative to pharmacological compounds that may cause greater risk of bleeding.” 
The Tomato Foundation is currently finalizing the study of tomato products aimed at showing that they contain all the bioactive compounds found in Fruitflow extracts which would mean that tomato products have the same potential health benefits and could also benefit from an EFSA health claim. The results of the Foundation study should be released in the next few weeks.

Tomato products can also be a source of vitamin E, another compounds mentioned in the review as having potential benefits. 
The authors of the review conclude that while nutrition is not a panacea to tackle COVID-19, it is apparent that a patient's nutritional status may affect patient outcomes and may have a role to play in tacking the disease. 
Reference: Tsoupras A, Lordan R and Zabetakis I (2020) Thrombosis and COVID-19: The Potential Role of Nutrition. Front. Nutr.7:583080. doi: 10.3389/fnut.2020.583080
Full article
here (free access)  
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