@article {Kim257, author = {Hyunju Kim and Casey M Rebholz and Sheila Hegde and Christine LaFiura and Madhunika Raghavan and John F Lloyd and Susan Cheng and Sara B Seidelmann}, title = {Plant-based diets, pescatarian diets and COVID-19 severity: a population-based case{\textendash}control study in six countries}, volume = {4}, number = {1}, pages = {257--266}, year = {2021}, doi = {10.1136/bmjnph-2021-000272}, publisher = {BMJ Specialist Journals}, abstract = {Background Several studies have hypothesised that dietary habits may play an important role in COVID-19 infection, severity of symptoms, and duration of illness. However, no previous studies have investigated the association between dietary patterns and COVID-19.Methods Healthcare workers (HCWs) from six countries (France, Germany, Italy, Spain, UK, USA) with substantial exposure to COVID-19 patients completed a web-based survey from 17 July to 25 September 2020. Participants provided information on demographic characteristics, dietary information, and COVID-19 outcomes. We used multivariable logistic regression models to evaluate the association between self-reported diets and COVID-19 infection, severity, and duration.Results There were 568 COVID-19 cases and 2316 controls. Among the 568 cases, 138 individuals had moderate-to-severe COVID-19 severity whereas 430 individuals had very mild to mild COVID-19 severity. After adjusting for important confounders, participants who reported following {\textquoteleft}plant-based diets{\textquoteright} and {\textquoteleft}plant-based diets or pescatarian diets{\textquoteright} had 73\% (OR 0.27, 95\% CI 0.10 to 0.81) and 59\% (OR 0.41, 95\% CI 0.17 to 0.99) lower odds of moderate-to-severe COVID-19 severity, respectively, compared with participants who did not follow these diets. Compared with participants who reported following {\textquoteleft}plant-based diets{\textquoteright}, those who reported following {\textquoteleft}low carbohydrate, high protein diets{\textquoteright} had greater odds of moderate-to-severe COVID-19 (OR 3.86, 95\% CI 1.13 to 13.24). No association was observed between self-reported diets and COVID-19 infection or duration.Conclusion In six countries, plant-based diets or pescatarian diets were associated with lower odds of moderate-to-severe COVID-19. These dietary patterns may be considered for protection against severe COVID-19.Data are not publicly available.}, URL = {https://nutrition.bmj.com/content/4/1/257}, eprint = {https://nutrition.bmj.com/content/4/1/257.full.pdf}, journal = {BMJ Nutrition, Prevention \& Health} }