The Association between Body Mass Index and Probiotics Supplementation with Hospital Stay Duration and Symptoms among COVID-19 Iranian Patients

Articles in Press

Document Type : Original Article

Authors

1 Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran, University of Medical Sciences, Tehran, Iran

3 Department of Nutrition, Science and Research Branch, Islamic Azad University, Tehran, Iran

4 Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Geelong, VIC 3220, Australia

5 Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran

6 Non-communicable Disease Research Centre, Alborz University of Medical Sciences, Karaj, Iran

10.30476/ijns.2026.108984.1581

Abstract

Background: Coronavirus disease-2019 (COVID-19) can cause a severe respiratory disease and systemic complications. The gut microbiota plays an important role in immune regulation, while obesity may worsen COVID-19 outcomes. This study investigated the interaction between body mass index (BMI) and probiotic supplementation on COVID-19 symptoms and length of hospital stay.
Methods: This cross-sectional study included 107 Iranian adults aged 20-60 years hospitalized with COVID-19 at Amir Alam Hospital, Tehran, Iran. Demographic characteristics, body composition, probiotic supplementation history, and COVID-19 symptoms were assessed using questionnaires and hospital records. Linear and binary logistic regression analyses were performed to evaluate associations and interactions.
Results: Probiotic consumption was negatively associated with lethargy (β=−3.09; 95%CI: −4.85, −1.32; p<0.01). BMI was positively associated with C-reactive protein (CRP) level (β=47.46; 95%CI: 5.24, 89.69; p= 0.02). A correlation was observed between probiotic intake and lower BMI for duration of hospitalization (β=−3.28; 95%CI: −7.28, 0.00; p=0.05) and
D-dimer level (β=−3.57; 95%CI: −31.35, 24.20; p=0.07). This association was also observed for diarrhea (OR=0.32; 95%CI: 0.01, 1.00; p=0.05) and stomachache (OR=0.43; 95%CI: 0.00, 1.45; p= 0.09).
Conclusion: Probiotic consumption was associated with lower lethargy, while higher BMI was correlated with an increased CRP level. The observed interactions between probiotic intake and BMI for hospitalization duration, D-dimer, and gastrointestinal symptoms warrant further investigation in larger longitudinal and randomized controlled studies.

Highlights

Atieh Mirzababaei (Google Scholar)

Keywords

References

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International Journal of Nutrition Sciences

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Available Online from 11 September 2026

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