Figure 3: Central role of Nrf2 in the impact of fermented
vegetables on COVID-19 severity . SARS-CoV-2 downregulates ACE2,
inducing an increased insulin resistance associated with oxidative
stress through the AT1R pathway. Fermented vegetables
are often made from Brassica vegetables that release glucoraphanin
converted by the plant or by the gut microbiome into sulforaphane which
activates Nrf2 and subsequently reduces insulin intolerance. Fermented
vegetables have a high content of Lactobacillus that can activate Nrf2
and impact the microbiome.