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Jia H, Sheng F, Yan Y, Liu X, Zeng B. Vitamin D supplementation for prevention of acute respiratory infections in older adults: A systematic review and meta-analysis. PLoS One 2024; 19:e0303495. [PMID: 38787821 PMCID: PMC11125479 DOI: 10.1371/journal.pone.0303495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 04/25/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Acute respiratory infections (ARIs) have a substantial impact on morbidity, healthcare utilization, and functional decline among older adults. Therefore, we systematically reviewed evidence from randomized controlled trials (RCTs) to evaluate the efficacy and safety of vitamin D supplementation in preventing ARIs in older adults. METHODS PubMed, Embase, the Cochrane Library, and ClinicalTrials.gov were searched until 1 February 2024. RCTs evaluating the use of vitamin D supplements to protect older adults from ARIs were included. Two reviewers independently screened papers, extracted the data and assessed the risk of bias. Data were summarised as relative risks (RRs) or odds ratios (ORs) with corresponding 95% confidence intervals (CIs). Random effects meta-analyses were used to synthesise the results. GRADE was used to evaluate the quality of evidence. All the analysis were performed with Stata version 17. RESULTS Twelve trials (41552 participants) were included in the meta-analysis. It showed that vitamin D supplementation probably does not reduce the incidence of ARIs (RR, 0.99; 95% CI, 0.97-1.02, I2 = 0%; moderate certainty). No significant effect of vitamin D supplementation on the risk of ARI was observed for any of the subgroups defined by baseline 25(OH)D concentration, control treatments, dose frequency, study duration, and participants' condition. However, there was a possibility, although not statistically significant, that vitamin D may reduce the risk of ARI in patients with a baseline 25(OH)D concentration <50 nmol/L (OR, 0.90; 95% CI, 0.79-1.04, I2 = 14.7%). Additionally, vitamin D supplements might result in little to no difference in death due to any cause, any adverse event, hypercalcinemia, and kidney stones. CONCLUSIONS Vitamin D supplementation among older adults probably results in little to no difference in the incidence of ARIs. However, further evidence is needed, particularly for individuals with vitamin D deficiency and populations residing in low and middle income countries. TRIAL REGISTRATION This study was registered on PROSPERO (CRD42023451265).
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Affiliation(s)
- Hao Jia
- Drug Clinical Trial Institution, Tianjin Fifth Central Hospital (Peking University Binhai Hospital), Tianjin, China
| | - Feng Sheng
- Department of Education and Science, Tianjin Fifth Central Hospital (Peking University Binhai Hospital), Tianjin, China
| | - Yulan Yan
- Department of Education and Science, Tianjin Fifth Central Hospital (Peking University Binhai Hospital), Tianjin, China
| | - Xiaozhi Liu
- Central Laboratory, Tianjin Fifth Central Hospital (Peking University Binhai Hospital), Tianjin, China
- Tianjin Key Laboratory of Epigenetic for Organ Development of Preterm Infants, Tianjin Fifth Central Hospital, Tianjin, China
- High Altitude Characteristic Medical Research Institute, Huangnan Tibetan Autonomous Prefecture People’s Hospital, Huangnan Prefecture, Qinghai, China
| | - Baoqi Zeng
- Central Laboratory, Tianjin Fifth Central Hospital (Peking University Binhai Hospital), Tianjin, China
- Emergency Department of Tianjin Fifth Central Hospital, Tianjin, China
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing, China
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Feketea G, Vassilopoulou E, Andreescu O, Berghea EC, Pop RM, Sabin O, Zdrenghea M, Bocsan IC. Vitamin D Level and Immune Modulation in Children with Recurrent Wheezing. CHILDREN (BASEL, SWITZERLAND) 2024; 11:219. [PMID: 38397331 PMCID: PMC10888088 DOI: 10.3390/children11020219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/03/2024] [Accepted: 02/05/2024] [Indexed: 02/25/2024]
Abstract
INTRODUCTION AND AIM A direct causal relationship between vitamin D (vit D) deficiency and recurrent wheezing has not been proven. The present study investigated the role of vit D in enhancing the risk of asthma or recurrent wheezing by modifying the intensity of the inflammatory process. MATERIAL AND METHOD Forty children with wheezing presenting at the emergency service and sixteen healthy control subjects were included in the study. Children with wheezing were either in the first episode (20) or with recurrent wheezing (20). Children with chronic diseases, and other conditions that present with acute wheezing or that might influence the vit D level, were excluded. Blood samples were taken at presentation and 3-6 months later, to evaluate the serum levels of total IgE, vit D, IL-10 and IL-31. Statistical analysis was performed using the SPSS 25 program, with a significance level of p < 0.05. RESULTS AND CONCLUSION The vit D level was lower in patients with recurrent wheezing compared with those with a single episode and with the control group, and this increased with time. IL-10 was significantly higher in children with wheezing than in the control group, with the highest values in those with an acute episode of wheezing. IL-31 was higher in children with recurrent wheezing than in those with a first episode only at the initial point, while at the final time point it was lower. Low levels of vit D appear to be detected more frequently in recurrent wheezing than in simple wheezing. Immune modulation, as measured by Th2 status reflected by IL-10 and IL-31 levels, appears to depend on the wheezing phenotype and on the general health status.
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Affiliation(s)
- Gavriela Feketea
- Department of Pharmacology, Toxicology and Clinical Pharmacology, University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania; (G.F.); (R.M.P.); (O.S.); (I.C.B.)
- Pediatric Allergy Outpatient Clinic, Department of Pediatrics, “Karamandaneio” Children’s Hospital of Patra, 26331 Patras, Greece
| | - Emilia Vassilopoulou
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Oana Andreescu
- Fundamental, Prophylactic and Clinical Specialties Department, Faculty of Medicine, Transilvania University of Brasov, 500019 Brasov, Romania;
| | - Elena Camelia Berghea
- Department of Pediatrics, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Pediatrics, “Marie S. Curie” Emergency Children’s Clinical Hospital, 041451 Bucharest, Romania
| | - Raluca Maria Pop
- Department of Pharmacology, Toxicology and Clinical Pharmacology, University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania; (G.F.); (R.M.P.); (O.S.); (I.C.B.)
| | - Octavia Sabin
- Department of Pharmacology, Toxicology and Clinical Pharmacology, University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania; (G.F.); (R.M.P.); (O.S.); (I.C.B.)
| | - Mihnea Zdrenghea
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, 8 Babes Str., 400012 Cluj-Napoca, Romania
- Department of Hematology, Ion Chiricuta Oncology Institute, 34-36 Republicii Str., 400015 Cluj-Napoca, Romania
| | - Ioana Corina Bocsan
- Department of Pharmacology, Toxicology and Clinical Pharmacology, University of Medicine and Pharmacy, 400337 Cluj-Napoca, Romania; (G.F.); (R.M.P.); (O.S.); (I.C.B.)
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Jain GK, Raina V, Grover R, Sharma J, Warsi MH, Aggarwal G, Kesharwani P. Revisiting the significance of nano-vitamin D for food fortification and therapeutic application. Drug Dev Ind Pharm 2024; 50:89-101. [PMID: 38175566 DOI: 10.1080/03639045.2023.2301478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 12/29/2023] [Indexed: 01/05/2024]
Abstract
OBJECTIVE Vitamin D (a prohormone) is an important micronutrient required by the body for skeletal homeostasis and a range of non-skeletal actions. Calcitriol, the active form of vitamin D, regulates a variety of cellular and metabolic processes through both genomic and nongenomic pathways. Often prescribed for treating rickets and osteoporosis, vitamin D deficiency can exacerbate various other medical conditions. SIGNIFICANCE, METHODS, AND RESULTS Despite its multifunctional uses, the sensitivity of vitamin D makes formulating an efficient drug delivery system a challenging task, which is further complicated by its poor aqueous solubility. Enhancing the oral absorption of vitamin D is vital in utilizing its full efficacy. Recent developments in encapsulation and nanotechnology have shown promising results in overcoming these constraints. CONCLUSION This review thus offers an insight to adequately comprehend the mechanistic pharmacology of vitamin D, its pathophysiological role, and justification of its medical indications, along with the benefits of utilizing nanotechnology for vitamin D delivery.
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Affiliation(s)
- Gaurav K Jain
- Center for Advanced Formulation Technology (CAFT), Delhi Pharmaceutical Science and Research University (DPSRU), New Delhi, India
| | - Vidya Raina
- Center for Advanced Formulation Technology (CAFT), Delhi Pharmaceutical Science and Research University (DPSRU), New Delhi, India
| | - Rakshita Grover
- Center for Advanced Formulation Technology (CAFT), Delhi Pharmaceutical Science and Research University (DPSRU), New Delhi, India
| | - Jagriti Sharma
- Center for Advanced Formulation Technology (CAFT), Delhi Pharmaceutical Science and Research University (DPSRU), New Delhi, India
| | - Musarrat Husain Warsi
- Department of Pharmaceutics and Industrial Pharmacy, College of Pharmacy, Taif University, Taif, Saudi Arabia
| | - Geeta Aggarwal
- Center for Advanced Formulation Technology (CAFT), Delhi Pharmaceutical Science and Research University (DPSRU), New Delhi, India
| | - Prashant Kesharwani
- Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
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4
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Ibrahim MAA, Shehata MNI, Moussa NAM, Hemia RRA, Abd Elhafez HSM, Abd El-Rahman MK, Sayed SRM, Sidhom PA, Dabbish E, Shoeib T. Preferability of Molnupiravir, an Anti-COVID-19 Drug, toward Purine Nucleosides: A Quantum Mechanical Study. ACS OMEGA 2023; 8:27553-27565. [PMID: 37546583 PMCID: PMC10398865 DOI: 10.1021/acsomega.3c03215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 06/28/2023] [Indexed: 08/08/2023]
Abstract
Structural aspects of molnupiravir complexed with the RNA of the SARS-CoV-2 virus have been recently resolved inside the RNA-dependent RNA polymerase (RdRp), demonstrating the interactions of molnupiravir with purine nucleosides. However, the preference of molnupiravir to interact with one purine nucleoside over another has not been clearly investigated. Herein, the complexation of molnupiravir in its active form with guanosine and adenosine was compared, using sundry density functional theory calculations. The plausible tautomeric structures of the molnupiravir drug in complex with guanosine/adenosine were minutely scrutinized. The relative energy findings outlined the favorability of amino-molnupiravir···keto-amino-guanosine and imino-molnupiravir···amino-adenosine optimized complexes. According to the interaction (Eint) and binding (Ebind) energy values, higher preferential base-pairing of molnupiravir with guanosine over the adenosine one was recognized with Eint/Ebind values of -31.16/-21.81 and -13.93/-12.83 kcal/mol, respectively. This could be interpreted by the presence of three and two hydrogen bonds within the former and latter complexes, respectively. Observable changes in the electronic properties and global indices of reactivity of the studied complexes also confirmed the preferential binding within the studied complexes. The findings from the quantum theory of atoms in molecules and the noncovalent interaction index also support the partially covalent nature of the investigated interactions. For both complexes, changes in thermodynamic parameters outlined the spontaneous, exothermic, and nonrandom states of the inspected interactions. Inspecting the solvent effect on the studied interactions outlined more observable amelioration within the water medium compared with the gas one. These results would be a durable ground for the forthcoming studies concerned with the interactions of the molnupiravir drug with purine nucleosides.
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Affiliation(s)
- Mahmoud A. A. Ibrahim
- Computational
Chemistry Laboratory, Chemistry Department, Faculty of Science, Minia University, Minia 61519, Egypt
- School
of Health Sciences, University of KwaZulu-Natal, Westville Campus, Durban 4000, South Africa
| | - Mohammed N. I. Shehata
- Computational
Chemistry Laboratory, Chemistry Department, Faculty of Science, Minia University, Minia 61519, Egypt
| | - Nayra A. M. Moussa
- Computational
Chemistry Laboratory, Chemistry Department, Faculty of Science, Minia University, Minia 61519, Egypt
| | - Randa R. A. Hemia
- Computational
Chemistry Laboratory, Chemistry Department, Faculty of Science, Minia University, Minia 61519, Egypt
| | - Heba S. M. Abd Elhafez
- Computational
Chemistry Laboratory, Chemistry Department, Faculty of Science, Minia University, Minia 61519, Egypt
| | - Mohamed K. Abd El-Rahman
- Department
of Chemistry and Chemical Biology, Harvard
University, 12 Oxford
Street, Cambridge, Massachusetts 02138, United States
| | - Shaban R. M. Sayed
- Department
of Botany and Microbiology, College of Science, King Saud University, P.O. Box 2455, Riyadh 11451, Saudi Arabia
| | - Peter A. Sidhom
- Department
of Pharmaceutical Chemistry, Faculty of Pharmacy, Tanta University, Tanta 31527, Egypt
| | - Eslam Dabbish
- Department
of Chemistry, The American University in
Cairo, New Cairo 11835, Egypt
| | - Tamer Shoeib
- Department
of Chemistry, The American University in
Cairo, New Cairo 11835, Egypt
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5
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Feehan O, Magee PJ, Pourshahidi LK, Armstrong DJ, McSorley EM. Vitamin D deficiency in nursing home residents: a systematic review. Nutr Rev 2023; 81:804-822. [PMID: 36367832 PMCID: PMC10251303 DOI: 10.1093/nutrit/nuac091] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Abstract
CONTEXT Vitamin D deficiency is a global public health issue, particularly in nursing home residents. OBJECTIVE This review critically summarizes the prevalence of vitamin D deficiency in nursing home residents worldwide. In addition, it outlines the effect of vitamin D intervention, alone or in combination with other nutrients or therapies, on improving vitamin D status and associated health outcomes in nursing home residents. DATA SOURCES, EXTRACTION, AND ANALYSIS Searches were conducted of electronic databases for articles published from 2010 to May 2021. After screening of the 366 papers initially identified, 58 articles were included. CONCLUSIONS A paucity of observational studies in nursing homes suggests a high prevalence of vitamin D deficiency ranging from 8% [25(OH)D <25 nmol/L], up to 94% [25(OH)D <50 nmol/L] in some cohorts where supplement use was low. Reported factors associated with deficiency and suboptimal vitamin D status include lack of sunlight exposure, poor dietary intake of vitamin D, limited vitamin D food fortification, frailty, poor renal function, and low use of vitamin D supplements. Residents who are severely deficient, deficient, or insufficient in vitamin D require remedial vitamin D supplementation prior to maintenance supplementation at doses >800 IU/day. High-dose vitamin D supplementation may reduce respiratory illness; however, supportive data are limited. Oral nutritional supplements, in combination with exercise, may benefit physical function and performance, whereas supplementation with vitamin D- and calcium-fortified foods has been associated with improved quality of life and reduced bone resorption. Globally, vitamin D deficiency is highly prevalent in nursing home residents. There is an urgent need for standardized dietary and supplementation guidelines to prevent deficiency in this vulnerable group.
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Affiliation(s)
- Orlagh Feehan
- are with the Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - Pamela J Magee
- are with the Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, Northern Ireland, United Kingdom
| | - L Kirsty Pourshahidi
- are with the Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, Northern Ireland, United Kingdom
- are with the Department of Rheumatology, Altnagelvin Hospital, Western Health and Social Care Trust, Londonderry, United Kingdom
| | - David J Armstrong
- are with the Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, Northern Ireland, United Kingdom
- are with the Department of Rheumatology, Altnagelvin Hospital, Western Health and Social Care Trust, Londonderry, United Kingdom
| | - Emeir M McSorley
- are with the Nutrition Innovation Centre for Food and Health, Ulster University, Coleraine, Northern Ireland, United Kingdom
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Contreras-Bolívar V, García-Fontana B, García-Fontana C, Muñoz-Torres M. Vitamin D and COVID-19: where are we now? Postgrad Med 2023; 135:195-207. [PMID: 34886758 PMCID: PMC8787834 DOI: 10.1080/00325481.2021.2017647] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 12/09/2021] [Indexed: 12/14/2022]
Abstract
The pandemic caused by the SARS-CoV-2 virus has triggered great interest in the search for the pathophysiological mechanisms of COVID-19 and its associated hyperinflammatory state. The presence of prognostic factors such as diabetes, cardiovascular disease, hypertension, obesity, and age influence the expression of the disease's clinical severity. Other elements, such as 25-hydroxyvitamin D (25(OH)D3) concentrations, are currently being studied. Various studies, mostly observational, have sought to demonstrate whether there is truly a relationship between 25(OH)D3 levels and the acquisition and/or severity of the disease. The objective of this study was to carry out a review of the current data that associate vitamin D status with the acquisition, evolution, and/or severity of infection by the SARS-CoV-2 virus and to assess whether prevention through vitamin D supplementation can prevent infection and/or improve the evolution once acquired. Vitamin D system has an immunomodulatory function and plays a significant role in various bacterial and viral infections. The immune function of vitamin D is explained in part by the presence of its receptor (VDR) and its activating enzyme 25-hydroxyvitamin D-1alpha-hydroxylase (CYP27B1) in immune cells. The vitamin D, VDR, and Retinoid X Receptor complex allows the transcription of genes with antimicrobial activities, such as cathelicidins and defensins. COVID-19 characteristically presents a marked hyperimmune state, with the release of proinflammatory cytokines such as IL-6, TNF-α, and IL-1β. Thus, there are biological factors linking vitamin D to the cytokine storm, which can herald some of the most severe consequences of COVID-19, such as acute respiratory distress syndrome. Hypovitaminosis D is widespread worldwide, so the prevention of COVID-19 through vitamin D supplementation is being considered as a possible therapeutic strategy easy to implement. However, more-quality studies and well-designed randomized clinical trials are needed to address this relevant question.
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Affiliation(s)
- Victoria Contreras-Bolívar
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs. Granada), Granada, Spain
| | - Beatriz García-Fontana
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs. Granada), Granada, Spain
- CIBERFES. Instituto de Salud Carlos III, Madrid, Spain
| | - Cristina García-Fontana
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs. Granada), Granada, Spain
- CIBERFES. Instituto de Salud Carlos III, Madrid, Spain
| | - Manuel Muñoz-Torres
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs. Granada), Granada, Spain
- CIBERFES. Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, University of Granada, Granada, Spain
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Lahaye C, Parant F, Haesebaert J, Goldet K, Bendim'red L, Henaff L, Saadatian-Elahi M, Vanhems P, Cuerq C, Gilbert T, Blond E, Bost M, Bonnefoy M. Minerals and Antioxidant Micronutrients Levels and Clinical Outcome in Older Patients Hospitalized for COVID-19 during the First Wave of the Pandemic. Nutrients 2023; 15:nu15061516. [PMID: 36986247 PMCID: PMC10056386 DOI: 10.3390/nu15061516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 03/17/2023] [Accepted: 03/18/2023] [Indexed: 03/30/2023] Open
Abstract
Excessive inflammatory response has been implicated in severe respiratory forms of coronavirus disease 2019 (COVID-19). Trace elements such as zinc, selenium, and copper are known to modulate inflammation and immunity. This study aimed to assess the relationships between antioxidant vitamins and mineral trace elements levels as well as COVID-19 severity in older adults hospitalized. In this observational retrospective cohort study, the levels of zinc, selenium, copper, vitamin A, β-carotene, and vitamin E were measured in 94 patients within the first 15 days of hospitalization. The outcomes were in-hospital mortality secondary to COVID-19 or severe COVID-19. A logistic regression analysis was conducted to test whether the levels of vitamins and minerals were independently associated with severity. In this cohort (average age of 78 years), severe forms (46%) were associated with lower zinc (p = 0.012) and β-carotene (p < 0.001) concentrations, and in-hospital mortality (15%) was associated with lower zinc (p = 0.009), selenium (p = 0.014), vitamin A (p = 0.001), and β-carotene (p = 0.002) concentrations. In regression analysis, severe forms remained independently associated with lower zinc (aOR 2.13, p = 0.018) concentrations, and death was associated with lower vitamin A (aOR = 0.165, p = 0.021) concentrations. Low plasma concentrations of zinc and vitamin A were associated with poor prognosis in older people hospitalized with COVID-19.
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Affiliation(s)
- Clément Lahaye
- Department of Geriatric Medicine, Hôpital Gabriel Montpied, 63000 Clermont-Ferrand, France
- Unité de Nutrition Humaine, Université Clermont Auvergne, INRAE, 63000 Clermont-Ferrand, France
| | - François Parant
- Biology Center South, Hôpital Lyon Sud, 69310 Pierre-Bénite, France
| | - Julie Haesebaert
- Public Health Unit, Department of Clinical Research and Epidemiology, Groupement Hospitalier Est, 69002 Lyon, France
- RESHAPE Research on Healthcare Performance Inserm U1290, Université Lyon 1, 69008 Lyon, France
| | - Karine Goldet
- Clinical Research Centre, Ageing, Brain, Fragility-Hôpital des Charpennes, 69100 Villeurbanne, France
| | - Lamia Bendim'red
- Clinical Research Centre, Ageing, Brain, Fragility-Hôpital des Charpennes, 69100 Villeurbanne, France
| | - Laetitia Henaff
- Department of Hygiene, Epidemiology and Prevention, Hôpital Édouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France
- ICIR-International Center for Infectiology Research (Team PHE3ID), Claude Bernard Lyon 1 University, Inserm, U1111, CNRS, UMR5308, ENS Lyon, 46 Allée d'Italie, 69007 Lyon, France
| | - Mitra Saadatian-Elahi
- Department of Hygiene, Epidemiology and Prevention, Hôpital Édouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France
- ICIR-International Center for Infectiology Research (Team PHE3ID), Claude Bernard Lyon 1 University, Inserm, U1111, CNRS, UMR5308, ENS Lyon, 46 Allée d'Italie, 69007 Lyon, France
| | - Philippe Vanhems
- Department of Hygiene, Epidemiology and Prevention, Hôpital Édouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France
- ICIR-International Center for Infectiology Research (Team PHE3ID), Claude Bernard Lyon 1 University, Inserm, U1111, CNRS, UMR5308, ENS Lyon, 46 Allée d'Italie, 69007 Lyon, France
| | - Charlotte Cuerq
- Biology Center South, Hôpital Lyon Sud, 69310 Pierre-Bénite, France
| | - Thomas Gilbert
- RESHAPE Research on Healthcare Performance Inserm U1290, Université Lyon 1, 69008 Lyon, France
- Department of Geriatric Medicine, Groupement Hospitalier Sud, CHU de Lyon, 69495 Pierre-Bénite, France
| | - Emilie Blond
- Biology Center South, Hôpital Lyon Sud, 69310 Pierre-Bénite, France
| | - Muriel Bost
- Biology Center South, Hôpital Lyon Sud, 69310 Pierre-Bénite, France
| | - Marc Bonnefoy
- Department of Geriatric Medicine, Groupement Hospitalier Sud, CHU de Lyon, 69495 Pierre-Bénite, France
- INSERM, 1060 CaRMeN 165 Chemin du Grand Revoyet, 69310 Pierre-Bénite, France
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8
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Grygorieva NV, Solonenko TY, Musiienko AS, Bystrytska MA. Vitamin D deficiency in Ukraine: current evidence. BMC Nutr 2023; 9:49. [PMID: 36918995 PMCID: PMC10014139 DOI: 10.1186/s40795-023-00706-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/08/2023] [Indexed: 03/15/2023] Open
Abstract
BACKGROUND Data from numerous studies demonstrate the high frequency of vitamin D deficiency (VDD) and insufficiency (VDI) in many countries worldwide that depend on age and sex, seasons, country, and concomitant pathology. This research aimed to study vitamin D status in the Ukrainian population during 2016-2022 years depending on age, sex, month, and year of the observation, and compare the results with the data of previous Ukrainian epidemiologic studies. METHODS In a single-center cohort study, we analyzed the serum total 25-hydroxyvitamin D (25(OH)D) level in 7,418 subjects aged 20-99 years. The analysis was performed depending on age, sex, month, season, and year of the observation. Also, we compared the results with the data of previous Ukrainian studies. 25(OH)D level was measured using the electrochemiluminescence method. RESULTS The mean serum 25(OH)D level in the total group was 31.0 [22.3-41.1] ng/mL, the lowest level was in the age group 90-99 years old. No gender differences were found in 25(OH)D levels, except the one for the women aged 60-69 years old who had higher vitamin D levels compared to male parameters. 41.6% of the subjects had an optimal (> 30-50 ng/mL) 25(OH)D level, 27.3% had VDI, and 19.5% had a VDD. The suboptimal and high serum concentration of 25(OH)D (> 50-100 ng/mL) was found in 11.4% of the subjects. Also, we established the increase of serum 25(OH)D level from 2016 to 2022 with the highest values in 2020-2022. Seasonal variations of 25(OH)D concentration confirmed the highest index in autumn (33.0 [24.0-42.4] ng/mL) and the lowest one in the spring (28.5 [19.7-38.7] ng/mL) with the highest 25(OH)D level in September and the lowest one in March. CONCLUSION Our results confirmed a decrease in VDD and VDI in 2020-2022 in the Ukrainian population compared to the previous years (2016-2019) and previous Ukrainian studies with similar age and seasonal particularities. It may be the consequence of an improvement in public awareness of global vitamin D deficiency, its positive skeletal and extra-skeletal effects, as well as more intensive vitamin D supplementation due to the COVID-19 pandemic in the recent years.
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Affiliation(s)
- N V Grygorieva
- Department of Clinical Physiology and Pathology of Musculoskeletal System, State Institution "D. F. Chebotarev Institute of Gerontology of the NAMS of Ukraine", Kiev, Ukraine.
| | - T Yu Solonenko
- Department of Clinical Physiology and Pathology of Musculoskeletal System, State Institution "D. F. Chebotarev Institute of Gerontology of the NAMS of Ukraine", Kiev, Ukraine
| | - A S Musiienko
- Department of Clinical Physiology and Pathology of Musculoskeletal System, State Institution "D. F. Chebotarev Institute of Gerontology of the NAMS of Ukraine", Kiev, Ukraine
| | - M A Bystrytska
- Department of Clinical Physiology and Pathology of Musculoskeletal System, State Institution "D. F. Chebotarev Institute of Gerontology of the NAMS of Ukraine", Kiev, Ukraine
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9
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Shrivastava AK, Sahu PK, Cecchi T, Shrestha L, Shah SK, Gupta A, Palikhey A, Joshi B, Gupta PP, Upadhyaya J, Paudel M, Koirala N. An emerging natural antioxidant therapy for COVID‐19 infection patients: Current and future directions. FOOD FRONTIERS 2023. [DOI: 10.1002/fft2.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- Amit Kumar Shrivastava
- Department of Pharmacology Universal College of Medical Sciences Bhairahawa Rupandehi Nepal
| | - Prafulla Kumar Sahu
- School of Pharmacy Centurion University of Technology and Management Bhubaneswar Odisha India
| | | | - Laxmi Shrestha
- Department of Pharmacology Universal College of Medical Sciences Bhairahawa Rupandehi Nepal
| | - Sanjay Kumar Shah
- Department of Reproductive MedicineJoint Inter‐national Research Laboratory of Reproduction and DevelopmentChongquing Medical University ChongqingPeople's Republic of China
| | - Anamika Gupta
- Sharjah Institute for Medical Sciences University of Sharjah Sharjah United Arab Emirates
| | - Anjan Palikhey
- Department of Pharmacology Universal College of Medical Sciences Bhairahawa Rupandehi Nepal
| | - Bishal Joshi
- Department of Physiology, Universal College of Medical Sciences Bhairahawa Rupandehi Nepal
| | - Pramodkumar P. Gupta
- School of Biotechnology and Bioinformatics D. Y. Patil Deemed to be University, CBD Belapur Navi Mumbai India
| | - Jitendra Upadhyaya
- Institute of Agriculture and Animal Science Tribhuvan University Chitwan Nepal
| | - Mahendra Paudel
- Department of Agri‐Botany and Ecology Institute of Agriculture and Animal Science Tribhuvan University Mahendranagar Nepal
| | - Niranjan Koirala
- Natural Products Research FacilityGandaki Province Academy of Science and Technology Pokhara, Gandaki Province Nepal
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10
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A Mathematical Model for Determining the Body's Fluctuating Need for and Synthesis of Active Vitamin D. Biomedicines 2023; 11:biomedicines11020324. [PMID: 36830861 PMCID: PMC9953299 DOI: 10.3390/biomedicines11020324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/03/2023] [Accepted: 01/09/2023] [Indexed: 01/27/2023] Open
Abstract
The process by which 1,25(OH)2D3 is synthesized and degraded and how it is transported out of the cell and body is described. The changing demand for the synthesis of 1-25(OH)2D3 during different conditions experienced by the body is reviewed. A method of determining 1,25(OH)2D3 synthesis and demand, and the percent utilization of 25(OH)D3 to make 1,25(OH)2D3 is presented based on the measurement of the end metabolites of 1,25(OH)2D3 and of its immediate precursor, 25(OH)D3. A mathematical model has been developed to allow the calculation of 1,25(OH)2 D synthesis, and demand, and the percent utilization of 25(OH)D3. Simple algebraic equations have been derived which allow the calculation of these new parameters using the concentrations of the end metabolites of 1,25(OH)2D3 and its immediate precursor, 25(OH)D3 in the serum and urine. Vitamin D plays an important role in combating invading bacteria and viruses and in subduing the body's associated inflammatory response. This new approach to evaluating vitamin D status may help clinicians determine 25(OH)D3 and 1,25(OH)2D3 levels needed to suppress bacterial infections, viral replication during new viral infections and the reactivation of latent viruses, and to downregulate the inflammatory responses caused by bacteria and viruses.
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11
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Heer RS, Sandhu P, Wenban C, Mandal AKJ, Missouris CG. Vitamin D in the news: A call for clear public health messaging during Covid-19. Nutr Health 2022; 28:733-739. [PMID: 35360990 PMCID: PMC9716052 DOI: 10.1177/02601060221090293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Background: The public are increasingly reliant on the internet and media to access healthcare related information during the Covid-19 pandemic. Vitamin D is essential for musculoskeletal and immune health, with daily supplementation advised by public health bodies. Several studies assessing a possible link between vitamin D and Covid-19 severity have arrived at conflicting results and news articles have been rapidly disseminating such research to the public. There has been little focus on studying the quality of information available. Aim: To identify if online search interest in vitamin D increased with pandemic burden and analyse the accuracy of public health messaging relating to vitamin D in online news articles. Methods: Online search interest data for vitamin D was correlated with pandemic burden, defined as the number of Covid-19 deaths. Online news articles discussing vitamin D and Covid-19 were analysed using qualitative coding. Results: Online search interest for vitamin D increased as pandemic burden increased (p < 0.0001, Spearman's rank). Of the 72 articles identified, most (50%) offered a mixed opinion on the benefit of vitamin D in Covid-19. From articles making a recommendation for vitamin D supplementation, 23% of articles gave mixed messaging or advised against supplementation. 16% of articles recommended a dose which exceeded the safe limit of 4000 IU/day, risking toxicity. Conclusion: A significant number of articles provided mixed messaging or incorrectly advised supratherapeutic doses. This study highlights an opportunity for public health bodies to utilise the increased interest in vitamin D during the pandemic to raise awareness with accurate information.
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Affiliation(s)
- Randeep S Heer
- Wexham Park Hospital, Frimley Health NHS Foundation Trust, UK
| | - Preeti Sandhu
- Wexham Park Hospital, Frimley Health NHS Foundation Trust, UK
| | | | - Amit K J Mandal
- Wexham Park Hospital, Frimley Health NHS Foundation Trust, UK
| | - Constantinos G Missouris
- Wexham Park Hospital, Frimley Health NHS Foundation Trust, UK
- University of Nicosia Medical
School, Nicosia, Cyprus
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12
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Polkinghorne A, Branley JM. Medications for early treatment of COVID-19 in Australia. Med J Aust 2022; 217 Suppl 9:S7-S13. [PMID: 36273391 PMCID: PMC9828711 DOI: 10.5694/mja2.51750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 09/13/2022] [Accepted: 09/20/2022] [Indexed: 11/07/2022]
Abstract
Early treatment of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections can prevent hospitalisation and death in patients with coronavirus disease 2019 (COVID-19) who have one or more risk factors for serious COVID-19 progression. While early treatment presents a range of logistical challenges, clinicians are nevertheless aided by a growing number of approved medications for early treatment of COVID-19. Medications include drugs that inhibit SARS-CoV-2 viral replication, anti-SARS-CoV-2 monoclonal antibody formulations that provide passive immunisation, and immunomodulatory drugs that suppress the body's inflammatory response. Several drugs with different modes of action are approved in Australia for early treatment of COVID-19, including nirmatrelvir plus ritonavir, molnupiravir, and monoclonal antibody formulations. Although these drugs are recommended, clinicians are encouraged to remain up to date on current indications, contraindications and the clinical efficacy of these drugs against SARS-CoV-2 variants currently circulating in communities. Other treatments, including hydroxychloroquine, ivermectin and dietary supplements, have been popularised but are not recommended for early treatment of COVID-19. As new drugs and new data on use of existing approved drugs become available, clinicians face a growing challenge in determining the optimal treatments from the array of options. As it stands, early treatment of COVID-19 needs to be individualised depending on age, pregnancy status, existing medications, and renal and liver disease status. Future treatments in development might have roles in patients with lower risk profiles and in reducing transmission as we learn to live with SARS-CoV-2.
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Affiliation(s)
- Adam Polkinghorne
- Pathology WestNepean HospitalSydneyNSW,Nepean Clinical SchoolUniversity of SydneySydneyNSW
| | - James M Branley
- Pathology WestNepean HospitalSydneyNSW,Nepean Clinical SchoolUniversity of SydneySydneyNSW
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13
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Foolchand A, Mazaleni S, Ghazi T, Chuturgoon AA. A Review: Highlighting the Links between Epigenetics, COVID-19 Infection, and Vitamin D. Int J Mol Sci 2022; 23:12292. [PMID: 36293144 PMCID: PMC9603374 DOI: 10.3390/ijms232012292] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/07/2022] [Accepted: 10/12/2022] [Indexed: 11/16/2022] Open
Abstract
The highly transmittable and infectious COVID-19 remains a major threat worldwide, with the elderly and comorbid individuals being the most vulnerable. While vaccines are currently available, therapeutic drugs will help ease the viral outbreak and prevent serious health outcomes. Epigenetic modifications regulate gene expression through changes in chromatin structure and have been linked to viral pathophysiology. Since epigenetic modifications contribute to the life cycle of the virus and host immune responses to infection, epigenetic drugs are promising treatment targets to ameliorate COVID-19. Deficiency of the multifunctional secosteroid hormone vitamin D is a global health threat. Vitamin D and its receptor function to regulate genes involved in immunity, apoptosis, proliferation, differentiation, and inflammation. Amassed evidence also indicates the biological relations of vitamin D with reduced disease risk, while its receptor can be modulated by epigenetic mechanisms. The immunomodulatory effects of vitamin D suggest a role for vitamin D as a COVID-19 therapeutic agent. Therefore, this review highlights the epigenetic effects on COVID-19 and vitamin D while also proposing a role for vitamin D in COVID-19 infections.
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Affiliation(s)
| | | | - Terisha Ghazi
- Discipline of Medical Biochemistry, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Howard College Campus, Durban 4041, South Africa
| | - Anil A. Chuturgoon
- Discipline of Medical Biochemistry, School of Laboratory Medicine and Medical Sciences, College of Health Sciences, University of KwaZulu-Natal, Howard College Campus, Durban 4041, South Africa
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14
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de Sire A, Lippi L, Aprile V, Calafiore D, Folli A, D’Abrosca F, Moalli S, Lucchi M, Ammendolia A, Invernizzi M. Pharmacological, Nutritional, and Rehabilitative Interventions to Improve the Complex Management of Osteoporosis in Patients with Chronic Obstructive Pulmonary Disease: A Narrative Review. J Pers Med 2022; 12:1626. [PMID: 36294765 PMCID: PMC9604650 DOI: 10.3390/jpm12101626] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022] Open
Abstract
Osteoporosis is a highly prevalent condition affecting a growing number of patients affected by chronic obstructive pulmonary disease (COPD), with crucial implications for risk of fragility fractures, hospitalization, and mortality. Several risk factors have been identified to have a role in osteoporosis development in COPD patients, including corticosteroid therapy, systemic inflammation, smoke, physical activity levels, malnutrition, and sarcopenia. In this scenario, a personalized multitarget intervention focusing on the pathological mechanisms underpinning osteoporosis is mandatory to improve bone health in these frail patients. Specifically, physical exercise, nutritional approach, dietary supplements, and smoke cessation are the cornerstone of the lifestyle approach to osteoporosis in COPD patients, improving not only bone health but also physical performance and balance. On the other hand, pharmacological treatment should be considered for both the prevention and treatment of osteoporosis in patients at higher risk of fragility fractures. Despite these considerations, several barriers still affect the integration of a personalized approach to managing osteoporosis in COPD patients. However, digital innovation solutions and telemedicine might have a role in optimizing sustainable networking between hospital assistance and community settings to improve bone health and reduce sanitary costs of the long-term management of COPD patients with osteoporosis.
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Affiliation(s)
- Alessandro de Sire
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, Viale Europa, 88100 Catanzaro, Italy
| | - Lorenzo Lippi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
| | - Vittorio Aprile
- Division of Thoracic Surgery, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56122 Pisa, Italy
| | - Dario Calafiore
- Physical Medicine and Rehabilitation Unit, Department of Neurosciences, ASST Carlo Poma, 46100 Mantua, Italy
| | - Arianna Folli
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
| | - Francesco D’Abrosca
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
| | - Stefano Moalli
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
| | - Marco Lucchi
- Division of Thoracic Surgery, Department of Surgical, Medical and Molecular Pathology and Critical Care Medicine, University of Pisa, 56122 Pisa, Italy
| | - Antonio Ammendolia
- Physical and Rehabilitative Medicine Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, Viale Europa, 88100 Catanzaro, Italy
| | - Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont “A. Avogadro”, 28100 Novara, Italy
- Dipartimento Attività Integrate Ricerca e Innovazione (DAIRI), Translational Medicine, Azienda Ospedaliera SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy
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15
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Sidebottom R, Wassie SB, Cerami C, Jallow MW, Fennell S, Dalzell S. A longitudinal investigation of dietary diversity during the COVID-19 pandemic in Mandinka households in Kanifing, Brikama, and the West Kiang region in The Gambia. Front Nutr 2022; 9:907969. [PMID: 36245476 PMCID: PMC9562626 DOI: 10.3389/fnut.2022.907969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 08/24/2022] [Indexed: 11/21/2022] Open
Abstract
The Covid pandemic has exposed fissures of inequality through heightened food insecurity and nutritional deficiency for vulnerable social cohorts with limited coping mechanisms. Given the multi-dimensional pathways through which its effects have been felt, several researchers have highlighted the need to analyse the pandemic in specific contexts. Using random and fixed effect regression models, this study analyzed longitudinal survey data collected from 103 Mandinka households in rural and urban Gambia. The study employed convenience and snowball sampling and involved the monthly collection of detailed income, food consumption, expenditure, sourcing, migration, health, and coping mechanism data through mobile phone interviews which yielded 676 observations. Food insecurity was manifest in terms of quality, not quantity, and spread unevenly across food types and households. Dietary outcomes and sourcing strategies were associated with location, improved sanitation, household size, changes in monthly income, Covid policy stringency, and Covid cases but these associations varied by food group. Staples were the most frequently consumed food group, and dark green vegetables were the least. Rural communities were more likely to eat more healthy millets but much less likely to consume dairy products or roots and tubers. Access to own production was also important for Vitamin A-rich foods but higher incomes and markets were key for protein and heme-iron-rich foods. Tighter Covid policy stringency was negatively associated with dietary diversity and, along with fear of market hoarding, was positively associated with reliance on a range of consumption and production coping mechanisms. Resilience was higher in larger households and those with improved water and sanitation. The number of Covid cases was associated with higher consumption of protein-rich foods and greater reliance on own produced iron-rich foods. Very few households received Government aid and those that did already had access to other income sources. Our findings suggest that the nature of food insecurity may have evolved over time during the pandemic. They also reiterate not only the importance of access to markets and employment but also that the capacity to absorb affordability shocks and maintain food choices through switching between sources for specific nutritious food groups varied by household and location.
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Affiliation(s)
- Richard Sidebottom
- Department of Land Economy, University of Cambridge, Cambridge, United Kingdom
- *Correspondence: Richard Sidebottom ;
| | | | - Carla Cerami
- Nutrition Unit, MRC Gambia at London School of Hygiene and Tropical Medicine, Banjul, Gambia
| | - Momodou W. Jallow
- Nutrition Unit, MRC Gambia at London School of Hygiene and Tropical Medicine, Banjul, Gambia
| | - Shailaja Fennell
- Department of Land Economy, University of Cambridge, Cambridge, United Kingdom
| | - Sarah Dalzell
- MRC Nutrition and Bone Health Research Group, University of Cambridge, Cambridge, United Kingdom
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16
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Buttriss JL, Lanham‐New SA. Vitamin D: One hundred years on. NUTR BULL 2022; 47:282-287. [DOI: 10.1111/nbu.12575] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 07/14/2022] [Indexed: 12/28/2022]
Affiliation(s)
| | - Susan A. Lanham‐New
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences University of Surrey Guildford UK
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17
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McKenna MJ, Lyons OC, Flynn MA, Crowley RK, Twomey PJ, Kilbane MT. COVID-19 pandemic and vitamin D: rising trends in status and in daily amounts of vitamin D provided by supplements. BMJ Open 2022; 12:e059477. [PMID: 35926985 PMCID: PMC9358618 DOI: 10.1136/bmjopen-2021-059477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 07/20/2022] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Since the onset of the COVID-19 pandemic in 2020, there have been plausible suggestions about the need to augment vitamin D intake by supplementation in order to prevent SARS-CoV2 infection and reduce mortality. Some groups have advocated supplementation for all adults, but governmental agencies have advocated targeted supplementation. We sought to explore the effect of the COVID-19 pandemic on both vitamin D status and on the dose of new-to-market vitamin D supplements. SETTING University hospital, Dublin, Ireland. PARTICIPANTS Laboratory-based samples of circulating 25-hydroxyvitamin D (25OHD) (n=100 505). PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcomes: comparing yearly average 25OHD prior to the pandemic (April 2019 to March 2020) with during the pandemic (April 2020 to March 2021) and comparing the dose of new-to-market vitamin D supplements between 2017 and 2021 (n=2689). SECONDARY OUTCOME comparing prevalence of vitamin D deficiency and vitamin D excess during the two time periods. RESULTS The average yearly serum 25OHD measurement increased by 2.8 nmol/L (61.4, 95% CI 61.5 to 61.7 vs 58.6, 95% CI 58.4 to 58.9, p<0.001), which was almost threefold higher than two similar trend analyses that we conducted between 1993 and 2016. There was a lower prevalence of low 25OHD and a higher prevalence of high 25OHD. The dose of new-to-market vitamin D supplements was higher in the years 2020-2021 compared with the years 2017-2019 (p<0.001). CONCLUSIONS We showed significant increases in serum 25OHD and in the dose of new-to-market vitamin D supplements. The frequency of low vitamin D status reduced indicating benefit, but the frequency of vitamin D excess increased indicating risk of harm. Rather than a blanket recommendation about vitamin D supplementation for all adults, we recommend a targeted approach of supplementation within current governmental guidelines to at-risk groups and cautioning consumers about adverse effects of high dose supplements on the market.
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Affiliation(s)
- Malachi J McKenna
- Department of Clinical Chemistry, St Vincent's University Hospital, and UCD School of Medicine, University College Dublin, Dublin, Ireland
| | - Oonagh C Lyons
- Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, UK
| | - Mary At Flynn
- Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, UK
| | - Rachel K Crowley
- Department of Clinical Chemistry, St Vincent's University Hospital, and UCD School of Medicine, University College Dublin, Dublin, Ireland
| | - Patrick J Twomey
- Department of Clinical Chemistry, St Vincent's University Hospital, and UCD School of Medicine, University College Dublin, Dublin, Ireland
| | - Mark T Kilbane
- Department of Clinical Chemistry, St Vincent's University Hospital, and UCD School of Medicine, University College Dublin, Dublin, Ireland
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18
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Buttriss JL, Lanham-New SA, Steenson S, Levy L, Swan GE, Darling AL, Cashman KD, Allen RE, Durrant LR, Smith CP, Magee P, Hill TR, Uday S, Kiely M, Delamare G, Hoyland AE, Larsen L, Street LN, Mathers JC, Prentice A. Implementation strategies for improving vitamin D status and increasing vitamin D intake in the UK: current controversies and future perspectives: proceedings of the 2nd Rank Prize Funds Forum on vitamin D. Br J Nutr 2022; 127:1567-1587. [PMID: 34284830 PMCID: PMC8376911 DOI: 10.1017/s0007114521002555] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 04/22/2021] [Accepted: 06/08/2021] [Indexed: 12/28/2022]
Abstract
A multi-disciplinary expert group met to discuss vitamin D deficiency in the UK and strategies for improving population intakes and status. Changes to UK Government advice since the 1st Rank Forum on Vitamin D (2009) were discussed, including rationale for setting a reference nutrient intake (10 µg/d; 400 IU/d) for adults and children (4+ years). Current UK data show inadequate intakes among all age groups and high prevalence of low vitamin D status among specific groups (e.g. pregnant women and adolescent males/females). Evidence of widespread deficiency within some minority ethnic groups, resulting in nutritional rickets (particularly among Black and South Asian infants), raised particular concern. Latest data indicate that UK population vitamin D intakes and status reamain relatively unchanged since Government recommendations changed in 2016. Vitamin D food fortification was discussed as a potential strategy to increase population intakes. Data from dose-response and dietary modelling studies indicate dairy products, bread, hens' eggs and some meats as potential fortification vehicles. Vitamin D3 appears more effective than vitamin D2 for raising serum 25-hydroxyvitamin D concentration, which has implications for choice of fortificant. Other considerations for successful fortification strategies include: (i) need for 'real-world' cost information for use in modelling work; (ii) supportive food legislation; (iii) improved consumer and health professional understanding of vitamin D's importance; (iv) clinical consequences of inadequate vitamin D status and (v) consistent communication of Government advice across health/social care professions, and via the food industry. These areas urgently require further research to enable universal improvement in vitamin D intakes and status in the UK population.
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Affiliation(s)
- Judy L. Buttriss
- British Nutrition Foundation, London, UK
- Department of Nutrition, Food and Exercise Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Susan A. Lanham-New
- Department of Nutrition, Food and Exercise Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | | | | | | | - Andrea L. Darling
- Department of Nutrition, Food and Exercise Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, UK
| | - Kevin D. Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland
| | | | - Louise R. Durrant
- Department of Nutrition, Food and Exercise Sciences, School of Biosciences and Medicine, University of Surrey, Guildford, UK
- Yakult, London, UK
| | - Collin P. Smith
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Brighton, UK
| | - Pamela Magee
- Nutrition Innovation Centre for Food & Health, Ulster University at Coleraine, Coleraine, UK
| | - Tom R. Hill
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | - Suma Uday
- University of Birmingham, Birmingham, UK
| | - Mairead Kiely
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Republic of Ireland
| | | | | | | | | | - John C. Mathers
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle-upon-Tyne, UK
| | - Ann Prentice
- MRC Nutrition and Bone Health Group, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
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19
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Lanham‐New SA, Buttriss JL, Gibson‐Moore H, Staines KA, Webb AR, Cashman KD, Hewison M, Martineau AR, Smith CP, Butler‐Laporte G, Bouillon R. UK
Nutrition Research Partnership ‘Hot Topic’ workshop: Vitamin D—A multi‐disciplinary approach to (1) elucidate its role in human health and (2) develop strategies to improve vitamin D status in the
UK
population. NUTR BULL 2022; 47:246-260. [DOI: 10.1111/nbu.12557] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 04/13/2022] [Indexed: 01/15/2023]
Affiliation(s)
- Susan A. Lanham‐New
- Department of Nutritional Sciences School of Biosciences and Medicine Faculty of Health and Medical Sciences University of Surrey Guildford UK
| | | | | | | | - Ann R. Webb
- Earth and Environmental Sciences University of Manchester Manchester UK
| | - Kevin D. Cashman
- School of Food and Nutritional Sciences University College Cork Cork Ireland
| | - Martin Hewison
- Institute of Metabolism and Systems Research University of Birmingham Birmingham UK
| | - Adrian R. Martineau
- Barts and The London School of Medicine and Dentistry Queen Mary University of London London UK
| | - Colin P. Smith
- Department of Nutritional Sciences School of Biosciences and Medicine Faculty of Health and Medical Sciences University of Surrey Guildford UK
- School of Pharmacy and Biomolecular Sciences University of Brighton Brighton UK
| | - Guillaume Butler‐Laporte
- Department of Epidemiology, Biostatistics and Occupational Health McGill University Montreal Quebec Canada
| | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing KU Leuven Leuven Belgium
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20
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Santana KVDSD, Oliver SL, Mendes MM, Lanham-New S, Charlton KE, Ribeiro H. Association between vitamin D status and lifestyle factors in Brazilian women: Implications of Sun Exposure Levels, Diet, and Health. EClinicalMedicine 2022; 47:101400. [PMID: 35497056 PMCID: PMC9043392 DOI: 10.1016/j.eclinm.2022.101400] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/21/2022] [Accepted: 03/31/2022] [Indexed: 10/26/2022] Open
Abstract
BACKGROUND Vitamin D deficiency has been documented to be prevalent, even in low latitude regions; and this may be related to sun exposure behaviors. The aim of the current study was to assess the association between serum 25-hydroxyvitamin D [25(OH)D] concentrations and lifestyle-related factors in a sample of Brazilian women living at latitude 21º 8' S. METHODS A cross-sectional study was undertaken in 101 women aged 35 years or older in July 2019 to assess the association between 25(OH)D concentration and level of exposure to ultraviolet radiation (UVR), smoking habits, alcohol consumption, and physical activity levels. Age, body mass index (BMI), and postmenopausal status were investigated. FINDINGS According to the slope coefficient for individual daily UVR levels, the concentration of 25(OH)D increased by 5 nmol / L for each extra Standard Erythema Dose of UVR, regardless of age and BMI (p < 0·001). Postmenopausal women had a significantly higher mean concentration of 25(OH)D (p = 0·01), higher UVR exposure (p = 0·01) and lower BMI (p = 0·005) compared with younger women, independent of other confounders including smoking, alcohol, occupation and physical activity. INTERPRETATION Although postmenopausal women from Brazil had higher mean concentrations of 25(OH)D than younger women, more studies are necessary to understand how sun exposure and lifestyle variables interfere with these levels. These findings have important public health implications since they suggest that vitamin D deficiency in older age is not inevitable. FUNDING This study was funded by an award received by Universities Global Partnership Network - UGPN. KVSS and SLO receive scholarship from CAPES, Brazilian Ministry of Education. HR receives a productivity grant from CNPq.
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Affiliation(s)
- Keila Valente de Souza de Santana
- Programa de Pós-Graduação em Saúde Global e Sustentabilidade, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Sofia Lizarralde Oliver
- Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Marcela Moraes Mendes
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, Department of Nutritional Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - Susan Lanham-New
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, Department of Nutritional Sciences, University of Surrey, Guildford, Surrey, United Kingdom
| | - Karen E Charlton
- School of Medicine, University of Wollongong, Wollongong, Australia NSW and Illawarra Health and Medical Research Institute, Wollongong, Australia NSW
| | - Helena Ribeiro
- Departamento de Saúde Ambiental, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil
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21
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Efird JT, Anderson E, Jindal C, Suzuki A. Interaction of Vitamin D and Corticosteroid Use in Hospitalized COVID-19 Patients: A Potential Explanation for Inconsistent Findings in the Literature. Curr Pharm Des 2022; 28:1695-1702. [PMID: 35440302 DOI: 10.2174/1381612828666220418132847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/11/2021] [Indexed: 12/15/2022]
Abstract
Vitamin D is an important immune-modulator with anti-inflammatory properties. While this prohormone has been studied extensively in the prevention and treatment of COVID-19, findings have been inconsistent regarding its overall benefit in patients hospitalized with COVID-19. Most studies to date have been observational in nature, not accounting for the use of corticosteroids. Furthermore, the few randomized clinical trials designed to examine the effect of vitamin D supplementation on COVID-19 outcomes have been relatively small and thus insufficiently powered to assure a balance of corticosteroid use between study arms. The current perspective addresses the interaction of vitamin D and corticosteroids as a potential explanation for the divergent results reported in the literature. Future research on vitamin D and COVID-19 will benefit by considering this interaction, especially among hospitalized patients requiring oxygen and mechanical ventilation.
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Affiliation(s)
- Jimmy T Efird
- Cooperative Studies Program Epidemiology Center, Durham (Duke) VA Health Care System, Durham, NC 27705, USA
| | | | - Charulata Jindal
- Harvard Medical School, Harvard University, Boston, MA 02115, USA
| | - Ayako Suzuki
- Cooperative Studies Program Epidemiology Center, Durham (Duke) VA Health Care System, Durham, NC 27705, USA.,Department of Pharmaceutical Sciences and Experimental Therapeutics, Fraternal Order of Eagles Diabetes Research Center, Abboud Cardiovascular Research Center, College of Pharmacy, University of Iowa, Iowa City, IA 52242, USA.,Division of Gastroenterology, Duke University, Durham, NC 27710, USA
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22
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Bandeira L, Lazaretti-Castro M, Binkley N. Clinical aspects of SARS-CoV-2 infection and vitamin D : COVID-19 and the endocrine system: special issue for reviews in endocrine and metabolic disorders (Felipe Casaneuva, Editor in Chief) A. Giustina and JP Bilezikian, Guest Editors. Rev Endocr Metab Disord 2022; 23:287-291. [PMID: 34559361 PMCID: PMC8460842 DOI: 10.1007/s11154-021-09683-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/21/2021] [Indexed: 12/19/2022]
Abstract
In December 2019, the first cases of severe acute respiratory syndrome due to a new coronavirus (SARS-Cov-2), later designated as Covid-19, were described in China. With rapid advance of the infection to several continents, in March 2020, WHO declared this to be a pandemic. In April 2020, the first papers suggesting a possible role of Vitamin D deficiency in the severity of this infection began to appear and dozens of articles evaluating a potential relationship of vitamin D with COVID have emerged subsequntly. This possibility was raised based on pre-existing evidence of the effects of Vitamin D on the immune system, and more specifically on acute respiratory viral infections. In addition, most Covid-19 victims belong to groups at risk for vitamin D deficiency such as the elderly, obese, chronically ill, and specific ethnic groups. Although with some contradictory reports exist, most observational and cohort studies find a relationship of low vitamin D status with greater Covid severity, others, including the few interventional studies available show inconsistent results. This paper aims to present the rapidly expanding literature to date regarding the clinical relevance of vitamin D in Covid-19 and, consequently, the reasonableness of avoiding its deficiency to keep the immune system able to respond in the best way to this acute viral infection. In the meantime, we wait for publication of several prospective randomized controlled studies that are underway, evaluating the effects of treatment with vitamin D or metabolites on the severity of Covid-19 outcomes.
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Affiliation(s)
- Leonardo Bandeira
- Universidade Federal de Sao Paulo, Sao Paulo, Brazil
- Grupo Fleury, Recife, Brazil
| | | | - Neil Binkley
- School of Medicine and Public Health, University of Wisconsin, Madison, WI USA
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23
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Health consequences of vitamin D deficiency in the human body. POSTEP HIG MED DOSW 2022. [DOI: 10.2478/ahem-2021-0045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Vitamin D is extremely important for the proper functioning of the body. The most commonly known role of vitamin D is its participation in regulation of calcium-phosphate metabolism and bone mineralization. This role is crucial in the prevention of rickets in children and osteoporosis in the elderly. In recent years, numerous studies have confirmed the pleiotropic effects of vitamin D. Proper vitamin D levels in blood have a positive effect on overall health, thus reducing the risk of many diseases. Vitamin D plays, inter alia, a positive role in some diseases of the gastrointestinal tract (inflammatory bowel disease), nervous system (Parkinson disease, Alzheimer disease), and cardiovascular disease (atherosclerosis). Additionally, its positive protective effect in the case of neoplastic and immunological diseases has been noted. Some studies also confirm the relationship of vitamin D deficiency to obesity and depression. In the event of these diseases, it is possible to prevent disease and support the process of treatment by maintaining appropriate levels of 25(OH)D in the blood. Besides, sufficient blood vitamin D levels reduces the risk of developing respiratory tract infections and suppresses cytokine storm, which is responsible for most COVID-19 deaths.
The aim of the study was to present the current state of knowledge regarding the role of vitamin D in the human body, especially in the context of the impact of its abnormal level on the development of various diseases.
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24
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Durrant LR, Bucca G, Hesketh A, Möller-Levet C, Tripkovic L, Wu H, Hart KH, Mathers JC, Elliott RM, Lanham-New SA, Smith CP. Vitamins D 2 and D 3 Have Overlapping But Different Effects on the Human Immune System Revealed Through Analysis of the Blood Transcriptome. Front Immunol 2022; 13:790444. [PMID: 35281034 PMCID: PMC8908317 DOI: 10.3389/fimmu.2022.790444] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/09/2022] [Indexed: 12/12/2022] Open
Abstract
Vitamin D is best known for its role in maintaining bone health and calcium homeostasis. However, it also exerts a broad range of extra-skeletal effects on cellular physiology and on the immune system. Vitamins D2 and D3 share a high degree of structural similarity. Functional equivalence in their vitamin D-dependent effects on human physiology is usually assumed but has in fact not been well defined experimentally. In this study we seek to redress the gap in knowledge by undertaking an in-depth examination of changes in the human blood transcriptome following supplementation with physiological doses of vitamin D2 and D3. Our work extends a previously published randomized placebo-controlled trial that recruited healthy white European and South Asian women who were given 15 µg of vitamin D2 or D3 daily over 12 weeks in wintertime in the UK (Nov-Mar) by additionally determining changes in the blood transcriptome over the intervention period using microarrays. An integrated comparison of the results defines both the effect of vitamin D3 or D2 on gene expression, and any influence of ethnic background. An important aspect of this analysis was the focus on the changes in expression from baseline to the 12-week endpoint of treatment within each individual, harnessing the longitudinal design of the study. Whilst overlap in the repertoire of differentially expressed genes was present in the D2 or D3-dependent effects identified, most changes were specific to either one vitamin or the other. The data also pointed to the possibility of ethnic differences in the responses. Notably, following vitamin D3 supplementation, the majority of changes in gene expression reflected a down-regulation in the activity of genes, many encoding pathways of the innate and adaptive immune systems, potentially shifting the immune system to a more tolerogenic status. Surprisingly, gene expression associated with type I and type II interferon activity, critical to the innate response to bacterial and viral infections, differed following supplementation with either vitamin D2 or vitamin D3, with only vitamin D3 having a stimulatory effect. This study suggests that further investigation of the respective physiological roles of vitamin D2 and vitamin D3 is warranted.
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Affiliation(s)
- Louise R Durrant
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Giselda Bucca
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom.,School of Applied Sciences, University of Brighton, Brighton, United Kingdom
| | - Andrew Hesketh
- School of Applied Sciences, University of Brighton, Brighton, United Kingdom
| | - Carla Möller-Levet
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Laura Tripkovic
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Huihai Wu
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Kathryn H Hart
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - John C Mathers
- Human Nutrition Research Centre, Population Health Sciences Institute, Newcastle University, Newcastle, United Kingdom
| | - Ruan M Elliott
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Susan A Lanham-New
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom
| | - Colin P Smith
- Department of Nutritional Sciences, School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, United Kingdom.,School of Applied Sciences, University of Brighton, Brighton, United Kingdom
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25
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Mehta A, Kumar Ratre Y, Sharma K, Soni VK, Tiwari AK, Singh RP, Dwivedi MK, Chandra V, Prajapati SK, Shukla D, Vishvakarma NK. Interplay of Nutrition and Psychoneuroendocrineimmune Modulation: Relevance for COVID-19 in BRICS Nations. Front Microbiol 2021; 12:769884. [PMID: 34975797 PMCID: PMC8718880 DOI: 10.3389/fmicb.2021.769884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/16/2021] [Indexed: 11/21/2022] Open
Abstract
The consequences of COVID-19 are not limited to physical health deterioration; the impact on neuropsychological well-being is also substantially reported. The inter-regulation of physical health and psychological well-being through the psychoneuroendocrineimmune (PNEI) axis has enduring consequences in susceptibility, treatment outcome as well as recuperation. The pandemic effects are upsetting the lifestyle, social interaction, and financial security; and also pose a threat through perceived fear. These consequences of COVID-19 also influence the PNEI system and wreck the prognosis. The nutritional status of individuals is also reported to have a determinative role in COVID-19 severity and convalescence. In addition to energetic demand, diet also provides precursor substances [amino acids (AAs), vitamins, etc.] for regulators of the PNEI axis such as neurotransmitters (NTs) and immunomodulators. Moreover, exaggerated immune response and recovery phase of COVID-19 demand additional nutrient intake; widening the gap of pre-existing undernourishment. Mushrooms, fresh fruits and vegetables, herbs and spices, and legumes are few of such readily available food ingredients which are rich in protein and also have medicinal benefits. BRICS nations have their influences on global development and are highly impacted by a large number of confirmed COVID-19 cases and deaths. The adequacy and access to healthcare are also low in BRICS nations as compared to the rest of the world. Attempt to combat the COVID-19 pandemic are praiseworthy in BRICS nations. However, large population sizes, high prevalence of undernourishment (PoU), and high incidence of mental health ailments in BRICS nations provide a suitable landscape for jeopardy of COVID-19. Therefore, appraising the interplay of nutrition and PNEI modulation especially in BRICS countries will provide better understanding; and will aid in combat COVID-19. It can be suggested that the monitoring will assist in designing adjunctive interventions through medical nutrition therapy and psychopsychiatric management.
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Affiliation(s)
- Arundhati Mehta
- Department of Biotechnology, Guru Ghasidas Vishwavidyalaya, Bilaspur, India
| | | | - Krishna Sharma
- Department of Psychology, Government Bilasa Girls Post Graduate Autonomous College, Bilaspur, India
| | - Vivek Kumar Soni
- Department of Biotechnology, Guru Ghasidas Vishwavidyalaya, Bilaspur, India
| | - Atul Kumar Tiwari
- Department of Zoology, Bhanwar Singh Porte Government Science College, Pendra, India
| | - Rajat Pratap Singh
- Department of Biotechnology, Guru Ghasidas Vishwavidyalaya, Bilaspur, India
| | - Mrigendra Kumar Dwivedi
- Department of Biochemistry, Government Nagarjuna Post Graduate College of Science, Raipur, India
| | - Vikas Chandra
- Department of Biotechnology, Guru Ghasidas Vishwavidyalaya, Bilaspur, India
| | | | - Dhananjay Shukla
- Department of Biotechnology, Guru Ghasidas Vishwavidyalaya, Bilaspur, India
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26
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Giovane RA, Di Giovanni-Kinsley S, Keeton E. Micronutrients for potential therapeutic use against COVID-19; a review. Clin Nutr ESPEN 2021; 46:9-13. [PMID: 34857253 PMCID: PMC8487093 DOI: 10.1016/j.clnesp.2021.09.744] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/09/2021] [Accepted: 09/27/2021] [Indexed: 01/19/2023]
Abstract
SARS CoV-2 has caused a pandemic that has challenged both clinicians and researchers in finding an effective treatment option. Currently there only exists a two series vaccine that has a high efficacy in preventing infection. There is no standard effective treatment against SARS CoV-2 however several nutraceuticals such as melatonin, zinc, selenium, vitamin C and vitamin D are being proposed as prevention and treatment options.
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Affiliation(s)
- Richard A Giovane
- Regional Medical Center of Central Alabama, 29 L.V. Stabler Drive, Greenville, AL, 36037, USA.
| | | | - Emily Keeton
- University of Alabama, Department of Family Medicine, 801 Campus Drive, Tuscaloosa, AL, 35487, USA
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27
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Moozhipurath RK, Kraft L. Association of lockdowns with the protective role of ultraviolet-B (UVB) radiation in reducing COVID-19 deaths. Sci Rep 2021; 11:22851. [PMID: 34819536 PMCID: PMC8613284 DOI: 10.1038/s41598-021-01908-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Accepted: 11/01/2021] [Indexed: 11/29/2022] Open
Abstract
Nations are imposing unprecedented measures at a large scale to contain the spread of the COVID-19 pandemic. While recent studies show that non-pharmaceutical intervention measures such as lockdowns may have mitigated the spread of COVID-19, those measures also lead to substantial economic and social costs, and might limit exposure to ultraviolet-B radiation (UVB). Emerging observational evidence indicates the protective role of UVB and vitamin D in reducing the severity and mortality of COVID-19 deaths. This observational study empirically outlines the protective roles of lockdown and UVB exposure as measured by the ultraviolet index (UVI). Specifically, we examine whether the severity of lockdown is associated with a reduction in the protective role of UVB exposure. We use a log-linear fixed-effects model on a panel dataset of secondary data of 155 countries from 22 January 2020 until 7 October 2020 (n = 29,327). We use the cumulative number of COVID-19 deaths as the dependent variable and isolate the mitigating influence of lockdown severity on the association between UVI and growth rates of COVID-19 deaths from time-constant country-specific and time-varying country-specific potentially confounding factors. After controlling for time-constant and time-varying factors, we find that a unit increase in UVI and lockdown severity are independently associated with − 0.85 percentage points (p.p) and − 4.7 p.p decline in COVID-19 deaths growth rate, indicating their respective protective roles. The change of UVI over time is typically large (e.g., on average, UVI in New York City increases up to 6 units between January until June), indicating that the protective role of UVI might be substantial. However, the widely utilized and least severe lockdown (governmental recommendation to not leave the house) is associated with the mitigation of the protective role of UVI by 81% (0.76 p.p), which indicates a downside risk associated with its widespread use. We find that lockdown severity and UVI are independently associated with a slowdown in the daily growth rates of cumulative COVID-19 deaths. However, we find evidence that an increase in lockdown severity is associated with significant mitigation in the protective role of UVI in reducing COVID-19 deaths. Our results suggest that lockdowns in conjunction with adequate exposure to UVB radiation might have even reduced the number of COVID-19 deaths more strongly than lockdowns alone. For example, we estimate that there would be 11% fewer deaths on average with sufficient UVB exposure during the period people were recommended not to leave their house. Therefore, our study outlines the importance of considering UVB exposure, especially while implementing lockdowns, and could inspire further clinical studies that may support policy decision-making in countries imposing such measures.
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Affiliation(s)
| | - Lennart Kraft
- Faculty of Economics and Business, Goethe University Frankfurt, Theodor-W.-Adorno-Platz 4, 60629, Frankfurt, Germany
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28
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Kalache A, Bazinet RP, Carlson S, Evans WJ, Kim CH, Lanham-New S, Visioli F, Griffiths JC. Science-based policy: targeted nutrition for all ages and the role of bioactives. Eur J Nutr 2021; 60:1-17. [PMID: 34427766 PMCID: PMC8383919 DOI: 10.1007/s00394-021-02662-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 08/13/2021] [Indexed: 12/26/2022]
Abstract
Globally, there has been a marked increase in longevity, but it is also apparent that significant inequalities remain, especially the inequality related to insufficient 'health' to enjoy or at least survive those later years. The major causes include lack of access to proper nutrition and healthcare services, and often the basic information to make the personal decisions related to diet and healthcare options and opportunities. Proper nutrition can be the best predictor of a long healthy life expectancy and, conversely, when inadequate and/or improper a prognosticator of a sharply curtailed expectancy. There is a dichotomy in both developed and developing countries as their populations are experiencing the phenomenon of being 'over fed and under nourished', i.e., caloric/energy excess and lack of essential nutrients, leading to health deficiencies, skyrocketing global obesity rates, excess chronic diseases, and premature mortality. There is need for new and/or innovative approaches to promoting health as individuals' age, and for public health programs to be a proactive blessing and not an archaic status quo 'eat your vegetables' mandate. A framework for progress has been proposed and published by the World Health Organization in their Global Strategy and Action Plan on Ageing and Health (WHO (2017) Advancing the right to health: the vital role of law. https://apps.who.int/iris/bitstream/handle/10665/252815/9789241511384-eng.pdf?sequence=1&isAllowed=y . Accessed 07 Jun 2021; WHO (2020a) What is Health Promotion. www.who.int/healthpromotion/fact-sheet/en/ . Accessed 07 Jun 2021; WHO (2020b) NCD mortality and morbidity. www.who.int/gho/ncd/mortality_morbidity/en/ . Accessed 07 Jun 2021). Couple this WHO mandate with current academic research into the processes of ageing, and the ingredients or regimens that have shown benefit and/or promise of such benefits. Now is the time for public health policy to 'not let the perfect be the enemy of the good,' but to progressively make health-promoting nutrition recommendations.
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Affiliation(s)
- Alexandre Kalache
- International Longevity Centre-Brazil, Rio de Janiero, Brazil
- Age Friendly Institute, Boston, MA, USA
| | - Richard P Bazinet
- Department of Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Susan Carlson
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS, USA
| | - William J Evans
- Department of Nutritional Sciences and Toxicology, University of California, Berkeley, CA, USA
| | - Chi Hee Kim
- Global Government Affairs, Herbalife Nutrition, Los Angeles, CA, USA
| | - Susan Lanham-New
- Nutritional Sciences Department, University of Surrey, Guildford, UK
| | - Francesco Visioli
- Department of Molecular Sciences, University of Padova, Padova, Italy
- IMDEA-Food, Madrid, Spain
| | - James C Griffiths
- Council for Responsible Nutrition-International, Washington, DC, USA.
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29
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Zarei M, Rahimi K, Hassanzadeh K, Abdi M, Hosseini V, Fathi A, Kakaei K. From the environment to the cells: An overview on pivotal factors which affect spreading and infection in COVID-19 pandemic. ENVIRONMENTAL RESEARCH 2021; 201:111555. [PMID: 34197816 PMCID: PMC8236413 DOI: 10.1016/j.envres.2021.111555] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 05/24/2021] [Accepted: 06/16/2021] [Indexed: 05/06/2023]
Abstract
Several factors ranging from environmental risks to the genetics of the virus and that of the hosts, affect the spread of COVID-19. The impact of physicochemical variables on virus vitality and spread should be taken into account in experimental and clinical studies. Another avenue to explore is the effect of diet and its interaction with the immune system on SARS-CoV-2 infection and mortality rate. Past year have witnessed extensive studies on virus and pathophysiology of the COVID-19 disease and the cellular mechanisms of virus spreading. However, our knowledge has not reached a level where we plan an efficient therapeutic approach to prevent the virus entry to the cells or decreasing the spreading and morbidity in severe cases of disease. The risk of infection directly correlates with the control of virus spreading via droplets and aerosol transmission, as well as patient immune system response. A key goal in virus restriction and transmission rate is to understand the physicochemical structure of aerosol and droplet formation, and the parameters that affect the droplet-borne and airborne in different environmental conditions. The lifetime of droplets on different surfaces is described based on the contact angle. Hereby, we recommend regular use of high-quality face masks in high temperature and low humidity conditions. However, in humid and cold weather conditions, wearing gloves and frequently hand washing, gain a higher priority. Additionally, social distancing rules should be respected in all aforementioned conditions. We will also discuss different routes of SARS-CoV-2 entry into the cells and how multiple genetic factors play a role in the spread of the virus. Given the role of environmental and nutritional factors, we discuss and recommend some strategies to prevent the disease and protect the population against COVID-19. Since an effective vaccine can prevent the transmission of communicable diseases and abolish pandemics, we added a brief review of candidate SARS-CoV-2 vaccines.
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Affiliation(s)
- Mohammad Zarei
- Department of Food Science and Technology, School of Industrial Technology, Faculty of Applied Sciences, Universiti Teknologi MARA, 40450, Shah Alam, Selangor, Malaysia
| | - Karim Rahimi
- Department of Molecular Biology and Genetics, Gene Expression and Gene Medicine, Aarhus University, Aarhus, Denmark
| | - Kambiz Hassanzadeh
- Laboratory of Neuronal Cell Signaling, EBRI Rita Levi-Montalcini Foundation, Rome, 00161, Italy; Department of Biotechnology and Applied Clinical Sciences, University of L'Aquila, 67100, L'Aquila, Italy
| | - Mohammad Abdi
- Department of Clinical Biochemistry, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Vahedeh Hosseini
- Department of Molecular Medicine and Genetics, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Ali Fathi
- FUJIFILM Cellular Dynamics, Inc., Madison, WI, USA.
| | - Karim Kakaei
- Department of Chemistry, Faculty of Science, University of Maragheh, Maragheh, Iran.
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30
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Erem AS, Razzaque MS. Vitamin D-independent benefits of safe sunlight exposure. J Steroid Biochem Mol Biol 2021; 213:105957. [PMID: 34329737 DOI: 10.1016/j.jsbmb.2021.105957] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 07/15/2021] [Accepted: 07/25/2021] [Indexed: 01/10/2023]
Abstract
This review examines the beneficial effects of ultraviolet radiation on systemic autoimmune diseases, including multiple sclerosis and type I diabetes, where the epidemiological evidence for the vitamin D-independent effects of sunlight is most apparent. Ultraviolet radiation, in addition to its role in the synthesis of vitamin D, stimulates anti-inflammatory pathways, alters the composition of dendritic cells, T cells, and T regulatory cells, and induces nitric oxide synthase and heme oxygenase metabolic pathways, which may directly or indirectly mitigate disease progression and susceptibility. Recent work has also explored how the immune-modulating functions of ultraviolet radiation affect type II diabetes, cancer, and the current global pandemic caused by SARS-CoV-2. These diseases are particularly important amidst global changes in lifestyle that result in unhealthy eating, increased sedentary habits, and alcohol and tobacco consumption. Compelling epidemiological data shows increased ultraviolet radiation associated with reduced rates of certain cancers, such as colorectal cancer, breast cancer, non-Hodgkins lymphoma, and ultraviolet radiation exposure correlated with susceptibility and mortality rates of COVID-19. Therefore, understanding the effects of ultraviolet radiation on both vitamin D-dependent and -independent pathways is necessary to understand how they influence the course of many human diseases.
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Affiliation(s)
- Anna S Erem
- Department of Pathology, Emory University School of Medicine, Atlanta, GA, USA
| | - Mohammed S Razzaque
- Department of Pathology, Lake Erie College of Osteopathic Medicine, Erie, PA, USA.
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31
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Leveraging vibration of effects analysis for robust discovery in observational biomedical data science. PLoS Biol 2021; 19:e3001398. [PMID: 34555021 PMCID: PMC8510627 DOI: 10.1371/journal.pbio.3001398] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 10/12/2021] [Accepted: 08/24/2021] [Indexed: 11/19/2022] Open
Abstract
Hypothesis generation in observational, biomedical data science often starts with computing an association or identifying the statistical relationship between a dependent and an independent variable. However, the outcome of this process depends fundamentally on modeling strategy, with differing strategies generating what can be called "vibration of effects" (VoE). VoE is defined by variation in associations that often lead to contradictory results. Here, we present a computational tool capable of modeling VoE in biomedical data by fitting millions of different models and comparing their output. We execute a VoE analysis on a series of widely reported associations (e.g., carrot intake associated with eyesight) with an extended additional focus on lifestyle exposures (e.g., physical activity) and components of the Framingham Risk Score for cardiovascular health (e.g., blood pressure). We leveraged our tool for potential confounder identification, investigating what adjusting variables are responsible for conflicting models. We propose modeling VoE as a critical step in navigating discovery in observational data, discerning robust associations, and cataloging adjusting variables that impact model output.
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32
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Salamanna F, Maglio M, Sartori M, Landini MP, Fini M. Vitamin D and Platelets: A Menacing Duo in COVID-19 and Potential Relation to Bone Remodeling. Int J Mol Sci 2021; 22:ijms221810010. [PMID: 34576172 PMCID: PMC8468972 DOI: 10.3390/ijms221810010] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 12/19/2022] Open
Abstract
Global data correlate severe vitamin D deficiency with COVID-19-associated coagulopathy, further suggesting the presence of a hypercoagulable state in severe COVID-19 patients, which could promote thrombosis in the lungs and in other organs. The feedback loop between COVID-19-associated coagulopathy and vitamin D also involves platelets (PLTs), since vitamin D deficiency stimulates PLT activation and aggregation and increases fibrinolysis and thrombosis. Vitamin D and PLTs share and play specific roles not only in coagulation and thrombosis but also during inflammation, endothelial dysfunction, and immune response. Additionally, another ‘fil rouge’ between vitamin D and PLTs is represented by their role in mineral metabolism and bone health, since vitamin D deficiency, low PLT count, and altered PLT-related parameters are linked to abnormal bone remodeling in certain pathological conditions, such as osteoporosis (OP). Hence, it is possible to speculate that severe COVID-19 patients are characterized by the presence of several predisposing factors to bone fragility and OP that may be monitored to avoid potential complications. Here, we hypothesize different pervasive actions of vitamin D and PLT association in COVID-19, also allowing for potential preliminary information on bone health status during COVID-19 infection.
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Affiliation(s)
- Francesca Salamanna
- Complex Structure Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (F.S.); (M.S.); (M.F.)
| | - Melania Maglio
- Complex Structure Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (F.S.); (M.S.); (M.F.)
- Correspondence: ; Tel.: +39-051-6366784
| | - Maria Sartori
- Complex Structure Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (F.S.); (M.S.); (M.F.)
| | - Maria Paola Landini
- Scientific Direction, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy;
| | - Milena Fini
- Complex Structure Surgical Sciences and Technologies, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (F.S.); (M.S.); (M.F.)
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Ristic-Medic D, Petrovic S, Arsic A, Vucic V. Liver disease and COVID-19: The link with oxidative stress, antioxidants and nutrition. World J Gastroenterol 2021; 27:5682-5699. [PMID: 34629794 PMCID: PMC8473601 DOI: 10.3748/wjg.v27.i34.5682] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/11/2021] [Accepted: 08/17/2021] [Indexed: 02/06/2023] Open
Abstract
Varying degrees of liver injuries have been reported in patients infected with the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2). In general, oxidative stress is actively involved in initiation and progression of liver damage. The liver metabolizes various compounds that produce free radicals. Maintaining the oxidative/antioxidative balance is important in coronavirus disease 2019 (COVID-19) patients. Antioxidant vitamins, essential trace elements and food compounds, such as polyphenols, appear to be promising agents, with effects in oxidative burst. Deficiency of these nutrients suppresses immune function and increases susceptibility to COVID-19. Daily micronutrient intake is necessary to support anti-inflammatory and antioxidative effects but for immune function may be higher than current recommended dietary intake. Antioxidant supplements (β-carotene, vitamin A, vitamin C, vitamin E, and selenium) could have a potential role in patients with liver damage. Available evidence suggests that supplementing the diet with a combination of micronutrients may help to optimize immune function and reduce the risk of infection. Clinical trials based on the associations of diet and SARS-CoV-2 infection are lacking. Unfortunately, it is not possible to definitively determine the dose, route of administration and best timing to intervene with antioxidants in COVID-19 patients because clinical trials are still ongoing. Until then, hopefully, this review will enable clinicians to understand the impact of micronutrient dietary intake and liver status assessment in COVID-19 patients.
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Affiliation(s)
- Danijela Ristic-Medic
- Group for Nutritional Biochemistry and Dietology, Centre of Research Excellence in Nutrition and Metabolism, National Institute for Medical Research, University of Belgrade, Belgrade 11129, Serbia
| | - Snjezana Petrovic
- Group for Nutritional Biochemistry and Dietology, Centre of Research Excellence in Nutrition and Metabolism, National Institute for Medical Research, University of Belgrade, Belgrade 11129, Serbia
| | - Aleksandra Arsic
- Group for Nutritional Biochemistry and Dietology, Centre of Research Excellence in Nutrition and Metabolism, National Institute for Medical Research, University of Belgrade, Belgrade 11129, Serbia
| | - Vesna Vucic
- Group for Nutritional Biochemistry and Dietology, Centre of Research Excellence in Nutrition and Metabolism, National Institute for Medical Research, University of Belgrade, Belgrade 11129, Serbia
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Giacalone A, Tovani-Palone MR, Marin L, Febbi M. Current Evidence on Vitamin C, D, and Zinc Supplementation for COVID-19 Prevention and/or Treatment. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2021. [DOI: 10.29333/ejgm/11099] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Moschetta L, Fasolino G, Kuijpers RW. Non-arteritic anterior ischaemic optic neuropathy sequential to SARS-CoV-2 virus pneumonia: preventable by endothelial protection? BMJ Case Rep 2021; 14:14/7/e240542. [PMID: 34281937 PMCID: PMC8291331 DOI: 10.1136/bcr-2020-240542] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
We present a case of non-arteritic anterior ischaemic optic neuropathy (NAION) with no ocular or systemic risk factors in a patient who recovered from a recent SARS-CoV-2 pneumonia. NAION is the most common acute optic neuropathy among individuals over 50 years of age. It results from a transient hypoperfusion of the optic nerve head circulation, especially in patients with low vascular compliance due to ocular or systemic risk factors. We attribute the ophthalmological condition to a SARS-CoV-2 virus-associated endotheliopathy that can be prevented with timely protection of endothelial function with vitamins D and K2.
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Affiliation(s)
| | | | - Robert W Kuijpers
- Ophthalmology, VUB University, Brussels, Belgium
- Ophthalmology, Erasmus Medical Center, Rotterdam, The Netherlands
- Eye department, Albert Schweitzer Hospital, Dordrecht, The Netherlands
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Papadopoulou SK, Mantzorou M, Koutridou D, Tassoulas E, Sakellaropoulou S, Biskanaki F, Xatziapostolou E, Papandreou D. COVID-19 disease, obesity and micronutrients: an updated narrative review of the literature. NUTRITION & FOOD SCIENCE 2021; 51:808-824. [DOI: 10.1108/nfs-08-2020-0310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
PurposeThe purpose of this paper is to critically summarize the current data concerning the impact of obesity and micronutrient adequacy and supplementation on the risk and severity of COVID-19 disease, and their potential impact on treatment and rehabilitation.Design/methodology/approachPubMed, Scopus and Google Scholar databases were thoroughly searched to identify studies concerning obesity and nutritional status, vitamin and other micronutrients adequacy with COVID-19 severity.FindingsIndividuals with higher body mass index are in greater risk of severe disease and need for mechanical ventilation. Concerning micronutrient adequacy, no published studies at the present time have evaluated the effect of supplementation on the risk and the treatment of the novel disease.Originality/valueRecently, COVID-19 has monopolized the interest of the medical community regarding diet and nutritional status and it possibly plays an important role in disease severity.
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Vitamin D and coronavirus disease 2019 (COVID-19): rapid evidence review. Aging Clin Exp Res 2021; 33:2031-2041. [PMID: 34118024 PMCID: PMC8195723 DOI: 10.1007/s40520-021-01894-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Accepted: 05/23/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The rapid global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes coronavirus disease 2019 (COVID-19), has re-ignited interest in the possible role of vitamin D in modulation of host responses to respiratory pathogens. Indeed, vitamin D supplementation has been proposed as a potential preventative or therapeutic strategy. Recommendations for any intervention, particularly in the context of a potentially fatal pandemic infection, should be strictly based on clinically informed appraisal of the evidence base. In this narrative review, we examine current evidence relating to vitamin D and COVID-19 and consider the most appropriate practical recommendations. OBSERVATIONS Although there are a growing number of studies investigating the links between vitamin D and COVID-19, they are mostly small and observational with high risk of bias, residual confounding, and reverse causality. Extrapolation of molecular actions of 1,25(OH)2-vitamin D to an effect of increased 25(OH)-vitamin D as a result of vitamin D supplementation is generally unfounded, as is the automatic conclusion of causal mechanisms from observational studies linking low 25(OH)-vitamin D to incident disease. Efficacy is ideally demonstrated in the context of adequately powered randomised intervention studies, although such approaches may not always be feasible. CONCLUSIONS At present, evidence to support vitamin D supplementation for the prevention or treatment of COVID-19 is inconclusive. In the absence of any further compelling data, adherence to existing national guidance on vitamin D supplementation to prevent vitamin D deficiency, predicated principally on maintaining musculoskeletal health, appears appropriate.
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James PT, Ali Z, Armitage AE, Bonell A, Cerami C, Drakesmith H, Jobe M, Jones KS, Liew Z, Moore SE, Morales-Berstein F, Nabwera HM, Nadjm B, Pasricha SR, Scheelbeek P, Silver MJ, Teh MR, Prentice AM. The Role of Nutrition in COVID-19 Susceptibility and Severity of Disease: A Systematic Review. J Nutr 2021; 151:1854-1878. [PMID: 33982105 PMCID: PMC8194602 DOI: 10.1093/jn/nxab059] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 12/22/2020] [Accepted: 02/17/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Many nutrients have powerful immunomodulatory actions with the potential to alter susceptibility to coronavirus disease 2019 (COVID-19) infection, progression to symptoms, likelihood of severe disease, and survival. OBJECTIVE The aim was to review the latest evidence on how malnutrition across all its forms (under- and overnutrition and micronutrient status) may influence both susceptibility to, and progression of, COVID-19. METHODS We synthesized information on 13 nutrition-related components and their potential interactions with COVID-19: overweight, obesity, and diabetes; protein-energy malnutrition; anemia; vitamins A, C, D, and E; PUFAs; iron; selenium; zinc; antioxidants; and nutritional support. For each section we provide: 1) a landscape review of pertinent material; 2) a systematic search of the literature in PubMed and EMBASE databases, including a wide range of preprint servers; and 3) a screen of 6 clinical trial registries. All original research was considered, without restriction to study design, and included if it covered: 1) severe acute respiratory syndrome coronavirus (CoV) 2 (SARS-CoV-2), Middle East respiratory syndrome CoV (MERS-CoV), or SARS-CoV viruses and 2) disease susceptibility or 3) disease progression, and 4) the nutritional component of interest. Searches took place between 16 May and 11 August 2020. RESULTS Across the 13 searches, 2732 articles from PubMed and EMBASE, 4164 articles from the preprint servers, and 433 trials were returned. In the final narrative synthesis, we include 22 published articles, 38 preprint articles, and 79 trials. CONCLUSIONS Currently there is limited evidence that high-dose supplements of micronutrients will either prevent severe disease or speed up recovery. However, results of clinical trials are eagerly awaited. Given the known impacts of all forms of malnutrition on the immune system, public health strategies to reduce micronutrient deficiencies and undernutrition remain of critical importance. Furthermore, there is strong evidence that prevention of obesity and type 2 diabetes will reduce the risk of serious COVID-19 outcomes. This review is registered at PROSPERO as CRD42020186194.
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Affiliation(s)
- Philip T James
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Zakari Ali
- Medical Research Council (MRC) Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - Andrew E Armitage
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
| | - Ana Bonell
- Medical Research Council (MRC) Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - Carla Cerami
- Medical Research Council (MRC) Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - Hal Drakesmith
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
| | - Modou Jobe
- Medical Research Council (MRC) Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - Kerry S Jones
- National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) Nutritional Biomarker Laboratory, MRC Epidemiology Unit, University of Cambridge, Cambridge, United Kingdom
| | - Zara Liew
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Sophie E Moore
- Medical Research Council (MRC) Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
- Department of Women and Children's Health, King's College London, London, United Kingdom
| | - Fernanda Morales-Berstein
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Helen M Nabwera
- Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Behzad Nadjm
- Medical Research Council (MRC) Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
| | - Sant-Rayn Pasricha
- Population Health and Immunity Division, Walter and Eliza Hall Institute of Medical Research, Parkville, Australia
- Department of Medical Biology, The University of Melbourne, Parkville, Australia
| | - Pauline Scheelbeek
- Department of Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Matt J Silver
- MRC Unit The Gambia at the London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Megan R Teh
- MRC Human Immunology Unit, MRC Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
| | - Andrew M Prentice
- Medical Research Council (MRC) Unit The Gambia at the London School of Hygiene & Tropical Medicine, Fajara, The Gambia
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Clark A, Kuznesof S, Davies S, Waller A, Ritchie A, Wilson S, Harbord L, Hill T. Egg enrichment with vitamin D: The Sunshine Eggs projects. NUTR BULL 2021. [DOI: 10.1111/nbu.12509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Adam Clark
- Human Nutrition Research Centre Population Health Sciences Institute Faculty of Medical Sciences Newcastle University Newcastle upon Tyne UK
| | - Sharron Kuznesof
- School of Natural and Environmental Sciences Faculty of Science, Agriculture and Engineering Newcastle University Newcastle upon Tyne UK
| | - Sarah Davies
- DSM Nutritional Products Ltd Heanor Derbyshire UK
| | | | | | | | | | - Tom Hill
- Human Nutrition Research Centre Population Health Sciences Institute Faculty of Medical Sciences Newcastle University Newcastle upon Tyne UK
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Gibson‐Moore H. Vitamin D: What's new a year on from the COVID-19 outbreak? NUTR BULL 2021; 46:195-205. [PMID: 34149314 PMCID: PMC8207114 DOI: 10.1111/nbu.12499] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 04/19/2021] [Accepted: 04/19/2021] [Indexed: 12/15/2022]
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Bassatne A, Basbous M, Chakhtoura M, El Zein O, Rahme M, El-Hajj Fuleihan G. The link between COVID-19 and VItamin D (VIVID): A systematic review and meta-analysis. Metabolism 2021; 119:154753. [PMID: 33774074 PMCID: PMC7989070 DOI: 10.1016/j.metabol.2021.154753] [Citation(s) in RCA: 114] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/16/2021] [Accepted: 03/16/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Disease severity and mortality rates due to COVID-19 infection are greater in the elderly and chronically ill patients, populations at high risk for vitamin D deficiency. Vitamin D plays an important role in immune function and inflammation. This systematic review and meta-analysis assesses the impact of vitamin D status and supplementation on COVID-19 related mortality and health outcomes. METHODS We searched four databases until December 18th 2020, and trial registries until January 20th 2021. Two reviewers screened the studies, collected data, assessed the risk of bias, and graded the evidence for each outcome across studies, independently and in duplicate. Pre-specified outcomes of interest were mortality, ICU admission, invasive and non-invasive ventilation, hospitalization, time of hospital stay, disease severity and SARS-CoV-2 positivity. We only included data from peer-reviewed articles in our primary analyses. RESULTS We identified 31 peer-reviewed observational studies. In our primary analysis, there was a positive trend between serum 25(OH)D level <20 ng/ml and an increased risk of mortality, ICU admission, invasive ventilation, non-invasive ventilation or SARS-CoV-2 positivity. However, these associations were not statistically significant. Mean 25(OH)D levels was 5.9 ng/ml (95% CI [-9.5, -2.3]) significantly lower in COVID-19 positive, compared to negative patients. The certainty of the evidence was very low. We identified 32 clinical trial protocols, but only three have published results to-date. The trials administer vitamin D doses of 357 to 60,000 IU/day, from one week to 12 months. Eight megatrials investigate the efficacy of vitamin D in outpatient populations. A pilot trial revealed a significant decrease in ICU admission with calcifediol, compared to placebo (OR = 0.003), but the certainty of the evidence was unclear. Another small trial showed that supplementation with cholecalciferol, 60,000 IU/day, decreased fibrinogen levels, but did not have an effect on D-dimer, procalcitonin and CRP levels, compared to placebo. The third trial did not find any effect of vitamin D supplementation on COVID-19 related health outcomes. CONCLUSION While the available evidence to-date, from largely poor-quality observational studies, may be viewed as showing a trend for an association between low serum 25(OH)D levels and COVID-19 related health outcomes, this relationship was not found to be statistically significant. Calcifediol supplementation may have a protective effect on COVID-19 related ICU admissions. The current use of high doses of vitamin D in COVID-19 patients is not based on solid evidence. It awaits results from ongoing trials to determine the efficacy, desirable doses, and safety, of vitamin D supplementation to prevent and treat COVID-19 related health outcomes.
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Affiliation(s)
- Aya Bassatne
- Scholars in HeAlth Research Program (SHARP), American University of Beirut, Beirut, Lebanon; Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center in Metabolic Bone Disorders, Division of Endocrinology and Metabolism, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Maya Basbous
- Scholars in HeAlth Research Program (SHARP), American University of Beirut, Beirut, Lebanon
| | - Marlene Chakhtoura
- Scholars in HeAlth Research Program (SHARP), American University of Beirut, Beirut, Lebanon; Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center in Metabolic Bone Disorders, Division of Endocrinology and Metabolism, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ola El Zein
- Saab Medical Library, American University of Beirut, Beirut, Lebanon
| | - Maya Rahme
- Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center in Metabolic Bone Disorders, Division of Endocrinology and Metabolism, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Ghada El-Hajj Fuleihan
- Scholars in HeAlth Research Program (SHARP), American University of Beirut, Beirut, Lebanon; Calcium Metabolism and Osteoporosis Program, WHO Collaborating Center in Metabolic Bone Disorders, Division of Endocrinology and Metabolism, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
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Truijen SPM, Hayhoe RPG, Hooper L, Schoenmakers I, Forbes A, Welch AA. Predicting Malnutrition Risk with Data from Routinely Measured Clinical Biochemical Diagnostic Tests in Free-Living Older Populations. Nutrients 2021; 13:1883. [PMID: 34072686 PMCID: PMC8226876 DOI: 10.3390/nu13061883] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/25/2021] [Accepted: 05/25/2021] [Indexed: 12/20/2022] Open
Abstract
Malnutrition (undernutrition) in older adults is often not diagnosed before its adverse consequences have occurred, despite the existence of established screening tools. As a potential method of early detection, we examined whether readily available and routinely measured clinical biochemical diagnostic test data could predict poor nutritional status. We combined 2008-2017 data of 1518 free-living individuals ≥50 years from the United Kingdom National Diet and Nutrition Survey (NDNS) and used logistic regression to determine associations between routine biochemical diagnostic test data, micronutrient deficiency biomarkers, and established malnutrition indicators (components of screening tools) in a three-step validation process. A prediction model was created to determine how effectively routine biochemical diagnostic tests and established malnutrition indicators predicted poor nutritional status (defined by ≥1 micronutrient deficiency in blood of vitamins B6, B12 and C; selenium; or zinc). Significant predictors of poor nutritional status were low concentrations of total cholesterol, haemoglobin, HbA1c, ferritin and vitamin D status, and high concentrations of C-reactive protein; except for HbA1c, these were also associated with established malnutrition indicators. Additional validation was provided by the significant association of established malnutrition indicators (low protein, fruit/vegetable and fluid intake) with biochemically defined poor nutritional status. The prediction model (including biochemical tests, established malnutrition indicators and covariates) showed an AUC of 0.79 (95% CI: 0.76-0.81), sensitivity of 66.0% and specificity of 78.1%. Clinical routine biochemical diagnostic test data have the potential to facilitate early detection of malnutrition risk in free-living older populations. However, further validation in different settings and against established malnutrition screening tools is warranted.
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Affiliation(s)
- Saskia P. M. Truijen
- Department of Epidemiology and Public Health, Faculty of Medicine and Health Sciences, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK; (S.P.M.T.); (R.P.G.H.); (L.H.); (I.S.); (A.F.)
| | - Richard P. G. Hayhoe
- Department of Epidemiology and Public Health, Faculty of Medicine and Health Sciences, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK; (S.P.M.T.); (R.P.G.H.); (L.H.); (I.S.); (A.F.)
- School of Allied Health, Faculty of Health, Education, Medicine and Social Care, Anglia Ruskin University, Chelmsford CM1 1SQ, UK
| | - Lee Hooper
- Department of Epidemiology and Public Health, Faculty of Medicine and Health Sciences, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK; (S.P.M.T.); (R.P.G.H.); (L.H.); (I.S.); (A.F.)
| | - Inez Schoenmakers
- Department of Epidemiology and Public Health, Faculty of Medicine and Health Sciences, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK; (S.P.M.T.); (R.P.G.H.); (L.H.); (I.S.); (A.F.)
| | - Alastair Forbes
- Department of Epidemiology and Public Health, Faculty of Medicine and Health Sciences, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK; (S.P.M.T.); (R.P.G.H.); (L.H.); (I.S.); (A.F.)
| | - Ailsa A. Welch
- Department of Epidemiology and Public Health, Faculty of Medicine and Health Sciences, Norwich Medical School, University of East Anglia, Norwich NR4 7TJ, UK; (S.P.M.T.); (R.P.G.H.); (L.H.); (I.S.); (A.F.)
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Grove A, Osokogu O, Al-Khudairy L, Mehrabian A, Zanganeh M, Brown A, Court R, Taylor-Phillips S, Uthman OA, McCarthy N, Kumar S, Clarke A. Association between vitamin D supplementation or serum vitamin D level and susceptibility to SARS-CoV-2 infection or COVID-19 including clinical course, morbidity and mortality outcomes? A systematic review. BMJ Open 2021; 11:e043737. [PMID: 34049903 PMCID: PMC8166456 DOI: 10.1136/bmjopen-2020-043737] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 05/09/2021] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVE To systemically review and critically appraise published studies of the association between vitamin D supplementation or serum vitamin D level and susceptibility to SARS-CoV-2 infection or COVID-19, including clinical course, morbidity and mortality outcomes. DESIGN Systematic review. DATA SOURCES MEDLINE (OVID), Embase (OVID), Cochrane Central Register of Controlled Trials, MedRxiv and BioRxiv preprint databases. COVID-19 databases of the WHO, Cochrane, CEBM Oxford and Bern University up to 10 June 2020. STUDY SELECTION Studies that assessed vitamin D supplementation and/or low serum vitamin D in patients acutely ill with, or at risk of, severe betacoronavirus infection (SARS-CoV, MERS-CoV, SARS-CoV-2). DATA EXTRACTION Two authors independently extracted data using a predefined data extraction form and assessed risk of bias using the Downs and Black Quality Assessment Checklist. RESULTS Searches elicited 449 papers, 59 studies were eligible full-text assessment and 4 met the eligibility criteria of this review. The four studies were narratively synthesised and included (1) a cross-sectional study (n=107) suggesting an inverse association between serum vitamin D and SARS-CoV-2; (2) a retrospective cohort study (348 598 participants, 449 cases) in which univariable analysis showed that vitamin D protects against COVID-19; (3) an ecological country level study demonstrating a negative correlation between vitamin D and COVID-19 case numbers and mortality; and (4) a case-control survey (n=1486) showing cases with confirmed/probable COVID-19 reported lower vitamin D supplementation. All studies were at high/unclear risk of bias. CONCLUSION There is no robust evidence of a negative association between vitamin D and COVID-19. No relevant randomised controlled trials were identified and there is no robust peer-reviewed published evidence of association between vitamin D levels and severity of symptoms or mortality due to COVID-19. Guideline producers should acknowledge that benefits of vitamin D supplementation in COVID-19 are as yet unproven despite increasing interest.
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Affiliation(s)
- Amy Grove
- Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, UK
| | - Osemeke Osokogu
- Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, UK
| | - Lena Al-Khudairy
- Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, UK
| | - Amin Mehrabian
- Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, UK
- Department of Pharmaceutical Nanotechnology, University of Medical Sciences, Mashhad, Iran (the Islamic Republic of)
| | - Mandana Zanganeh
- Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, UK
| | - Anna Brown
- Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, UK
| | - Rachel Court
- Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, UK
| | - Sian Taylor-Phillips
- Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, UK
| | - Olalekan A Uthman
- Warwick-Centre for Applied Health Research (WCAHRD), University of Warwick, Coventry, UK
| | - Noel McCarthy
- Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, UK
| | - Sudhesh Kumar
- Warwick Medical School, The University of Warwick, Coventry, UK
| | - Aileen Clarke
- Division of Health Sciences, Warwick Medical School, The University of Warwick, Coventry, UK
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Eden T, McAuliffe S. Critical care nutrition and COVID-19: a cause of malnutrition not to be underestimated. BMJ Nutr Prev Health 2021; 4:342-347. [PMID: 34308142 PMCID: PMC8258038 DOI: 10.1136/bmjnph-2021-000271] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 05/03/2021] [Indexed: 01/03/2023] Open
Abstract
Malnutrition in critical care is highly prevalent and well documented to have adverse implications on morbidity and mortality. During the current COVID-19 pandemic, the evolving literature has been able to identify high risk groups in whom unfavourable outcomes are more common, for example, obesity, premorbid status, male sex, members from the Black, Asian and Minority Ethnic (BAME) community and others. Nutritional status and provision precritical and pericritical phase of COVID-19 illness is gaining traction in the literature assessing how this can influence the clinical course. It is therefore of importance to understand and address the challenges present in critical care nutrition and to identify and mitigate factors contributing to malnutrition specific to this patient group. We report a case of significant disease burden and the associated cachexia and evidence of malnutrition in a young 36-year-old male with Somalian heritage with no pre-existing medical conditions but presenting with severe COVID-19 during the first wave of the pandemic (March 2020). We highlight some key nutritional challenges during the critical phase of illness signposting to some of the management instigated to counter this. These considerations are hoped to provide further insight to help continue to evolve nutritional management when treating patients with COVID-19.
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Affiliation(s)
- Timothy Eden
- ICU Dept, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.,NNEdPro Global Centre for Nutrition and Health, Cambridge, UK
| | - Shane McAuliffe
- NNEdPro Global Centre for Nutrition and Health, Cambridge, UK.,Nutrition and Dietetics, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
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Rodriguez-Leyva D, Pierce GN. The Impact of Nutrition on the COVID-19 Pandemic and the Impact of the COVID-19 Pandemic on Nutrition. Nutrients 2021; 13:nu13061752. [PMID: 34064053 PMCID: PMC8223988 DOI: 10.3390/nu13061752] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/13/2021] [Accepted: 05/20/2021] [Indexed: 12/12/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has had significant morbidity, mortality, social and financial implications for the global population. Despite this knowledge, we still know very little about how COVID-19 infection affects quality of life resulting from changes in nutritional behaviour and, conversely, how nutrition could modulate the epidemiology of COVID-19. In addition, the social isolation most have experienced due to the regulations imposed by governments during the COVID-19 pandemic may have also had effects on our nutritional behaviour. It is possible that nutritional interventions may have effects on the incidence of COVID-19 infection and mortality rates. The purpose of this review is to evaluate the current status of research on the topic of nutrition as it relates to the COVID-19 pandemic.
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Affiliation(s)
- Delfin Rodriguez-Leyva
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W3, Canada;
- Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W3, Canada
- Institute of Cardiovascular Sciences, Albrechtsen Research Centre, St. Boniface Hospital, 351 Tache Avenue, Winnipeg, MB R2H 2A6, Canada
| | - Grant N. Pierce
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W3, Canada;
- Institute of Cardiovascular Sciences, Albrechtsen Research Centre, St. Boniface Hospital, 351 Tache Avenue, Winnipeg, MB R2H 2A6, Canada
- Canadian Centre for Agri-Food Research in Health and Medicine (CCARM), Albrechtsen Research Centre, St. Boniface Hospital, 351 Tache Avenue, Winnipeg, MB R2H 2A6, Canada
- Correspondence:
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Maha Q, Talal M. Can Vitamin D Deficiency Increase the Susceptibility to COVID-19? Front Physiol 2021; 12:630956. [PMID: 34093219 PMCID: PMC8176109 DOI: 10.3389/fphys.2021.630956] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 04/29/2021] [Indexed: 12/19/2022] Open
Affiliation(s)
| | - Muhammad Talal
- Medical College, Dow University of Health Sciences, Karachi, Pakistan
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Jolliffe DA, Camargo CA, Sluyter JD, Aglipay M, Aloia JF, Ganmaa D, Bergman P, Bischoff-Ferrari HA, Borzutzky A, Damsgaard CT, Dubnov-Raz G, Esposito S, Gilham C, Ginde AA, Golan-Tripto I, Goodall EC, Grant CC, Griffiths CJ, Hibbs AM, Janssens W, Khadilkar AV, Laaksi I, Lee MT, Loeb M, Maguire JL, Majak P, Mauger DT, Manaseki-Holland S, Murdoch DR, Nakashima A, Neale RE, Pham H, Rake C, Rees JR, Rosendahl J, Scragg R, Shah D, Shimizu Y, Simpson-Yap S, Trilok-Kumar G, Urashima M, Martineau AR. Vitamin D supplementation to prevent acute respiratory infections: a systematic review and meta-analysis of aggregate data from randomised controlled trials. Lancet Diabetes Endocrinol 2021; 9:276-292. [PMID: 33798465 DOI: 10.1016/s2213-8587(21)00051-6] [Citation(s) in RCA: 254] [Impact Index Per Article: 84.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 02/11/2021] [Accepted: 02/15/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND A 2017 meta-analysis of data from 25 randomised controlled trials (RCTs) of vitamin D supplementation for the prevention of acute respiratory infections (ARIs) revealed a protective effect of this intervention. We aimed to examine the link between vitamin D supplementation and prevention of ARIs in an updated meta-analysis. METHODS For this systematic review and meta-analysis, we searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and the ClinicalTrials.gov registry for studies listed from database inception to May 1, 2020. Double-blind RCTs of vitamin D3, vitamin D2, or 25-hydroxyvitamin D (25[OH]D) supplementation for any duration, with a placebo or low-dose vitamin D control, were eligible if they had been approved by a research ethics committee, and if ARI incidence was collected prospectively and prespecified as an efficacy outcome. Studies reporting results of long-term follow-up of primary RCTs were excluded. Aggregated study-level data, stratified by baseline 25(OH)D concentration and age, were obtained from study authors. Using the proportion of participants in each trial who had one or more ARIs, we did a random-effects meta-analysis to obtain pooled odds ratios (ORs) and 95% CIs to estimate the effect of vitamin D supplementation on the risk of having one or more ARIs (primary outcome) compared with placebo. Subgroup analyses were done to estimate whether the effects of vitamin D supplementation on the risk of ARI varied according to baseline 25(OH)D concentration (<25 nmol/L vs 25·0-49·9 nmol/L vs 50·0-74·9 nmol/L vs >75·0 nmol/L), vitamin D dose (daily equivalent of <400 international units [IU] vs 400-1000 IU vs 1001-2000 IU vs >2000 IU), dosing frequency (daily vs weekly vs once per month to once every 3 months), trial duration (≤12 months vs >12 months), age at enrolment (<1·00 years vs 1·00-15·99 years vs 16·00-64·99 years vs ≥65·00 years), and presence versus absence of airway disease (ie, asthma only, COPD only, or unrestricted). Risk of bias was assessed with the Cochrane Collaboration Risk of Bias Tool. The study was registered with PROSPERO, CRD42020190633. FINDINGS We identified 1528 articles, of which 46 RCTs (75 541 participants) were eligible. Data for the primary outcome were obtained for 48 488 (98·1%) of 49 419 participants (aged 0-95 years) in 43 studies. A significantly lower proportion of participants in the vitamin D supplementation group had one or more ARIs (14 332 [61·3%] of 23 364 participants) than in the placebo group (14 217 [62·3%] of 22 802 participants), with an OR of 0·92 (95% CI 0·86-0·99; 37 studies; I2=35·6%, pheterogeneity=0·018). No significant effect of vitamin D supplementation on the risk of having one or more ARIs was observed for any of the subgroups defined by baseline 25(OH)D concentration. However, protective effects of supplementation were observed in trials in which vitamin D was given in a daily dosing regimen (OR 0·78 [95% CI 0·65-0·94]; 19 studies; I2=53·5%, pheterogeneity=0·003), at daily dose equivalents of 400-1000 IU (0·70 [0·55-0·89]; ten studies; I2=31·2%, pheterogeneity=0·16), for a duration of 12 months or less (0·82 [0·72-0·93]; 29 studies; I2=38·1%, pheterogeneity=0·021), and to participants aged 1·00-15·99 years at enrolment (0·71 [0·57-0·90]; 15 studies; I2=46·0%, pheterogeneity=0·027). No significant interaction between allocation to the vitamin D supplementation group versus the placebo group and dose, dose frequency, study duration, or age was observed. In addition, no significant difference in the proportion of participants who had at least one serious adverse event in the vitamin supplementation group compared with the placebo group was observed (0·97 [0·86-1·07]; 36 studies; I2=0·0%, pheterogeneity=0·99). Risk of bias within individual studies was assessed as being low for all but three trials. INTERPRETATION Despite evidence of significant heterogeneity across trials, vitamin D supplementation was safe and overall reduced the risk of ARI compared with placebo, although the risk reduction was small. Protection was associated with administration of daily doses of 400-1000 IU for up to 12 months, and age at enrolment of 1·00-15·99 years. The relevance of these findings to COVID-19 is not known and requires further investigation. FUNDING None.
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Affiliation(s)
- David A Jolliffe
- Barts and The London School of Medicine and Dentistry, and Asthma UK Centre for Applied Research, Queen Mary University of London, London, UK.
| | - Carlos A Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - John D Sluyter
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Mary Aglipay
- Department of Pediatrics, St Michael's Hospital, Toronto, ON, Canada
| | - John F Aloia
- Bone Mineral Research Center, Winthrop University Hospital, Mineola, NY, USA
| | - Davaasambuu Ganmaa
- Department of Nutrition, Harvard TH Chan Shool of Public Health, Boston, MA, USA
| | - Peter Bergman
- Department of Laboratory Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Heike A Bischoff-Ferrari
- Department of Geriatric Medicine and Aging Research, University Hospital Zurich, Zurich, Switzerland
| | - Arturo Borzutzky
- Department of Pediatric Infectious Diseases and Immunology, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Camilla T Damsgaard
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Gal Dubnov-Raz
- Exercise, Lifestyle and Nutrition Clinic, Edmond and Lily Safra Children's Hospital, Tel Hashomer, Israel
| | - Susanna Esposito
- Paediatric Clinic, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Clare Gilham
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Adit A Ginde
- Department of Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Inbal Golan-Tripto
- Saban Pediatric Medical Center, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel
| | - Emma C Goodall
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
| | - Cameron C Grant
- Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Christopher J Griffiths
- Barts and The London School of Medicine and Dentistry, and Asthma UK Centre for Applied Research, Queen Mary University of London, London, UK
| | - Anna Maria Hibbs
- Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH, USA; University Hospitals Rainbow Babies and Children's Hospital, Cleveland, OH, USA
| | | | | | - Ilkka Laaksi
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland; Centre for Military Medicine, Helsinki, Finland
| | - Margaret T Lee
- Division of Pediatric Hematology, Oncology, and Stem Cell Transplantation, Columbia University Medical Center, New York, NY USA
| | - Mark Loeb
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | | | - Paweł Majak
- Department of Pediatric Pulmonology, Medical University of Lodz, Lodz, Poland
| | - David T Mauger
- Department of Statistics, The Pennsylvania State University, Hershey, PA, USA
| | - Semira Manaseki-Holland
- Department of Public Health, Epidemiology and Biostatistics, Institute of Applied Health Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - David R Murdoch
- Department of Pathology, University of Otago, Christchurch, New Zealand
| | | | - Rachel E Neale
- Population Health Department, QIMR Berghofer Medical Research Institute, QLD, Australia
| | - Hai Pham
- Population Health Department, QIMR Berghofer Medical Research Institute, QLD, Australia
| | - Christine Rake
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Judy R Rees
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA
| | - Jenni Rosendahl
- Children's Hospital, Pediatric Research Centre, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Robert Scragg
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Dheeraj Shah
- Department of Paediatrics, University College of Medical Sciences, Delhi, India
| | - Yoshiki Shimizu
- FANCL Research Institute, FANCL Corporation, Yokohama, Japan
| | - Steve Simpson-Yap
- Neuroepidemiology Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia; Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | | | | | - Adrian R Martineau
- Barts and The London School of Medicine and Dentistry, and Asthma UK Centre for Applied Research, Queen Mary University of London, London, UK.
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Nasiri M, Khodadadi J, Molaei S. Does vitamin D serum level affect prognosis of COVID-19 patients? Int J Infect Dis 2021; 107:264-267. [PMID: 33940189 PMCID: PMC8086264 DOI: 10.1016/j.ijid.2021.04.083] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 04/27/2021] [Accepted: 04/27/2021] [Indexed: 02/07/2023] Open
Abstract
Background Since the beginning of the Coronavirus disease 2019 (COVID-19) pandemic there have been contradictions and speculations about the relationship between vitamin D and COVID-19. Given that there is an association between vitamin D deficiency and some diseases – including cancer, autoimmune disease and some infectious diseases – a higher incidence and mortality rate in the vitamin-D-deficient COVID-19 population was not a surprise; conversely, some research would argue this relationship. Considering these contradictions, this study aimed to determine the relationship between prognosis and vitamin D level in cases with COVID-19. Methods In this cross-sectional study, 329 confirmed cases of COVID-19 – who were admitted to Kamkar-ArabNia Hospital in Qom city, Iran from March–July 2020 – were categorized into three groups according to vitamin D serum levels (ng/ml): sufficient (>30), insufficient (20–30) and deficient (<20). Prognosis was determined across the groups. Results There was a significant difference in hospital stay between patients with sufficient and insufficient vitamin D levels (P = 0.007). Adjusting vitamin D levels for confounding variables, linear regression underscored significant differences in the association between length of hospitalization and lower vitamin D levels, with a longer stay noted in insufficient groups (P = 0.002). However, there was no significant difference in the time interval to return to normal oxygen level (from SpO2 < 93%) or death rate between groups (P > 0.05). Conclusion There was a significant association between hospital stay and lower serum vitamin D levels. However, the relationship between vitamin D status and death rate or the time interval to return to normal oxygen levels was not significant.
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Affiliation(s)
- Maryam Nasiri
- Department of Infectious Diseases, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran.
| | - Javad Khodadadi
- Department of Infectious Diseases, Faculty of Medicine, Qom University of Medical Sciences, Qom, Iran
| | - Sedigheh Molaei
- Student Research Committee, School of Medicine, Qom University of Medical Sciences, Qom, Iran
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Al-Daghri NM, Amer OE, Alotaibi NH, Aldisi DA, Enani MA, Sheshah E, Aljohani NJ, Alshingetti N, Alomar SY, Alfawaz H, Hussain SD, Alnaami AM, Sabico S. Vitamin D status of Arab Gulf residents screened for SARS-CoV-2 and its association with COVID-19 infection: a multi-centre case-control study. J Transl Med 2021; 19:166. [PMID: 33902635 PMCID: PMC8072076 DOI: 10.1186/s12967-021-02838-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 04/16/2021] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Vitamin D status in patients with COVID-19 is an on-going controversial issue. This study aims to determine differences in the serum 25(OH)D concentrations of Arab Gulf adult residents screened for SARS-CoV-2 and its association with risk of COVID-19 infection together with other comorbidities. METHODS In this multi-center, case-control study, a total of 220 male and female adults presenting with none to mild symptoms were screened for COVID-19 (n = 138 RT-PCR-confirmed SARS-CoV-2 positive and 82 negative controls). Medical history was noted. Anthropometrics were measured and non-fasting blood samples were collected for the assessment of glucose, lipids, inflammatory markers and serum 25(OH)D concentrations. RESULTS Serum 25(OH)D levels were significantly lower in the SARS-CoV-2 positive group compared to the negative group after adjustment for age and BMI (52.8 nmol/l ± 11.0 versus 64.5 nmol/l ± 11.1; p = 0.009). Being elderly (> 60 years) [Odds ratio 6 (95% Confidence Interval, CI 2-18; p = 0.001) as well as having type 2 diabetes (T2D) [OR 6 (95% CI 3-14); p < 0.001)] and low HDL cholesterol (HDL-c) [OR 6 (95% CI 3-14); p < 0.001)] were significant risk factors for COVID-19 infection independent of age, sex and obesity. CONCLUSIONS Among Arab Gulf residents screened for SARS-CoV-2, serum 25(OH) D levels were observed to be lower in those who tested positive than negative individuals, but it was the presence of old age, diabetes mellitus and low-HDL-c that were significantly associated with risk of COVID-19 infection. Large population-based randomized controlled trials should be conducted to assess the protective effects of vitamin D supplementation against COVID-19.
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Affiliation(s)
- Nasser M. Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, PO Box, 2455, Riyadh, 11451 Saudi Arabia
| | - Osama E. Amer
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, PO Box, 2455, Riyadh, 11451 Saudi Arabia
| | - Naif H. Alotaibi
- Department of Medicine, College of Medicine, King Saud University, Riyadh, 12372 Saudi Arabia
| | - Dara A. Aldisi
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh, 11451 Saudi Arabia
| | - Mushira A. Enani
- Infectious Diseases Section, King Fahad Medical City, Riyadh, 59046 Saudi Arabia
| | - Eman Sheshah
- Diabetes Care Center, King Salman Bin Abdulaziz Hospital, Riyadh, 12769 Saudi Arabia
| | - Naji J. Aljohani
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, PO Box, 2455, Riyadh, 11451 Saudi Arabia
- Obesity, Endocrine and Metabolism Center, Department of Medicine, King Fahad Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Naemah Alshingetti
- Obstetrics and Gynaecology Department, King Salman Bin Abdulaziz Hospital, Riyadh, 11564 Saudi Arabia
| | - Suliman Y. Alomar
- Doping Research Chair, Department of Zoology, College of Science, King Saud University, Riyadh, 11495 Saudi Arabia
| | - Hanan Alfawaz
- College of Food Science & Agriculture, Department of Food Science & Nutrition, King Saud University, Riyadh, 11495 Saudi Arabia
| | - Syed D. Hussain
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, PO Box, 2455, Riyadh, 11451 Saudi Arabia
| | - Abdullah M. Alnaami
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, PO Box, 2455, Riyadh, 11451 Saudi Arabia
| | - Shaun Sabico
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, PO Box, 2455, Riyadh, 11451 Saudi Arabia
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Paiz N, Alonso P, Portillo AL. Vitamin D Status: Can It Affect the Risk of Infection and the Severity of COVID-19 Symptoms? CURRENT TROPICAL MEDICINE REPORTS 2021; 8:204-211. [PMID: 33816060 PMCID: PMC8010782 DOI: 10.1007/s40475-021-00236-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2021] [Indexed: 11/30/2022]
Abstract
Purpose of Review In the midst of the COVID-19 pandemic, several academic studies have emerged that explore the importance of vitamin D in the development of the SARS-CoV2 infection. The basis of this interest comes from the established effect vitamin D status has on other acute respiratory infections, such as influenza. This article aims to determine the role and effect of vitamin D serum concentration in the prevalence and severity of COVID-19. Recent Findings Several observational studies have demonstrated that suboptimal levels of vitamin D serum concentrations can significantly increase the risk of developing COVID-19 and lead to a more severe symptomatology. One study suggests, however, that supplementation of vitamin D could potentially increase the incidence of mortality in COVID-19 patients. Summary Vitamin D status could have an influential role in the development and progression of SARS-CoV2 infection. Further studies are warranted to understand fully the veracity and the extent of this association.
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Affiliation(s)
- Nicole Paiz
- Baccalaureus Scientiae in Clinical Nutrition, Guatemala, Guatemala
- Baccalaureate of Arts Anthropology, Grinnell, IA USA
| | - Paula Alonso
- Baccalaureus Scientiae in Clinical Nutrition, Guatemala, Guatemala
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