1
|
Inoue T, Kumai T, Ohara K, Takahara M. Hypocalcemia Following Thyroidectomy in a Patient With COVID-19: A Case Report and Literature Review. Cureus 2024; 16:e66665. [PMID: 39262524 PMCID: PMC11390140 DOI: 10.7759/cureus.66665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2024] [Indexed: 09/13/2024] Open
Abstract
COVID-19 can lead to various complications, including severe respiratory symptoms. Both viral infections and total thyroidectomy are known to cause hypocalcemia, making a history of thyroidectomy a potential risk factor for hypocalcemia in COVID-19 patients. We present the case of a 34-year-old woman with Graves' disease who developed hypocalcemia due to COVID-19 following a total thyroidectomy. The patient underwent an uneventful total thyroidectomy, with preservation of at least three of the four parathyroid glands. Postoperatively, her parathyroid hormone (PTH) levels were normal, and she was discharged without tetany. However, on postoperative day 90, she experienced mild hypocalcemia during a COVID-19 infection, although it was asymptomatic. By postoperative day 127, she presented with severe tetany and general malaise. Testing confirmed a reinfection with SARS-CoV-2 and hypocalcemia, while PTH levels remained normal. Treatment with intravenous calcium gluconate, oral calcium lactate, and alfacalcidol effectively resolved the hypocalcemia and tetany. The patient was subsequently discharged without tetany and has since been monitored without the need for calcium or vitamin D supplementation. This case highlights that the COVID-19 infection following a total thyroidectomy can cause hypocalcemia. Postoperative hypocalcemia is a common issue in head and neck surgery, and viral infections like COVID-19 should be considered in the differential diagnosis of hypocalcemia.
Collapse
Affiliation(s)
- Takahiro Inoue
- Department of Otolaryngology - Head and Neck Surgery, Asahikawa Medical University, Asahikawa, JPN
| | - Takumi Kumai
- Department of Otolaryngology - Head and Neck Surgery, Asahikawa Medical University, Asahikawa, JPN
| | - Kenzo Ohara
- Department of Otolaryngology - Head and Neck Surgery, Asahikawa Medical University, Asahikawa, JPN
| | - Miki Takahara
- Department of Otolaryngology - Head and Neck Surgery, Asahikawa Medical University, Asahikawa, JPN
| |
Collapse
|
2
|
Salehi Z, Askari M, Jafari A, Ghosn B, Surkan PJ, Hosseinzadeh-Attar MJ, Pouraram H, Azadbakht L. Dietary patterns and micronutrients in respiratory infections including COVID-19: a narrative review. BMC Public Health 2024; 24:1661. [PMID: 38907196 PMCID: PMC11193220 DOI: 10.1186/s12889-024-18760-y] [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: 02/12/2023] [Accepted: 05/02/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND COVID-19 is a pandemic caused by nCoV-2019, a new beta-coronavirus from Wuhan, China, that mainly affects the respiratory system and can be modulated by nutrition. METHODS This review aims to summarize the current literature on the association between dietary intake and serum levels of micronutrients, malnutrition, and dietary patterns and respiratory infections, including flu, pneumonia, and acute respiratory syndrome, with a focus on COVID-19. We searched for relevant articles in various databases and selected those that met our inclusion criteria. RESULTS Some studies suggest that dietary patterns, malnutrition, and certain nutrients such as vitamins D, E, A, iron, zinc, selenium, magnesium, omega-3 fatty acids, and fiber may have a significant role in preventing respiratory diseases, alleviating symptoms, and lowering mortality rates. However, the evidence is not consistent and conclusive, and more research is needed to clarify the mechanisms and the optimal doses of these dietary components. The impact of omega-3 and fiber on respiratory diseases has been mainly studied in children and adults, respectively, and few studies have examined the effect of dietary components on COVID-19 prevention, with a greater focus on vitamin D. CONCLUSION This review highlights the potential of nutrition as a modifiable factor in the prevention and management of respiratory infections and suggests some directions for future research. However, it also acknowledges the limitations of the existing literature, such as the heterogeneity of the study designs, populations, interventions, and outcomes, and the difficulty of isolating the effects of single nutrients from the complex interactions of the whole diet.
Collapse
Affiliation(s)
- Zahra Salehi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Mohammadreza Askari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Alireza Jafari
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Batoul Ghosn
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Pamela J Surkan
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mohammad Javad Hosseinzadeh-Attar
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetic, Tehran University of Medical Sciences, Tehran, Iran
- Department of Nutrition and Biochemistry, School of Public Health, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Hamed Pouraram
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, IR, Iran.
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, IR, Iran.
- Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, IR, Iran.
| |
Collapse
|
3
|
Younes S. The role of nutrition on the treatment of Covid 19. HUMAN NUTRITION & METABOLISM 2024; 36:200255. [DOI: 10.1016/j.hnm.2024.200255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/05/2024]
|
4
|
Guðnadóttir SD, Gunnarsdóttir I, Hernandez UB, Ingadóttir ÁR. High risk of malnutrition among hospitalised coronavirus disease 2019 (COVID-19) patients is associated with mortality and other clinical outcomes. Clin Nutr ESPEN 2024; 61:1-7. [PMID: 38777420 DOI: 10.1016/j.clnesp.2024.02.023] [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: 07/09/2023] [Revised: 01/28/2024] [Accepted: 02/21/2024] [Indexed: 05/25/2024]
Abstract
INTRODUCTION Increasing evidence indicates an association between nutritional status and Coronavirus disease 2019 (COVID-19) disease severity. The aim of the study was to describe the risk of malnutrition, body mass index (BMI) and vitamin D status of hospitalised COVID-19 patients and assess whether they are associated with duration of hospital stay, intensive care unit (ICU) admission, mechanical ventilation, and mortality. METHODS The study is a descriptive retrospective study of 273 patients with COVID-19 admitted to Hospital from February 2020 to March 2021. Patients were screened for risk of malnutrition using a validated screening tool. BMI was calculated from height and weight. Insufficient Vitamin D status was defined as 25(OH)vitD <50 nmol/L. Logistic regression analysis was used to assess the association between indicators of nutritional status of patients with COVID-19, and outcomes such as duration of stay >7 days, ICU admission, mechanical ventilation, and mortality. Interaction between risk of malnutrition and BMI of ≥30 kg/m2 was assessed using the likelihood ratio test with hospital stay, ICU admission, mechanical ventilation, and mortality as outcomes. RESULTS Screening for risk of malnutrition identified 201 (74%) patients at a medium to high risk of malnutrition. Patients defined as being at a medium or high risk of malnutrition were more likely to be hospitalised for >7 days compared to those defined as low risk (OR: 10.72; 95% CI: 3.9-29.46; p < 0.001 and OR: 61.57; 95% CI: 19.48-194.62; p < 0.001, respectively). All patients who were admitted to ICU (n = 41) and required mechanical ventilation (n = 27) were defined as having medium or high risk of malnutrition. High risk of malnutrition was also associated with increased odds of mortality (OR: 8.87; 955 CI 1.08-72,96; p = 0.042). BMI of ≥30 kg/m2 (43%) and 25(OH)vitD <50 nmol/L (20%) were not associated with duration of stay >7 days or mortality, although BMI ≥30 kg/m2 was associated with increased risk of ICU admission (OR: 7.12; 95% CI: 1.59-31.94; p = 0.010) and mechanical ventilation (OR: 8.86; 95% CI: 1.12-69.87; p = 0.038). Interactions between risk of malnutrition and BMI ≥30 kg/m2 were not significant to explain the outcomes of hospital stay >7 days, ICU admission, mechanical ventilation, or mortality. CONCLUSION High risk of malnutrition among hospitalised COVID-19 patients was associated with longer duration of hospital stay, ICU admission, mechanical ventilation and mortality, and BMI ≥30 kg/m2 was associated with ICU admission and mechanical ventilation. Insufficient Vitamin D status was not associated with duration of hospital stay, ICU admission, mechanical ventilation, or mortality.
Collapse
Affiliation(s)
| | - Ingibjörg Gunnarsdóttir
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland; Department of Clinical Nutrition, Landspitali University Hospital, Reykjavik, Iceland
| | | | - Áróra Rós Ingadóttir
- Faculty of Food Science and Nutrition, University of Iceland, Reykjavik, Iceland; Department of Clinical Nutrition, Landspitali University Hospital, Reykjavik, Iceland
| |
Collapse
|
5
|
Zhang X, Chen Z, Xiang Y, Zhou Y, Tang M, Cai J, Xu X, Cui H, Feng Y, Xu R. The Association between Serum Level of Vitamin D and Inflammatory Biomarkers in Hospitalized Adult Patients: A Cross-Sectional Study Based on Real-World Data. Mediators Inflamm 2024; 2024:8360538. [PMID: 38549715 PMCID: PMC10978080 DOI: 10.1155/2024/8360538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Revised: 02/16/2024] [Accepted: 03/11/2024] [Indexed: 04/02/2024] Open
Abstract
Objective The association between vitamin D status and inflammation remains unclear in hospitalized patients. Materials and Methods We performed the current study based on real-world data from two teaching hospitals. Serum level of vitamin D (assessed by 25-hydroxyvitamin D) was evaluated within 2 days after admission. All the patients were further classified into three groups: deficiency (<12 ng/mL), insufficiency (12-20 ng/mL), and adequate (≥20 ng/mL). White blood cell (WBC) count, serum level of C-reactive protein (CRP), and procalcitonin were also measured and used to evaluate inflammation. Other potential covariates were abstracted from medical records. Charlson comorbidity index (CCI) was calculated to assess the severity of disease. Results A total number of 35,528 hospitalized adult patients (21,171 men and 14,357 women) were included. The average age and BMI were 57.5 ± 16.2 years and 23.4 ± 3.7 kg/m2, respectively, while medium vitamin D level was 16.1 ng/mL (interquartile range: 11.4 ng/mL, 21.6 ng/mL) and median CCI was one point (interquartile range: 0 point, two points). The prevalence of deficiency and insufficiency was 28.0% and 40.5%. Multivariate linear regression model showed that serum level of vitamin D was significantly associated with WBC and CRP but not associated with procalcitonin. Each standard deviation (≈7.4 ng/mL) increase in vitamin D was associated with a decrease in WBC by 0.13 × 109/mL (95% CI: 0.2 × 109/mL, 0.06 × 109/mL) and 0.62 mg/L (95% CI: 0.88 mg/L, 0.37 mg/L) for CRP. Subgroup analysis and sensitivity analysis (excluding those whose eGFR <60 ml/min/1.73 m2, those whose daily calorie intake <1,000 kcal, and those who were recruited from Xin Hua hospital) generated similar results. Conclusions The deficiency and insufficiency of vitamin D in the hospitalized adult patients was very common. However, the results should be interpreted with caution for limited representation of the whole inpatients. Low level of vitamin D was associated with inflammatory biomarkers, which provide the evidences to early intervention for lower the risk of infection.
Collapse
Affiliation(s)
- Xiaomin Zhang
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Zhiqi Chen
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Yi Xiang
- Department of Clinical Nutrition Center, Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Yiquan Zhou
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Molian Tang
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
| | - Jun Cai
- Department of Clinical Nutrition, Long Hua Hospital affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 200031, China
| | - Xinyi Xu
- University of Michigan, LSA 500 S, State Street, Ann Arbor, MI 48109, USA
| | - Hongyuan Cui
- Department of General Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing 100730, China
| | - Yi Feng
- Department of Clinical Nutrition Center, Xin Hua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Renying Xu
- Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China
- Department of Nutrition, College of Health Science and Technology, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
| |
Collapse
|
6
|
Plasek J, Dodulik J, Gai P, Hrstkova B, Skrha J, Zlatohlavek L, Vlasakova R, Danko P, Ondracek P, Cubova E, Capek B, Kollarova M, Furst T, Vaclavik J. Mortality of hospitalized patients with COVID-19: Effects of treatment options (vitamin D, anticoagulation, isoprinosine, ivermectin) assessed by propensity score matching, retrospective analysis. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2024; 168:35-43. [PMID: 38050692 DOI: 10.5507/bp.2023.045] [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: 07/04/2023] [Accepted: 11/07/2023] [Indexed: 12/06/2023] Open
Abstract
INTRODUCTION SARS-CoV-2 respiratory infection is associated with significant morbidity and mortality, especially in hospitalized high-risk patients. We aimed to evaluate the effects of treatment options (vitamin D, anticoagulation, isoprinosine, ivermectin) on hospital mortality in non-vaccinated patients during the 2021 spring wave in the Czech Republic. METHODS Initially, 991 patients hospitalized in the period January 1, 2021, to March 31, 2021, with PCR-confirmed SARS-CoV-2 acute respiratory infection in two university and five rural hospitals were included in the study. After exclusion of patients with an unknown outcome, a total of 790 patients entered the final analysis. The effects of different treatments were assessed in this cohort by means of propensity score matching. RESULTS Of the 790 patients, 282 patients died in the hospital; 37.7% were male and 33.3% were female. Age, sex, state of the disease, pneumonia, therapy, and several comorbidities were matched to simulate a case-control study. For anticoagulation treatment, 233 cases (full-dose) vs. 233 controls (prophylactic dose) were matched. The difference in mortality was significant in 16 of the 50 runs. For the treatment with isoprinosine, ivermectin, and vitamin D, none of the 50 runs led to a significant difference in hospital mortality. CONCLUSION Prophylactic-dose anticoagulation treatment in our study was found to be beneficial in comparison with the full dose. Supplementation with vitamin D did not show any meaningful benefit in terms of lowering the hospital mortality. Neither ivermectin nor, isoprinosine was found to significantly decrease hospital mortality.
Collapse
Affiliation(s)
- Jiri Plasek
- Department of Internal Medicine and Cardiology, University Hospital Ostrava, Ostrava, Czech Republic
- Center for Research on Internal Medicine and Cardiovascular diseases, Faculty of Medicine, University of Ostrava, Czech Republic
| | - Jozef Dodulik
- Department of Internal Medicine and Cardiology, University Hospital Ostrava, Ostrava, Czech Republic
| | - Petr Gai
- Department of Pulmonary Medicine and Tuberculosis, University Hospital Ostrava, Ostrava, Czech Republic
| | - Barbora Hrstkova
- Clinic for Infectious diseases, University Hospital Ostrava, Ostrava, Czech Republic
| | - Jan Skrha
- 3rd Department of Internal Medicine, General University Hospital, Prague
| | - Lukas Zlatohlavek
- 3rd Department of Internal Medicine, General University Hospital, Prague
| | - Renata Vlasakova
- 3rd Department of Internal Medicine, General University Hospital, Prague
| | - Peter Danko
- Department of Internal Medicine, Havirov Regional Hospital, Havirov, Czech Republic
| | - Petr Ondracek
- Department of Internal Medicine, Bilovec Regional Hospital, Bilovec, Czech Republic
| | - Eva Cubova
- Department of Internal Medicine, Fifejdy Ostrava City Hospital, Ostrava, Czech Republic
| | - Bronislav Capek
- Department of Internal Medicine, Associated Medical Facilities, Krnov, Czech Republic
| | - Marie Kollarova
- Department of Internal Medicine, Trinec Regional Hospital, Trinec, Czech Republic
| | - Tomas Furst
- Department of Mathematical Analysis and Application of Mathematics, Faculty of Science, Palacky University Olomouc, Czech Republic
| | - Jan Vaclavik
- Department of Internal Medicine and Cardiology, University Hospital Ostrava, Ostrava, Czech Republic
- Center for Research on Internal Medicine and Cardiovascular diseases, Faculty of Medicine, University of Ostrava, Czech Republic
| |
Collapse
|
7
|
Sartini M, Del Puente F, Oliva M, Carbone A, Bobbio N, Schinca E, Giribone L, Cristina ML. Preventive Vitamin D Supplementation and Risk for COVID-19 Infection: A Systematic Review and Meta-Analysis. Nutrients 2024; 16:679. [PMID: 38474807 PMCID: PMC10935157 DOI: 10.3390/nu16050679] [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: 01/18/2024] [Revised: 02/15/2024] [Accepted: 02/25/2024] [Indexed: 03/14/2024] Open
Abstract
Over the past few decades, vitamin D has been found to play a crucial role in bone homeostasis, muscle function, oncogenesis, immune response and metabolism. In the context of the COVID-19 pandemic, numerous researchers have tried to determine the role vitamin D might play in the immune response to the virus. The aim of this systematic review and meta-analysis is to demonstrate that preventive vitamin D supplementation can play a protective role in the incidence of COVID-19, mortality and admission to intensive care units (ICUs). A comprehensive search on the PubMed/MEDLINE, Scopus, Cochrane and Google Scholar databases was performed on 15 May 2023, and two of the authors independently screened the literature. As effect measures, we calculated the Odds Ratios with their corresponding 95% confidence intervals (ICs). The assessment of potential bias and the evaluation of study quality will be conducted independently by two researchers. Sixteen publications were selected for inclusion in the meta-analysis. Our findings indicate that vitamin D supplementation has a protective effect against the incidence of COVID-19 in RCT studies (OR 0.403, 95% IC 0.218, 0.747), in the incidence of COVID-19 in analytical studies (OR = 0.592, 95% IC 0.476-0.736) and in ICU admission (OR 0.317, 95% IC 0.147-0.680). Subsequent analyses were conducted by type of subject treated (patient/healthcare workers) and type of supplementation (vitamin D vs. placebo/no treatment or high dose vs. low dose). Our meta-analysis suggests a definitive and significant association between the protective role of vitamin D and COVID-19 incidence and ICU admission.
Collapse
Affiliation(s)
- Marina Sartini
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (M.O.); (A.C.); (E.S.); (L.G.); (M.L.C.)
- Operating Unit Hospital Hygiene, Galliera Hospital, 16128 Genoa, Italy
| | - Filippo Del Puente
- Department of Infectious Diseases, Galliera Hospital, 16128 Genoa, Italy;
| | - Martino Oliva
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (M.O.); (A.C.); (E.S.); (L.G.); (M.L.C.)
| | - Alessio Carbone
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (M.O.); (A.C.); (E.S.); (L.G.); (M.L.C.)
| | - Nicoletta Bobbio
- Department of Infectious Diseases, Galliera Hospital, 16128 Genoa, Italy;
| | - Elisa Schinca
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (M.O.); (A.C.); (E.S.); (L.G.); (M.L.C.)
- Operating Unit Hospital Hygiene, Galliera Hospital, 16128 Genoa, Italy
| | - Luana Giribone
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (M.O.); (A.C.); (E.S.); (L.G.); (M.L.C.)
| | - Maria Luisa Cristina
- Department of Health Sciences, University of Genoa, 16132 Genoa, Italy; (M.O.); (A.C.); (E.S.); (L.G.); (M.L.C.)
- Operating Unit Hospital Hygiene, Galliera Hospital, 16128 Genoa, Italy
| |
Collapse
|
8
|
Moguem Soubgui AF, Ndeme Mboussi WS, Kojom Foko LP, Embolo Enyegue EL, Koanga Mogtomo ML. Exploring demographical, clinical, and dietary determinants of vitamin D deficiency among adults in Douala, Cameroon during the COVID-19 era. Heliyon 2024; 10:e24926. [PMID: 38352796 PMCID: PMC10862520 DOI: 10.1016/j.heliyon.2024.e24926] [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: 07/25/2023] [Revised: 12/28/2023] [Accepted: 01/17/2024] [Indexed: 02/16/2024] Open
Abstract
Background and aim Vitamin D deficiency (VDD) is a global public health problem in African populations. This study aimed at determining the prevalence, characteristics, and determinants of VDD in the era of SARS-CoV-2/COVID-19. This study was conducted from January to September 2022 in seven health facilities in Douala, Cameroon. Methods A structured, pre-tested questionnaire was administered to each participant to collect participants' information. Molecular detection of the SARS-CoV-2 genome was done. A serum level of 25-hydroxyvitamin D < 20 ng/mL was used to diagnose VDD. Results A total of 420 participants were included in the study. A Serum levels of 25(OH) vitamin D were reduced in SARS-CoV-2 (+) patients as compared to SARS-CoV-2 (-) patients (21.69 ± 5.64 ng/mL vs 42.09 ± 20.03 ng/mL, p < 0.0001). The overall prevalence of VDD was 10.2 %. SARS-CoV-2 (+) individuals had nearly two times more risk of being VDD compared to SARS-CoV-2 (-) individuals (aRR = 1.81, p < 0.0001). The risk of VDD was reduced by 46 % and 71 % in those consuming cocoa bean or powder regularly (aRR = 0.54, p = 0.03) and rarely (aRR = 0.29, p = 0.02) as compared to those never consuming it. Likewise, the risk of VDD was reduced by 59 % and 78 % in those consuming sardine fish regularly (aRR = 0.47, p = 0.002) and rarely (aRR = 0.22, p = 0.03). Overall, the association between VDD and SARS-CoV-2 infection was consistent, i.e., reduced risk of VDD in SARS-CoV-2 (-) individuals, after stratification for confounding variables. Conclusion This study outlined a high burden of VDD, a strong link between VDD and SARS-CoV-2, and suggests the possible utility of vitamin D supplementation for COVID-19 patients in Cameroon.
Collapse
Affiliation(s)
| | - Wilfried Steve Ndeme Mboussi
- Department of Biochemistry, Faculty of Sciences, The University of Douala, Cameroon
- Centre de Recherche et d’Expertise en Biologie, Douala, Cameroon
| | - Loick Pradel Kojom Foko
- Centre de Recherche et d’Expertise en Biologie, Douala, Cameroon
- Department of Animal Organisms, Faculty of Science, The University of Douala, Cameroon
| | | | - Martin Luther Koanga Mogtomo
- Department of Biochemistry, Faculty of Sciences, The University of Douala, Cameroon
- Centre de Recherche et d’Expertise en Biologie, Douala, Cameroon
| |
Collapse
|
9
|
Mehdad S, Belghiti H, Zahrou FE, Guerinech H, Mouzouni FZ, El Hajjab A, El Berri H, El Ammari L, Benaich S, Benkirane H, Barkat A, Aguenaou H. Vitamin D status and its relationship with obesity indicators in Moroccan adult women. Nutr Health 2023; 29:673-681. [PMID: 35435056 DOI: 10.1177/02601060221094376] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Background: Although vitamin D deficiency has been studied in various populations, there are few data on its prevalence and associated factors among Moroccan women. Aim: To determine the prevalence of vitamin D deficiency and investigate its association with body mass index (BMI), waist circumference, and serum concentrations of parathyroid hormone, calcium, and phosphorus in a sample of Moroccan adult women. Methods: This is a cross-sectional study conducted at Mohammed V Military Hospital of Instruction, Rabat. Anthropometric measurements and biochemical analyses were performed using standard procedures Results: A total of 714 women aged 18-65 years participated in this study. The overall prevalence of vitamin D deficiency was 74.4%. Approximately 24% and 51% of women had severe and moderate vitamin D deficiency, respectively. Serum 25-hydroxyvitamin D (25(OH)D) concentrations were inversely correlated with BMI in vitamin D-deficient subjects (P = 0.036) and with parathyroid hormone 1-84 (PTH1-84) levels in the study sample (P = 0.010). PTH1-84 concentrations were greater among overweight/obese individuals compared to their non-overweight peers (P = 0.001) and tended to be higher among vitamin D-deficient women than vitamin D-sufficient women (P = 0.053). Conclusion: This study showed a very high prevalence of vitamin D deficiency in this sample of Moroccan women. Lower serum 25(OH)D levels were associated with increased BMI in vitamin D-deficient women and with elevated PTH1-84 levels among the study sample. Although these findings come from a convenience sample of women that attended a nutrition clinic, they underscore the urgent need to develop public health interventions to improve women's vitamin D status.
Collapse
Affiliation(s)
- Slimane Mehdad
- Physiology and Physiopathology Research Team, Research Centre of Human Pathologies Genomics, Faculty of Sciences, Mohammed V University in Rabat, Morocco
- Clinical Nutrition Unit, Mohammed V Military Hospital of Instruction, Rabat, Morocco
- Ibn Tofail University- CNESTEN, Joint Unit of Nutrition, Health and Environment, Laboratory of Biology and Health, FSK, Regional Designated Center for Nutrition (AFRA/IAEA), Kenitra, 14000, Morocco
| | - Hakim Belghiti
- Clinical Nutrition Unit, Mohammed V Military Hospital of Instruction, Rabat, Morocco
- Ibn Tofail University- CNESTEN, Joint Unit of Nutrition, Health and Environment, Laboratory of Biology and Health, FSK, Regional Designated Center for Nutrition (AFRA/IAEA), Kenitra, 14000, Morocco
| | - Fatima Ezzahra Zahrou
- Ibn Tofail University- CNESTEN, Joint Unit of Nutrition, Health and Environment, Laboratory of Biology and Health, FSK, Regional Designated Center for Nutrition (AFRA/IAEA), Kenitra, 14000, Morocco
| | - Hassania Guerinech
- Clinical Nutrition Unit, Mohammed V Military Hospital of Instruction, Rabat, Morocco
| | | | - Amina El Hajjab
- Ibn Tofail University- CNESTEN, Joint Unit of Nutrition, Health and Environment, Laboratory of Biology and Health, FSK, Regional Designated Center for Nutrition (AFRA/IAEA), Kenitra, 14000, Morocco
| | | | | | - Souad Benaich
- Ibn Tofail University- CNESTEN, Joint Unit of Nutrition, Health and Environment, Laboratory of Biology and Health, FSK, Regional Designated Center for Nutrition (AFRA/IAEA), Kenitra, 14000, Morocco
| | - Hasnae Benkirane
- Ibn Tofail University- CNESTEN, Joint Unit of Nutrition, Health and Environment, Laboratory of Biology and Health, FSK, Regional Designated Center for Nutrition (AFRA/IAEA), Kenitra, 14000, Morocco
| | - Amina Barkat
- Health and Nutrition Research Team of the Mother-Child Couple, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Morocco
| | - Hassan Aguenaou
- Ibn Tofail University- CNESTEN, Joint Unit of Nutrition, Health and Environment, Laboratory of Biology and Health, FSK, Regional Designated Center for Nutrition (AFRA/IAEA), Kenitra, 14000, Morocco
| |
Collapse
|
10
|
Monye IN, Makinde MT, Oseni TIA, Adelowo AB, Nyirenda S. Covid-19 and Pre-Morbid Lifestyle-Related Risk Factors-A Review. Health Serv Insights 2023; 16:11786329231215049. [PMID: 38046558 PMCID: PMC10691316 DOI: 10.1177/11786329231215049] [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: 08/24/2023] [Accepted: 11/01/2023] [Indexed: 12/05/2023] Open
Abstract
Since its outbreak in December 2019 in China, COVID-19 has spread like wild fire to affect many communities of the world. The high infectivity and case fatality rates of the disease among the general population and the severely ill patients respectively drew the attention of the global community. Our review showed that socio-demographic and lifestyle-related risk factors and underlying comorbid diseases were directly and indirectly associated with increased susceptibility and severity of COVID-19. These factors included older age (⩾60 years), male gender, and ethnic minority groups (especially blacks), smoking, low serum level of vitamin D, unhealthy diet, physical inactivity (with poor exposure to sunlight), overweight/obesity, high blood pressure/hypertension, high blood cholesterol, cardiovascular diseases (like stroke and coronary heart disease), diabetes mellitus, chronic obstructive pulmonary disease, chronic kidney disease, chronic liver disease, and some cancers (like leukemia, lymphoma, or myeloma). The literature further revealed that the clinical progression of the majority of these associated risk factors can be modified through effective and comprehensive risk reduction through healthy living and lifestyle modification. COVID-19 preventive and treatment guidelines that give adequate attention to risk reduction and healthy lifestyle among people-either in the pre-, peri-, or post-COVID-19 stage, should be developed by public health policymakers and clinicians. This will play a significant role in the global effort to combat the pandemic, and reduce its negative impact on the life expectancy and socio-economic development of the world particularly in low- and middle-income countries (LMICs).
Collapse
Affiliation(s)
- Ifeoma N Monye
- Brookfield Clinics Centre for Lifestyle Medicine/Department of Family Medicine, National Hospital, Abuja, Nigeria
| | - Moyosore Taiwo Makinde
- Department of Family Medicine, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
| | - Tijani Idris Ahmad Oseni
- Department of Family Medicine, Ambrose Alli university, Ekpoma, Nigeria
- Lifestyle and Behavioural Medicine Unit, Department of Family Medicine, Irrua Specialist Teaching Hospital, Irrua, Nigeria
| | | | | |
Collapse
|
11
|
Panda SK, Sen Gupta PS, Karmakar S, Biswal S, Mahanandia NC, Rana MK. Unmasking an Allosteric Binding Site of the Papain-like Protease in SARS-CoV-2: Molecular Dynamics Simulations of Corticosteroids. J Phys Chem Lett 2023; 14:10278-10284. [PMID: 37942913 DOI: 10.1021/acs.jpclett.3c01980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
To date, mechanistic insights into many clinical drugs against COVID-19 remain unexplored. Dexamethasone, a corticosteroid, is one of them. While treating the entire corticosteroid database, including vitamins D2 and D3, with cutting-edge computational techniques, several intriguing results are unfolded. From the top-notch candidates, dexamethasone is likely to inhibit the viral main protease (Mpro), with vitamin D3 exhibiting multitarget [Mpro, papain-like protease (PLpro), and nucleocapsid protein (N-pro)] roles and ciclesonide's dynamic flipping disinterring a cryptic allosteric site in the PLpro enzyme. The results rationalize why these drugs improve the health of COVID-19 patients. Understanding an enzyme's secret binding site is essential to understanding how the enzyme works and how to inhibit its function. Ciclesonide's allosteric inhibition could not only jeopardize PLpro's catalytic role in polyprotein processing but also make it less vulnerable to the host body's defense machinery. Hotspot residues in the identified allosteric site could be considered for effective therapeutic designs against PLpro.
Collapse
Affiliation(s)
- Saroj Kumar Panda
- Department of Chemical Sciences, Indian Institute of Science Education and Research (IISER), Berhampur 760010, Odisha, India
| | - Parth Sarthi Sen Gupta
- School of Biosciences and Bioengineering, D Y Patil International University (DYPIU), Akurdi, Pune 411044, Maharashtra, India
| | - Shaswata Karmakar
- Department of Chemical Sciences, Indian Institute of Science Education and Research (IISER), Berhampur 760010, Odisha, India
| | - Satyaranjan Biswal
- Department of Chemical Sciences, Indian Institute of Science Education and Research (IISER), Berhampur 760010, Odisha, India
| | - Nimai Charan Mahanandia
- Division of Agricultural Bioinformatics, ICAR-Indian Agricultural Statistics Research Institute, Pusa 110012, New Delhi, India
| | - Malay Kumar Rana
- Department of Chemical Sciences, Indian Institute of Science Education and Research (IISER), Berhampur 760010, Odisha, India
| |
Collapse
|
12
|
Johnson CR, Thacher TD. Vitamin D: immune function, inflammation, infections and auto-immunity. Paediatr Int Child Health 2023; 43:29-39. [PMID: 36857810 DOI: 10.1080/20469047.2023.2171759] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/12/2022] [Indexed: 03/03/2023]
Abstract
Vitamin D plays an active role beyond mineral metabolism and skeletal health, including regulation of the immune system. Vitamin D deficiency is widely prevalent, and observational studies link low vitamin D status to a risk of infections and auto-immune disorders. Reports indicate an inverse relationship between vitamin D status and such conditions. This review details vitamin D signalling interactions with the immune system and provides experimental and clinical evidence evaluating vitamin D status, vitamin D supplementation and host susceptibility to infections, inflammation and auto-immunity. The published literature including related reviews, systematic reviews, meta-analyses, randomised controlled trials (RCTs), observational studies and basic science reports have been synthesised. Meta-analyses of observational studies have demonstrated a link between low vitamin D status and risk of acute respiratory infections, COVID-19 disorders, multiple sclerosis, type 1 diabetes (T1DM), inflammatory bowel disease (IBD), systemic lupus erythematosus and other auto-immune disorders. Observational studies suggest that vitamin D supplementation may protect against several infectious and auto-immune conditions. Meta-analyses of RCTs had mixed results, demonstrating a small protective role for vitamin D supplementation against acute respiratory infections, especially in those with vitamin D deficiency and children, and providing modest benefits for the management of T1DM and IBD. Vitamin D status is inversely associated with the incidence of several infectious and auto-immune conditions. Supplementation is recommended for those with vitamin D deficiency or at high risk of deficiency, and it might provide additional benefit in acute respiratory infections and certain auto-immune conditions.
Collapse
Affiliation(s)
- Casey R Johnson
- Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Tom D Thacher
- Department of Family Medicine, Mayo Clinic, Rochester, New York, USA
| |
Collapse
|
13
|
Al-Mohammedawi AKK, Anvari E, Fateh A. Relationship between CDX2 rs11568820 and EcoRV rs4516035 polymorphisms on the vitamin D receptor gene with susceptibility to different SARS-CoV-2 variants. Cell Biol Int 2023; 47:1728-1736. [PMID: 37369952 DOI: 10.1002/cbin.12064] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/22/2023] [Accepted: 06/18/2023] [Indexed: 06/29/2023]
Abstract
Several studies have revealed that vitamin D deficiency is linked to an increased risk of developing coronavirus disease 19 (COVID-19). In individuals with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections, vitamin D receptor activation is required to decrease acute respiratory distress syndrome. The purpose of this study was to examine the genotypic distribution and allelic frequencies of CDX2 rs11568820 and EcoRV rs4516035 polymorphisms in COVID-19 patients with various SARS-CoV-2 variants. For genotyping of CDX2 rs11568820 and EcoRV rs4516035 polymorphisms, we used the polymerase chain reaction-restriction fragment length polymorphism technique in 1734 and 1450 recovered and deceased patients, respectively. The results indicated the rate of COVID-19 mortality was associated with CDX2 rs11568820 AA and GA genotypes in the Delta variant and with CDX2 rs11568820 AA in the Omicron BA.5 variant, while no association was shown in the Alpha variant. Therefore, the rate of COVID-19 mortality was associated with EcoRV rs4516035 TC and CC genotypes in the Delta variant, while no association was shown in the Alpha and Omicron BA.5 variants. According to our analysis, the T-G haplotype was more common in all SARS-CoV-2 variants. The C-A haplotype was associated with COVID-19 mortality in the Delta and Omicron BA.5 variants, and the T-A haplotype was related to the Alpha variant. In conclusion, the genotype frequencies of the CDX2 rs11568820 and EcoRV rs4516035 polymorphisms between SARS-CoV-2 variants were significantly different between the deceased patients and recovered patients. However, more studies should be done to confirm the results.
Collapse
Affiliation(s)
| | - Enayat Anvari
- Clinical Research Development Unit, Shahid Mostafa Khomeini Hospital, Ilam University of Medical Science, Ilam, Iran
| | - Abolfazl Fateh
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran, Iran
- Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran, Iran
| |
Collapse
|
14
|
Qiu Y, Bao W, Tian X, Zhang Y, Pan Y, Xie G, Bao A, Yin D, Zhang M, Zhou Y. Vitamin D status in hospitalized COVID‑19 patients is associated with disease severity and IL-5 production. Virol J 2023; 20:212. [PMID: 37705107 PMCID: PMC10500897 DOI: 10.1186/s12985-023-02165-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/23/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND There are many studies on the relationship between vitamin D and coronavirus disease 2019 (COVID-19), while the results are matters of debate and the mechanisms remain unknown. The present study was performed to assess the impact of serum 25-hydroxyvitamin D [25(OH)D] levels on the severity of disease in hospitalized COVID-19 patients and identify potential mechanisms of 25(OH)D alterations. METHODS A total of 399 hospitalized COVID-19 patients were recruited from three centers between December 19, 2022, and February 1, 2023. Medical history, laboratory examination, and radiologic data were retrospectively collected. The patients were divided into four groups based on disease severity. Serum 25(OH)D levels in the patients were determined by the electrochemiluminescence method and cytokines were detected by flow cytometry. The relationship between serum 25(OH)D status and the severity of COVID-19, and the correlation between 25(OH)D levels and cytokines in COVID-19 patients were assessed. RESULTS Levels of 25(OH)D were significantly lower in the deceased group than in the other three groups (P < 0.05), and lower in the critical group than in the general group (P < 0.05). There were no significant differences in the 25(OH)D levels between the general and severe groups (P > 0.05). The levels of 25(OH)D (odds ratio = 0.986, 95% confidence interval: 0.973-0.998, P = 0.024) and IL-5 (odds ratio = 1.239, 95% confidence interval: 1.104-1.391, P = 0.04) were independent risk factors for the severity of COVID-19 disease upon admission. Serum 25(OH)D levels were able to predict the mortality of patients with COVID-19, and the predictive value was even higher when combined with IL-5 levels and eosinophil (Eos) count. Circulating 25(OH)D status correlated negatively with the expression of IL-5 (r=-0.262, P < 0.001) and was positively linked with CD8+ T cell counts (r=-0.121, P < 0.05) in patients with COVID-19. CONCLUSIONS This study found that the serum 25(OH)D status combined with IL-5 levels and Eos counts could be identified as a predictive factor for recognizing the risk of COVID-19 mortality. The serum 25(OH)D status in COVID-19 patients correlated negatively with the expression of IL-5. The potential mechanism for this relationship is worth further exploration.
Collapse
Affiliation(s)
- Yali Qiu
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital of Nanjing Medical University, Shanghai, China
- Department of Respiratory and Critical Care Medicine, Changzhou Medical Center, Changzhou Third People's Hospital, Nanjing Medical University, Changzhou, China
| | - Wuping Bao
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xue Tian
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yingying Zhang
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yilin Pan
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guogang Xie
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Aihua Bao
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dongning Yin
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min Zhang
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Yan Zhou
- Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| |
Collapse
|
15
|
Memar EHE, Mohsenipour R, Sadrosadat ST, Rostami P. Pediatric endocrinopathies related to COVID-19: an update. World J Pediatr 2023; 19:823-834. [PMID: 36480134 PMCID: PMC9734372 DOI: 10.1007/s12519-022-00662-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 11/20/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is a disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the seventh coronavirus to be linked to human disease. The SARS-CoV-2 virus may have several pathophysiologic interactions with endocrine systems, resulting in disruptions in glucose metabolism, hypothalamus and pituitary function, adrenal function, and mineral metabolism. An increasing amount of evidence demonstrates both the influence of underlying endocrine abnormalities on the outcome of COVID-19 and the effect of the SARS-CoV-2 virus on endocrine systems. However, a systematic examination of the link to pediatric endocrine diseases has been missing. DATA SOURCES The purpose of this review is to discuss the impact of SARS-CoV-2 infection on endocrine systems and to summarize the available knowledge on COVID-19 consequences in children with underlying endocrine abnormalities. For this purpose, a literature search was conducted in EMBASE, and data that were discussed about the effects of COVID-19 on endocrine systems were used in the current study. RESULTS Treatment suggestions were provided for endocrinopathies associated with SARS-CoV-2 infection. CONCLUSIONS With the global outbreak of COVID-19, it is critical for pediatric endocrinologists to understand how SARS-CoV-2 interacts with the endocrine system and the therapeutic concerns for children with underlying problems who develop COVID-19. While children and adults share certain risk factors for SARS-CoV-2 infection sequelae, it is becoming obvious that pediatric responses are different and that adult study results cannot be generalized. While pediatric research gives some insight, it also shows the need for more study in this area.
Collapse
Affiliation(s)
| | - Reihaneh Mohsenipour
- Growth and Development Research Center, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Taravat Sadrosadat
- Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Children's Medical Center, Pediatric Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
| | - Parastoo Rostami
- Growth and Development Research Center, Department of Endocrinology and Metabolism, Pediatric Center of Excellence, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
16
|
Chen Y, Wu Y, Ran W, Yuan J, Yang Z, Chen S, Wang Y. Early oral nutritional supplement improves COVID-19 outcomes among hospitalized older patients during the Omicron wave. Nutrition 2023; 113:112087. [PMID: 37354650 PMCID: PMC10200278 DOI: 10.1016/j.nut.2023.112087] [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: 02/19/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 06/26/2023]
Abstract
OBJECTIVES The effect of and optimal timing for initiating an oral nutritional supplement(ONS) in hospitalized older patients with the Omicron variant infection remain unclear. The aim of this study was to explore the associations between the ONS and clinical outcomes. METHODS This study used a retrospective cohort design as primary analysis and a case-control design as sensitivity analysis. We collected data from patients with confirmed coronavirus disease 2019 (COVID-19) between April 2022 and June 2022 at Shanghai Fourth People's Hospital, one of the designated medical centers for COVID-19 in Shanghai, China. Patients were identified as ONS users or non-ONS users, with the former defined as early ONS (ONS initiated within 48 h from hospital admission), and late ONS (ONS initiated after 48 h) users. RESULTS The study included 1181 hospitalized patients ≥60 y of age. The mean age of the cohort was 78 y, and most patients were women (57.7%). Mortalities after propensity-score matching were 1.2% and 4.3% in the ONS group and non-ONS groups, respectively (P = 0.032). Subgroup analysis results showed that median (IQR) hospital length of stay and the median (IQR) length from symptom onset to viral clearance were shorter for the early ONS than for the late ONS group (9 [6-13] d versus 14 [11 -18] d; P < 0.001, and 11 [8-17] d versus 17 [13-22] d; P < 0.001, respectively). The findings from the case-control analysis supported those from the primary analysis. CONCLUSIONS Early ONS might have significantly lowered risk for in-hospital death, as well as reduce hospital length of stay and days of viral clearance in older patients with COVID-19 during the Omicron wave.
Collapse
Affiliation(s)
- Ying Chen
- Department of Clinical Nutrition, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yinfan Wu
- Department of Clinical Nutrition, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Wei Ran
- Department of Clinical Nutrition, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jingjue Yuan
- Department of Clinical Nutrition, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zhangwei Yang
- Department of Medical Administration, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shunjie Chen
- Department of Medical Administration, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China.
| | - Ying Wang
- Department of Clinical Nutrition, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| |
Collapse
|
17
|
Mbata MK, Hunziker M, Makhdoomi A, Lüthi-Corridori G, Boesing M, Giezendanner S, Muser J, Leuppi-Taegtmeyer AB, Leuppi JD. Is Serum 25-Hydroxyvitamin D Level Associated with Severity of COVID-19? A Retrospective Study. J Clin Med 2023; 12:5520. [PMID: 37685586 PMCID: PMC10488373 DOI: 10.3390/jcm12175520] [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: 07/17/2023] [Revised: 08/19/2023] [Accepted: 08/23/2023] [Indexed: 09/10/2023] Open
Abstract
(1) Background: SARS-COV2 infection has a clinical spectrum ranging from asymptomatic infection to COVID-19 with acute respiratory distress syndrome (ARDS). Although vitamin D deficiency is often found in patients with ARDS, its role in COVID-19 is not clear. The aim of this study was to explore a possible association between serum 25-hydroxyvitamin D levels and the severity of COVID-19 in hospitalised patients. (2) Methods: In this retrospective observational study, we analysed data from 763 patients hospitalised for COVID-19 in 2020 and 2021. Patients were included in the study if serum 25-hydroxyvitamin D was assessed 30 days before or after hospital admission. Vitamin D deficiency was defined as <50 nmol/L (<20 ng/mL). The primary outcome was COVID-19 severity. (3) Results: The overall median serum 25-hydroxyvitamin D level was 54 nmol/L (IQR 35-76); 47% of the patients were vitamin D deficient. Most patients had mild to moderate COVID-19 and no differences were observed between vitamin D deficient and non-deficient patients (81% vs. 84% of patients, respectively p = 0.829). (4) Conclusion: No association was found between serum 25-hydroxyvitamin D levels and COVID-19 severity in this large observational study conducted over 2 years of the pandemic.
Collapse
Affiliation(s)
- Munachimso Kizito Mbata
- Cantonal Hospital Baselland, University Center of Internal Medicine, Rheinstrasse 26, 4410 Liestal, Switzerland
- Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland
| | - Mireille Hunziker
- Cantonal Hospital Baselland, University Center of Internal Medicine, Rheinstrasse 26, 4410 Liestal, Switzerland
- Center for Rehabilitation and Geriatrics, Cantonal Hospital Baselland, Gemeindeholzweg, 4101 Bruderholz, Switzerland
| | - Anja Makhdoomi
- Cantonal Hospital Baselland, University Center of Internal Medicine, Rheinstrasse 26, 4410 Liestal, Switzerland
| | - Giorgia Lüthi-Corridori
- Cantonal Hospital Baselland, University Center of Internal Medicine, Rheinstrasse 26, 4410 Liestal, Switzerland
- Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland
| | - Maria Boesing
- Cantonal Hospital Baselland, University Center of Internal Medicine, Rheinstrasse 26, 4410 Liestal, Switzerland
- Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland
| | - Stéphanie Giezendanner
- Cantonal Hospital Baselland, University Center of Internal Medicine, Rheinstrasse 26, 4410 Liestal, Switzerland
| | - Jürgen Muser
- Central Laboratories, Cantonal Hospital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland
| | - Anne B. Leuppi-Taegtmeyer
- Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland
- Hospital Pharmacy, Cantonal Hospital Baselland, Rheinstrasse 26, 4410 Liestal, Switzerland
- Department of Patient Safety, Medical Directorate, University Hospital Basel, Schanzenstrasse 55, 4056 Basel, Switzerland
| | - Jörg D. Leuppi
- Cantonal Hospital Baselland, University Center of Internal Medicine, Rheinstrasse 26, 4410 Liestal, Switzerland
- Faculty of Medicine, University of Basel, Klingelbergstrasse 61, 4056 Basel, Switzerland
| |
Collapse
|
18
|
Alvi MM, Imtiaz N, Shabbir B, Waheed Z, Atta-ur-Rehman. Evaluating the role of antioxidant therapy in outcome of severe and critical COVID-19 infection requiring high flow oxygen. Lung India 2023; 40:333-338. [PMID: 37417086 PMCID: PMC10401983 DOI: 10.4103/lungindia.lungindia_369_22] [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: 07/19/2022] [Revised: 11/01/2022] [Accepted: 11/08/2022] [Indexed: 07/08/2023] Open
Abstract
Objective To determine the efficacy of antioxidant therapy in the outcome of critical COVID-19-infected patients. Methods At the Patel Hospital, a retrospective cohort analysis was carried out between June 2020 and October 2021. The study included a record of 200 individuals with severe or critical stage COVID-19 who were older than 18 and of either gender. Based on the antioxidant therapy, study participants were placed evenly into two groups. Antioxidant therapy was provided to one group (the exposed group), whereas the other group received simply normal COVID-19 medication (the unexposed group). Outcomes from both groups were evaluated and compared. Results Patients on antioxidant therapy had lesser mortality and shorter hospital stay than patients on coventional management, but the difference in proportions of mortality and length of hospital stay was statistically insignificant between groups (p > 0.05). Patients on antioxidant therapy had a significantly higher proportion of moderate to severe ARDS and septic shock than unexposed patients. A significantly higher number of patients in the unexposed group had AKI as compared to the exposed group (p = 0.048). Conclusions Antioxidant therapy seems to have a non-significant positive effect on mortality, hospital stay, and AKI, while it showed a negative effect on the severity of ARDS and septic shock.
Collapse
Affiliation(s)
- Malick Maria Alvi
- Department of Medicine, Patel Hospital, Street 18, Block 4, Gulshan-e-Iqbal, Karachi, Pakistan
| | - Nimra Imtiaz
- Department of Medicine, Patel Hospital, Street 18, Block 4, Gulshan-e-Iqbal, Karachi, Pakistan
| | - Bushra Shabbir
- Department of Medicine, Patel Hospital, Street 18, Block 4, Gulshan-e-Iqbal, Karachi, Pakistan
| | - Zeeshan Waheed
- Department of Medicine, Patel Hospital, Street 18, Block 4, Gulshan-e-Iqbal, Karachi, Pakistan
| | - Atta-ur-Rehman
- Department of Medicine, Patel Hospital, Street 18, Block 4, Gulshan-e-Iqbal, Karachi, Pakistan
| |
Collapse
|
19
|
Charkowick SV, Logothetis CN, Tsay K, Jordan A, Hanna C, Zhang S, Coughlin E, Weppelmann TA, Mhaskar R, Oxner A. A Retrospective Analysis of Vitamin D Levels in Hospitalized COVID-19 Patients With Suspected Pulmonary Embolism. Cureus 2023; 15:e41805. [PMID: 37575807 PMCID: PMC10422855 DOI: 10.7759/cureus.41805] [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: 05/24/2023] [Accepted: 07/12/2023] [Indexed: 08/15/2023] Open
Abstract
Introduction Despite using anti-coagulation therapy in hospitalized coronavirus disease 2019 (COVID-19) patients, they have high rates of pulmonary embolism (PE) and deep vein thrombosis (DVT). The main objective of this study was to evaluate the association between vitamin D deficiency and thrombotic events (defined as the occurrence of a new PE or DVT) in hospitalized COVID-19 patients. Materials and Methods This was a retrospective, cross-sectional study of 208 hospitalized COVID-19 patients who received a computed tomographic pulmonary angiography (CTPA) based on clinical suspicion of PE between January 1, 2020, and February 5, 2021. A <20 ng/mL serum vitamin D level was used to categorize vitamin D deficiency. Nonparametric tests and multivariate binary logistic regression were used to evaluate the association between serum vitamin D levels and clinical outcomes. Results The mean vitamin D level was 26.7±13.0 ng/mL (n=208), and approximately one-third of patients were vitamin D deficient (n=68, 32.7%). No association was found between vitamin D deficiency and the occurrence of thrombotic events. The incidence of PE was 19.1% in vitamin D deficient patients compared to 11.4% in vitamin D sufficient patients (p=0.13). Vitamin D deficiency was positively associated with ICU admission (OR 3.047, 95%CI 1.57-5.91, p=0.001) and mortality (OR 3.76, 95%CI 1.29-11.01, p=0.016). Conclusions This study found no association between vitamin D deficiency and the occurrence of a new PE or DVT in hospitalized COVID-19 patients. Patients with vitamin D deficiency were more likely to be admitted to the ICU and had increased overall mortality.
Collapse
Affiliation(s)
- Shaun V Charkowick
- College of Medicine, University of South Florida Health Morsani College of Medicine, Tampa, USA
| | - Constantine N Logothetis
- Department of Internal Medicine, University of South Florida Health Morsani College of Medicine, Tampa, USA
| | - Katherine Tsay
- College of Medicine, University of South Florida Health Morsani College of Medicine, Tampa, USA
| | - Aryanna Jordan
- Department of Internal Medicine, University of South Florida Health Morsani College of Medicine, Tampa, USA
| | - Catherine Hanna
- College of Medicine, University of South Florida Health Morsani College of Medicine, Tampa, USA
| | - Sherry Zhang
- College of Medicine, University of South Florida Health Morsani College of Medicine, Tampa, USA
- Department of Medicine, Kaiser Permanente Oakland Medical Center, Oakland, USA
| | - Emily Coughlin
- College of Medicine, University of South Florida Health Morsani College of Medicine, Tampa, USA
| | - Thomas A Weppelmann
- Department of Ophthalmology, University of South Florida Health Morsani College of Medicine, Tampa, USA
| | - Rahul Mhaskar
- Department of Internal Medicine, University of South Florida Health Morsani College of Medicine, Tampa, USA
| | - Asa Oxner
- Department of Internal Medicine, University of South Florida Health Morsani College of Medicine, Tampa, USA
| |
Collapse
|
20
|
Beheshti M, Neisi N, Parsanahad M, Rasti M, Nashibi R, Cheraghian B. Correlation of vitamin D levels with serum parameters in Covid-19 patients. Clin Nutr ESPEN 2023; 55:325-331. [PMID: 37202065 DOI: 10.1016/j.clnesp.2023.04.012] [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: 01/26/2023] [Revised: 04/05/2023] [Accepted: 04/17/2023] [Indexed: 05/20/2023]
Abstract
BACKGROUND It is well-established that vitamins have many beneficial roles and protect humans against inflammatory diseases. Vitamin D, a lipid-soluble vitamin, plays a crucial role in viral infections. Therefore, this study aimed to investigate if serum 25(OH)D levels affect morbidity, mortality, and levels of inflammatory parameters in COVID-19 patients. METHODS 140 COVID-19 patients participated in this study (65 outpatients and 75 inpatients). Their blood samples were collected to determine TNFα, IL-6, D-dimer, zinc, Ca2+, and 25(OH)D levels. Patients with O2 saturation <93% were admitted and hospitalized in the infectious disease ward (inpatient group). Patients with O2 saturation >93% received routine treatment and were discharged (Outpatient group). RESULTS The serum levels of 25(OH)D in the inpatient group were significantly lower than those in the outpatient group (p < 0.001). Serum TNF-α, IL-6, and D-dimer levels in the inpatient group were significantly higher than those in the outpatient group (p < 0.001). Serum TNF-α, IL-6, and D-dimer levels were inversely correlated with 25(OH)D levels. No significant differences were observed in the serum levels of zinc and Ca2+ between the studied groups (p = 0.96, p = 0.41 respectively). Ten out of 75 patients in the inpatient group were admitted to ICU (intubated). Nine out of them lost their lives (the mortality rate in ICU-admitted patients was 90%). CONCLUSIONS The lower mortality and severity of COVID-19 patients with higher 25(OH)D levels represented that this vitamin alleviates the severity of COVID-19.
Collapse
Affiliation(s)
- Masoud Beheshti
- Infectious and Tropical Diseases Research Center, Health Research Institute, Department of Medical Virology, The School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Niloofar Neisi
- Infectious and Tropical Diseases Research Center, Health Research Institute, Department of Medical Virology, The School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Mehdi Parsanahad
- Infectious and Tropical Diseases Research Center, Health Research Institute, Department of Medical Virology, The School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mojtaba Rasti
- Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Roohangiz Nashibi
- Infectious and Tropical Diseases Research Center, Health Research Institute, Infectious Diseases and Tropical Medicine Ward, Razi Teaching Hospital, Ahvaz Jundishapur University of Medical Science, Ahvaz, Iran
| | - Bahman Cheraghian
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| |
Collapse
|
21
|
Sedaghat M, Talebi-Ghane E, Goodarzi A, Kamkari S, Anvari R, Beheshti rouy R, Radnia N. Evaluation of Vitamin D Serum Levels in Pregnant Women with COVID-19 Compared with the Control Group in Pregnant Women: A Case-Control Study. SN COMPREHENSIVE CLINICAL MEDICINE 2023; 5:140. [PMID: 37193317 PMCID: PMC10170026 DOI: 10.1007/s42399-023-01478-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/28/2023] [Indexed: 05/18/2023]
Abstract
The findings of studies on serum 25-hydroxy-vitamin D [25(OH) D] levels in pregnant women with or without coronavirus disease 2019 (COVID-19) were found to be controversial and inadequate. The present study was thus carried out at to fill the gap felt in this regard. In this case-control study, 63 pregnant women with singleton pregnancy who were infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and 62 pregnant women who were matched for gestational age and not infected by COVID-19 were examined. Based on clinical symptoms, the patients with COVID-19 were divided into three groups: mild, moderate, and severe. ELISA method was adopted to measure [25(OH) D] level. The [25(OH) D] means of 23.4 ± 9.2 ng/ml and 31.2 ± 0.15 ng/ml were noted in the case and control groups, respectively (p < 0.001). The [25(OH) D] level of lower than 30 ng/ml was observed in 43.5% of the control group (n = 27) and 71.4% of the case group (n = 45; p = 0.002). Multivariate linear regression analysis to match age, gestational age, [25(OH) D] supplement use, and number of pregnancies showed that [25(OH) D] mean in the case group is 8.2 units lower, compared to the control group (p < 0.001). The [25(OH) D] level in pregnant women with COVID-19 is lower, compared to non-infected pregnant women. However, there is no significant relationship between [25(OH) D] level and disease severity. A sufficient level of [25(OH) D] may protect pregnant women against COVID-19.
Collapse
Affiliation(s)
- Maryam Sedaghat
- Resident of obstetrics and gynecology , clinical research development unit of fatemieh hospital , department of gynecology , school of medicine, Hamadan university of medical sciences, Hamadan, Iran
| | - Elaheh Talebi-Ghane
- Assistant professor of biostatistics , Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Science, Hamadan, Iran
| | - Aryan Goodarzi
- General Physician, Clinical Research Development Unit of Fatemieh Hospital, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran, Hamadan, Iran
| | - Sima Kamkari
- Assistant Professor of Obstetrics and Gynecology, Clinical Research Development Unit of Fatemieh Hospital, Department of Gynecology , School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Roghayeh Anvari
- Assistant Professor of Obstetrics and Gynecology, Fellowship of Infertility Fellowship Clinical Research Development Unit of Fatemieh Hospital, Department of Gynecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Rezvaneh Beheshti rouy
- Clinical Research Development Unit of Fatemieh Hospital, Department of Gynecology, School of Medicine, , Hamadan University of Medical Sciences, Hamadan, Iran
| | - Nahid Radnia
- Assistant Professor of Obstetrics and Gynecology, Fellowship of Female pelvic Floor disorders, Clinical Research Development Unit of Fatemieh Hospital, Department of Gynecology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| |
Collapse
|
22
|
Novakovic V, Benfield T, Jørgensen HL, Mitchell NH. Vitamin D as a prognostic biomarker in COVID-19: single-center study and meta-analyses. Scand J Clin Lab Invest 2023; 83:173-182. [PMID: 37067370 DOI: 10.1080/00365513.2023.2191333] [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: 08/26/2022] [Accepted: 03/12/2023] [Indexed: 04/18/2023]
Abstract
Vitamin D was investigated as a prognostic biomarker in COVID-19, in relation to both disease susceptibility and outcomes in infected individuals. Patients admitted to the hospital with a confirmed COVID-19 diagnosis were included if they had a vitamin D measurement prior to hospitalization. Using age- and sex-matched controls, vitamin D levels were investigated for an association with COVID-19 related hospitalizations. Further, vitamin D levels were investigated for an association with 30-day mortality in hospitalized COVID-19 patients. Additionally, three meta-analyses were conducted, investigating the association of vitamin D with the following outcomes: Having a positive SARS-CoV-2 test, hospitalization with COVID-19, and mortality in COVID-19 patients. A total of 685 hospitalized COVID-19 patients were included in the single-center study. Compared to controls, they had higher vitamin D levels. Unadjusted analysis of these 685 cases found higher vitamin D levels associated with increased 30-day mortality. This association disappeared after adjusting for age. In the fully adjusted model, no association between vitamin D and 30-day mortality was found. The meta-analyses found significant associations between lower vitamin D and having a positive SARS-CoV-2 test, and mortality among hospital-admitted COVID-19 patients. The relationship between lower vitamin D and COVID-19 related hospital admissions trended towards being positive but was not statistically significant. Many factors seem to influence the associations between vitamin D and COVID-19 related outcomes. Consequently, we do not believe that vitamin D in and of itself is likely to be a clinically useful and widely applicable predictor for the susceptibility and severity of COVID-19 infections.
Collapse
Affiliation(s)
- Vasilije Novakovic
- Department of Clinical Biochemistry, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark
| | - Thomas Benfield
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Infectious Diseases, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark
| | - Henrik Løvendahl Jørgensen
- Department of Clinical Biochemistry, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Nikki Have Mitchell
- Department of Clinical Biochemistry, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre, Denmark
| |
Collapse
|
23
|
Moon Y. Gut distress and intervention via communications of SARS-CoV-2 with mucosal exposome. Front Public Health 2023; 11:1098774. [PMID: 37139365 PMCID: PMC10150023 DOI: 10.3389/fpubh.2023.1098774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 03/27/2023] [Indexed: 05/05/2023] Open
Abstract
Acute coronavirus disease 2019 (COVID-19) has been associated with prevalent gastrointestinal distress, characterized by fecal shedding of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA or persistent antigen presence in the gut. Using a meta-analysis, the present review addressed gastrointestinal symptoms, such as nausea, vomiting, abdominal pain, and diarrhea. Despite limited data on the gut-lung axis, viral transmission to the gut and its influence on gut mucosa and microbial community were found to be associated by means of various biochemical mechanisms. Notably, the prolonged presence of viral antigens and disrupted mucosal immunity may increase gut microbial and inflammatory risks, leading to acute pathological outcomes or post-acute COVID-19 symptoms. Patients with COVID-19 exhibit lower bacterial diversity and a higher relative abundance of opportunistic pathogens in their gut microbiota than healthy controls. Considering the dysbiotic changes during infection, remodeling or supplementation with beneficial microbial communities may counteract adverse outcomes in the gut and other organs in patients with COVID-19. Moreover, nutritional status, such as vitamin D deficiency, has been associated with disease severity in patients with COVID-19 via the regulation of the gut microbial community and host immunity. The nutritional and microbiological interventions improve the gut exposome including the host immunity, gut microbiota, and nutritional status, contributing to defense against acute or post-acute COVID-19 in the gut-lung axis.
Collapse
Affiliation(s)
- Yuseok Moon
- Laboratory of Mucosal Exposome and Biomodulation, Department of Integrative Biomedical Sciences, Pusan National University, Yangsan-si, Republic of Korea
- Biomedical Research Institute, Pusan National University, Busan, Republic of Korea
- Graduate Program of Genomic Data Sciences, Pusan National University, Yangsan-si, Republic of Korea
| |
Collapse
|
24
|
Ceja-Gálvez HR, Renteria-Flores FI, Nicoletti F, Hernández-Bello J, Macedo-Ojeda G, Muñoz-Valle JF. Severe COVID-19: Drugs and Clinical Trials. J Clin Med 2023; 12:2893. [PMID: 37109231 PMCID: PMC10142549 DOI: 10.3390/jcm12082893] [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: 02/27/2023] [Revised: 04/08/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
By January of 2023, the COVID-19 pandemic had led to a reported total of 6,700,883 deaths and 662,631,114 cases worldwide. To date, there have been no effective therapies or standardized treatment schemes for this disease; therefore, the search for effective prophylactic and therapeutic strategies is a primary goal that must be addressed. This review aims to provide an analysis of the most efficient and promising therapies and drugs for the prevention and treatment of severe COVID-19, comparing their degree of success, scope, and limitations, with the aim of providing support to health professionals in choosing the best pharmacological approach. An investigation of the most promising and effective treatments against COVID-19 that are currently available was carried out by employing search terms including "Convalescent plasma therapy in COVID-19" or "Viral polymerase inhibitors" and "COVID-19" in the Clinicaltrials.gov and PubMed databases. From the current perspective and with the information available from the various clinical trials assessing the efficacy of different therapeutic options, we conclude that it is necessary to standardize certain variables-such as the viral clearance time, biomarkers associated with severity, hospital stay, requirement of invasive mechanical ventilation, and mortality rate-in order to facilitate verification of the efficacy of such treatments and to better assess the repeatability of the most effective and promising results.
Collapse
Affiliation(s)
- Hazael Ramiro Ceja-Gálvez
- Institute of Research in Biomedical Sciences, University Center of Health Sciences (CUCS), University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Francisco Israel Renteria-Flores
- Institute of Research in Biomedical Sciences, University Center of Health Sciences (CUCS), University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Ferdinando Nicoletti
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Jorge Hernández-Bello
- Institute of Research in Biomedical Sciences, University Center of Health Sciences (CUCS), University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - Gabriela Macedo-Ojeda
- Institute of Research in Biomedical Sciences, University Center of Health Sciences (CUCS), University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| | - José Francisco Muñoz-Valle
- Institute of Research in Biomedical Sciences, University Center of Health Sciences (CUCS), University of Guadalajara, Guadalajara 44340, Jalisco, Mexico
| |
Collapse
|
25
|
Zaazouee MS, Eleisawy M, Abdalalaziz AM, Elhady MM, Ali OA, Abdelbari TM, Hasan SM, Almadhoon HW, Ahmed AY, Fassad AS, Elgendy R, Abdel-Baset EA, Elsayed HA, Elsnhory AB, Abdraboh AB, Faragalla HM, Elshanbary AA, Kensara OA, Abdel-Daim MM. Hospital and laboratory outcomes of patients with COVID-19 who received vitamin D supplementation: a systematic review and meta-analysis of randomized controlled trials. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2023; 396:607-620. [PMID: 36508011 PMCID: PMC9743115 DOI: 10.1007/s00210-022-02360-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 12/02/2022] [Indexed: 12/14/2022]
Abstract
Coronavirus disease 2019 (COVID-19) has a wide-ranging spectrum of clinical symptoms, from asymptomatic/mild to severe. Recent research indicates that, among several factors, a low vitamin D level is a modifiable risk factor for COVID-19 patients. This study aims to evaluate the effect of vitamin D on hospital and laboratory outcomes of patients with COVID-19.Five databases (PubMed, Embase, Scopus, Web of Science, and Cochrane Library) and clinicaltrials.gov were searched until July 2022, using relevant keywords/Mesh terms. Only randomized clinical trials (RCTs) that addressed the topic were included. The Cochrane tool was used to assess the studies' risk of bias, and the data were analyzed using the review manager (RevMan 5.4).We included nine RCTs with 1586 confirmed COVID-19 patients. Vitamin D group showed a significant reduction of intensive care unit (ICU) admission (risk ratio = 0.59, 95% confidence interval (CI) [0.41, 0.84], P = 0.003), and higher change in vitamin D level (standardized mean difference = 2.27, 95% CI [2.08, 2.47], P < 0.00001) compared to the control group. Other studied hospital and laboratory outcomes showed non-significant difference between vitamin D and the control group (P ≥ 0.05).In conclusion, vitamin D reduced the risk of ICU admission and showed superiority in changing vitamin D level compared to the control group. However, other outcomes showed no difference between the two groups. More RCTs are needed to confirm these results.
Collapse
Affiliation(s)
| | | | | | | | - Omar Adel Ali
- Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | | | - Hossam Waleed Almadhoon
- Institute of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK
| | | | | | - Rewan Elgendy
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | | | | | | | | | | | | | - Osama A Kensara
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mohamed M Abdel-Daim
- Department of Pharmaceutical Sciences, Pharmacy Program, Batterjee Medical College, Jeddah, Saudi Arabia
- Pharmacology Department, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
| |
Collapse
|
26
|
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.
Collapse
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
| |
Collapse
|
27
|
Basińska-Lewandowska M, Lewandowski K, Horzelski W, Lewiński A, Skowrońska-Jóźwiak E. Frequency of COVID-19 Infection as a Function of Vitamin D Levels. Nutrients 2023; 15:1581. [PMID: 37049423 PMCID: PMC10097275 DOI: 10.3390/nu15071581] [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: 02/24/2023] [Revised: 03/19/2023] [Accepted: 03/23/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND It has been speculated that higher concentrations of 25-hydroxy-vitamin D (25OHD) provide some protection against COVID-19. We assessed whether there is any relationship between 25OHD concentrations and the subsequent development of COVID-19 infection. MATERIALS AND METHODS Concentrations of 25OHD were measured in March-April 2020 in 134 healthy subjects (57 males), age range 6-50, from a single urban general practice in central Poland. Data on COVID-19 infection during the subsequent 12 months (prior to the vaccination program) were obtained from the national database of COVID-19 cases. None of the subjects received any 25OHD supplements. RESULTS The average 25OHD concentrations were 18.1 ± 7.39 ng/mL (37.3% had 25OHD above 20 ng/mL). Thirty-one (23.1%) patients developed COVID-19 infection, but an increased risk was only observed in individuals with 25OHD concentrations below 12 ng/mL (COVID-19 infection in 11 out of 25 patients (44%) with 25OHD < 12 ng/mL versus 20 out of 109 (18.3%) for those with 25OHD above 12 ng/mL, p = 0.0063). Such a relationship was no longer observed for subjects with 25OHD concentrations above 20 ng/mL (p = 0.2787). CONCLUSIONS Although only a minority of healthy subjects had 25OHD concentrations above 20 ng/mL in spring, an increased risk of subsequent COVID-19 infection was only observed in those with severe 25OHD deficiency (<12 ng/mL).
Collapse
Affiliation(s)
| | - Krzysztof Lewandowski
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, 90-419 Lodz, Poland; (K.L.); (A.L.)
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital—Research Institute, 93-338 Lodz, Poland
| | - Wojciech Horzelski
- Department of Mathematics and Computer Science, University of Lodz, 90-238 Lodz, Poland;
| | - Andrzej Lewiński
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, 90-419 Lodz, Poland; (K.L.); (A.L.)
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital—Research Institute, 93-338 Lodz, Poland
| | - Elżbieta Skowrońska-Jóźwiak
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, 90-419 Lodz, Poland; (K.L.); (A.L.)
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital—Research Institute, 93-338 Lodz, Poland
| |
Collapse
|
28
|
Bignardi PR, de Andrade Castello P, de Matos Aquino B, Delfino VDA. Is the vitamin D status of patients with COVID-19 associated with reduced mortality? A systematic review and meta-analysis. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2023; 67:276-288. [PMID: 36913680 PMCID: PMC10689034 DOI: 10.20945/2359-3997000000588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Accepted: 08/05/2022] [Indexed: 02/08/2023]
Abstract
To conduct a systematic review and meta-analysis of studies assessing the association between serum vitamin D status and mortality in patients with COVID- 19. We searched PubMed and Embase for studies addressing the association of serum vitamin D levels and COVID-19 mortality published until April 24, 2022. Risk ratios (RRs) and 95% confidence interval (CIs) were pooled using fixed or random effects models. The risk of bias was assessed using the Newcastle-Ottawa Scale. The meta-analysis included 21 studies that measured serum vitamin D levels close to the date of admission, of which 2 were case-control and 19 were cohort studies. Vitamin D deficiency was associated with COVID-19 mortality in the overall analysis but not when the analysis was adjusted to vitamin D cutoff levels < 10 or < 12 ng/mL (RR 1.60, 95% CI 0.93-2.27, I2 60.2%). Similarly, analyses including only studies that adjusted measures of effect for confounders showed no association between vitamin D status and death. However, when the analysis included studies without adjustments for confounding factors, the RR was 1.51 (95% CI 1.28-1.74, I2 0.0%), suggesting that confounders may have led to many observational studies incorrectly estimating the association between vitamin D status and mortality in patients with COVID-19. Deficient vitamin D levels were not associated with increased mortality rate in patients with COVID-19 when the analysis included studies with adjustments for confounders. Randomized clinical trials are needed to assess this association.
Collapse
Affiliation(s)
- Paulo R Bignardi
- Faculdade de Medicina, Pontifícia Universidade Católica do Paraná, Londrina, PR, Brasil,
| | | | - Bruno de Matos Aquino
- Faculdade de Medicina, Pontifícia Universidade Católica do Paraná, Londrina, PR, Brasil
| | - Vinicius Daher Alvares Delfino
- Faculdade de Medicina, Pontifícia Universidade Católica do Paraná, Londrina, PR, Brasil
- Universidade Estadual de Londrina, Londrina, PR, Brasil
| |
Collapse
|
29
|
Liu Y, Clare S, D'Erasmo G, Heilbronner A, Dash A, Krez A, Zaworski C, Haseltine K, Serota A, Miller A, Veiga K, Sandoval M, T Lu T, McMahon DJ, Nieves JW, Stein EM. Vitamin D and SARS-CoV-2 Infection: SERVE Study (SARS-CoV-2 Exposure and the Role of Vitamin D among Hospital Employees). J Nutr 2023; 153:1420-1426. [PMID: 36871833 PMCID: PMC9985522 DOI: 10.1016/j.tjnut.2023.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND Recognition of the role of vitamin D in immune function has led to interest in its relationship with SARS-CoV-2 infection. Although clinical studies to date have had conflicting results, many individuals currently take high doses of vitamin D to prevent infection. The goal of this study was to investigate the relationship between serum 25-hydroxyvitamin D (25OHD) and vitamin D supplement use with incident SARS-CoV-2 infection. METHODS In this prospective cohort study, 250 health care workers were enrolled at a single institution and observed for 15 mo. Participants completed questionnaires every 3 mo regarding new SARS-CoV-2 infection, vaccination, and supplement use. Serum was drawn at baseline, 6, and 12 mo for 25OHD and SARS-CoV-2 nucleocapsid antibodies. RESULTS The mean age of the participants was 40 y, BMI 26 kg/m2, 71% were Caucasian, and 78% female. Over 15 mo, 56 participants (22%) developed incident SARS-CoV-2 infections. At baseline, ∼50% reported using vitamin D supplements (mean daily dose 2250 units). Mean serum 25OHD was 38 ng/mL. Baseline 25OHD did not predict incident SARS-CoV-2 infection (OR: 0.98; 95% CI: 0.80, 1.20). Neither the use of vitamin D supplements (OR: 1.18; 95% CI: 0.65, 2.14) or supplement dose was associated with incident infection (OR: 1.01 per 100-units increase; 95% CI: 0.99, 1.02). CONCLUSION In this prospective study of health care workers, neither serum 25OHD nor the use of vitamin D supplements was associated with the incident SARS-CoV-2 infection. Our findings argue against the common practice of consuming high-dose vitamin D supplements for the presumed prevention of COVID-19.
Collapse
Affiliation(s)
- Yi Liu
- Division of Endocrinology, Hospital for Special Surgery, New York, NY, United States; Metabolic Bone Service, Hospital for Special Surgery, New York, United States
| | - Shannon Clare
- Division of Endocrinology, Hospital for Special Surgery, New York, NY, United States; Metabolic Bone Service, Hospital for Special Surgery, New York, United States
| | - Gia D'Erasmo
- Division of Endocrinology, Hospital for Special Surgery, New York, NY, United States; Metabolic Bone Service, Hospital for Special Surgery, New York, United States
| | - Alison Heilbronner
- Division of Endocrinology, Hospital for Special Surgery, New York, NY, United States; Metabolic Bone Service, Hospital for Special Surgery, New York, United States
| | - Alexander Dash
- Division of Endocrinology, Hospital for Special Surgery, New York, NY, United States; Metabolic Bone Service, Hospital for Special Surgery, New York, United States
| | - Alexandra Krez
- Division of Endocrinology, Hospital for Special Surgery, New York, NY, United States; Metabolic Bone Service, Hospital for Special Surgery, New York, United States
| | - Caroline Zaworski
- Division of Endocrinology, Hospital for Special Surgery, New York, NY, United States; Metabolic Bone Service, Hospital for Special Surgery, New York, United States
| | - Katherine Haseltine
- Division of Endocrinology, Hospital for Special Surgery, New York, NY, United States; Metabolic Bone Service, Hospital for Special Surgery, New York, United States
| | - Alana Serota
- Metabolic Bone Service, Hospital for Special Surgery, New York, United States
| | - Andy Miller
- Division of Infectious Diseases, Hospital for Special Surgery, New York, NY, United States
| | - Keila Veiga
- Research Institute, Hospital for Special Surgery, New York, NY, United States
| | - Marvin Sandoval
- Research Institute, Hospital for Special Surgery, New York, NY, United States
| | - Theresa T Lu
- Research Institute, Hospital for Special Surgery, New York, NY, United States
| | - Donald J McMahon
- Division of Endocrinology, Hospital for Special Surgery, New York, NY, United States; Metabolic Bone Service, Hospital for Special Surgery, New York, United States
| | - Jeri W Nieves
- Metabolic Bone Service, Hospital for Special Surgery, New York, United States
| | - Emily Margaret Stein
- Division of Endocrinology, Hospital for Special Surgery, New York, NY, United States; Metabolic Bone Service, Hospital for Special Surgery, New York, United States; Research Institute, Hospital for Special Surgery, New York, NY, United States.
| |
Collapse
|
30
|
Vásquez V, Orozco J. Detection of COVID-19-related biomarkers by electrochemical biosensors and potential for diagnosis, prognosis, and prediction of the course of the disease in the context of personalized medicine. Anal Bioanal Chem 2023; 415:1003-1031. [PMID: 35970970 PMCID: PMC9378265 DOI: 10.1007/s00216-022-04237-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/30/2022] [Accepted: 07/18/2022] [Indexed: 02/07/2023]
Abstract
As a more efficient and effective way to address disease diagnosis and intervention, cutting-edge technologies, devices, therapeutic approaches, and practices have emerged within the personalized medicine concept depending on the particular patient's biology and the molecular basis of the disease. Personalized medicine is expected to play a pivotal role in assessing disease risk or predicting response to treatment, understanding a person's health status, and, therefore, health care decision-making. This work discusses electrochemical biosensors for monitoring multiparametric biomarkers at different molecular levels and their potential to elucidate the health status of an individual in a personalized manner. In particular, and as an illustration, we discuss several aspects of the infection produced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as a current health care concern worldwide. This includes SARS-CoV-2 structure, mechanism of infection, biomarkers, and electrochemical biosensors most commonly explored for diagnostics, prognostics, and potentially assessing the risk of complications in patients in the context of personalized medicine. Finally, some concluding remarks and perspectives hint at the use of electrochemical biosensors in the frame of other cutting-edge converging/emerging technologies toward the inauguration of a new paradigm of personalized medicine.
Collapse
Affiliation(s)
- Viviana Vásquez
- Max Planck Tandem Group in Nanobioengineering, Institute of Chemistry, Faculty of Natural and Exact Sciences, University of Antioquia, Complejo Ruta N, Calle 67 N° 52-20, Medellín, 050010, Colombia
| | - Jahir Orozco
- Max Planck Tandem Group in Nanobioengineering, Institute of Chemistry, Faculty of Natural and Exact Sciences, University of Antioquia, Complejo Ruta N, Calle 67 N° 52-20, Medellín, 050010, Colombia.
| |
Collapse
|
31
|
Ahmed J, Thomas L, Mulla MZ, Al-Attar H, Maniruzzaman M. Dry granulation of vitamin D3 and iron in corn starch matrix: Powder flow and structural properties. Food Res Int 2023; 165:112497. [PMID: 36869503 DOI: 10.1016/j.foodres.2023.112497] [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: 08/21/2022] [Revised: 12/19/2022] [Accepted: 01/20/2023] [Indexed: 01/27/2023]
Abstract
In this work, a twin-screw dry granulation (TSDG) was adopted to produce vitamin D3 (VD3) and iron blended dry granules using corn starch as an excipient. Response surface methodology was applied to determine the effect of the formulation compositions (VD3 and iron) on granule properties [tapped bulk density, oil holding capacity, and volumetric mean particle size (Dv50)]. Results indicated that the model fitted well, and responses, in particular flow properties, were significantly affected by the composition. The Dv50 was only influenced by the addition of VD3. The flow properties were characterized by the Carr index and Hausner ratio, which indicated very poor flow of the granules. Scanning electron microscopy with energy dispersive spectroscopy confirm the presence and distribution of Fe++ and VD3 in the granules. Overall, TSDG was proven to be a simple alternative method for the preparation of dry granules of VD3 and iron in a blend.
Collapse
Affiliation(s)
- Jasim Ahmed
- Environment & Life Sciences Research Center, Kuwait Institute for Scientific Research, P.O. Box 24885, Safat 13109, Kuwait.
| | - Linu Thomas
- Environment & Life Sciences Research Center, Kuwait Institute for Scientific Research, P.O. Box 24885, Safat 13109, Kuwait
| | - Mehrajfatema Z Mulla
- Environment & Life Sciences Research Center, Kuwait Institute for Scientific Research, P.O. Box 24885, Safat 13109, Kuwait
| | - Hasan Al-Attar
- Environment & Life Sciences Research Center, Kuwait Institute for Scientific Research, P.O. Box 24885, Safat 13109, Kuwait
| | - M Maniruzzaman
- Pharmaceutical Engineering and 3D Printing Lab (PharmE3D) The Division of Molecular Pharmaceutics and Drug Delivery, College of Pharmacy The University of Texas at Austin, Austin, TX 78712, USA
| |
Collapse
|
32
|
Fernandes de Souza WD, da Fonseca DM, Sartori A. COVID-19 and Multiple Sclerosis: A Complex Relationship Possibly Aggravated by Low Vitamin D Levels. Cells 2023; 12:684. [PMID: 36899820 PMCID: PMC10000583 DOI: 10.3390/cells12050684] [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: 12/31/2022] [Revised: 01/21/2023] [Accepted: 02/08/2023] [Indexed: 02/24/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an exceptionally transmissible and pathogenic coronavirus that appeared at the end of 2019 and triggered a pandemic of acute respiratory disease, known as coronavirus disease 2019 (COVID-19). COVID-19 can evolve into a severe disease associated with immediate and delayed sequelae in different organs, including the central nervous system (CNS). A topic that deserves attention in this context is the complex relationship between SARS-CoV-2 infection and multiple sclerosis (MS). Here, we initially described the clinical and immunopathogenic characteristics of these two illnesses, accentuating the fact that COVID-19 can, in defined patients, reach the CNS, the target tissue of the MS autoimmune process. The well-known contribution of viral agents such as the Epstein-Barr virus and the postulated participation of SARS-CoV-2 as a risk factor for the triggering or worsening of MS are then described. We emphasize the contribution of vitamin D in this scenario, considering its relevance in the susceptibility, severity and control of both pathologies. Finally, we discuss the experimental animal models that could be explored to better understand the complex interplay of these two diseases, including the possible use of vitamin D as an adjunct immunomodulator to treat them.
Collapse
Affiliation(s)
- William Danilo Fernandes de Souza
- Department of Chemical and Biological Sciences, Institute of Biosciences, São Paulo State University (UNESP), Botucatu 18618-689, Brazil
| | - Denise Morais da Fonseca
- Laboratory of Mucosal Immunology, Department of Immunology, Institute of Biomedical Sciences, University of Sao Paulo, São Paulo 05508-000, Brazil
| | - Alexandrina Sartori
- Department of Chemical and Biological Sciences, Institute of Biosciences, São Paulo State University (UNESP), Botucatu 18618-689, Brazil
| |
Collapse
|
33
|
Elgormus Y, Okuyan O, Uzun H. The relationship between hematological indices as indicators of inflammation and 25-hydroxyvitamin D3 status in newborns. BMC Pediatr 2023; 23:83. [PMID: 36804004 PMCID: PMC9938614 DOI: 10.1186/s12887-023-03903-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 02/13/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND There is still much unknown about the relationship between hematological parameters and vitamin D status in newborns. The aim of the study is to evaluate the relationship between 25(OH)D3 (vitamin D) status and new defined systemic inflammatory markers neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), and platelet to lymphocyte ratio (PLR) in newborns. METHODS One hundred newborns were enrolled in the study. Serum vitamin D status, below < 12 ng/mL (< 30 nmol/L) as deficient, 12-20 ng/mL (30-50 nmol/L) as insufficient, and > 20 ng/mL (> 50 nmol/L) was considered as sufficient. RESULTS Parallel to maternal and newborn vitamin D status were also statistically different between the groups (p < 0.05). Moreover, there was a statistically significant difference was found between the deficient, sufficient and insufficient groups in terms of newborn hemoglobin, neutrophil, monocytes, NLR, PLT, PLR and neutrophil to monocyte ratio (NMR) (p < 0.05, in all). There was also a positive correlation between maternal and newborn vitamin D status (r = 0.975, p = 0.000). The newborn NLR were negative correlated with newborn vitamin D status (r = -0.616, p = 0.000). CONCLUSIONS The results of this study suggest that there may be potential new biomarkers to predict inflammation associated with the inflammatory state that may arise due to changes in NLR, LMR, and PLR in vitamin D deficiency in newborns. NLR and other hematologic indices may be non-invasive, simple, easily measurable, cost-effective markers of inflammation in newborns.
Collapse
Affiliation(s)
- Yusuf Elgormus
- Faculty of Medicine, Department of Pediatrics, Istanbul Atlas University, Medicine Hospital, Istanbul, 34408 Turkey
| | - Omer Okuyan
- Faculty of Medicine, Department of Pediatrics, Istanbul Atlas University, Medicine Hospital, Istanbul, 34408 Turkey
| | - Hafize Uzun
- Faculty of Medicine, Department of Medical Biochemistry, Istanbul Atlas University, Istanbul, Turkey.
| |
Collapse
|
34
|
D'Alessandro A, Ciavardelli D, Pastore A, Lupisella S, Cristofaro RC, Di Felice G, Salierno R, Infante M, De Stefano A, Onetti Muda A, Morello M, Porzio O. Contribution of vitamin D 3 and thiols status to the outcome of COVID-19 disease in Italian pediatric and adult patients. Sci Rep 2023; 13:2504. [PMID: 36781931 PMCID: PMC9925220 DOI: 10.1038/s41598-023-29519-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/06/2023] [Indexed: 02/15/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV-2), was declared a global pandemic by the World Health Organization (WHO) on March 2020, causing unprecedented disease with million deaths across the globe, mostly adults. Indeed, children accounted for only a few percent of cases. Italy was the first Western country struck by the COVID-19 epidemic. Increasing age, which is one of the principal risk factors for COVID-19 mortality, is associated with declined glutathione (GSH) levels. Over the last decade, several studies demonstrated that both vitamin D (VD) and GSH have immunomodulatory properties. To verify the association between VD, GSH and the outcome of COVID-19 disease, we conducted a multicenter retrospective study in 35 children and 128 adult patients with COVID-19. Our study demonstrated a hypovitaminosis D in COVID-19 patients, suggesting a possible role of low VD status in increasing the risk of COVID-19 infection and subsequent hospitalization. In addition, we find a thiol disturbance with a GSH depletion associated to the disease severity. In children, who fortunately survived, both VD and GSH levels at admission were higher than in adults, suggesting that lower VD and thiols levels upon admission may be a modifiable risk factor for adverse outcomes and mortality in hospitalized patients with COVID-19.
Collapse
Affiliation(s)
- Annamaria D'Alessandro
- Clinical Biochemistry Laboratory, IRCCS Bambino Gesù Children's Hospital, 00165, Rome, Italy
| | - Domenico Ciavardelli
- School of Medicine, University "Kore" of Enna, 94100, Enna, Italy
- Center for Advanced Studies and Technology (C.A.S.T.), G. D'Annunzio University of Chieti-Pescara, 66100, Chieti, Italy
| | - Anna Pastore
- Research Unit of Diagnostical and Management Innovations, IRCCS Bambino Gesù Children's Hospital, 00165, Rome, Italy.
| | - Santina Lupisella
- Clinical Biochemistry Department, Tor Vergata University Hospital (PTV), Rome, Italy
| | - Rosa Carmela Cristofaro
- Clinical Biochemistry Laboratory, IRCCS Bambino Gesù Children's Hospital, 00165, Rome, Italy
| | - Giovina Di Felice
- Clinical Biochemistry Laboratory, IRCCS Bambino Gesù Children's Hospital, 00165, Rome, Italy
| | - Roberta Salierno
- Clinical Biochemistry Department, Tor Vergata University Hospital (PTV), Rome, Italy
| | - Marco Infante
- Department of Systems Medicine, Diabetes Research Institute Federation (DRIF), Tor Vergata University, Rome, Italy
- UniCamillus, Saint Camillus International University of Health Sciences, Rome, Italy
- Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Rome, Italy
| | - Alberto De Stefano
- Psychiatric Unit Department of Systems Medicine, Tor Vergata University, Rome, Italy
- Volunteers Association of Tor Vergata University Hospital (PTV), Rome, Italy
| | - Andrea Onetti Muda
- Research Unit of Diagnostical and Management Innovations, IRCCS Bambino Gesù Children's Hospital, 00165, Rome, Italy
| | - Maria Morello
- Clinical Biochemistry Department, Tor Vergata University Hospital (PTV), Rome, Italy
- Clinical Biochemistry and Molecular Biology, Department of Experimental Medicine, Faculty of Medicine, Tor Vergata University, Rome, Italy
| | - Ottavia Porzio
- Clinical Biochemistry Laboratory, IRCCS Bambino Gesù Children's Hospital, 00165, Rome, Italy
- Department of Experimental Medicine, Tor Vergata University, Rome, Italy
| |
Collapse
|
35
|
Zhang JJ, Dong X, Liu GH, Gao YD. Risk and Protective Factors for COVID-19 Morbidity, Severity, and Mortality. Clin Rev Allergy Immunol 2023; 64:90-107. [PMID: 35044620 PMCID: PMC8767775 DOI: 10.1007/s12016-022-08921-5] [Citation(s) in RCA: 230] [Impact Index Per Article: 230.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2022] [Indexed: 02/06/2023]
Abstract
The outbreak of the coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become an evolving global health crisis. Currently, a number of risk factors have been identified to have a potential impact on increasing the morbidity of COVID-19 in adults, including old age, male sex, pre-existing comorbidities, and racial/ethnic disparities. In addition to these factors, changes in laboratory indices and pro-inflammatory cytokines, as well as possible complications, could indicate the progression of COVID-19 into a severe and critical stage. Children predominantly suffer from mild illnesses due to COVID-19. Similar to adults, the main risk factors in pediatric patients include age and pre-existing comorbidities. In contrast, supplementation with a healthy diet and sufficient nutrition, COVID-19 vaccination, and atopic conditions may act as protective factors against the infection of SARS-CoV-2. COVID-19 vaccination not only protects vulnerable individuals from SARS-CoV-2 infection, more importantly, it may also reduce the development of severe disease and death due to COVID-19. Currently used therapies for COVID-19 are off-label and empiric, and their impacts on the severity and mortality of COVID-19 are still unclear. The interaction between asthma and COVID-19 may be bidirectional and needs to be clarified in more studies. In this review, we highlight the clinical evidence supporting the rationale for the risk and protective factors for the morbidity, severity, and mortality of COVID-19.
Collapse
Affiliation(s)
- Jin-Jin Zhang
- Department of Allergology, Zhongnan Hospital of Wuhan University, Donghu Road 169, Wuhan, 430071, Hubei, China
- Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, 430071, Hubei, China
| | - Xiang Dong
- Department of Allergology, Zhongnan Hospital of Wuhan University, Donghu Road 169, Wuhan, 430071, Hubei, China
- Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, 430071, Hubei, China
| | - Guang-Hui Liu
- Department of Allergology, Zhongnan Hospital of Wuhan University, Donghu Road 169, Wuhan, 430071, Hubei, China
- Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, 430071, Hubei, China
| | - Ya-Dong Gao
- Department of Allergology, Zhongnan Hospital of Wuhan University, Donghu Road 169, Wuhan, 430071, Hubei, China.
- Hubei Province Key Laboratory of Allergy and Immunology, Wuhan University, Wuhan, 430071, Hubei, China.
| |
Collapse
|
36
|
Park JH, Lee Y, Choi M, Park E. The Role of Some Vitamins in Respiratory-related Viral Infections: A Narrative Review. Clin Nutr Res 2023; 12:77-89. [PMID: 36793782 PMCID: PMC9900078 DOI: 10.7762/cnr.2023.12.1.77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 01/19/2023] [Accepted: 01/25/2023] [Indexed: 02/04/2023] Open
Abstract
This study aimed to find out the effect of vitamins on respiratory-related viral infections, including coronavirus disease 2019 (COVID-19), through the literature reviews. From January 2000 to June 2021, the studies (cohort studies, cross-sectional studies, case-control studies, randomized control trials) related to vitamins (vitamin A, D, E, C, B6, folate, and B12) and COVID-19/severe acute respiratory syndrome/Middle East respiratory syndrome/cold/influenza were selected from the PubMed, Embase, and Cochrane libraries and analyzed. The relationship between vitamins and virus-related respiratory diseases was identified. Through the review, 39 studies were selected on vitamin D, one study on vitamin E, 11 studies on vitamin C, and 3 studies on folate. Regarding COVID-19, 18 studies on vitamin D, 4 studies on vitamin C, and 2 studies on folate showed significant effects of the intake of these nutrients in preventing COVID-19. Regarding colds and influenza, 3 studies on vitamin D, 1 study on vitamin E, 3 studies on vitamin C, and 1 study on folate demonstrated that the intake of these nutrients significantly prevents these diseases. Therefore, this review suggested the intake of vitamins D, E, C, and folate is important for preventing respiratory diseases related to viruses, such as COVID-19, colds, and influenza. The relationship between these nutrients and virus-related respiratory diseases should be continuously monitored in the future.
Collapse
Affiliation(s)
- Jae-Hee Park
- Department of Food and Nutrition, Kyungnam University, Changwon 51767, Korea
| | - Yunjung Lee
- Department of Food and Nutrition, Kyungnam University, Changwon 51767, Korea
| | - Mijoo Choi
- Department of Food and Nutrition, Kyungnam University, Changwon 51767, Korea
| | - Eunju Park
- Department of Food and Nutrition, Kyungnam University, Changwon 51767, Korea
| |
Collapse
|
37
|
Zhang Y, Li J, Yang M, Wang Q. Effect of vitamin D supplementation on COVID-19 patients: A systematic review and meta-analysis. Front Nutr 2023; 10:1131103. [PMID: 36960206 PMCID: PMC10027755 DOI: 10.3389/fnut.2023.1131103] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 02/21/2023] [Indexed: 03/09/2023] Open
Abstract
Objective To systematically evaluate the impact of vitamin D supplementation on mortality, ICU admission, and the rates of mechanical ventilation or intubation among COVID-19 patients. Data sources and study selection The PubMed, Embase, Cochrane Library, CBM, CNKI, VIP, and WanFang databases were searched from 1 December 2019 to 31 December 2022. The authors sought to identify randomized controlled trials and cohort studies that examined the relationship between vitamin D supplementation and mortality, ICU admission, and mechanical ventilation or intubation rates among COVID-19 patients. Data extraction and synthesis Two investigators independently searched the literature, extracted the data, and assessed the quality of the included studies. The Grading of Recommendation, Assessment, Development, and Evaluation approach was used to evaluate the quality of the evidence. Meta-analysis was conducted using RevMan 5.3, STATA 15.1, and R 4.1.3 software. Results Eight randomized controlled trials (RCTs) and eight cohort studies were included, involving 3359 COVID-19 patients. The pooled analysis of randomized controlled trials showed that vitamin D supplementation did not have a significant effect on reducing mortality (Relative Risk, RR = 0.94, 95% CI 0.69-1.29, P = 0.7), while the results of cohort studies indicated that vitamin D supplementation had a positive impact on reducing mortality among COVID-19 patients (RR = 0.33, 95% CI 0.23-0.47, P < 0.001). There was no statistically significant difference in the rates of ICU admission (RCTs: RR = 0.64, 95%CI 0.38-1.08, P = 0.10; cohort studies: RR = 0.32, 95% CI 0.08-1.29, P = 0.109) or rates of mechanical ventilation or intubation (RCTs: RR = 0.77, 95% CI 0.58-1.02, P = 0.07; cohort studies: RR = 0.93, 95% CI 0.55-1.58, P = 0.789). Conclusion The results of this systematic review and meta-analysis suggest that vitamin D supplementation does not have a significant impact on reducing mortality, ICU admission, and the rates of mechanical ventilation or intubation among COVID-19 patients. However, due to the limited number and quality of the studies included, further high-quality studies are needed to confirm these findings. Systematic review registration www.crd.york.ac.uk, identifier CRD42021299521.
Collapse
|
38
|
Pak VM, Lee J. Examining the role of micronutrients on improving long COVID sleep-related symptoms. J Clin Nurs 2022:10.1111/jocn.16326. [PMID: 36539931 PMCID: PMC9880629 DOI: 10.1111/jocn.16326] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/20/2022] [Indexed: 12/24/2022]
Abstract
AIMS AND OBJECTIVES Long COVID is defined as the continuation of symptoms for four or more weeks after initial contraction of the virus. This review article examines the role of four select micronutrients (zinc, vitamins C, D and polyphenols) for their anti-inflammatory and therapeutic potential to improve sleep-related symptoms in persons with long COVID. BACKGROUND Evidence suggests a link between long COVID and increased inflammation. There are currently no therapeutic interventions for common sleep-related symptoms associated with long COVID. Micronutrients, due to their antioxidant and anti-inflammatory properties, may have a role in the treatment of sleep-related symptoms in the context of long COVID. DESIGN A narrative literature review was conducted and guided by the PRISMA checklist. METHODS All articles were screened from PubMed, ScienceDirect, NCBI or Google Scholar and were limited to human studies. The following keywords were used: 'COVID-19', 'sleep symptoms', 'zinc', 'vitamin C', 'vitamin D', 'polyphenols' and 'micronutrients'. RESULTS There are currently no studies that examine the usage of micronutrients and its impacts on long-term, sleep-related symptoms post-COVID-19 infection. We focussed our review on prior studies that examined micronutrients in the context of sleep symptoms and inflammation, while exploring the potential for micronutrients to help improve sleep-related symptoms associated with long COVID. CONCLUSIONS There is evidence to suggest that sleep-related symptoms associated with long COVID, such as fatigue and poor sleep quality, are associated with inflammation. Zinc, vitamins C, D and polyphenols all have the potential to improve both inflammation and sleep quality to alleviate symptoms. Future research should further examine these micronutrients in the context of long COVID to improve sleep and quality of life. RELEVANCE TO CLINICAL PRACTICE This article provides implications for clinicians to be at the forefront of research on the usage of micronutrients to improve sleep-related symptoms in persons with long COVID.
Collapse
Affiliation(s)
- Victoria M. Pak
- Emory Nell Hodgson Woodruff School of NursingAtlantaGeorgiaUSA
- Department of EpidemiologyEmory Rollins School of Public HealthAtlantaGeorgiaUSA
| | - Jiyun Lee
- Emory University‐College of Arts and SciencesAtlantaGeorgiaUSA
| |
Collapse
|
39
|
Abdrabbo AlYafei N, Fathima Jaleel BN, Abdel-Salam ASG, Ali Al-Saadi H, Al Abdulla SA. Association of Serum Vitamin D level and COVID-19 infection: A Case-control Study. Qatar Med J 2022; 2022:48. [PMID: 36504923 PMCID: PMC9720159 DOI: 10.5339/qmj.2022.48] [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: 05/31/2022] [Accepted: 08/22/2022] [Indexed: 12/07/2022] Open
Abstract
BACKGROUND Vitamin D is considered a potent modulator of the immune system, albeit its role in COVID-19 infection is a matter of debate. The present study aimed to estimate the association between serum vitamin D levels and COVID-19 among people in Qatar. METHODS This case-control study, approved by the Institutional Review Board of Primary Health Care Corporation (PHCC) Qatar, retrospectively evaluated the principal public healthcare sector population data repository retrieved from the cloud-based Electronic Health Record (EHR) software-Cerner, during April 2020-2021. The health records of all adult patients aged >18 years who had undergone the reverse transcription-polymerase chain reaction (RT-PCR) test and whose medical records had documented serum 25-hydroxyvitamin D [25 (OH)D] levels were analyzed. RESULTS A total of 924,173 EHRs were extracted, of which 62,451 EHR comprised of 16,446 (26.3%) COVID-19 patients and 46,005 (73.7%) negative-control group patients met the inclusion criteria. The odds ratio (OR) among different categories of vitamin D deficiency (VDD) revealed that people with mild/moderate VDD were 1.18 times (95% CI 1.126-1.258) and those with severe VDD were 1.90 times (95% CI 1.116-1.251) more likely to have COVID-19 infection when compared to the people with optimal serum vitamin D level. On applying multiple logistic regression, the odds of having COVID-19 infection were found to be 1.27 times (95% CI 1.184-1.371) higher among those with mild/moderate VDD and 1.32 times (95% CI 1.206-1.405) higher among those with severe VDD when compared to people with optimal vitamin D level (p < 0.001). CONCLUSION Our findings demonstrated a significant association between the suboptimal serum vitamin D level and COVID-19 infection. Further studies are required to determine the effects of VDD on the severity and outcomes of COVID-19 infections.
Collapse
Affiliation(s)
- Najat Abdrabbo AlYafei
- Primary Health Care Corporation, Qatar. Email & ORCID ID: & https://orcid.org/0000-0002-8071-3646
| | | | - Abdel-Salam G Abdel-Salam
- Department of Mathmatics, Statistics and Physics, College of Art and Sciences, Qatar unitversity, Doha, Box. 2713, Qatar
| | - Hamda Ali Al-Saadi
- Primary Health Care Corporation, Qatar. Email & ORCID ID: & https://orcid.org/0000-0002-8071-3646
| | - Samya Ahmad Al Abdulla
- Primary Health Care Corporation, Qatar. Email & ORCID ID: & https://orcid.org/0000-0002-8071-3646
| |
Collapse
|
40
|
Vásquez-Procopio J, Torres-Torres J, Borboa-Olivares H, Sosa SEY, Martínez-Portilla RJ, Solis-Paredes M, Tolentino-Dolores MC, Helguera-Repetto AC, Marrufo-Gallegos KC, Missirlis F, Perichart-Perera O, Estrada-Gutierrez G. Association between 25-OH Vitamin D Deficiency and COVID-19 Severity in Pregnant Women. Int J Mol Sci 2022; 23:15188. [PMID: 36499537 PMCID: PMC9735729 DOI: 10.3390/ijms232315188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/15/2022] [Accepted: 11/22/2022] [Indexed: 12/07/2022] Open
Abstract
Evidence from studies in the general population suggests an association between vitamin D insufficiency/deficiency and COVID-19 susceptibility and disease severity. The present study was performed on 165 third-trimester pregnant women at the time of delivery. Seventy-nine women tested negative for SARS-CoV-2. From 86 women testing positive, 32 were asymptomatic, 44 presented a mild form of the disease, and 10 experienced severe symptoms. Serum 25-OH vitamin D levels were measured on blood samples collected on admission. Low vitamin D levels were detected in symptomatic but not asymptomatic COVID-19 patients compared to healthy women (p = 0.0227). In addition, 20 (45.4%) pregnant women in the mild COVID-19 group and 6 (60%) in the severe group were vitamin D deficient (p = 0.030). On the other hand, lasso regression analysis showed that 25-OH vitamin D deficiency is an independent predictor of severe COVID-19 with an odds ratio (OR) of 5.81 (95% CI: 1.108-30.541; p = 0.037). These results show the relationship between vitamin D deficiency in pregnant women and the severity of COVID-19 infection and support the recommendation to supplement with vitamin D to avoid worse COVID-19 outcomes during pregnancy.
Collapse
Affiliation(s)
- Johana Vásquez-Procopio
- Department of Immunobiochemistry, Instituto Nacional de Perinatología, Mexico City 11000, Mexico
- Department of Physiology, Biophysics and Neuroscience, Center for Research and Advanced Studies (Cinvestav), Mexico City 07360, Mexico
| | - Johnatan Torres-Torres
- Clinical Research Division, Instituto Nacional de Perinatología, Mexico City 11000, Mexico
| | - Hector Borboa-Olivares
- Community Interventions Research Branch, Instituto Nacional de Perinatología, Mexico City 11000, Mexico
| | - Salvador Espino Y Sosa
- Clinical Research Division, Instituto Nacional de Perinatología, Mexico City 11000, Mexico
| | | | - Mario Solis-Paredes
- Clinical Research Division, Instituto Nacional de Perinatología, Mexico City 11000, Mexico
| | - Mari-Cruz Tolentino-Dolores
- Coordination of Nutrition and Bioprogramming, Instituto Nacional de Perinatología, Mexico City 11000, Mexico
| | | | | | - Fanis Missirlis
- Department of Physiology, Biophysics and Neuroscience, Center for Research and Advanced Studies (Cinvestav), Mexico City 07360, Mexico
| | - Otilia Perichart-Perera
- Coordination of Nutrition and Bioprogramming, Instituto Nacional de Perinatología, Mexico City 11000, Mexico
| | | |
Collapse
|
41
|
Nielsen NM, Junker TG, Boelt SG, Cohen AS, Munger KL, Stenager E, Ascherio A, Boding L, Hviid A. Vitamin D status and severity of COVID-19. Sci Rep 2022; 12:19823. [PMID: 36396686 PMCID: PMC9672358 DOI: 10.1038/s41598-022-21513-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/28/2022] [Indexed: 11/18/2022] Open
Abstract
We explored the association between COVID-19 severity and vitamin D status using information from Danish nation-wide health registers, the COVID-19 surveillance database and stored blood samples from the national biobank. 25-hydroxyvitamin D (25(OH)D) was measured using tandem mass spectroscopy. The association between 25(OH)D levels and COVID-19 severity, classified hierarchical as non-hospitalized, hospitalized but not admitted to an intensive care unit (ICU), admitted to ICU, and death, was evaluated by proportional odds ratios (POR) assuming proportionality between the four degrees of severity. Among 447 adults tested SARS-CoV-2 positive in the spring of 2020, low levels of 25(OH)D were associated with a higher risk of severe COVID-19. Thus, odds of experiencing more severe COVID-19 among individuals with insufficient (25 to < 50 nmol/L) and sufficient (≥ 50 nmol/L) 25(OH)D levels were approximately 50% of that among individuals with deficient levels (< 25 nmol/L) (POR = 0.49 (95% CI 0.25-0.94), POR = 0.51 (95% CI 0.27-0.96), respectively). Dividing sufficient vitamin D levels into 50 to < 75 nmol/L and ≥ 75 nmol/L revealed no additional beneficial effect of higher 25(OH)D levels. In this observational study, low levels of 25(OH)D were associated with a higher risk of severe COVID-19. A possible therapeutic role of vitamin D should be evaluated in well-designed interventional studies.
Collapse
Affiliation(s)
- Nete Munk Nielsen
- grid.6203.70000 0004 0417 4147Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark ,grid.10825.3e0000 0001 0728 0170Focused Research Unit in Neurology, Department of Neurology, Hospital of Southern Jutland, University of Southern Denmark, Aabenraa, Denmark
| | - Thor Grønborg Junker
- grid.6203.70000 0004 0417 4147Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Sanne Grundvad Boelt
- grid.6203.70000 0004 0417 4147Section for Clinical Mass Spectrometry, Danish Center for Neonatal Screening, Department of Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark ,grid.452548.a0000 0000 9817 5300iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
| | - Arieh S. Cohen
- grid.6203.70000 0004 0417 4147Test Center Denmark, Statens Serum Institut, Copenhagen, Denmark
| | - Kassandra L. Munger
- grid.38142.3c000000041936754XDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Egon Stenager
- grid.10825.3e0000 0001 0728 0170Focused Research Unit in Neurology, Department of Neurology, Hospital of Southern Jutland, University of Southern Denmark, Aabenraa, Denmark ,grid.10825.3e0000 0001 0728 0170Multiple Sclerosis Clinic of Southern Jutland (Sønderborg, Kolding, Esbjerg), Department of Neurology, Hospital of Southern Jutland, University of Southern Denmark, Sønderborg, Denmark
| | - Alberto Ascherio
- grid.38142.3c000000041936754XDepartment of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA USA ,grid.38142.3c000000041936754XDepartment of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA ,grid.38142.3c000000041936754XChanning Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA USA
| | - Lasse Boding
- grid.6203.70000 0004 0417 4147The Danish National Biobank, Statens Serum Institut, Copenhagen, Denmark
| | - Anders Hviid
- grid.6203.70000 0004 0417 4147Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark ,grid.5254.60000 0001 0674 042XPharmacovigilance Research Centre, Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
42
|
PLATIKANOVA M, HRISTOVA P. Vitamin D and COVID-19: questions and answers for future research? GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2022. [DOI: 10.23736/s0393-3660.22.04769-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
43
|
di Filippo L, Frara S, Doga M, Giustina A. The osteo-metabolic phenotype of COVID-19: an update. Endocrine 2022; 78:247-254. [PMID: 35857271 PMCID: PMC9297261 DOI: 10.1007/s12020-022-03135-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 07/03/2022] [Indexed: 11/10/2022]
Abstract
CONTEXT In the multifaceted COVID-19 clinical scenario characterized by a multi-system disorder with negative implications not only on respiratory function but also on cardiac, hematological, neurological and endocrine-metabolic systems, a distinctive osteo-metabolic phenotype with an independent influence on disease severity and recovery of patients affected was early reported. AIM To summarize and update the main evidences regarding the distinct components of this phenotype in acute and Long COVID-19, reinforcing its clinical relevance and discussing the main pathophysiological and clinical-therapeutic implications of the most recent reported findings. RESULTS This emerging phenotype is characterized by a widespread acute hypocalcemia and hypovitaminosis D with an impaired compensatory parathyroid hormone response, and a high prevalence of skeletal complications such as vertebral fractures. The clinical relevance of this osteo-metabolic phenotype on acute COVID-19 is well characterized, and novel seminal evidences are progressively highlighting its importance also in predicting patient's long-term outcomes and Long COVID-19 occurrence. CONCLUSIONS These findings reinforced the central role of a multidisciplinary team, including endocrinologists, in evaluating these patients for a proactive search of each aspect of the osteo-metabolic phenotype components since they may represent suitable therapeutic targets to prevent SARS-CoV-2 infection, poor COVID-19 outcomes, Long COVID-19 occurrence and even possibly better responses to COVID-19 vaccination.
Collapse
Affiliation(s)
- Luigi di Filippo
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy
| | - Stefano Frara
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy
| | - Mauro Doga
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy
| | - Andrea Giustina
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy.
| |
Collapse
|
44
|
Subramanian S, Griffin G, Hewison M, Hopkin J, Kenny RA, Laird E, Quinton R, Thickett D, Rhodes JM. Vitamin D and COVID-19-Revisited. J Intern Med 2022; 292:604-626. [PMID: 35798564 PMCID: PMC9349414 DOI: 10.1111/joim.13536] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Vitamin D, when activated to 1,25-dihydroxyvitamin D, is a steroid hormone that induces responses in several hundred genes, including many involved in immune responses to infection. Without supplementation, people living in temperate zones commonly become deficient in the precursor form of vitamin D, 25-hydroxyvitamin D, during winter, as do people who receive less sunlight exposure or those with darker skin pigmentation. Studies performed pre-COVID-19 have shown significant but modest reduction in upper respiratory infections in people receiving regular daily vitamin D supplementation. Vitamin D deficiency, like the risk of severe COVID-19, is linked with darker skin colour and also with obesity. Greater risk from COVID-19 has been associated with reduced ultraviolet exposure. Various studies have examined serum 25-hydroxyvitamin D levels, either historical or current, in patients with COVID-19. The results of these studies have varied but the majority have shown an association between vitamin D deficiency and increased risk of COVID-19 illness or severity. Interventional studies of vitamin D supplementation have so far been inconclusive. Trial protocols commonly allow control groups to receive low-dose supplementation that may be adequate for many. The effects of vitamin D supplementation on disease severity in patients with existing COVID-19 are further complicated by the frequent use of large bolus dose vitamin D to achieve rapid effects, even though this approach has been shown to be ineffective in other settings. As the pandemic passes into its third year, a substantial role of vitamin D deficiency in determining the risk from COVID-19 remains possible but unproven.
Collapse
Affiliation(s)
- Sreedhar Subramanian
- Department of GastroenterologyCambridge University Hospitals Foundation TrustCambridgeUK
| | - George Griffin
- Department of Infectious Diseases and MedicineSt George's UniversityLondonUK
| | - Martin Hewison
- Institute of Metabolism and Systems ResearchUniversity of BirminghamBirminghamUK
| | - Julian Hopkin
- College of MedicineInstitute of Life ScienceSwansea UniversitySwanseaUK
| | - Rose Anne Kenny
- Department of Medical GerontologySchool of MedicineTrinity College DublinDublinIreland
| | - Eamon Laird
- The Irish Longitudinal Study on AgeingSchool of MedicineTrinity College DublinDublinIreland
| | - Richard Quinton
- Department of EndocrinologyTranslational and Clinical Research InstituteNewcastle University Faculty of Medical SciencesNewcastle upon TyneUK
| | - David Thickett
- Institute of Inflammation and AgeingUniversity of Birmingham College of Medical and Dental SciencesBirminghamUK
| | - Jonathan M. Rhodes
- Molecular Physiology and Cell SignallingInstitute of Systems, Molecular and Integrative BiologyUniversity of LiverpoolLiverpoolUK
| |
Collapse
|
45
|
Luo X, Deng Y, He W. Visual analysis of the research trend and status on the association between vitamin D and immunity: From 2012 to 2021. Front Nutr 2022; 9:1000400. [PMID: 36211484 PMCID: PMC9533358 DOI: 10.3389/fnut.2022.1000400] [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: 07/22/2022] [Accepted: 08/29/2022] [Indexed: 01/09/2023] Open
Abstract
Objective We conducted this study to visualize hot spots and trends in the correlation between vitamin D and immunity over the past decade with bibliometric analysis. Methods We collected relevant articles in the Web of Science Core Collection from 2012 to 2021 as the data source, and then used CiteSpace software to perform the data analysis. Some graphics were done with Graphpad software. Results A total of 1,656 articles were retrieved, with an average citation count of 25.2 times. The United States (439 articles, 26.51%) has the top number of published articles, followed by China (164 articles, 9.90%), England (135 articles, 8.15%), Italy (114 articles, 6.88%), and India (82 articles, 4.95%). The most literature is found in areas of Immunology (337 articles, 20.35%) and Biochemistry Molecular Biology (179 articles, 10.81%). In terms of institutions, the top five institutions with the highest number of publications all belong to Europe. Among them, the League of European Research Universities (LERU) (121, 7.31%) has a greater proportion of output articles. The United States Department of Health Human Services (225, 13.59%) and National Institutes of Health United States (223, 13.47%) funded most articles. The leading five authors with the largest number of publications were Hewison M (19, 1.15%), Bergman P (14, 0.85%), Agerberth B (13, 0.76%), Carlberg C (12, 0.73%), and White JH (12, 0.73%). The top five keywords with the highest co-occurrence frequency are “vitamin d” (367), “d deficiency” (217), “expression” (195), “association” (151), and “d receptor” (132). Among the 17 keyword clusters, the largest cluster is #0 “diet.” Despite cluster #13 “covid-19,” most of the clusters were conducted the studies before 2012. Conclusion The overall development of research in this field is promising. Western developed countries made outstanding contributions in this area and still take the leading role. But the participation of developing and low-income countries is also impressive. The potential therapeutic effects of vitamin D in immune-related diseases have been noted, especially in multiple sclerosis, COVID-19, etc. This is also the focus and frontier of current research. However, there is still no consensus conclusion in this field. Further research is needed in the future.
Collapse
Affiliation(s)
- Xuemei Luo
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yali Deng
- Department of Obstetrics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Wenfang He
- Department of Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Wenfang He,
| |
Collapse
|
46
|
Yilmaz Aİ, Ünal G, Keleş S, Pekcan S, Kiliç AO, Akcan ÖM, Erdoğan KN, Özdemir HS, Kilinç I, Özdemir M. Serum Vitamins A, D, and Zinc Levels in Children with Coronavirus Disease 2019 and Multisystem Inflammatory Syndrome in Children. J PEDIAT INF DIS-GER 2022. [DOI: 10.1055/s-0042-1756442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Abstract
Objective Vitamin D, due to its immunomodulating effect, zinc, and vitamin A, which affect cellular and humoral immunity, are thought to affect the clinical severity of coronavirus disease 2019 (COVID-19) infection. The present study evaluates the association between vitamin A, D, and zinc deficiencies and disease severity in pediatric patients with COVID-19 infections.
Methods The levels of vitamin A, D, and zinc at the time of diagnosis of 123 pediatric patients who presented to our hospital and were diagnosed as having hospitalized, nonhospitalized COVID-19 infection group, and multisystem inflammatory syndrome in children (MIS-C) were evaluated. The correlations of the measured levels with the disease severity and the need for intensive care or hospitalization were analyzed.
Results Among the 123 patients, 21.1% (n = 26), 42.2% (n = 52), and 36.7% (n = 45) had a diagnosis of MIS-C, belonged to the hospitalized COVID-19 infection group, or belonged to the nonhospitalized COVID-19 infection group, respectively. Zinc levels were significantly lower in the MIS-C group than in the nonhospitalized group (p < 0.05). Vitamin A levels were found to be significantly lower in the MIS-C group than in the nonhospitalized group (p < 0.01) and significantly lower in the hospitalized group when compared with the nonhospitalized group (p < 0.001). Deficiencies in vitamin A, vitamin D, and zinc levels were found to be most common in the MIS-C group (42.3%) and in hospitalized COVID-19 group (15.3%). In the nonhospitalized COVID-19 group, it was found to be the lowest at 6.6%.
Conclusion Based on the results of the present study and a literature review, it can be said that vitamin A, D, and zinc deficiencies may associate with the severity of COVID-19, although more studies are required to clarify this subject further.
Collapse
Affiliation(s)
- Aslı İmran Yilmaz
- Meram Faculty of Medicine, Department of Pediatric Pulmonology, Necmettin Erbakan University, Konya, Turkey
| | - Gökçen Ünal
- Meram Faculty of Medicine, Department of Pediatric Pulmonology, Necmettin Erbakan University, Konya, Turkey
| | - Sevgi Keleş
- Department of Pediatric Allergy Immunology, University of Necmettin Erbakan, Meram School of Medicine, Konya, Turkey
| | - Sevgi Pekcan
- Meram Faculty of Medicine, Department of Pediatric Pulmonology, Necmettin Erbakan University, Konya, Turkey
| | - Ahmet Osman Kiliç
- Meram Faculty of Medicine, Department of Pediatrics, Necmettin Erbakan University, Konya, Turkey
| | - Özge Metin Akcan
- Meram Faculty of Medicine, Department of Department of Pediatric Infectious Diseases, Necmettin Erbakan University, Konya, Turkey
| | - Kubra Nur Erdoğan
- Meram Faculty of Medicine, Department of Pediatrics, Necmettin Erbakan University, Konya, Turkey
| | - Hüseyin Safa Özdemir
- Meram Faculty of Medicine, Department of Pediatrics, Necmettin Erbakan University, Konya, Turkey
| | - Ibrahim Kilinç
- Meram Faculty of Medicine Department of Biochemistry, Necmettin Erbakan University, Konya, Turkey
| | - Mehmet Özdemir
- Meram Faculty of Medicine Department of Medical Microbiology, Necmettin Erbakan University, Turkey
| |
Collapse
|
47
|
Li B, Yang S, Hou N. Could vitamin D supplementation play a role against COVID-19? Front Immunol 2022; 13:967215. [PMID: 36172345 PMCID: PMC9511139 DOI: 10.3389/fimmu.2022.967215] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 08/23/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Bi Li
- Department of Pharmacy, Medical Supplies Center of Chinese PLA General Hospital, Beijing, China
| | - Shuangshuang Yang
- Department of Pharmacy, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
- Graduate Department, Shandong First Medical University (Shandong Academy of Medical Sciences), Jinan, China
| | - Ning Hou
- Department of Pharmacy, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| |
Collapse
|
48
|
Foshati S, Mirjalili F, Rezazadegan M, Fakoorziba F, Amani R. Antioxidants and clinical outcomes of patients with coronavirus disease 2019: A systematic review of observational and interventional studies. Food Sci Nutr 2022; 10:FSN33034. [PMID: 36245940 PMCID: PMC9538172 DOI: 10.1002/fsn3.3034] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 07/22/2022] [Accepted: 07/31/2022] [Indexed: 12/14/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a newly emerging viral infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Oxidative stress appears to be a prominent contributor to the pathogenicity of SARS-CoV-2. Therefore, we carried out a systematic review of human observational and interventional studies to investigate the role of some antioxidants such as vitamins A, E, D, and C, selenium, zinc, and α-lipoic acid in the main clinical outcomes of subjects with COVID-19. Google Scholar, Cochrane Library, Web of Science, Scopus, and Medline were searched using Medical Subject Headings (MeSH) and non-MeSH terms without restrictions. Finally, 36 studies for vitamins C and D, selenium, and zinc were included in this systematic review; however, no eligible studies were found for vitamins A and E as well as α-lipoic acid. The results showed the promising role of vitamin C in inflammation, Horowitz index, and mortality; vitamin D in disease manifestations and severity, inflammatory markers, lung involvement, ventilation requirement, hospitalization, intensive care unit (ICU) admission, and mortality; selenium in cure rate and mortality; and zinc in ventilation requirement, hospitalization, ICU admission, biomarkers of inflammation and bacterial infection, and disease complications. In conclusion, it seems that antioxidants, especially vitamins C and D, selenium, and zinc, can improve multiple COVID-19 clinical outcomes. Nevertheless, more studies are necessary to affirm these results.
Collapse
Affiliation(s)
- Sahar Foshati
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Fatemeh Mirjalili
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Mahsa Rezazadegan
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research CenterIsfahan University of Medical SciencesIsfahanIran
| | | | - Reza Amani
- Department of Clinical Nutrition, School of Nutrition and Food Science, Food Security Research CenterIsfahan University of Medical SciencesIsfahanIran
| |
Collapse
|
49
|
Severino P, D’Amato A, Prosperi S, Myftari V, Labbro Francia A, Önkaya M, Notari C, Papisca I, Canuti ES, Yarden Revivo M, Birtolo LI, Celli P, Galardo G, Maestrini V, d’Ettorre G, Mancone M, Fedele F. The Mutual Relationship among Cardiovascular Diseases and COVID-19: Focus on Micronutrients Imbalance. Nutrients 2022; 14:3439. [PMID: 36014944 PMCID: PMC9416353 DOI: 10.3390/nu14163439] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 08/12/2022] [Accepted: 08/15/2022] [Indexed: 12/16/2022] Open
Abstract
Micronutrients are ions and vitamins humbly required by the human body. They play a main role in several physiological mechanisms and their imbalance is strongly associated with potentially-fatal complications. Micronutrient imbalance is associated with many cardiovascular diseases, such as arrythmias, heart failure, and ischemic heart disease. It has been also observed in coronavirus disease 2019 (COVID-19), particularly in most severe patients. The relationship between cardiovascular diseases and COVID-19 is mutual: the latter triggers cardiovascular disease onset and worsening while patients with previous cardiovascular disease may develop a more severe form of COVID-19. In addition to the well-known pathophysiological mechanisms binding COVID-19 and cardiovascular diseases together, increasing importance is being given to the impact of micronutrient alterations, often present during COVID-19 and able to affect the balance responsible for a good functioning of the cardiovascular system. In particular, hypokalemia, hypomagnesemia, hyponatremia, and hypocalcemia are strongly associated with worse outcome, while vitamin A and D deficiency are associated with thromboembolic events in COVID-19. Thus, considering how frequent the cardiovascular involvement is in patients with COVID-19, and how it majorly affects their prognosis, this manuscript provides a comprehensive review on the role of micronutrient imbalance in the interconnection between COVID-19 and cardiovascular diseases.
Collapse
Affiliation(s)
- Paolo Severino
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Andrea D’Amato
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Silvia Prosperi
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Vincenzo Myftari
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Aurora Labbro Francia
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Merve Önkaya
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Claudia Notari
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Ilaria Papisca
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Elena Sofia Canuti
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Mia Yarden Revivo
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Lucia Ilaria Birtolo
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Paola Celli
- Anesthesiology and Intensive Care Unit, Sapienza University of Rome, Policlinico Umberto I, 00161 Rome, Italy
| | - Gioacchino Galardo
- Medical Emergency Unit, Sapienza University of Rome, Policlinico Umberto I, 00185 Rome, Italy
| | - Viviana Maestrini
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Gabriella d’Ettorre
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy
| | - Massimo Mancone
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| | - Francesco Fedele
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161 Rome, Italy
| |
Collapse
|
50
|
He W, Deng Y, Luo X. Bibliometric analysis of the global research status and trends of the association between Vitamin D and infections from 2001 to 2021. Front Public Health 2022; 10:934106. [PMID: 35991038 PMCID: PMC9386288 DOI: 10.3389/fpubh.2022.934106] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 07/07/2022] [Indexed: 12/11/2022] Open
Abstract
Objective The objective of this study was the visualization of hot spots and evolving trends in research on the association between vitamin D and infections through the use of bibliometric analysis. Methods Based on 3046 relevant articles collected in the Web of Science Core Collection for the period of 2001–2021, the data were processed using CiteSpace software. GraphPad software was used for some of the graphics. Results A total of 3,046 literature were retrieved, with an average citation frequency of 27.89 times. The number of published papers in the direction of “Immunology” (453 articles, 14.9%) and “Infectious diseases” (312 articles, 10.2%) is much higher. The United States presents the highest publication count (890, 29.2%) and shows a strong leadership in this field. Country burst shows that since 2015, many developing countries and low-income countries have carried out enthusiastic research in this regard, including China, Pakistan, and Iran. As for institutions, the League of European Research Universities produces a larger proportion of articles (220, 7.2%). In terms of authors, Martineau AR and Camargo CA have the highest number of published articles, contributing 30 (0.99%) and 28 articles (0.92%), respectively. Major studies are supported by the United States Department of Health Human Services funding (394, 12.9%). According to the keyword co-occurrence diagram, the 10 most frequent keywords from 2001 to 2021 are “vitamin D”, “infection”, “d deficiency”, “risk”, “association”, “expression”, “disease”, “d supplementation”, “vitamin d deficiency”, and “children”. The top 10 cited articles in 2021 are all related to COVID-19, suggesting it is a hotspot in recent times. Conclusion Research on the association between vitamin D and infection has grown rapidly since 2012 and is generally developing well. While developed Western countries continue to be leading roles in this field, research trends in developing countries are also very promising. It is demonstrated that the relationship between vitamin D and respiratory infections, especially respiratory viruses and the more recently COVID-19, has received a lot of attention in the last two decades, suggesting that this is the hotspot and frontier of research issue.
Collapse
Affiliation(s)
- Wenfang He
- Department of Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yali Deng
- Department of Obstetrics, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xuemei Luo
- Department of Pediatrics, The Second Xiangya Hospital, Central South University, Changsha, China
- *Correspondence: Xuemei Luo
| |
Collapse
|