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Sabit H, Abdel-Ghany S, Abdallah MS, Abul-Maaty O, Khoder AI, Shoman NA, Farrag MS, Martasek P, Noreddin AM, Nazih M. Vitamin D: A key player in COVID-19 immunity and lessons from the pandemic to combat immune-evasive variants. Inflammopharmacology 2024; 32:3631-3652. [PMID: 39406981 PMCID: PMC11550250 DOI: 10.1007/s10787-024-01578-w] [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: 09/09/2024] [Accepted: 09/18/2024] [Indexed: 11/10/2024]
Abstract
As of the 7th of July 2024, 775,754,322 confirmed cases of COVID-19, including 7,053,902 deaths worldwide, had been reported to the WHO (World Health Organization). Nevertheless, untill the 15th of July 2024, a total of 13,578,710,228 vaccine doses had been administered, with almost no country spared from COVID-19 attacks. The pathophysiology of this virus is complicated, and several symptoms require a deep understanding of the actual mechanisms. It is unclear why some patients develop severe symptoms while others do not, although literature suggests a role for vitamin D. Vitamin D plays a crucial role in the infection or in ameliorating the severity of symptoms. The mechanism of action of vitamin D and vitamin D deficiency (VDD) is well understood. VDD is associated with increased hospitalization of severely ill patients and increased levels of COVID-19-caused mortality. Recent studies suggest that vitamin D levels and genetic variations in the vitamin D receptor (VDR) gene significantly impact the severity and outcomes of COVID-19, especially in the infections caused by Delta and Omicron variants. Furthermore, VDD causes immune system dysregulation upon infection with SARS-CoV-2, indicating that vitamin D sufficiency is crucial in fighting against COVID-19 infection. The therapeutic effect of vitamin D raises interest in its potential role as a prophylactic and treatment adjunct. We evaluate the immunomodulatory effects of vitamin D and its ability to enhance the efficacy of new antiviral drugs like molnupiravir and paxlovid against SARS-CoV-2. This review discusses the role of vitamin D sufficiency and VDD in COVID-19 initiation and progression, emphasizing the molecular mechanisms by which vitamin D exerts its actions as a proactive step for the next pandemic. However, there is still no clear evidence of vitamin D's impact on prevention and treatment, leading to contradictory findings. Therefore, large-scale randomized trials are required to reach a definitive conclusion. A bibliometric analysis of publications related to vitamin D, immunity, and COVID-19 revealed a significant increase in research activity in this area, particularly in 2020-2024, underscoring the growing recognition of vitamin D's potential role in the context of the pandemic.
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Affiliation(s)
- Hussein Sabit
- Department of Medical Biotechnology, College of Biotechnology, Misr University for Science and Technology, P. O. Box 77, Giza, Egypt.
| | - Shaimaa Abdel-Ghany
- Department of Environmental Biotechnology, College of Biotechnology, Misr University for Science and Technology, P. O. Box 77, Giza, Egypt
| | - Mahmoud S Abdallah
- Department of Clinical Pharmacy, Faculty of Pharmacy, University of Sadat City (USC), Sadat City, 32897, Egypt
- Department of PharmD, Faculty of Pharmacy, Jadara University, Irbid, 21110, Jordan
| | | | - Ahmed I Khoder
- Scientific Office, Egyptian Society of Pharmacogenomics and Personalized Medicine (ESPM), Cairo, Egypt
- Molecular Biology Department, Genetic Engineering and Biotechnology Research Institute, University of Sadat City, Sadat City, Egypt
- Pharmacology and Toxicology Department, Faculty of Pharmacy, Menoufia University, Shebin El-Koum, Egypt
| | - Nabil A Shoman
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Ahram Canadian University, Giza, Egypt
| | - Mohamed Sameh Farrag
- Scientific Office, Egyptian Society of Pharmacogenomics and Personalized Medicine (ESPM), Cairo, Egypt
- Department of Paediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague Ke Karlovu 2, 128 08, Praha 2, Czech Republic
| | - Pavel Martasek
- Department of Paediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague Ke Karlovu 2, 128 08, Praha 2, Czech Republic
| | - Ayman M Noreddin
- Scientific Office, Egyptian Society of Pharmacogenomics and Personalized Medicine (ESPM), Cairo, Egypt
- Department of Clinical Pharmacy, Faculty of Pharmacy, Ahram Canadian University (ACU), 6th of October City, Giza, 12566, Egypt
- Department of Internal Medicine, School of Medicine, University of California-Irvine, Irvine, CA, USA
| | - Mahmoud Nazih
- Scientific Office, Egyptian Society of Pharmacogenomics and Personalized Medicine (ESPM), Cairo, Egypt.
- Department of Clinical Pharmacy, Faculty of Pharmacy, Ahram Canadian University (ACU), 6th of October City, Giza, 12566, Egypt.
- Al Ryada University for Science and Technology (RST), ElMehwar ElMarkazy-2, Cairo - Alex desert RD K92, Sadat City, 16504, Egypt.
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Engin MMN, Özdemir Ö. Role of vitamin D in COVID-19 and other viral infections. World J Virol 2024; 13:95349. [PMID: 39323448 PMCID: PMC11401007 DOI: 10.5501/wjv.v13.i3.95349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 06/14/2024] [Accepted: 07/19/2024] [Indexed: 08/29/2024] Open
Abstract
Vitamin D is a steroid hormone that is naturally produced in the body or obtained through dietary sources, primarily under the influence of UVB radiation. This essential nutrient has a vital role in numerous physiological processes, encompassing immune function, cell growth, differentiation, insulin regulation, and cardiovascular well-being, along with its pivotal role in sustaining the delicate equilibrium of calcium and phosphate concentrations in the body. Moreover, vitamin D reinforces mucosal defense and bolsters the immune system through immunomodulation, making it a critical component of overall health. Numerous studies have unveiled the profound connection between vitamin D and the predisposition to respiratory tract infections, including well-known viruses such as influenza and the novel severe acute respiratory syndrome coronavirus 2. Vitamin D deficiency has been consistently linked to increased severity of coronavirus disease 2019 (COVID-19) and a heightened risk of mortality among afflicted individuals. Retrospective observational studies have further substantiated these findings, indicating that levels of vitamin D are linked with both the occurrence and severity of COVID-19 cases. Vitamin D has its influence on viral infections through a multitude of mechanisms, such as promoting the release of antimicrobial peptides and fine-tuning the responses of the immune system. Additionally, vitamin D is intertwined with the intricate network of the renin-angiotensin system, suggesting a potential impact on the development of complications related to COVID-19. While further clinical trials and extensive research are warranted, the existing body of evidence strongly hints at the possible use of vitamin D as a valuable tool in the prophylaxis and management of COVID-19 and other viral infectious diseases.
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Affiliation(s)
| | - Öner Özdemir
- Division of Allergy and Immunology, Department of Pediatrics, Sakarya Research and Training Hospital, Sakarya University, Faculty of Medicine, Sakarya 54100, Türkiye
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Abdullah G, Akpan A, Phelan MM, Wright HL. New insights into healthy ageing, inflammageing and frailty using metabolomics. FRONTIERS IN AGING 2024; 5:1426436. [PMID: 39044748 PMCID: PMC11263002 DOI: 10.3389/fragi.2024.1426436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2024] [Accepted: 06/24/2024] [Indexed: 07/25/2024]
Abstract
Human ageing is a normal process and does not necessarily result in the development of frailty. A mix of genetic, environmental, dietary, and lifestyle factors can have an impact on ageing, and whether an individual develops frailty. Frailty is defined as the loss of physiological reserve both at the physical and cellular levels, where systemic processes such as oxidative stress and inflammation contribute to physical decline. The newest "omics" technology and systems biology discipline, metabolomics, enables thorough characterisation of small-molecule metabolites in biological systems at a particular time and condition. In a biological system, metabolites-cellular intermediate products of metabolic reactions-reflect the system's final response to genomic, transcriptomic, proteomic, epigenetic, or environmental alterations. As a relatively newer technique to characterise metabolites and biomarkers in ageing and illness, metabolomics has gained popularity and has a wide range of applications. We will give a comprehensive summary of what is currently known about metabolomics in studies of ageing, with a focus on biomarkers for frailty. Metabolites related to amino acids, lipids, carbohydrates, and redox metabolism may function as biomarkers of ageing and/or frailty development, based on data obtained from human studies. However, there is a complexity that underpins biological ageing, due to both genetic and environmental factors that play a role in orchestrating the ageing process. Therefore, there is a critical need to identify pathways that contribute to functional decline in people with frailty.
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Affiliation(s)
- Genna Abdullah
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Asangaedem Akpan
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
- Division of Internal Medicine, University of Western Australia, Bunbury, WA, Australia
- Faculty of Health Sciences, Curtis University, Bunbury, WA, Australia
- Department of Geriatric Medicine, Bunbury Regional Hospital, Bunbury, WA, Australia
| | - Marie M. Phelan
- Institute of Systems, Molecular and Integrative Biology, University of Liverpool, Liverpool, United Kingdom
- High Field NMR Facility, Liverpool Shared Research Facilities University of Liverpool, Liverpool, United Kingdom
| | - Helen L. Wright
- Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
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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.
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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.
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Totan M, Matacuta-Bogdan IO, Hasegan A, Maniu I. Vitamin D Levels in COVID-19 and NonCOVID-19 Pediatric Patients and Its Relationship with Clinical and Laboratory Characteristics. Biomedicines 2024; 12:905. [PMID: 38672258 PMCID: PMC11048677 DOI: 10.3390/biomedicines12040905] [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: 03/26/2024] [Revised: 04/14/2024] [Accepted: 04/16/2024] [Indexed: 04/28/2024] Open
Abstract
25-hydroxyvitamin D [25(OH)D] is a marker with an important role in regulating the inflammatory response. Low concentrations of this vitamin are often found among the population, correlated with increased risk of respiratory tract infections. The aim of the study is to evaluate the relationship between vitamin D levels and clinical and laboratory markers in children and adolescents hospitalized with and without COVID-19. A retrospective study, including all patients tested for SARS-CoV-2 and having vitamin D measured, was performed. All included hospitalized cases, 78 COVID-19 patients and 162 NonCOVID-19 patients, were divided into subgroups according to their 25(OH)D serum levels (<20 ng/mL-deficiency, 20-30 ng/mL-insufficiency, ≥30 ng/mL-normal or <30 ng/mL, ≥30 ng/mL) and age (≤2 years, >2 years). Vitamin D deficiency and insufficiency increased with age, in both COVID-19 and NonCOVID-19 groups. All symptoms were encountered more frequently in cases of pediatric patients with COVID-19 in comparison with NonCOVID-19 cases. The most frequently encountered symptoms in the COVID-19 group were fever, loss of appetite, and nasal congestion. In the NonCOVID-19 group, serum 25(OH)D concentrations were positively correlated with leukocytes, lymphocytes, and LMR and negatively correlated with neutrophils, NLR, and PLR while no significant correlation was observed in the case of COVID-19 group. Differences between vitamin D status and clinical and laboratory parameters were observed, but their clinical significance should be interpreted with caution. The results of this study may offer further support for future studies exploring the mechanisms of the relationship between vitamin D and clinical and laboratory markers as well as for studies investigating the implications of vitamin D deficiency/supplementation on overall health/clinical outcomes of patients with/without COVID-19.
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Affiliation(s)
- Maria Totan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 2A Lucian Blaga Str., 550169 Sibiu, Romania; (M.T.); (A.H.)
- Clinical Laboratory, Pediatric Clinical Hospital Sibiu, 2-4 Pompeiu Onofreiu Str., 550166 Sibiu, Romania
| | | | - Adrian Hasegan
- Faculty of Medicine, Lucian Blaga University of Sibiu, 2A Lucian Blaga Str., 550169 Sibiu, Romania; (M.T.); (A.H.)
| | - Ionela Maniu
- Research Team, Pediatric Clinical Hospital Sibiu, 550166 Sibiu, Romania
- Research Center in Informatics and Information Technology, Mathematics and Informatics Department, Faculty of Sciences, Lucian Blaga University of Sibiu, 550025 Sibiu, Romania
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6
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Zhong Z, Zhao L, Zhao Y, Xia S. High-dose vitamin D supplementation in patients with COVID-19: A meta-analysis of randomized controlled trials. Food Sci Nutr 2024; 12:1808-1817. [PMID: 38455212 PMCID: PMC10916595 DOI: 10.1002/fsn3.3875] [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: 02/19/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 03/09/2024] Open
Abstract
The efficacy of administering high doses of vitamin D to patients diagnosed with COVID-19 remains uncertain. We conducted a comprehensive search across multiple databases (PubMed, EMBASE, Cochrane Library, and ISI Web of Science) from inception until August 2022, with no limitations on language, to locate randomized controlled trials (RCTs) that investigated the impact of high-dose vitamin D supplementation (defined as a single dose of ≥100,000 IU or daily dose of ≥10,000 IU reaching a total dose of ≥100,000 IU) on COVID-19 patients. Risk ratios (RR) with 95% confidence intervals (CI) and weighted mean differences (WMD) with 95% CI were calculated. Our meta-analysis included 5 RCTs with a total of 834 patients. High-dose vitamin D supplementation did not show any significant benefits for mortality (I 2 = 0.0%, p = .670; RR 1.092, 95% CI 0.685-1.742, p = .711) or intensive care unit (ICU) admission (I 2 = 0.0%, p = .519; RR 0.707, 95% CI 0.454-1.102, p = .126) in COVID-19 patients compared to the control group. However, it was found to be safe and well-tolerated (I 2 = 0.0%, p = .887; RR 1.218, 95% CI 0.930-1.594, p = .151). Subgroup analysis also showed no benefits in overall mortality, including for patients with vitamin D deficiency (I 2 = 0.0%, p = .452; RR 2.441, 95% CI 0.448-13.312, p = .303) or compared to the placebo (I 2 = 0.0%, p = .673; RR 1.666, 95% CI 0.711-3.902, p = .240). Our research indicates that there is no evidence to support the efficacy of high-dose vitamin D supplementation in improving clinical outcomes among individuals with COVID-19, in line with previous studies focused on contexts including rickets. Considering the limitations of the study, additional research may be required.
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Affiliation(s)
- Zhaoshuang Zhong
- Department of RespiratoryCentral Hospital, Shenyang Medical CollegeShenyangChina
| | - Long Zhao
- Department of RespiratoryCentral Hospital, Shenyang Medical CollegeShenyangChina
| | - Yan Zhao
- Department of RespiratoryCentral Hospital, Shenyang Medical CollegeShenyangChina
| | - Shuyue Xia
- Department of RespiratoryCentral Hospital, Shenyang Medical CollegeShenyangChina
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Kallioğlu MA, Sharma A, Kallioğlu A, Kumar S, Khargotra R, Singh T. UV index-based model for predicting synthesis of (pre-)vitamin D3 in the mediterranean basin. Sci Rep 2024; 14:3541. [PMID: 38347060 PMCID: PMC10861575 DOI: 10.1038/s41598-024-54188-5] [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: 10/08/2023] [Accepted: 02/09/2024] [Indexed: 02/15/2024] Open
Abstract
The importance of solar radiation for the body's ability to synthesize Vitamin D3 is well documented, yet the precise amount of sun exposure required to avoid Vitamin D insufficiency is less clear. To address this knowledge gap, this study sought to utilize the sun in a suitable period at the optimum dose by utilizing numerical simulations to determine the amount of Vitamin D3 synthesis in the skin according to season, time of day, and geographical location in Turkey. The study was carried out in three stages; in the first stage, daily, monthly, and annual values were determined in cases where the solar zenith angle has the active UV-B wavelength. The second stage determined the level of Vitamin D that can be synthesized in all skin types at 25% solar radiation exposure. In the third stage, the sun exposure time required for 1000 International Units (IU) for all skin types was calculated. According to the analysis, the yearly period of active synthesis of D3 on Earth lasts from the beginning of March to the third week of October. During the day, it is between 10:00 and 16:00. For 1000 IU/day, the average annual estimated times (minutes) are 5.05 for Type I, 6.3 for Type II, 7.6 for Type III, 11.35 for Type IV, 15.15 for Type V, and 25.25 for Type VI. The results of this paper will impact awareness for academic-medical users.
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Affiliation(s)
| | - Ashutosh Sharma
- College of Science and Engineering, James Cook University, Townsville, QLD, 4810, Australia
| | - Ayşan Kallioğlu
- Department of Neurology, Faculty of Medicine, Cigli Research and Training Hospital, Izmir Bakırçay University, 8780, Çiğli - İzmir, Turkey
| | - Sunil Kumar
- Department of Nanotechnology and Advanced Materials Engineering and HMC, Sejong University, Seoul, 05006, South Korea
| | - Rohit Khargotra
- Institute of Materials Engineering, Faculty of Engineering, Pannonia University, Veszprem, 8200, Hungary.
- Sustainability Solutions Research Lab, University of Pannonia, Egyetem u. 10., Veszprém, 8200, Hungary.
| | - Tej Singh
- Savaria Institute of Technology, Faculty of Informatics, ELTE Eötvös Loránd University, Budapest, Budapest, 1117, Hungary
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Spadera L, Lugarà M, Spadera M, Conticelli M, Oliva G, Bassi V, Apuzzi V, Calderaro F, Fattoruso O, Guzzi P, D'Amora M, Catapano O, Marra R, Galdo M, Zappalà M, Inui T, Mette M, Vitiello G, Corvino M, Tortoriello G. Adjunctive use of oral MAF is associated with no disease progression or mortality in hospitalized patients with COVID-19 pneumonia: The single-arm COral-MAF1 prospective trial. Biomed Pharmacother 2023; 169:115894. [PMID: 37988850 DOI: 10.1016/j.biopha.2023.115894] [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: 07/21/2023] [Revised: 11/09/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023] Open
Abstract
Based on a growing body of evidence that a dysregulated innate immune response mediated by monocytes/macrophages plays a key role in the pathogenesis of COVID-19, a clinical trial was conducted to investigate the therapeutic potential and safety of oral macrophage activating factor (MAF) plus standard of care (SoC) in the treatment of hospitalized patients with COVID-19 pneumonia. Ninety-seven hospitalized patients with confirmed COVID-19 pneumonia were treated with oral MAF and a vitamin D3 supplement, in combination with SoC, in a single-arm, open label, multicentre, phase II clinical trial. The primary outcome measure was a reduction in an intensive care unit transfer rate below 13% after MAF administration. At the end of the study, an additional propensity score matching (PSM) analysis was performed to compare the MAF group with a control group treated with SoC alone. Out of 97 patients treated with MAF, none needed care in the ICU and/or intubation with mechanical ventilation or died during hospitalization. Oxygen therapy was discontinued after a median of nine days of MAF treatment. The median length of viral shedding and hospital stay was 14 days and 18 days, respectively. After PSM, statistically significant differences were found in all of the in-hospital outcomes between the two groups. No mild to serious adverse events were recorded during the study. Notwithstanding the limitations of a single-arm study, which prevented definitive conclusions, a 21-day course of MAF treatment plus SoC was found to be safe and promising in the treatment of hospitalized adult patients with COVID-19 pneumonia. Further research will be needed to confirm these preliminary findings.
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Affiliation(s)
- Lucrezia Spadera
- Department of Otolaryngology-Head and Neck Surgery, Ospedale del Mare hospital, ASL Napoli 1 Centro, Naples, Italy.
| | - Marina Lugarà
- Department of General Medicine, Ospedale del Mare hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Maria Spadera
- Department of Anesthesiology and Intensive Care, San Giovanni Bosco hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Mariano Conticelli
- Department of Clinical Pathology, Ospedale del Mare Hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Gabriella Oliva
- Department of General Medicine, Ospedale del Mare hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Vincenzo Bassi
- Department of General Medicine, San Giovanni Bosco Hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Valentina Apuzzi
- Department of General Medicine, San Giovanni Bosco Hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Francesco Calderaro
- Department of General Medicine, San Giovanni Bosco Hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Olimpia Fattoruso
- Department of Clinical Pathology, San Giovanni Bosco Hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Pietro Guzzi
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, Campus Universitario, Germaneto, 88100 Catanzaro, Italy
| | - Maurizio D'Amora
- Department of Laboratory Medicine and Clinical Pathology, San Paolo Hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Oriana Catapano
- Department of Laboratory Medicine and Clinical Pathology, San Paolo Hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Roberta Marra
- Department of Pharmacy, Ospedale del Mare Hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Maria Galdo
- Department of Pharmacy, AORN Ospedali dei Colli Monaldi - Cotugno - C.T.O. Hospital, Naples, Italy
| | - Michele Zappalà
- Department of Medicine, Vesuvio Clinic, ASL Napoli 1 Centro, Naples, Italy
| | - Toshio Inui
- Department of Life System, Institute of Technology and Science, Graduate School, Tokushima University, Tokushima, Japan; Saisei Mirai Cell Processing Center, Osaka, Japan; Saisei Mirai Keihan Clinic, Osaka, Japan; Saisei Mirai Kobe Clinic, Kobe, Japan
| | - Martin Mette
- Saisei Mirai Keihan Clinic, Osaka, Japan; Saisei Mirai Kobe Clinic, Kobe, Japan
| | - Giuseppe Vitiello
- Department of Health Management, Ospedale del Mare hospital, ASL Napoli 1 Centro, Naples, Italy
| | - Maria Corvino
- Department of Health Management, ASL Napoli 1 Centro, Naples, Italy
| | - Giuseppe Tortoriello
- Department of Otolaryngology-Head and Neck Surgery, AORN Ospedali dei Colli Monaldi - Cotugno - C.T.O. Hospital, Naples, Italy
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9
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Kirk H, Tufuor TA, Shaver AL, Nie J, Devarshi PP, Marshall K, Mitmesser SH, Noyes K. The association of the Affordable Care Act with nutrient consumption in adults in the United States. Front Public Health 2023; 11:1244042. [PMID: 38186698 PMCID: PMC10768893 DOI: 10.3389/fpubh.2023.1244042] [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: 06/21/2023] [Accepted: 12/05/2023] [Indexed: 01/09/2024] Open
Abstract
The Patient Protection and Affordable Care Act, more commonly known as the ACA, was legislation passed in the United States in 2010 to expand access to health insurance coverage for millions of Americans with a key emphasis on preventive care. Nutrition plays a critical role in overall wellness, disease prevention and resilience to chronic illness but prior to the ACA many Americans did not have adequate health insurance coverage to ensure proper nutrition. With passage of the ACA, more individuals received access to nutritional counseling through their primary care physicians as well as prescription vitamins and supplements free of charge. The objective of this study was to evaluate the impact of a national health insurance reform on nutrient intake among general population, including more vulnerable low-income individuals and patients with chronic conditions. Using data from the National Health and Nutrition Examination Survey (NHANES), we identified 8,443 adults aged 21 years and older who participated in the survey before (2011-2012) and after the ACA (2015-2016) implementation and conducted a subgroup analysis of 952 respondents who identified as Medicaid beneficiaries and 719 patients with a history of cancer. Using pre-post study design and bivariate and multivariable logistic analyses, we compared nutrient intake from food and supplementation before and after the ACA and identified risk factors for inadequate intake. Our results suggest that intake of micronutrients found in nutrient-dense foods, mainly fruit and vegetables, has not changed significantly after the ACA. However, overall use of nutritional supplements increased after the ACA (p = 0.05), particularly magnesium (OR = 1.02), potassium (OR = 0.76), vitamin D (both D2, and D3, OR = 1.34), vitamin K (OR = 1.15) and zinc (OR = 0.83), for the general population as well as those in our subgroup analysis Cancer Survivors and Medicaid Recipients. Given the association of increased use of nutritional supplements and expansion of insurance access, particularly in our subgroup analysis, more research is necessary to understand the effect of increasing access to nutritional supplements on the overall intake of micro- and macronutrients to meet daily nutritional recommended allowances.
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Affiliation(s)
- Hilary Kirk
- Division of Health Services Policy and Practice, Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, United States
| | - Theresa A. Tufuor
- Department of Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY, United States
| | - Amy L. Shaver
- Division of Health Services Policy and Practice, Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, United States
| | - Jing Nie
- Division of Health Services Policy and Practice, Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, United States
| | | | | | | | - Katia Noyes
- Division of Health Services Policy and Practice, Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, United States
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Harkous D, Ghorayeb N, Gannagé-Yared MH. Prevalence and predictors of vitamin D deficiency in Lebanon: 2016-2022, before and during the COVID-19 outbreak. Endocrine 2023; 82:654-663. [PMID: 37597096 DOI: 10.1007/s12020-023-03483-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 08/04/2023] [Indexed: 08/21/2023]
Abstract
BACKGROUND Vitamin D deficiency is very common worldwide, particularly in Middle-Eastern countries. Recent Lebanese studies demonstrated an improvement in vitamin D status over time. However, the comparison between the years before and during the COVID-19 outbreak has never been analyzed in the Middle-East area. This study aimed to determine the prevalence and the predictors of 25-hydroxyvitamin D (25(OH)D) levels during the last 7 years. METHODS Serum 25(OH)D levels from a large laboratory database were retrospectively collected from Hôtel-Dieu de France Hospital between January 2016 and June 2022 (N = 66,127). Data related to age, gender, season and year of sampling were also retrieved. RESULTS Mean age of the population was 50.6 ± 19 years, 62.7% were women, 5.3% were children and adolescents, 67.6% adults and 27% elderly. Mean serum 25(OH)D level was 25.7 ± 11.9 ng/mL. The overall population with vitamin D sufficiency (>30 ng/mL) was 31.9%. The increase in mean serum 25(OH)D observed between 2016 and 2022 was 6.36 ng/mL (p < 0.0001). The prevalence of 25(OH)D deficiency (<30 ng/mL) decreased from 76.2% in 2016 to 56.5% in 2022 (p < 0.0001) with a significant difference between the period before and during the COVID-19 outbreak (72.3% vs.42.5%, p < 0.0001). In a multivariate logistic regression, older age, female sex, summer season, years of the COVID-19 outbreak and outpatient samples were protective factors against the risk of hypovitaminosis D (p < 0.0001 for all variables). CONCLUSION Our study showed a continuous positive change in vitamin D status time, most notably after the COVID-19 outbreak. Further studies are needed to assess the clinical impact of the pandemic on vitamin D status in our population.
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Affiliation(s)
- Diala Harkous
- Department of Endocrinology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
| | - Nada Ghorayeb
- Department of Endocrinology, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
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11
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Yilmaz R. Efficacy and safety of single or consecutive double high-dose oral cholecalciferol supplementation in adult patients with vitamin D deficiency. Steroids 2023; 199:109308. [PMID: 37673409 DOI: 10.1016/j.steroids.2023.109308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 08/28/2023] [Accepted: 09/03/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND AND AIM Enhancing vitamin D levels as a crucial modifiable risk factor may provide a critical contribution to prevent susceptibility to various diseases, including musculoskeletal, autoimmune, and inflammatory rheumatic diseases as well as promoting overall health. However, adherence to daily vitamin D supplementation is generally poor, and there are some concerns regarding the high-dose vitamin D supplementation's safety. We aimed to investigate whether a single oral dose of 300,000 IU or consecutive two-day dosing of 300,000 IU each day of cholecalciferol could sufficiently and safely elevate vitamin D levels. METHODS This cross-sectional study was conducted on 160 inpatients with vitamin D deficiency and various musculoskeletal diseases.Subjects with serum 25(OH)D levels between 10 and 20 ng/mL (mild to moderate deficiency) received a single oral dose of 300,000 IU cholecalciferol, while those with severe vitamin D deficiency (<10 ng/mL) were supplemented with consecutive two-day doses of 300,000 IU cholecalciferol (a total of 600,000 IU). RESULTS After one week of replacement therapy, the 25(OH)D levels increased from 6.3 (4.0-9.9) ng/mL to 53.3 (8.3-84.4) ng/mL and from 15.0 (10.1-19.6) ng/mL to 38.4 (16.3-67.7) in the group with severe and those with the mild-to-moderate vitamin D deficiency, respectively. Except for three patients, nearly all patients (98%) achieved levels above 20 ng/mL. No signs of toxicity were observed in any of the patients. During the 6-month follow-up, falls were observed in 3 patients (2.8%), but no fractures were reported. CONCLUSION A single dose of 300,000 IU of oral cholecalciferol or two consecutive doses with a total dose of 600,000 IU cholecalciferol can effectively and reliably increase the 25(OH)D serum levels within one week in nearly all patients. The results may contribute to optimizing treatment strategies for vitamin D deficiency and re-evaluating the potential negative impact of high-dose vitamin D supplementation.
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Affiliation(s)
- Ramazan Yilmaz
- Department of Physical Medicine and Rehabilitation, Konya Beyhekim Training and Research Hospital, University of Health Sciences, 42060, Konya, Turkiye.
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Huang SM, Hsieh CY, Ting JU, De Castro-Cruz KA, Wang CC, Lee CJ, Tsai PW. Anti-COVID-19, Anti-Inflammatory, and Anti-Osteoarthritis Activities of Sesamin from Sesamum indicum L. Bioengineering (Basel) 2023; 10:1263. [PMID: 38002386 PMCID: PMC10669907 DOI: 10.3390/bioengineering10111263] [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: 09/07/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 11/26/2023] Open
Abstract
During the COVID-19 (coronavirus disease 2019) outbreak, many people were infected, and the symptoms may persist for several weeks or months for recovering patients. This is also known as "long COVID" and includes symptoms such as fatigue, joint pain, muscle pain, et cetera. The COVID-19 virus may trigger hyper-inflammation associated with cytokine levels in the body. COVID-19 can trigger inflammation in the joints, which can lead to osteoarthritis (OA), while long-term COVID-19 symptoms may lead to joint damage and other inflammation problems. According to several studies, sesame has potent anti-inflammatory properties due to its major constituent, sesamin. This study examined sesamin's anti-inflammatory, anti-osteoarthritis, and anti-COVID-19 effects. Moreover, in vivo and in vitro assays were used to determine sesamin's anti-inflammatory activity against the RAW264.7 and SW1353 cell lines. Sesamin had a dose-dependent effect (20 mg/kg) in a monoiodoacetic acid (MIA)-induced osteoarthritis rat model. Sesamin reduced paw swelling and joint discomfort. In addition, the findings indicated that sesamin suppressed the expression of iNOS (inducible nitric oxide synthase) and COX-2 (cyclooxygenase-2) in the RAW264.7 cell line within the concentration range of 6.25-50 μM. Furthermore, sesamin also had a suppressive effect on MMP (matrix metalloproteinase) expression in chondrocytes and the SW1353 cell line within the same concentration range of 6.25-50 μM. To examine the anti-viral activity, an in silico analysis was performed to evaluate sesamin's binding affinity with SARS-CoV-2 RdRp (severe acute respiratory syndrome coronavirus 2 RNA-dependent RNA polymerase) and human ACE2 (angiotensin-converting enzyme 2). Compared to the controls, sesamin exhibited strong binding affinities towards SARS-CoV-2 RdRp and human ACE2. Furthermore, sesamin had a higher binding affinity for the ACE2 target protein. This study suggests that sesamin shows potential anti-SARS-CoV-2 activity for drug development.
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Affiliation(s)
- Shu-Ming Huang
- Department of Nutrition, College of Medical and Health Care, Hungkuang University, Taichung 433, Taiwan;
- Department of Nutrition, Nantou Hospital of Ministry of Health and Welfare, Nantou 540, Taiwan
| | - Cheng-Yang Hsieh
- Ph.D. Program in Clinical Drug Development of Herbal Medicine, College of Pharmacy, Taipei Medical University, Taipei 110, Taiwan; (C.-Y.H.); (C.-C.W.)
- Laboratory of Oncology, Pharmacy Practice and Sciences, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai 980-8577, Japan
| | - Jasmine U. Ting
- Department of Chemistry, College of Science, De La Salle University, Metro Manila 1004, Philippines;
| | - Kathlia A. De Castro-Cruz
- School of Chemical, Biological, and Materials Engineering and Sciences, Mapúa University, Metro Manila 1002, Philippines;
| | - Ching-Chiung Wang
- Ph.D. Program in Clinical Drug Development of Herbal Medicine, College of Pharmacy, Taipei Medical University, Taipei 110, Taiwan; (C.-Y.H.); (C.-C.W.)
- Traditional Herbal Medicine Research Center, Taipei Medical University Hospital, Taipei 110, Taiwan
- Graduate Institute of Pharmacognosy, College of Pharmacy, Taipei Medical University, Taipei 110, Taiwan
- School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei 110, Taiwan
- Orthopedics Research Center, Taipei Medical University Hospital, Taipei 110, Taiwan
| | - Chia-Jung Lee
- Ph.D. Program in Clinical Drug Development of Herbal Medicine, College of Pharmacy, Taipei Medical University, Taipei 110, Taiwan; (C.-Y.H.); (C.-C.W.)
- Traditional Herbal Medicine Research Center, Taipei Medical University Hospital, Taipei 110, Taiwan
- Graduate Institute of Pharmacognosy, College of Pharmacy, Taipei Medical University, Taipei 110, Taiwan
| | - Po-Wei Tsai
- Department of Medical Science Industries, College of Health Sciences, Chang Jung Christian University, Tainan 711, Taiwan
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13
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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.
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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
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Anghel L, Manole C, Nechita A, Tatu AL, Ștefănescu BI, Nechita L, Bușilă C, Zainea P, Baroiu L, Mușat CL. Calcium, Phosphorus and Magnesium Abnormalities Associated with COVID-19 Infection, and Beyond. Biomedicines 2023; 11:2362. [PMID: 37760804 PMCID: PMC10525362 DOI: 10.3390/biomedicines11092362] [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: 07/19/2023] [Revised: 08/08/2023] [Accepted: 08/18/2023] [Indexed: 09/29/2023] Open
Abstract
The coronavirus disease (COVID-19) pandemic caused by the novel coronavirus SARS-CoV-2 has had a profound impact on global health, leading to a surge in research to better understand the pathophysiology of the disease. Among the various aspects under investigation, disruptions in mineral homeostasis have emerged as a critical area of interest. This review aims to provide an overview of the current evidence linking calcium, phosphorus and magnesium abnormalities with COVID-19 infection and explores the potential implications beyond the acute phase of the disease. Beyond the acute phase of COVID-19, evidence suggests a potential impact of these mineral abnormalities on long-term health outcomes. Persistent alterations in calcium, phosphorus and magnesium levels have been linked to increased cardiovascular risk, skeletal complications and metabolic disorders, warranting continuous monitoring and management in post-COVID-19 patients.
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Affiliation(s)
- Lucreția Anghel
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.A.); (A.N.); (A.L.T.); (L.N.); (C.B.); (L.B.)
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (B.I.Ș.); (C.L.M.)
| | - Corina Manole
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.A.); (A.N.); (A.L.T.); (L.N.); (C.B.); (L.B.)
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (B.I.Ș.); (C.L.M.)
| | - Aurel Nechita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.A.); (A.N.); (A.L.T.); (L.N.); (C.B.); (L.B.)
- ‘Sf. Ioan’ Clinical Hospital for Children, 800487 Galati, Romania
| | - Alin Laurențiu Tatu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.A.); (A.N.); (A.L.T.); (L.N.); (C.B.); (L.B.)
- ‘Sf. Cuv. Parascheva’ Clinical Hospital of Infectious Diseases, 800179 Galati, Romania
- Multidisciplinary Integrated Center of Dermatological Interface Research MIC-DIR, 800010 Galati, Romania
| | - Bogdan Ioan Ștefănescu
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (B.I.Ș.); (C.L.M.)
- Clinical Surgery Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania
| | - Luiza Nechita
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.A.); (A.N.); (A.L.T.); (L.N.); (C.B.); (L.B.)
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (B.I.Ș.); (C.L.M.)
| | - Camelia Bușilă
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.A.); (A.N.); (A.L.T.); (L.N.); (C.B.); (L.B.)
- ‘Sf. Ioan’ Clinical Hospital for Children, 800487 Galati, Romania
| | - Pușica Zainea
- Clinical Emergency County Hospital Braila, 810318 Braila, Romania;
| | - Liliana Baroiu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania; (L.A.); (A.N.); (A.L.T.); (L.N.); (C.B.); (L.B.)
- ‘Sf. Cuv. Parascheva’ Clinical Hospital of Infectious Diseases, 800179 Galati, Romania
| | - Carmina Liana Mușat
- ‘Sf. Apostol Andrei’ Clinical Emergency County Hospital, 800578 Galati, Romania; (B.I.Ș.); (C.L.M.)
- Department of Morphological and Functional Sciences, Faculty of Medicine and Pharmacy, ‘Dunarea de Jos’ University, 800008 Galati, Romania
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15
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Jamali Z, Ghorbani F, Shafie'ei M, Tolooefar F, Maleki E. Risk factors associated with vitamin D deficiency in preterm neonates: a single-center step-wise regression analysis. BMC Pediatr 2023; 23:324. [PMID: 37365549 DOI: 10.1186/s12887-023-04088-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 05/23/2023] [Indexed: 06/28/2023] Open
Abstract
BACKGROUND Vitamin D deficiency is particularly concerning in pregnant women, leading to various health-related issues in mothers and their babies, especially those born prematurely, including neonatal skeletal and respiratory disorders. In addition, there have been several reports indicating the presence of multiple impactful factors in the development of vitamin D deficiency. Therefore, we aimed to evaluate the vitamin D level in very preterm and moderately preterm newborns and investigate its association with presumed influential factors. METHODS This cross-sectional descriptive study was performed on 54 mothers and their preterm neonates with gestational ages less than 34 weeks at delivery (i.e., very preterm and moderately preterm). After the serum vitamin D levels were determined from samples obtained in the first 24 h after birth, the babies were divided into two groups based on the presence or absence of deficiency. The relationship between several factors and the neonatal serum vitamin D level was investigated separately and in a linear step-wise regression model. RESULTS The differences between the groups regarding maternal age, gestational age, neonate's gender, birth weight, and delivery method with neonatal vitamin D levels were not statistically significant. However, maternal vitamin D levels strongly correlated with neonatal vitamin D levels (P-value < 0.001, r = 0.636). The regression model also yielded a strong predictive capability (P-value < 0.001, Adjusted R2 = 0.606), with the maternal vitamin D level demonstrating a significant impact. CONCLUSIONS Low vitamin D levels in pregnant mothers correlate with deficient levels in their preterm neonates. Therefore, as vitamin D deficiency significantly affects both the mother's and newborn's health, it is recommended that healthcare providers provide comprehensive plans for vitamin D supplementation during pregnancy.
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Affiliation(s)
- Zahra Jamali
- Department of Pediatrics, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Fereshteh Ghorbani
- Nursing Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Shafie'ei
- Faculty of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | | | - Elham Maleki
- Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Science, Kerman University of Medical Sciences, Kerman, Iran.
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Repas SJ, Schmeusser BN, McCullough WP, Lehrer DS, Travers JB, McCullough PJ. Normal 24-hour Urine Calcium Concentrations after Long-term Daily Oral Intake of Vitamin D in Doses Ranging from 5000 to 50,000 International Units in 14 Adult Hospitalized Psychiatric Patients. J Steroid Biochem Mol Biol 2023; 231:106329. [PMID: 37182752 DOI: 10.1016/j.jsbmb.2023.106329] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 03/18/2023] [Accepted: 05/11/2023] [Indexed: 05/16/2023]
Abstract
Many controversies exist regarding vitamin D3 supplementation. These include not only diseases that are responsive to vitamin D supplementation, but also the long-term safety of prolonged daily oral vitamin D3 intake above 4000 to 10,000 International Units (IU). In particular, supplementation levels that do not result in adverse events, and the upper limits of safe serum 25-hydroxyvitamin D (25OHD) concentrations. Adverse reactions reported to occur with excessive vitamin D intake include hypercalcemia, renal failure, calcium crystal formation, undetectable parathyroid hormone concentrations, and hypercalciuria, all of which are reported to be reversible. To address the long-term safety of vitamin D supplementation, we previously reported data from patients in our hospital who have been voluntarily supplemented with vitamin D3 ranging from 5,000 to 10,000 IU/day since July 2011 as a standard of care for the prevention and treatment of vitamin D deficiency. Historically 90% of patients have agreed to daily supplementation, with most taking 10,000 IU/day. These data indicate no evidence for hypercalcemia, renal failure, calcium crystal formation, nephrolithiasis. or undetectable parathyroid hormone concentrations in patients taking 5,000 or 10,000 IU/day for extended periods of time. As another measure for potential vitamin D toxicity, we retrospectively assessed 24-hour urine calcium excretion in 14 individuals on long-term daily oral vitamin D intake ranging from 5,000 to 50,000 IU/day to further assess the safety of supplementation using these doses. This included patients taking either 5,000 (4), 10,000 (9), or 50,000 (1) IU/day. Time on supplementation ranged from 10 to 102 months. A patient taking 400 IU/day and getting frequent sun exposure was also included. All fifteen 24-hour urine calcium measurements were normal. The current findings complement our experience with over 7000 patients in the past 13 years, indicating that prolonged daily oral intake of vitamin D3 ranging from 5000 to 10,000 IU/day is safe.
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Affiliation(s)
- Steven J Repas
- Wright State University Boonshoft School of Medicine, 3640 Colonel Glenn Hwy, Dayton, OH 45435
| | - Benjamin N Schmeusser
- Wright State University Boonshoft School of Medicine, 3640 Colonel Glenn Hwy, Dayton, OH 45435
| | | | - Douglas S Lehrer
- Department of Psychiatry, Wright State University Boonshoft School of Medicine, 3640 Colonel Glenn Hwy, Dayton, OH 45435
| | - Jeffrey B Travers
- Department of Pharmacology & Toxicology, Wright State University Boonshoft School of Medicine, 3640 Colonel Glenn Hwy, Dayton, OH 45435
| | - Patrick J McCullough
- Department of Psychiatry, Wright State University Boonshoft School of Medicine, 3640 Colonel Glenn Hwy, Dayton, OH 45435; Medical Services, Summit Behavioral Healthcare, Ohio Department of Mental Health and Addiction Services, 1101 Summit Rd, Cincinnati, OH 45237.
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Alabdullatif W, Almnaizel A, Alhijji A, Alshathri A, Albarrag A, Bindayel I. Correlation of Plasma 25(OH)D 3 and Vitamin D Binding Protein Levels with COVID-19 Severity and Outcome in Hospitalized Patients. Nutrients 2023; 15:nu15081818. [PMID: 37111039 PMCID: PMC10142640 DOI: 10.3390/nu15081818] [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: 03/08/2023] [Revised: 04/07/2023] [Accepted: 04/08/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The Coronavirus Disease-19 (COVID-19) caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has been declared a worldwide pandemic. The severity of COVID-19 varies greatly across infected individuals. Possible factors may include plasma levels of 25(OH)D and vitamin D binding protein (DBP), as both are involved in the host immune response. Other possible nutrition-related factors include malnutrition and/or obesity which disrupt the optimal host immune response to infections. Current literature shows inconsistent evidence about the association of plasma 25(OH)D3 and DBP on infection severity and clinical outcomes. OBJECTIVES This study aimed to measure plasma 25(OH)D3 and DBP in hospitalized COVID-19 cases and assess their correlation with infection severity, inflammatory markers, and clinical outcome. METHODS 167 patients were included in this analytical cross-sectional study, of which 81 were critical and 86 were non-critical hospitalized COVID-19 patients. Plasma levels of 25(OH)D3, DBP, and the inflammatory cytokines, IL-6, IL-8, IL-10, and TNF-α were assessed using the Enzyme-linked Immunosorbent Assay (ELISA). Information regarding biochemical and anthropometrical indices, hospital length of stay (LoS), and illness outcome was obtained from the medical records. RESULTS Plasma 25(OH)D3 level was found to be significantly lower in critical compared to non-critical patients (Median = 8.38 (IQR = 2.33) vs. 9.83 (IQR = 3.03) nmol/L, respectively; p < 0.001), and it positively correlated with hospital LoS. However, plasma 25(OH)D3 did not correlate with mortality or any of the inflammatory markers. DBP on the other hand correlated positively with mortality (rs = 0.188, p = 0.015) and hospital LoS (rs = 0.233, p = 0.002). DBP was significantly higher in critical than non-critical patients (Median = 1262.18 (IQR = 463.66) vs. 1153.35 (IQR = 418.46) ng/mL, respectively; p < 0.001). Furthermore, IL-6 and IL-8 were significantly higher in critical than non-critical patients. However, no differences were found in IL-10, TNF-α, IL-10/TNF-α, TNF-α/IL-10, IL-6/IL-10, or CRP between groups. CONCLUSION The current study found that critical COVID-19 patients had lower 25(OH)D3 than non-critical patients, yet, levels were found to be suboptimal in both groups. Further, critical patients had higher DBP levels as compared to non-critical patients. This finding may encourage future research to unravel the effects of this understudied protein that appears to have significant associations with inflammation, even though the precise mechanism is unknown.
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Affiliation(s)
- Wajude Alabdullatif
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Ahmad Almnaizel
- Prince Naif for Health Research Center, King Saud University, Riyadh 11472, Saudi Arabia
| | - Ali Alhijji
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
| | - Aldanah Alshathri
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Ahmed Albarrag
- Department of Pathology, College of Medicine, King Saud University, Riyadh 11461, Saudi Arabia
| | - Iman Bindayel
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
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Zeidan NMS, Lateef HMAE, Selim DM, Razek SA, Abd-Elrehim GAB, Nashat M, ElGyar N, Waked NM, Soliman AA, Elhewala AA, Shehab MMM, Ibraheem AAA, Shehata H, Yousif YM, Akeel NE, Hashem MIA, Ahmed AA, Emam AA, Abdelmohsen MM, Ahmed MF, Saleh ASE, Eltrawy HH, Shahin GH, Nabil RM, Hosny TA, Abdelhamed MR, Afify MR, Alharbi MT, Nagshabandi MK, Tarabulsi MK, Osman SF, Abd-Elrazek ASM, Rashad MM, El-Gaaly SAA, Gad SAB, Mohamed MY, Abdelkhalek K, Yousef AA. Vitamin D deficiency and vitamin D receptor FokI polymorphism as risk factors for COVID-19. Pediatr Res 2023; 93:1383-1390. [PMID: 36085364 PMCID: PMC9461391 DOI: 10.1038/s41390-022-02275-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/22/2022] [Accepted: 08/05/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Given the sparse data on vitamin D status in pediatric COVID-19, we investigated whether vitamin D deficiency could be a risk factor for susceptibility to COVID-19 in Egyptian children and adolescents. We also investigated whether vitamin D receptor (VDR) FokI polymorphism could be a genetic marker for COVID-19 susceptibility. METHODS One hundred and eighty patients diagnosed to have COVID-19 and 200 matched control children and adolescents were recruited. Patients were laboratory confirmed as SARS-CoV-2 positive by real-time RT-PCR. All participants were genotyped for VDR Fok1 polymorphism by RT-PCR. Vitamin D status was defined as sufficient for serum 25(OH) D at least 30 ng/mL, insufficient at 21-29 ng/mL, deficient at <20 ng/mL. RESULTS Ninety-four patients (52%) had low vitamin D levels with 74 (41%) being deficient and 20 (11%) had vitamin D insufficiency. Vitamin D deficiency was associated with 2.6-fold increased risk for COVID-19 (OR = 2.6; [95% CI 1.96-4.9]; P = 0.002. The FokI FF genotype was significantly more represented in patients compared to control group (OR = 4.05; [95% CI: 1.95-8.55]; P < 0.001). CONCLUSIONS Vitamin D deficiency and VDR Fok I polymorphism may constitute independent risk factors for susceptibility to COVID-19 in Egyptian children and adolescents. IMPACT Vitamin D deficiency could be a modifiable risk factor for COVID-19 in children and adolescents because of its immune-modulatory action. To our knowledge, ours is the first such study to investigate the VDR Fok I polymorphism in Caucasian children and adolescents with COVID-19. Vitamin D deficiency and the VDR Fok I polymorphism may constitute independent risk factors for susceptibility to COVID-19 in Egyptian children and adolescents. Clinical trials should be urgently conducted to test for causality and to evaluate the efficacy of vitamin D supplementation for prophylaxis and treatment of COVID-19 taking into account the VDR polymorphisms.
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Affiliation(s)
- Nancy M S Zeidan
- Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt
| | | | - Dalia M Selim
- Department of Pediatrics, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Suzan A Razek
- Department of Pediatrics, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | | | - Mohamed Nashat
- Department of Pediatrics, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Noha ElGyar
- Department of Pediatrics, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Nevin M Waked
- Department of Pediatrics, Faculty of Medicine, October 6 University, 6th of October City, Egypt
| | - Attia A Soliman
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed A Elhewala
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed M M Shehab
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed A A Ibraheem
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Hassan Shehata
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Yousif M Yousif
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Nagwa E Akeel
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mustafa I A Hashem
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Amani A Ahmed
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed A Emam
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
| | - Mohamed M Abdelmohsen
- Department of Pediatrics, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt
| | - Mohamed F Ahmed
- Department of Pediatrics, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt
| | - Ahmed S E Saleh
- Department of Otorhinolaryngology, Faculty of Medicine, Benha University, Benha, Egypt
| | - Heba H Eltrawy
- Department of Chest Diseases, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Gehan H Shahin
- Department of Clinical Pathology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Rehab M Nabil
- Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Thoraya A Hosny
- Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | - Mona R Afify
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Mohanned T Alharbi
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Mohammed K Nagshabandi
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Muyassar K Tarabulsi
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Sherif F Osman
- Department of Radiology, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | | | - Manal M Rashad
- Department of Anesthesia, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Sonya A A El-Gaaly
- Department of Internal Medicine, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Said A B Gad
- Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed Y Mohamed
- Department of Psychiatry, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Khalil Abdelkhalek
- Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Aly A Yousef
- Department of Pediatrics, Faculty of Medicine, Helwan University, Helwan, Egypt
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Renata RBN, Arely GRA, Gabriela LMA, Esther MLM. Immunomodulatory Role of Microelements in COVID-19 Outcome: a Relationship with Nutritional Status. Biol Trace Elem Res 2023; 201:1596-1614. [PMID: 35668151 PMCID: PMC9170122 DOI: 10.1007/s12011-022-03290-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 05/16/2022] [Indexed: 12/17/2022]
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19). SARS-CoV-2 infection can activate innate and adaptive immune responses and result in massive inflammatory responses in the disease. A comprehensive understanding of the participation of micronutrients in the immune response to COVID-19 will allow the creation of prevention and supplementation scenarios in malnutrition states. Microelement deficiency can be decisive in the progression of diseases and their optimal levels can act as protective factors, helping to maintain homeostasis. Vitamin A, B, D, selenium, zinc, and copper, through their complementary and synergistic effects, allow the components of innate and adaptive immunity to counteract infections like those occurring in the respiratory tract.Thus, alterations in nutritional status are related to metabolic diseases, systemic inflammation, and deterioration of the immune system that alter the response against viral infections, such as COVID-19. The aim of this review is to describe the micronutrients that play an important role as immunomodulators and its relationship between malnutrition and the development of respiratory infections with an emphasis on severe and critical COVID-19. We conclude that although an unbalanced diet is not the only risk factor that predisposes to COVID-19, a correct and balanced diet, which provides the optimal amount of micronutrients and favors an adequate nutritional status, could confer beneficial effects for prevention and improvement of clinical results. The potential usefulness of micronutrient supplementation in special cases is highlighted.
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Affiliation(s)
- Roldán-Bretón Nuria Renata
- Facultad de Medicina Mexicali, Universidad Autónoma de Baja California, Dr. Humberto Torres Sanginés S/N, Centro Cívico, 21000, Mexicali, Baja California, México
| | - González-Rascón Anna Arely
- Facultad de Odontología Mexicali, Universidad Autónoma de Baja California, Mexicali, Baja California, México
| | - Leija-Montoya Ana Gabriela
- Facultad de Medicina Mexicali, Universidad Autónoma de Baja California, Dr. Humberto Torres Sanginés S/N, Centro Cívico, 21000, Mexicali, Baja California, México
| | - Mejía-León María Esther
- Facultad de Medicina Mexicali, Universidad Autónoma de Baja California, Dr. Humberto Torres Sanginés S/N, Centro Cívico, 21000, Mexicali, Baja California, México.
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20
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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.
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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
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21
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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.
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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
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22
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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.
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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
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23
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A Mathematical Model for Determining the Body's Fluctuating Need for and Synthesis of Active Vitamin D. Biomedicines 2023; 11:biomedicines11020324. [PMID: 36830861 PMCID: PMC9953299 DOI: 10.3390/biomedicines11020324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/03/2023] [Accepted: 01/09/2023] [Indexed: 01/27/2023] Open
Abstract
The process by which 1,25(OH)2D3 is synthesized and degraded and how it is transported out of the cell and body is described. The changing demand for the synthesis of 1-25(OH)2D3 during different conditions experienced by the body is reviewed. A method of determining 1,25(OH)2D3 synthesis and demand, and the percent utilization of 25(OH)D3 to make 1,25(OH)2D3 is presented based on the measurement of the end metabolites of 1,25(OH)2D3 and of its immediate precursor, 25(OH)D3. A mathematical model has been developed to allow the calculation of 1,25(OH)2 D synthesis, and demand, and the percent utilization of 25(OH)D3. Simple algebraic equations have been derived which allow the calculation of these new parameters using the concentrations of the end metabolites of 1,25(OH)2D3 and its immediate precursor, 25(OH)D3 in the serum and urine. Vitamin D plays an important role in combating invading bacteria and viruses and in subduing the body's associated inflammatory response. This new approach to evaluating vitamin D status may help clinicians determine 25(OH)D3 and 1,25(OH)2D3 levels needed to suppress bacterial infections, viral replication during new viral infections and the reactivation of latent viruses, and to downregulate the inflammatory responses caused by bacteria and viruses.
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24
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Lin CH, Lin PS, Lee MS, Lin CY, Sung YH, Li ST, Weng SL, Chang SJ, Lee HC, Lee YJ, Chang HY, Lin CS. Associations between Vitamin D Deficiency and Carbohydrate Intake and Dietary Factors in Taiwanese Pregnant Women. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59010107. [PMID: 36676731 PMCID: PMC9863845 DOI: 10.3390/medicina59010107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/20/2022] [Accepted: 12/26/2022] [Indexed: 01/05/2023]
Abstract
This cross-sectional observation study investigated the vitamin D (VD) status in Taiwanese pregnant women and the effects of VD supplementation and macronutrient intake on serum 25-hydroxy-vitamin D (25[OH]D) level. Data on VD intake, daily sunlight exposure, and carbohydrate intake were obtained from 125 pregnant women at 30−37 weeks’ gestation. Serum 25[OH]D level was measured before delivery in all enrolled women; and the mean 25(OH)D level was 43 nmol/L or 17.2 ng/mL. The 25(OH)D level was significantly correlated with total VD intake of pregnant women (r = 0.239; p = 0.007). The severe VD deficiency group (n = 16; mean of 25(OH)D level = 8.5 ng/mL) had significantly lower total VD intake and supplementation than the groups with VD deficiency (n = 69), insufficiency (n = 32), and sufficiency (n = 8). Those with ≥400 IU/day total VD intake (including VD from food and supplementation) had significantly higher 25(OH)D concentration than those with <400 IU/day total VD intake. Those with 400 IU/day VD supplementation could significantly increase serum 25(OH)D concentrations for pregnant women. Among 85 pregnant women with carbohydrate intake of ≥300 g/day, serum 25(OH)D levels were negatively correlated with carbohydrate intake (p = 0.031). In conclusion, VD deficiency was highly prevalent in Taiwanese pregnant women. VD supplementation was the most effective method for increasing 25(OH)D concentration in pregnant women. Higher carbohydrate intake might reduce 25(OH)D levels.
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Affiliation(s)
- Chao-Hsu Lin
- Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu 300, Taiwan
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei 252, Taiwan
| | - Pei-Shun Lin
- Department of Nutrition, Hsinchu MacKay Memorial Hospital, Hsinchu 300, Taiwan
- Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei 112, Taiwan
| | - Meei-Shyuan Lee
- School of Public Health, National Defense Medical Center, Taipei 114, Taiwan
| | - Chien-Yu Lin
- Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu 300, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei 252, Taiwan
| | - Yi-Hsiang Sung
- Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu 300, Taiwan
| | - Sung-Tse Li
- Department of Pediatrics, Hsinchu MacKay Memorial Hospital, Hsinchu 300, Taiwan
| | - Shun-Long Weng
- Department of Obstetrics and Gynecology, Hsinchu MacKay Memorial Hospital, Hsinchu 300, Taiwan
| | - Shing-Jyh Chang
- Department of Obstetrics and Gynecology, Hsinchu MacKay Memorial Hospital, Hsinchu 300, Taiwan
| | - Hung-Chang Lee
- Department of Pediatrics, MacKay Children’s Hospital, Taipei 104, Taiwan
| | - Yann-Jinn Lee
- Department of Medicine, MacKay Medical College, New Taipei 252, Taiwan
- Department of Pediatrics, MacKay Children’s Hospital, Taipei 104, Taiwan
- Department of Medical Research, Tamshui MacKay Memorial Hospital, New Taipei 251, Taiwan
- Department of Pediatrics, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Institute of Biomedical Sciences, MacKay Medical College, New Taipei 252, Taiwan
| | - Hung-Yang Chang
- Department of Medicine, MacKay Medical College, New Taipei 252, Taiwan
- Department of Pediatrics, MacKay Children’s Hospital, Taipei 104, Taiwan
| | - Chih-Sheng Lin
- Department of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
- Center for Intelligent Drug Systems and Smart Bio-Devices (IDS2B), National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
- Correspondence: ; Tel.: +886-3-5131338
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25
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Ashique S, Gupta K, Gupta G, Mishra N, Singh S, Wadhwa S, Gulati M, Dureja H, Zacconi F, Oliver BG, Paudel KR, Hansbro PM, Chellappan DK, Dua K. Vitamin D-A prominent immunomodulator to prevent COVID-19 infection. Int J Rheum Dis 2023; 26:13-30. [PMID: 36308699 PMCID: PMC9874620 DOI: 10.1111/1756-185x.14477] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 09/15/2022] [Accepted: 10/07/2022] [Indexed: 01/27/2023]
Abstract
COVID-19 remains a life-threatening infectious disease worldwide. Several bio-active agents have been tested and evaluated in an effort to contain this disease. Unfortunately, none of the therapies have been successful, owing to their safety concerns and the presence of various adverse effects. Various countries have developed vaccines as a preventive measure; however, they have not been widely accepted as effective strategies. The virus has proven to be exceedingly contagious and lethal, so finding an effective treatment strategy has been a top priority in medical research. The significance of vitamin D in influencing many components of the innate and adaptive immune systems is examined in this study. This review aims to summarize the research on the use of vitamin D for COVID-19 treatment and prevention. Vitamin D supplementation has now become an efficient option to boost the immune response for all ages in preventing the spread of infection. Vitamin D is an immunomodulator that treats infected lung tissue by improving innate and adaptive immune responses and downregulating the inflammatory cascades. The preventive action exerted by vitamin D supplementation (at a specific dose) has been accepted by several observational research investigations and clinical trials on the avoidance of viral and acute respiratory dysfunctions. To assess the existing consensus about vitamin D supplementation as a strategy to treat and prevent the development and progression of COVID-19 disease, this review intends to synthesize the evidence around vitamin D in relation to COVID-19 infection.
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Affiliation(s)
- Sumel Ashique
- Department of PharmaceuticsBharat Institute of Technology (BIT), School of PharmacyMeerutIndia
| | - Kirti Gupta
- Department of Pharmacology, MM College of PharmacyMaharishi Markandeshwar (Deemed to be) UniversityAmbalaIndia
| | - Gaurav Gupta
- School of PharmacySuresh Gyan Vihar UniversityJaipurIndia
- Department of Pharmacology, Saveetha Dental College, Saveetha Institute of Medical and Technical SciencesSaveetha UniversityChennaiIndia
- Uttaranchal Institute of Pharmaceutical SciencesUttaranchal UniversityDehradunIndia
| | - Neeraj Mishra
- Department of Pharmaceutics, Amity Institute of PharmacyAmity University Madhya Pradesh (AUMP)GwaliorIndia
| | - Sachin Kumar Singh
- School of Pharmaceutical SciencesLovely Professional UniversityJalandharIndia
- Faculty of Health, Australian Research Centre in Complementary and Integrative MedicineUniversity of Technology SydneyNew South WalesUltimoAustralia
| | - Sheetu Wadhwa
- School of Pharmaceutical SciencesLovely Professional UniversityJalandharIndia
| | - Monica Gulati
- School of Pharmaceutical SciencesLovely Professional UniversityJalandharIndia
| | - Harish Dureja
- Department of Pharmaceutical SciencesMaharshi Dayanand UniversityRohtakIndia
| | - Flavia Zacconi
- Facultad de Química y de FarmaciaPontificia Universidad Católica de ChileSantiagoChile
- Institute for Biological and Medical Engineering, Schools of Engineering, Medicine and Biological SciencesPontificia Universidad Católica de ChileSantiagoChile
| | - Brian G. Oliver
- Woolcock Institute of Medical ResearchUniversity of SydneyNew South WalesSydneyAustralia
- School of Life Sciences, Faculty of ScienceUniversity of Technology Sydney2007New South WalesSydneyAustralia
| | - Keshav Raj Paudel
- Centre for InflammationCentenary Institute and University of Technology Sydney, Faculty of Science, School of Life SciencesNew South WalesSydneyAustralia
| | - Philip M. Hansbro
- Centre for InflammationCentenary Institute and University of Technology Sydney, Faculty of Science, School of Life SciencesNew South WalesSydneyAustralia
| | - Dinesh Kumar Chellappan
- Department of Life Sciences, School of PharmacyInternational Medical UniversityKuala LumpurMalaysia
| | - Kamal Dua
- School of Life Sciences, Faculty of ScienceUniversity of Technology Sydney2007New South WalesSydneyAustralia
- Discipline of Pharmacy, Graduate School of HealthUniversity of Technology SydneyNew South WalesSydneyAustralia
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Li T, Li X, Chen N, Yang J, Yang J, Bi L. Influence of the COVID-19 pandemic on the vitamin D status of children: A cross-sectional study. J Med Virol 2023; 95:e28438. [PMID: 36573423 PMCID: PMC9880748 DOI: 10.1002/jmv.28438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/06/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022]
Abstract
Coronavirus disease 2019 (COVID-19), as well as its prevention and control measures, seriously affected people's livehood, which may have affected the body's level of vitamin D (VD). This study aimed to investigate the effect of the COVID-19 pandemic on the VD status of children in Zhengzhou, China. In this study, we included 12 272 children in 2019 (before the COVID-19 pandemic) and 16 495 children in 2020 (during the COVID-19 pandemic) to examine the changes in VD levels and deficiency rates among children before and during the COVID-19 pandemic. Total VD levels in 2020 were significantly higher than those in 2019 (26.56 [18.15, 41.40] vs. 25.98 [17.92, 40.09] ng/ml, p < 0.001). Further analysis revealed that during the COVID-19 pandemic control period in 2020, the VD levels in February, March, and April were lower than those in the same months of 2019, while the VD deficiency rates were significantly higher. Additionally, our data revealed that VD levels decreased significantly with age. Among children older than 6 years, the VD deficiency rate exceeded 50%. These results indicate that we should pay close attention to VD supplementation during the COVID-19 pandemic control period and in children older than 6 years of age.
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Affiliation(s)
- Tiewei Li
- Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Xiaojuan Li
- Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Nan Chen
- Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Jianli Yang
- Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Junmei Yang
- Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Henan Children's Hospital, Zhengzhou Children's Hospital, Zhengzhou, China
| | - Lijun Bi
- Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
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Us MC, Devrim Lanpir A, Özdatli Kurtuluş Ş, Yagci M, Akarsu Ö, Şahin K, Akkoç G. The role of free vitamin D and vitamin D binding protein in SARS-Cov-2 infection in children. Pediatr Int 2023; 65:e15680. [PMID: 37888613 DOI: 10.1111/ped.15680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 08/25/2023] [Accepted: 09/12/2023] [Indexed: 10/28/2023]
Abstract
BACKGROUND Many studies have discussed the effects of serum vitamin D deficiency in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) patients. This study aimed to investigate the relationship between SARS-CoV-2 infection severity and free vitamin D (FVD) and bioavailable vitamin D (BAVD) levels in children. METHODS A prospective case-control study design was used. Participants were divided into three groups based on the World Health Organization COVID-19 Clinical Progression Scale. Serum 25-hydroxyvitamin D (ng/mL), albumin (g/L), and vitamin D binding protein (ng/mL) levels were evaluated to investigate the relationship between disease severity and FVD and BAVD levels. RESULTS In total, 82 participants were included in the study. Of those, 24.4% were uninfected (n = 20), 50% had a mild case of SARS-CoV-2 (n = 41), and 25.6% had a moderate case (n = 21). There was a statistically significant difference in FVD and BAVD levels between the groups (p = 0.026). Median FVD (p = 0.007, Cohen's d = 0.84) and BAVD (p = 0.007, Cohen's d = 0.86) levels were significantly higher in the mild group compared to the moderate group. FVD and BAVD metabolites were moderately positively correlated with lymphocyte counts (FVD: r = 0.437, p < 0.001; BAVD: r = 0.439, p < 0.001). CONCLUSIONS This is the first study to demonstrate a relationship between SARS-CoV-2 symptom severity and FVD and BAVD levels. The relationship between FVD and BAVD levels and lymphocyte counts could play an important role in symptom severity and should be evaluated in further studies.
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Affiliation(s)
- Mahmut Caner Us
- Department of Pediatrics, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey
- Department of Social Pediatrics, Marmara University, Institute of Health Sciences, Istanbul, Turkey
| | - Aslı Devrim Lanpir
- Faculty of Health Sciences, Nutrition and Dietetics, Nutrition Sciences, Istanbul Medeniyet University, Istanbul, Turkey
- School of Human Performance and Health, Dublin City University, Dublin, Ireland
| | - Şükran Özdatli Kurtuluş
- Department of Pharmaceutical Toxicology, Faculty of Pharmacy, University of Health Sciences, Istanbul, Turkey
| | - Mesut Yagci
- Department of Biochemistry, University of Health Sciences, Istanbul Şişli Etfal Training and Research Hospital, Istanbul, Turkey
| | - Özlem Akarsu
- Division of Child Health and Diseases Nursing, Faculty of Health Sciences, Nursing, Istanbul Medeniyet University, Istanbul, Turkey
| | - Kamil Şahin
- Department of Pediatrics, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey
| | - Gülşen Akkoç
- Department of Infectious Diseases, University of Health Sciences, Haseki Training and Research Hospital, Istanbul, Turkey
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Mamurova B, Akan G, Mogol E, Turgay A, Tuncel G, Evren EU, Evren H, Suer K, Sanlidag T, Ergoren MC. Strong Association between Vitamin D Receptor Gene and Severe Acute Respiratory Syndrome coronavirus 2 Infectious Variants. Glob Med Genet 2023; 10:27-33. [PMID: 36819669 PMCID: PMC9935054 DOI: 10.1055/s-0043-1761924] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023] Open
Abstract
A coronavirus disease 2019 (COVID-19) disease, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has created significant concern since December 2019 worldwide. The virus is known to be highly transmissible. Heterogenic clinical features even vary more among SARS-CoV-2 variants from asymptomatic forms to severe symptoms. Previous studies revealed an association between COVID-19 and vitamin D deficiency resulting from its low levels in COVID-19 patients. To our knowledge, there is no scientific investigation that evaluates the direct association between SARS-CoV-2 variants of concern and vitamin D receptor ( VDR ) gene markers in Cyprus. Thus, the present study aimed to identify the putative impact of VDR gene polymorphisms on SARS-CoV-2 infection among different variants. The nasopharyngeal swabs were taken from a total number of 600 patients who were admitted to Near East University Hospital COVID-19 Polymerase Chain Reaction (PCR) Diagnosis Laboratory for routine SARS-CoV-2 real-time quantitative reverse transcription PCR (RT-qPCR) test. The RT-qPCR negative resulting samples were taken as control samples ( n = 300). On the contrary, the case group consisted of patients who were SARS-CoV-2 RT-qPCR positive, infected with either SARS-CoV-2 Alpha ( n = 100), Delta ( n = 100), or Omicron ( n = 100) variants. Two VDR gene polymorphisms, Taq I-rs731236 T > C and Fok I-rs10735810 C > T, were genotyped by polymerase chain reaction-restriction fragment length polymorphism. The mean age of the COVID-19 patient's ± standard deviation was 46.12 ± 12.36 and 45.25 ± 12.71 years old for the control group ( p > 0.05). The gender distribution of the patient group was 48.3% female and 51.7% male and for the control group 43% female and 57% male ( p > 0.05). Significant differences were observed in genotype frequencies of FokI and TaqI variants between SARS-CoV-2 patients compared to the control group ( p < 0.005). Furthermore, the risk alleles, FokI T allele and TaqI C, were found to be statistically significant (odds ratio [OR] = 1.80, 95% confidence interval [CI] = 1.42-2.29, OR = 1.62, 95% CI = 1.27-2.05, respectively) in COVID-19 patients. The highest number of patients with wild-type genotype was found in the control group, which is 52.9% compared with 17.5% in the case group. Moreover, most of the COVID-19 patients had heterozygous/homozygous genotypes, reaching 82.5%, while 47.1% of the control group patients had heterozygous/homozygous genotypes. Our results suggested that patients with FokI and TaqI polymorphisms might tend to be more susceptible to getting infected with SARS-CoV-2. Overall, findings from this study provided evidence regarding vitamin D supplements recommendation in individuals with vitamin D deficiency/insufficiency in the peri- or post-COVID-19 pandemic.
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Affiliation(s)
- Begimai Mamurova
- Department of Molecular Medicine, Institute of Graduate Studies, Near East University, Nicosia, Cyprus
| | - Gokce Akan
- DESAM Research Institute, Near East University, Nicosia, Cyprus
| | - Evren Mogol
- Department of Molecular Medicine, Institute of Graduate Studies, Near East University, Nicosia, Cyprus
| | - Ayla Turgay
- Department of Molecular Medicine, Institute of Graduate Studies, Near East University, Nicosia, Cyprus
- Laboratory of Medical Genetics, Near East University Hospital, Near East University, Nicosia, Cyprus
| | - Gulten Tuncel
- DESAM Research Institute, Near East University, Nicosia, Cyprus
| | - Emine Unal Evren
- Department of Medical Microbiology and Infectious Diseases, Faculty of Medicine, Kyrenia University
| | - Hakan Evren
- Department of Medical Microbiology and Infectious Diseases, Faculty of Medicine, Kyrenia University
| | - Kaya Suer
- Department of Medical Microbiology and Infectious Diseases, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Tamer Sanlidag
- DESAM Research Institute, Near East University, Nicosia, Cyprus
| | - Mahmut Cerkez Ergoren
- Department of Molecular Medicine, Institute of Graduate Studies, Near East University, Nicosia, Cyprus
- Laboratory of Medical Genetics, Near East University Hospital, Near East University, Nicosia, Cyprus
- Department of Medical Genetics, Faculty of Medicine, Near East University, Nicosia, Cyprus
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A combined role for low vitamin D and low albumin circulating levels as strong predictors of worse outcome in COVID-19 patients. Ir J Med Sci 2023; 192:423-430. [PMID: 35182287 PMCID: PMC8857533 DOI: 10.1007/s11845-022-02952-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 02/08/2022] [Indexed: 02/04/2023]
Abstract
PURPOSE We aimed to assess the combined role of vitamin D and albumin serum levels as predictors of COVID-19 disease progression. METHODS We conducted a prospective observational study on adult patients hospitalized for SARS-CoV-2 pneumonia (March-September 2020). Vitamin D and albumin serum levels were measured on admission. These variables were categorized in albumin < 3.5 or ≥ 3.5 g/dL and vitamin D < 30 ng/mL or ≥ 30 ng/mL. We excluded patients with known bone diseases, renal failure, hypercalcemia and/or treated with antiepileptic drugs and steroids, and patients who received previous vitamin D supplementation. A composite outcome including any ventilatory support, PaO2/FiO2 ratio, and 60-day mortality was defined. RESULTS Sixty-nine patients were enrolled, of whom 50% received non-invasive (NIV) or invasive mechanical ventilation (IMV), 10% died, whereas 89% and 66% presented low albumin and low vitamin D serum levels, respectively. No correlation between vitamin D and albumin levels was found. In multivariable logistic regression analyses adjusted for sex and age-corrected comorbidities, patients having albumin < 3.5 g/dL and vitamin D < 30 ng/mL showed a significant increased risk for all study outcomes, namely NIV/IMV (OR 3.815; 95% CI 1.122-12.966; p = 0.032), NIV/IMV or death (OR 3.173; 95% CI 1.002-10.043; p = 0.049) and PaO2/FIO2 ≤ 100 (OR 3.410; 95% CI 1.138-10.219; p = 0.029). CONCLUSION The measurement of both vitamin D and serum albumin levels on COVID-19 patients' admission, and their combined evaluation, provides a simple prognostic tool that could be employed to guide prompt clinical decisions.
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Vitamins, microelements and the immune system: current standpoint in the fight against coronavirus disease 2019. Br J Nutr 2022; 128:2131-2146. [PMID: 35057876 DOI: 10.1017/s0007114522000083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is an acute respiratory disease associated with severe systemic inflammation. The optimal status of vitamins and microelements is considered crucial for the proper functioning of the immune system and necessary for successful recovery. Most patients with respiratory distress in COVID-19 are vitamin and microelement deficient, with vitamin D and Se deficiency being the most common. Anyway, various micronutrient supplements are widely and arbitrarily used for prevention or in the treatment of COVID-19. We aimed to summarise current knowledge about molecular and physiological mechanisms of vitamins (D, A, C, B6, B9 and B12) and microelements (Se, Zn, Cu and Fe) involved in the immune system regulation in consideration with COVID-19 pathogenesis, as well as recent findings related to their usage and effects in the prevention and treatment of COVID-19. In the early course of the pandemic, several, mainly observational, studies reported an association of some micronutrients, such as vitamin C, D and Zn, with severity reduction and survival improvement. Still, emerging randomised controlled trials showed no effect of vitamin D on hospitalisation length and no effect of vitamin C and Zn on symptom reduction. Up to date, there is evidence neither for nor against the use of micronutrients in the treatment of COVID-19. The doses that exceed the recommended for the general population and age group should not be used, except in clinical trials. Benefits of supplementation are primarily expected in populations prone to micronutrient deficiencies, who are, as well, at a higher risk of worse outcomes in COVID-19.
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Albu-Mohammed WHM, Anvari E, Fateh A. Evaluating the Role of BglI rs739837 and TaqI rs731236 Polymorphisms in Vitamin D Receptor with SARS-CoV-2 Variants Mortality Rate. Genes (Basel) 2022; 13:2346. [PMID: 36553614 PMCID: PMC9777972 DOI: 10.3390/genes13122346] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Revised: 12/08/2022] [Accepted: 12/10/2022] [Indexed: 12/14/2022] Open
Abstract
A lack of vitamin D is a potential risk factor for coronavirus disease (COVID-19). Variants in the Vitamin D Receptor (VDR) gene, such as BglI rs739837 and TaqI rs731236, are associated with various viral infection progressions. This study aimed to evaluate the relationship between the BglI rs739837 and TaqI rs731236 polymorphisms and the mortality rate of COVID-19 based on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants. The genotyping of BglI rs739837 and TaqI rs731236 genotypes was analyzed using the polymerase chain reaction-restriction fragment length polymorphism in 1734 improved and 1450 deceased patients positive for SARS-CoV-2. In this study, the rate of COVID-19 mortality was correlated with TaqI rs731236 TC and CC in the α variant and with TaqI rs731236 CC in the Delta variant, whereas no relationship was found in the Omicron BA.5 variant. In addition, the rate of COVID-19 mortality was associated with BglI rs739837 GT and TT in the Omicron BA.5 variant, while there was no association between BglI rs739837 and COVID-19 mortality in the α and Delta variants. The TG haplotype was more common in all SARS-CoV-2 variants, while the CT haplotype was associated with COVID-19 mortality in the Delta and Omicron BA.5 variants. In conclusion, this study indicated that the impacts of BglI rs739837 and TaqI rs731236 polymorphisms were related to SARS-CoV-2 variants. However, further research is still needed to approve our findings.
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Affiliation(s)
| | - Enayat Anvari
- Department of Physiology, School of Medicine, Ilam University of Medical Science, Ilam 693917134, Iran
| | - Abolfazl Fateh
- Department of Mycobacteriology and Pulmonary Research, Pasteur Institute of Iran, Tehran 1316943551, Iran
- Microbiology Research Center (MRC), Pasteur Institute of Iran, Tehran 1316943551, Iran
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Lei S, Chen X, Wu J, Duan X, Men K. Small molecules in the treatment of COVID-19. Signal Transduct Target Ther 2022; 7:387. [PMID: 36464706 PMCID: PMC9719906 DOI: 10.1038/s41392-022-01249-8] [Citation(s) in RCA: 53] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/02/2022] [Accepted: 11/08/2022] [Indexed: 12/11/2022] Open
Abstract
The outbreak of COVID-19 has become a global crisis, and brought severe disruptions to societies and economies. Until now, effective therapeutics against COVID-19 are in high demand. Along with our improved understanding of the structure, function, and pathogenic process of SARS-CoV-2, many small molecules with potential anti-COVID-19 effects have been developed. So far, several antiviral strategies were explored. Besides directly inhibition of viral proteins such as RdRp and Mpro, interference of host enzymes including ACE2 and proteases, and blocking relevant immunoregulatory pathways represented by JAK/STAT, BTK, NF-κB, and NLRP3 pathways, are regarded feasible in drug development. The development of small molecules to treat COVID-19 has been achieved by several strategies, including computer-aided lead compound design and screening, natural product discovery, drug repurposing, and combination therapy. Several small molecules representative by remdesivir and paxlovid have been proved or authorized emergency use in many countries. And many candidates have entered clinical-trial stage. Nevertheless, due to the epidemiological features and variability issues of SARS-CoV-2, it is necessary to continue exploring novel strategies against COVID-19. This review discusses the current findings in the development of small molecules for COVID-19 treatment. Moreover, their detailed mechanism of action, chemical structures, and preclinical and clinical efficacies are discussed.
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Affiliation(s)
- Sibei Lei
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Xiaohua Chen
- Department of Pharmacy, Personalized Drug Therapy Key Laboratory of Sichuan Province Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China
| | - Jieping Wu
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China
| | - Xingmei Duan
- Department of Pharmacy, Personalized Drug Therapy Key Laboratory of Sichuan Province Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, 610072, China.
| | - Ke Men
- State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China.
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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.
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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
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Karonova TL, Rudenco EV, Radaeva OA, Chernikova AT, Golovatyuk KA, Shlyakhto EV. Vitamin D status during the COVID-19 pandemic: the experience of Russia and Belarus. PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF BELARUS, MEDICAL SERIES 2022; 19:424-432. [DOI: 10.29235/1814-6023-2022-19-4-424-432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/02/2024]
Abstract
During the COVID-19 pandemic, a high prevalence of vitamin D deficiency and insufficiency remains. Thus, the studies carried out on the territory of the Russian Federation (RF) and the Republic of Belarus over the last 3 years have shown the prevalence of vitamin D deficiency and insufficiency in the population, regardless of the gender of examined persons, the geographic location and the season of the year. Taking into account the known immunomodulatory functions of serum 25(OH)D, the aim of this review was to assess the data that were accumulated in the world, Russia and Belarus and were concerned with a possible contribution of vitamin D deficiency to COVID-19 infection, course and prognosis, as well as with the role of cholecalciferol therapy in prevention and treatment of the disease. Most of the studies demonstrate a negative association between the serum 25(OH)D level and COVID-19 severity and/or mortality. Previously, it has been shown that the serum 25(OH)D level less than 11.4 ng/ml is associated with an increased risk of COVID-19 mortality. At the same time, the results of the studies using cholecalciferol therapy for COVID-19 prevention and treatment are conflicting. Intervention studies in the Russian Federation and the Republic of Belarus are scanty; however, the available data indicate a possible benefit of therapy, which allows it to be considered as an addition to the main methods of treating COVID-19.
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Affiliation(s)
| | - E. V. Rudenco
- Belarusian Medical Academy of Postgraduate Education
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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.
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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
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Tarantino U, Visconti VV, Bonanni R, Gatti A, Marcozzi M, Calabrò D, Cariati I. Osteosarcopenia and Long-COVID: a dangerous combination. Ther Adv Musculoskelet Dis 2022; 14:1759720X221130485. [PMID: 36317068 PMCID: PMC9614591 DOI: 10.1177/1759720x221130485] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 09/16/2022] [Indexed: 11/07/2022] Open
Abstract
SARS-CoV-2 has caused a global pandemic and an unprecedented public health crisis, infecting more than 580 million people worldwide. Moreover, recent evidence has suggested the emergence of a new syndrome known as Long-COVID, a term used to describe a diverse set of physical and mental symptoms that persist after a diagnosed SARS-CoV-2 infection. Epidemiological data have identified myalgias, muscle and joint dysfunction, and bone fragility as common sequelae in patients with moderate and severe forms of this disease. Significant musculoskeletal dysfunction has also been detected in some healed patients, although knowledge about pathophysiological mechanisms of Long-COVID is still rather scarce. In this context, SARS-CoV-2 infection has been suggested to amplify the effects of aging on the musculoskeletal system by aggravating the osteosarcopenic state. Based on this evidence, our review focused on the muscle and bone tissue alterations induced by SARS-CoV-2 infection and Long-COVID, summarizing the current knowledge on the underlying biological mechanisms and highlighting the need for a multidisciplinary approach to predict the musculoskeletal targets and long-term consequences of COVID-19 disease.
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Affiliation(s)
- Umberto Tarantino
- Department of Clinical Sciences and Translational Medicine, University of Rome ‘Tor Vergata’, Rome, Italy,Department of Orthopaedics and Traumatology, ‘Policlinico Tor Vergata’ Foundation, Rome, Italy
| | - Virginia V. Visconti
- Department of Clinical Sciences and Translational Medicine, University of Rome ‘Tor Vergata’, Rome, Italy
| | - Roberto Bonanni
- Department of Clinical Sciences and Translational Medicine, University of Rome ‘Tor Vergata’, Rome, Italy
| | - Andrea Gatti
- Department of Orthopaedics and Traumatology, ‘Policlinico Tor Vergata’ Foundation, Rome, Italy
| | - Martina Marcozzi
- Department of Orthopaedics and Traumatology, ‘Policlinico Tor Vergata’ Foundation, Rome, Italy
| | - Davide Calabrò
- Department of Orthopaedics and Traumatology, ‘Policlinico Tor Vergata’ Foundation, Rome, Italy
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The Effects of Vitamin D Supplementation in COVID-19 Patients: A Systematic Review. Int J Mol Sci 2022; 23:ijms232012424. [PMID: 36293279 PMCID: PMC9604062 DOI: 10.3390/ijms232012424] [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: 09/12/2022] [Revised: 09/30/2022] [Accepted: 10/04/2022] [Indexed: 11/17/2022] Open
Abstract
Vitamin D has an immune-modulating effect on respiratory tract infections. For this reason, it has been proposed as part of the treatment in COVID-19. Furthermore, vitamin D deficiency has been associated with worse clinical outcomes of this disease. The aim of this systematic review was to determine whether vitamin D supplementation modifies the disease course. Therefore, eleven studies involving randomised clinical trials are analysed, in which groups of COVID-19 patients with or without vitamin D supplementation as part of the treatment are compared. A control group was treated with best available therapy, and in some of the clinical trials, also with a placebo. According to the outcomes, it seems that patients benefit from receiving a daily or maintained in time vitamin D dose regardless of vitamin D serum levels at the beginning of the trial. The administration of a single vitamin D dose does not seem to have any effect on the health status of these patients. However, the outcomes are heterogeneous and larger clinical trials are necessary.
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Dana N, Nasirian M, Vaseghi G, Heshmat-Ghahdarijani K, Ataei B, Mosayebi A, Manteghinejad A, Haghjooy Javanmard S. Vitamin D Level in Laboratory Confirmed COVID-19 and Disease Progression. Eurasian J Med 2022; 54:206-212. [PMID: 35950827 PMCID: PMC9797700 DOI: 10.5152/eurasianjmed.2022.21088] [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] [Indexed: 01/05/2023] Open
Abstract
OBJECTIVE There is no conclusive evidence to suggest vitamin D level can prevent or treat infection with the new coronavirus disease 2019. This study aimed to investigate the effects of serum level of vitamin D in patients with coronavirus disease 2019 on death, severity, and hospitalization duration. MATERIALS AND METHODS Baseline characteristic of patients was extracted from the Isfahan coronavirus disease 2019 registry database (I-CORE). Blood samples were taken from all patients to measure the level of vitamin D (25-hydroxyvitamin D) and categorized. The effect of 25(OH) D on death, severity, and hospitalization duration was analyzed by logistic regression. RESULTS Among our study patients, 5.5% had a severe deficiency of vitamin D, 23.7% deficiency, and 24.8% insufficiency. Of the 107 patients who died, 7.5% were severely deficient in vitamin D. We found that vitamin D deficiency had no significant effect on death, disease severity, and hospitalization (P > .05). However, having at least one comorbidity increased the odds of death five times after adjusting age > 60 years and gender (P < .0001). The results showed that among all comorbidities, diabetes has the greatest impact on the outcomes as it raised the odds of death, disease severity, and length of hospital stay by 2.23,1.72, and 1.48, respectively, after controlling the age > 60 and gender (P = .0002, P=.08, P=.012). CONCLUSIONS The mortality, disease severity, and hospitalization of coronavirus disease 2019 patients seem to be not affected by the low levels of 25(OH)D. However, the synergy between vitamin D levels and comorbidities, age, and gender could affect the outcome of coronavirus disease 2019 patients.
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Affiliation(s)
- Nasim Dana
- Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Maryam Nasirian
- Infectious Diseases and Tropical Medicine Research Center; and Epidemiology and Biostatistics Department, Health School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Golnaz Vaseghi
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kiyan Heshmat-Ghahdarijani
- Heart Failure Research Center, ardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behrooz Ataei
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azam Mosayebi
- Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Amirreza Manteghinejad
- Cancer Prevention Research Center, Isfahan University of Medical Sciences, Omid Hospital, Isfahan, Iran
| | - Shaghayegh Haghjooy Javanmard
- Applied Physiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran,Corresponding author: Shaghayegh Haghjooy Javanmard E-mail:
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Esmaeilzadeh A, Elahi R, Siahmansouri A, Maleki AJ, Moradi A. Endocrine and metabolic complications of COVID-19: lessons learned and future prospects. J Mol Endocrinol 2022; 69:R125-R150. [PMID: 35900847 DOI: 10.1530/jme-22-0036] [Citation(s) in RCA: 10] [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: 05/07/2022] [Accepted: 07/18/2022] [Indexed: 01/08/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is well known for its respiratory complications; however, it can also cause extrapulmonary manifestations, including cardiovascular, thrombotic, renal, gastrointestinal, neurologic, and endocrinological symptoms. Endocrinological complications of COVID-19 are rare but can considerably impact the outcome of the patients. Moreover, preexisting endocrinologic disorders can affect the severity of COVID-19. Thyroid, pancreas, adrenal, neuroendocrine, gonadal, and parathyroid glands are the main endocrinologic organs that can be targeted by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Endocrinological complications of COVID-19 are rare but can significantly deteriorate the patients' prognosis. Understanding the interaction between COVID-19 and the endocrine system can provide a potential treatment option to improve the outcome of COVID-19. In this article, we aim to review the short-term and long-term organ-based endocrinological complications of COVID-19, the pathophysiology, the influence of each complication on COVID-19 prognosis, and potential therapeutic interventions based on current published data. Moreover, current clinical trials of potential endocrinological interventions to develop therapeutic strategies for COVID-19 have been discussed.
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Affiliation(s)
- Abdolreza Esmaeilzadeh
- Department of Immunology, Zanjan University of Medical Sciences, Zanjan, Iran
- Cancer Gene Therapy Research Center (CGRC), Zanjan University of Medical Sciences, Zanjan, Iran
| | - Reza Elahi
- School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Amir Siahmansouri
- School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | | | - Amirhosein Moradi
- School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
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Catalano A, Iacopetta D, Ceramella J, Maio ACD, Basile G, Giuzio F, Bonomo MG, Aquaro S, Walsh TJ, Sinicropi MS, Saturnino C, Geronikaki A, Salzano G. Are Nutraceuticals Effective in COVID-19 and Post-COVID Prevention and Treatment? Foods 2022; 11:2884. [PMID: 36141012 PMCID: PMC9498392 DOI: 10.3390/foods11182884] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/09/2022] [Accepted: 09/15/2022] [Indexed: 11/17/2022] Open
Abstract
The beginning of the end or the end of the beginning? After two years mastered by coronavirus disease 19 (COVID-19) pandemic, we are now witnessing a turnaround. The reduction of severe cases and deaths from COVID-19 led to increasing importance of a new disease called post-COVID syndrome. The term post-COVID is used to indicate permanency of symptoms in patients who have recovered from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Immune, antiviral, antimicrobial therapies, as well as ozone therapy have been used to treat COVID-19 disease. Vaccines have then become available and administered worldwide to prevent the insurgence of the disease. However, the pandemic is not over yet at all given the emergence of new omicron variants. New therapeutic strategies are urgently needed. In this view, great interest was found in nutraceutical products, including vitamins (C, D, and E), minerals (zinc), melatonin, probiotics, flavonoids (quercetin), and curcumin. This review summarizes the role of nutraceuticals in the prevention and/or treatment of COVID-19 disease and post-COVID syndrome.
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Affiliation(s)
- Alessia Catalano
- Department of Pharmacy-Drug Sciences, University of Bari “Aldo Moro”, 70126 Bari, Italy
| | - Domenico Iacopetta
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Jessica Ceramella
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Azzurra Chiara De Maio
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Giovanna Basile
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Federica Giuzio
- Department of Science, University of Basilicata, 85100 Potenza, Italy
| | | | - Stefano Aquaro
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Thomas J. Walsh
- Center for Innovative Therapeutics and Diagnostics, Richmond, VA 23223, USA
| | - Maria Stefania Sinicropi
- Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Arcavacata di Rende, Italy
| | - Carmela Saturnino
- Department of Science, University of Basilicata, 85100 Potenza, Italy
| | - Athina Geronikaki
- School of Pharmacy, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece
| | - Giovanni Salzano
- Department of Science, University of Basilicata, 85100 Potenza, Italy
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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
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Bozzola E, Caffarelli C, Santamaria F, Corsello G. The year 2021 in COVID-19 pandemic in children. Ital J Pediatr 2022; 48:161. [PMID: 36064605 PMCID: PMC9444079 DOI: 10.1186/s13052-022-01360-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/30/2022] [Indexed: 01/08/2023] Open
Abstract
In this article, the developments in the field of COVID-19 pandemic published in the Italian Journal of Pediatrics in 2021 are reflected. We describe progresses in SARS-CoV-2 transmission route, clinical presentation, diagnosis, treatment, and access to health care facilities in children. They led to substantial changes in the clinical approach.
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Affiliation(s)
- Elena Bozzola
- Department of Pediatric, IRCCS Bambino Gesù Children's Hospital, Pediatric Diseases Unit, Rome, Italy.
| | - Carlo Caffarelli
- Department of Medicine and Surgery, Clinica Pediatrica, Azienda Ospedaliera-Universitaria, University of Parma, Parma, Italy
| | - Francesca Santamaria
- Department of Translational Medical Sciences, Federico II University, Naples, Italy
| | - Giovanni Corsello
- Department of Sciences for Health Promotion and Mother and Child Care "G. D'Alessandro", University of Palermo, Palermo, Italy
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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.
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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
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Mohamed Y, El-Maradny YA, Saleh AK, Nayl AA, El-Gendi H, El-Fakharany EM. A comprehensive insight into current control of COVID-19: Immunogenicity, vaccination, and treatment. Biomed Pharmacother 2022; 153:113499. [PMID: 36076589 PMCID: PMC9343749 DOI: 10.1016/j.biopha.2022.113499] [Citation(s) in RCA: 14] [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: 05/12/2022] [Revised: 07/29/2022] [Accepted: 07/30/2022] [Indexed: 02/07/2023] Open
Abstract
The healthy immune system eliminates pathogens and maintains tissue homeostasis through extraordinarily complex networks with feedback systems while avoiding potentially massive tissue destruction. Many parameters influence humoral and cellular vaccine responses, including intrinsic and extrinsic, environmental, and behavioral, nutritional, perinatal and administrative parameters. The relative contributions of persisting antibodies and immune memory as well as the determinants of immune memory induction, to protect against specific diseases are the main parameters of long-term vaccine efficacy. Natural and vaccine-induced immunity and monoclonal antibody immunotherapeutic, may be evaded by SARS-CoV-2 variants. Besides the complications of the production of COVID-19 vaccinations, there is no effective single treatment against COVID-19. However, administration of a combined treatment at different stages of COVID-19 infection may offer some cure assistance. Combination treatment of antiviral drugs and immunomodulatory drugs may reduce inflammation in critical COVID-19 patients with cytokine release syndrome. Molnupiravir, remdesivir and paxlovid are the approved antiviral agents that may reduce the recovery time. In addition, immunomodulatory drugs such as lactoferrin and monoclonal antibodies are used to control inflammatory responses in their respective auto-immune conditions. Therefore, the widespread occurrence of highly transmissible variants like Delta and Omicron indicates that there is still a lot of work to be done in designing efficient vaccines and medicines for COVID-19. In this review, we briefly discussed the immunological response against SARS-CoV-2 and the vaccines approved by the World Health Organization (WHO) for COVID-19, their mechanisms, and side effects. Moreover, we mentioned various treatment trials and strategies for COVID-19.
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Affiliation(s)
- Yasser Mohamed
- Protein Research Department, Genetic Engineering and Biotechnology Research Institute, City of Scientific Research and Technological Applications (SRTA-City), New Borg EL-Arab, Alexandria 21934, Egypt; Laboratory of Kafr El-Sheikh Fever Hospital, Kafr El-Sheikh Fever Hospital, 33511 Kafr El-Sheikh, Egypt.
| | - Yousra A El-Maradny
- Protein Research Department, Genetic Engineering and Biotechnology Research Institute, City of Scientific Research and Technological Applications (SRTA-City), New Borg EL-Arab, Alexandria 21934, Egypt; Microbiology Department, High Institute of Public Health, Alexandria University, Alexandria 21526, Egypt.
| | - Ahmed K Saleh
- Cellulose and Paper Department, National Research Centre, El-Tahrir St., Dokki, P.O. 12622, Giza, Egypt
| | - AbdElAziz A Nayl
- Department of Chemistry, College of Science, Jouf University, Sakaka 72341, Al Jouf, Saudi Arabia.
| | - Hamada El-Gendi
- Bioprocess Development Department, Genetic Engineering and Biotechnology Research Institute, City of Scientific Research and Technological Applications (SRTA-City), Universities and Research Institutes zone, New Borg El-Arab, Alexandria 21934, Egypt.
| | - Esmail M El-Fakharany
- Protein Research Department, Genetic Engineering and Biotechnology Research Institute, City of Scientific Research and Technological Applications (SRTA-City), New Borg EL-Arab, Alexandria 21934, Egypt.
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Arora J, Patel DR, Nicol MJ, Field CJ, Restori KH, Wang J, Froelich NE, Katkere B, Terwilliger JA, Weaver V, Luley E, Kelly K, Kirimanjeswara GS, Sutton TC, Cantorna MT. Vitamin D and the Ability to Produce 1,25(OH) 2D Are Critical for Protection from Viral Infection of the Lungs. Nutrients 2022; 14:3061. [PMID: 35893921 PMCID: PMC9332570 DOI: 10.3390/nu14153061] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/19/2022] [Accepted: 07/20/2022] [Indexed: 01/27/2023] Open
Abstract
Vitamin D supplementation is linked to improved outcomes from respiratory virus infection, and the COVID-19 pandemic renewed interest in understanding the potential role of vitamin D in protecting the lung from viral infections. Therefore, we evaluated the role of vitamin D using animal models of pandemic H1N1 influenza and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. In mice, dietary-induced vitamin D deficiency resulted in lung inflammation that was present prior to infection. Vitamin D sufficient (D+) and deficient (D-) wildtype (WT) and D+ and D- Cyp27B1 (Cyp) knockout (KO, cannot produce 1,25(OH)2D) mice were infected with pandemic H1N1. D- WT, D+ Cyp KO, and D- Cyp KO mice all exhibited significantly reduced survival compared to D+ WT mice. Importantly, survival was not the result of reduced viral replication, as influenza M gene expression in the lungs was similar for all animals. Based on these findings, additional experiments were performed using the mouse and hamster models of SARS-CoV-2 infection. In these studies, high dose vitamin D supplementation reduced lung inflammation in mice but not hamsters. A trend to faster weight recovery was observed in 1,25(OH)2D treated mice that survived SARS-CoV-2 infection. There was no effect of vitamin D on SARS-CoV-2 N gene expression in the lung of either mice or hamsters. Therefore, vitamin D deficiency enhanced disease severity, while vitamin D sufficiency/supplementation reduced inflammation following infections with H1N1 influenza and SARS-CoV-2.
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Affiliation(s)
- Juhi Arora
- Department of Veterinary and Biomedical Sciences, The Pennsylvania State University, University Park, PA 16802, USA; (J.A.); (D.R.P.); (M.J.N.); (C.J.F.); (K.H.R.); (J.W.); (N.E.F.); (B.K.); (J.A.T.); (V.W.); (G.S.K.)
| | - Devanshi R. Patel
- Department of Veterinary and Biomedical Sciences, The Pennsylvania State University, University Park, PA 16802, USA; (J.A.); (D.R.P.); (M.J.N.); (C.J.F.); (K.H.R.); (J.W.); (N.E.F.); (B.K.); (J.A.T.); (V.W.); (G.S.K.)
| | - McKayla J. Nicol
- Department of Veterinary and Biomedical Sciences, The Pennsylvania State University, University Park, PA 16802, USA; (J.A.); (D.R.P.); (M.J.N.); (C.J.F.); (K.H.R.); (J.W.); (N.E.F.); (B.K.); (J.A.T.); (V.W.); (G.S.K.)
| | - Cassandra J. Field
- Department of Veterinary and Biomedical Sciences, The Pennsylvania State University, University Park, PA 16802, USA; (J.A.); (D.R.P.); (M.J.N.); (C.J.F.); (K.H.R.); (J.W.); (N.E.F.); (B.K.); (J.A.T.); (V.W.); (G.S.K.)
| | - Katherine H. Restori
- Department of Veterinary and Biomedical Sciences, The Pennsylvania State University, University Park, PA 16802, USA; (J.A.); (D.R.P.); (M.J.N.); (C.J.F.); (K.H.R.); (J.W.); (N.E.F.); (B.K.); (J.A.T.); (V.W.); (G.S.K.)
| | - Jinpeng Wang
- Department of Veterinary and Biomedical Sciences, The Pennsylvania State University, University Park, PA 16802, USA; (J.A.); (D.R.P.); (M.J.N.); (C.J.F.); (K.H.R.); (J.W.); (N.E.F.); (B.K.); (J.A.T.); (V.W.); (G.S.K.)
| | - Nicole E. Froelich
- Department of Veterinary and Biomedical Sciences, The Pennsylvania State University, University Park, PA 16802, USA; (J.A.); (D.R.P.); (M.J.N.); (C.J.F.); (K.H.R.); (J.W.); (N.E.F.); (B.K.); (J.A.T.); (V.W.); (G.S.K.)
| | - Bhuvana Katkere
- Department of Veterinary and Biomedical Sciences, The Pennsylvania State University, University Park, PA 16802, USA; (J.A.); (D.R.P.); (M.J.N.); (C.J.F.); (K.H.R.); (J.W.); (N.E.F.); (B.K.); (J.A.T.); (V.W.); (G.S.K.)
| | - Josey A. Terwilliger
- Department of Veterinary and Biomedical Sciences, The Pennsylvania State University, University Park, PA 16802, USA; (J.A.); (D.R.P.); (M.J.N.); (C.J.F.); (K.H.R.); (J.W.); (N.E.F.); (B.K.); (J.A.T.); (V.W.); (G.S.K.)
| | - Veronika Weaver
- Department of Veterinary and Biomedical Sciences, The Pennsylvania State University, University Park, PA 16802, USA; (J.A.); (D.R.P.); (M.J.N.); (C.J.F.); (K.H.R.); (J.W.); (N.E.F.); (B.K.); (J.A.T.); (V.W.); (G.S.K.)
| | - Erin Luley
- Animal Diagnostic Laboratory, The Pennsylvania State University, University Park, PA 16802, USA; (E.L.); (K.K.)
| | - Kathleen Kelly
- Animal Diagnostic Laboratory, The Pennsylvania State University, University Park, PA 16802, USA; (E.L.); (K.K.)
| | - Girish S. Kirimanjeswara
- Department of Veterinary and Biomedical Sciences, The Pennsylvania State University, University Park, PA 16802, USA; (J.A.); (D.R.P.); (M.J.N.); (C.J.F.); (K.H.R.); (J.W.); (N.E.F.); (B.K.); (J.A.T.); (V.W.); (G.S.K.)
| | - Troy C. Sutton
- Department of Veterinary and Biomedical Sciences, The Pennsylvania State University, University Park, PA 16802, USA; (J.A.); (D.R.P.); (M.J.N.); (C.J.F.); (K.H.R.); (J.W.); (N.E.F.); (B.K.); (J.A.T.); (V.W.); (G.S.K.)
| | - Margherita T. Cantorna
- Department of Veterinary and Biomedical Sciences, The Pennsylvania State University, University Park, PA 16802, USA; (J.A.); (D.R.P.); (M.J.N.); (C.J.F.); (K.H.R.); (J.W.); (N.E.F.); (B.K.); (J.A.T.); (V.W.); (G.S.K.)
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Migliorini F, Vaishya R, Eschweiler J, Oliva F, Hildebrand F, Maffulli N. Vitamins C and D and COVID-19 Susceptibility, Severity and Progression: An Evidence Based Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:941. [PMID: 35888660 PMCID: PMC9318801 DOI: 10.3390/medicina58070941] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 07/02/2022] [Accepted: 07/12/2022] [Indexed: 04/07/2023]
Abstract
Background and Objectives: Starting in early December 2019, the novel Coronavirus Disease (COVID-19) from infection with COVID-19 has caused a global pandemic. Many aspects of its pathogenesis and related clinical consequences are still unclear. Early diagnosis and dynamic monitoring of prognostic factors are essential to improve the ability to manage COVID-19 infection. This study aimed to provide an account of the role played by vitamins C and D on the onset, progression and severity of COVID-19. Clinical features and infection-related risk factors are also briefly discussed. Material and Methods: In March 2022, the main online databases were accessed. All the articles that investigate the possible role of vitamins C and D on COVID-19 susceptibility, severity and progression were considered. Results: The current evidence on vitamin C and D supplementation in patients with COVID-19 infection is inconsistent and controversial. In some studies, vitamins were used as coadjuvant of a formal experimental therapy, while in others as main treatment. Ethnicity and hospital setting (inpatient/outpatient) were also variable. Moreover, there was no consensus between studies in administration protocol: high heterogeneity in dosage, administration, and duration of the treatment were evident. Finally, some studies administered vitamins pre- and/or during COVID infection, in patients with different risk factors and infection severity. Conclusions: While waiting to develop a targeted, safe and effective therapy, it is important to investigate individual predisposition and proper disease management. Concluding, available data on the use of nutraceuticals in COVID-19 are inconsistent. However, there is a lack of evidence-based guidelines which recommend vitamin C and D supplementation in patients with COVID-19, and results from high quality randomised controlled trials (RCTs) are inconsistent. Current investigations so far are mostly observational, and include a relatively small sample size which can lead to biased results. Large-scale multicentre studies are therefore needed.
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Affiliation(s)
- Filippo Migliorini
- Department of Orthopaedic, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (J.E.); (F.H.)
| | - Raju Vaishya
- Department of Orthopaedics, Indraprastha Apollo Hospitals Institutes of Orthopaedics, New Delhi 110076, India;
| | - Jörg Eschweiler
- Department of Orthopaedic, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (J.E.); (F.H.)
| | - Francesco Oliva
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (F.O.); (N.M.)
| | - Frank Hildebrand
- Department of Orthopaedic, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany; (J.E.); (F.H.)
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Via S. Allende, 84081 Baronissi, Italy; (F.O.); (N.M.)
- School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, Thornburrow Drive, Stoke on Trent ST5 5BG, UK
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Centre for Sports and Exercise Medicine, Mile End Hospital, 275 Bancroft Road, London E1 4DG, UK
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D’Ecclesiis O, Gavioli C, Martinoli C, Raimondi S, Chiocca S, Miccolo C, Bossi P, Cortinovis D, Chiaradonna F, Palorini R, Faciotti F, Bellerba F, Canova S, Jemos C, Salé EO, Gaeta A, Zerbato B, Gnagnarella P, Gandini S. Vitamin D and SARS-CoV2 infection, severity and mortality: A systematic review and meta-analysis. PLoS One 2022; 17:e0268396. [PMID: 35793346 PMCID: PMC9258852 DOI: 10.1371/journal.pone.0268396] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 04/28/2022] [Indexed: 12/12/2022] Open
Abstract
To assess the evidence on SARS-CoV2 infection and Covid-19 in relation to deficiency and supplementation of vitamin D, we conducted a systematic review up to April 2021. We summarised data from 38 eligible studies, which presented risk estimates for at least one endpoint, including two RCT and 27 cohort-studies: 205565 patients with information on 25OHD status and 2022 taking vitamin D supplementation with a total of 1197 admitted to the ICU or who needed invasive mechanical ventilation or intubation and hospital stay, and more than 910 Covid-19 deaths. Primary outcomes were severity and mortality and the main aim was to evaluate the association with vitamin D supplementation. Random effects models showed that supplementation was associated with a significant lower risk of both Covid-19 severe disease (SRR 0.38, 95% CI 0.20-0.72, 6 studies) and mortality (SRR 0.35, 95% CI 0.17-0.70, 8 studies). There were no statistically significant dose differences between studies: summary estimates with regular doses remain statistically significant, suggesting that higher doses are not necessary. For patients on vitamin D supplementation, a greater reduction in mortality risk emerged in older individuals and at higher latitudes. Regarding the quality of studies, assessed using the New Castle-Ottawa quality scale, the analysis revealed in most cases no statistically significant differences between low, medium or high quality studies. We found significant associations of vitamin D supplementation with Covid-19, encompassing risks of disease worsening and mortality, especially in seasons characterized by 25OHD deficiency and with not severe patients. Dedicated randomized clinical studies are encouraged to confirm these results.
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Affiliation(s)
- Oriana D’Ecclesiis
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Costanza Gavioli
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Chiara Martinoli
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Sara Raimondi
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Susanna Chiocca
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Claudia Miccolo
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Paolo Bossi
- Medical Oncology, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health University of Brescia, ASST-Spedali Civili, Brescia, Italy
| | | | | | - Roberta Palorini
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milan, Italy
| | - Federica Faciotti
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Federica Bellerba
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Costantino Jemos
- Department of Clinical Pharmacy, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Emanuela Omodeo Salé
- Department of Clinical Pharmacy, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Aurora Gaeta
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Barbara Zerbato
- Department of Biotechnology and Biosciences, University of Milano-Bicocca, Milan, Italy
| | - Patrizia Gnagnarella
- Division of Epidemiology and Biostatistics, IEO European Institute of Oncology IRCCS, Milan, Italy
| | - Sara Gandini
- Department of Experimental Oncology, IEO, European Institute of Oncology IRCCS, Milan, Italy
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Spira B. The Impact of the Highly Virulent SARS-CoV-2 Gamma Variant on Young Adults in the State of São Paulo: Was It Inevitable? Cureus 2022; 14:e26486. [PMID: 35919213 PMCID: PMC9339207 DOI: 10.7759/cureus.26486] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/30/2022] [Indexed: 11/21/2022] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic had and is still having a tremendous impact on people all over the world, but it has been particularly harsh in South America. Nine out of 13 South American countries are among the 50 countries with the highest COVID-19 death rates. The gamma severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant that emerged by the end of 2020 in the Brazilian Amazon quickly spread throughout the country causing the harsh COVID-19 second wave. This variant displayed high viral loads, high transmissibility, and increased virulence as compared to previous variants. Aims The aim of this retrospective study is to revisit and analyse the epidemiology of the COVID-19 second wave in the state of São Paulo, the most populous Brazilian state. In addition to examining the possible factors that led to the emergence and propagation of the gamma variant, measures that could have prevented its spread and that of other highly virulent variants were also investigated. Materials and methods Data from São Paulo's official sources on morbidity, mortality, age distribution, and testing prior to and during the COVID-19 second wave (February - June 2021) and data regarding the distribution of SARS-CoV-2 variants in the country were parsed, analyzed, and compared to the period that anteceded the eruption of the second COVID-19 wave. Results In the state of São Paulo, the toll of the COVID-19 second wave surpassed that of the first 11 months of the pandemic (from March 2020 to January 2021), as 56% of the deaths occurred in the five months of the second wave between February and June 2021. The mean age of COVID-19 victims, which was already below life expectancy in the state dropped even further in the pandemic's second wave, reaching an average of 60 years of age. The years of life lost per death per month doubled and the case-fatality rate (CFR) of young adults (20-39 years old) more than trebled during this period. A number of hypotheses have been raised that might explain the emergence and spread of the gamma variant and the measures that could have been taken to prevent it and minimise its impact on the population. Conclusions Over 142,000 people died as a result of the SARS-CoV-2 gamma variant sweep in São Paulo in the first semester of 2021. Due to its high viral load, the gamma variant displayed high transmissibility and a high degree of virulence resulting in increased case fatality rates across most age tiers. Notably, this second wave was marked by a very significant increase in deaths among young adults. This increase was at least partially due to a deterioration in general health provoked by non-pharmaceutical interventions. In hindsight, a safer and more effective measure might have been to allow the free spread of the virus among the young and healthy in the first wave, thus conferring immunity against more virulent variants that emerged later on.
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Shoemaker ME, Huynh LM, Smith CM, Mustad VA, Duarte MO, Cramer JT. Immunomodulatory Effects of Vitamin D and Prevention of Respiratory Tract Infections and COVID-19. TOP CLIN NUTR 2022; 37:203-217. [PMID: 35761885 PMCID: PMC9222791 DOI: 10.1097/tin.0000000000000284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Little is known about potential protective factors for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), referred to as COVID-19. Suboptimal vitamin D status is a risk factor for immune dysfunction, respiratory tract infections (RTIs), and viral infections. Supplementation of vitamin D (2000-4000 IU) has decreased incidence and complications from RTIs, respiratory distress syndrome, and pneumonia and may be beneficial in high-risk populations. Given the possible link between low vitamin D status and RTIs, such as COVID-19, this review examined whether vitamin D supplementation can be supported as a nutritional strategy for reducing risk of infection, complications, and mortality from COVID-19 and found that the relationship between vitamin D and RTIs warrants further exploration.
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Affiliation(s)
- Marni E. Shoemaker
- College of Health Sciences, The University of Texas at El Paso, El Paso (Drs Shoemaker and Cramer); University of Nebraska Medical Center, Omaha (Ms Huynh); Departments of Kinesiology (Dr Smith) and Public Health Sciences (Dr Duarte), The University of Texas at El Paso, El Paso; and Nutrition Science Consulting, LLC, Galena, Ohio (Dr Mustad)
| | - Linda M. Huynh
- College of Health Sciences, The University of Texas at El Paso, El Paso (Drs Shoemaker and Cramer); University of Nebraska Medical Center, Omaha (Ms Huynh); Departments of Kinesiology (Dr Smith) and Public Health Sciences (Dr Duarte), The University of Texas at El Paso, El Paso; and Nutrition Science Consulting, LLC, Galena, Ohio (Dr Mustad)
| | - Cory M. Smith
- College of Health Sciences, The University of Texas at El Paso, El Paso (Drs Shoemaker and Cramer); University of Nebraska Medical Center, Omaha (Ms Huynh); Departments of Kinesiology (Dr Smith) and Public Health Sciences (Dr Duarte), The University of Texas at El Paso, El Paso; and Nutrition Science Consulting, LLC, Galena, Ohio (Dr Mustad)
| | - Vikkie A. Mustad
- College of Health Sciences, The University of Texas at El Paso, El Paso (Drs Shoemaker and Cramer); University of Nebraska Medical Center, Omaha (Ms Huynh); Departments of Kinesiology (Dr Smith) and Public Health Sciences (Dr Duarte), The University of Texas at El Paso, El Paso; and Nutrition Science Consulting, LLC, Galena, Ohio (Dr Mustad)
| | - Maria O. Duarte
- College of Health Sciences, The University of Texas at El Paso, El Paso (Drs Shoemaker and Cramer); University of Nebraska Medical Center, Omaha (Ms Huynh); Departments of Kinesiology (Dr Smith) and Public Health Sciences (Dr Duarte), The University of Texas at El Paso, El Paso; and Nutrition Science Consulting, LLC, Galena, Ohio (Dr Mustad)
| | - Joel T. Cramer
- College of Health Sciences, The University of Texas at El Paso, El Paso (Drs Shoemaker and Cramer); University of Nebraska Medical Center, Omaha (Ms Huynh); Departments of Kinesiology (Dr Smith) and Public Health Sciences (Dr Duarte), The University of Texas at El Paso, El Paso; and Nutrition Science Consulting, LLC, Galena, Ohio (Dr Mustad)
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Zafar M, Karkhanis M, Shahbaz M, Khanna A, Barry L, Alam S, Lawrence K, Pun B, Eldebri R, Makanjuola O, Safarova D, Farooq M, Nooredinavand H, Cuison F, Subba K, Singh Randhawa R, Hegner J, Oluwamayowa O, Elyasaky A, Adekunle B, Periasamy M, Abdelbagi M, Maryam Z, Khuu B, Esteves Morete A, Ciroi G, Moran S, O'Neill W, Zafar MJ, Zafar N, Patel M, Golez R, Hadid A, Muhammad T, Mayhead P, Whitehead M, Dashora U. Vitamin D levels and mortality with SARS-COV-2 infection: a retrospective two-centre cohort study. Postgrad Med J 2022; 98:523-528. [PMID: 34489318 PMCID: PMC8423517 DOI: 10.1136/postgradmedj-2021-140564] [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] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 08/22/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND The role of vitamin D in increased mortality with SARS-COV-2 virus, namely, COVID-19, remains uncertain. We analysed all the patients who were treated as COVID-19-positive with or without a positive swab and were tested for vitamin D levels. METHODS This was a retrospective, study involving 1226 patients swabbed for SARS-CoV-2 between the 10 February 2020 and 1 May 2020 at two hospitals of East Sussex Healthcare NHS Trust. Patients who were swab-positive for COVID-19 or treated as COVID-19-positive on clinical grounds even though swab results were negative were included in this study. We analysed the association of vitamin D levels and mortality, assessing linear and non-linear associations. RESULTS A total of 1226 patients had SARS-CoV-2 RNA swabs in this period with age range from 1 year to 101 years. A cohort of 433 of these patients had swabs and recent vitamin D levels anytime in the previous 3 months. Mortality rates were not found to be associated with vitamin D levels (OR=1.04, 95% CI 0.96 to 1.12). CONCLUSION Our findings suggest similar mortality risk from COVID-19 irrespective of the levels of vitamin D. Larger prospective studies will be needed to confirm these findings.
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Affiliation(s)
- Mansoor Zafar
- Gastroenterology, GIM, Conquest Hospital, Saint Leonards on Sea, UK
| | | | | | | | | | - Saba Alam
- Conquest Hospital, Saint Leonards on Sea, UK
| | | | - Bipin Pun
- Conquest Hospital, Saint Leonards on Sea, UK
| | | | | | | | | | | | | | | | | | | | | | - Amr Elyasaky
- Geriatric, Conquest Hospital, Saint Leonards on Sea, UK
| | | | | | | | | | - Bao Khuu
- General Internal Medicine, Conquest Hospital, East Sussex healthcare NHS Trust, St. Leonards-on-sea, UK
| | | | - Giulio Ciroi
- General Internal Medicine, Conquest Hospital, East Sussex healthcare NHS Trust, St. Leonards-on-sea, UK
| | - Steve Moran
- Microbiology, Eastbourne District General Hospital, East Sussex Healthcare NHS Trust, Eastbourne, UK
| | - William O'Neill
- Microbiology, Eastbourne District General Hospital, Eastbourne, UK
| | - Maaryah J Zafar
- Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
| | - Nadiyah Zafar
- Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania
| | - Mirej Patel
- Medical School and Health Science Center, University of Debrecen, Debrecen, Hungary
| | - Raphael Golez
- Geriatric, Conquest Hospital, Saint Leonards on Sea, UK
| | - Abubakr Hadid
- General Internal Medicine, Conquest Hospital, Saint Leonards on Sea, UK
| | - Tila Muhammad
- Gastroenterology, East Sussex Hospitals NHS Trust, Saint Leonards-on-Sea, UK
| | - Philip Mayhead
- Gastroenterology, Eastbourne District General Hospital. East Sussex Healthcare NHS Trust, Eastbourne, UK
| | - Mark Whitehead
- Consultant Physician and Gastroenterologist, Conquest Hospital, Saint Leonards on Sea, East Sussex, UK
| | - Umesh Dashora
- Diabetes and Endocrinology and General Internal Medicine, Conquest Hospital, Saint Leonards on Sea, UK
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