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Rachman A, Rahmaniyah R, Khomeini A, Iriani A. The association between vitamin D deficiency and the clinical outcomes of hospitalized COVID-19 patients. F1000Res 2024; 12:394. [PMID: 38434628 PMCID: PMC10905025 DOI: 10.12688/f1000research.132214.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/01/2024] [Indexed: 03/05/2024] Open
Abstract
Background Vitamin D deficiency is an emerging public health problem that affects more than one billion people worldwide. Vitamin D has been shown to be effective in preventing and reducing the severity of viral respiratory diseases, including influenza. However, the role of vitamin D in COVID-19 infection remains controversial. This study aimed to analyze the association of vitamin D deficiency on the clinical outcome of hospitalized COVID-19 patients. Methods A prospective cohort study was conducted among hospitalized COVID-19 patients at two COVID-19 referral hospitals in Indonesia from October 2021 until February 2022. Results The median serum 25(OH)D level in 191 hospitalized COVID-19 patients was 13.6 [IQR=10.98] ng/mL. The serum 25(OH)D levels were significantly lower among COVID-19 patients with vitamin D deficiency who had cardiovascular disease (p-value=0.04), the use of a ventilator (p-value=0.004), more severe COVID-19 cases (p-value=0.047), and mortality (p-value=0.002). Furthermore, serum 25(OH)D levels were significantly different between patients with mild and severe COVID-19 cases (p-value=0.019). Serum 25(OH)D levels in moderate and severe COVID-19 cases were significantly different (p-value=0.031). Lower serum 25(OH)D levels were significantly associated with an increased number of comorbidities (p-value=0.03), the severity of COVID-19 (p-value=0.002), and the use of mechanical ventilation (p-value=0.032). Mortality was found in 7.3% of patients with deficient vitamin D levels. However, patients with either sufficient or insufficient vitamin D levels did not develop mortality. Conclusions COVID-19 patients with vitamin D deficiency were significantly associated with having cardiovascular disease, mortality, more severe COVID-19 cases, and the used of mechanical ventilation. Lower serum 25(OH)D levels were associated with an increased number of comorbidities, COVID-19 severity, and the use of mechanical-ventilation. Thus, we suggest hospitalized COVID-19 patients to reach a sufficient vitamin D status to improve the clinical outcome of the disease.
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Affiliation(s)
- Andhika Rachman
- Division of Hematology and Oncology, Department of Internal Medicine, Dr. Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Centra Jakarta, DKI Jakarta, 10430, Indonesia
| | - Rizky Rahmaniyah
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Central Jakarta, DKI Jakarta, 10430, Indonesia
| | - Andi Khomeini
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Central Jakarta, DKI Jakarta, 10430, Indonesia
- Department of Internal Medicine, Wisma Atlet COVID-19 Emergency Hospital, North Jakarta, DKI Jakarta, 14360, Indonesia
| | - Anggraini Iriani
- Department of Clinical Pathology, Yarsi University, Central Jakarta, DKI Jakarta, 10510, Indonesia
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2
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Wierzbicka A, Pawlina-Tyszko K, Świątkiewicz M, Szmatoła T, Oczkowicz M. Changes in miRNA expression in the lungs of pigs supplemented with different levels and forms of vitamin D. Mol Biol Rep 2023; 51:8. [PMID: 38085380 PMCID: PMC10716066 DOI: 10.1007/s11033-023-08940-1] [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: 08/18/2023] [Accepted: 10/23/2023] [Indexed: 12/18/2023]
Abstract
BACKGROUND Vitamin D is an immunomodulator, and its effects have been linked to many diseases, including the pathogenesis of cancer. However, the effect of vitamin D supplementation on the regulation of gene expression of the lungs is not fully understood. This study aims to determine the effect of the increased dose of cholecalciferol and a combination of cholecalciferol + calcidiol, as well as the replacement of cholecalciferol with calcidiol, on the miRNA profile of healthy swine lungs. METHODS AND RESULTS The swine were long-term (88 days) supplemented with a standard dose (2000IU/kg) of cholecalciferol and calcidiol, the increased dose (3000 IU/kg) of cholecalciferol, and the cholecalciferol + calcidiol combination: grower: 3000 IU/Kg of vitamin D (67% of cholecalciferol and 33% of calcidiol), finisher 2500 IU/Kg of vitamin D (60% of cholecalciferol and 40% of calcidiol). Swine lung tissue was used for Next Generation Sequencing (NGS) of miRNA. Long-term supplementation with the cholecalciferol + calcidiol combination caused significant changes in the miRNA profile. They embraced altered levels of the expression of miR-150, miR-193, miR-145, miR-574, miR-340, miR-381, miR-148 and miR-96 (q-value < 0.05). In contrast, raising the dose of cholecalciferol only changed the expression of miR-215, and the total replacement of cholecalciferol with calcidiol did not significantly affect the miRNAome profile. CONCLUSIONS The functional analysis of differentially expressed miRNAs suggests that the use of the increased dose of the cholecalciferol + calcidiol combination may affect tumorigenesis processes through, inter alia, modulation of gene regulation of the TGF- β pathway and pathways related to metabolism and synthesis of glycan.
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Affiliation(s)
- Alicja Wierzbicka
- Department of Animal Molecular Biology, National Research Institute of Animal Production, Ul. Krakowska 1, Balice, 32-083, Poland
| | - Klaudia Pawlina-Tyszko
- Department of Animal Molecular Biology, National Research Institute of Animal Production, Ul. Krakowska 1, Balice, 32-083, Poland
| | - Małgorzata Świątkiewicz
- Department of Animal Nutrition and Feed Science, National Research Institute of Animal Production, Ul. Krakowska 1, Balice, 32-083, Poland
| | - Tomasz Szmatoła
- Department of Animal Molecular Biology, National Research Institute of Animal Production, Ul. Krakowska 1, Balice, 32-083, Poland
- Center for Experimental and Innovative Medicine, University of Agriculture in Kraków, Rędzina 1c, Kraków, 30 248, Poland
| | - Maria Oczkowicz
- Department of Animal Molecular Biology, National Research Institute of Animal Production, Ul. Krakowska 1, Balice, 32-083, Poland.
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Bopape PG, Wagenaar C, Poka M, Bronkhorst E. Vitamin D supplementation in a post-pandemic era: A narrative review. S Afr Fam Pract (2004) 2023; 65:e1-e6. [PMID: 37916701 PMCID: PMC10623655 DOI: 10.4102/safp.v65i1.5752] [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: 03/23/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 11/03/2023] Open
Abstract
Vitamin D is a fat-soluble molecule referring to the different isoforms, ergocalciferol (D2) and cholecalciferol (D3). Its physiological functions include increasing calcium serum concentrations. 25-hydroxyvitamin D3 (25(OH)D) (Calcifediol), a non-active, circulating instant precursor is seen as a pre-hormone. Studies have shown that a deficiency in calcifediol is related to chronic conditions such as cardiovascular, musculoskeletal, immune system, neurological, and anti-neoplastic functions. Vitamin D supplementation has shown its benefit as prophylaxis and treatment during the coronavirus disease 2019 (COVID-19) pandemic and an increase in the prescribing of vitamin D supplementation has been observed. The intention of this review article is to provide guidance on the recommended dosage regimen as a prophylactic measure during COVID-19 and its use as a supplement in general. From this review article, it is clear that vitamin D has an important role to play not only in COVID-19 but also in various other health aspects of the human body.Contribution: This review article highlighted the role of vitamin D in managing vitamin D deficiency and its role as a supplement in the management of respiratory tract infections, especially COVID-19. This overview can assist physicians in optimising healthcare by optimised dosing recommendations and indications.
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Affiliation(s)
- Pheagane G Bopape
- Department of Clinical Pharmacy, Faculty of Health Sciences, School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria.
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Maggini V, Crescioli G, Ippoliti I, Gallo E, Menniti-Ippolito F, Chiaravalloti A, Mascherini V, Da Cas R, Potenza S, Gritti G, Galiulo MT, Sottosanti L, Vannacci A, Lombardi N, Firenzuoli F. Safety Profile of Vitamin D in Italy: An Analysis of Spontaneous Reports of Adverse Reactions Related to Drugs and Food Supplements. J Clin Med 2023; 12:4726. [PMID: 37510843 PMCID: PMC10381134 DOI: 10.3390/jcm12144726] [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: 05/26/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 07/30/2023] Open
Abstract
Vitamin D (VitD) is largely used in Italy, often inappropriately; thus, an evaluation of its safety is a crucial issue. This study analyses the adverse reactions (ARs) associated with the use of products containing VitD (VitDps) reported to the Italian National Pharmacovigilance and Phytovigilance networks. From March 2002 to August 2022, a total of 643 and 127 reports concerning 903 and 215 ARs were retrieved from Pharmacovigilance and Phytovigilance networks, respectively. Overall, 332 (29.6%) ARs were classified as serious, and the most described ones were hypercalcaemia, renal failure and tachycardia. Serious AR risk was significantly higher for subjects using more than four concomitant products (OR 2.44 [95% CI 1.30-4.60]) and VitD doses higher than 1000 IU/day (OR 2.70 [95% CI 1.30-5.64]). In Italy, there was a modest decrease in AR reporting, despite the slightly increased use of VitD during the COVID-19 pandemic. To the best of our knowledge, this is the first study describing all VitDps-related ARs observed in the Italian general population. Since underreporting is the main limitation of the safety reporting systems, the necessity to continue ARs monitoring, also using real-world data on VitDps prescription, use and outcome patterns is highlighted.
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Affiliation(s)
- Valentina Maggini
- Research and Innovation Center in Phytotherapy and Integrated Medicine-CERFIT, Referring Center for Phytotherapy of Tuscany Region, Careggi University Hospital, 50141 Florence, Italy
| | - Giada Crescioli
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, 50141 Florence, Italy
| | - Ilaria Ippoliti
- National Centre for Drug Research and Evaluation, National Institute of Health, 00161 Rome, Italy
| | - Eugenia Gallo
- Research and Innovation Center in Phytotherapy and Integrated Medicine-CERFIT, Referring Center for Phytotherapy of Tuscany Region, Careggi University Hospital, 50141 Florence, Italy
| | | | - Adelaide Chiaravalloti
- Research and Innovation Center in Phytotherapy and Integrated Medicine-CERFIT, Referring Center for Phytotherapy of Tuscany Region, Careggi University Hospital, 50141 Florence, Italy
- General and Clinical Phytotherapy, Department of Experimental and Clinical Medicine, University of Florence, 50141 Florence, Italy
| | - Vittorio Mascherini
- Research and Innovation Center in Phytotherapy and Integrated Medicine-CERFIT, Referring Center for Phytotherapy of Tuscany Region, Careggi University Hospital, 50141 Florence, Italy
| | - Roberto Da Cas
- National Centre for Drug Research and Evaluation, National Institute of Health, 00161 Rome, Italy
| | | | | | | | | | - Alfredo Vannacci
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, 50141 Florence, Italy
| | - Niccolò Lombardi
- Department of Neurosciences, Psychology, Drug Research and Child Health, Section of Pharmacology and Toxicology, University of Florence, 50141 Florence, Italy
| | - Fabio Firenzuoli
- Research and Innovation Center in Phytotherapy and Integrated Medicine-CERFIT, Referring Center for Phytotherapy of Tuscany Region, Careggi University Hospital, 50141 Florence, Italy
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Contreras-Bolívar V, García-Fontana B, García-Fontana C, Muñoz-Torres M. Vitamin D and COVID-19: where are we now? Postgrad Med 2023; 135:195-207. [PMID: 34886758 PMCID: PMC8787834 DOI: 10.1080/00325481.2021.2017647] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The pandemic caused by the SARS-CoV-2 virus has triggered great interest in the search for the pathophysiological mechanisms of COVID-19 and its associated hyperinflammatory state. The presence of prognostic factors such as diabetes, cardiovascular disease, hypertension, obesity, and age influence the expression of the disease's clinical severity. Other elements, such as 25-hydroxyvitamin D (25(OH)D3) concentrations, are currently being studied. Various studies, mostly observational, have sought to demonstrate whether there is truly a relationship between 25(OH)D3 levels and the acquisition and/or severity of the disease. The objective of this study was to carry out a review of the current data that associate vitamin D status with the acquisition, evolution, and/or severity of infection by the SARS-CoV-2 virus and to assess whether prevention through vitamin D supplementation can prevent infection and/or improve the evolution once acquired. Vitamin D system has an immunomodulatory function and plays a significant role in various bacterial and viral infections. The immune function of vitamin D is explained in part by the presence of its receptor (VDR) and its activating enzyme 25-hydroxyvitamin D-1alpha-hydroxylase (CYP27B1) in immune cells. The vitamin D, VDR, and Retinoid X Receptor complex allows the transcription of genes with antimicrobial activities, such as cathelicidins and defensins. COVID-19 characteristically presents a marked hyperimmune state, with the release of proinflammatory cytokines such as IL-6, TNF-α, and IL-1β. Thus, there are biological factors linking vitamin D to the cytokine storm, which can herald some of the most severe consequences of COVID-19, such as acute respiratory distress syndrome. Hypovitaminosis D is widespread worldwide, so the prevention of COVID-19 through vitamin D supplementation is being considered as a possible therapeutic strategy easy to implement. However, more-quality studies and well-designed randomized clinical trials are needed to address this relevant question.
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Affiliation(s)
- Victoria Contreras-Bolívar
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs. Granada), Granada, Spain
| | - Beatriz García-Fontana
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs. Granada), Granada, Spain
- CIBERFES. Instituto de Salud Carlos III, Madrid, Spain
- CONTACT Beatriz García-Fontana University Hospital Clínico San Cecilio, Granada, Spain
| | - Cristina García-Fontana
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs. Granada), Granada, Spain
- CIBERFES. Instituto de Salud Carlos III, Madrid, Spain
- Cristina García-Fontana
| | - Manuel Muñoz-Torres
- Endocrinology and Nutrition Unit, University Hospital Clínico San Cecilio, Granada, Spain
- Instituto de Investigación Biosanitaria de Granada (Ibs. Granada), Granada, Spain
- CIBERFES. Instituto de Salud Carlos III, Madrid, Spain
- Department of Medicine, University of Granada, Granada, Spain
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6
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Ahmed J, Thomas L, Mulla MZ, Al-Attar H, Maniruzzaman M. Dry granulation of vitamin D3 and iron in corn starch matrix: Powder flow and structural properties. Food Res Int 2023; 165:112497. [PMID: 36869503 DOI: 10.1016/j.foodres.2023.112497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 12/19/2022] [Accepted: 01/20/2023] [Indexed: 01/27/2023]
Abstract
In this work, a twin-screw dry granulation (TSDG) was adopted to produce vitamin D3 (VD3) and iron blended dry granules using corn starch as an excipient. Response surface methodology was applied to determine the effect of the formulation compositions (VD3 and iron) on granule properties [tapped bulk density, oil holding capacity, and volumetric mean particle size (Dv50)]. Results indicated that the model fitted well, and responses, in particular flow properties, were significantly affected by the composition. The Dv50 was only influenced by the addition of VD3. The flow properties were characterized by the Carr index and Hausner ratio, which indicated very poor flow of the granules. Scanning electron microscopy with energy dispersive spectroscopy confirm the presence and distribution of Fe++ and VD3 in the granules. Overall, TSDG was proven to be a simple alternative method for the preparation of dry granules of VD3 and iron in a blend.
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Affiliation(s)
- Jasim Ahmed
- Environment & Life Sciences Research Center, Kuwait Institute for Scientific Research, P.O. Box 24885, Safat 13109, Kuwait.
| | - Linu Thomas
- Environment & Life Sciences Research Center, Kuwait Institute for Scientific Research, P.O. Box 24885, Safat 13109, Kuwait
| | - Mehrajfatema Z Mulla
- Environment & Life Sciences Research Center, Kuwait Institute for Scientific Research, P.O. Box 24885, Safat 13109, Kuwait
| | - Hasan Al-Attar
- Environment & Life Sciences Research Center, Kuwait Institute for Scientific Research, P.O. Box 24885, Safat 13109, Kuwait
| | - M Maniruzzaman
- Pharmaceutical Engineering and 3D Printing Lab (PharmE3D) The Division of Molecular Pharmaceutics and Drug Delivery, College of Pharmacy The University of Texas at Austin, Austin, TX 78712, USA
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7
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Ubaldi F, Montanari E, Margarucci LM, Caprara C, Gianfranceschi G, Scaramucci E, Piccolella A, Valeriani F, Romano Spica V. Vitamin D status and COVID-19 prevention in a worker subgroup in Italy. Work 2023:WOR220387. [PMID: 36641729 DOI: 10.3233/wor-220387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Low levels of vitamin D are widespread in the world's population and associated with sun exposure, genetics, and lifestyles. Office workers in different occupational sectors seem more vulnerable than others. Scientific evidence reports a contribution of vitamin D in resistance to infections, opening to supplementation as a preventive action against pathogens, including SARS-CoV-2. OBJECTIVE A pilot campaign in the workplace during the coronavirus 2019 (COVID-19) pandemic was conducted based on the preliminary measurement of vitamin D amount and its integration. METHODS A preventive action to contrast the deficiency of vitamin D was offered to a population of 700 bank employees. Vitamin D supplementation was performed between April and June 2021, on workers (n = 139) and showed 25(OH)D serum levels ≤ 30 ng/ml. Demographic, anthropometric and lifestyle information were collected by survey and changes in the serum 25(OH)D amounts were monitored. RESULTS The adherence of the target population to the prevention campaign was 21%. 75% of the enrolled workers had low levels of vitamin D. After the intervention, serum vitamin D levels increased (1.28-fold;p = 0.0001) and 80% of the subjects reported optimal values > 30 ng/ml. Only 2.9% reported slight flu-like symptoms, but only 0.7% was confirmed as COVID-19, with respect to a ten-fold higher incidence in the general population. CONCLUSIONS Vitamin D supplementation can be achieved by simple and noninvasive approaches and can bring along further insights into health literacy on diet and lifestyles, representing an opportunity to protect the population by the widespread state of vitamin deficiency.
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Affiliation(s)
| | | | | | | | | | - Elena Scaramucci
- Sant' Andrea Hospital A.O.U., Sapienza University of Rome, Rome,Italy
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8
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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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Zaazouee MS, Eleisawy M, Abdalalaziz AM, Elhady MM, Ali OA, Abdelbari TM, Hasan SM, Almadhoon HW, Ahmed AY, Fassad AS, Elgendy R, Abdel-Baset EA, Elsayed HA, Elsnhory AB, Abdraboh AB, Faragalla HM, Elshanbary AA, Kensara OA, Abdel-Daim MM. Hospital and laboratory outcomes of patients with COVID-19 who received vitamin D supplementation: a systematic review and meta-analysis of randomized controlled trials. NAUNYN-SCHMIEDEBERG'S ARCHIVES OF PHARMACOLOGY 2022; 396:607-620. [PMID: 36508011 PMCID: PMC9743115 DOI: 10.1007/s00210-022-02360-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 12/02/2022] [Indexed: 12/14/2022]
Abstract
Coronavirus disease 2019 (COVID-19) has a wide-ranging spectrum of clinical symptoms, from asymptomatic/mild to severe. Recent research indicates that, among several factors, a low vitamin D level is a modifiable risk factor for COVID-19 patients. This study aims to evaluate the effect of vitamin D on hospital and laboratory outcomes of patients with COVID-19.Five databases (PubMed, Embase, Scopus, Web of Science, and Cochrane Library) and clinicaltrials.gov were searched until July 2022, using relevant keywords/Mesh terms. Only randomized clinical trials (RCTs) that addressed the topic were included. The Cochrane tool was used to assess the studies' risk of bias, and the data were analyzed using the review manager (RevMan 5.4).We included nine RCTs with 1586 confirmed COVID-19 patients. Vitamin D group showed a significant reduction of intensive care unit (ICU) admission (risk ratio = 0.59, 95% confidence interval (CI) [0.41, 0.84], P = 0.003), and higher change in vitamin D level (standardized mean difference = 2.27, 95% CI [2.08, 2.47], P < 0.00001) compared to the control group. Other studied hospital and laboratory outcomes showed non-significant difference between vitamin D and the control group (P ≥ 0.05).In conclusion, vitamin D reduced the risk of ICU admission and showed superiority in changing vitamin D level compared to the control group. However, other outcomes showed no difference between the two groups. More RCTs are needed to confirm these results.
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Affiliation(s)
| | - Mahmoud Eleisawy
- grid.411660.40000 0004 0621 2741Faculty of Medicine, Benha University, Benha, Egypt
| | - Amira M. Abdalalaziz
- grid.7155.60000 0001 2260 6941Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Mahmoud M. Elhady
- grid.411660.40000 0004 0621 2741Faculty of Medicine, Benha University, Benha, Egypt
| | - Omar Adel Ali
- grid.7269.a0000 0004 0621 1570Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Sara Mohamed Hasan
- grid.411303.40000 0001 2155 6022Faculty of Medicine, Al‐Azhar University, Assiut, Egypt
| | - Hossam Waleed Almadhoon
- grid.8756.c0000 0001 2193 314XInstitute of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK
| | - Alaa Yehia Ahmed
- grid.7155.60000 0001 2260 6941Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Alaa Shaban Fassad
- grid.7155.60000 0001 2260 6941Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Rewan Elgendy
- grid.7155.60000 0001 2260 6941Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | | | - Hamis A. Elsayed
- grid.10251.370000000103426662Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | | | - Alaa Bahaaeldin Abdraboh
- grid.440876.90000 0004 0377 3957Faculty of Medicine, Modern University for Technology and Information (MTI), Cairo, Egypt
| | | | - Alaa Ahmed Elshanbary
- grid.7155.60000 0001 2260 6941Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Osama A. Kensara
- grid.412832.e0000 0000 9137 6644Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Mohamed M. Abdel-Daim
- Department of Pharmaceutical Sciences, Pharmacy Program, Batterjee Medical College, Jeddah, Saudi Arabia ,grid.33003.330000 0000 9889 5690Pharmacology Department, Faculty of Veterinary Medicine, Suez Canal University, Ismailia, Egypt
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Shah K, Varna VP, Sharma U, Mavalankar D. Does vitamin D supplementation reduce COVID-19 severity?: a systematic review. QJM 2022; 115:665-672. [PMID: 35166850 PMCID: PMC9383458 DOI: 10.1093/qjmed/hcac040] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 02/04/2022] [Accepted: 02/05/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND The evidence regarding the efficacy of vitamin D supplementation in reducing severity of COVID-19 is still insufficient. This is partially due to the lack of primary robust trial-based data and heterogeneous study designs. AIM This evidence summary, aims to study the effect of vitamin D supplementation on morbidity and mortality in hospitalized COVID-19 patients.Design: Evidence summary of systematic reviews. METHODS For this study, systematic reviews and meta-analysis published from December 2019 to January 2022 presenting the impact of vitamin D supplementation on COVID-19 severity were screened and selected from PubMed and Google scholar. After initial screening, 10 eligible reviews were identified and quality of included reviews were assessed using AMSTAR and GRADE tools and overlapping among the primary studies used were also assessed. RESULTS The number of primary studies included in the systematic reviews ranged from 3 to 13. Meta-analysis of seven systematic reviews showed strong evidence that vitamin D supplementation reduces the risk of mortality (Odds ratio: 0.48, 95% CI: 0.346-0.664; P < 0.001) in COVID patients. It was also observed that supplementation reduces the need for intensive care (Odds ratio: 0.35; 95%CI: 0.28-0.44; P < 0.001) and mechanical ventilation (Odds ratio: 0.54; 95% CI: 0.411-0.708; P < 0.001) requirement. The findings were robust and reliable as level of heterogeneity was considerably low. However the included studies were of varied quality. Qualitative analysis showed that supplements (oral and IV) are well tolerated, safe and effective in COVID patients. CONCLUSION The findings of this study show that vitamin D supplementation is effective in reducing the COVID-19 severity. Hence, vitamin D should be recommended as an adjuvant therapy for COVID-19.However, more robust and larger trials are required to substantiate it further.
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Affiliation(s)
- K Shah
- From the Indian Institute of Public Health, Gujarat 382042, India
| | - V P Varna
- From the Indian Institute of Public Health, Gujarat 382042, India
| | - U Sharma
- From the Indian Institute of Public Health, Gujarat 382042, India
| | - D Mavalankar
- From the Indian Institute of Public Health, Gujarat 382042, India
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Calder PC, Ortega EF, Meydani SN, Adkins Y, Stephensen CB, Thompson B, Zwickey H. Nutrition, Immunosenescence, and Infectious Disease: An Overview of the Scientific Evidence on Micronutrients and on Modulation of the Gut Microbiota. Adv Nutr 2022; 13:S1-S26. [PMID: 36183242 PMCID: PMC9526826 DOI: 10.1093/advances/nmac052] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/30/2022] [Accepted: 05/06/2022] [Indexed: 01/28/2023] Open
Abstract
The immune system is key to host defense against pathogenic organisms. Aging is associated with changes in the immune system, with a decline in protective components (immunosenescence), increasing susceptibility to infectious disease, and a chronic elevation in low-grade inflammation (inflammaging), increasing the risk of multiple noncommunicable diseases. Nutrition is a determinant of immune cell function and of the gut microbiota. In turn, the gut microbiota shapes and controls the immune and inflammatory responses. Many older people show changes in the gut microbiota. Age-related changes in immune competence, low-grade inflammation, and gut dysbiosis may be interlinked and may relate, at least in part, to age-related changes in nutrition. A number of micronutrients (vitamins C, D, and E and zinc and selenium) play roles in supporting the function of many immune cell types. Some trials report that providing these micronutrients as individual supplements can reverse immune deficits in older people and/or in those with insufficient intakes. There is inconsistent evidence that this will reduce the risk or severity of infections including respiratory infections. Probiotic, prebiotic, or synbiotic strategies that modulate the gut microbiota, especially by promoting the colonization of lactobacilli and bifidobacteria, have been demonstrated to modulate some immune and inflammatory biomarkers in older people and, in some cases, to reduce the risk and severity of gastrointestinal and respiratory infections, although, again, the evidence is inconsistent. Further research with well-designed and well-powered trials in at-risk older populations is required to be more certain about the role of micronutrients and of strategies that modify the gut microbiota-host relationship in protecting against infection, especially respiratory infection.
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Affiliation(s)
- Philip C Calder
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, United Kingdom
| | - Edwin Frank Ortega
- Nutritional Immunology Laboratory, Jean Mayer–USDA Human Nutrition Research on Aging at Tufts University, Boston, MA, USA
| | - Simin N Meydani
- Nutritional Immunology Laboratory, Jean Mayer–USDA Human Nutrition Research on Aging at Tufts University, Boston, MA, USA
| | - Yuriko Adkins
- USDA Western Human Nutrition Research Center, Davis, CA, USA
- Nutrition Department, University of California, Davis, CA, USA
| | - Charles B Stephensen
- USDA Western Human Nutrition Research Center, Davis, CA, USA
- Nutrition Department, University of California, Davis, CA, USA
| | - Brice Thompson
- Department of Pharmaceutics, University of Washington, Seattle, WA, USA
| | - Heather Zwickey
- Helfgott Research Institute, National University of Natural Medicine, Portland, OR, USA
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12
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McKenna MJ, Lyons OC, Flynn MA, Crowley RK, Twomey PJ, Kilbane MT. COVID-19 pandemic and vitamin D: rising trends in status and in daily amounts of vitamin D provided by supplements. BMJ Open 2022; 12:e059477. [PMID: 35926985 PMCID: PMC9358618 DOI: 10.1136/bmjopen-2021-059477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVES Since the onset of the COVID-19 pandemic in 2020, there have been plausible suggestions about the need to augment vitamin D intake by supplementation in order to prevent SARS-CoV2 infection and reduce mortality. Some groups have advocated supplementation for all adults, but governmental agencies have advocated targeted supplementation. We sought to explore the effect of the COVID-19 pandemic on both vitamin D status and on the dose of new-to-market vitamin D supplements. SETTING University hospital, Dublin, Ireland. PARTICIPANTS Laboratory-based samples of circulating 25-hydroxyvitamin D (25OHD) (n=100 505). PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcomes: comparing yearly average 25OHD prior to the pandemic (April 2019 to March 2020) with during the pandemic (April 2020 to March 2021) and comparing the dose of new-to-market vitamin D supplements between 2017 and 2021 (n=2689). SECONDARY OUTCOME comparing prevalence of vitamin D deficiency and vitamin D excess during the two time periods. RESULTS The average yearly serum 25OHD measurement increased by 2.8 nmol/L (61.4, 95% CI 61.5 to 61.7 vs 58.6, 95% CI 58.4 to 58.9, p<0.001), which was almost threefold higher than two similar trend analyses that we conducted between 1993 and 2016. There was a lower prevalence of low 25OHD and a higher prevalence of high 25OHD. The dose of new-to-market vitamin D supplements was higher in the years 2020-2021 compared with the years 2017-2019 (p<0.001). CONCLUSIONS We showed significant increases in serum 25OHD and in the dose of new-to-market vitamin D supplements. The frequency of low vitamin D status reduced indicating benefit, but the frequency of vitamin D excess increased indicating risk of harm. Rather than a blanket recommendation about vitamin D supplementation for all adults, we recommend a targeted approach of supplementation within current governmental guidelines to at-risk groups and cautioning consumers about adverse effects of high dose supplements on the market.
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Affiliation(s)
- Malachi J McKenna
- Department of Clinical Chemistry, St Vincent's University Hospital, and UCD School of Medicine, University College Dublin, Dublin, Ireland
| | - Oonagh C Lyons
- Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, UK
| | - Mary At Flynn
- Nutrition Innovation Centre for Food and Health, School of Biomedical Sciences, Ulster University, Coleraine, UK
| | - Rachel K Crowley
- Department of Clinical Chemistry, St Vincent's University Hospital, and UCD School of Medicine, University College Dublin, Dublin, Ireland
| | - Patrick J Twomey
- Department of Clinical Chemistry, St Vincent's University Hospital, and UCD School of Medicine, University College Dublin, Dublin, Ireland
| | - Mark T Kilbane
- Department of Clinical Chemistry, St Vincent's University Hospital, and UCD School of Medicine, University College Dublin, Dublin, Ireland
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13
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Wimalawansa SJ. Rapidly Increasing Serum 25(OH)D Boosts the Immune System, against Infections-Sepsis and COVID-19. Nutrients 2022; 14:2997. [PMID: 35889955 PMCID: PMC9319502 DOI: 10.3390/nu14142997] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/31/2022] [Accepted: 06/16/2022] [Indexed: 12/24/2022] Open
Abstract
Vitamin D deficiency is a global public health problem, a pandemic that commonly affects the elderly and those with comorbidities such as obesity, diabetes, hypertension, respiratory disorders, recurrent infections, immune deficiency, and malignancies, as well as ethnic minorities living in temperate countries. The same groups were worst affected by COVID-19. Since vitamin D deficiency weakens the immune system, it increases the risk of infections, complications, and deaths, such as from sepsis and COVID-19. Deficiency can be remedied cost-effectively through targeted food fortification, supplementation, and/or daily safe sun exposure. Its endocrine functions are limited to mineral metabolism, musculoskeletal systems, specific cell membrane interactions, and parathyroid gland functions. Except for the rapid, endocrine, and cell membrane-based non-genomic functions, all other biological and physiological activities of vitamin D depend on the adequate intracellular synthesis of 1,25(OH)2D (calcitriol) in peripheral target cells via the genome. Calcitriol mediates autocrine (intracrine) and paracrine signalling in immune cells, which provides broader, protective immune functions crucial to overcoming infections. The synthesis of 1,25(OH)2D (calcitriol) in peripheral target cells is dependent on diffusion and endocytosis of D3 and 25(OH)D from the circulation into them, which requires maintenance of serum 25(OH)D concentration above 50 ng/mL. Therefore, in acute infections such as sepsis and respiratory infections like COVID-19, it is necessary to rapidly provide its precursors, D3 and 25(OH)D, through the circulation to generate adequate intracellular calcitriol. Immune defence is one of the crucial non-hormonal functions of vitamin D. A single oral (bolus) dose or divided upfront loading doses between 100,000 and 500,000 IU, using 50,000 IU vitamin D3 increase the serum 25(OH)D concentrations to a therapeutic level of above 50 ng/mL that lasts between two to three months. This takes three to five days to raise serum 25(OH)D. In contrast, a single oral dose of calcifediol (0.014 mg/kg body weight) can generate the needed 25(OH)D concentration within four hours. Considering both D3 and 25(OH)D enter immune cells for generating calcitriol, using the combination of D3 (medium-term) and calcifediol (immediate) is cost-effective and leads to the best clinical outcome. To maximise protection against infections, particularly to reduce COVID-19-associated complications and deaths, healthcare workers should advise patients on safe sun exposure, adequate vitamin D supplementation and balanced diets containing zinc, magnesium, and other micronutrients to support the immune system. Meanwhile, governments, the World Health Organisation, the Centers for Disease Control, and governments should consider similar recommendations to physicians and the public, change the outdated vitamin D and other micronutrient recommendations directed to their population, and organise targetted food fortification programs for the vulnerable groups. This article discusses a rational approach to maintaining a sustained serum 25(OH)D concentration above 50 ng/mL, necessary to attain a robust immune system for overcoming infections. Such would cost-effectively improve the population’s health and reduce healthcare costs. It also describes three cost-effective, straightforward protocols for achieving and sustaining therapeutic serum 25(OH)D concentrations above 50 ng/mL (>125 nmol/L) to keep the population healthy, reduce absenteeism, improve productivity, and lower healthcare costs.
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Affiliation(s)
- Sunil J Wimalawansa
- Endocrinology & Nutrition, Department of Medicine, Cardiometabolic & Endocrine Institute, North Brunswick, NJ 08873, USA
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14
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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: 35] [Impact Index Per Article: 17.5] [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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15
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Jude EB, Tentolouris N, Rastogi A, Yap MH, Pedrosa HC, Ling SF. Vitamin D prescribing practices among clinical practitioners during the COVID‐19 pandemic. Health Sci Rep 2022; 5:e691. [PMID: 35844828 PMCID: PMC9273939 DOI: 10.1002/hsr2.691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/27/2022] [Accepted: 05/06/2022] [Indexed: 11/11/2022] Open
Abstract
Background and Aims COVID‐19 has caused devastation globally. Low vitamin D status, particularly during the winter months, remains commonplace around the world, and it is thought to be one of the contributing factors toward causation and severity of COVID‐19. Many guidelines do not recommend vitamin D for the treatment or prevention of the disease. Hence, we set out to conduct a global survey to understand the use and prescribing habits of vitamin D among clinicians for COVID‐19. Methods An online anonymous questionnaire was sent to clinicians enquiring about their prescribing habits of vitamin D and personal use of vitamin D. Data of the survey were collected between January 15, 2021, and February 13, 2021. Results Four thousand four hundred forty practicing clinicians were included in the analysis, with the majority of those responding from Asia, followed by Europe. 82.9% prescribed vitamin D before COVID‐19, more commonly among general practitioners (GPs) in comparison with medical specialists, and Asian clinicians were more likely to prescribe vitamin D in comparison with Caucasian physicians (p < 0.01). GPs were also more likely to prescribe vitamin D prophylactically to prevent COVID‐19 in comparison with medical specialists (OR 1.47, p < 0.01). Most GPs (72.8%) would also prescribe vitamin D to treat COVID‐19 in comparison with medical specialists (OR 1.81, p < 0.01), as well as more Asian in comparison with Caucasian physicians (OR 4.57, p < 0.01). 80.4% of respondents were taking vitamin D, more so in the 45–54 and 65–74 age groups in comparison with the 18–24 years category (OR 2.15 and 2.40, respectively, both p < 0.05), many of whom did so before COVID‐19 (72.1%). Conclusion This survey has shown that many clinicians would prescribe vitamin D for the prevention and treatment of COVID‐19. The majority would also recommend measuring vitamin D levels, but not so in patients with COVID‐19.
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Affiliation(s)
- Edward B. Jude
- Department of Diabetes and Endocrinology Tameside and Glossop Integrated Care NHS Foundation Trust Ashton‐under‐Lyne UK
- Department of Diabetes and Endocrinology The University of Manchester Manchester UK
- Department of Diabetes and Endocrinology Manchester Metropolitan University Manchester UK
| | - Nikolaos Tentolouris
- 1st Department of Internal Medicine, Medical School, National and Kapodistrian University of Athens Laiko General Hospital Athens Greece
| | - Ashu Rastogi
- Department of Diabetes and Endocrinology Post Graduate Institute of Medical Education and Research Chandigarh India
| | - Moi H. Yap
- Department of Diabetes and Endocrinology Manchester Metropolitan University Manchester UK
| | - Hermelinda C. Pedrosa
- Department of Diabetes and Endocrinology, Endocrinology Unit, Research Centre, Taguatinga Regional Hospital Secretariat of Health Brasilia‐DF Brazil
| | - Stephanie F. Ling
- Department of Diabetes and Endocrinology The University of Manchester Manchester UK
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16
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Briceno Noriega D, Savelkoul HFJ. Vitamin D: A Potential Mitigation Tool for the Endemic Stage of the COVID-19 Pandemic? Front Public Health 2022; 10:888168. [PMID: 35757617 PMCID: PMC9226430 DOI: 10.3389/fpubh.2022.888168] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/06/2022] [Indexed: 12/12/2022] Open
Abstract
The impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic and associated development of clinical symptoms of COVID-19 have presented an enormous global impact on our health care systems, public health and economy. To date several observational epidemiological studies consistently found that vitamin D deficiency, measured as low levels of circulating 25-hydroxyvitamin D, is associated with cardiovascular diseases, diabetes, certain cancers, autoimmune diseases and many infectious diseases, including acute respiratory infections. Since vitamin D is not merely immunosuppressive but also acts as an immunomodulator in tolerance and homeostasis, many experts have considered a role of vitamin D in the prevalence and severity of immune mediated inflammatory diseases, such as SARS-CoV-2, adding to the evidence of the importance of vitamin D in the immune response against viral respiratory infections and reinforcing the need for targeted vitamin D supplementation, with a focus on high-risk populations and a high-dose supplementation treatment for COVID-19 hospitalized patients. The expected transition to endemicity of SARS-CoV-2 even further corroborates as a potential of vitamin D as an potential mitigation tool for the prevention of COVID-19. The aim of this paper is to analyse the current evidence regarding vitamin D and present a hypothesis of its potential role in the current COVID-19 pandemic and in the future as a potential preventive measurement in public health.
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Affiliation(s)
- Daniela Briceno Noriega
- Cell Biology and Immunology Group, Wageningen University & Research, Wageningen, Netherlands
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17
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Wang L, Guo H, Li J, He S, Yang G, Li E. Adenovirus is prevalent in juvenile polyps and correlates with low vitamin D receptor expression. Pediatr Res 2022; 91:1703-1708. [PMID: 34400787 PMCID: PMC8365564 DOI: 10.1038/s41390-021-01697-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 05/19/2021] [Accepted: 07/09/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND The objective of this study was to assess human adenovirus (HAdV) infection in juvenile polyps (JPs) and to preliminarily establish a correlation to vitamin D receptor (VDR) expression. METHODS The study includes 76 patients of 5.2 ± 2.8 years old. Seventy-eight JP specimens and 24 parapolyp tissues from polypectomy were used. PCR was used to detect HAdV DNA and quantitative reverse transcription-PCR for viral and host gene expression. The PCR products were sequenced for virus typing. The correlation between VDR expression and HAdV infection was established using nonparametric Spearman's analysis. RESULTS Seventy-four children (97.4%) had a single polyp and two had two polyps. The histopathological characteristics of the polyps were in line with JP. Thirty-three samples had HAdV DNA (43.4%), including 32 subgroup C and 1 subgroup B HAdV; no enteric HAdV was detected. HAdV messenger RNA was detected in 5 of the 33 samples (15.2%). The samples had increased interleukin-1β (IL-1β), IL-6, and calprotectin expression, and reduced E-cadherin and VDR expression. JP samples with low VDR expression were more prevalent of HAdV DNA (r = 1.261, 95% confidence interval, 1.017-1.563), while VDR expression positively correlated with E-cadherin and negatively with inflammation gene expression. CONCLUSIONS HAdV latent infection was prevalent among JP tissues. The presence of HAdV correlated positively to low VDR expression. IMPACT The HAdVs infect the upper airways and gastrointestinal system and is found to persist in lymphoid tissues. The prevalence of HAdV and the status of the infection is unknown. The study investigated the prevalence of HAdV from polypectomy specimens of JP patients and found that HAdV was prevalent and was in a persistent state. HAdV infection was more prevalent in samples with low VDR expression. Whether HAdV infection and reactivation is a contributing factor to JPs is unknown. Factors such as proinflammation and bacterial metabolites that are known to promote HAdV reactivation warrant further investigation.
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Affiliation(s)
- Lingling Wang
- SKL of Pharmaceutical Biotechnology, Medical School of Nanjing University, Nanjing, China
- Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China
| | - Hongmei Guo
- Nanjing Children's Hospital, Nanjing Medical University, Nanjing, China
| | - Jingwen Li
- Changzhou #2 People's Hospital, Nanjing Medical University, Nanjing, China
| | - Susu He
- SKL of Pharmaceutical Biotechnology, Medical School of Nanjing University, Nanjing, China
- Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China
| | - Guang Yang
- Nanjing Children's Hospital, Nanjing Medical University, Nanjing, China.
| | - Erguang Li
- SKL of Pharmaceutical Biotechnology, Medical School of Nanjing University, Nanjing, China.
- Jiangsu Key Laboratory of Molecular Medicine, Medical School of Nanjing University, Nanjing, China.
- Shenzhen Research Institute of Nanjing University, Shenzhen, China.
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18
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Lord Ferguson S, Berthon P. A renewable resource model of health decision-making: insights to improve health marketing. AMS REVIEW 2022. [PMCID: PMC8551663 DOI: 10.1007/s13162-021-00208-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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19
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Roudi F, Saghi E, Ayoubi SS, Pouryazdanpanah M. Clinical nutrition approach in medical management of COVID-19 hospitalized patients: A narrative review. Nutr Health 2022; 28:357-368. [PMID: 35581719 PMCID: PMC9117992 DOI: 10.1177/02601060221101696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Background: Malnutrition in COVID-19 hospitalized patients is associated with a high-risk
condition to increase disease severity and prolonging the recovery period.
Therefore, nutritional therapy, including supplements plays a critical role
to reduce disease-related complications and the length of hospital stay. Aim: To review the latest evidence on nutritional management options in COVID-19
hospitalized patients, as well as possibly prescribed supplements.
Methods: This review was conducted by considering the
latest recommendations, using the guidelines of the American Society of
Enteral and Parenteral (ASPEN) and the European Society of Enteral and
Parenteral (ESPEN), and searching Web of Science, PubMed/Medline, ISI, and
Medline databases. The relevant articles were found using a mix of related
mesh terms and keywords. We attempted to cover all elements of COVID-19
hospitalized patients’ dietary management. Results: Energy
demand in COVID-19 patients is a vital issue. Indirect Calorimetry (IC) is
the recommended method to measure resting energy expenditure. However, in
the absence of IC, predictive equations may be used. The ratio of
administered diet for the macronutrients could be based on the phase and
severity of Covid-19 disease. Moreover, there are recommendations for taking
micronutrient supplements with known effects on improving the immune system
or reducing inflammation. Conclusions: Nutritional treatment of
COVID-19 patients in hospitals seems to be an important element of their
medical care. Enteral nutrition would be the recommended feeding method for
early nutrition support. However, data in the COVID-19 nutritional domain
relating to micronutrient supplementation are still fragmentary and
disputed, and further study is required.
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Affiliation(s)
- Fatemeh Roudi
- Department of Nutrition, Faculty of Medicine, 37552Mashhad University of Medical Sciences, Mashhad, Iran
| | - Effat Saghi
- Department of Nutrition, Faculty of Medicine, 37552Mashhad University of Medical Sciences, Mashhad, Iran
| | - Samaneh Sadat Ayoubi
- Department of Nutrition, Faculty of Medicine, 37552Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mahdieh Pouryazdanpanah
- Department of Nutrition, Public Health School, Kerman University of Medical Sciences, Kerman, Iran
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20
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Boucher BJ. Discrepancies between current guidance from NICE on the treatment of vitamin D deficiency and the recommended daily amounts [RDAs] for its prevention in the UK. Expert Rev Endocrinol Metab 2022; 17:201-203. [PMID: 35450494 DOI: 10.1080/17446651.2022.2067143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 04/13/2022] [Indexed: 10/18/2022]
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Subramanian S, Rhodes JM, Taylor JM, Milan AM, Lane S, Hewison M, Chun RF, Jorgensen A, Richardson P, Nitchingham D, Aslan J, Shah M, Chandrasekar CR, Wood A, Beadsworth M, Pirmohamed M. Vitamin D, vitamin D-binding protein, free vitamin D and COVID-19 mortality in hospitalized patients. Am J Clin Nutr 2022; 115:1367-1377. [PMID: 35102371 PMCID: PMC8903333 DOI: 10.1093/ajcn/nqac027] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/27/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Vitamin D deficiency has been associated with worse coronavirus disease 2019 (COVID-19) outcomes, but circulating 25-hydroxyvitamin D [25(OH)D] is largely bound to vitamin D-binding protein (DBP) or albumin, both of which tend to fall in illness, making the 25(OH)D status hard to interpret. Because of this, measurements of unbound ("free") and albumin-bound ("bioavailable") 25(OH)D have been proposed. OBJECTIVES We aimed to examine the relationship between vitamin D status and mortality from COVID-19. METHODS In this observational study conducted in Liverpool, UK, hospitalized COVID-19 patients with surplus sera available for 25(OH)D analysis were studied. Clinical data, including age, ethnicity, and comorbidities, were extracted from case notes. Serum 25(OH)D, DBP, and albumin concentrations were measured. Free and bioavailable 25(OH)D were calculated. Relationships between total, free, and bioavailable 25(OH)D and 28-day mortality were analyzed by logistic regression. RESULTS There were 472 patients with COVID-19 included, of whom 112 (23.7%) died within 28 days. Nonsurvivors were older (mean age, 73 years; range, 34-98 years) than survivors (mean age, 65 years; range, 19-95 years; P = 0.003) and were more likely to be male (67%; P = 0.02). The frequency of vitamin D deficiency [25(OH)D < 50 nmol/L] was similar between nonsurvivors (71/112; 63.4%) and survivors (204/360; 56.7%; P = 0.15) but, after adjustments for age, sex, and comorbidities, increased odds for mortality were present in those with severe deficiency [25(OH)D < 25 nmol/L: OR, 2.37; 95% CI, 1.17-4.78] or a high 25(OH)D (≥100 nmol/L; OR, 4.65; 95% CI, 1.51-14.34) compared with a 25(OH)D value of 50-74 nmol/L (reference). Serum DBP levels were not associated with mortality after adjustments for 25(OH)D, age, sex, and comorbidities. Neither free nor bioavailable 25(OH)D values were associated with mortality. CONCLUSIONS Vitamin D deficiency, as commonly defined by serum 25(OH)D levels (<50 nmol/L), is not associated with increased mortality from COVID-19, but extremely low (<25 nmol/L) and high (>100 nmol/L) levels may be associated with mortality risks. Neither free nor bioavailable 25(OH)D values are associated with mortality risk. The study protocol was approved by the London-Surrey Research Ethics Committee (20/HRA/2282).
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Affiliation(s)
- Sreedhar Subramanian
- Department of Gastroenterology, Liverpool University Hospital Foundation NHS Trust, Liverpool, United Kingdom,Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom,Address correspondence to SS (E-mail: )
| | - Jonathan M Rhodes
- Department of Cellular and Molecular Physiology, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Joseph M Taylor
- Department of Clinical Chemistry, Liverpool University Hospital Foundation NHS Trust, Liverpool, United Kingdom
| | - Anna M Milan
- Department of Clinical Chemistry, Liverpool University Hospital Foundation NHS Trust, Liverpool, United Kingdom
| | - Steven Lane
- Department of Biostatistics, Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Martin Hewison
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
| | - Rene F Chun
- Department of Orthopaedic Surgery, University of California, Los Angeles, CA, USA
| | - Andrea Jorgensen
- Department of Health Data Science, University of Liverpool, Liverpool, United Kingdom
| | - Paul Richardson
- Department of Gastroenterology, Liverpool University Hospital Foundation NHS Trust, Liverpool, United Kingdom
| | - Darshan Nitchingham
- Department of Gastroenterology, Liverpool University Hospital Foundation NHS Trust, Liverpool, United Kingdom
| | - Joseph Aslan
- Department of Gastroenterology, Liverpool University Hospital Foundation NHS Trust, Liverpool, United Kingdom
| | - Maya Shah
- Department of Gastroenterology, Liverpool University Hospital Foundation NHS Trust, Liverpool, United Kingdom
| | - Coonoor R Chandrasekar
- Department of Orthopaedic Surgery, Liverpool University Hospital Foundation NHS Trust, Liverpool, United Kingdom
| | - Amanda Wood
- Department of Clinical Pharmacology, Liverpool University Hospital Foundation NHS Trust, Liverpool, United Kingdom
| | - Mike Beadsworth
- Tropical and Infectious Diseases Unit, Liverpool University Hospital Foundation NHS Trust, Liverpool, United Kingdom
| | - Munir Pirmohamed
- Department of Molecular and Clinical Pharmacology, University of Liverpool, Liverpool, United Kingdom
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22
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Tentolouris N, Samakidou G, Eleftheriadou I, Tentolouris A, Jude EB. The effect of vitamin D supplementation on mortality and intensive care unit admission of COVID-19 patients. A systematic review, meta-analysis and meta-regression. Diabetes Metab Res Rev 2022; 38:e3517. [PMID: 34965318 PMCID: PMC9015406 DOI: 10.1002/dmrr.3517] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 11/16/2021] [Accepted: 11/26/2021] [Indexed: 12/02/2022]
Abstract
AIMS The aim of this systematic review and meta-analysis was to investigate the effect of vitamin D supplementation on mortality and admission to intensive care unit (ICU) of COVID-19 patients. METHODS A systematic search of PubMed, Google Scholar, Embase, Web of Science and medRxiv with terms relative to vitamin D supplementation and COVID-19 was conducted on 26 March 2021. Comprehensive Meta-Analysis software was used for the quantitative assessment of data and random-effects model was applied. To investigate the association between the dose of vitamin D and the outcomes of interest, meta-regression analysis was performed. RESULTS Two thousand and seventy-eight patients from nine studies with data on mortality were included (583 received vitamin D supplementation, while 1495 did not). Sixty-one (10.46%) individuals in the treated group died, compared to 386 (25.81%) in the non-treated group (odds ratio [OR]: 0.597; 95% CI: 0.318-1.121; p = 0.109). Eight hundred and sixty patients from six studies with data on ICU admission were included (369 received vitamin D supplementation, while 491 did not). Forty-five (12.19%) individuals in the treated group were admitted to ICU, compared to 129 (26.27%) in the non-treated group (OR: 0.326; 95% CI: 0.149-0.712; p = 0.005). No significant linear relationship between vitamin D dose and log OR of mortality or log OR of ICU admission was observed. CONCLUSION This meta-analysis indicates a beneficial role of vitamin D supplementation on ICU admission, but not on mortality, of COVID-19 patients. Further research is urgently needed to understand the benefit of vitamin D in COVID-19.
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Affiliation(s)
- Nikolaos Tentolouris
- First Department of Propaedeutic Internal MedicineDiabetes CentreMedical SchoolNational and Kapodistrian University of AthensLaiko General HospitalAthensGreece
| | - Georgia Samakidou
- First Department of Propaedeutic Internal MedicineDiabetes CentreMedical SchoolNational and Kapodistrian University of AthensLaiko General HospitalAthensGreece
| | - Ioanna Eleftheriadou
- First Department of Propaedeutic Internal MedicineDiabetes CentreMedical SchoolNational and Kapodistrian University of AthensLaiko General HospitalAthensGreece
| | - Anastasios Tentolouris
- First Department of Propaedeutic Internal MedicineDiabetes CentreMedical SchoolNational and Kapodistrian University of AthensLaiko General HospitalAthensGreece
| | - Edward B. Jude
- Tameside and Glossop Integrated Care NHS Foundation TrustAshton‐under‐LyneUK
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23
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Efird JT, Anderson E, Jindal C, Suzuki A. Interaction of Vitamin D and Corticosteroid Use in Hospitalized COVID-19 Patients: A Potential Explanation for Inconsistent Findings in the Literature. Curr Pharm Des 2022; 28:1695-1702. [PMID: 35440302 DOI: 10.2174/1381612828666220418132847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/11/2021] [Indexed: 12/15/2022]
Abstract
Vitamin D is an important immune-modulator with anti-inflammatory properties. While this prohormone has been studied extensively in the prevention and treatment of COVID-19, findings have been inconsistent regarding its overall benefit in patients hospitalized with COVID-19. Most studies to date have been observational in nature, not accounting for the use of corticosteroids. Furthermore, the few randomized clinical trials designed to examine the effect of vitamin D supplementation on COVID-19 outcomes have been relatively small and thus insufficiently powered to assure a balance of corticosteroid use between study arms. The current perspective addresses the interaction of vitamin D and corticosteroids as a potential explanation for the divergent results reported in the literature. Future research on vitamin D and COVID-19 will benefit by considering this interaction, especially among hospitalized patients requiring oxygen and mechanical ventilation.
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Affiliation(s)
- Jimmy T Efird
- Cooperative Studies Program Epidemiology Center, Durham (Duke) VA Health Care System, Durham, NC 27705, USA
| | | | - Charulata Jindal
- Harvard Medical School, Harvard University, Boston, MA 02115, USA
| | - Ayako Suzuki
- Cooperative Studies Program Epidemiology Center, Durham (Duke) VA Health Care System, Durham, NC 27705, USA.,Department of Pharmaceutical Sciences and Experimental Therapeutics, Fraternal Order of Eagles Diabetes Research Center, Abboud Cardiovascular Research Center, College of Pharmacy, University of Iowa, Iowa City, IA 52242, USA.,Division of Gastroenterology, Duke University, Durham, NC 27710, USA
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24
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Parant F, Bouloy J, Haesebaert J, Bendim’red L, Goldet K, Vanhems P, Henaff L, Gilbert T, Cuerq C, Blond E, Bost M, Bonnefoy M. Vitamin D and COVID-19 Severity in Hospitalized Older Patients: Potential Benefit of Prehospital Vitamin D Supplementation. Nutrients 2022; 14:nu14081641. [PMID: 35458203 PMCID: PMC9031320 DOI: 10.3390/nu14081641] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 02/06/2023] Open
Abstract
Studies involving the associations between vitamin D supplementation taken before the onset of COVID-19 infection and the clinical outcomes are still scarce and this issue remains controversial. This study aimed to assess the relationships between vitamin D (VitD) status and supplementation and coronavirus disease 2019 (COVID-19) severity in older adults (average age of 78 years) hospitalized for COVID-19. We conducted an observational retrospective cohort study with 228 older hospitalized patients during the first wave of the COVID-19 pandemic. The outcomes were in-hospital mortality secondary to COVID-19 or critically severe COVID-19. A logistic regression analysis was conducted to test whether pre-hospital VitD supplementation was independently associated with severity. In this study, 46% of patients developed a severe form and the overall in-hospital mortality was 15%. Sixty-six (29%) patients received a VitD supplement during the 3 months preceding the infection onset. Additionally, a VitD supplement was associated with fewer severe COVID-19 forms (OR = 0.426, p = 0.0135) and intensive care unit (ICU) admissions (OR = 0.341, p = 0.0076). As expected, age > 70 years, male gender and BMI ≥ 35 kg/m2 were independent risk factors for severe forms of COVID-19. No relationship between serum 25(OH)D levels and the severity of the COVID-19 was identified. VitD supplementation taken during the 3 months preceding the infection onset may have a protective effect on the development of severe COVID-19 forms in older adults. Randomized controlled trials and large-scale cohort studies are necessary to strengthen this observation.
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Affiliation(s)
- François Parant
- Biology Center South, Hôpital Lyon Sud, 69310 Pierre-Bénite, France; (F.P.); (C.C.); (E.B.); (M.B.)
| | - Justin Bouloy
- Department of Geriatric Medicine, Groupement Hospitalier Sud, CHU de Lyon, 69495 Pierre-Bénite, France; (T.G.); (M.B.)
- Correspondence: ; Tel.: +33-6-68-41-83-65
| | - Julie Haesebaert
- Department of Clinical Research and Epidemiology, Public Health Unit, Groupement Hospitalier Est, 69002 Lyon, France;
- RESHAPE Research on Healthcare Performance Inserm U1290, Université Lyon 1, 69008 Lyon, France
| | - Lamia Bendim’red
- Clinical Research Centre, Ageing, Brain, Fragility-Hôpital des Charpennes, 69100 Villeurbanne, France; (L.B.); (K.G.)
| | - Karine Goldet
- Clinical Research Centre, Ageing, Brain, Fragility-Hôpital des Charpennes, 69100 Villeurbanne, France; (L.B.); (K.G.)
| | - Philippe Vanhems
- Department of Hygiene, Epidemiology and Prevention, Hôpital Édouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France; (P.V.); (L.H.)
- ICIR-International Center for Infectiology Research (Team PHE3ID), Claude Bernard Lyon 1 University, Inserm, U1111, CNRS, UMR5308, ENS Lyon, 46 Allée d’Italie, 69007 Lyon, France
| | - Laetitia Henaff
- Department of Hygiene, Epidemiology and Prevention, Hôpital Édouard Herriot, Hospices Civils de Lyon, 69003 Lyon, France; (P.V.); (L.H.)
- ICIR-International Center for Infectiology Research (Team PHE3ID), Claude Bernard Lyon 1 University, Inserm, U1111, CNRS, UMR5308, ENS Lyon, 46 Allée d’Italie, 69007 Lyon, France
| | - Thomas Gilbert
- Department of Geriatric Medicine, Groupement Hospitalier Sud, CHU de Lyon, 69495 Pierre-Bénite, France; (T.G.); (M.B.)
- RESHAPE Research on Healthcare Performance Inserm U1290, Université Lyon 1, 69008 Lyon, France
| | - Charlotte Cuerq
- Biology Center South, Hôpital Lyon Sud, 69310 Pierre-Bénite, France; (F.P.); (C.C.); (E.B.); (M.B.)
| | - Emilie Blond
- Biology Center South, Hôpital Lyon Sud, 69310 Pierre-Bénite, France; (F.P.); (C.C.); (E.B.); (M.B.)
| | - Muriel Bost
- Biology Center South, Hôpital Lyon Sud, 69310 Pierre-Bénite, France; (F.P.); (C.C.); (E.B.); (M.B.)
| | - Marc Bonnefoy
- Department of Geriatric Medicine, Groupement Hospitalier Sud, CHU de Lyon, 69495 Pierre-Bénite, France; (T.G.); (M.B.)
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25
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Albracht SP. Hypothesis: mutual dependency of ascorbate and calcidiol for optimal performance of the immune system. Med Hypotheses 2022. [DOI: 10.1016/j.mehy.2022.110845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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26
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Abstract
PURPOSE OF REVIEW This article will briefly describe the role of specific dietary components, mainly micronutrients, in supporting the immune response and summarise the literature regarding foods and dietary patterns in the context of immunity and infectious illness. Literature on SARS-COV-2 infection and COVID-19 is referred to where appropriate. RECENT FINDINGS Micronutrients, other nutrients and plant bioactives have roles in supporting the immune response. Low status of a number of micronutrients is associated with increased risk and severity of COVID-19. Recent studies report associations of plant-based diets with lower risk of, and less severe, COVID-19. SUMMARY In order to support the immune response, sufficient amounts of a range of essential and non-essential nutrients and other bioactives, mainly from a plant-based diet should be consumed. Further research should define cause-and-effect relationships of intakes of individual dietary components and foods, and of dietary patterns with susceptibility to, and severity of, viral infections.
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Affiliation(s)
- Philip C Calder
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, United Kingdom,NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton SO16 6YD, United Kingdom
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27
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Abdul Ridha Al-Awade H, Shakir Abed Almjalawi B. Effects of Vitamin D on Risks and Severity of COVID-19 Infection. ARCHIVES OF RAZI INSTITUTE 2022; 77:163-168. [PMID: 35891758 PMCID: PMC9288609 DOI: 10.22092/ari.2021.356807.1914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 12/04/2021] [Indexed: 05/25/2023]
Abstract
In the last two decades, numerous studies have been carried out to find correlations between vitamin D and the efficiency of the lungs and respiratory system. This study aimed to find the relationship of taking vitamin D with the risks of the severity of infection with coronavirus disease 2019 (COVID-19) and the risk of infection of patients with chronic diseases. A total of 100 COVID-19 patients (61 males and 39 females) were included in the study and divided into groups, namely never taken vitamin D and taken a dose of 50 and 1,000 IU. The effects of gender, chronic diseases (i.e., hypertension and diabetes), and requiring intensive care unit (ICU) were evaluated. The results showed that females were at lower risks of infection with COVID-19 than males and taking 50 IU of vitamin D could lower the severe cases by 33%. It was also revealed that patients with chronic disease were more sensitive to COVID-19 and administering 50 units of vitamin D in these patients decreased the need for ICU from 49% to 9%. Given that vitamin D enhances the immune system and respiratory function, the findings of this research indicated that vitamin D reduced the risk of COVID-19; however, it was not able to prevent it.
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Affiliation(s)
- H Abdul Ridha Al-Awade
- Department of Biology, College of Education for Pure Sciences, University of Kerbala, Kerbala, Iraq
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28
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Chiodini I, Gatti D, Soranna D, Merlotti D, Mingiano C, Fassio A, Adami G, Falchetti A, Eller-Vainicher C, Rossini M, Persani L, Zambon A, Gennari L. Vitamin D Status and SARS-CoV-2 Infection and COVID-19 Clinical Outcomes. Front Public Health 2021; 9:736665. [PMID: 35004568 PMCID: PMC8727532 DOI: 10.3389/fpubh.2021.736665] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 11/11/2021] [Indexed: 12/17/2022] Open
Abstract
Background: Several studies suggest an association between serum 25-hydroxyvitamin D (25OHD) and the outcomes of Severe Acute Respiratory Syndrome Corona-Virus-2 (SARS-CoV-2) infection, in particular Coronavirus Disease-2019 (COVID-19) related severity and mortality. The aim of the present meta-analysis was to investigate whether vitamin D status is associated with the COVID-19 severity, defined as ARDS requiring admission to intensive care unit (ICU) or mortality (primary endpoints) and with the susceptibility to SARS-CoV-2 and COVID-19-related hospitalization (secondary endpoints). Methods: A search in PubMed, ScienceDirect, Web of Science, Google Scholar, Scopus, and preprints repositories was performed until March 31th 2021 to identify all original observational studies reporting association measures, or enough data to calculate them, between Vitamin D status (insufficiency <75, deficiency <50, or severe deficiency <25 nmol/L) and risk of SARS-CoV-2 infection, COVID-19 hospitalization, ICU admission, or death during COVID-19 hospitalization. Findings: Fifty-four studies (49 as fully-printed and 5 as pre-print publications) were included for a total of 1,403,715 individuals. The association between vitamin D status and SARS-CoV2 infection, COVID-19 related hospitalization, COVID-19 related ICU admission, and COVID-19 related mortality was reported in 17, 9, 27, and 35 studies, respectively. Severe deficiency, deficiency and insufficiency of vitamin D were all associated with ICU admission (odds ratio [OR], 95% confidence intervals [95%CIs]: 2.63, 1.45-4.77; 2.16, 1.43-3.26; 2.83, 1.74-4.61, respectively), mortality (OR, 95%CIs: 2.60, 1.93-3.49; 1.84, 1.26-2.69; 4.15, 1.76-9.77, respectively), SARS-CoV-2 infection (OR, 95%CIs: 1.68, 1.32-2.13; 1.83, 1.43-2.33; 1.49, 1.16-1.91, respectively) and COVID-19 hospitalization (OR, 95%CIs 2.51, 1.63-3.85; 2.38, 1.56-3.63; 1.82, 1.43-2.33). Considering specific subgroups (i.e., Caucasian patients, high quality studies, and studies reporting adjusted association estimates) the results of primary endpoints did not change. Interpretations: Patients with low vitamin D levels present an increased risk of ARDS requiring admission to intensive care unit (ICU) or mortality due to SARS-CoV-2 infection and a higher susceptibility to SARS-CoV-2 infection and related hospitalization.
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Affiliation(s)
- Iacopo Chiodini
- Department of Endocrine and Metabolic Diseases, Istituto di Ricovero e Cura a Caratttere Scientifico (IRCCS), Istituto Auxologico Italiano, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Davide Gatti
- Rheumatology Unit, University of Verona, Verona, Italy
| | - Davide Soranna
- Biostatistic Unit, Istituto di Ricovero e Cura a Caratttere Scientifico (IRCCS), Istituto Auxologico Italiano, Milan, Italy
| | - Daniela Merlotti
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Christian Mingiano
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Angelo Fassio
- Rheumatology Unit, University of Verona, Verona, Italy
| | | | - Alberto Falchetti
- Unit of Rehabilitation Medicine, San Giuseppe Hospital, Istituto di Ricovero e Cura a Caratttere Scientifico (IRCCS), Istituto Auxologico Italiano, Piancavallo, Italy
| | - Cristina Eller-Vainicher
- Unit of Endocrinology, Fondazione Istituto di Ricovero e Cura a Caratttere Scientifico (IRCCS) Cà Granda, Milan, Italy
| | | | - Luca Persani
- Department of Endocrine and Metabolic Diseases, Istituto di Ricovero e Cura a Caratttere Scientifico (IRCCS), Istituto Auxologico Italiano, Milan, Italy
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Antonella Zambon
- Biostatistic Unit, Istituto di Ricovero e Cura a Caratttere Scientifico (IRCCS), Istituto Auxologico Italiano, Milan, Italy
- Department of Statistics and Quantitative Methods, Università di Milano-Bicocca, Milan, Italy
| | - Luigi Gennari
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
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29
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Comparing Serum Levels of Vitamin D and Zinc in Novel Coronavirus-Infected Patients and Healthy Individuals in Northeastern Iran, 2020. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2021; 29:e390-e394. [PMID: 34803346 PMCID: PMC8594403 DOI: 10.1097/ipc.0000000000001051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background COVID-19 infection has recently become a pandemic disease around the world, and its risk factors have not fully evaluated. This study aimed to compare the serum vitamin D (Vit D) and zinc levels in patients infected with novel coronavirus and healthy volunteers (HVs). Methods This was a single-center, cross-sectional study conducted on 56 patients (32 severe cases and 24 nonsevere) admitted to the COVID-19 ward and 46 HVs living in Esfarayen City, North Khorasan Province of Iran. Serum levels of Vit D and zinc in admitted patients to the COVID-19 ward and HVs were measured. Results The average levels of serum Vit D in severe cases, nonsevere cases, and HVs were 31.03 ± 15.49, 37.25 ± 18.49, and 39.33 ± 14.83, respectively (P = 0.05). Moreover, the average concentrations of serum zinc in severe cases, nonsevere cases, and HVs were 31.03 ± 15.49, 37.25 ± 18.49, and 39.33 ± 14.83, respectively (P = 0.01). Mortality rate, reinfection (for 5 months), and length of hospital stay in severe cases were higher than in nonsevere cases (P > 0.05). Conclusions Results showed that severe cases had lower levels of Vit D than did other groups and were marginally significant. Also, severe cases had a significantly low level of zinc when compared with nonsevere cases and HVs. Levels of Vit D and zinc can affect the incidence of COVID-19 infection.
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30
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Gallelli L, Mannino GC, Luciani F, de Sire A, Mancuso E, Gangemi P, Cosco L, Monea G, Averta C, Minchella P, Colosimo M, Muraca L, Longhini F, Ammendolia A, Andreozzi F, De Sarro G, Cione E. Vitamin D Serum Levels in Subjects Tested for SARS-CoV-2: What Are the Differences among Acute, Healed, and Negative COVID-19 Patients? A Multicenter Real-Practice Study. Nutrients 2021; 13:nu13113932. [PMID: 34836187 PMCID: PMC8625490 DOI: 10.3390/nu13113932] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 10/30/2021] [Accepted: 11/01/2021] [Indexed: 02/06/2023] Open
Abstract
Vitamin D might play a role in counteracting COVID-19, albeit strong evidence is still lacking in the literature. The present multicenter real-practice study aimed to evaluate the differences of 25(OH)D3 serum levels in adults tested for SARS-CoV-2 (acute COVID-19 patients, subjects healed from COVID-19, and non-infected ones) recruited over a 6-month period (March-September 2021). In a sample of 117 subjects, a statistically significant difference was found, with acute COVID-19 patients demonstrating the lowest levels of serum 25(OH)D3 (9.63 ± 8.70 ng/mL), significantly lower than values reported by no-COVID-19 patients (15.96 ± 5.99 ng/mL, p = 0.0091) and healed COVID-19 patients (11.52 ± 4.90 ng/mL, p > 0.05). Male gender across the three groups displayed unfluctuating 25(OH)D3 levels, hinting at an inability to ensure adequate levels of the active vitamin D3 form (1α,25(OH)2D3). As a secondary endpoint, we assessed the correlation between serum 25(OH)D3 levels and pro-inflammatory cytokine interleukin-6 (IL-6) in patients with extremely low serum 25(OH)D3 levels (<1 ng/mL) and in a subset supplemented with 1α,25(OH)2D3. Although patients with severe hypovitaminosis-D showed no significant increase in IL-6 levels, acute COVID-19 patients manifested high circulating IL-6 at admission (females = 127.64 ± 22.24 pg/mL, males = 139.28 ± 48.95 ng/mL) which dropped drastically after the administration of 1α,25(OH)2D3 (1.84 ± 0.77 pg/mL and 2.65 ± 0.92 ng/mL, respectively). Taken together, these findings suggest that an administration of 1α,25(OH)2D3 might be helpful for treating male patients with an acute COVID-19 infection. Further studies on rapid correction of vitamin D deficiency with fast acting metabolites are warranted in COVID-19 patients.
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Affiliation(s)
- Luca Gallelli
- Department of Health Science, School of Medicine, University of Catanzaro, Operative Unit of Clinical Pharmacology, Mater Domini University Hospital, 88100 Catanzaro, Italy; (L.G.); (G.D.S.)
| | - Gaia Chiara Mannino
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (G.C.M.); (E.M.); (G.M.); (C.A.)
| | - Filippo Luciani
- Infectious Diseases Unit of Annunziata Hospital, 87100 Cosenza, Italy;
| | - Alessandro de Sire
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
- Correspondence: (A.d.S.); (F.A.); Tel.: +39-0961-7128-19 (A.d.S.); +39-0961-36471-20 (F.A.)
| | - Elettra Mancuso
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (G.C.M.); (E.M.); (G.M.); (C.A.)
| | - Pietro Gangemi
- Operative Unit of Clinical Chemistry Laboratory, Pugliese Ciaccio Hospital, 88100 Catanzaro, Italy;
| | - Lucio Cosco
- Department of Infectious Disease, Pugliese Ciaccio Hospital, 88100 Catanzaro, Italy;
| | - Giuseppe Monea
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (G.C.M.); (E.M.); (G.M.); (C.A.)
| | - Carolina Averta
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (G.C.M.); (E.M.); (G.M.); (C.A.)
| | - Pasquale Minchella
- Department of Microbiology and Virology, Pugliese Ciaccio Hospital, 88100 Catanzaro, Italy; (P.M.); (M.C.)
| | - Manuela Colosimo
- Department of Microbiology and Virology, Pugliese Ciaccio Hospital, 88100 Catanzaro, Italy; (P.M.); (M.C.)
| | - Lucia Muraca
- Department of General Medicine, ASP 7, 88100 Catanzaro, Italy;
| | - Federico Longhini
- Department of Anesthesiology and Reanimation, Pugliese Ciaccio Hospital, 88100 Catanzaro, Italy;
| | - Antonio Ammendolia
- Physical Medicine and Rehabilitation Unit, Department of Medical and Surgical Sciences, University of Catanzaro “Magna Graecia”, 88100 Catanzaro, Italy;
| | - Francesco Andreozzi
- Department of Medical and Surgical Sciences, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy; (G.C.M.); (E.M.); (G.M.); (C.A.)
- Correspondence: (A.d.S.); (F.A.); Tel.: +39-0961-7128-19 (A.d.S.); +39-0961-36471-20 (F.A.)
| | - Giovambattista De Sarro
- Department of Health Science, School of Medicine, University of Catanzaro, Operative Unit of Clinical Pharmacology, Mater Domini University Hospital, 88100 Catanzaro, Italy; (L.G.); (G.D.S.)
| | | | - Erika Cione
- Department of Pharmacy, Health and Nutritional Sciences, Department of Excellence 2018–2022, University of Calabria, 87036 Cosenza, Italy;
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31
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The relationship between serum 25-hydroxyvitamin D levels and the severity of COVID-19 disease and its mortality. Sci Rep 2021; 11:17594. [PMID: 34475485 PMCID: PMC8413335 DOI: 10.1038/s41598-021-97017-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 08/10/2021] [Indexed: 01/28/2023] Open
Abstract
Supplemental vitamin D can reduce the risk and mortality of viral pneumonia. The relationship between 25 hydroxyvitamin D [25(OH)D] levels and the severity and mortality of Coronavirus disease 2019 (COVID-19) was evaluated. In this cross-sectional study, the admitted patients with COVID-19 were categorized as mild, moderate, severe, and critical based on clinical and radiologic characteristics. Calcium, phosphorus, albumin, creatinine, and serum 25(OH)D were measured and their correlation with the severity of disease and mortality were analyzed. During 2 months, 508 patients (442 patients in general wards and 66 patients in the intensive care unit (ICU)) were included. The participants were 56 ± 17 years old (52% male, 37% with comorbidity). Concerning severity, 13%, 42%, 36%, and 9% had mild, moderate, severe, and critical diseases, respectively. The mortality rate was 10.8%. Admission to ICU, severity of disease and mortality decreased significantly across quartiles of 25(OH)D. According to multivariate logistic regression analysis, disease mortality had a positive correlation with age and had a negative correlation with the serum level of 25(OH)D, calcium, and albumin. In hospitalized patients with COVID-19, low 25(OH)D was associated with severe disease and increased ICU admission and mortality rate.
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32
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Abril Rubio A, Arjona González P, Castillo Fernández N, Salmerón Portela P, Hidalgo Martín F, Mancera Romero J. [Adequacy of the prescription of vitamin D in Primary Care]. Semergen 2021; 48:38-44. [PMID: 34465546 DOI: 10.1016/j.semerg.2021.07.010] [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: 04/26/2021] [Revised: 07/20/2021] [Accepted: 07/26/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To evaluate the adequacy of vitamin D treatment based on clinic evidence in a Primary Care Center as well as to analyze some characteristics of the prescriptions made. MATERIALS AND METHODS Descriptive cross-sectional study. Primary Care. Patients above 14 years old with vitamin D prescription. Main variable was the therapeutic adequacy with vitamin D compounds (adequacy was considered when there was a clinical indication for treatment and blood vitamin D levels below 20ng/ml). Other clinical variables were collected. Frequency and association measures were used for statistical analysis. Level of statistical significance was considered <0.05. RESULTS 430 patients, 346 women (80.5%, 95% CI=77-84). Record of vitamin D values in 216 (50.2%, 95% CI=45-55). Screening/treatment indications in 219 patients (50.9%, 95% CI=46-56), of those in 150 patients vitamin D values were recorded (68.5%, 95% CI=62-75), average (±SD) was 21.22±12ng/ml, deficiency criteria in 86 (57.3%, 95% CI=51-64), insufficiency in 37 (24.7%, 95% CI=19-30) and sufficiency in 27 (18%, 95% CI=13-23). 86 patients (20%, 95% CI=16-24) had treatment indications plus vitamin D deficiency with no differences between genders. CONCLUSIONS Only 20% of the patients had treatment indications plus vitamin D deficiency. Female predominance. Just over half had indications for screening of serological vitamin D values and/or indications for treatment with vitamin D compounds.
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Affiliation(s)
- A Abril Rubio
- Medicina Familiar y Comunitaria, CS Ciudad Jardín, DS Málaga-Guadalhorce, Málaga, España.
| | - P Arjona González
- Medicina Familiar y Comunitaria, CS Ciudad Jardín, DS Málaga-Guadalhorce, Málaga, España
| | - N Castillo Fernández
- Medicina Familiar y Comunitaria, CS Ciudad Jardín, DS Málaga-Guadalhorce, Málaga, España
| | - P Salmerón Portela
- Medicina Familiar y Comunitaria, CS Ciudad Jardín, DS Málaga-Guadalhorce, Málaga, España
| | - F Hidalgo Martín
- Medicina Familiar y Comunitaria, CS Colmenar, AGS Este de Málaga-Axarquía, Málaga, España
| | - J Mancera Romero
- Medicina Familiar y Comunitaria, CS Ciudad Jardín, DS Málaga-Guadalhorce, Málaga, España
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Mohammad Zadeh N, Mashinchi Asl NS, Forouharnejad K, Ghadimi K, Parsa S, Mohammadi S, Omidi A. Mechanism and adverse effects of COVID-19 drugs: a basic review. INTERNATIONAL JOURNAL OF PHYSIOLOGY, PATHOPHYSIOLOGY AND PHARMACOLOGY 2021; 13:102-109. [PMID: 34540130 PMCID: PMC8446775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 07/01/2021] [Indexed: 06/13/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Coronavirus disease 2019 (COVID-19) is chronic, inflammatory. Although the exact mechanisms of COVID-19 have not been yet discovered some drugs are found helpful for its treatment. These drugs which are divided into some lines therapies, have demonstrated to be helpful for COVID-19 patients based on immune basic and its antiviral properties of the disease. Previous studies have been indicated that deterioration of COVID-19 condition is associated with a weaker immune system. Most of these therapies impact on the immune system and immune cells. Beside many beneficial effects of these drugs, some adverse effects (AE) have been reported in many experiments and clinical trials among patients suffering from COVID-19. In this review, we conclude some AEs of vitamin-D, zinc, remdesivir, hydroxychloroquine or chloroquine, azithromycin, dexamethasone, amantadine, aspirin reported in different papers and we continue the rest of the drugs in second part of our review article.
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Affiliation(s)
- Nadia Mohammad Zadeh
- School of Medicine, Islamic Azad University Tehran Faculty of MedicineTehran, Iran
| | | | | | - Keyvan Ghadimi
- School of Medicine, Isfahan University of Medical SciencesIsfahan, Iran
| | - Sara Parsa
- School of Medicine, Islamic Azad University of Najafabad BranchIsfahan, Iran
| | - Sima Mohammadi
- School of Medicine, Isfahan University of Medical SciencesIsfahan, Iran
| | - Ashkan Omidi
- School of Medicine, Islamic Azad University Tehran Faculty of MedicineTehran, Iran
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Stojanović E, Jakovljević V, Scanlan AT, Dalbo VJ, Radovanović D. Vitamin D 3 supplementation reduces serum markers of bone resorption and muscle damage in female basketball players with vitamin D inadequacy. Eur J Sport Sci 2021; 22:1532-1542. [PMID: 34240659 DOI: 10.1080/17461391.2021.1953153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
This study aimed to investigate the effect of vitamin D3 supplementation at a dose of 4,000 IU/day for 6 weeks on serum levels of: 25-hydroxyvitamin D [25(OH)D], bone turnover [osteocalcin and carboxy-terminal telopeptides of crosslinks of type I collagen (CTx-I)], and muscle damage [lactate dehydrogenase (LDH) and creatine kinase (CK)] in middle adolescent (15-18 years) and late-adolescent to early adulthood (19-30 years) female basketball players with inadequate vitamin D status. Participants (N=24) were randomly assigned in a double-blind manner into a vitamin D or placebo group. Data were analyzed using separate 2×2x2 mixed ANOVAs with one within-subjects factor (time) and two between-subjects factors (condition and age). When a significant interaction was observed, the intra-group changes were assessed using paired t tests and Hedge's g. Paired t-tests comparing intra-group changes in the vitamin D condition revealed a non-significant large improvement in 25(OH)D (p = 0.06; g = 0.86), non-significant small decreases in CTx-I (p = 0.13; g = -0.22) and CK (p = 0.07; g = -0.26), as well as a significant moderate decrease in LDH (p = 0.004; g = -0.74). Paired t-tests comparing intra-group changes in the placebo condition revealed a significant moderate decline in 25(OH)D (p <0.001; g = -0.77), as well as significant small increases in CTx-I (p = 0.04; g = 0.47) and CK (p = 0.04; g = 0.36). Vitamin D3 supplementation at 4,000 IU/day could be effective in reducing bone resorption and muscle damage in female basketball players with inadequate baseline vitamin D, irrespective of age.
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Affiliation(s)
- Emilija Stojanović
- Faculty of Sport and Physical Education, University of Niš, Niš, Serbia.,Faculty of Medical Sciences, Department of Physiology, University of Kragujevac, Kragujevac, Serbia
| | - Vladimir Jakovljević
- Faculty of Medical Sciences, Department of Physiology, University of Kragujevac, Kragujevac, Serbia.,Department of Human Pathology, Moscow State Medical University IM Sechenov, Moscow, Russia
| | - Aaron T Scanlan
- Human Exercise and Training Laboratory, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
| | - Vincent J Dalbo
- Human Exercise and Training Laboratory, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, Australia
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Abstract
PURPOSE OF REVIEW To summarize the recent evidence on the role of vitamin D deficiency in critically ill patients and emerging data claiming a role of vitamin D in COVID-19. RECENT FINDINGS Vitamin D is a strong predictor for worse outcomes in critically ill patients, and as well in COVID-19. The vitamin D content in typical nutrition regimes is lower than what is recommended for the general population. Although its supplementation has been shown to reduce respiratory tract infections, asthma exacerbations and mortality risk in noncritically ill patients, its role in the acute setting is not yet clear. Several small intervention trials have shown interesting results in COVID-19, and larger studies are ongoing. SUMMARY Although research on this topic is still ongoing, it appears reasonable to recommend at least the standard vitamin dose for the healthy population (600--800 IU of native vitamin D3). Many questions remain on the actual role, the best metabolite, regime, and so forth. However, the role for vitamin D in bone health is clear. Elderly ICU survivors have a high risk for osteoporosis/fractures, so at least in this population, an optimal vitamin D status should be targeted.
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Clemente-Suárez VJ, Ramos-Campo DJ, Mielgo-Ayuso J, Dalamitros AA, Nikolaidis PA, Hormeño-Holgado A, Tornero-Aguilera JF. Nutrition in the Actual COVID-19 Pandemic. A Narrative Review. Nutrients 2021; 13:1924. [PMID: 34205138 PMCID: PMC8228835 DOI: 10.3390/nu13061924] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 05/27/2021] [Accepted: 05/31/2021] [Indexed: 02/08/2023] Open
Abstract
The pandemic of Coronavirus Disease 2019 (COVID-19) has shocked world health authorities generating a global health crisis. The present study discusses the main finding in nutrition sciences associated with COVID-19 in the literature. We conducted a consensus critical review using primary sources, scientific articles, and secondary bibliographic indexes, databases, and web pages. The method was a narrative literature review of the available literature regarding nutrition interventions and nutrition-related factors during the COVID-19 pandemic. The main search engines used in the present research were PubMed, SciELO, and Google Scholar. We found how the COVID-19 lockdown promoted unhealthy dietary changes and increases in body weight of the population, showing obesity and low physical activity levels as increased risk factors of COVID-19 affection and physiopathology. In addition, hospitalized COVID-19 patients presented malnutrition and deficiencies in vitamin C, D, B12 selenium, iron, omega-3, and medium and long-chain fatty acids highlighting the potential health effect of vitamin C and D interventions. Further investigations are needed to show the complete role and implications of nutrition both in the prevention and in the treatment of patients with COVID-19.
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Affiliation(s)
- Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain;
- Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, 080002 Barranquilla, Colombia
- Studies Centre in Applied Combat (CESCA), 45007 Toledo, Spain;
| | | | - Juan Mielgo-Ayuso
- Department of Health Sciences, Faculty of Health Sciences, University of Burgos, 09001 Burgos, Spain;
| | - Athanasios A. Dalamitros
- Laboratory of Evaluation of Human Biological Performance, School of Physical Education and Sport Sciences, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | | | | | - Jose Francisco Tornero-Aguilera
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, 28670 Madrid, Spain;
- Studies Centre in Applied Combat (CESCA), 45007 Toledo, Spain;
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37
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Gibson‐Moore H. Vitamin D: What's new a year on from the COVID-19 outbreak? NUTR BULL 2021; 46:195-205. [PMID: 34149314 PMCID: PMC8207114 DOI: 10.1111/nbu.12499] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 04/19/2021] [Accepted: 04/19/2021] [Indexed: 12/15/2022]
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Eden T, McAuliffe S. Critical care nutrition and COVID-19: a cause of malnutrition not to be underestimated. BMJ Nutr Prev Health 2021; 4:342-347. [PMID: 34308142 PMCID: PMC8258038 DOI: 10.1136/bmjnph-2021-000271] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 05/03/2021] [Indexed: 01/03/2023] Open
Abstract
Malnutrition in critical care is highly prevalent and well documented to have adverse implications on morbidity and mortality. During the current COVID-19 pandemic, the evolving literature has been able to identify high risk groups in whom unfavourable outcomes are more common, for example, obesity, premorbid status, male sex, members from the Black, Asian and Minority Ethnic (BAME) community and others. Nutritional status and provision precritical and pericritical phase of COVID-19 illness is gaining traction in the literature assessing how this can influence the clinical course. It is therefore of importance to understand and address the challenges present in critical care nutrition and to identify and mitigate factors contributing to malnutrition specific to this patient group. We report a case of significant disease burden and the associated cachexia and evidence of malnutrition in a young 36-year-old male with Somalian heritage with no pre-existing medical conditions but presenting with severe COVID-19 during the first wave of the pandemic (March 2020). We highlight some key nutritional challenges during the critical phase of illness signposting to some of the management instigated to counter this. These considerations are hoped to provide further insight to help continue to evolve nutritional management when treating patients with COVID-19.
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Affiliation(s)
- Timothy Eden
- ICU Dept, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, UK.,NNEdPro Global Centre for Nutrition and Health, Cambridge, UK
| | - Shane McAuliffe
- NNEdPro Global Centre for Nutrition and Health, Cambridge, UK.,Nutrition and Dietetics, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK
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Tarazona-Santabalbina FJ, Cuadra L, Cancio JM, Carbonell FR, Garrote JMPC, Casas-Herrero Á, Martínez-Velilla N, Serra-Rexach JA, Formiga F. VitaminD supplementation for the prevention and treatment of COVID-19: a position statement from the Spanish Society of Geriatrics and Gerontology. Rev Esp Geriatr Gerontol 2021; 56:177-182. [PMID: 33642133 PMCID: PMC8055189 DOI: 10.1016/j.regg.2021.02.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 01/31/2021] [Accepted: 02/03/2021] [Indexed: 02/07/2023]
Abstract
The coronavirus disease 2019 (COVID-19) produces severe respiratory symptoms such as bilateral pneumonia associated to a high morbidity and mortality, especially in patients of advanced age. Vitamin D deficiency has been reported in several chronic conditions associated with increased inflammation and dysregulation of the immune system. Vitamin D in modulates immune function too. Vitamin D receptor (VDR) is expressed by most immune cells, including B and T lymphocytes, monocytes, macrophages, and dendritic cells and the signalling of vitamin D and VDR together has an anti-inflammatory effect. Some studies have reported that vitamin D treatment could be useful for the prevention and treatment of COVID-19 because vitamin D plays an important role as a modulator of immunocompetence. Over the last few months, some studies have hypothesized the possible beneficial effect of vitamin D supplementation in patients with COVID-19 in order to improve the immune balance and prevent the hyperinflammatory cytokine storm. Some preliminary studies have already shown promising results with vitamin D supplementation in hospitalized COVID-19 patients. Vitamin D should be administered daily until adequate levels are achieved due to vitamin D behaves as a negative acute phase reactant (APR). Despite the lack of evidence on specific doses of vitamin D to treat COVID-19 in older adults, authors consider it is necessary to standardize the use in clinical practice. These recommendations advice supplement vitamin D in a protocoled fashion based on expert opinions, level of evidence 5.
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Affiliation(s)
- Francisco J Tarazona-Santabalbina
- Geriatric Service, Hospital Universitario de la Ribera, Alzira, Valencia, Spain. CIBERFES, Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable, Madrid, Spain.
| | - Leonor Cuadra
- Departament of Geriatric Medicine and Palliative Care, Badalona Serveis Assistencials, Barcelona, Spain. Catalonia Geriatrics and Gerontology Society, Barcelona, Spain
| | - José Manuel Cancio
- Centro Sociosanitario El Carme, Servicio de Geriatría y Cuidados Paliativos de BSA (Badalona Servicios Asistenciales), Badalona, Spain; Badalona Welfare Services: Badalona Serveis Assistencials SA, Badalona, Spain
| | - Ferran Roca Carbonell
- Servicio de Geriatría Hospital Universitari de la Santa Creu, Vic, Spain; Hospital Universitari de Vic: Hospital General de Vic, Spain
| | - Juan Manuel Pérez-Castejón Garrote
- Doctor en Medicina por la UB Especialista en Geriatria, Jefe del Servicio de Geriatria y Cuidados Paliativos de Badalona Serveis Assistencials BSA, CSS El Carme Badalona, Spain; Badalona Welfare Services: Badalona Serveis Assistencials SA, Badalona, Spain
| | - Álvaro Casas-Herrero
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), (UPNA), IdiSNA, Pamplona, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Hospital de Navarra: Complejo Hospitalario de Navarra, Spain
| | - Nicolás Martínez-Velilla
- Navarrabiomed, Complejo Hospitalario de Navarra (CHN), (UPNA), IdiSNA, Pamplona, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid, Spain; Hospital de Navarra: Complejo Hospitalario de Navarra, Spain
| | - José Antonio Serra-Rexach
- Jefe del Servicio de Geriatría Hospital General Universitario Gregorio Marañón Profesor Titular de Medicina, Departarmento de Medicina, Facultad de Medicina Universidad Complutense CIBER-Fragilidad y Envejecimiento Saludable Madrid, Spain; Hospital General Universitario Gregorio Marañón: Hospital General Universitario Gregorio Maranon, Spain
| | - Francesc Formiga
- Programa de Geriatría, Servicio medicina Interna, Hospital de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain; Systemic Diseases and Ageing Group, Cardiovascular, Respiratory and Systemic Diseases and Cellular Ageing Program, Translational Medicine Area, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Spain
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Wong RS, Tung KTS, So HK, Wong WHS, Wong SY, Tsang HW, Tung JYL, Chua GT, Ho MHK, Wong ICK, Ip P. Impact of COVID-19 Pandemic on Serum Vitamin D Level among Infants and Toddlers: An Interrupted Time Series Analysis and before-and-after Comparison. Nutrients 2021; 13:nu13041270. [PMID: 33924387 PMCID: PMC8069706 DOI: 10.3390/nu13041270] [Citation(s) in RCA: 6] [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: 02/19/2021] [Revised: 03/31/2021] [Accepted: 04/02/2021] [Indexed: 12/16/2022] Open
Abstract
Background: During the coronavirus disease 2019 (COVID-19) pandemic, the implementation of social distancing and home confinement measures may elevate the risk of vitamin D deficiency particularly for infants. This study aimed to quantify changes in vitamin D level among infants and toddlers in Hong Kong after the COVID-19 outbreak. Methods: We recruited 303 infants and toddlers aged 2–24 months by stratified random sampling from 1 June 2019 to November 30, 2020. Regression models were used to estimate the effect of time on infants’ serum 25-hydroxyvitamin D (25(OH)D) level overall and by age groups before and after the outbreak. Interrupted time series (ITS) analysis was performed to examine the sustained effect of COVID-19 on their serum 25(OH)D level. Results: The ITS results showed no immediate reduction in serum 25(OH)D level among infants, but a decreasing trend was observed in the subsequent months post-outbreak at a monthly decline rate of −6.32 nmol/L. When analyzed by age group, the magnitude of post-outbreak reduction in 25(OH)D was stronger among younger infants (aged 2–6 months). Conclusion: Guidelines and recommendations should be given to pregnant women and mothers to ensure sufficient vitamin D level in their infants during the COVID-19 period.
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Affiliation(s)
- Rosa S. Wong
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China; (R.S.W.); (K.T.S.T.); (H.-K.S.); (W.H.S.W.); (S.Y.W.); (H.W.T.); (J.Y.L.T.); (G.T.C.); (M.H.K.H.)
| | - Keith T. S. Tung
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China; (R.S.W.); (K.T.S.T.); (H.-K.S.); (W.H.S.W.); (S.Y.W.); (H.W.T.); (J.Y.L.T.); (G.T.C.); (M.H.K.H.)
| | - Hung-Kwan So
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China; (R.S.W.); (K.T.S.T.); (H.-K.S.); (W.H.S.W.); (S.Y.W.); (H.W.T.); (J.Y.L.T.); (G.T.C.); (M.H.K.H.)
| | - Wilfred H. S. Wong
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China; (R.S.W.); (K.T.S.T.); (H.-K.S.); (W.H.S.W.); (S.Y.W.); (H.W.T.); (J.Y.L.T.); (G.T.C.); (M.H.K.H.)
| | - Siew Yan Wong
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China; (R.S.W.); (K.T.S.T.); (H.-K.S.); (W.H.S.W.); (S.Y.W.); (H.W.T.); (J.Y.L.T.); (G.T.C.); (M.H.K.H.)
| | - Hing Wai Tsang
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China; (R.S.W.); (K.T.S.T.); (H.-K.S.); (W.H.S.W.); (S.Y.W.); (H.W.T.); (J.Y.L.T.); (G.T.C.); (M.H.K.H.)
| | - Joanna Y. L. Tung
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China; (R.S.W.); (K.T.S.T.); (H.-K.S.); (W.H.S.W.); (S.Y.W.); (H.W.T.); (J.Y.L.T.); (G.T.C.); (M.H.K.H.)
- Department of Paediatrics, Hong Kong Children’s Hospital, Hong Kong, China
| | - Gilbert T. Chua
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China; (R.S.W.); (K.T.S.T.); (H.-K.S.); (W.H.S.W.); (S.Y.W.); (H.W.T.); (J.Y.L.T.); (G.T.C.); (M.H.K.H.)
| | - Marco H. K. Ho
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China; (R.S.W.); (K.T.S.T.); (H.-K.S.); (W.H.S.W.); (S.Y.W.); (H.W.T.); (J.Y.L.T.); (G.T.C.); (M.H.K.H.)
| | - Ian C. K. Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, China;
- Research Department of Practice and Policy, UCL School of Pharmacy, London WC1E 6BT, UK
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, The University of Hong Kong, Hong Kong, China; (R.S.W.); (K.T.S.T.); (H.-K.S.); (W.H.S.W.); (S.Y.W.); (H.W.T.); (J.Y.L.T.); (G.T.C.); (M.H.K.H.)
- Correspondence: ; Tel.: +852-2255-4090; Fax: +852-2855-1523
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Griffin G, Hewison M, Hopkin J, Kenny RA, Quinton R, Rhodes J, Subramanian S, Thickett D. Perspective: Vitamin D supplementation prevents rickets and acute respiratory infections when given as daily maintenance but not as intermittent bolus: implications for COVID-19. Clin Med (Lond) 2021; 21:e144-e149. [PMID: 33593830 DOI: 10.7861/clinmed.2021-0035] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The value of vitamin D supplementation in the treatment or prevention of various conditions is often viewed with scepticism as a result of contradictory results of randomised trials. It is now becoming apparent that there is a pattern to these inconsistencies. A recent large trial has shown that high-dose intermittent bolus vitamin D therapy is ineffective at preventing rickets - the condition that is most unequivocally caused by vitamin D deficiency. There is a plausible biological explanation since high-dose bolus replacement induces long-term expression of the catabolic enzyme 24-hydroxylase and fibroblast growth factor 23, both of which have vitamin D inactivating effects. Meta-analyses of vitamin D supplementation in prevention of acute respiratory infection and trials in tuberculosis and other conditions also support efficacy of low dose daily maintenance rather than intermittent bolus dosing. This is particularly relevant during the current COVID-19 pandemic given the well-documented associations between COVID-19 risk and vitamin D deficiency. We would urge that clinicians take note of these findings and give strong support to widespread use of daily vitamin D supplementation.
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Griffin G, Hewison M, Hopkin J, Kenny RA, Quinton R, Rhodes J, Subramanian S, Thickett D. Response. Clin Med (Lond) 2021; 21:e120. [PMID: 33479101 PMCID: PMC7850200 DOI: 10.7861/clinmed.let.21.1.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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