1
|
Peshevska-Sekulovska M, Bakalova P, Snegarova V, Lazova S, Velikova T. COVID-19 Vaccines for Adults and Children with Autoimmune Gut or Liver Disease. Vaccines (Basel) 2022; 10:vaccines10122075. [PMID: 36560485 PMCID: PMC9781431 DOI: 10.3390/vaccines10122075] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 12/07/2022] Open
Abstract
The SARS-CoV-2 pandemic raised many challenges for all patients with chronic conditions and those with autoimmune diseases, both adults and children. Special attention is paid to their immunological status, concomitant diseases, and the need for immunosuppressive therapy. All of these factors may impact their COVID-19 course and outcome. COVID-19 vaccination is accepted as one of the most successful strategies for pandemic control. However, individuals with immune-mediated chronic diseases, including autoimmune liver and gut diseases, have been excluded from the vaccine clinical trials. Therefore, we rely on real-world data from vaccination after vaccine approval for these patients to fill the evidence gap for the long-term safety and efficacy of COVID-19 vaccines in patients with autoimmune gut and liver diseases. Current recommendations from inflammatory bowel disease (IBD) societies suggest COVID-19 vaccination in children older than 5 years old, adults and even pregnant females with IBD. The same recommendations are applied to patients with autoimmune liver diseases. Nevertheless, autoimmune disease patients still experience high levels of COVID-19 vaccine hesitancy, and more studies have to be conducted to clarify this issue.
Collapse
Affiliation(s)
- Monika Peshevska-Sekulovska
- Department of Gastroenterology, University Hospital Lozenetz, 1407 Sofia, Bulgaria
- Medical Faculty, Sofia University St. Kliment Ohridski, 1407 Sofia, Bulgaria
| | - Plamena Bakalova
- Department of Gastroenterology, University Hospital Lozenetz, 1407 Sofia, Bulgaria
| | - Violeta Snegarova
- Clinic of Internal Diseases, Naval Hospital—Varna, Military Medical Academy, Medical Faculty, Medical University, 9000 Varna, Bulgaria
| | - Snezhina Lazova
- Pediatric Department, University Hospital “N. I. Pirogov”,“General Eduard I. Totleben” Blvd 21, Health Care Department, 1606 Sofia, Bulgaria
- Faculty of Public Health, Medical University Sofia, Bialo More 8 Str., 1527 Sofia, Bulgaria
| | - Tsvetelina Velikova
- Medical Faculty, Sofia University St. Kliment Ohridski, 1407 Sofia, Bulgaria
- Department of Clinical Immunology, University Hospital Lozenetz, Medical Faculty, Sofia University St. Kliment Ohridski, 1407 Sofia, Bulgaria
- Correspondence:
| |
Collapse
|
2
|
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.
Collapse
Affiliation(s)
- Sunil J Wimalawansa
- Endocrinology & Nutrition, Department of Medicine, Cardiometabolic & Endocrine Institute, North Brunswick, NJ 08873, USA
| |
Collapse
|
3
|
Calcuttawala F. Nutrition as a key to boost immunity against COVID-19. Clin Nutr ESPEN 2022; 49:17-23. [PMID: 35623808 PMCID: PMC9012504 DOI: 10.1016/j.clnesp.2022.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 03/20/2022] [Accepted: 04/08/2022] [Indexed: 11/16/2022]
Abstract
The Coronavirus-disease 2019 (COVID-19) was declared as a global pandemic on March 11, 2020 by the World Health Organization. Since then, the scientific community has been actively engaged in developing a vaccine against the dreaded disease. Considerable research has also been performed for drugs that can directly interfere with the viral replication pathway. However, the production of these vaccines and drugs demands a lot of time and effort which is undesirable considering the pace at which the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is spreading across the continents. For this reason, the possible role of dietary nutrients in reducing the risk of SARS-CoV-2 infection as well as mitigating the symptoms, may be explored. These natural substances are readily available, have negligible side effects and confer several benefits to the immune system. Macronutrients like proteins are vital for antibody production. Dietary constituents such as omega-3-fatty acids, vitamin C, vitamin E, phytochemicals such as carotenoids and polyphenols exhibit anti-inflammatory and antioxidant properties. This review highlights the significance of relevant nutrients in boosting the immune system.
Collapse
|
4
|
Garg A, Agrawal A, Behera A, Mohapatra E, Sakale H, Shah S, Kar B, Ojha M, Nayak B. Correlation of Vitamin D levels with markers of bone metabolism in COVID-19 patients. JOURNAL OF ORTHOPEDICS, TRAUMATOLOGY AND REHABILITATION 2022. [DOI: 10.4103/jotr.jotr_115_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
|
5
|
Eze UA, Ndoh KI, Ibisola BA, Onwuliri CD, Osiyemi A, Ude N, Chime AA, Ogbor EO, Alao AO, Abdullahi A. Determinants for Acceptance of COVID-19 Vaccine in Nigeria. Cureus 2021; 13:e19801. [PMID: 34963828 PMCID: PMC8695669 DOI: 10.7759/cureus.19801] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 12/24/2022] Open
Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic heralded an unprecedented race to the development of several vaccine candidates at record speeds never seen in global health. Within nine months, Pfizer-BioNTech’s COVID-19 vaccine was approved by the United States FDA. Unfortunately, while these advances were ongoing, there was a burgeoning epidemic of disinformation about the virus and the vaccines that affected the willingness of people, especially minority groups, to get vaccinated. In Nigeria, this wave of vaccine hesitancy was happening against the backdrop of landmark pharmaceutical litigations such as the 2007 Pfizer trovafloxacin lawsuit in the country. Aim: To assess the determinants of the COVID-19 vaccine's acceptability among Nigerians. Materials and methods: Following ethical approval, a population-based cross-sectional study was conducted from November 2020 to January 2021 using an adapted pretested, self-administered questionnaire originally designed by Amyn Malik and colleagues who conducted a similar study at Yale University School of Public Health. The participants were recruited through simple random sampling using a list of community and corporate sites obtained from Google Maps in the three regional zones of Nigeria (north, east, and west) in diverse occupational and residential settings. Information obtained includes socio-demographics, medical history related to COVID-19, level of knowledge, risk perception, and attitudes toward COVID-19 and the vaccines. Descriptive and inferential statistics were done, and results were summarized into percentages and associations. The level of statistical significance was set at a p-value of <0.05. Using the open EpiR package (Emory), we determined a minimum of 340 participants for a statistical power of 80%. Results: A total of 358 responses were obtained out of the 120 questionnaires distributed in each of the three regions, of which 189 (53%) were females. The mean age of respondents was 32 years (±11.2 SD). About 75% of the participants had at least a college education. The majority (66.2%) of the participants were willing to accept the approved vaccine. The mean risk perception score for COVID-19 was 5.1 (±2.2 SD) out of 10, while the mean COVID-19 symptom knowledge score was 8.6 (±4.1 SD) out of 19. Variables such as being male, identifying as Christian, Hausa ethnicity, and living in northern Nigeria had a statistically significant relationship with the willingness to get vaccinated. Conclusion: Over 60% of Nigerians are willing to take the COVID-19 vaccines if recommended by health workers. We found male gender, religion, ethnicity, and geographical location to positively influence the willingness of Nigerians to get vaccinated against COVID-19. Health workers should be supported to go beyond the confines of the hospital to educate the general public in schools, marketplaces, churches, and corporate organizations on the efficacy and safety of the approved vaccines.
Collapse
Affiliation(s)
- Ugochukwu A Eze
- Department of Ophthalmology, Federal Medical Centre, Asaba, NGA.,Department of Public Health, University of Suffolk, Ipswich, GBR.,Health Economics Program, Department of Economics, Kaduna State University, Kaduna, NGA
| | - Kingsley I Ndoh
- Department of Global Health, University of Washington, Seattle, USA
| | | | - Chinemerem D Onwuliri
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu, NGA
| | - Adenekan Osiyemi
- Department of Family Medicine, University College Hospital, Ibadan, NGA
| | - Nnamdi Ude
- Department of Community Medicine, University of Nigeria Teaching Hospital, Enugu, NGA
| | - Amalachukwu A Chime
- Department of Ophthalmology, University of Nigeria Teaching Hospital, Enugu, NGA
| | - Eric O Ogbor
- Department of Ophthalmology, Jos University Teaching Hospital, Jos, NGA
| | - Adegboyega O Alao
- Department of Family Medicine, University College Hospital, Ibadan, NGA
| | - Ashiru Abdullahi
- Department of Ophthalmology, Federal Medical Centre, Katsina, NGA
| |
Collapse
|
6
|
Maganeva IS, Gorbacheva AM, Bibik EE, Aboisheva EA, Eremkina AK, Mokrysheva NG. Mineral metabolism and COVID-19: is there a connection? TERAPEVT ARKH 2021; 93:1227-1233. [DOI: 10.26442/00403660.2021.10.201114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 11/05/2021] [Indexed: 11/22/2022]
Abstract
Due to global spread of COVID-19, the search for new factors that could influence its clinical course becomes highly important. This review summarize the relevant publications on the association between immune system and the main regulators of mineral homeostasis including. In addition, we have highlighted the various aspects of phosphorus-calcium metabolism related to the acute respiratory diseases and in particular to COVID-19. The data about the calcium-phosphorus metabolism in SARS-CoV-2 infection is required to understand the possible clinical implications and to develop new therapeutic and preventive interventions.
Collapse
|
7
|
Silverio R, Gonçalves DC, Andrade MF, Seelaender M. Coronavirus Disease 2019 (COVID-19) and Nutritional Status: The Missing Link? Adv Nutr 2021; 12:682-692. [PMID: 32975565 PMCID: PMC7543263 DOI: 10.1093/advances/nmaa125] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 08/19/2020] [Accepted: 09/09/2020] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is an emerging disease that has reached pandemic status by rapidly spreading worldwide. Elderly individuals and patients with comorbidities such as obesity, diabetes, and hypertension show a higher risk of hospitalization, severe disease, and mortality by acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. These patients frequently show exacerbated secretion of proinflammatory cytokines associated with an overreaction of the immune system, the so-called cytokine storm. Host nutritional status plays a pivotal role in the outcome of a variety of different infectious diseases. It is known that the immune system is highly affected by malnutrition, leading to decreased immune responses with consequent augmented risk of infection and disease severity. Body composition, especially low lean mass and high adiposity, has consistently been linked to worsened prognosis in many different diseases. In this review, evidence concerning the impact of nutritional status on viral infection outcomes is discussed.
Collapse
Affiliation(s)
- Renata Silverio
- Cancer Metabolism Research Group, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
- Multicenter Graduate Program in Physiological Sciences, Center of Biological Sciences, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Daniela Caetano Gonçalves
- Cancer Metabolism Research Group, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
- Biosciences Department, Universidade Federal de São Paulo (UNIFESP), Campus Baixada Santista, Santos, Brazil
| | - Márcia Fábia Andrade
- Cancer Metabolism Research Group, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | - Marilia Seelaender
- Cancer Metabolism Research Group, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
- Department of Clinical Surgery, LIM 26-HC, Faculdade de Medicina, University of São Paulo, São Paulo, Brazil
| |
Collapse
|
8
|
Megna M, Marasca C, Fabbrocini G, Monfrecola G. Ultraviolet radiation, vitamin D, and COVID-19. Ital J Dermatol Venerol 2021; 156:366-373. [PMID: 33913665 DOI: 10.23736/s2784-8671.21.06833-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), has become pandemic on March 11th, 2020. COVID-19 has a range of symptoms that includes fever, fatigue, dry cough, aches, and labored breathing to acute respiratory distress and possibly death. Health systems and hospitals have been completely rearranged since March 2020 in order to limit the high rate of virus spreading. Hence, a great debate on deferrable visits and treatments including phototherapy for skin diseases is developing. In particular, as regards phototherapy very few data are currently available regarding the chance to continue it, even if it may be a useful resource for treating numerous dermatological patients. However, phototherapy has an immunosuppressive action possibly facilitating virus infection. In the context of COVID-19 infection risk it is important to pointed out whether sunlight, phototherapy and in particular ultraviolet radiation (UV-R) constitute or not a risk for patients. In this review we aimed to focus on the relationship between UV-R, sunlight, phototherapy, and viral infections particularly focusing on COVID-19.
Collapse
Affiliation(s)
- Matteo Megna
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy -
| | - Claudio Marasca
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Gabriella Fabbrocini
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Giuseppe Monfrecola
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| |
Collapse
|
9
|
Abstract
Vitamin D (VitD) deficiency is considered a global problem and might be associated with increased susceptibility to COVID-19 illness. In the light of COVID-19 pandemic, VitD might be a promising agent for fighting the SARS-CoV-2, since VitD is involved in various pathophysiological mechanisms that occur during COVID-19 infection. High-dose VitD supplementation, particularly for risk groups, could be recommended to achieve and maintain optimal (range 40-60 ng/mL) serum 25-hydroxy vitamin D levels (marker of VitD status) both for COVID-19 prevention and treatment.
Collapse
Affiliation(s)
- Andrius Bleizgys
- Clinic of Internal Diseases, Family Medicine and OncologyVilnius University Faculty of MedicineVilniusLithuania
| |
Collapse
|
10
|
Rizzello F, Calabrese C, Salice M, Calandrini L, Privitera H, Melotti L, Peruzzi G, Dussias N, Belluzzi A, Scaioli E, Decorato A, Siniscalchi A, Filippone E, Laureti S, Rottoli M, Poggioli G, Gionchetti P. COVID-19 in IBD: The experience of a single tertiary IBD center. Dig Liver Dis 2021; 53:271-276. [PMID: 33451910 PMCID: PMC7764386 DOI: 10.1016/j.dld.2020.12.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Revised: 12/16/2020] [Accepted: 12/18/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Italy has been one of the most affected countries in the world by COVID-19. There has been increasing concern regarding the impact of COVID-19 on patients with inflammatory bowel disease (IBD), particularly in patients treated with immunosuppressants or biologics. The aim of our study is to understand the incidence of COVID-19 in a large cohort of patients with IBD. Furthermore, we analyzed possible risk factors for infection and severity of COVID-19. METHODS This was an observational study evaluating the impact of COVID-19 on IBD patients in a single tertiary center. A 23 multiple-choice-question anonymous survey was administered to 1200 patients with IBD between March 10th and June 10th 2020. RESULTS 1158 questionnaires were analyzed. The majority of patients had Crohn's disease (CD) (60%) and most of them were in clinical remission. Among the 26 patients (2.2%) who tested positive for COVID-19, only 5 (3CD) were on biological treatment and none required hospitalization. Two patients died and were on treatment with mesalazine only. Of the 1158 patients, 521 were on biological therapy, which was discontinued in 85 (16.3%) and delayed in 195 patients (37.4%). A worsening of IBD symptoms was observed in 200 patients on biological therapy (38.4%). Most of these patients, 189 (94.5%), had stopped or delayed biological treatment, while 11 (5.5%) had continued their therapy regularly (p<0.001). CONCLUSIONS Our data are in line with the current literature and confirm a higher incidence compared to the general population. Biological therapy for IBD seems to not be a risk factor for infection and should not be discontinued in order to avoid IBD relapse.
Collapse
Affiliation(s)
- Fernando Rizzello
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Carlo Calabrese
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Marco Salice
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Lucia Calandrini
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Hana Privitera
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Laura Melotti
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Giulia Peruzzi
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Nikolas Dussias
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Andrea Belluzzi
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Eleonora Scaioli
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Anastasio Decorato
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Antonio Siniscalchi
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Eleonora Filippone
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Silvio Laureti
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Matteo Rottoli
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Gilberto Poggioli
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy
| | - Paolo Gionchetti
- Centro di Riferimento Regionale Malattie Infiammatorie Croniche Intestinali, DIMEC Azienda Ospedaliero-Universitaria Policlinico Sant'Orsola-Malpighi, Bologna, Italy.
| |
Collapse
|
11
|
Kumar R, Rathi H, Haq A, Wimalawansa SJ, Sharma A. Putative roles of vitamin D in modulating immune response and immunopathology associated with COVID-19. Virus Res 2021; 292:198235. [PMID: 33232783 PMCID: PMC7680047 DOI: 10.1016/j.virusres.2020.198235] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2020] [Revised: 11/15/2020] [Accepted: 11/16/2020] [Indexed: 01/08/2023]
Abstract
The first incidence of COVID-19 was reported in the Wuhan city of Hubei province in China in late December 2019. Because of failure in timely closing of borders of the affected region, COVID-19 spread across like a wildfire through air travel initiating a pandemic. It is a serious lower respiratory track viral infection caused by highly contagious, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Coronavirus including COVID-19 causing SARS-CoV-2 causes zoonotic diseases and thought to be originated from bats. Since its first incidence, the virus has spread all across the world, causing serious human casualties, economic losses, and disrupting global supply chains. As with SARS-CoV, COVID-19 causing SARS-CoV-2 follows a similar path of airborne infection, but is less lethal and more infectious than SARS and MERS. This review focusses on the pathogenesis of SARS-CoV-2, especially on the dysfunctional immune responses following a cytokine storm in severely affected persons. The mode of entry of SARS-CoV-2 is via the angiotensin converting enzyme 2 (ACE-2) receptors present on the epithelial lining of lungs, gastrointestinal tract, and mucus membranes. Older persons with weaker immune system and associated co-morbidities are more vulnerable to have dysfunctional immune responses, as most of them concomitantly have severe hypovitaminosis D. Consequently, causing severe damage to key organs of the body including lungs and the cardiovascular system. Since, vast majority of persons enters to the intensive care units and died, had severe vitamin D deficiency, thus, this area must be investigated seriously. In addition, this article assesses the role of vitamin D in reducing the risk of COVID-19. Vitamin D is a key regulator of the renin-angiotensin system that is exploited by SARS-CoV-2 for entry into the host cells. Further, vitamin D modulates multiple mechanisms of the immune system to contain the virus that includes dampening the entry and replication of SARS-CoV-2, reduces concentration of pro-inflammatory cytokines and increases levels of anti-inflammatory cytokines, enhances the production of natural antimicrobial peptide and activates defensive cells such as macrophages that could destroy SARS-CoV-2. Thus, this article provides the urgency of needed evidences through large population based randomized controlled trials and ecological studies to evaluate the potential role of vitamin D in COVID-19.
Collapse
Affiliation(s)
- Raman Kumar
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India; Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
| | - Himani Rathi
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
| | - Afrozul Haq
- Department of Food Technology, Jamia Hamdard, New Delhi, India
| | | | - Alpana Sharma
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), New Delhi, India.
| |
Collapse
|
12
|
Cereda E, Bogliolo L, de Stefano L, Caccialanza R. A brief discussion of the benefit and mechanism of vitamin D supplementation on coronavirus disease 2019. Curr Opin Clin Nutr Metab Care 2021; 24:102-107. [PMID: 33003119 DOI: 10.1097/mco.0000000000000701] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Vitamin D exerts extraskeletal functions, including immunomodulatory activity, protection against respiratory tract infections and pleiotropic effects on the cardiovascular system. Since the outbreak of the coronavirus disease-2019 (COVID-19) pandemic, several articles have suggested the potential involvement of vitamin D in reducing the risk and severity of the disease. RECENT FINDINGS Epidemiological and observational studies support the hypothesis of a protective role of vitamin D but most studies are retrospective or based on small samples. However, the pandemic progression and the increased knowledge on the pathogenesis of COVID-19 have challenged the first evidence, suggesting also potential negative consequences derived by adequate vitamin D status. A cautious interpretation of the significance of low vitamin D25OH levels is advisable. The balance between over-activation of innate immunity and the exhaustibility of the adaptive immune response still needs to be clarified. In addition, the modulation of endothelial function, the down-regulation of renin, angiotensin-converting-enzyme (ACE) and angiotensin genes and the up-regulation of ACE2 expression is still an area of research. SUMMARY Speculative hypotheses and observational data have suggested a protective role of vitamin D in COVID-19. However, many unanswered questions remain, aberrant detrimental effects of adequate vitamin D25OH levels cannot be excluded and whether its adequacy may prevent the infection or improve clinical outcomes needs to be assessed by adequately sized and designed population-based studies and intervention trials.
Collapse
Affiliation(s)
| | - Laura Bogliolo
- Rheumatology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | | |
Collapse
|
13
|
Gorman S, Weller RB. Investigating the Potential for Ultraviolet Light to Modulate Morbidity and Mortality From COVID-19: A Narrative Review and Update. Front Cardiovasc Med 2020; 7:616527. [PMID: 33426009 PMCID: PMC7786057 DOI: 10.3389/fcvm.2020.616527] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Accepted: 11/26/2020] [Indexed: 12/16/2022] Open
Abstract
During the COVID-19 (coronavirus disease of 2019) pandemic, researchers have been seeking low-cost and accessible means of providing protection from its harms, particularly for at-risk individuals such as those with cardiovascular disease, diabetes and obesity. One possible way is via safe sun exposure, and/or dietary supplementation with induced beneficial mediators (e.g., vitamin D). In this narrative review, we provide rationale and updated evidence on the potential benefits and harms of sun exposure and ultraviolet (UV) light that may impact COVID-19. We review recent studies that provide new evidence for any benefits (or otherwise) of UV light, sun exposure, and the induced mediators, vitamin D and nitric oxide, and their potential to modulate morbidity and mortality induced by infection with SARS-CoV-2 (severe acute respiratory disease coronavirus-2). We identified substantial interest in this research area, with many commentaries and reviews already published; however, most of these have focused on vitamin D, with less consideration of UV light (or sun exposure) or other mediators such as nitric oxide. Data collected to-date suggest that ambient levels of both UVA and UVB may be beneficial for reducing severity or mortality due to COVID-19, with some inconsistent findings. Currently unresolved are the nature of the associations between blood 25-hydroxyvitamin D and COVID-19 measures, with more prospective data needed that better consider lifestyle factors, such as physical activity and personal sun exposure levels. Another short-coming has been a lack of measurement of sun exposure, and its potential to influence COVID-19 outcomes. We also discuss possible mechanisms by which sun exposure, UV light and induced mediators could affect COVID-19 morbidity and mortality, by focusing on likely effects on viral pathogenesis, immunity and inflammation, and potential cardiometabolic protective mechanisms. Finally, we explore potential issues including the impacts of exposure to high dose UV radiation on COVID-19 and vaccination, and effective and safe doses for vitamin D supplementation.
Collapse
Affiliation(s)
- Shelley Gorman
- Telethon Kids Institute, University of Western Australia, Perth, WA, Australia
| | - Richard B. Weller
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, United Kingdom
| |
Collapse
|
14
|
Santaolalla A, Beckmann K, Kibaru J, Josephs D, Van Hemelrijck M, Irshad S. Association Between Vitamin D and Novel SARS-CoV-2 Respiratory Dysfunction - A Scoping Review of Current Evidence and Its Implication for COVID-19 Pandemic. Front Physiol 2020; 11:564387. [PMID: 33324234 PMCID: PMC7726316 DOI: 10.3389/fphys.2020.564387] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 11/02/2020] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES To assess the association between vitamin D deficiency and increased morbidity/mortality with COVID-19 respiratory dysfunction. DESIGN Scoping review. DATA SOURCES Ovid MEDLINE (1946 to 24 of April 2020) and PubMed (2020 to 17 of September 2020). ELIGIBILITY CRITERIA FOR SELECTING STUDIES A search using the search terms: [(cholecalciferol or ergocalciferol or vitamin D2 or vitamin D3 or vitamin D or 25OHD) and (SARS-CoV-2 or coronavirus or COVID or betacoronavirus or MERS-CoV or SARS-CoV or respiratory infection or acute respiratory distress syndrome or ARDS)]m.p. was conducted on the 24/04/2020 (Search A) and 17/09/2020 (Search B). RESULTS 91 studies were identified as being concerned with Acute Respiratory Infection (ARI)/Acute Respiratory Distress Syndrome (ARDS) and vitamin D, and 25 publications specifically explored the role of vitamin D deficiency in the development and progression of SARS-CoV-2/COVID-19 related ARDS. Search "A" identified three main themes of indirect evidence supporting such an association. Consistent epidemiological evidence exists linking low vitamin D levels to increased risk and severity of respiratory tract infections. We also report on plausible biological processes supporting such an association; and present weaker evidence supporting the benefit of vitamin D supplementation in reducing the risk and severity of ARIs. Uncertainty remains about what constitutes an appropriate dosing regimen in relation to reducing risk/severity of ARI/ARDS. More recent evidence (Search B) provided new insights into some direct links between vitamin D and COVID-19; with a number of cohort and ecological studies supporting an association with PCR-positivity for SARS-CoV-2 and vitamin D deficiency. The exact efficacy of the vitamin D supplementation for prevention of, or as an adjunct treatment for COVID-19 remains to be determined; but a number of randomized control trials (RCTs) currently underway are actively investigating these potential benefits. CONCLUSION Our rapid review of literature supports the need for observational studies with COVID-19 infected populations to measure and assess vitamin D levels in relation to risk/severity and outcomes; alongside RCTs designed to evaluate the efficacy of supplementation both in preventive and therapeutic contexts. The overlap in the vitamin D associated biological pathways with the dysregulation reported to drive COVID-19 outcomes warrants further investigation.
Collapse
Affiliation(s)
- Aida Santaolalla
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom
| | - Kerri Beckmann
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom
- Cancer Research Institute, University of South Australia, Adelaide, SA, Australia
| | - Joyce Kibaru
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom
| | - Debra Josephs
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom
- Department of Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
| | - Mieke Van Hemelrijck
- Translational Oncology and Urology Research, School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom
| | - Sheeba Irshad
- Department of Medical Oncology, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
- School of Cancer and Pharmaceutical Sciences, King’s College London, London, United Kingdom
| |
Collapse
|
15
|
Segal JP, Mak JWY, Mullish BH, Alexander JL, Ng SC, Marchesi JR. The gut microbiome: an under-recognised contributor to the COVID-19 pandemic? Therap Adv Gastroenterol 2020; 13:1756284820974914. [PMID: 33281941 PMCID: PMC7692338 DOI: 10.1177/1756284820974914] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 10/29/2020] [Indexed: 02/04/2023] Open
Abstract
The novel coronavirus infection (COVID-19) caused by the SARS-CoV-2 virus has spread rapidly across the globe, culminating in major global morbidity and mortality. As such, there has been a rapid escalation in scientific and clinical activity aimed at increasing our comprehension of this virus. This volume of work has led to early insights into risk factors associated with severity of disease, and mechanisms that underpin the virulence and dynamics involved in viral transmission. These insights ultimately may help guide potential therapeutics to reduce the human, economic and social impact of this pandemic. Importantly, the gastrointestinal (GI) tract has emerged as an important organ influencing propensity to, and potentially severity of, COVID-19 infection. Furthermore, the gut microbiome has been linked to a variety of risk factors for COVID-19 infection, and manipulation of the gut microbiome is an attractive potential therapeutic target for a number of diseases. While data profiling the gut microbiome in COVID-19 infection to date are limited, they support the possibility of several routes of interaction between COVID-19, the gut microbiome, angiotensin converting enzyme 2 (ACE-2) expression in the small bowel and colon and gut inflammation. This article will explore the evidence that implicates the gut microbiome as a contributing factor to the pathogenesis, severity and disease course of COVID-19, and speculate about the gut microbiome's capability as a therapeutic avenue against COVID-19. LAY SUMMARY It has been noted that certain baseline gut profiles of COVID-19 patients are associated with a more severe disease course, and the gut microbiome impacts the disease course of several contributory risk factors to the severity of COVID-19. A protein called ACE-2, which is found in the small intestine among other sites, is a key receptor for COVID-19 virus entry; there is evidence that the gut microbiome influences ACE-2 receptor expression, and hence may play a role in influencing COVID-19 infectivity and disease severity. Furthermore, the gut microbiome plays a significant role in immune regulation, and hence may be pivotal in influencing the immune response to COVID-19. In terms of understanding COVID-19 treatments, the gut microbiome is known to interact with several drug classes being used to target COVID-19 and should be factored into our understanding of how patients respond to treatment. Importantly, our understanding of the role of the gut microbiome in COVID-19 infection remains in its infancy, but future research may potentially aid our mechanistic understanding of viral infection, and new ways in which we might approach treating it.
Collapse
Affiliation(s)
- Jonathan P. Segal
- Departments of Gastroenterology and Hepatology, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, W2 1NY, UK
- Department of Metabolism, Division of Digestive Diseases, Digestion and Reproduction, Faculty of Medicine, Imperial College London, SW7 2AZ, UK
| | - Joyce W. Y. Mak
- Centre for Gut Microbiota Research, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
- Institute of Digestive Disease, State Key Laboratory of Digestive Disease, LKS
- Institute of Health Science, The Chinese University of Hong Kong, Hong Kong
| | - Benjamin H. Mullish
- Departments of Gastroenterology and Hepatology, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, UK
- Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, UK
| | - James L. Alexander
- Departments of Gastroenterology and Hepatology, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, UK
- Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, UK
| | - Siew C. Ng
- Centre for Gut Microbiota Research, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong
- Institute of Digestive Disease, State Key Laboratory of Digestive Disease, LKS
- Institute of Health Science, The Chinese University of Hong Kong, Hong Kong
| | - Julian R. Marchesi
- Departments of Gastroenterology and Hepatology, St Mary’s Hospital, Imperial College Healthcare NHS Trust, London, UK
- Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London, UK
| |
Collapse
|
16
|
Mardani R, Alamdary A, Mousavi Nasab SD, Gholami R, Ahmadi N, Gholami A. Association of vitamin D with the modulation of the disease severity in COVID-19. Virus Res 2020; 289:198148. [PMID: 32866536 PMCID: PMC7455115 DOI: 10.1016/j.virusres.2020.198148] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 08/25/2020] [Accepted: 08/26/2020] [Indexed: 01/15/2023]
Abstract
In late 2019, SARS-CoV-2 started to spread throughout the world causing the COVID-19 that has taken a considerable number of lives. Results obtained from several investigations have explained the virus origin, pathogenicity, and transmission. Similar to SARS coronavirus, the pulmonary angiotensin converting enzyme (ACE) 2 was introduced as the virus receptor for entering the cell. An increased body of epidemiological and clinical evidences has shown modulating effects of vitamin D in lung injuries through several mechanisms. Several clinical symptoms as well as molecular factors have shown to be related to the disease transmission and severity. In this study, vitamin D, ACE concentrations, and neutrophil to lymphocyte ratio (NLR) were measured in patients with confirmed COVID-19 in comparison with control group. Results demonstrated significant alterations in vitamin D and ACE levels as well as NLR in the patients' group. Contribution of those factors with the prognosis and severity of the disease has been shown.
Collapse
Affiliation(s)
- R Mardani
- Viral Vaccines Production Unit, Pasteur Institute of Iran Production Complex, Tehran, Iran
| | - A Alamdary
- Viral Vaccines Production Unit, Pasteur Institute of Iran Production Complex, Tehran, Iran
| | - S D Mousavi Nasab
- Rotavaccine Research Lab, Pasteur Institute of Iran Production Complex, Tehran, Iran
| | - R Gholami
- Shoushtar University of Medical Sciences, Shoushtar, Iran
| | - N Ahmadi
- Proteomics Research Center, Department of Medical Lab Technology, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - A Gholami
- Viral Vaccines Production Unit, Pasteur Institute of Iran Production Complex, Tehran, Iran.
| |
Collapse
|
17
|
Taqarort N, Chadli S. Vitamine D et risque des infections respiratoires aiguës : grippe et COVID-19. NUTR CLIN METAB 2020. [PMCID: PMC7377790 DOI: 10.1016/j.nupar.2020.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
18
|
Benskin LL. A Basic Review of the Preliminary Evidence That COVID-19 Risk and Severity Is Increased in Vitamin D Deficiency. Front Public Health 2020; 8:513. [PMID: 33014983 PMCID: PMC7513835 DOI: 10.3389/fpubh.2020.00513] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 08/07/2020] [Indexed: 12/15/2022] Open
Abstract
As the world's attention has been riveted upon the growing COVID-19 pandemic, many researchers have written brief reports supporting the hypothesis that vitamin D deficiency is related to the incidence and severity of COVID-19. The clear common thread among the top risk groups-vitamin D deficiency-may be being overlooked because of previous overstated claims of vitamin D benefits. However, the need to decrease COVID-19 fatalities among high-risk populations is urgent. Early researchers reported three striking patterns. Firstly, the innate immune system is impaired by vitamin D deficiency, which would predispose sufferers to viral infections such as COVID-19. Vitamin D deficiency also increases the activity of the X-chromosome-linked "Renin-Angiotensin" System, making vitamin D deficient individuals (especially men) more susceptible to COVID-19's deadly "cytokine storm" (dramatic immune system overreaction). Secondly, the groups who are at highest risk for severe COVID-19 match those who are at highest risk for severe vitamin D deficiency. This includes the elderly, men, ethnic groups whose skin is naturally rich in melanin (if living outside the tropics), those who avoid sun exposure for cultural and health reasons, those who live in institutions, the obese, and/or those who suffer with hypertension, cardiovascular disease, or diabetes. And thirdly, the pattern of geographical spread of COVID-19 reflects higher population vitamin D deficiency. Both within the USA and throughout the world, COVID-19 fatality rates parallel vitamin D deficiency rates. A literature search was performed on PubMed, Google Scholar, and RSMLDS, with targeted Google searches providing additional sources. Although randomized controlled trial results may be available eventually, the correlational and causal study evidence supporting a link between vitamin D deficiency and COVID-19 risks is already so strong that it supports action. The 141 author groups writing primarily about biological plausibility detailed how vitamin D deficiency can explain every risk factor and every complication of COVID-19, but agreed that other factors are undoubtedly at work. COVID-19 was compared with dengue fever, for which oral vitamin D supplements of 4,000 IU for 10 days were significantly more effective than 1,000 IU in reducing virus replication and controlling the "cytokine storm" (dramatic immune system over-reaction) responsible for fatalities. Among the 47 original research studies summarized here, chart reviews found that serum vitamin D levels predicted COVID-19 mortality rates (16 studies) and linearly predicted COVID-19 illness severity (8 studies). Two causal modeling studies and several analyses of variance strongly supported the hypothesis that vitamin D deficiency is a causal, rather than a bystander, factor in COVID-19 outcomes. Three of the four studies whose findings opposed the hypothesis relied upon disproven assumptions. The literature review also found that prophylactically correcting possible vitamin D deficiency during the COVID-19 pandemic is extremely safe. Widely recommending 2,000 IU of vitamin D daily for all populations with limited ability to manufacture vitamin D from the sun has virtually no potential for harm and is reasonably likely to save many lives.
Collapse
Affiliation(s)
- Linda L. Benskin
- Independent Researcher for Improving Health in Rural Areas of Tropical Developing Countries, Austin, TX, United States
- Ferris Mfg. Corp., Makers of PolyMem® Multifunctional Dressings, Ft. Worth, TX, United States
| |
Collapse
|
19
|
Kwak-Kim J, Ota K, Sung N, Huang C, Alsubki L, Lee S, Han JW, Han A, Yang X, Saab W, Derbala Y, Wang WJ, He Q, Liao A, Takahashi T, Cavalcante MB, Barini R, Bao S, Fukui A, Lédée N, Coulam C. COVID-19 and immunomodulation treatment for women with reproductive failures. J Reprod Immunol 2020; 141:103168. [PMID: 32603991 PMCID: PMC7291967 DOI: 10.1016/j.jri.2020.103168] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Accepted: 06/11/2020] [Indexed: 12/19/2022]
Abstract
COVID-19 pandemic is affecting various areas of health care, including human reproduction. Many women with reproductive failures, during the peri-implantation period and pregnancy, are on the immunotherapy using immune modulators and immunosuppressant due to underlying autoimmune diseases, cellular immune dysfunction, and rheumatic conditions. Many questions have been raised for women with immunotherapy during the COVID-19 pandemic, including infection susceptibility, how to manage women with an increased risk of and active COVID-19 infection. SARS-CoV-2 is a novel virus, and not enough information exists. Yet, we aim to review the data from previous coronavirus outbreaks and current COVID-19 and provide interim guidelines for immunotherapy in women with reproductive failures.
Collapse
Affiliation(s)
- Joanne Kwak-Kim
- Reproductive Medicine and Immunology, Obstetrics and Gynecology, Clinical Sciences Department, Center for Cancer Cell Biology, Immunology and Infection, Chicago Medical School, Rosalind Franklin University of Medicine and Science, 830 West End Court, Vernon Hills, IL, 60061, USA.
| | - Kuniaki Ota
- Fukushima Medical Center for Children and Women, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
| | - Nayoung Sung
- Reproductive Medicine and Immunology, Obstetrics and Gynecology, Clinical Sciences Department, Center for Cancer Cell Biology, Immunology and Infection, Chicago Medical School, Rosalind Franklin University of Medicine and Science, 830 West End Court, Vernon Hills, IL, 60061, USA
| | - Changsheng Huang
- Reproductive Medicine and Immunology, Obstetrics and Gynecology, Clinical Sciences Department, Center for Cancer Cell Biology, Immunology and Infection, Chicago Medical School, Rosalind Franklin University of Medicine and Science, 830 West End Court, Vernon Hills, IL, 60061, USA; Traditional Chinese Medicine Department of Rheumatism, Huazhong University of Science and Technology Union Shenzhen Hospital, China
| | - Lujain Alsubki
- Reproductive Medicine and Immunology, Obstetrics and Gynecology, Clinical Sciences Department, Center for Cancer Cell Biology, Immunology and Infection, Chicago Medical School, Rosalind Franklin University of Medicine and Science, 830 West End Court, Vernon Hills, IL, 60061, USA; Department of Obstetrics and Gynecology, King Faisal Specialist Hospital and Research Center, Riyadh. Saudi Arabia
| | - Sungki Lee
- Department of Obstetrics and Gynecology, Myuonggok Medical Research Center, Konyang University College of Medicine, Daejeon, South Korea
| | - Jae Won Han
- Department of Obstetrics and Gynecology, Myuonggok Medical Research Center, Konyang University College of Medicine, Daejeon, South Korea
| | - Aera Han
- Department of Obstetrics and Gynecology, MizMedi Hospital, Seoul, South Korea
| | - Xiuhua Yang
- Department of Obstetrics, The First Hospital of China Medical University, Shenyang, China
| | - Wael Saab
- The Centre for Reproductive & Genetic Health, 230-232 Great Portland St, Fitzrovia, London W1W 5QS, UK
| | - Youssef Derbala
- Obstetrics and Gynecology, Beaumont Hospital, Dearborn, Grosse Pointe, MI, USA
| | - Wen-Juan Wang
- Reproduction Medical Center, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, 264000, China
| | - Qiaohua He
- Department of Reproductive Medicine Center, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Henan Provincial People's Hospital of Henan University, Zhengzhou, Henan, 450003, China
| | - Aihua Liao
- Institute of Reproductive Health, Center for Reproductive Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Toshifumi Takahashi
- Fukushima Medical Center for Children and Women, Fukushima Medical University, 1 Hikarigaoka, Fukushima City, Fukushima 960-1295, Japan
| | - Marcelo Borges Cavalcante
- Department of Obstetrics and Gynecology, Fortaleza University (UNIFOR), Fortaleza, CE, Brazil; CONCEPTUS - Reproductive Medicine, Fortaleza, CE, Brazil
| | - Ricardo Barini
- Department of Obstetrics and Gynecology, Campinas University (UNICAMP), Campinas, SP, Brazil
| | - Shihua Bao
- Department of Reproductive Immunology, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, 201204, China
| | - Atsushi Fukui
- Department of Obstetrics and Gynecology, Hyogo College of Medicine, 1-1 Mukogawa-cho, Nishinomiya, Hyogo 663-8501, Japan
| | - Nathalie Lédée
- MatriceLAB Innove, Pépinière Paris Santé Cochin, Hôpital Cochin, 29 rue du faubourg St Jacques, 75014 Paris, France; Centre d'assistance médicale à la procréation, Hôpital des Bluets, 4 rue Lasson, 75012, Paris, France
| | - Carolyn Coulam
- Clinical Immunology Laboratory, Rosalind Franklin University of Medicine and Science, North Chicago, 60064, IL, USA
| |
Collapse
|
20
|
Merzon E, Tworowski D, Gorohovski A, Vinker S, Golan Cohen A, Green I, Frenkel-Morgenstern M. Low plasma 25(OH) vitamin D level is associated with increased risk of COVID-19 infection: an Israeli population-based study. FEBS J 2020; 287:3693-3702. [PMID: 32700398 PMCID: PMC7404739 DOI: 10.1111/febs.15495] [Citation(s) in RCA: 259] [Impact Index Per Article: 64.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/26/2020] [Accepted: 07/20/2020] [Indexed: 12/12/2022]
Abstract
Vitamin D deficiency is a worldwide pandemic. The aim of this study was to evaluate associations of plasma 25(OH)D levels with the likelihood of coronavirus disease 2019 (COVID‐19) infection and hospitalization. The study population included the 14 000 members of Leumit Health Services, who were tested for COVID‐19 infection from February 1st to April 30th, 2020, and who had at least one previous blood test for the plasma 25(OH)D level. ‘Suboptimal’ or ‘low’ plasma 25(OH)D level was defined as plasma 25‐hydroxyvitamin D, or 25(OH)D, concentration below the level of 30 ng/mL. Of 7807 individuals, 782 (10.02%) were COVID‐19‐positive, and 7025 (89.98%) COVID‐19‐negative. The mean plasma vitamin D level was significantly lower among those who tested positive than negative for COVID‐19 [19.00 ng/mL (95% confidence interval (CI) 18.41–19.59) vs. 20.55 (95% CI: 20.32–20.78)]. Univariate analysis demonstrated an association between the low plasma 25(OH)D level and increased likelihood of COVID‐19 infection [crude odds ratio (OR) of 1.58 (95% CI: 1.24–2.01, P < 0.001)], and of hospitalization due to the SARS‐CoV‐2 virus [crude OR of 2.09 (95% CI: 1.01–4.30, P < 0.05)]. In multivariate analyses that controlled for demographic variables, and psychiatric and somatic disorders, the adjusted OR of COVID‐19 infection [1.45 (95% CI: 1.08–1.95, P < 0.001)] and of hospitalization due to the SARS‐CoV‐2 virus [1.95 (95% CI: 0.98–4.845, P = 0.061)] were preserved. In the multivariate analyses, age over 50 years, male gender and low–medium socioeconomic status were also positively associated with the risk of COVID‐19 infection; age over 50 years was positively associated with the likelihood of hospitalization due to COVID‐19. We concluded that low plasma 25(OH)D levels appear to be an independent risk factor for COVID‐19 infection and hospitalization.
Collapse
Affiliation(s)
- Eugene Merzon
- Leumit Health Services, Tel Aviv, Israel.,Department of Family Medicine, Sackler School of Medicine, Tel Aviv University, Israel
| | - Dmitry Tworowski
- Cancer Genomics and BioComputing of Complex Diseases Lab, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Alessandro Gorohovski
- Cancer Genomics and BioComputing of Complex Diseases Lab, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Shlomo Vinker
- Leumit Health Services, Tel Aviv, Israel.,Department of Family Medicine, Sackler School of Medicine, Tel Aviv University, Israel
| | - Avivit Golan Cohen
- Leumit Health Services, Tel Aviv, Israel.,Department of Family Medicine, Sackler School of Medicine, Tel Aviv University, Israel
| | - Ilan Green
- Leumit Health Services, Tel Aviv, Israel.,Department of Family Medicine, Sackler School of Medicine, Tel Aviv University, Israel
| | - Milana Frenkel-Morgenstern
- Cancer Genomics and BioComputing of Complex Diseases Lab, Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| |
Collapse
|
21
|
Chakhtoura M, Napoli N, El Hajj Fuleihan G. Commentary: Myths and facts on vitamin D amidst the COVID-19 pandemic. Metabolism 2020; 109:154276. [PMID: 32470350 PMCID: PMC7250097 DOI: 10.1016/j.metabol.2020.154276] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 05/24/2020] [Accepted: 05/25/2020] [Indexed: 12/13/2022]
Affiliation(s)
- M Chakhtoura
- Calcium Metabolism and Osteoporosis Program, American University of Beirut Medical Center, Beirut, Lebanon; Scholars in HeAlth Research Program (SHARP), American University of Beirut Medical Center, Beirut, Lebanon.
| | - N Napoli
- Unit of Endocrinology and Diabetes, Department of Medicine, Università Campus Bio-Medico di Roma, Via Alvaro di Portillo 21, 00128, Roma, Italy; Division of Bone and Mineral Diseases, Washington University in St Louis, St Louis, MO, USA
| | - G El Hajj Fuleihan
- Calcium Metabolism and Osteoporosis Program, American University of Beirut Medical Center, Beirut, Lebanon; Scholars in HeAlth Research Program (SHARP), American University of Beirut Medical Center, Beirut, Lebanon
| |
Collapse
|
22
|
Kyrou I, Karteris E, Robbins T, Chatha K, Drenos F, Randeva HS. Polycystic ovary syndrome (PCOS) and COVID-19: an overlooked female patient population at potentially higher risk during the COVID-19 pandemic. BMC Med 2020; 18:220. [PMID: 32664957 PMCID: PMC7360476 DOI: 10.1186/s12916-020-01697-5] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 07/02/2020] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND In women of reproductive age, polycystic ovary syndrome (PCOS) constitutes the most frequent endocrine disorder. Women with PCOS are considered to typically belong to an age and sex group which is at lower risk for severe COVID-19. MAIN BODY Emerging data link the risk of severe COVID-19 with certain factors such as hyper-inflammation, ethnicity predisposition, low vitamin D levels, and hyperandrogenism, all of which have known direct associations with PCOS. Moreover, in this common female patient population, there is markedly high prevalence of multiple cardio-metabolic conditions, such as type 2 diabetes, obesity, and hypertension, which may significantly increase the risk for adverse COVID-19-related outcomes. This strong overlap of risk factors for both worse PCOS cardio-metabolic manifestations and severe COVID-19 should be highlighted for the clinical practice, particularly since women with PCOS often receive fragmented care from multiple healthcare services. Comprehensively informing women with PCOS regarding the potential risks from COVID-19 and how this may affect their management is also essential. CONCLUSION Despite the immense challenges posed by the COVID-19 outbreak to the healthcare systems in affected countries, attention should be directed to maintain a high standard of care for complex patients such as many women with PCOS and provide relevant practical recommendations for optimal management in the setting of this fast moving pandemic.
Collapse
Affiliation(s)
- Ioannis Kyrou
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, UK.,Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham, B4 7ET, UK.,Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK
| | - Emmanouil Karteris
- College of Health and Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK
| | - Tim Robbins
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, UK.,Institute of Digital Healthcare, WMG, University of Warwick, Coventry, CV4 7AL, UK
| | - Kamaljit Chatha
- Department of Biochemistry and Immunology, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, UK
| | - Fotios Drenos
- College of Health and Life Sciences, Brunel University London, Uxbridge, UB8 3PH, UK.,Institute of Cardiovascular Science, University College London, London, UK
| | - Harpal S Randeva
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry, CV2 2DX, UK. .,Aston Medical Research Institute, Aston Medical School, Aston University, Birmingham, B4 7ET, UK. .,Warwick Medical School, University of Warwick, Coventry, CV4 7AL, UK.
| |
Collapse
|
23
|
Jesenak M, Brndiarova M, Urbancikova I, Rennerova Z, Vojtkova J, Bobcakova A, Ostro R, Banovcin P. Immune Parameters and COVID-19 Infection - Associations With Clinical Severity and Disease Prognosis. Front Cell Infect Microbiol 2020; 10:364. [PMID: 32695683 PMCID: PMC7338601 DOI: 10.3389/fcimb.2020.00364] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/12/2020] [Indexed: 12/23/2022] Open
Abstract
Severe acute respiratory syndrome caused by a novel 2019 coronavirus (SARS-CoV2) represents one of the most studied infectious diseases of today. The number of scientific reports and publications increases exponentially day by day. While the majority of infected subjects are asymptomatic or show mild symptoms, there is an important proportion of patients who requires hospitalization and, sometimes, intensive care. Immune response to novel coronavirus is complex, involves both innate and adaptive immunity, and is biphasic. Significant differences were observed when comparing severe and non-severe patients. Analysis of the reported results from clinical trials clearly show an involvement of specific cellular immunity (predominantly leucopenia, decreased counts of CD3+, CD4+, and CD8+ T lymphocytes, changes of T cell compartment) and the so-called cytokine storm, which is associated with worsening of symptoms and the promotion of lung damage. An interesting finding regarding eosinopenia that can have both diagnostic and prognostic value is reported by some authors. Examination of selected immune parameters could help to identify severe patients with the risk of unfavorable course of the disease, predict the prognosis and recognize improvement in the clinical status. Moreover, detailed analysis of the immune changes could help to select novel prospective therapeutic strategies.
Collapse
Affiliation(s)
- Milos Jesenak
- Department of Pediatrics, Jessenius Faculty of Medicine, Comenius University in Bratislava, University Hospital in Martin, Martin, Slovakia
- Department of Pulmonology and Phthisiology, Jessenius Faculty of Medicine, Comenius University in Bratislava, University Hospital in Martin, Martin, Slovakia
- Department of Clinical Immunology and Allergology, University Hospital in Martin, Martin, Slovakia
| | - Miroslava Brndiarova
- Department of Pediatrics, Jessenius Faculty of Medicine, Comenius University in Bratislava, University Hospital in Martin, Martin, Slovakia
| | - Ingrid Urbancikova
- Department of Pediatrics, Faculty of Medicine, Children Faculty Hospital, P. J. Safarik University, Kosice, Slovakia
- Department of Pediatric Infectology, Faculty of Medicine, Children Faculty Hospital, P. J. Safarik University, Kosice, Slovakia
| | - Zuzana Rennerova
- Pneumo-Alergo Centre Ltd., Falck Healthcare Group, Bratislava, Slovakia
- Department of Pediatric Pulmonology and Phthisiology, Faculty of Medicine, National Institute of Children Diseases, Slovak Medical University, Bratislava, Slovakia
| | - Jarmila Vojtkova
- Department of Pediatrics, Jessenius Faculty of Medicine, Comenius University in Bratislava, University Hospital in Martin, Martin, Slovakia
| | - Anna Bobcakova
- Department of Pulmonology and Phthisiology, Jessenius Faculty of Medicine, Comenius University in Bratislava, University Hospital in Martin, Martin, Slovakia
| | - Robert Ostro
- Department of Pediatrics, Faculty of Medicine, Children Faculty Hospital, P. J. Safarik University, Kosice, Slovakia
| | - Peter Banovcin
- Department of Pediatrics, Jessenius Faculty of Medicine, Comenius University in Bratislava, University Hospital in Martin, Martin, Slovakia
| |
Collapse
|