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Chen Y, Kong G. Changes in vitamin D status among adults from the COVID-19 pandemic to post-pandemic normality. Front Nutr 2024; 11:1407890. [PMID: 39155929 PMCID: PMC11327124 DOI: 10.3389/fnut.2024.1407890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 07/23/2024] [Indexed: 08/20/2024] Open
Abstract
Introduction The COVID-19 pandemic has prompted widespread lockdown measures globally, significantly impacting daily activities and outdoor exposure. This study investigates the effect of the pandemic on vitamin D levels and the prevalence of vitamin D deficiency in the adult population, with a focus on gender-specific differences. Methods A total of 1525 adults from Henan Provincial People's Hospital were included. Serum 25-hydroxyvitamin D (25(OH)D) levels were measured using the Elecsys® Vitamin D total kit on the Roche Cobas® 8000 analyzer. The Clinical Application Consensus on Vitamin D and Its Analogs defined deficiency as 25(OH)D levels below 20 ng/ml. Statistical analysis was performed using SPSS 23.0 and GraphPad Prism 8 software. Results The overall 25(OH)D levels increased from 18.14 ng/ml [IQR: 13.78, 23.68] in 2022 to 19.15 ng/ml [IQR: 14.88, 25.01] in 2023 (p=0.004). Males exhibited significant improvement in 25(OH)D levels from 18.01 ng/ml [IQR: 14.10, 23.53] in 2022 to 20.49 ng/ml [IQR: 16.11, 26.01] in 2023 (p<0.001). The prevalence of vitamin D deficiency decreased from 62% in 2022 to 54.9% in 2023 (p=0.009), with a notable reduction in males (64.1% in 2022 to 47.2% in 2023). Among 168 individuals tested in both years, 25(OH)D levels increased from 20.73 ± 9.37 ng/ml in 2022 to 22.28 ± 8.59 ng/ml in 2023 (p=0.012), and the deficiency rate decreased from 58.3% in 2022 to 47.0% in 2023 (p=0.038). The 40-49 age group showed significant improvement in 25(OH)D levels from 16.10 ng/ml [IQR: 12.41, 21.18] in 2022 to 18.28 ng/ml [IQR: 13.91, 23.86] in 2023 (p=0.005), with a reduction in deficiency rate from 72.8% to 59.9% (p=0.02). Furthermore, in February, March, and April, 2022, 25(OH)D levels were significantly lower compared to 2023 (p<0.001, p=0.002, p<0.001, respectively), accompanied by a higher prevalence of vitamin D deficiency (p<0.001, p=0.015, p<0.001, respectively). Discussion This study demonstrates that the COVID-19 pandemic significantly impacted vitamin D levels, leading to an increased prevalence of deficiency, particularly among males. These findings highlight the critical importance of maintaining sufficient outdoor activities to ensure adequate vitamin D levels. The data underscore the need for public health strategies to address potential deficiencies during prolonged periods of limited outdoor exposure.
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Affiliation(s)
- Yanzhao Chen
- Demonstration Laboratory of Quality Control for in vitro Analysis, Department of Nuclear Medicine, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, The Clinical Medical College of Provincial Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Guilian Kong
- Demonstration Laboratory of Quality Control for in vitro Analysis, Department of Nuclear Medicine, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, The Clinical Medical College of Provincial Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Benameur T, Kaliyadan F, Saidi N, Porro C. A Retrospective Chart Review Evaluating Changes in 25-Hydroxyvitamin D Levels among Patients Attending the University Healthcare Centre during the COVID-19 Pandemic. Nutrients 2023; 15:2345. [PMID: 37242228 PMCID: PMC10223421 DOI: 10.3390/nu15102345] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
COVID-19-pandemic-related home confinement aids in limiting the spread of the virus but restricts exposure to sunlight, thereby possibly affecting 25(OH)D concentrations. This study aimed to investigate the effect of lockdown measures on 25(OH)D levels in outpatients visiting the healthcare centre over a period of two years. In this retrospective chart review, outpatients who visited a university healthcare centre for a health check-up over a period of two years were included. The patients' 25(OH)D serum levels and status were compared before, during, and after the lockdown periods. A total of 7234 patients were included in this study, with a mean age of 34.66 ± 16.78. The overall prevalence of 25(OH)D insufficiency, deficiency and sufficiency was 33.8%, 30.7% and 35.4%, respectively. The proportion of individuals with 25-(OH) D deficiency prior to lockdown was 29% and this proportion increased in the lockdown and post-lockdown periods to 31.1% and 32%, respectively. Although gender was less likely to have an impact on the 25 (OH) D level during the lockdown period (p = 0.630), we found an association between gender and 25 (OH) D status in the pre-lockdown and post-lockdown periods (p < 0.001 and p < 0.001, respectively). Another association between nationality and 25 (OH)D levels was found before, during and after the lockdown periods (p < 0.001). In addition, the youngest population, aged between 1 and 14, was strongly affected by the home confinement. Age had a positive and significant (p < 0.05) effect on 25 (OH) D status regardless of the different periods. Moreover, in the pre-lockdown period, male outpatients had 1.56 chance of having a sufficient level of 25 (OH)D. However, during the lockdown period, this chance decreased to 0.85 and then increased to 0.99 after the lockdown period. We found no statistically significant difference in the mean serum concentrations or in the prevalence of vitamin D insufficiency when we compared values from before, during and immediately after the COVID-19 lockdown period. However, there was a generally increased prevalence of vitamin D insufficiency in our study population. Another association between gender, nationality and age groups with 25(OH) D was found. Regular exposure to UVR is recommended for maintaining adequate vitamin D levels and to prevent vitamin D deficiency. Further research is needed to determine the best indications for vitamin D supplementation if confinement periods are extended and to consider the potential health consequences of prolonged confinement periods not only on vitamin D status but also on overall public health. The findings of this study may be considered by stakeholders for a targeted supplementation approach for risk groups.
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Affiliation(s)
- Tarek Benameur
- Department of Biomedical Sciences, College of Medicine, King Faisal University, Al Ahsa 31982, Saudi Arabia
| | - Feroze Kaliyadan
- Sree Narayana Institute of Medical Sciences, Kerala University of Health Sciences, Thrissur 683594, India
| | - Neji Saidi
- Department of Mathematics and Statistics, College of Sciences, King Faisal University, Al Ahsa 31982, Saudi Arabia
| | - Chiara Porro
- Department of Clinical and Experimental Medicine, University of Foggia, 71121 Foggia, Italy
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Smaha J, Jackuliak P, Kužma M, Max F, Binkley N, Payer J. Vitamin D Deficiency Prevalence in Hospitalized Patients with COVID-19 Significantly Decreased during the Pandemic in Slovakia from 2020 to 2022 Which Was Associated with Decreasing Mortality. Nutrients 2023; 15:1132. [PMID: 36904131 PMCID: PMC10005285 DOI: 10.3390/nu15051132] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 02/26/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has led to changes in lifestyle, which could influence vitamin D status on a population level. The purpose of our study was to compare 25-hydroxyvitamin D (25[OH]D) levels in patients hospitalized because of severe COVID-19 during two waves of the pandemic (2020/21 vs. 2021/22). A total of 101 patients from the 2021/22 wave were compared with 101 sex- and age-matched subjects from the 2020/21 wave. Patients from both groups were hospitalized during the winter season from 1 December to 28 February. Men and women were analyzed together and separately. The mean 25(OH)D concentration increased from 17.8 ± 9.7 ng/mL to 25.2 ± 12.6 ng/mL between waves. The prevalence of vitamin D deficiency (<20 ng/mL) decreased from 82% to 54%. The prevalence of adequate serum 25(OH)D concentration (>30 ng/mL) increased from 10% to 34% (p < 0.0001). The proportion of patients with a history of vitamin D supplementation increased from 18% to 44% (p < 0.0001). Low serum 25(OH)D concentration was independently associated with mortality after adjusting for age and sex for the whole cohort of patients (p < 0.0001). The prevalence of inadequate vitamin D status in hospitalized patients with COVID-19 in Slovakia decreased significantly, probably due to a higher rate of vitamin D supplementation during the COVID-19 pandemic.
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Affiliation(s)
- Juraj Smaha
- 5th Department of Internal Medicine, Comenius University Faculty of Medicine, University Hospital, Ruzinovska 6, 826 06 Bratislava, Slovakia
| | - Peter Jackuliak
- 5th Department of Internal Medicine, Comenius University Faculty of Medicine, University Hospital, Ruzinovska 6, 826 06 Bratislava, Slovakia
| | - Martin Kužma
- 5th Department of Internal Medicine, Comenius University Faculty of Medicine, University Hospital, Ruzinovska 6, 826 06 Bratislava, Slovakia
| | - Filip Max
- Department of Pharmacology and Toxicology, Comenius University Faculty of Pharmacy, Odbojarov 10, 832 32 Bratislava, Slovakia
| | - Neil Binkley
- Department of Medicine, Geriatrics Faculty, Medical Sciences Center, University of Wisconsin, 1300 University Ave, Madison, WI 53706-1510, USA
| | - Juraj Payer
- 5th Department of Internal Medicine, Comenius University Faculty of Medicine, University Hospital, Ruzinovska 6, 826 06 Bratislava, Slovakia
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Ponti L, Gabutti L, Faré PB, Janett S, Bianchetti MG, Schulz PJ, Lava SAG, Agostoni C, Milani GP. Vitamin D Supply of Multivitamins Commercialized Online by Amazon in Western and Southern Europe: A Labeling Analysis. Nutrients 2023; 15:nu15020326. [PMID: 36678197 PMCID: PMC9861848 DOI: 10.3390/nu15020326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 01/12/2023] Open
Abstract
Multivitamins are commonly used by the general population, often without medical prescription. The purpose of this report is to inform on the daily vitamin D supply provided by multivitamins containing vitamin D that are commercialized online by Amazon in Western and Southern Europe. We surveyed multivitamins aimed at adults using the following marketplaces: amazon.es®, amazon.de®, amazon.it®, and amazon.fr®. We identified 199 vitamin D3-containing multivitamins sold by Amazon marketplaces: 77 from amazon.es®, 73 from amazon.de®, 33 from amazon.it®, and 16 from amazon.fr®. No multivitamin contained vitamin D2. The daily vitamin D3 supply ranged from 16 to 2000 IU: it was less than 400 IU daily in 108 (54%), 400−800 IU daily in 53 (27%), and more than 800 IU daily in the remaining 38 (19%) products. The vitamin D3 supply of products sold by amazon.it® was on average higher (p < 0.05) than that of products sold by amazon.de®, amazon.fr®, and amazon.es®. In conclusion, the vitamin D supply of multivitamins sold by Amazon may be insufficient, marginally sufficient, or adequate for subjects at high risk of hypovitaminosis D such as subjects 65 years or more of age, pregnant (or lactating) women, or patients on drug treatment or with an underlying disease, where a vitamin D supplementation is advocated.
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Affiliation(s)
- Lisa Ponti
- Department of Internal Medicine, Clinical Research Unit, Regional Hospital of Bellinzona and Valli, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland
- Family Medicine, Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland
| | - Luca Gabutti
- Department of Internal Medicine, Clinical Research Unit, Regional Hospital of Bellinzona and Valli, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland
| | - Pietro B. Faré
- Division of Infectious Diseases, Department of Medicine, Ente Ospedaliero Cantonale, 6900 Lugano, Switzerland
| | - Simone Janett
- Department of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland
| | - Mario G. Bianchetti
- Family Medicine, Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland
- Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland
| | - Peter J. Schulz
- Family Medicine, Faculty of Biomedical Sciences, Università della Svizzera Italiana, 6900 Lugano, Switzerland
- Department of Communication and Media, Ewha Womans University, Seoul 03760, Republic of Korea
| | - Sebastiano A. G. Lava
- Pediatric Cardiology Unit, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois, University of Lausanne, 1011 Lausanne, Switzerland
- Heart Failure and Transplantation, Department of Paediatric Cardiology, Great Ormond Street Hospital, London WC1N 3JH, UK
| | - Carlo Agostoni
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
| | - Gregorio P. Milani
- Pediatric Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milan, Italy
- Correspondence: ; Tel.: +39-0255032266
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Park JH, Lee Y, Choi M, Park E. The Role of Some Vitamins in Respiratory-related Viral Infections: A Narrative Review. Clin Nutr Res 2023; 12:77-89. [PMID: 36793782 PMCID: PMC9900078 DOI: 10.7762/cnr.2023.12.1.77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 01/19/2023] [Accepted: 01/25/2023] [Indexed: 02/04/2023] Open
Abstract
This study aimed to find out the effect of vitamins on respiratory-related viral infections, including coronavirus disease 2019 (COVID-19), through the literature reviews. From January 2000 to June 2021, the studies (cohort studies, cross-sectional studies, case-control studies, randomized control trials) related to vitamins (vitamin A, D, E, C, B6, folate, and B12) and COVID-19/severe acute respiratory syndrome/Middle East respiratory syndrome/cold/influenza were selected from the PubMed, Embase, and Cochrane libraries and analyzed. The relationship between vitamins and virus-related respiratory diseases was identified. Through the review, 39 studies were selected on vitamin D, one study on vitamin E, 11 studies on vitamin C, and 3 studies on folate. Regarding COVID-19, 18 studies on vitamin D, 4 studies on vitamin C, and 2 studies on folate showed significant effects of the intake of these nutrients in preventing COVID-19. Regarding colds and influenza, 3 studies on vitamin D, 1 study on vitamin E, 3 studies on vitamin C, and 1 study on folate demonstrated that the intake of these nutrients significantly prevents these diseases. Therefore, this review suggested the intake of vitamins D, E, C, and folate is important for preventing respiratory diseases related to viruses, such as COVID-19, colds, and influenza. The relationship between these nutrients and virus-related respiratory diseases should be continuously monitored in the future.
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Affiliation(s)
- Jae-Hee Park
- Department of Food and Nutrition, Kyungnam University, Changwon 51767, Korea
| | - Yunjung Lee
- Department of Food and Nutrition, Kyungnam University, Changwon 51767, Korea
| | - Mijoo Choi
- Department of Food and Nutrition, Kyungnam University, Changwon 51767, Korea
| | - Eunju Park
- Department of Food and Nutrition, Kyungnam University, Changwon 51767, Korea
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Changes in Vitamin D Status in Korean Adults during the COVID-19 Pandemic. Nutrients 2022; 14:nu14224863. [PMID: 36432549 PMCID: PMC9696842 DOI: 10.3390/nu14224863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 11/09/2022] [Accepted: 11/12/2022] [Indexed: 11/19/2022] Open
Abstract
The aim of this study was to investigate changes in 25(OH)D (25-hydroxyvitamin D) levels and in the vitamin D status of Korean adults before and during the coronavirus disease (COVID-19) pandemic. This study compared serum 25(OH)D levels before and after the pandemic in 1483 adults aged 19 years and older who were screened at a university hospital. Subjects were selected only from participants tested in the same season before and after the pandemic. The pre-COVID-19 testing period was from 1 March 2018 to 31 November 2019; the testing period in the COVID-19 era was from 1 June 2020 to 31 November 2021. The mean 25(OH)D level for all participants was 21.4 ± 10.2 ng/mL prior to the outbreak of COVID-19, which increased to 23.6 ± 11.8 ng/mL during the COVID-19 lockdown period (p < 0.001). The increase was particularly dramatic in elderly females (28.8 ± 12.3 ng/mL to 37.7 ± 18.6 ng/mL, p = 0.008). The prevalence of vitamin D deficiency decreased in both males (48.4% to 44.5%, p = 0.005) and females (57.0% to 46.0%, p < 0.001). In conclusion, 25(OH)D levels in Korean adults increased during the COVID-19 era, and the prevalence of vitamin D deficiency decreased accordingly.
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Beyazgül G, Bağ Ö, Yurtseven İ, Coşkunol F, Başer S, Çiçek D, Kanberoğlu Gİ, Çelik F, Nalbantoğlu Ö, Özkan B. How Vitamin D Levels of Children Changed During COVID-19 Pandemic: A Comparison of Pre-pandemic and Pandemic Periods. J Clin Res Pediatr Endocrinol 2022; 14:188-195. [PMID: 35135185 PMCID: PMC9176086 DOI: 10.4274/jcrpe.galenos.2022.2021-10-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The synthesis of vitamin D is related to sun exposure, thus the restrictions during the Coronavirus disease-2019 (COVID-19) pandemic may have affected the levels of vitamin D in all age groups. The aim of this study was to evaluate vitamin D levels of healthy children and adolescents during the first year of the pandemic. METHODS The study group included healthy children and adolescents who were admitted for general check-ups and evaluated with 25(OH)D levels. Then, it was divided into two groups: Group 1 “pre-pandemic”, and Group 2 “pandemic”. Vitamin D levels were recorded from the hospital database and were compared according to age groups, gender, and the season, retrospectively. RESULTS The study group [mean age=90.29±59.45 median age=79 interquartile range (IQR): 102 months, male/female: 1409/1624] included 3033 children and adolescents (Group 1/Group 2 n=1864/1169). Although the mean 25(OH)D levels among preschool children did not differ between groups, the vitamin D levels of school-aged children and adolescents were significantly lower in the pandemic period than in the pre-pandemic period [Group 1 median=16.50 (IQR: 10.5) vs Group 2 median=15.9 (IQR: 11.3) in 6-12 age group (p=0.026); Group 1 median=13.30 (IQR: 10.2) vs Group 2 median=11.20 (IQR: 9.7) in 12-18 age group (p=0.003)]. Moreover, the 25(OH)D levels of adolescents showed seasonal variance with lower levels in winter, and unexpectedly, in summer. CONCLUSION Pandemic-related restrictions have caused significant decreases in vitamin D levels of school-aged children and adolescents. We suggest that children and adolescents should be given vitamin D supplementation in order to maintain sufficient levels of vitamin D during the pandemic.
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Affiliation(s)
- Güler Beyazgül
- University of Health Sciences Turkey, Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Clinic of General Pediatrics, İzmir, Turkey,* Address for Correspondence: University of Health Sciences Turkey, Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Clinic of General Pediatrics, İzmir, Turkey Phone: +90 232 464 61 67 E-mail:
| | - Özlem Bağ
- University of Health Sciences Turkey, Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Clinic of General Pediatrics, İzmir, Turkey
| | - İlkay Yurtseven
- University of Health Sciences Turkey, Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Clinic of General Pediatrics, İzmir, Turkey
| | - Fulya Coşkunol
- University of Health Sciences Turkey, Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Clinic of General Pediatrics, İzmir, Turkey
| | - Saynur Başer
- University of Health Sciences Turkey, Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Clinic of General Pediatrics, İzmir, Turkey
| | - Duygu Çiçek
- University of Health Sciences Turkey, Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Clinic of General Pediatrics, İzmir, Turkey
| | - Gül İrem Kanberoğlu
- University of Health Sciences Turkey, Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Clinic of General Pediatrics, İzmir, Turkey
| | - Filiz Çelik
- University of Health Sciences Turkey, Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Clinic of General Pediatrics, İzmir, Turkey
| | - Özlem Nalbantoğlu
- University of Health Sciences Turkey, Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Clinic of Pediatric Endocrinology, İzmir, Turkey
| | - Behzat Özkan
- University of Health Sciences Turkey, Dr. Behçet Uz Pediatric Diseases and Surgery Training and Research Hospital, Clinic of Pediatric Endocrinology, İzmir, Turkey
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Singh B, Eshaghian E, Chuang J, Covasa M. Do Diet and Dietary Supplements Mitigate Clinical Outcomes in COVID-19? Nutrients 2022; 14:nu14091909. [PMID: 35565876 PMCID: PMC9104892 DOI: 10.3390/nu14091909] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 02/07/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) has caused a pandemic and upheaval that health authorities and citizens around the globe are still grappling with to this day. While public health measures, vaccine development, and new therapeutics have made great strides in understanding and managing the pandemic, there has been an increasing focus on the potential roles of diet and supplementation in disease prevention and adjuvant treatment. In the literature, the impact of nutrition on other respiratory illnesses, including the common cold, pneumonia, and influenza, has been widely demonstrated in both animal and human models. However, there is much less research on the impact related to COVID-19. The present study discusses the potential uses of diets, vitamins, and supplements, including the Mediterranean diet, glutathione, zinc, and traditional Chinese medicine, in the prevention of infection and severe illness. The evidence demonstrating the efficacy of diet supplementation on infection risk, disease duration, severity, and recovery is mixed and inconsistent. More clinical trials are necessary in order to clearly demonstrate the contribution of nutrition and to guide potential therapeutic protocols.
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Affiliation(s)
- Bhavdeep Singh
- Department of Basic Medical Sciences, College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA 91766, USA; (B.S.); (E.E.); (J.C.)
| | - Eli Eshaghian
- Department of Basic Medical Sciences, College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA 91766, USA; (B.S.); (E.E.); (J.C.)
| | - Judith Chuang
- Department of Basic Medical Sciences, College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA 91766, USA; (B.S.); (E.E.); (J.C.)
| | - Mihai Covasa
- Department of Basic Medical Sciences, College of Osteopathic Medicine, Western University of Health Sciences, Pomona, CA 91766, USA; (B.S.); (E.E.); (J.C.)
- Department of Biomedical Sciences, College of Medicine and Biological Sciences, University of Suceava, 7200229 Suceava, Romania
- Correspondence:
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Zurita-Cruz J, Fonseca-Tenorio J, Villasís-Keever M, López-Alarcón M, Parra-Ortega I, López-Martínez B, Miranda-Novales G. Efficacy and safety of vitamin D supplementation in hospitalized COVID-19 pediatric patients: A randomized controlled trial. Front Pediatr 2022; 10:943529. [PMID: 35958172 PMCID: PMC9357919 DOI: 10.3389/fped.2022.943529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 06/27/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Some studies suggested that adequate levels of vitamin D (VD) decrease the risk of severe COVID-19. Information about the effectiveness of VD supplementation in children is scarce. OBJECTIVE To assess the efficacy and safety of VD supplementation compared to the standard of care in hospitalized children with COVID-19. PATIENTS AND METHODS An open-label randomized controlled single-blind clinical trial was carried out. We included patients from 1 month to 17 years, with moderate COVID-19, who required hospitalization and supplemental oxygen. They were randomized into two groups: the VD group, which received doses of 1,000 (children < 1 year) or 2,000 IU/day (from 1 to 17 years) and the group without VD (control). The outcome variables were the progression of oxygen requirement, the development of complications, and death. STATISTICAL ANALYSIS For comparison between groups, we used the chi-squared test or Fisher's exact test and the Mann-Whitney U test. Absolute risk reduction (ARR) and the number needed to treat (NNT) were calculated. p ≤ 0.05 was considered statistically significant. RESULTS From 24 March 2020 to 31 March 2021, 87 patients were eligible to participate in the trial; 45 patients were randomized: 20 to the VD group and 25 to the control group. There was no difference in general characteristics at baseline, including serum VD levels (median 13.8 ng/ml in the VD group and 11.4 ng/ml in the control group). OUTCOMES 2/20 (10%) in the VD group vs. 9/25 (36%) in the control group progressed to a superior ventilation modality (p = 0.10); one patient in the VD group died (5%) compared to 6 (24%) patients in the control group (p = 0.23). ARR was 26% (95% CI 8.8 to 60.2%) and NNT was 3 (2 to 11) for progression and ARR was 19% (95% CI -3.9 to 42.8%) and NNT was 6 (2 to 26) for death. None of the patients receiving VD had adverse effects. The trial was stopped for ethical reasons; since after receiving the results of the basal VD values, none of the patients had normal levels. CONCLUSION In this trial, VD supplementation in pediatric patients seems to decrease the risk of COVID-19 progression and death. More studies are needed to confirm these findings. CLINICAL TRIAL REGISTRATION This protocol was registered on ClinicalTrials.gov with the registration number NCT04502667.
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Affiliation(s)
- Jessie Zurita-Cruz
- Faculty of Medicine, National Autonomous University of Mexico, Pediatric Hospital Federico Gómez, Mexico City, Mexico
| | - Jeffry Fonseca-Tenorio
- Infectious Diseases Department, Pediatric Hospital National Medical Center, XXI Century, Mexican Institute of Social Security, Mexico City, Mexico
| | - Miguel Villasís-Keever
- Analysis and Synthesis of the Evidence Research Unit, National Medical Center XXI Century, Mexican Institute of Social Security, Mexico City, Mexico
| | - Mardia López-Alarcón
- Medical Nutrition Research Unit, Pediatric Hospital National Medical Center, XXI Century, Mexican Institute of Social Security, Mexico City, Mexico
| | - Israel Parra-Ortega
- Clinical Laboratory Department, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Briceida López-Martínez
- Auxiliary Diagnostic Services, Hospital Infantil de México Federico Gómez, Ministry of Health, Mexico City, Mexico
| | - Guadalupe Miranda-Novales
- Analysis and Synthesis of the Evidence Research Unit, National Medical Center XXI Century, Mexican Institute of Social Security, Mexico City, Mexico
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Differences in the Concentration of Vitamin D Metabolites in Plasma Due to the Low-Carbohydrate-High-Fat Diet and the Eastern European Diet-A Pilot Study. Nutrients 2021; 13:nu13082774. [PMID: 34444934 PMCID: PMC8400948 DOI: 10.3390/nu13082774] [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] [Received: 06/25/2021] [Revised: 08/05/2021] [Accepted: 08/12/2021] [Indexed: 01/27/2023] Open
Abstract
Vitamin D deficiency is a global problem with many health consequences, and it is currently recommended to supplement vitamin D. Change of diet should also be considered to ensure adequate vitamin D in the human body. The aim of this study was to assess the concentration of vitamin D metabolites in two different groups: one group on the low-carbohydrate-high-fat (LCHF) diet and the other group on the Eastern European (EE) diet. In the first stage, 817 participants declaring traditional EE diet or LCHF diet were investigated. Nutrition (self-reported 3-day estimated food record) and basic anthropometric parameters were assessed. After extra screening, 67 participants on the EE diet and 41 on the LCHF diet were qualified for the second stage. Plasma 25-hydroxycholecalciferol (25(OH)D3) and (25(OH)D2) concentration was measured by the validated HPLC—MS/MS method. Plasma 25(OH)D3 concentration was significantly higher in the group on the LCHF diet (34.9 ± 15.9 ng/mL) than in the group on the EE diet (22.6 ± 12.1 ng/mL). No statistical differences were observed in plasma 25(OH)D2 concentration between the study groups (p > 0.05). Women had a higher plasma 25(OH)D2 concentration than men regardless of diet type. The LCHF diet had a positive influence on plasma vitamin D concentration. However, long-term use of the LCHF diet remains contentious due to the high risk of cardiovascular disease. This study confirmed that the type of diet influences the concentration of vitamin D metabolites in the plasma.
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