1
|
McGovern J, Wadsworth J, Catchpole A, Richards C, McMillan DC, Kelliher T, Goodall E, Murray E, Melaugh T, McPhillips S, Brice K, Barbour K, Robinson S, Moffitt P, Kemp O, Talwar D, Maguire D. The relationship between micronutrient status, frailty, systemic inflammation, and clinical outcomes in patients admitted to hospital with COVID-19. J Transl Med 2023; 21:284. [PMID: 37118813 PMCID: PMC10139911 DOI: 10.1186/s12967-023-04138-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 04/16/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND Micronutrients have been associated with disease severity and poorer clinical outcomes in patients with COVID-19. However, there is a paucity of studies examining if the relationship with micronutrient status and clinical outcomes is independent of recognised prognostic factors, specifically frailty and the systemic inflammatory response (SIR). The aim of the present study was to examine the relationship between micronutrient status, frailty, systemic inflammation, and clinical outcomes in patients admitted with COVID-19. METHODS Retrospective analysis of prospectively collected data was performed on patients with confirmed COVID-19, admitted to hospital between the 1st April 2020-6th July 2020. Clinicopathological characteristics, frailty assessment, biochemical and micronutrient laboratory results were recorded. Frailty status was determined using the Clinical Frailty scale. SIR was determined using serum CRP. Clinical outcomes of interest were oxygen requirement, ITU admission and 30-day mortality. Categorical variables were analysed using chi-square test and binary logistics regression analysis. Continuous variables were analysed using the Mann-Whitney U or Kruskal Wallis tests. RESULTS 281 patients were included. 55% (n = 155) were aged ≥ 70 years and 39% (n = 109) were male. 49% (n = 138) of patients were frail (CFS > 3). 86% (n = 242) of patients had a serum CRP > 10 mg/L. On univariate analysis, frailty was significantly associated with thirty-day mortality (p < 0.001). On univariate analysis, serum CRP was found to be significantly associated with an oxygen requirement on admission in non-frail patients (p = 0.004). Over a third (36%) of non-frail patients had a low vitamin B1, despite having normal reference range values of red cell B2, B6 and selenium. Furthermore, serum CRP was found to be significantly associated with a lower median red cell vitamin B1 (p = 0.029). CONCLUSION Vitamin B1 stores may be depleted in COVID-19 patients experiencing a significant SIR and providing rationale for thiamine supplementation. Further longitudinal studies are warranted to delineate the trend in thiamine status following COVID-19.
Collapse
Affiliation(s)
- Josh McGovern
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Level 2, New Lister Building, Glasgow Royal Infirmary, Glasgow, G31 2ER, UK.
| | - John Wadsworth
- Clinical Biochemistry Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Anthony Catchpole
- Clinical Biochemistry Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Conor Richards
- Emergency Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Donald C McMillan
- Academic Unit of Surgery, School of Medicine, University of Glasgow, Level 2, New Lister Building, Glasgow Royal Infirmary, Glasgow, G31 2ER, UK
| | - Tadhg Kelliher
- Emergency Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Emma Goodall
- Emergency Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Ellie Murray
- Emergency Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Terry Melaugh
- Emergency Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | | | - Kathryn Brice
- Emergency Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Katie Barbour
- Emergency Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Sophie Robinson
- Emergency Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Peter Moffitt
- Emergency Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Olivia Kemp
- Emergency Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Dinesh Talwar
- Clinical Biochemistry Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| | - Donogh Maguire
- Emergency Department, Glasgow Royal Infirmary, Glasgow, G4 0SF, UK
| |
Collapse
|
2
|
Passini CSM, Cavalcanti MB, Ribas SA, de Carvalho CMP, Bocca C, Lamarca F. Conflict of Interests in the Scientific Production on Vitamin D and COVID-19: A Scoping Review. Front Public Health 2022; 10:821740. [PMID: 35903374 PMCID: PMC9320027 DOI: 10.3389/fpubh.2022.821740] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 06/06/2022] [Indexed: 11/25/2022] Open
Abstract
The use of scientific evidence to support the process of formulating and implementing public policies might be biased by studies funded by the pharmaceutical and food industry, which more often than not meet corporate interests. This review aimed to analyze the occurrence of conflict of interest (COI) in academic production regarding vitamin D and COVID-19, considering the facility offered during the pandemic for academic publications of heterogeneous quality. A scoping review of observational studies published in Medline, Lilacs, and Google Scholar databases was carried out. The selected studies were published between December 2019 and August 2021, focused on the relationship between vitamin D and prevention or treatment of COVID-19 in non-institutionalized individuals, with no language restrictions. Twenty-nine studies met eligibility criteria. COI was disclosed in five papers and further identified by review authors in eight other papers, meaning COI was present in thirteen papers (44.8%). Studies were funded by companies in the diagnostics, pharmaceutical and food sectors. Conclusions favorable to vitamin D supplementation were more prevalent in papers where COI was identified (9/13, 69.2%) than among papers where COI was not found (4/16, 25.0%). Omissions of disclosure of COI, funding source, and sponsor functions were observed. The identification of possible corporate political activities in scientific papers about vitamin D published during the COVID-19 pandemic signals a need for greater transparency and guideline development on the prevention of COI in scientific production.
Collapse
Affiliation(s)
| | - Maria Birman Cavalcanti
- School of Nutrition, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Simone Augusta Ribas
- Department of Public Health Nutrition, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
- Graduate Program in Food and Nutrition Security (PPGSAN), Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | | | - Cláudia Bocca
- Department of Public Health Nutrition, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
- Graduate Program in Food and Nutrition Security (PPGSAN), Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
| | - Fernando Lamarca
- Department of Applied Nutrition, Federal University of the State of Rio de Janeiro (UNIRIO), Rio de Janeiro, Brazil
- Department of Applied Nutrition, Rio de Janeiro State University (UERJ), Rio de Janeiro, Brazil
- *Correspondence: Fernando Lamarca
| |
Collapse
|
3
|
Therapeutic Vitamin D Supplementation Following COVID-19 Diagnosis: Where Do We Stand?—A Systematic Review. J Pers Med 2022; 12:jpm12030419. [PMID: 35330419 PMCID: PMC8950116 DOI: 10.3390/jpm12030419] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/03/2022] [Accepted: 03/05/2022] [Indexed: 02/04/2023] Open
Abstract
Vitamin D has known immunomodulatory activity and multiple indications exist supporting its potential use against SARS-CoV-2 infection in the setting of the current pandemic. The purpose of this systematic review is to examine the efficacy of vitamin D administered to adult patients following COVID-19 diagnosis in terms of length of hospital stay, intubation, ICU admission and mortality rates. Therefore, PubMed and Scopus databases were searched for original articles referring to the aforementioned parameters. Of the 1376 identified studies, eleven were finally included. Vitamin D supplements, and especially calcifediol, were shown to be useful in significantly reducing ICU admissions and/or mortality in four of the studies, but not in diminishing the duration of hospitalization of COVID-19 patients. Due to the large variation in vitamin D supplementation schemes no absolute conclusions can be drawn until larger randomized controlled trials are completed. However, calcifediol administered to COVID-19 patients upon diagnosis represents by far the most promising agent and should be the focus of upcoming research efforts.
Collapse
|
4
|
Hange N, Somagutta MR, Wadagale A, Hamdan AHY, Jain MS, Bobba SH, Batti E, Emuze B. Impact of the Coronavirus Disease on Micronutrient Search Trends and Interest in Global Population: A Worldwide Google Trend Analysis. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2022. [DOI: 10.29333/ejgm/11877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
|
5
|
Altooq N, Humood A, Alajaimi A, Alenezi AF, Janahi M, AlHaj O, Jahrami H. The role of micronutrients in the management of COIVD-19 and optimizing vaccine efficacy. HUMAN NUTRITION & METABOLISM 2022; 27:200141. [PMID: 38620928 PMCID: PMC8788090 DOI: 10.1016/j.hnm.2022.200141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 01/13/2022] [Accepted: 01/22/2022] [Indexed: 04/25/2023]
Abstract
Since COVID-19 was declared as a pandemic, a race between researchers has begun to deeply examine the mechanism of the virus and how to combat it. Few clinical investigations and studies have paid attention to the role of micronutrients in the disease's course and how it may affect the disease outcomes. Micronutrients have a noticeable effect on the host immune system regulation, as well as micronutrients insufficiencies where they can affect the host immune response against SARS-CoV-2 by, for example, altering the production and the function of the inflammatory cytokines such as IFN-γ, IFN-α, TNF and interleukins. Recent studies have shown that low levels of vitamin D, vitamin C, vitamin A, zinc, selenium, copper and magnesium have a great clinical impact on COVID-19 patients, where, they are linked to prolong hospital stay, increase the mortality rate and raise the complications rate related not only to the respiratory system but also to the other systems. Optimizing the need for these micronutrients will act as a productive factor by decreasing the incidence of COVID-19 infection, lowering the rate of complications, and improving the disease prognosis and outcomes. Optimal micro-nutrition supports and contributes to the efficiency of COVID-19 vaccine. The aim of this review is to highlight the role of different micronutrients in the management of COVID-19 and optimizing vaccines, and to revile the clinical effects of micronutrients deficiencies on patients with COVID-19.
Collapse
Affiliation(s)
- Noor Altooq
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Ali Humood
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Ahmed Alajaimi
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Ahmad F Alenezi
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Mohamed Janahi
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Omar AlHaj
- Department of Nutrition, Faculty of Pharmacy and Medical Science, University of Petra, Amman, Jordan
| | - Haitham Jahrami
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
- Ministry of Health, Manama, Bahrain
| |
Collapse
|
6
|
Editorial: A Review of Micronutrients and the Immune System-Working in Harmony to Reduce the Risk of Infection. Nutrients 2021; 13:nu13114180. [PMID: 34836435 PMCID: PMC8625324 DOI: 10.3390/nu13114180] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 11/08/2021] [Indexed: 01/26/2023] Open
|
7
|
Speakman LL, Michienzi SM, Badowski ME. Vitamins, supplements and COVID-19: a review of currently available evidence. Drugs Context 2021; 10:2021-6-2. [PMID: 34659426 PMCID: PMC8496749 DOI: 10.7573/dic.2021-6-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/26/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND In the midst of the COVID-19 pandemic, there has been an information overload of health data (both accurate and inaccurate) available to the public. With vitamins and supplements being readily accessible, many have turned to using them in an effort to combat the virus. The purpose of this review was to analyse clinical trials regarding vitamins and supplements for the treatment of COVID-19 infections. METHODS Articles were identified through a literature search utilizing online databases and bibliographic review. RESULTS A total of seven articles were identified for review. All articles evaluated the use of vitamins and supplements for the treatment of COVID-19. Drug therapies included oral vitamin D, intravenous and oral vitamin C, oral vitamin D/magnesium/vitamin B12, oral zinc, oral combination zinc/ascorbic acid, and intravenous alpha-lipoic acid. The end points of each study varied, including the Sequential Organ Failure Assessment score, mortality, rate of intensive care unit (ICU) admissions, negativity of COVID-19 tests, oxygen requirements, and symptom burden. CONCLUSION Of the vitamins and supplements that were studied, vitamin D presented the most promising data demonstrating significant decreases in oxygen requirements, need for ICU treatment, SARS-CoV-2 RNA test positivity, and mortality. All of these benefits were exhibited in hospitalized patients. Other vitamins and supplements that were evaluated in studies did not demonstrate any statistically significant benefits. Common shortcomings of the articles included generally small sample sizes, varying sites of study (which could determine the virus variant), a lack of standard of care as background therapy, and utilization of doses that were higher than standard.
Collapse
Affiliation(s)
- Lauren L Speakman
- Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA
| | - Sarah M Michienzi
- Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA
| | - Melissa E Badowski
- Department of Pharmacy Practice, University of Illinois at Chicago College of Pharmacy, Chicago, IL, USA
| |
Collapse
|
8
|
Chiba T, Tanemura N, Nishijima C. The Perception of Vitamins and Their Prevalence in Fortified Food and Supplements in Japan. Nutrients 2021; 13:nu13093136. [PMID: 34579013 PMCID: PMC8469082 DOI: 10.3390/nu13093136] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/04/2021] [Accepted: 09/07/2021] [Indexed: 01/04/2023] Open
Abstract
Most vitamins are primarily ingested from foods. However, it has been reported that intakes of some vitamins do not meet the nutrition reference values even in high-income countries. In this case, vitamin-fortified foods and/or vitamin supplements are helpful to fix insufficient/deficient status. However, it is not clear whether consumers are aware of their nutritional status or whether they use these products efficiently. To address this issue, we conducted an online cross-sectional questionnaire survey among 14,741 Japanese adults (over 20 years old, 7489 males and 7252 females) concerning the perceptions and prevalence of vitamin-fortified food and/or vitamin supplements. Differences in distribution among groups were compared using the chi-squared test. According to dietary habits, 33.2% of the participants consumed a well-balanced diet every day, but 25.5% could not because of time (41.6%) or money (36.9%) constraints. The perception of each vitamin varied: the highest was for vitamin C (93.2%) and the lowest was for biotin (41.9%). In addition, only a portion of the participants believed that they took sufficient amounts of each vitamin; the highest was vitamin C (22.3%) and the lowest was biotin (5.2%). Despite this situation, most did not use vitamin-fortified food and/or vitamin supplements due to economic reasons. Among vitamin-fortified food and/or vitamin supplement users, the purposes for the usage of these products were varied, such as maintaining health (80.5%), supplementation of nutrients (47.8%), beauty-related purposes (27.5%), and to prevent infectious disease (23.2%). To remedy nutritional status in individuals, it is important to improve not only consumer awareness but also the environment, which can lead consumers to use acceptable vitamin products without any burden.
Collapse
|