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Zhang X, Han X, Chen B, Fu X, Gong Y, Yang W, Chen Q. Influence of nutritional supplements on antibody levels in pregnant women vaccinated with inactivated SARS-CoV-2 vaccines. PLoS One 2024; 19:e0289255. [PMID: 38452000 PMCID: PMC10919710 DOI: 10.1371/journal.pone.0289255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 09/03/2023] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND Because of the significantly higher demand for nutrients during pregnancy, pregnant women are more likely to have nutrient deficiencies, which may adversely affect maternal and fetal health. The influence of nutritional supplements on the immune effects of inactivated SARS-CoV-2 vaccines during pregnancy is not clear. METHODS In a multicenter cross-sectional study, we enrolled 873 pregnant women aged 18-45 y in Guangdong, China. The general demographic characteristics of pregnant women and their use of nutritional supplements were investigated, and the serum antibody levels induced by inactivated SARS-CoV-2 vaccines were measured. A logistic regression model was used to analyze the association between nutritional supplements and SARS-CoV-2 antibody levels. RESULTS Of the 873 pregnant women enrolled, 825 (94.5%) took folic acid during pregnancy, 165 (18.9%) took iron supplements, and 197 (22.6%) took DHA. All pregnant women received at least one dose of inactivated SARS-CoV-2 vaccine, and the positive rates of serum SARS-CoV-2 neutralizing antibodies (NAbs) and immunoglobulin G (IgG) antibodies were 44.7% and 46.4%, respectively. After adjustment for confounding factors, whether pregnant women took folic acid, iron supplements, or DHA did not influence NAb positivity or IgG positivity (P > 0.05). Compared with pregnant women who did not take folic acid, the odds ratios (ORs) for the presence of SARS-CoV-2 NAb and IgG antibody in pregnant women who took folic acid were 0.67 (P = 0.255; 95% CI, 0.34-1.32) and 1.24 (P = 0.547; 95% CI, 0.60-2.55), respectively. Compared with pregnant women who did not take iron supplements, the ORs for the presence of NAb and IgG antibody in pregnant women who took iron supplements were 1.16(P = 0.465; 95% CI, 0.77-1.76) and 0.98 (P = 0.931; 95% CI, 0.64-1.49), respectively. Similarly, the ORs for NAb and IgG antibody were 0.71 (P = 0.085; 95% CI, 0.49-1.04) and 0.95 (P = 0.801; 95% CI, 0.65-1.38) in pregnant women who took DHA compared with those who did not. CONCLUSIONS Nutritional supplementation with folic acid, iron, or DHA during pregnancy was not associated with antibody levels in pregnant women who received inactivated SARS-CoV-2 vaccines.
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Affiliation(s)
- Xi Zhang
- Department of Occupational and Environmental Health, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China
| | - Xue Han
- Department of Occupational and Environmental Health, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China
| | - Baolan Chen
- Department of Occupational and Environmental Health, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China
| | - Xi Fu
- Department of Occupational and Environmental Health, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China
| | - Yajie Gong
- Department of Epidemiology and Medical Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China
| | - Wenhan Yang
- Department of Child and Adolescent Health, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China
| | - Qingsong Chen
- Department of Occupational and Environmental Health, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China
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Popescu IM, Baditoiu LM, Reddy SR, Nalla A, Popovici ED, Margan MM, Anghel M, Laitin SMD, Toma AO, Herlo A, Fericean RM, Baghina N, Anghel A. Environmental Factors Influencing the Dynamics and Evolution of COVID-19: A Systematic Review on the Study of Short-Term Ozone Exposure. Healthcare (Basel) 2023; 11:2670. [PMID: 37830707 PMCID: PMC10572520 DOI: 10.3390/healthcare11192670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/25/2023] [Accepted: 09/30/2023] [Indexed: 10/14/2023] Open
Abstract
The potential influence of environmental factors, particularly air pollutants such as ozone (O3), on the dynamics and progression of COVID-19 remains a significant concern. This study aimed to systematically review and analyze the current body of literature to assess the impact of short-term ozone exposure on COVID-19 transmission dynamics and disease evolution. A rigorous systematic review was conducted in March 2023, covering studies from January 2020 to January 2023 found in PubMed, Web of Science, and Scopus. We followed the PRISMA guidelines and PROSPERO criteria, focusing exclusively on the effects of short-term ozone exposure on COVID-19. The literature search was restricted to English-language journal articles, with the inclusion and exclusion criteria strictly adhered to. Out of 4674 identified studies, 18 fulfilled the inclusion criteria, conducted across eight countries. The findings showed a varied association between short-term ozone exposure and COVID-19 incidence, severity, and mortality. Some studies reported a higher association between ozone exposure and incidence in institutional settings (OR: 1.06, 95% CI: 1.00-1.13) compared to the general population (OR: 1.00, 95% CI: 0.98-1.03). The present research identified a positive association between ozone exposure and both total and active COVID-19 cases as well as related deaths (coefficient for cases: 0.214; for recoveries: 0.216; for active cases: 0.467; for deaths: 0.215). Other studies also found positive associations between ozone levels and COVID-19 cases and deaths, while fewer reports identified a negative association between ozone exposure and COVID-19 incidence (coefficient: -0.187) and mortality (coefficient: -0.215). Conversely, some studies found no significant association between ozone exposure and COVID-19, suggesting a complex and potentially region-specific relationship. The relationship between short-term ozone exposure and COVID-19 dynamics is complex and multifaceted, indicating both positive and negative associations. These variations are possibly due to demographic and regional factors. Further research is necessary to bridge current knowledge gaps, especially considering the potential influence of short-term O3 exposure on COVID-19 outcomes and the broader implications on public health policy and preventive strategies during pandemics.
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Affiliation(s)
- Irina-Maria Popescu
- Department of Infectious Diseases, Discipline of Epidemiology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (I.-M.P.); (L.M.B.); (E.D.P.); (M.A.); (S.M.D.L.)
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Luminita Mirela Baditoiu
- Department of Infectious Diseases, Discipline of Epidemiology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (I.-M.P.); (L.M.B.); (E.D.P.); (M.A.); (S.M.D.L.)
| | - Sandhya Rani Reddy
- Department of General Medicine, Prathima Institute of Medical Sciences, Nagunur 505417, Telangana, India;
| | - Akhila Nalla
- Department of General Medicine, MNR Medical College, Sangareddy 502294, Telangana, India;
| | - Emilian Damian Popovici
- Department of Infectious Diseases, Discipline of Epidemiology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (I.-M.P.); (L.M.B.); (E.D.P.); (M.A.); (S.M.D.L.)
| | - Madalin-Marius Margan
- Department of Functional Sciences, Discipline of Public Health, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Mariana Anghel
- Department of Infectious Diseases, Discipline of Epidemiology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (I.-M.P.); (L.M.B.); (E.D.P.); (M.A.); (S.M.D.L.)
| | - Sorina Maria Denisa Laitin
- Department of Infectious Diseases, Discipline of Epidemiology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (I.-M.P.); (L.M.B.); (E.D.P.); (M.A.); (S.M.D.L.)
| | - Ana-Olivia Toma
- Department of Dermatology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Alexandra Herlo
- Department of Infectious Diseases, Discipline of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Roxana Manuela Fericean
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Nina Baghina
- National Meteorological Administration of Romania, Soseaua Bucuresti-Ploiesti 97, 013686 Bucuresti, Romania;
| | - Andrei Anghel
- Department of Biochemistry and Pharmacology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
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Musat O, Sorop VB, Sorop MI, Lazar V, Marti DT, Susan M, Avram CR, Oprisoni A, Vulcanescu DD, Horhat FG, Bagiu IC, Horhat DI, Diaconu MM. COVID-19 and Laboratory Markers from Romanian Patients-A Narrative Review. Life (Basel) 2023; 13:1837. [PMID: 37763241 PMCID: PMC10532991 DOI: 10.3390/life13091837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/09/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
COVID-19 has significantly impacted the whole world, and Romania was no exception. Biomarkers play a crucial role in understanding and managing the disease. However, research regarding laboratory analyses for patients with COVID-19 is fairly limited. For detection, PCR testing is still considered the golden standard, while antibodies are still useful for monitoring both patients and their vaccination status. In our country, biomarkers such as CRP, LDH, transaminases, cardiac, and iron markers have been used to assess the status of patients and even predict illness outcome. CRP, IL-6, LDH, FER, fibrinogen, creatinine, and vitamin D levels have been associated with increased severity, risk of ICU admission, and death. Cardiac markers and D-dimers are also good predictors, but their role seems more important in patients with complications. HDL cholesterol and BUN levels were also suggested as potential biomarkers. Hematological issues in SARS-CoV-2 infections include neutrophilia, lymphopenia and their ratio, while PCT, which is a marker of bacterial infections, is better to be used in patients with co- or supra-infections. The current research is a narrative review that focuses on the laboratory results of Romanian COVID-19 patients. The goal of this article is to provide an update on the research on biomarkers and other laboratory tests conducted inside the borders of Romania and identify gaps in this regard. Secondly, options for further research are discussed and encouraged.
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Affiliation(s)
- Ovidiu Musat
- Department of Ophthalmology, “Carol Davila” University of Medicine and Pharmacy, Dionisie Lupu Street, No. 37, Sector 2, 020021 Bucharest, Romania;
- Department of Ophthalmology, “Dr Carol Davila” Central Military Emergency University Hospital, Mircea Vulcanescu Street, No. 88, 010825 Bucharest, Romania
| | - Virgiliu Bogdan Sorop
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (V.B.S.); (M.M.D.)
| | - Madalina Ioana Sorop
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (M.I.S.); (D.D.V.)
| | - Viorica Lazar
- Department of General Medicine, “Vasile Goldis” University of Medicine, Liviu Rebreanu Street, No. 86, 310048 Arad, Romania;
- Pediatric Clinic II, Clinical Hospital Emergency of Arad County, Andrényi Károly Street, No. 2-4, 310037 Arad, Romania
| | - Daniela Teodora Marti
- Department of Biology and Life Sciences, “Vasile Goldis” University of Medicine, Liviu Rebreanu Street, No. 86, 310048 Arad, Romania;
- Clinical Analysis Laboratory Clinical Hospital Emergency of Arad County, Andrényi Károly Street, No. 2-4, 310037 Arad, Romania
| | - Monica Susan
- Department of Internal Medicine, Centre for Preventive Medicine, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania;
| | - Cecilia Roberta Avram
- Department of Residential Training and Post-University Courses, “Vasile Goldis” Western University, Liviu Rebreanu Street 86, 310414 Arad, Romania;
| | - Andrada Oprisoni
- Department of Pediatrics, Discipline of Pediatric Oncology and Hematology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania;
| | - Dan Dumitru Vulcanescu
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (M.I.S.); (D.D.V.)
- Department of Microbiology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania;
- Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Clinical Analysis Laboratory, “Louis Turcanu” Emergency Clinical Hospital for Children, Iosif Nemoianu Street 2, 300011 Timisoara, Romania
| | - Florin George Horhat
- Department of Microbiology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania;
- Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Clinical Analysis Laboratory, “Louis Turcanu” Emergency Clinical Hospital for Children, Iosif Nemoianu Street 2, 300011 Timisoara, Romania
| | - Iulia Cristina Bagiu
- Department of Microbiology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania;
- Multidisciplinary Research Center on Antimicrobial Resistance (MULTI-REZ), Microbiology Department, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
- Clinical Analysis Laboratory, “Louis Turcanu” Emergency Clinical Hospital for Children, Iosif Nemoianu Street 2, 300011 Timisoara, Romania
| | - Delia Ioana Horhat
- Department of ENT, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania;
| | - Mircea Mihai Diaconu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania; (V.B.S.); (M.M.D.)
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Iordache O, Anastasiu DM, Kakarla M, Ali A, Bratosin F, Neamtu R, Dumitru C, Olaru F, Erdelean I, Gherman A, Avram CR, Stelea L. Influence of Antiphospholipid Antibody-Associated Thrombophilia on the Risk of Preterm Birth: A Systematic Review. J Clin Med 2023; 12:5316. [PMID: 37629357 PMCID: PMC10456069 DOI: 10.3390/jcm12165316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/08/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
Antiphospholipid antibody (aPL)-associated thrombophilia has been implicated in various adverse pregnancy outcomes, including preterm birth and impaired fetal development. This systematic review aimed to elucidate the relationship between aPL-associated thrombophilia and these outcomes, as well as to identify potential modifiers of this relationship such as maternal age, coexisting maternal medical conditions, type of aPL antibodies involved, and the timing of thrombophilia diagnosis during gestation. We conducted a comprehensive literature search in PubMed, Web of Science, Cochrane, and Scopus in May 2023, covering literature published within the last 10 years. Eight articles, involving 2935 patients, were eligible for inclusion in the review. Single aCL was the most common type of aPL found in patients, with rates up to 61.0% in some studies, followed by single LA and single ab2GPI. Multiple aPL antibody positivity was found to be associated with a higher risk of preterm birth, with odds ratios ranging from 1.29 to 9.61. Patient characteristics and previous pregnancy history varied significantly across the studies. Risk factors such as diabetes mellitus, thrombosis, and systemic lupus erythematosus were also variable across the studies, but presence of these risk factors did not consistently affect the risk of preterm birth. Furthermore, although a triple positive aPL test was the most important risk factor for preterm birth, it was observed that thrombophilia treatment during pregnancy significantly reduced the risk by 2.44 times (95% CI = 1.18-6.20). This review supports the evidence for aPL-associated thrombophilia being a significant contributor to preterm birth and fetal developmental abnormalities. Further research is required to investigate the exact mechanisms and to determine the best clinical management for patients with aPL-associated thrombophilia during pregnancy.
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Affiliation(s)
- Olivera Iordache
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (O.I.); (D.M.A.); (R.N.); (F.O.); (I.E.); (L.S.)
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Doru Mihai Anastasiu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (O.I.); (D.M.A.); (R.N.); (F.O.); (I.E.); (L.S.)
| | - Manaswini Kakarla
- Kamineni Institute of Medical Sciences, School of Medicine, Hyderabad 500001, Telangana, India;
| | - Ayesha Ali
- Bhaskar Medical College, Amdapur Road 156-162, Hyderabad 500075, Telangana, India;
| | - Felix Bratosin
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Radu Neamtu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (O.I.); (D.M.A.); (R.N.); (F.O.); (I.E.); (L.S.)
| | - Catalin Dumitru
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (O.I.); (D.M.A.); (R.N.); (F.O.); (I.E.); (L.S.)
| | - Flavius Olaru
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (O.I.); (D.M.A.); (R.N.); (F.O.); (I.E.); (L.S.)
| | - Izabella Erdelean
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (O.I.); (D.M.A.); (R.N.); (F.O.); (I.E.); (L.S.)
| | - Angelica Gherman
- Research Center for Medical Communication, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania;
| | - Cecilia Roberta Avram
- Department of Residential Training and Post-University Training, “Vasile Goldis” Western University, Liviu Rebreanu Street 86, 310414 Arad, Romania;
| | - Lavinia Stelea
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (O.I.); (D.M.A.); (R.N.); (F.O.); (I.E.); (L.S.)
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Choi R, Park W, Chun G, Lee SG, Lee EH. The Utilization of Serum Folate and Homocysteine Tests and the Prevalence of Folate Deficiency in Reproductive-Age Korean Women during the COVID-19 Pandemic. Nutrients 2023; 15:3236. [PMID: 37513654 PMCID: PMC10384824 DOI: 10.3390/nu15143236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 07/18/2023] [Accepted: 07/19/2023] [Indexed: 07/30/2023] Open
Abstract
We investigated the prevalence of folate deficiency and associated factors in a large population of Korean women of reproductive age during the COVID-19 pandemic. We utilized different cut-offs and evaluated age, year of testing, geographical region, and the utilization of serum homocysteine levels. Out of the 27,758 women evaluated, the overall prevalence of folate deficiency was 12.5% (<4 ng/mL, metabolic indicator) and 5.4% (<3 ng/mL, hematologic indicator). Homocysteine testing was observed in 8.4% of women, with 2.7% having elevated homocysteine levels (>15.4 µmol/L). According to our multiple logistic regression analysis, younger women, particularly those aged 20 to 24 years, tested in 2020, and from Jeolla province, Gyeongsang province, and Jeju Island, were identified as being more prone to folate deficiency. Receiver operating characteristic curve analysis demonstrated that a cut-off of >8.4 µmol/L provided the most accurate definition of folate deficiency with serum folate levels <4 ng/mL, while a cut-off of >8.8 µmol/L best defined folate deficiency with serum folate levels <3 ng/mL, with both cut-offs being lower than 15.4 µmol/L. Our study emphasizes the prevalence of folate deficiency, associated factors, and the role of homocysteine in planning nutritional support programs in Korea.
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Affiliation(s)
- Rihwa Choi
- Department of Laboratory Medicine, Green Cross Laboratories, Yongin 16924, Republic of Korea
- Department of Laboratory Medicine and Genetics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Republic of Korea
| | - Wonseo Park
- Infectious Disease Research Center, Green Cross Laboratories, Yongin 16924, Republic of Korea
| | - Gayoung Chun
- Infectious Disease Research Center, Green Cross Laboratories, Yongin 16924, Republic of Korea
| | - Sang Gon Lee
- Department of Laboratory Medicine, Green Cross Laboratories, Yongin 16924, Republic of Korea
| | - Eun Hee Lee
- Green Cross Laboratories, Yongin 16924, Republic of Korea
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Das A, Bai CH, Chang JS, Huang YL, Wang FF, Chen YC, Chao JCJ. Associations of Dietary Patterns and Vitamin D Levels with Iron Status in Pregnant Women: A Cross-Sectional Study in Taiwan. Nutrients 2023; 15:nu15081805. [PMID: 37111023 PMCID: PMC10143533 DOI: 10.3390/nu15081805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/17/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
Vitamin D is involved in the pathophysiology of anemia. This cross-sectional study was conducted using the Nationwide Nutrition and Health Survey in Pregnant Women in Taiwan database. We investigated associations among dietary patterns (DPs), vitamin D, and iron-related biomarkers in pregnant women. The principal component analysis revealed four DPs. Linear and logistic regression analyses were performed to investigate the association of DPs with anemia-related biomarkers. Plant-based, carnivore, and dairy and nondairy alternatives DPs were positively associated with serum vitamin D levels. After adjusting covariates, the pregnant women consuming plant-based DPs at the mid-tertile (T2) were associated with reduced risks of low serum folate and vitamin D levels, and those consuming carnivore DPs at higher tertiles (T2 and/or T3) were correlated with an increased risk of low serum iron levels but decreased risks of low serum transferrin saturation, vitamin B12, and vitamin D levels. The pregnant women consuming dairy and nondairy alternatives DPs at the highest tertile (T3) were associated with reduced risks of low serum folate and vitamin B12 levels. However, the processed food DP was not correlated with anemia-related biomarkers. Thus, plant-based, carnivore, and dairy and nondairy alternatives DPs were associated with the risk of low-serum-anemia-related variables.
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Affiliation(s)
- Arpita Das
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110301, Taiwan
| | - Chyi-Huey Bai
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110301, Taiwan
- School of Public Health, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110301, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, 252 Wu-Hsing Street, Taipei 110301, Taiwan
| | - Jung-Su Chang
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110301, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, 252 Wu-Hsing Street, Taipei 110301, Taiwan
- Graduate Institute of Metabolism and Obesity Sciences, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110301, Taiwan
| | - Ya-Li Huang
- Department of Public Health, School of Medicine, College of Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110301, Taiwan
- School of Public Health, College of Public Health, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110301, Taiwan
| | - Fan-Fen Wang
- Department of Metabolism, Yangming Branch, Taipei City Hospital, 105 Yusheng Street, Taipei 111024, Taiwan
| | - Yi-Chun Chen
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110301, Taiwan
| | - Jane C-J Chao
- School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110301, Taiwan
- Nutrition Research Center, Taipei Medical University Hospital, 252 Wu-Hsing Street, Taipei 110301, Taiwan
- Master Program in Global Health and Health Security, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110301, Taiwan
- TMU Research Center for Digestive Medicine, Taipei Medical University, 250 Wu-Hsing Street, Taipei 110301, Taiwan
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Kostoff RN, Briggs MB, Kanduc D, Dewanjee S, Kandimalla R, Shoenfeld Y, Porter AL, Tsatsakis A. Modifiable contributing factors to COVID-19: A comprehensive review. Food Chem Toxicol 2023; 171:113511. [PMID: 36450305 PMCID: PMC9701571 DOI: 10.1016/j.fct.2022.113511] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/01/2022] [Accepted: 11/03/2022] [Indexed: 11/29/2022]
Abstract
The devastating complications of coronavirus disease 2019 (COVID-19) result from an individual's dysfunctional immune response following the initial severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Multiple toxic stressors and behaviors contribute to underlying immune system dysfunction. SARS-CoV-2 exploits the dysfunctional immune system to trigger a chain of events ultimately leading to COVID-19. The current study identifies eighty immune system dysfunction-enabling toxic stressors and behaviors (hereafter called modifiable contributing factors (CFs)) that also link directly to COVID-19. Each CF is assigned to one of the five categories in the CF taxonomy shown in Section 3.3.: Lifestyle (e.g., diet, substance abuse); Iatrogenic (e.g., drugs, surgery); Biotoxins (e.g., micro-organisms, mycotoxins); Occupational/Environmental (e.g., heavy metals, pesticides); Psychosocial/Socioeconomic (e.g., chronic stress, lower education). The current study shows how each modifiable factor contributes to decreased immune system capability, increased inflammation and coagulation, and increased neural damage and neurodegeneration. It is unclear how real progress can be made in combatting COVID-19 and other similar diseases caused by viral variants without addressing and eliminating these modifiable CFs.
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Affiliation(s)
- Ronald Neil Kostoff
- Independent Consultant, Gainesville, VA, 20155, USA,Corresponding author. Independent Consultant, 13500 Tallyrand Way, Gainesville, VA, 20155, USA
| | | | - Darja Kanduc
- Dept. of Biosciences, Biotechnologies, and Biopharmaceutics, University of Bari, Via Orabona 4, Bari, 70125, Italy
| | - Saikat Dewanjee
- Advanced Pharmacognosy Research Laboratory, Department of Pharmaceutical Technology, Jadavpur University, Kolkata, 700032, India
| | - Ramesh Kandimalla
- Applied Biology, CSIR-Indian Institute of Chemical Technology, Uppal Road, Tarnaka, Hyderabad, 500007, Telangana, India
| | - Yehuda Shoenfeld
- Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, 5265601, Israel
| | - Alan L. Porter
- School of Public Policy, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Aristidis Tsatsakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003, Heraklion, Greece
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8
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Exploring Clinical and Biological Features of Premature Births among Pregnant Women with SARS-CoV-2 Infection during the Pregnancy Period. J Pers Med 2022; 12:jpm12111871. [PMID: 36579593 PMCID: PMC9694165 DOI: 10.3390/jpm12111871] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 11/05/2022] [Accepted: 11/07/2022] [Indexed: 11/11/2022] Open
Abstract
Studies observed that women infected with SARS-CoV-2 during pregnancy had a higher risk of preterm birth. Although it is likely that COVID-19 during the late trimester of pregnancy can trigger premature birth, prematurity remains a concern, and it is vital to study additional clinical and biological patient factors that are highly associated with this negative pregnancy outcome and allow for better management based on the existing predictors. In order to achieve this goal, the current study retrospectively recruited 428 pregnant patients that were separated into three study groups using a 1:2:4 matching ratio and a nearest-neighbor matching method. Sixty-one pregnant patients had a history of COVID-19 during pregnancy and gave birth prematurely; 124 pregnant patient controls had COVID-19 and gave birth full-term, while the second control group of 243 pregnant patients had a premature birth but no history of COVID-19. It was observed that a symptomatic SARS-CoV-2 infection during the third trimester was significantly more likely to be associated with premature birth. Even though the rate of ICU admission was higher in these cases, the mortality rate did not change significantly in the COVID-19 groups. However, SARS-CoV-2 infection alone did not show statistical significance in determining a premature birth (β = 1.09, CI = 0.94−1.15, p-value = 0.067). Maternal anemia was the strongest predictor for prematurity in association with SARS-CoV-2 infection (β = 3.65, CI = 1.46−5.39, p-value < 0.001), followed by elevated CRP (β = 2.11, CI = 1.20−3.06, p-value < 0.001), and respectively IL-6 (β = 1.92, CI = 1.20−2.47, p-value = 0.001. SARS-CoV-2 infection is associated with an increased risk of preterm birth, as shown by our data. If SARS-CoV-2 infection arises during the third trimester, it is recommended that these patients be hospitalized for surveillance of clinical evolution and biological parameters, such as anemia and high inflammatory markers, which have a multiplicative influence on the pregnancy result.
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9
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Zhou S, Li H, Li S. The Associations of Iron Related Biomarkers with Risk, Clinical Severity and Mortality in SARS-CoV-2 Patients: A Meta-Analysis. Nutrients 2022; 14:3406. [PMID: 36014912 PMCID: PMC9416650 DOI: 10.3390/nu14163406] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/04/2022] [Accepted: 08/07/2022] [Indexed: 11/22/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is spreading rapidly around the world and has led to millions of infections and deaths. Growing evidence indicates that iron metabolism is associated with COVID-19 progression, and iron-related biomarkers have great potential for detecting these diseases. However, the results of previous studies are conflicting, and there is not consistent numerical magnitude relationship between those biomarkers and COVID-19. Thereby, we aimed to integrate the results of current studies and to further explore their relationships through a meta-analysis. We searched peer-reviewed literature in PubMed, Scopus and Web of Science up to 31 May 2022. A random effects model was used for pooling standard mean difference (SMD) and the calculation of the corresponding 95% confidence interval (CI). I2 was used to evaluate heterogeneity among studies. A total of 72 eligible articles were included in the meta-analysis. It was found that the ferritin levels of patients increased with the severity of the disease, whereas their serum iron levels and hemoglobin levels showed opposite trends. In addition, non-survivors had higher ferritin levels (SMD (95%CI): 1.121 (0.854, 1.388); Z = 8.22 p for Z < 0.001; I2 = 95.7%, p for I2 < 0.001), lower serum iron levels (SMD (95%CI): −0.483 (−0.597, −0.368), Z = 8.27, p for Z < 0.001; I2 = 0.9%, p for I2 =0.423) and significantly lower TIBC levels (SMD (95%CI): −0.612 (−0.900, −0.324), Z = 4.16, p for Z < 0.001; I2 = 71%, p for I2 = 0.016) than survivors. This meta-analysis demonstrates that ferritin, serum iron, hemoglobin and total iron banding capacity (TIBC) levels are strongly associated with the risk, severity and mortality of COVID-19, providing strong evidence for their potential in predicting disease occurrence and progression.
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Affiliation(s)
| | | | - Shiru Li
- Department of Epidemiology and Health Statistics, School of Public Health, Qingdao University, Qingdao 266071, China
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10
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Dellino M, Cascardi E, Vinciguerra M, Lamanna B, Malvasi A, Scacco S, Acquaviva S, Pinto V, Di Vagno G, Cormio G, De Luca R, Lafranceschina M, Cazzato G, Ingravallo G, Maiorano E, Resta L, Daniele A, La Forgia D. Nutrition as Personalized Medicine against SARS-CoV-2 Infections: Clinical and Oncological Options with a Specific Female Groups Overview. Int J Mol Sci 2022; 23:9136. [PMID: 36012402 PMCID: PMC9409275 DOI: 10.3390/ijms23169136] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/10/2022] [Accepted: 08/12/2022] [Indexed: 01/08/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a respiratory disease caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). It is acknowledged that vulnerable people can suffer from mortal complications of COVID-19. Therefore, strengthening the immune system particularly in the most fragile people could help to protect them from infection. First, general nutritional status and food consumption patterns of everyone affect the effectiveness of each immune system. The effects of nutrition could impact the level of intestinal and genital microbiota, the adaptive immune system, and the innate immune system. Indeed, immune system cells and mediators, which are crucial to inflammatory reaction, are in the structures of fats, carbohydrates, and proteins and are activated through vitamins (vit) and minerals. Therefore, the association of malnutrition and infection could damage the immune response, reducing the immune cells and amplifying inflammatory mediators. Both amount and type of dietary fat impact on cytokine biology, that consequently assumes a crucial role in inflammatory disease. This review explores the power of nutrition in the immune response against COVID-19 infection, since a specific diet could modify the cytokine storm during the infection phase. This can be of vital importance in the most vulnerable subjects such as pregnant women or cancer patients to whom we have deemed it necessary to dedicate personalized indications.
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Affiliation(s)
- Miriam Dellino
- Department of Biomedical Sciences and Human Oncology, University of Bari, 70100 Bari, Italy
- Clinic of Obstetrics and Gynecology, “San Paolo” Hospital, 70123 Bari, Italy
| | - Eliano Cascardi
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy
- Pathology Unit, FPO-IRCCS Candiolo Cancer Institute, Str. Provinciale 142, Km 3.95, 10060 Candiolo, Italy
| | - Marina Vinciguerra
- Department of Biomedical Sciences and Human Oncology, University of Bari, 70100 Bari, Italy
| | - Bruno Lamanna
- Department of Biomedical Sciences and Human Oncology, University of Bari, 70100 Bari, Italy
- Fetal Medicine Research Institute, King’s College Hospital, London SE5 9RS, UK
| | - Antonio Malvasi
- Department of Biomedical Sciences and Human Oncology, University of Bari, 70100 Bari, Italy
| | - Salvatore Scacco
- Department of Basic Medical Sciences and Neurosciences, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Silvia Acquaviva
- Department of Basic Medical Sciences and Neurosciences, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Vincenzo Pinto
- Department of Biomedical Sciences and Human Oncology, University of Bari, 70100 Bari, Italy
| | - Giovanni Di Vagno
- Clinic of Obstetrics and Gynecology, “San Paolo” Hospital, 70123 Bari, Italy
| | - Gennaro Cormio
- Gynecologic Oncology Unit, IRCCS Istituto Tumori Giovanni Paolo II, Department of Interdisciplinary Medicine (DIM), University of Bari “Aldo Moro”, 70121 Bari, Italy
| | | | | | - Gerardo Cazzato
- Department of Emergency and Organ Transplantation, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Giuseppe Ingravallo
- Department of Emergency and Organ Transplantation, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Eugenio Maiorano
- Department of Emergency and Organ Transplantation, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Leonardo Resta
- Department of Emergency and Organ Transplantation, University of Bari “Aldo Moro”, 70121 Bari, Italy
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11
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Dahma G, Neamtu R, Nitu R, Gluhovschi A, Bratosin F, Grigoras ML, Silaghi C, Citu C, Orlu IN, Bhattarai S, Mocanu AG, Craina M, Bernad E. The Influence of Maternal Vitamin D Supplementation in Pregnancies Associated with Preeclampsia: A Case-Control Study. Nutrients 2022; 14:nu14153008. [PMID: 35893862 PMCID: PMC9330723 DOI: 10.3390/nu14153008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/20/2022] [Accepted: 07/20/2022] [Indexed: 12/14/2022] Open
Abstract
Preeclampsia is a pregnancy-specific illness that is hypothesized to occur due to vitamin D deficiency during pregnancy. Therefore, vitamin D supplementation in early pregnancy should be explored for preventing preeclampsia and promoting neonatal well-being. The present study follows a case-control analysis that aims to determine the effect of vitamin D supplements on reducing the probability of recurrent preeclampsia. We identified 59 patients for the control group without vitamin D supplementation during pregnancy, while 139 patients were included in the cases group of pregnant women with a history of preeclampsia who confirmed taking daily vitamin D supplements in either 2000 UI or 4000 UI until the 36th week of pregnancy. There were 61 (80.3%) patients with a normal serum vitamin D level measured at 32 weeks in the pregnant women who took a daily dose of 4000 UI vitamin D and 43 (68.3%) in those who took a 2000 UI dose of vitamin D, compared to just 32 (54.2%) in those who did not take vitamin D at all. Regarding the blood pressure of pregnant women measured at 32 weeks, it was observed that 20.3% were hypertensive in the no supplementation group, compared to only 11.1% and 6.6% in those who were taking vitamin D during pregnancy (p-value = 0.049). Serum vitamin D levels at 32 weeks were measured at an average value of 23.9 ng/mL, compared with 28.4 ng/mL in the group taking a 2000 UI daily dose and 33.6 in those who supplemented with 4000 UI daily (p-value < 0.001). Proteinuria was identified more often in the group at risk for preeclampsia who did not take vitamin D supplements, while systolic blood pressure (p-value = 0.036) as well as diastolic blood pressure (p-value = 0.012), were all identified to have significantly higher values in the pregnant women with a history of preeclampsia that did not take vitamin D during the current pregnancy. The significant risk factors for preeclampsia development in pregnant patients at risk are: insufficient vitamin D serum levels (<20 ng/mL), OR = 2.52; no vitamin D supplementation, OR = 1.46; more than two pregnancies, OR = 1.89; gestational diabetes mellitus, OR = 1.66; and cardiovascular comorbidities, OR = 2.18. These findings imply that vitamin D has a role in the preservation of placental function and, therefore, in the prevention of the development of late preeclampsia. Pregnant mothers who supplemented their diets with vitamin D were protected against preeclampsia recurrence. Vitamin D supplementation during pregnancy may aid in the prevention of gestational hypertension and preeclampsia.
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Affiliation(s)
- George Dahma
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (G.D.); (R.N.); (A.G.); (C.S.); (C.C.); (A.G.M.); (M.C.); (E.B.)
| | - Radu Neamtu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (G.D.); (R.N.); (A.G.); (C.S.); (C.C.); (A.G.M.); (M.C.); (E.B.)
| | - Razvan Nitu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (G.D.); (R.N.); (A.G.); (C.S.); (C.C.); (A.G.M.); (M.C.); (E.B.)
- Correspondence: ; Tel.: +40-729-098-886
| | - Adrian Gluhovschi
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (G.D.); (R.N.); (A.G.); (C.S.); (C.C.); (A.G.M.); (M.C.); (E.B.)
| | - Felix Bratosin
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (F.B.); (M.L.G.)
| | - Mirela Loredana Grigoras
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (F.B.); (M.L.G.)
| | - Carmen Silaghi
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (G.D.); (R.N.); (A.G.); (C.S.); (C.C.); (A.G.M.); (M.C.); (E.B.)
| | - Cosmin Citu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (G.D.); (R.N.); (A.G.); (C.S.); (C.C.); (A.G.M.); (M.C.); (E.B.)
| | - Igwe Nwobueze Orlu
- Faculty of General Medicine, University of Debrecen Medical School, Nagyerdei Street 94, 4032 Debrecen, Hungary;
| | | | - Adelina Geanina Mocanu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (G.D.); (R.N.); (A.G.); (C.S.); (C.C.); (A.G.M.); (M.C.); (E.B.)
| | - Marius Craina
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (G.D.); (R.N.); (A.G.); (C.S.); (C.C.); (A.G.M.); (M.C.); (E.B.)
| | - Elena Bernad
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (G.D.); (R.N.); (A.G.); (C.S.); (C.C.); (A.G.M.); (M.C.); (E.B.)
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12
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Galmés S, Palou A, Serra F. Suboptimal Consumption of Relevant Immune System Micronutrients Is Associated with a Worse Impact of COVID-19 in Spanish Populations. Nutrients 2022; 14:2254. [PMID: 35684054 PMCID: PMC9183133 DOI: 10.3390/nu14112254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 05/23/2022] [Accepted: 05/26/2022] [Indexed: 12/04/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) has caused a global health crisis and the factors behind its differential impact on COVID-19 among populations are still being known. Geographical differences in nutrient profile could be a relevant factor, especially considering that scientific evidence supports that 10 micronutrients are essential for proper immune system function. This study aims to evaluate these micronutrient intakes in the territories of Spain and to analyze their relationship with epidemiological indicators of COVID-19 from the first two waves of COVID-19, when neither specific vaccines nor drugs had yet come into play. Results showed that vitamin D, A, B9, and zinc intakes were particularly insufficient in Spain. The joint intake of these four micronutrients was lower in regions with the highest COVID-19 incidence and mortality, and of particular importance, was the insufficient intake of vitamin D. A pattern of food consumption associated with lower COVID-19 impact was observed. In conclusion, the results show the relevance of the optimal consumption of foods rich in essential nutrients for the immune system. Therefore, this assessment could serve to launch specific dietary recommendations to strengthen the immune system in Spanish territories to better face potential new COVID-19 variants and/or further infectious diseases.
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Affiliation(s)
- Sebastià Galmés
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Nutrigenomics, Biomarkers and Risk Evaluation-NuBE), University of the Balearic Islands, 07122 Palma, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
| | - Andreu Palou
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Nutrigenomics, Biomarkers and Risk Evaluation-NuBE), University of the Balearic Islands, 07122 Palma, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
| | - Francisca Serra
- Laboratory of Molecular Biology, Nutrition and Biotechnology (Nutrigenomics, Biomarkers and Risk Evaluation-NuBE), University of the Balearic Islands, 07122 Palma, Spain
- Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, 28029 Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma, Spain
- Alimentómica S.L., Spin-off n.1 of the University of the Balearic Islands, 07121 Palma, Spain
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13
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Citu IM, Citu C, Margan MM, Craina M, Neamtu R, Gorun OM, Burlea B, Bratosin F, Rosca O, Grigoras ML, Motoc A, Malita D, Neagoe O, Gorun F. Calcium, Magnesium, and Zinc Supplementation during Pregnancy: The Additive Value of Micronutrients on Maternal Immune Response after SARS-CoV-2 Infection. Nutrients 2022; 14:nu14071445. [PMID: 35406057 PMCID: PMC9003126 DOI: 10.3390/nu14071445] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 03/24/2022] [Accepted: 03/29/2022] [Indexed: 02/04/2023] Open
Abstract
Magnesium may contribute to the immune response during and after SARS-CoV-2 infection by acting as a cofactor for immunoglobulin production and other processes required for T and B cell activity. Considering magnesium as a recommended dietary supplement during pregnancy and the possible role of magnesium deficiency in COVID-19 and its complications, the current study sought to determine the effect of magnesium and magnesium-containing nutritional supplements on the immune response following SARS-CoV-2 infection in pregnant women, as well as to observe differences in pregnancy outcomes based on the supplements taken during pregnancy. The study followed a cross-sectional design, where patients with a history of SARS-CoV-2 infection during their pregnancy were surveyed for their preferences in nutritional supplementation and their profile compared with existing records from the institutional database. A cohort of 448 pregnant women with COVID-19 during 22 months of the pandemic was assembled, out of which 13.6% took a magnesium-only supplement, and 16.5% supplemented their diet with a combination of calcium, magnesium, and zinc. Around 60% of patients in the no-supplementation group had the SARS-CoV-2 anti-RBD lower than 500 U/mL, compared with 50% in those who took magnesium-based supplements. A quantity of magnesium >450 mg in the taken supplements determined higher levels of antibody titers after COVID-19. Low magnesium dosage (<450 mg) was an independent risk factor for a weak immune response (OR-1.25, p-value = 0.003). The observed findings suggest supplementing the nutritional intake of pregnant women with magnesium-based supplements to determine higher levels of SARS-CoV-2 anti-RBD antibodies, although causality remains unclear.
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Affiliation(s)
- Ioana Mihaela Citu
- Department of Internal Medicine I, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
| | - Cosmin Citu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.-M.M.); (M.C.); (R.N.); (F.G.)
- Correspondence: ; Tel.: +40-(722)-322-877
| | - Madalin-Marius Margan
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.-M.M.); (M.C.); (R.N.); (F.G.)
| | - Marius Craina
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.-M.M.); (M.C.); (R.N.); (F.G.)
| | - Radu Neamtu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.-M.M.); (M.C.); (R.N.); (F.G.)
| | - Oana Maria Gorun
- Department of Obstetrics and Gynecology, Municipal Emergency Clinical Hospital Timisoara, 300202 Timisoara, Romania; (O.M.G.); (B.B.)
| | - Bogdan Burlea
- Department of Obstetrics and Gynecology, Municipal Emergency Clinical Hospital Timisoara, 300202 Timisoara, Romania; (O.M.G.); (B.B.)
| | - Felix Bratosin
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (F.B.); (O.R.)
| | - Ovidiu Rosca
- Methodological and Infectious Diseases Research Center, Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (F.B.); (O.R.)
| | - Mirela Loredana Grigoras
- Department of Anatomy and Embryology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.L.G.); (A.M.)
| | - Andrei Motoc
- Department of Anatomy and Embryology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.L.G.); (A.M.)
| | - Daniel Malita
- Department of Radiology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania;
| | - Octavian Neagoe
- First Department of Surgery, Second Discipline of Surgical Semiology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Florin Gorun
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (M.-M.M.); (M.C.); (R.N.); (F.G.)
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