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Jun JS, Kim DJ, Kim SC, Yeom JS, Park JS. Mediation Effect of Social Distancing on Neonatal Vitamin D Status and Related Clinical Outcomes during the Coronavirus Disease-19 Pandemic. Nutrients 2024; 16:1858. [PMID: 38931213 PMCID: PMC11206872 DOI: 10.3390/nu16121858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/06/2024] [Accepted: 06/08/2024] [Indexed: 06/28/2024] Open
Abstract
BACKGROUND We analyzed the impact of social distancing (SD) on vitamin D status and associated morbidity in neonates during the coronavirus disease (COVID-19) pandemic. METHODS Serum levels of 25-hydroxy vitamin D (25OHD) and clinical characteristics of newborn infants before (2019) and during SD (2021) were compared. RESULTS A total of 526 neonates (263 in 2019 and 263 in 2021) were included. The rate of vitamin D deficiency in neonates (47.1% vs. 35.4 %, p = 0.008) decreased and the rate of maternal vitamin D intake increased (6.8% vs. 37.6%, p < 0.001), respectively, during SD compared to those in 2019. The rates of hypocalcemia (12.5% vs. 3.8%, p < 0.001) and respiratory illness (57.0% vs. 43.0%, p = 0.002) decreased during SD. Neonatal vitamin D deficiency during SD was associated with maternal vitamin D supplementation (odds ratio [OR] = 0.463, p = 0.003) but was not associated with SD (OR = 0.772, p = 0.189). The mediation effect of SD on neonatal morbidity by neonatal vitamin D status was statistically insignificant. CONCLUSIONS SD might affect the increased maternal vitamin D intake and decreased neonatal vitamin D deficiency. However, neonatal morbidity was not affected by SD, even with neonatal vitamin D status changes.
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Affiliation(s)
- Jin Su Jun
- Department of Pediatrics, College of Medicine, Gyeongsang National University, Jinju 52727, Republic of Korea; (J.S.J.); (D.J.K.); (J.S.Y.)
- Department of Pediatircs, Gyeongsang National University Hospital, Jinju 52727, Republic of Korea
- Institute of Medical Science, Gyeongsang National University, Jinju 52727, Republic of Korea
| | - Dong Joon Kim
- Department of Pediatrics, College of Medicine, Gyeongsang National University, Jinju 52727, Republic of Korea; (J.S.J.); (D.J.K.); (J.S.Y.)
- Department of Pediatircs, Gyeongsang National University Hospital, Jinju 52727, Republic of Korea
- Institute of Medical Science, Gyeongsang National University, Jinju 52727, Republic of Korea
| | - Seung Chan Kim
- Biostatics Cooperation Center, Gyeongsang National University Hospital, Jinju 52727, Republic of Korea;
| | - Jung Sook Yeom
- Department of Pediatrics, College of Medicine, Gyeongsang National University, Jinju 52727, Republic of Korea; (J.S.J.); (D.J.K.); (J.S.Y.)
- Department of Pediatircs, Gyeongsang National University Hospital, Jinju 52727, Republic of Korea
- Institute of Medical Science, Gyeongsang National University, Jinju 52727, Republic of Korea
| | - Ji Sook Park
- Department of Pediatrics, College of Medicine, Gyeongsang National University, Jinju 52727, Republic of Korea; (J.S.J.); (D.J.K.); (J.S.Y.)
- Department of Pediatircs, Gyeongsang National University Hospital, Jinju 52727, Republic of Korea
- Institute of Medical Science, Gyeongsang National University, Jinju 52727, Republic of Korea
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Lupu VV, Lupu A, Jechel E, Starcea IM, Stoleriu G, Ioniuc I, Azoicai A, Danielescu C, Knieling A, Borka-Balas R, Salaru DL, Revenco N, Fotea S. The role of vitamin D in pediatric systemic lupus erythematosus - a double pawn in the immune and microbial balance. Front Immunol 2024; 15:1373904. [PMID: 38715605 PMCID: PMC11074404 DOI: 10.3389/fimmu.2024.1373904] [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: 01/20/2024] [Accepted: 04/08/2024] [Indexed: 05/23/2024] Open
Abstract
Having increased popularity during the Covid-19 pandemic, vitamin D3 is currently impressing thanks to the numerous researches aimed at its interactions with the body's homeostasis. At the same time, there is a peak in terms of recommendations for supplementation with it. Some of the studies focus on the link between autoimmune diseases and nutritional deficiencies, especially vitamin D3. Since the specialized literature aimed at children (patients between 0-18 years old) is far from equal to the informational diversity of the adult-centered branch, this review aims to bring up to date the relationship between the microbial and nutritional balance and the activity of pediatric systemic lupus erythematosus (pSLE). The desired practical purpose resides in a better understanding and an adequate, individualized management of the affected persons to reduce morbidity. The center of the summary is to establish the impact of hypovitaminosis D in the development and evolution of pediatric lupus erythematosus. We will address aspects related to the two entities of the impact played by vitamin D3 in the pathophysiological cascade of lupus, but also the risk of toxicity and its effects when the deficiency is over supplemented (hypervitaminosis D). We will debate the relationship of hypovitaminosis D with the modulation of immune function, the potentiation of inflammatory processes, the increase of oxidative stress, the perfusion of cognitive brain areas, the seasonal incidence of SLE and its severity. Finally, we review current knowledge, post-pandemic, regarding the hypovitaminosis D - pSLE relationship.
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Affiliation(s)
- Vasile Valeriu Lupu
- Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Ancuta Lupu
- Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Elena Jechel
- Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | | | - Gabriela Stoleriu
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, Galati, Romania
| | - Ileana Ioniuc
- Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Alice Azoicai
- Pediatrics, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Ciprian Danielescu
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Anton Knieling
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Reka Borka-Balas
- Pediatrics, “George Emil Palade” University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania
| | - Delia Lidia Salaru
- Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, Iasi, Romania
| | - Ninel Revenco
- Pediatrics, “Nicolae Testemitanu” State University of Medicine and Pharmacy, Chisinau, Moldova
| | - Silvia Fotea
- Clinical Medical Department, Faculty of Medicine and Pharmacy, “Dunarea de Jos” University of Galati, Galati, Romania
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VIČIČ V, PANDEL MIKUŠ R. Vitamin D Supplementation During COVID-19 Lockdown and After 20 Months: Follow-Up Study on Slovenian Women Aged Between 44 and 66. Zdr Varst 2023; 62:182-189. [PMID: 37799414 PMCID: PMC10549253 DOI: 10.2478/sjph-2023-0026] [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: 09/06/2023] [Accepted: 09/11/2023] [Indexed: 10/07/2023] Open
Abstract
Introduction The main objective was to assess the impact of the COVID-19 pandemic on vitamin D supplementation habits and their changes in the follow-up, 20 months after the study in Slovenian premenopausal and postmenopausal women. Methods A cross-sectional study was conducted between March and May 2021. 176 healthy women aged 44 to 65 from the Central Slovenian region were included in the final analysis. Vitamin D status was determined by measuring 25(OH)D concentration. After 20 months an online follow-up questionnaire was sent out, to which 123 participants responded with complete data. Results Between March and May 2021, 61% of the participants were supplementing vitamin D. 55% of the supplementers and 88% of the non-supplementers had insufficient levels (total 25(OH)D <75 nmol/L). After 20 months in the follow-up, it was found that 62% of participants were taking vitamin D supplements, but only 70% of those who had initially reported taking supplements were still doing so. In the follow-up 61% of participants stated that they started or increased vitamin D intake due to COVID-19. Conclusions Vitamin D supplementation increased 7-fold compared to pre-pandemic levels and remained at a high level after 20 months. However, a significant number of participants discontinued supplementation, and only one-fifth were taking vitamin D throughout the entire year. Supplementation is effective for vitamin D deficiency prevention only at the individual level, however due to low compliance it should not be the only strategy for preventing vitamin D deficiency in the population.
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Affiliation(s)
- Vid VIČIČ
- University of Ljubljana, Faculty of Health Sciences, Chair of Biomedicine in Healthcare, Zdravstvena pot 5, 1000Ljubljana, Slovenia
| | - Ruža PANDEL MIKUŠ
- University of Ljubljana, Faculty of Health Sciences, Chair of Biomedicine in Healthcare, Zdravstvena pot 5, 1000Ljubljana, Slovenia
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Chandankere V, Konanki R, Maryada VR, Reddy AVG. Impact of COVID lockdown: Increased prevalence of symptomatic Vitamin D deficiency in adolescents. J Clin Orthop Trauma 2023; 47:102316. [PMID: 38196497 PMCID: PMC10772364 DOI: 10.1016/j.jcot.2023.102316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 09/06/2023] [Accepted: 12/08/2023] [Indexed: 01/11/2024] Open
Abstract
Background During the COVID lockdown in India, which lasted for more than a year, all schools were closed and children were homebound. When the lockdown was lifted, we observed an increased prevalence of Vitamin D deficiency(VDD) in adolescents. We want to highlight the effect of home lockdown on adolescents, which can predispose such children to VDD. Aim To document the increased prevalence of symptomatic VDD in adolescents after COVID lockdown and to study the symptoms, biochemical abnormalities, and response to therapy in this subset. Methods This prospective observational study was done from November 2021 to May 2022 with a minimum follow-up of six months. Inclusions Consecutive children presenting with gait abnormalities, proximal myopathy, and pains, with documented VDD. Exclusion: Genetic, neuromuscular disorders, juvenile rheumatoid arthritis, chronic renal failure, thyroid disorders and those on anti-epileptic medications and vitamin D supplementation in the past 6 months were excluded from the study. We recorded the symptomatology, biochemical abnormalities, and muscle weakness and followed their improvement after Vitamin D and Calcium supplementation. Results A statistically significant increase in symptomatic VDD in adolescents, in six months post-lockdown was noted. Thirty-one adolescents between 9 to 14 years were studied. All cases were relieved of pain and muscle power normalized in 12 weeks. Conclusion Prolonged house arrest may cause VDD in adolescents. Physicians should consider VDD in adolescents with myopathy and pain after pandemic lockdowns. Supplementation of Vitamin D and calcium resolves most symptoms except deformities. Follow-up is needed until growth spurt completion for recurrence of symptoms.
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Parra-Ortega I, Zurita-Cruz JN, Ortiz-Flores I, Romero-Navarro B, Villasis-Keever MA, Martínez BL, Domínguez-Castillo V, Romo-Vázquez JC. Vitamin D levels in the pre- and post-COVID-19 pandemic periods in pediatric patients with chronic kidney disease. Front Nutr 2023; 10:1268347. [PMID: 38024354 PMCID: PMC10654788 DOI: 10.3389/fnut.2023.1268347] [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: 07/27/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Vitamin D (VD) deficiency is common in children with chronic kidney disease (CKD) because of multiple factors. During the coronavirus disease 2019 (COVID-19) pandemic, it increased because of medicine shortage and no enough medical service for patients with non-COVID-19 diseases. Objective To analyze the effects of the COVID-19 pandemic-related lockdown on the serum levels and status of 25-hydroxyvitamin D3 (25-[OH]D) in children with CKD. Materials and methods This retrospective study included patients (6-18 years old) who were diagnosed with CKD stage 2-5 and routinely measured for serum VD levels between May 2019 and December 2022. Serum 25-(OH)D levels were measured before, during, and after the pandemic (2019, 2020-2021, and 2022, respectively). The daily dose of cholecalciferol supplementation and the readjustment (if required) were recorded. Results This study included 171 patients (median age: 12 years). Before the pandemic, the median serum VD level was 25.0 ng/mL (19.3% VD deficiency). Then, VD supplementation was adjusted to 400-1,200 UI daily in 98.8% (n = 169) of patients. During the pandemic, the median VD level decreased to 22.5 ng/mL (43.3% VD deficiency). Hence, the supplementation was readjusted, and after the pandemic, the level was 28.7 ng/mL (18.7% VD deficiency), indicating a statistically significant increase in serum VD levels from the prepandemic period (p = 0.007). Conclusion Decreased serum VD levels and increased VD deficiency frequency were observed in patients with CKD during the COVID-19 but improved after readjustment of supplementation.
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Affiliation(s)
- Israel Parra-Ortega
- Auxiliary Diagnostic Services, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City, Mexico
| | - Jessie Nallely Zurita-Cruz
- Facultad de Medicina Universidad Nacional Autónoma de México, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Itzel Ortiz-Flores
- Facultad de Medicina Universidad Nacional Autónoma de México, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Benjamin Romero-Navarro
- Auxiliary Diagnostic Services, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City, Mexico
| | - Miguel Angel Villasis-Keever
- Analysis and Synthesis of the Evidence Research Unit, National Medical Center XXI Century, Instituto Mexicano del Seguro Social, Mexico City, Mexico
| | | | - Veronica Domínguez-Castillo
- Auxiliary Diagnostic Services, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City, Mexico
| | - José Carlos Romo-Vázquez
- Department of Pediatric Nephology, Hospital Infantil de México Federico Gómez, Ministry of Health (SSA), Mexico City, Mexico
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Cavarzere P, Pausilli R, Nicolussi Prinicpe L, Gaudino R, Guzzo A, Cantalupo G, Antoniazzi F. Decreased vitamin D levels in the pediatric population after COVID-19 lockdown. Ital J Pediatr 2023; 49:113. [PMID: 37670325 PMCID: PMC10478299 DOI: 10.1186/s13052-023-01515-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 08/19/2023] [Indexed: 09/07/2023] Open
Abstract
BACKGROUD SARS-Cov2 infection began to spread worldwide since December 2019; on March 2020, the World Health Organization characterized its related disease, named COVID-19, as a pandemic. In Italy, to contain the spread of infection a severe lockdown in the spring 2020 was instituted. Other less severe restrictions were imposed in the winter 2020-2021 and in the spring 2021. The containment measures caused a series of consequences for the population and, in particular, for children and adolescents that presented psychophysical problems. The aim of this manuscript is to investigate the serum levels of vitamin D in children and adolescents before, during and after the lockdown consequent to COVID-19 pandemic. METHODS This is a retrospective cross-sectional study, including all children and adolescents between 1 to 18 years referring to the Pediatric Endocrinology Service of the University Hospital of Verona, Italy, between January 2019 and December 2021. All patients affected by clinical conditions that involve vitamin D metabolism or assuming vitamin D supplementation were excluded. RESULTS In total, 491 children (36.7% males and 63.3% females) were enrolled in this study. The vitamin D levels decreased over time: 28.3 ± 10.2 ng/mL in 2019; 28.2 ± 11.4 ng/mL in 2020 and 24.9 ± 10.1 ng/mL in 2021 (p < 0.05). The vitamin D levels are significant higher in summer and in autumn in comparison with the levels of winter and spring, regardless of the examined years. CONCLUSIONS The measures adopted to contain the COVID-19 pandemic led to a reduction of serum levels of vitamin D in pediatric population, probably due to the reduced solar exposure. This may have severe consequences on the bone metabolism of those children who did not present optimal vitamin D levels even before the lockdown. Therefore, an adequate supplementation of vitamin D is necessary from the end of fall to the beginning of spring (November-April) in all children and adolescents living in Northern Italy.
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Affiliation(s)
- Paolo Cavarzere
- Pediatric Division, Department of Pediatrics, University Hospital of Verona, Piazzale Stefani 1, 37126, Verona, Italy.
| | - Romina Pausilli
- Pediatric Division, Department of Pediatrics, University Hospital of Verona, Piazzale Stefani 1, 37126, Verona, Italy
| | - Lara Nicolussi Prinicpe
- Pediatric Division, Department of Pediatrics, University Hospital of Verona, Piazzale Stefani 1, 37126, Verona, Italy
| | - Rossella Gaudino
- Pediatric Division, Department of Pediatrics, University Hospital of Verona, Piazzale Stefani 1, 37126, Verona, Italy
- Department Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona, Verona, Italy
| | - Alessandra Guzzo
- Laboratory Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - Gaetano Cantalupo
- Innovation Biomedicine Section, Department of Engineering for Innovation Medicine, University of Verona, Verona, Italy
- Child Neuropsychiatry Unit, University Hospital of Verona, Verona, Italy
| | - Franco Antoniazzi
- Pediatric Division, Department of Pediatrics, University Hospital of Verona, Piazzale Stefani 1, 37126, Verona, Italy
- Department Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona, Verona, Italy
- Regional Center for the Diagnosis and Treatment of Children and Adolescents With Rare Skeletal Disorders. Pediatric Clinic, Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy
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Smyczyńska J, Pawelak N, Hilczer M, Łupińska A, Lewiński A, Stawerska R. The Variability of Vitamin D Concentrations in Short Children with Short Stature from Central Poland-The Effects of Insolation, Supplementation, and COVID-19 Pandemic Isolation. Nutrients 2023; 15:3629. [PMID: 37630820 PMCID: PMC10459029 DOI: 10.3390/nu15163629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/13/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023] Open
Abstract
The aim of the study was to investigate the effects of seasonal variability of insolation, the implementation of new recommendations for vitamin D supplementation (2018), and the SARS-CoV-2 pandemic lockdown (2020) on 25(OH)D concentrations in children from central Poland. The retrospective analysis of variability of 25(OH)D concentrations during the last 8 years was performed in a group of 1440 children with short stature, aged 3.0-18.0 years. Significant differences in 25(OH)D concentrations were found between the periods from mid-2014 to mid-2018, from mid-2018 to mid-2020, and from mid-2020 to mid-2022 (medians: 22.9, 26.0, and 29.9 ng/mL, respectively). Time series models created on the grounds of data from 6 years of the pre-pandemic period and used for prediction for the pandemic period explained over 80% of the seasonal variability of 25(OH)D concentrations, with overprediction for the first year of the pandemic and underprediction for the second year. A significant increase in 25(OH)D concentrations was observed both after the introduction of new vitamin D supplementation guidelines and during the SARS-CoV-2 pandemic; however, the scale of vitamin D deficiency and insufficiency was still too high. Time series models are useful in analyzing the impact of health policy interventions and pandemic restrictions on the seasonal variability of vitamin D concentrations.
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Affiliation(s)
- Joanna Smyczyńska
- Department of Pediatrics, Diabetology, Endocrinology and Nephrology, Medical University of Lodz, 90-419 Lodz, Poland
| | - Natalia Pawelak
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital—Research Institute in Lodz, 93-338 Lodz, Poland; (N.P.); (M.H.); (A.Ł.); (A.L.); (R.S.)
| | - Maciej Hilczer
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital—Research Institute in Lodz, 93-338 Lodz, Poland; (N.P.); (M.H.); (A.Ł.); (A.L.); (R.S.)
| | - Anna Łupińska
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital—Research Institute in Lodz, 93-338 Lodz, Poland; (N.P.); (M.H.); (A.Ł.); (A.L.); (R.S.)
- Department of Pediatric Endocrinology, Medical University of Lodz, 93-338 Lodz, Poland
| | - Andrzej Lewiński
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital—Research Institute in Lodz, 93-338 Lodz, Poland; (N.P.); (M.H.); (A.Ł.); (A.L.); (R.S.)
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, 93-338 Lodz, Poland
| | - Renata Stawerska
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital—Research Institute in Lodz, 93-338 Lodz, Poland; (N.P.); (M.H.); (A.Ł.); (A.L.); (R.S.)
- Department of Pediatric Endocrinology, Medical University of Lodz, 93-338 Lodz, Poland
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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:nu15102345. [PMID: 37242228 DOI: 10.3390/nu15102345] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [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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Mosca C, Colucci A, Savoia F, Calì C, Del Bene M, Ranucci G, Maglione A, Pepe A, Morelli A, Vajro P, Mandato C. Vitamin D Levels in the Pre- and Post-COVID-19 Pandemic Periods and Related Confinement at Pediatric Age. Nutrients 2023; 15:2089. [PMCID: PMC10181113 DOI: 10.3390/nu15092089] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 04/19/2023] [Accepted: 04/24/2023] [Indexed: 06/01/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) restrictions have been correlated with vitamin D deficiency in children, but some uncertainties remain. We retrospectively studied vitamin 25-(OH) D blood levels in 2182 Italian children/adolescents hospitalized for various chronic diseases in the year before (n = 1052) and after (n = 1130) the nationwide lockdown. The type of underlying disease, gender, and mean age (91 ± 55 and 91 ± 61 months, respectively) of patients included in the two periods were comparable. Although mean levels were the same (p = 0.24), deficiency status affected a significantly higher number of subjects during the lockdown period than in the pre-COVID period (p = 0.03), particularly in summer (p = 0.02), and there was also a smoothing of seasonal variations in vitamin D levels. Particularly at risk were males (OR = 1.22; p = 0.03), the 1–5 year age group (OR = 1.57; p < 0.01) and the 6–12 year age group (OR = 1.30; p = 0.04). Infants appeared not to be affected (p = 1.00). In the post-COVID period, the risk of vitamin D deficiency was unchanged in disease-specific groups. However, the proportion of deficiency or severe deficiency differed significantly in the subgroup with endocrinopathy (higher; Chi-square p = 0.04), and with respiratory problems and obesity (lower; Chi-square p = 0.01 and p < 0.01, respectively). Conflicting/opposite literature results advocate for further studies to clearly indicate the need for supplementation during possible future periods of confinement.
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Affiliation(s)
- Caterina Mosca
- Department of Translational Medical Science, Section of Pediatrics, University Federico II, 80131 Naples, Italy
| | - Angelo Colucci
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy
| | - Fabio Savoia
- Epidemiology, Biostatistic and Childhood Cancer Registry of Campania, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy
| | - Camilla Calì
- Epidemiology, Biostatistic and Childhood Cancer Registry of Campania, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy
| | - Margherita Del Bene
- Department of Translational Medical Science, Section of Pediatrics, University Federico II, 80131 Naples, Italy
| | - Giusy Ranucci
- Pediatric Department for the Treatment and Study of Abdominal Diseases and Abdominal Transplantation, IRCCS ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), University of Pittsburgh Medical Center, 90127 Palermo, Italy
| | - Antonio Maglione
- Pediatric Emergency Unit, Santobono-Pausilipon Children’s Hospital, 80129 Naples, Italy
| | - Angela Pepe
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy
| | - Annalisa Morelli
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy
| | - Pietro Vajro
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy
| | - Claudia Mandato
- Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, Pediatrics Section, University of Salerno, 84081 Baronissi, Italy
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10
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Zeidan NMS, Lateef HMAE, Selim DM, Razek SA, Abd-Elrehim GAB, Nashat M, ElGyar N, Waked NM, Soliman AA, Elhewala AA, Shehab MMM, Ibraheem AAA, Shehata H, Yousif YM, Akeel NE, Hashem MIA, Ahmed AA, Emam AA, Abdelmohsen MM, Ahmed MF, Saleh ASE, Eltrawy HH, Shahin GH, Nabil RM, Hosny TA, Abdelhamed MR, Afify MR, Alharbi MT, Nagshabandi MK, Tarabulsi MK, Osman SF, Abd-Elrazek ASM, Rashad MM, El-Gaaly SAA, Gad SAB, Mohamed MY, Abdelkhalek K, Yousef AA. Vitamin D deficiency and vitamin D receptor FokI polymorphism as risk factors for COVID-19. Pediatr Res 2023; 93:1383-1390. [PMID: 36085364 PMCID: PMC9461391 DOI: 10.1038/s41390-022-02275-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Revised: 07/22/2022] [Accepted: 08/05/2022] [Indexed: 01/22/2023]
Abstract
BACKGROUND Given the sparse data on vitamin D status in pediatric COVID-19, we investigated whether vitamin D deficiency could be a risk factor for susceptibility to COVID-19 in Egyptian children and adolescents. We also investigated whether vitamin D receptor (VDR) FokI polymorphism could be a genetic marker for COVID-19 susceptibility. METHODS One hundred and eighty patients diagnosed to have COVID-19 and 200 matched control children and adolescents were recruited. Patients were laboratory confirmed as SARS-CoV-2 positive by real-time RT-PCR. All participants were genotyped for VDR Fok1 polymorphism by RT-PCR. Vitamin D status was defined as sufficient for serum 25(OH) D at least 30 ng/mL, insufficient at 21-29 ng/mL, deficient at <20 ng/mL. RESULTS Ninety-four patients (52%) had low vitamin D levels with 74 (41%) being deficient and 20 (11%) had vitamin D insufficiency. Vitamin D deficiency was associated with 2.6-fold increased risk for COVID-19 (OR = 2.6; [95% CI 1.96-4.9]; P = 0.002. The FokI FF genotype was significantly more represented in patients compared to control group (OR = 4.05; [95% CI: 1.95-8.55]; P < 0.001). CONCLUSIONS Vitamin D deficiency and VDR Fok I polymorphism may constitute independent risk factors for susceptibility to COVID-19 in Egyptian children and adolescents. IMPACT Vitamin D deficiency could be a modifiable risk factor for COVID-19 in children and adolescents because of its immune-modulatory action. To our knowledge, ours is the first such study to investigate the VDR Fok I polymorphism in Caucasian children and adolescents with COVID-19. Vitamin D deficiency and the VDR Fok I polymorphism may constitute independent risk factors for susceptibility to COVID-19 in Egyptian children and adolescents. Clinical trials should be urgently conducted to test for causality and to evaluate the efficacy of vitamin D supplementation for prophylaxis and treatment of COVID-19 taking into account the VDR polymorphisms.
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Affiliation(s)
- Nancy M S Zeidan
- Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt
| | | | - Dalia M Selim
- Department of Pediatrics, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Suzan A Razek
- Department of Pediatrics, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | | | - Mohamed Nashat
- Department of Pediatrics, Faculty of Medicine, Aswan University, Aswan, Egypt
| | - Noha ElGyar
- Department of Pediatrics, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Nevin M Waked
- Department of Pediatrics, Faculty of Medicine, October 6 University, 6th of October City, Egypt
| | - Attia A Soliman
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed A Elhewala
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed M M Shehab
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed A A Ibraheem
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Hassan Shehata
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Yousif M Yousif
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Nagwa E Akeel
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mustafa I A Hashem
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Amani A Ahmed
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Ahmed A Emam
- Department of Pediatrics, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
| | - Mohamed M Abdelmohsen
- Department of Pediatrics, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt
| | - Mohamed F Ahmed
- Department of Pediatrics, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt
| | - Ahmed S E Saleh
- Department of Otorhinolaryngology, Faculty of Medicine, Benha University, Benha, Egypt
| | - Heba H Eltrawy
- Department of Chest Diseases, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt
| | - Gehan H Shahin
- Department of Clinical Pathology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Rehab M Nabil
- Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Thoraya A Hosny
- Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | - Mona R Afify
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Mohanned T Alharbi
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Mohammed K Nagshabandi
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Muyassar K Tarabulsi
- Department of Medical Microbiology and Parasitology, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Sherif F Osman
- Department of Radiology, Texas Tech University Health Sciences Center, El Paso, TX, USA
| | | | - Manal M Rashad
- Department of Anesthesia, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Sonya A A El-Gaaly
- Department of Internal Medicine, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Said A B Gad
- Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | - Mohamed Y Mohamed
- Department of Psychiatry, Faculty of Medicine, Ain-Shams University, Cairo, Egypt
| | - Khalil Abdelkhalek
- Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Aly A Yousef
- Department of Pediatrics, Faculty of Medicine, Helwan University, Helwan, Egypt
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11
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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:nu15051132. [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] [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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12
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COVID-19 Inflammatory Markers and Vitamin D Relationship in Pediatric Patients. LIFE (BASEL, SWITZERLAND) 2022; 13:life13010091. [PMID: 36676040 PMCID: PMC9864767 DOI: 10.3390/life13010091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 12/22/2022] [Accepted: 12/23/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Biomarkers play an important role in COVID-19, and more research in this regard is needed, especially in the case of children. This study aimed to look for a link between the C reactive protein (CRP), lactate dehydrogenase (LDH), creatine kinase (CK), vitamin D and COVID-19 in pediatric patients. METHODS This is a retrospective cohort study, performed on children diagnosed positively with COVID-19 at a children's hospital in western Romania. Available CRP, LDH, CK vitamin D and clinical severity were recorded. For each biomarker, groups were formed by patients' age. Mean/median group differences were assessed using Student's t test or Mann-Whitney and Kruskal-Wallis with Dunn's post hoc tests. Association was assessed using the chi2 test, while correlation was assessed using Spearman's rank correlation. RESULTS 181 positive children were studied between 1 August 2021 and 1 February 2022. Average age was 8.76 years (SD = 3.93). There were 94 (51.93%) males and 87 (48.07%) females. The cases were: 62 asymptomatic (34.25%), 107 mild (59.12%), 9 moderate (4.97%), 3 severe (1.66%). Regarding CRP, a significant difference between older and younger patients was observed (p = 0.0034). Clinical severity was associated with CRP (p = 0.0281), LDH (p = 0.0410) and vitamin D (p = 0.0444). Regarding CK, no differences or associations proved significant. Correlation testing was conducted for CRP, LDH, vitamin D and clinical signs. With the exception of LDH-CRP and LDH-vitamin D, all relationships proved statistically significant. CONCLUSIONS CRP, LDH and vitamin D levels are important biomarkers for COVID-19-positive pediatric patients, while CK was mostly within normal ranges.
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Miraglia del Giudice M, Indolfi C, Dinardo G, Decimo F, Decimo A, Klain A. Vitamin D status can affect COVID-19 outcomes also in pediatric population. PHARMANUTRITION 2022; 22:100319. [PMID: 36268528 PMCID: PMC9562619 DOI: 10.1016/j.phanu.2022.100319] [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: 05/03/2022] [Revised: 10/12/2022] [Accepted: 10/12/2022] [Indexed: 11/03/2022]
Abstract
Background vitamin D influences the immune system and the inflammatory response. It is known that vitamin D supplementation reduces the risk of acute respiratory tract infection. In the last two years, many researchers have investigated vitamin D's role in the pathophysiology of COVID-19 disease. Results the findings obtained from clinical trials and systematic reviews highlight that most patients with COVID-19 have decreased vitamin D levels and low levels of vitamin D increase the risk of severe disease. This evidence seems to be also confirmed in the pediatric population. Conclusions further studies (systematic review and meta-analysis) conducted on children are needed to confirm that vitamin D affects COVID-19 outcomes and to determine the effectiveness of supplementation and the appropriate dose, duration and mode of administration.
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Key Words
- , IFN-γ, reduce interferon-gamma
- , RAS, renin-angiotensin system
- ACE2, angiotensin-converting enzyme 2
- CI, confidence interval
- COVID-19
- Children
- DAMPs, damage-associated molecular patterns
- DCs, dendritic cells
- HR, Hazard Risk
- ICU, intensive care unit
- IL, interleukin
- IgE, immunoglobulin E
- Immunity
- MD, mean difference
- NK, natural killer
- OR, odds ratio
- PAMPs, pathogen-associated molecular patterns
- PRRs, pattern recognition receptors
- RCTs, randomized control trials
- RR, risk ratio
- SARS-CoV-2 infection
- TLRs, Toll-like receptors
- TNF-α, tumor necrosis factor-α
- Treg cells, CD, regulatory T cellcluster of differentiation
- VDRs, vitamin D receptors
- Vitamin D
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Affiliation(s)
- Michele Miraglia del Giudice
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy,Correspondence to: Department of Woman, Child and General and Specialized Surgery, University of Campania “Luigi Vanvitelli”, Via Luigi de Crecchio, 4, 80138 Naples, Italy
| | - Cristiana Indolfi
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Giulio Dinardo
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Fabio Decimo
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alberto Decimo
- Department of Mental, Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Angela Klain
- Department of Woman, Child and General and Specialized Surgery, University of Campania "Luigi Vanvitelli", Naples, Italy
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14
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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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15
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Shobako N. Lessons from the health policies for children during the pandemic in Japan. Front Public Health 2022; 10:1015955. [PMID: 36339184 PMCID: PMC9628751 DOI: 10.3389/fpubh.2022.1015955] [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: 08/10/2022] [Accepted: 09/21/2022] [Indexed: 01/28/2023] Open
Abstract
It is everyone's desire to seek the sound growth of children through food education and there is a critical need for fostering an environment for this purpose. Health policies are important for this support. To the present, the Japanese society has been greatly disrupted by COVID-19 pandemic. "Stay at home", "mokusyoku (silent eating)", and mask wearing were encouraged in nationwide campaigns as public health measures to combat COVID-19. There are some papers reporting negative effects of "stay at home" and lockdowns such as weight gain, decrease in physical activities and change in eating habits. In Japan, while benefits and advantages of food education during mealtime were previously well studied, the "mokusyoku" rule may directly run counter to this food education. Moreover, there are several reports showing that nutrients might contribute to prevention of infectious diseases. Japanese children were also encouraged to wear masks all day long. The results of the clinical research, especially randomized control trials, show limited protective effect of masks. On the other hand, negative outcomes of the masks were reported in various scenes. This review focuses on these topics and arousing reconsideration for a better environment for children.
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