The relationship between vitamin D deficiency and mortality in older adults before and during COVID-19 pandemic.

BACKGROUND: Vitamin D is an essential fat-soluble vitamin thought to be associated with chronic diseases, mortality and COVID-19. OBJECTIVE: To investigate the association between 25(OH) vitamin D levels and mortality of chronic diseases in subjects aged ≥65 years before and during COVID-19 pandemic. METHODS: A single-center, retrospective study was performed using the hospital database of subjects aged 65 years and older who had undergone vitamin D measurement between 01.01.2019 and 31.12.2021. All patients with vitamin D measurement (N = 2155) were followed as a cohort from the date of serum vitamin D analysis through death date or 01.01.2022. Age, gender, chronic diseases, survival status, date of death of the deceased, laboratory values including complete blood count, liver/renal functions and 25(OH) vitamin D levels were all noted. Subjects were classified into three groups according to their 25(OH) vitamin D levels; severe deficient group (<10 ng/ml), moderate deficient group (10-19.9 ng/ml), and control group (≥20 ng/ml). RESULTS: Data of 1949 subjects were included in this retrospective analysis and 206 of them (10.6%) had at least two vitamin D measurements. Until the time of data collection (01.01.2022), 94 of the cases had died within the last three years, and only five of them had repeated measurements. While the mean vitamin D level was lower, age and frequency of dyslipidemia, coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), arrhythmia, dementia and severe vitamin D deficiency (<10 ng/ml) were higher in subjectswho died (all p<0.05). According to the Cox proportional hazards model; age, presence of CAD, COPD, arrhythmia, dementia, anemia and severe vitamin D deficiency were independently related with mortality (all p<0.05). After adjusted by age, gender, and comorbidities, the probability of death was found to be 1.91 (95% CI=1.12-3.24) times higher in the severe vitamin D deficient group. CONCLUSIONS: The results of this study have shown that - after having adjusted for potential factors - severe vitamin D deficiency (<10 ng/ml) seems to be an independent predictor for non-cancer mortality. Although vitamin D measurement/treatment is very easy and cheap where, on the contrary, severe vitamin D deficiency can be quite mortal.

Grip strength as a predictor of disease severity in hospitalized COVID-19 patients.

BACKGROUND: Grip strength is one of the main components for the physical functioning in sarcopenia and physical frailty. OBJECTIVES: To explore the role of grip strength measurement at admission for predicting disease severity in COVID-19. METHODS: Demographic data, smoking status, comorbidities, COVID-19 related symptoms, grip strength, laboratory and computed tomography (CT) findings at admission were all noted. Using a Smedley hand dynamometer, the maximum grip strength value (kg) after three measurements on the dominant side was recorded. Low grip strength was defined as two standard deviations below the gender-specific peak mean value of the healthy young adults (<32 kg for males, <19 kg for females). Patients were categorized into three groups according to clinical and CT findings. Severe illness group had pneumonia with a respiratory rate >30/min, oxygen saturation ≤90%, or extensive lung involvement in CT. Moderate illness group had pneumonia with CT score ≤11. Mild illness group had normal CT findings. RESULTS: The study population included 312 patients (140 F, 172 M). The distribution of mild, moderate and severe disease groups were 36.9%, 51.0% and 12.2%, respectively. Cough, fever, dyspnea, hypertension, obesity, cardiovascular disease (CVD) and chronic obstructive pulmonary disease (COPD) were most frequent, and C-reactive protein (CRP), ferritin, D-dimer, and neutrophil levels were highest in the severe group (all p<.05). Absolute grip strength values were lowest and the frequency of having low grip strength were highest in the severe group (both p<.01). Since we found that the significant differences were stemming from the severe group, we combined the mild and moderate group as non-severe, and compared severe vs. non-severe groups with binary logistic regression analyses. When age, gender, body mass index, smoking status, presence of comorbidities and low grip strength, and abnormal laboratory findings were taken into analyses; age (odds ratio [OR]: 1.054 [95% confidence interval (CI): 1.020-1.089]), obesity (OR: 2.822 [95% CI: 1.143-6.966]), COPD (OR: 5.699 [95 %CI: 1.231-26.383]), CRP level (OR: 1.023 [95% CI: 1.010-1.036]) and low grip strength (OR: 3.047 [95% CI: 1.146-8.103]) were observed to be independent predictors for severe COVID-19 disease (all p<.05). CONCLUSIONS: In addition to the well-known independent risk factors (i.e. age, obesity, COPD, and CRP level), low grip strength independently increased (about three times) the severity of COVID-19.

'Scientific Strabismus' or two related pandemics: coronavirus disease and vitamin D deficiency.

The WHO has announced the novel coronavirus disease (COVID-19) outbreak to be a global pandemic. The distribution of community outbreaks shows seasonal patterns along certain latitude, temperature and humidity, that is, similar to the behaviour of seasonal viral respiratory tract infections. COVID-19 displays significant spread in northern mid-latitude countries with an average temperature of 5­11°C and low humidity. Vitamin D deficiency has also been described as pandemic, especially in Europe. Regardless of age, ethnicity and latitude, recent data showed that 40 % of Europeans are vitamin D deficient (25-hydroxyvitamin D (25(OH)D) levels <50 nmol/l), and 13 % are severely deficient (25(OH)D < 30 nmol/l). A quadratic relationship was found between the prevalences of vitamin D deficiency in most commonly affected countries by COVID-19 and the latitudes. Vitamin D deficiency is more common in the subtropical and mid-latitude countries than the tropical and high-latitude countries. The most commonly affected countries with severe vitamin D deficiency are from the subtropical (Saudi Arabia 46 %; Qatar 46 %; Iran 33·4 %; Chile 26·4 %) and mid-latitude (France 27·3 %; Portugal 21·2 %; Austria 19·3 %) regions. Severe vitamin D deficiency was found to be nearly 0 % in some high-latitude countries (e.g. Norway, Finland, Sweden, Denmark and Netherlands). Accordingly, we would like to call attention to the possible association between severe vitamin D deficiency and mortality pertaining to COVID-19. Given its rare side effects and relatively wide safety, prophylactic vitamin D supplementation and/or food fortification might reasonably serve as a very convenient adjuvant therapy for these two worldwide public health problems alike.

Saporin, a Polynucleotide-Adenosine Nucleosidase, May Be an Efficacious Therapeutic Agent for SARS-CoV-2 Infection.

Saporin, a type I ribosome-inactivating protein from soapwort plant, is a potent protein synthesis inhibitor. Catalytically, saporin is a characteristic N-glycosidase, and it depurinates a specific adenine residue from a universally conserved loop of the major ribosomal RNA (rRNA) of eukaryotic cells. It is well-known that saporin induces apoptosis through different pathways, including ribotoxic stress response, cell signal transduction, genomic DNA fragmentation and RNA abasic lyase (RAlyase) activity, and NAD+ depletion by poly-(ADP)-ribose polymerase hyperactivation. Saporin's high enzymatic activity, high stability, and resistance to conjugation procedures make it a well-suited tool for immunotherapy approaches.In the present study, we focus on saporin-based targeted toxins that may be efficacious therapeutic agents for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Our discussed points suggest that saporin may be a strategic molecule for therapeutic knockout treatments and a powerful candidate for novel drugs in the struggle against coronavirus 2019 (COVID-19).

Impact of COVID-19 outbreak on plastic surgery: Taken precautions, distribution of surgical procedures and changes in admissions to outpatient clinic.

The COVID-19 outbreak is a global problem affecting the world in many respects. In the medical field, its impact on surgical branches as well as clinical branches is inevitable. From the plastic surgery perspective, the COVID-19 outbreak affects the number and distribution of surgeries, patient admissions and educational activities. Although these impacts are predictable, it is beneficial to document these data that would contribute to the proper response to a similar crisis in the future. From this standpoint, the present study aims to analyze the effect of the COVID-19 pandemic on plastic surgery practice in some aspects. Epidemiologic data of the two-time frames, routine period, and pandemic period of plastic surgery were reviewed retrospectively. The ratios of the listed data were compared between the two periods; admissions to the outpatient clinic, surgeries, consultations, anesthesia type, hospitalizations, and demographic data. While the number of outpatient clinic patients was 3511 in the routine period, it was 490 in the pandemic period. Compared to the routine period, the number of surgical interventions was decreased from 793 to 129 during the pandemic period. In particular, a statistically significant increase was observed in the rate of hand trauma and maxillofacial trauma cases during the pandemic period compared with the routine period (p < 0.001, and p = 0.032, respectively). Therefore, high rates of hand trauma and maxillofacial trauma should be taken into consideration when making arrangements such as personnel distribution, use of medical resources, and regulation of hospital infrastructure in extraordinary situations like COVID-19 pandemics.