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Gastroenterology ; 162(7):S-459-S-460, 2022.
Article in English | EMBASE | ID: covidwho-1967306


Background and aims: Micronutrient supplements such as vitamin D, vitamin C, and zinc have been used in managing viral illnesses. However, the role of these micronutrients in reducing mortality in patients with Coronavirus disease 2019 (COVID-19) remains unclear. We conducted this meta-analysis to provide a quantitative assessment of the effect of these individual micronutrients on mortality in COVID-19. Methods: We performed a comprehensive literature search using MEDLINE, Embase, and Cochrane databases through November 5th, 2021. All individual micronutrients reported by ≥3 studies and compared with standardof- care (SOC) were included. The outcome was mortality. All statistical analyses were performed using the Review Manager. Pooled risk ratios (RR) and corresponding 95% confidence intervals (CI) were calculated using the random-effects model. Results: We involving 5573 COVID-19 patients that compared three individual micronutrient supplements (vitamin C, vitamin D, and zinc) with SOC. Eight studies evaluated vitamin C in 1338 patients (530 in vitamin C and 808 in SOC). Vitamin C supplementation had no significant effect on the risk of mortality (RR 1.06, 95% CI 0.63-1.80, P=0.82, Figure 1A). Fourteen studies assessed the impact of vitamin D supplementation on mortality risk among 3497 patients (927 in vitamin D and 2570 in SOC). Vitamin D did not reduce the mortality risk in patients (RR 0.75, 95% CI 0.49-1.17, P=0.21, Figure 1B). Subgroup analysis showed that vitamin D supplementation was not associated with a mortality benefit in patients receiving vitamin D pre or post COVID-19 diagnosis (Figure 1B). Five studies, including 738 patients, compared zinc intake with SOC (447 in zinc and 291 in SOC). Zinc supplementation was not associated with a significant reduction of mortality (RR 0.79, 95% CI 0.60- 1.03, P=0.08, Figure 1C). Subgroup analyses of RCTs for all three micronutrient supplements showed consistent findings (Figure 2). Conclusions: Individual micronutrient supplementations, including vitamin C, vitamin D, and zinc, did not reduce mortality in patients with COVID-19. Further research is needed to validate our findings. (Figure Presented)

Gastroenterology ; 162(7):S-374, 2022.
Article in English | EMBASE | ID: covidwho-1967301


Background: Pancreatic involvement in patients with Coronavirus 2019 (COVID-19) has been reported in the literature. The pancreatic injury in COVID-19 patients might be a result of the direct cytopathic effect of viral replication or indirectly related to the immune response to the viral infection. Methods:Westudied 183 patients diagnosed with symptomatic SARS-CoV-2 and admitted to COVID-19 facilities in Qatar. We included only the patients with documented positive SARS-COV-2 PCR and measured lipase levels. The cohort was categorized into two groups based on the serum lipase level. The cutoff was the elevation of the serum lipase more than three times the upper limit of normal. Patients with lipase levels below the cutoff were included in the first group, and those with lipase levels above the cutoff were included in the second group. The primary outcome was mortality. The secondary outcomes were disease severity on presentation and markers of disease progression. Markers of disease progression (Table 1) included the development of acute respiratory distress syndrome (ARDS), shock, multi-organ failure, the requirement for ICU admission, mechanical ventilation, continuous renal replacement therapy (CRRT), and extracorporeal membrane oxygenation (ECMO). Results: Our study population had a mean age of 49 and a mean BMI of 28. There was a male predominance in the study sample (more than 91%), reflecting the country's demographics. There was no statistically significant difference between the two groups in the mean age, BMI, gender distribution, or patients' reported symptoms. There was an increased prevalence of diabetes mellitus (DM) and hypertension (HTN) in our study population (45.4% and 44.8%). Apart from the increased prevalence of chronic liver disease in the second group, there was no statistically significant difference in the prevalence of comorbidities (e.g., DM, HTN) between the two groups (Table 1). The second group showed a statistically significant increase in mean creatinine, troponin, procalcitonin, ferritin, and amylase compared to the first group. On the other hand, the mean hemoglobin, sodium and albumin were lower (Table 2). Interestingly, more patients in the second group received tocilizumab and oseltamivir (Table 1). The mortality rate in our study population was 15.3%, with a higher mortality rate in the second group (Table 1). Almost 50% of the patients developed ARDS. Multiple markers of disease progression, including the development of ARDS, shock, and multi-organ failure;requirement for ICU, mechanical ventilation, and CRRT were increased in the second group compared to the first group. Also, the mean length of stay was higher in the second group (Table 1). Conclusion: Based on our study, hospitalized patients with COVID-19 who had higher lipase levels had a higher mortality rate and higher risk for disease progression. (Table Presented)