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1.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-311652

ABSTRACT

Background: The changes and general alarm of the current COVID-19 pandemic have amplified the sense of precariousness and vulnerability for family members who, in addition to the emotional trauma of the cancer diagnosis, add the distress and fear of the risks associated with infection. The primary objectives of the present study was to investigate the psychological impact of the COVID-19 pandemic on the parents of pediatric cancer patients, and to investigate the level of stress, anxiety, and the child’s quality of life perceived by the parents during the Covid-19 epidemic. Methods. The parents of 45 consecutive children with solid and haematological tumors were enrolled. Four questionnaires (Impact of Event Scale-Revised - IES-R ;Perceived Stress Scale - PSS;Spielberger State - Trait Anxiety Inventory - STAI-Y ;Pediatric Quality of Life Inventory - PedsQL) were administered to the parents at the beginning of the pandemic lockdown. Results. 75% of parents exhibited remarkable levels of anxiety, with 60 subjects in state scale and 45 subjects in trait scale having scores that reached and exceeded the STAI-Y cut off. The bivariate matrix of correlation (Figure 1) found a strong significant positive correlation between the IES-R and PSS scores (r = 0.55, P < 0.001). There was a positive correlations between the PSS and PedsQL (emotional needs) scale (P < 0.001) and a negative correlation between IES-R and STAI-Y (P < 0.001). Conclusion. The results confirm that parents of pediatric cancer patients have a high psychological risk for post-traumatic symptoms, high stress levels, and the presence of clinically significant levels of anxiety.

2.
Rev Endocr Metab Disord ; 22(4): 1201-1218, 2021 12.
Article in English | MEDLINE | ID: covidwho-1630454

ABSTRACT

The 4th International Conference on Controversies in Vitamin D was held as a virtual meeting in September, 2020, gathering together leading international scientific and medical experts in vitamin D. Since vitamin D has a crucial role in skeletal and extra-skeletal systems, the aim of the Conference was to discuss improved management of vitamin D dosing, therapeutic levels and form or route of administration in the general population and in different clinical conditions. A tailored approach, based on the specific mechanisms underlying vitamin D deficiency in different diseases that were discussed, was recommended. Specifically, in comparison to healthy populations, higher levels of vitamin D and greater amounts of vitamin D were deemed necessary in osteoporosis, diabetes mellitus, obesity (particularly after bariatric surgery), and in those treated with glucocorticoids. Emerging and still open issues were related to target vitamin D levels and the role of vitamin D supplementation in COVID-19 since low vitamin D may predispose to SARS-CoV-2 infection and to worse COVID-19 outcomes. Finally, whereas oral daily cholecalciferol appears to be the preferred choice for vitamin D supplementation in the general population, and in most clinical conditions, active vitamin D analogs may be indicated in patients with hypoparathyroidism and severe kidney and liver insufficiency. Parenteral vitamin D administration could be helpful in malabsorption syndromes or in states of vitamin D resistance.Specific guidelines for desired levels of vitamin D should be tailored to the different conditions affecting vitamin D metabolism with the goal to define disease-specific normative values.


Subject(s)
COVID-19 , Vitamin D Deficiency , Cholecalciferol , Humans , SARS-CoV-2 , Vitamin D , Vitamin D Deficiency/drug therapy
3.
Front Endocrinol (Lausanne) ; 12: 726696, 2021.
Article in English | MEDLINE | ID: covidwho-1581362

ABSTRACT

Epidemiological evidence shows clear gender disparities in the Coronavirus 2019 Disease (COVID-19) severity and fatality. This may reflect the contribution of gender-related factors, such as sex hormones, to COVID-19 pathogenesis. However, the mechanism linking gender disparities to COVID-19 severity is still poorly understood. In this review, we will pinpoint several elements involved in COVID-19 pathogenesis that are regulated by the two main sex hormones, estrogen and androgen. These include tissue specific gene regulation of SARS-CoV2 entry factors, innate and adaptive immune responses to infection, immunometabolism, and susceptibility to tissue injury by cytopathic effect or hyper-inflammatory response. We will discuss the mechanistic link between sex hormone regulation of COVID-19 pathogenetic factors and disease severity. Finally, we will summarize current evidence from clinical studies and trials targeting sex hormones and their signalling in COVID-19. A better understanding of the role of sex hormones in COVID-19 may identify targets for therapeutic intervention and allow optimization of treatment outcomes towards gender-based personalised medicine.


Subject(s)
Androgens/immunology , COVID-19/immunology , Estrogens/immunology , SARS-CoV-2/immunology , Androgens/metabolism , Angiotensin-Converting Enzyme 2/immunology , Angiotensin-Converting Enzyme 2/metabolism , COVID-19/metabolism , COVID-19/virology , Estrogens/metabolism , Female , Humans , Male , SARS-CoV-2/metabolism , SARS-CoV-2/physiology , Sex Factors , Virus Internalization
4.
Endocrine ; 74(3): 461-469, 2021 12.
Article in English | MEDLINE | ID: covidwho-1411789

ABSTRACT

BACKGROUND AND OBJECTIVE: Bone fragility has been linked to COVID-19 severity. The objective of this study was to evaluate whether a diagnosis of vertebral fracture (VF) increased mortality risk in COVID-19 patients and whether this effect was greater than in those without COVID-19. METHODS: We assessed VFs by computed tomography (CT) in a cohort of 501 patients consecutively admitted to the emergency department (ED) for clinical suspicion of SARS-CoV-2 infection during the first wave of pandemic emergency. Of those, 239 had a confirmed diagnosis of COVID-19. RESULTS: VF prevalence was similar between COVID-19 and non-COVID-19 groups (22.2 vs. 19%; p = 0.458). Death rates were similar between COVID-19 and non-COVID-19 groups at both 30 (15.8 vs. 12.2%; p = 0.234) and 120 days (21.8 vs. 17.6%; p = 0.236). The mortality risk was higher in COVID-19 patients either with one or multiple fractures compared to those without VFs, at 30 and 120 days, but statistical significance was reached only in those with multiple VFs (30-day HR 3.03, 95% CI 1.36-6.75; 120-day HR 2.91, 95% CI 1.43-5.91). In the non-COVID-19 group, the 30-day mortality risk was significantly higher in patients either with one (HR 7.46, 95% CI 3.12-17.8) or multiple fractures (HR 6.2, 95% CI 2.75-13.98) compared to those without VFs. A similar effect was observed at 120 days. After adjustment for age, sex and bone density, mortality risk remained associated with VFs in the non-COVID-19 group only. CONCLUSIONS: VFs were not independently associated with short-term mortality in patients with COVID-19, but they strongly increased mortality risk in those without COVID-19.


Subject(s)
COVID-19 , Osteoporotic Fractures , Spinal Fractures , Bone Density , Emergency Service, Hospital , Humans , Osteoporotic Fractures/diagnostic imaging , Osteoporotic Fractures/epidemiology , Pandemics , SARS-CoV-2 , Spinal Fractures/diagnostic imaging , Spinal Fractures/epidemiology
5.
Endocrine ; 72(3): 597-603, 2021 06.
Article in English | MEDLINE | ID: covidwho-1230294

ABSTRACT

Vitamin D (VITD) is a key hormone for bone health and has relevant extra-skeletal effects that might play a role in the prevention and treatment of COronaVIrus Disease 19 (COVID-19). Literature regarding this scenario is voluminous but controversial. Glucocorticoid Induced Osteoporosis Skeletal Endocrinology Group (G.I.O.S.E.G) has been present in the scientific debate about the use of VITD and has regularly interfaced national regulatory agencies to ensure appropriateness of its employment. Given the current pandemic and the questions on COVID-19 and VITD, G.I.O.S.E.G. appointed an expert panel to advise how to consider this issue best. The results of these deliberations are reported in the current recommendation paper.


Subject(s)
COVID-19 , Vitamin D , Humans , Pandemics , SARS-CoV-2 , Vitamins
8.
Eur J Endocrinol ; 183(5): R133-R147, 2020 Nov.
Article in English | MEDLINE | ID: covidwho-695333

ABSTRACT

The SARS-CoV-2 virus responsible for the COVID-19 pandemic has generated an explosion of interest both in the mechanisms of infection leading to dissemination and expression of this disease, and in potential risk factors that may have a mechanistic basis for disease propagation or control. Vitamin D has emerged as a factor that may be involved in these two areas. The focus of this article is to apply our current understanding of vitamin D as a facilitator of immunocompetence both with regard to innate and adaptive immunity and to consider how this may relate to COVID-19 disease. There are also intriguing potential links to vitamin D as a factor in the cytokine storm that portends some of the most serious consequences of SARS-CoV-2 infection, such as the acute respiratory distress syndrome. Moreover, cardiac and coagulopathic features of COVID-19 disease deserve attention as they may also be related to vitamin D. Finally, we review the current clinical data associating vitamin D with SARS-CoV-2 infection, a putative clinical link that at this time must still be considered hypothetical.


Subject(s)
Adaptive Immunity/immunology , Coronavirus Infections/immunology , Cytokine Release Syndrome/immunology , Immunity, Innate/immunology , Immunocompetence/immunology , Lung/immunology , Pneumonia, Viral/immunology , T-Lymphocytes/immunology , Vitamin D/immunology , Antimicrobial Cationic Peptides/immunology , Autophagy/immunology , Betacoronavirus , COVID-19 , Defensins/immunology , Humans , Pandemics , SARS-CoV-2 , T-Lymphocytes, Regulatory/immunology , Th1 Cells/immunology , Th17 Cells/immunology , Th2 Cells/immunology , Vitamin D/analogs & derivatives
10.
Endocrine ; 69(2): 237-240, 2020 08.
Article in English | MEDLINE | ID: covidwho-648625

ABSTRACT

Coronavirus 2019 disease (COVID-19) mostly adversely affects the elderly, a population at higher risk for low serum 25-hydroxyvitamin D (25(OH)D) levels. In this viewpoint, we highlight the well-known musculoskeletal properties of vitamin D, which are particularly relevant in the context of COVID-19, suggesting further potential benefits through extra-skeletal effects. Maintaining optimal 25(OH)D is crucial to prevent falls, frailty and fractures in elderly patients, with low activity levels due to lockdown, or who are relatively immobilized during hospitalization and after discharge for prolonged periods of time. Hypovitaminosis D is also associated with susceptibility to respiratory infections, admissions to the intensive care unit, and mortality. We underscore the importance of achieving desirable serum 25(OH)D in COVID-19 elderly patients, to ensure beneficial musculoskeletal effects and possibly respiratory effects of vitamin D, in the context of COVID-19.


Subject(s)
Bone Density Conservation Agents/therapeutic use , Coronavirus Infections/complications , Fractures, Bone/prevention & control , Pneumonia, Viral/complications , Vitamin D Deficiency/complications , Vitamin D/therapeutic use , Accidental Falls/prevention & control , Aged , COVID-19 , Humans , Pandemics , Vitamin D Deficiency/prevention & control
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