ABSTRACT
Background: Several studies suggest an association between serum Vitamin D levels and outcomes in patients diagnosed with COVID-19. Prevention measures for COVID-19 continue to be one of the best strategies to combat the virus but identification of individuals at high risk will help clinician's direct preventative care to reduce infections and improve outcomes. This work assesses the vitamin D levels of hospitalized COVID-19 patients at one community hospital in central Pennsylvania. Method(s): This prospective study, conducted on adult, hospitalized patients under the care of clinical nutrition services between April 2021 and April 2022. Inclusion criteria included age >18 years, COVID-19 positive by polymerase chain reaction (PCR) test with associated symptoms, and not receiving vitamin D supplementation prior to or during hospital admission (N = 122). Vitamin D 25 hydroxy laboratory values were obtained, and values were interpreted utilizing the recommended range categories: 25(OH)D level >= 30 ng/ml was representative of adequate vitamin D stores, while values between 21-29 ng/ml signified vitamin D insufficiency. A 25(OH)D value <20 ng/ml is indicative of vitamin D deficiency. Result(s): Over 77% (n = 95) of all patients included in study had vitamin D values below the recommended levels, with one half (n = 61) demonstrating vitamin D deficiency. Only 22.1% (n = 27) were found to have values consistent with a blood level deemed adequate. Conclusion(s): Many hospitalized patients with COVID-19 demonstrate vitamin D levels below acceptable ranges, many with vitamin D deficiencies. Identification of these individuals in the community will allow clinicians an opportunity to treat the vitamin insufficiency or deficiency with the goal of preventing infections and potential morbidity or mortality associated with the disease. (Figure Presented).
ABSTRACT
Background: Integrative therapies are shown to support cancer patients' treatment plans, help with side effect management, and improve patients' quality of life ([1-9]). In 2017, the American Society of Clinical Oncology endorsed the Association of Integrative Oncology's Clinical Practice Guidelines highlighting their importance in breast cancer care. Recent studies suggest that more evidence is needed to bring attention to the role of integrative therapies in advanced breast cancer care [4, 7, 8, 10]. This analysis explores participants' experiences with a wellness program implemented by Unite for HER (UFH), a non-profit organization that delivers integrative therapies and support services such as whole food nutrition services, medical acupuncture, oncology massage therapy, counseling, reiki, meditation, yoga, and fitness classes to patients with breast, metastatic breast, and ovarian cancer. As of April 2022, there were over 1,700 women diagnosed with metastatic breast cancer (MBC) participating in UFH locally and nationally. Method(s): UFH members completed a survey about the impact of the UFH Wellness Program on the overall quality of life, including measures on side-effect management, OTC/prescription drug utilization rate, stress reduction, changes to wellness habits, and the social and emotional challenges associated with living with MBC. In total, 119 unique UFH members with MBC answered online surveys distributed by email in 2020 and 2021. Survey questions were designed to evaluate the impact of the UFH Wellness Program. Descriptive analyses of survey questions and openended comments were conducted to assess program impact. Result(s): All respondents were MBC patients/survivors. No other demographic information was collected. While 2020 respondents received mostly in-person services for part of their program, all 2021 respondents received primarily virtual services due to the Covid-19 restrictions. Despite the inaccessibility of in-person services, the satisfaction levels with the wellness program did not drop significantly in 2021. More than two-thirds of respondents (80% in 2020, 67% in 2021) indicated that the therapies offered through UFH Wellness Program significantly improved the side effects of their treatment for MBC. Notably, more than a quarter of respondents (28% in 2020, 26% in 2021) specified that due to UFH integrative therapies they were able to reduce or eliminate one or more OTC/prescription drugs to manage side effects. At the same time, the majority reported experiencing reduced levels of stress after utilizing integrative therapies offered by UFH (93% in 2020, 81% in 2021), as well as improvements in their emotional wellbeing (95% in 2020, 83% in 2021), and quality of life during or after treatment for MBC (97% in 2020, 96% in 2021). Also, 86% of respondents in both years indicated that UFH services, such as nutrition counseling, cooking classes, and exercise classes, helped them adopt and maintain healthier habits in their life. Furthermore, a qualitative analysis of open-ended comments found that 1) respondents expressed deep gratitude and appreciation for UFH integrative therapies, 2) noted that they would otherwise not be able to access such therapies due to financial barriers, and 3) helped them feel better prepared to cope with the psychosocial aspects of their MBC experience. Discussion(s): These results suggest that integrative therapies such as those offered by UFH can play a significant role in improving patients' outcomes by reducing stress and drug utilization to manage side effects and improving patients' well-being and quality of life during metastatic breast cancer treatment. These findings highlight the importance of choosing integrative oncology programs to support MBC patients' needs in managing the psychosocial and physical side effects of the disease.
ABSTRACT
Background The COVID-19 pandemic has impacted the nutrition and health of individuals, households, and populations globally. Through exposing fragilities in food, health, and social welfare systems, the negative influence of COVID-19 continues to affect the global burden of malnutrition. The nature and scale of these impacts are not yet well understood thus the body of evidence for informing policy is limited. Collating and monitoring relevant data in real-time from multiple levels, sectors and sources is essential in preparing and responding to the ongoing COVID-19 pandemic. Objectives To identify key data sources related to food, nutrition, and health indicators in the context of the COVID-19 pandemic. Methods A COVID-19, food, nutrition and health framework was developed through multiple iterative rounds of online multidisciplinary discussions including the NNEdPro COVID- 19 taskforce and the Swiss Re Institute's Republic of Science, which comprised researchers and clinicians with expertise in data science, food, nutrition, and health. Results The proposed framework encompasses five socio-ecological levels which were further sub-divided by six categories of the food and nutrition ecosystem, including food production & supply, food environment & access, food choices & dietary patterns, nutritional status & comorbidities, health & disease outcomes, health & nutrition services. A limited number of exemplar variables for the assessment of global status of food, nutrition and health are identified under each category. Discussion/Conclusion This collaborative framework is the first step towards the development of a better understanding of the impact of COVID-19 on food, nutrition, and health systems. Limited data availability and disruption in routine data collection as well as other nutrition assessments during the pandemic are challenges that might limit the potential of the proposed framework. Next steps will include formal research and data gap analysis and the identification, as well as utilisation, of other indicators that could be used as proxies of the variables identified. (Table Presented).