TESTING A NEW FATIGUE CHECKLIST IN SLE PATIENTS FOR EVERYDAY CLINICAL PRACTICE - AN INTERIM ANALYSIS

BackgroundFatigue is a difficult subject for both physicians and patients. It is barely addressed during consultations and can therefore burden patient-physician-relations. To improve communication regarding fatigue, we developed a checklist that includes suggestions for evaluating possible causes for fatigue. In this analysis, we describe our study population and report first results 3 and 6 months after using the checklist.ObjectivesThe aims of our study are to validate the use of our newly developed fatigue checklist and to demonstrate that addressing fatigue in daily clinical practice and offering possible interventions can improve fatigue.MethodsWe recruited n=110 SLE patients with fatigue from our university hospital-based lupus reference centre in Duesseldorf. Fatigue was measured using the FSS (Fatigue Severity Scale). Our checklist included signs of depression and anxiety using the PHQ-4 (Patient Health Questionnaire), BMI (body mass index), physical activity, anemia, hypothyroidism and vitamin D deficiency. For each applicable cause, we listed possible interventions for free selection by the treating physician, such as replacement therapy (vitamin D, vitamin B12, iron, folic acid, erythropoietin), physical activity programs and psychosomatic consultations that were discussed with the patients. We re-evaluated our patients after 3 (T1) and 6 months (T2).ResultsBaseline characteristics of patients are summarized in Table 1.Table 1.BMI=body mass index, TSH=thyroidea stimulating hormone, PHQ4=patient health questionnaire (cut-off >3 points), HAQ=health assessment questionnaire, IMET= Index for measuring restrictions on social participation (higher scores point towards more restrictions on social participation), FSS=fatigue severity scale (≥4 points equal severe fatigue)N = 110n (%)Mean (SD)Age (years)49.0 (12.34)Female sex99.0 (90.0)BMI (kg/m2)25.9 (5.55)Disease duration (years)19.1 (10.05)TSH (µIU/ml)1.5 (1.05)25-OH-Vitamin D (ng/ml)39.5 (15.35)Haemoglobin (g/dl)13.0 (1.64)Sports activities>4h/week6.0 (5.5)2-4h/week18.0 (16.4)1-2h/week16.0 (14.5)<1h/week28.0 (25.5)No sport42.0 (38.2)Depression (PHQ4 score)2.3 (1.63)Anxiety (PHQ4 score)2.0 (1.71)Functional status (HAQ score)0.8 (0.49)Participation (IMET score)2.8 (2.31)Fatigue (FSS score)5.3 (1.35)After 3 and 6 months, we re-evaluated 83 patients and saw a significant reduction in fatigue measured by the FSS score (T1: mean difference estimate 0.367 and p-value <0.001;T2: mean difference estimate 0.305;p-value <0.005).Figure 1.Comparing FSS-Scores from T0, T1 and T2[Figure omitted. See PDF]ConclusionThe preliminary analysis of our study shows for the first time that incorporation of a checklist procedure into the management of patients with fatigue may improve short-term outcome after 3 and 6 months of observation. The improvement of symptoms documented in our study occurred even though the suggested exercise program and psychosomatic counseling sessions were not available for use during the current observation period because of the COVID-19 pandemic. At present, the mechanisms behind the observed effect remain unclear. Our ongoing analysis will clarify whether an additional effect on fatigue will occur after all suggested interventions resulting from the use of the checklist have been executed. Finally, it will demonstrate whether the incorporation of our checklist into routine clinical practice is capable to reduce fatigue over a prolonged time period.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.

Metformin - a new approach.

Metformin is a widely used biguanide drug recommended as a first-line antidiabetic for type 2 diabetes. Currently, metformin is used not only in the treatment of diabetes but also in other diseases. Some studies have shown that metformin causes weight loss in insulin-sensitive and insulin-resistant overweight and obese patients. Metformin is an effective and safe option for women with gestational diabetes and type 2 diabetes in pregnancy, and it may also increase the ovulation rate in patients with polycystic ovary syndrome (PCOS). Longer survival times have been observed in cancer patients using metformin. Metformin has been shown to significantly correlate with lower mortality in obese or type 2 diabetic women hospitalized for COVID-19. It also has a protective effect on the development and progression of many types of cancer. The mechanisms of action of metformin are complex and still not fully understood. Metformin has been shown to act through both AMP-activated protein kinase (AMPK)-dependent mechanisms and AMPK-independent mechanisms. This paper presents the benefits of using metformin in the treatment of various diseases.

The association between B vitamins and the risk of COVID-19.

The fast spread of the coronavirus disease 2019 (COVID-19) epidemic and its high mortality were quickly noticed by the health community. B vitamins are essential micronutrients for the body with antioxidant, anti-inflammatory, and immune-regulating properties. The present study can provide a comprehensive picture of the associations between B vitamins and COVID-19 incidence. This study was undertaken on 9189 adult participants of the Yazd Health Study (YaHS) and Taghzieh Mardom-e-Yazd (TAMIZ) study aged 20 to 69 years. Data on dietary intakes were obtained using a validated food frequency questionnaire (FFQ). Multivariable logistic regression analysis was used to evaluate the association between B vitamins and COVID-19. Our findings indicated that participants in the fourth quartile of vitamin B5 intake compared to the first quartile had a protective effect against COVID-19 (OR: 0. 53 CI: 0.28- 0.99, p- trend =0.02) after adjustment for all possible confounds in model 3. In addition, participants in the third quartile of vitamin B12 intake compared to the first quartile (OR: 0.63, 95% CI 0.40-0.98, P-trend= 0.11) had fewer odds of COVID-19 after full adjustments for confounders. Our findings indicated no significant relationship between dietary intake of vitamin B1, B2, B3, B9, and B-complex and COVID-19. A higher intake of vitamin B5 could reduce the odds of COVID-19 by 47%, and a moderate intake of vitamin B12 had a protective effect on COVID-19. Although our study has promising results, stronger clinical studies are needed.

Age- and ethnicity-related reference intervals for serum vitamin B12.

BACKGROUND: Age and ethnicity are known to influence serum vitamin B12 (B12) concentration, yet universal reference intervals (RIs) are typically applied by laboratories. Both lower and upper RI limits for B12 are clinically relevant. Low values suggest deficiency leading to anemia and/or neurological impairment, while high values are not always an innocuous consequence of high B12 intake but are associated with some cancers, autoimmune, liver, and renal diseases. This work aimed to establish age- and ethnicity-related RIs for B12 using a modified indirect method based on Hoffmann's approach. METHODS: A total of 72,091 anonymized B12 results (Jan 2018-Nov 2019) were analyzed from an ethnically-diverse South-East London general practice patient population. Patients belonged to five ethnic groups: Asian, Black, White, Mixed, or Other. Multiple records for the same patient and results with missing ethnicity were excluded from the analysis of adult RIs. B12 analyses were performed using ARCHITECT® (Abbott Diagnostics). RESULTS: B12 was significantly higher in Black compared with Asian and White adults. There were no differences in B12 between Asian and White adults. Children (all ethnicities) between 2 and 5 years old had the highest B12. Because of the small number of children (up to the age of 13) in each ethnic-related age category, all ethnic groups were combined to obtain age-related RIs. The children's RIs ranged from 159 to 1025 pmol/L for 0-1-year-olds to 276-1102 pmol/L for 2-5-year-olds. The RIs for Black and White/Asian people >13 years of age were 166-805 pmol/L and 134-511 pmol/L respectively. CONCLUSIONS: The application of age- and ethnicity-appropriate RIs into diagnostic practice will provide a more accurate evaluation of B12 status when using the B12 test alone or in combination with other markers.

Notes from the 2022 Folate, Vitamin B12, and One-Carbon Metabolism Conference.

Here, we present notes from the Folate, Vitamin B12, and One-Carbon Metabolism Conference organized by The Federation of American Societies for Experimental Biology (FASEB), held in Asheville, North Carolina, USA, 14-19 August 2022. We aim to share the most recent findings in the field with members of our scientific community who did not attend the meeting and who are interested in the research that was presented. The research described includes discussions of one-carbon metabolism at the biochemical and physiological levels and studies of the role of folate and B12 in development and in the adult, and from bacteria to mammals. Furthermore, the summarized studies address the role of one-carbon metabolism in disease, including COVID-19, neurodegeneration, and cancer.

Proton pump inhibitors: Understanding the associated risks and benefits of long-term use.

PURPOSE: Proton pump inhibitors (PPIs) are widely prescribed medications. Various adverse clinical effects of PPIs have been reported in the literature, particularly over the past decade. The purpose of this article is to review published data primarily describing adverse effects associated with PPI use and to help clinicians determine which patients may still benefit from therapy despite safety concerns. SUMMARY: Associations between PPIs and the following have been described: bone fracture, acute and chronic kidney disease, gastrointestinal infections, deficiencies in vitamin B12 and magnesium, and coronavirus disease 2019 and respiratory infections. For inclusion in this review, studies must have evaluated potential adverse events associated with PPIs as a primary or secondary objective. Increased risks of bone fracture, acute and chronic kidney disease, gastrointestinal infections, and magnesium deficiency were consistently reported, albeit mostly in studies involving low-quality data (case-control and/or observational studies) and subject to bias. In the only pertinent randomized controlled trial to date, chronic pantoprazole use was associated with a greater risk of enteric infections relative to placebo use; there was no significant between-group difference in any other adverse event evaluated. PPIs continue to be recommended by the American College of Gastroenterology as a first-line treatment for management of gastroesophageal reflux disease and in the acute period following upper gastrointestinal and ulcer bleeding. CONCLUSION: Higher-quality data is needed to better understand PPI-associated risks of the adverse effects listed above. Until then, clinicians may consider greater vigilance with PPI use; however, the data does not demonstrate a need for wide adoption of de-escalation strategies solely out of safety concerns.

Metabolism-Mediated Thrombotic Microangiopathy in an Older Patient Without Malnutrition.

Vitamin B12 deficiency can cause thrombotic microangiopathy (TMA)-like symptoms such as purpura caused by platelet reduction, general fatigue caused by anemia, and renal and hepatic abnormalities caused by malnutrition. TMA-like symptoms are known as metabolism-mediated TMA (MM-TMA). In MM-TMA, blood cell production is altered, and both pancytopenia and schistocytes appear. The initial presentation of MM-TMA makes it challenging to distinguish between primary and secondary TMA when patients do not present risk factors for malnutrition. We encountered an older female patient with a chief complaint of unconsciousness and loss of appetite for two days. Laboratory tests revealed pancytopenia with schistocytes. Moreover, the laboratory data revealed low serum levels of vitamin B12, indicating MM-TMA. The patient was successfully treated with intravenous vitamin B12 supplementation and discharged home. The patient had atrophic gastritis, which could have impeded the absorption of vitamin B12 from food. Among older patients without prolonged appetite loss, TMA-like symptoms should be investigated as MM-TMA induced by vitamin B12 deficiency, and prompt initiation of appropriate treatment is essential to differentiate between MM-TMA and true TMA.

Vitamin B12 attenuates leukocyte inflammatory signature in COVID-19 via methyl-dependent changes in epigenetic markings.

COVID-19 induces chromatin remodeling in host immune cells, and it had previously been shown that vitamin B12 downregulates some inflammatory genes via methyl-dependent epigenetic mechanisms. In this work, whole blood cultures from moderate or severe COVID-19 patients were used to assess the potential of B12 as adjuvant drug. The vitamin normalized the expression of a panel of inflammatory genes still dysregulated in the leukocytes despite glucocorticoid therapy during hospitalization. B12 also increased the flux of the sulfur amino acid pathway, that regulates the bioavailability of methyl. Accordingly, B12-induced downregulation of CCL3 strongly and negatively correlated with the hypermethylation of CpGs in its regulatory regions. Transcriptome analysis revealed that B12 attenuates the effects of COVID-19 on most inflammation-related pathways affected by the disease. As far as we are aware, this is the first study to demonstrate that pharmacological modulation of epigenetic markings in leukocytes favorably regulates central components of COVID-19 physiopathology.

Effect of COVID-19 pandemic on children undergone percutaneous endoscopic gastrostomy due to neurologic diseases

Aim: To investigate the effects of SAR-CoV-2 infection on nutritional status in patients who underwent percutaneous endoscopic gastrostomy (PEG) for neurological disorders.Methods: The clinical and laboratory follow-up data of the patients who underwent PEG in our clinic between 2002 and 2018 were evaluated before and during the pandemic. The results were analyzed statistically.Results:Twenty patients were included. They were 70.9±64.4 months old at the time of PEG, 97.9±67.8 months before the pandemic, and 105.5±60.8 months during the pandemic (p=0.048). Weight for age at the time of PEG increased from 10.7±4.6 kg to 15.6±7.2 kg before the pandemic. Hemoglobin was 12.3±1.4 g/dl at the time of PEG, 13.5±1.6 g/dl before the pandemic (p=0.045). Vitamin D was 24.1±8.9 ng/ml at the time of PEG and increased to 45.7±9.7 ng/ml during the pandemic (p=0.018). The annual number of visits before the pandemic was 9.8±5.7 and decreased to 2±1.7 during the pandemic (p=0.003). Twelve (%60) of the patients developed PEG complications, 6(30%) had their PEG replaced. Those who had developed PEG complications had low levels of albumin (3.3±0.4 vs 4±0.4 g/dl, p=0.022) and vitamin B12 (578±199 vs 1299±533 pg/ml, p=0.007).Conclusions:Even if PEG is applied late, it provides a partial improvement in patients, but the COVID-19 pandemic reversed these benefits and caused an increase in PEG complications. In order for the patient to get the maximum benefit from PEG, close follow-up is essential.

Multifactorial utility of vitamins in treatment of covid - 19

The pathogenesis of the SARS-CoV-2 virus responsible for COVID-19 disease is ever unravelling. Researchers are continuously generating evidence regarding the mechanism of the infection and its complications. There is also an attempt to understand the role of various biomolecules in preventing or treating COVID-19 disease and its complications. Trials show that Vitamin D decreases the rate of admission in ICU. Vitamin C is known to exert the positive influence in decreasing the intensity of viral infections and severe sepsis. Vitamin B12 plays a pivotal role in gut microbiome management. Dietary supplementation of micronutrients with defined roles in immune function can streamline the balance of the body's immune reaction, lessening the incidence of infections and ICU hospital stay. The focus of this review is to apply our modern knowledge of vitamin D, B12 and C as micronutrients & facilitator of immune competence. We suggest that vitamins D, B12 and C may serve as attenuators to COVID-19 symptoms. Large randomized trials are required to confirm this hypothesis.

Relation between Vitamin B12 Levels and Smell Affection in COVID-19 Patients.

Introduction Olfactory and gustative alterations are frequent in the initial stages of the COVID-19 infection. Vitamin B12 deficiency has been linked to olfactory dysfunction. Objective The present study aimed to assess the relationship between vitamin B12 levels and smell affection in COVID-19 patients. Methods The present study included 201 laboratory-confirmed COVID-19 patients. Smell affection was assessed using self-rated olfactory function. Serum vitamin B12 levels were assessed using commercial enzyme-linked immunosorbent assay (ELISA) kits. Results According to the smell function assessment, the patients were classified into three categories: normal osmesis ( n = 77), hyposmia ( n = 49), and anosmia ( n = 75) ( Fig. 1 ). Four weeks later, 195 patients (97.0%) had their normal smell function restored. The remainder 6 patients included 4 anosmic and 2 hyposmic patients. Patients with hyposmia or anosmia had significantly lower vitamin B12 levels when compared with patients with normal osmesis (median [IQR]: 363.0 [198.0-539.0] versus 337.0 [175.0-467.0] and 491.0 [364.5-584.5] pg/ml, respectively, p < 0.001). Conclusion Vitamin B12 appears to have some contribution to smell affection in patients with COVID-19 infection.

Association Between Low Serum Folic Acid and Vitamin B12 Levels with Covid-19 Prognosis

Background and aim: It is important that the immune system is active and strong in protection from the COVID-19 pandemic. Folic acid and vitamin B12 are involved in the initiation, maintenance and regulation of both innate and adaptive immune reactions of the host against infections. In this study, it was aimed to investigate the relationship between serum folic acid and vitamin B12 levels of COVID-19 patients on the prognosis of the disease. Methods: The sample of the study consists of 529 individuals hospitalized in the Pandemic Chest Diseases Intensive Care Unit. General characteristics of the individuals, biochemical parameters checked routinely (white blood cell (WBC), platelet (PLT), lymphocyte, Neutrophil/Lympho-cyte (N/L) rate, C-reactive protein (CRP), oxygen (O2) saturation at the time of admission), serum vitamin B12 and folic acid levels, length of stay in intensive care units (ICUs) and hospitalization, and mortality were recorded. Results: The mean age of individuals was 62.8 +/- 15.12 years, and 50.9% were men and 49.1% were women. The mean level of serum folic acid in the subjects was 9.1 +/- 4.91 (ng/mL), and 2.4% had folic acid deficiency and 28.4% had folic acid insufficiency. The mean serum vitamin B12 was 295.6 +/- 229.98 (pg/mL), and vitamin B12 deficiency was observed only in 14.4%. The increase in serum folic acid levels reduces the total length of hospitalization and the risk of mortality (p<0.05). On the other hand, no correlation was found between B12 levels and the length of stay in ICU, hospitalization, and mortality. It was shown that WBC and N/L rates decreased as serum folic acid levels increased, and O2 saturation at the first hospital admission was higher. Conclusions: Folate deficiency and insufficiency are common among hospitalized COVID-19 patients and cause progression to severe disease. Therefore, examining COVID-19 patients in terms of nutritional deficiencies is critical in monitoring the clinical outcomes of the disease.

Level of vitamins and minerals for people with coronavirus (Covid-19) in Taif, Kingdom of Saudi Arabia

Few works studied the levels of vitamins and minerals in Saudi Arabia among COVID-19 patients, especially in the region of Taif (high altitude). So, this work aims to study the serum vitamin D, vitamin B12, calcium, Phosphorous, Magnesium and hemoglobin levels in recovered patients with COVID-19 and compare them to mortalities. The levels of a sample of 100 recovered patients and 93 mortalities were chosen from the Covid 19 patient records between March 2020 and February 2021 in King Faisal Hospital, Taif, Saudi Arabia. Vitamins and Minerals data wereIP: 182.75.distilled for48 10 statisticalOn: Fr, 12 analysis.Aug The2022 results10:57:33reported that vitamin D was the highest in recovered patients compared with coronvirus mortalities, whilt vitamin B12 was the highest in Copyright: American Sc entific Publshers mortalities compared with recovered patients with coronavirus. Calcium, as well as hemoglobin, were relaDelive ed by Ingena tively elevated in recovered patients with coronavirus compared to mortalities with coronavirus. The results indicated that there is a significant difference between recovered patients and mortalities in age, Vitamin B12, Calcium, Phosphorous, Magnesium and hemoglobin. There is a significant positive correlation between Age and Vitamin B12 and Phosphorous. There is a significant negative correlation between Age and Magnesium and Hemoglobin. On the other hand, there is a significant positive correlation between Vitamin D and Vitamin B12. Finally, there is a significant positive correlation between Calcium and Phosphorous and between Calcium Hemoglobin. As a result, deficiency of vitamin D, calcium, phosphorus and hemoglobin levels may cause a failure in the immune system against COVID-19 and cause a quick transfer to severe disease.

The flavonoids, vitamin C and B12 have a prognosis on Covde-19 infections and detect by plant bionanosensor in vitro

Plant secondary metabolites are an important source of new drugs, especially flavonoids, were shown to have antioxidant, antiviral, antibacterial, anticancer.. Antioxidant compounds have the potential to improve the prognosis of COVID-19 infections. The antiviral effect of flavonoids, which are secondary plant phenolics, as well as other antioxidants has been explored for their effect on SARS-CoV-2. There are various methods for measuring biological compounds. Qualitative and quantitative techniques of polyphenols measurement include chromatography such as HPLC and GC-MS. These techniques are expensive and time-consuming.In this study, for the first time, the amount of vitamins of vitamin B12, vitamin C and Hawthorn extract flavonoids by plant biosensor that is a new approach was become to a visible rotation, and its amount can be detected through this rotation. For the detection of vitamin B12, vitamin C and Hawthorn extract flavonoids the rotations of them were analyzed by plant bionanosensor in a completely randomized design with three replications by sas9.1 software. It was determined that plant bionanosensor capability of detecting vitamin B12, vitamin C and flavonoids through the rotation is likely to be 99%

Nitrous Oxide/Whippits-Induced Thoracic Spinal Cord Myelopathy and Cognitive Decline With Normal Serum Vitamin B12.

Abuse of nitrous oxide leads to irreversible neurologic deficits. Nitrous oxide is commonly abused through the inhalation of whipped cream canisters. These whipped cream chargers, also known as "whippits," are widely available in the United States and their sale is unregulated. There is an increasing prevalence of whippet abuse, and many are unaware of the catastrophic effects. The mechanism of injury is mediated through severe depletion of vitamin B12. Here, we report a case of nitrous oxide abuse leading to thoracic cord myelopathy. The patient has been inhaling approximately 80-100 nitrous oxide canisters daily for three months total. A magnetic resonance imaging (MRI) of the spinal cord illustrates the lesion within the thoracic cord. Further diagnostic workup with serum vitamin B12 levels was normal. However, elevated levels of methylmalonic acid (MMA) were seen. Despite supplementation of vitamin B12, the patient's neurologic deficits persisted, and he was referred to a rehabilitation center. The abuse of whippets is a serious public health threat and warrants greater regulation of their sale. MMA and holotranscobalamin (holoTC) are improved biomarkers for diagnosing vitamin B12 deficiency.

Potential Role of Certain Biomarkers Such as Vitamin B12, ROS, Albumin, as Early Predictors for Prognosis of COVID-19 Outcomes.

COVID-19 disease is still a major global concern because of its morbidity and its mortality in severe disease. Certain biomarkers including Reactive Oxygen Species (ROS), vitamins, and trace elements are known to play a crucial role in the pathophysiology of the disease. The aim of our study was to evaluate how certain biomarkers, such as ROS, biochemical indicators, trace elements in serum blood of 139 COVID-19 hospitalized patients, and 60 non-COVID cases according to age and sex variations, can serve as the predictors for prognosis of COVID-19 outcome. An attempt of correlating these biomarkers with the severity of the disease as well as with each other is represented. All subjects were hospitalized from April 2021 until June 2021. A statistically significant increase of B12 levels (p = 0.0029) and ROS levels (p < 0.0001) as well as a decrease in albumin and Total Protein (T.P.) levels (p < 0.001) was observed especially in the early stage of the disease before CRP and ferritin elevation. Additionally, a statistically significant increase in ferritin (p = 0.007), B12 (p = 0.035, sALT p = 0.069, Glucose p = 0.012 and urea p = 0.096 and a decrease in Ca p = 0.005, T.P p = 0.052 albumin p = 0.046 between stage B (CRP values 6-30 mg/L) and C (CRP values 30-100 mg/L) was evident. Thus, this study concludes that clinicians could successfully employ biomarkers such as vitamin B12, ROS and albumin as possible prognosis tools for an early diagnosis. In addition, the total biochemical profile can assist in the understanding of the severity of COVID-19 disease, and could potentially lead to a better diet or early pharmaceutical treatment to prevent some of the more acute symptoms.

Beef as a Functional Food for Improving Human Nutrition and Health

Beef is an abundant source of all proteinogenic amino acids (AAs;in both adequate amounts and balanced ratios) and physiologically essential nonproteinogenic AAs (taurine and β-alanine). The content and bioavailabilities of proteinogenic AAs in beef are greater than those in plant-sourced foods. Taurine (a potent anti-oxidant) is essential for the integrity and functions of tissues, including eyes, heart, and skeletal muscle, whereas β-alanine is required for the production of antioxidative and neuromodulatory dipeptides. Furthermore, beef contains a large amount of creatine (essential for energy metabolism in tissues, particularly brain and skeletal muscle), anti-oxidative dipeptides (carnosine and anserine), and 4-hydroxyproline (an anti-inflammatory nutrient that maintains intestinal integrity and inhibits colitis). There are myths that plants provide all nutrients that are available in animal-sourced foods. However, taurine, vitamin B12, creatine, carnosine, and anserine are absent from plants, whereas β-alanine and 4-hydroxyproline are low or negligible in plants. Like other animal-sourced foods, beef plays an important role in the optimum growth of children and the prevention of anemia in humans, as well as maintaining muscle mass, delaying ageing, and mitigating sarcopenia in adults, while meeting the high demands of exercising individuals for high-quality protein. Some epidemiological studies raised concern that the consumption of red meat might increase risks for chronic diseases in humans, including obesity, type 2 diabetes mellitus, cardiovascular disease, kidney disease, and cancers. However, findings from many epidemiological and clinical studies do not support these claims. Beef-derived AAs and other nutrients enhance the metabolism (e.g., nitric-oxide and glutathione syntheses) and the functions of monocytes, macrophages, lymphocytes, and other cells of the immune system, thereby helping the human host to kill pathogenic bacteria, fungi, parasites, and viruses. The latter include severe acute respiratory syndrome coronavirus (SARS-CoV) and SARS-CoV-2 (COVID-19). Therefore, beef is a functional food for optimizing human growth, development, and health.

Unravelling Vitamin B12 as a potential inhibitor against SARS-CoV-2: A computational approach.

The new severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) is the etiological agent of Coronavirus disease 2019 (COVID-19), which becomes an eventual pandemic outbreak. Lack of proper therapeutic management has accelerated the researchers to repurpose existing drugs with known preclinical and toxicity profiles, which can easily enter Phase 3 or 4 or can be used directly in clinical settings. Vitamins are necessary nutrients for cell growth, function, and development. Furthermore, they play an important role in pathogen defence via cell-mediated responses and boost immunity. Using a computational approach, we intend to identify the probable inhibitory effect of all vitamins on the drug targets of COVID-19. The computational analysis demonstrated that vitamin B12 resulted in depicting suitable significant binding with furin, RNA dependent RNA polymerase (RdRp), Main proteases (Mpro), ORF3a and ORF7a and Vitamin D3 with spike protein and vitamin B9 with non structural protein 3 (NSP3). A detailed examination of vitamins suggests that vitamin B12 may be the component that reduces virulence by blocking furin which is responsible for entry of virus in the host cell. Details from the Molecular Dynamics (MD) simulation study aided in determining vitamin B12 as a possible furin inhibitor.

Relationship between serum levels of procalcitonin, vitamin B12, vitamin D in patients with COVID-19

COVID-19 is a new infectious disease, for which there is currently no treatment. It is therefore necessary to explore biomarkers to determine the extent of lung lesions and disease severity. Objective. The study aimed to assess the usefulness of procalcitonin levels in the COVID-19 and to correlate them with other biomarkers. Methods. the collected the data, prospectively, all COVID-19 cases admitted in lab private (30) cases with COVID-19 pneumonia and (30) control patients had Reverse Transcription Polymerase Chain Reaction (RT-PCR) positive. laboratory analysis of inflammatory indices and organ function was accomplished for the sum total of cases and controls measured procalcitonin, CRP, B12, LDH. Result. Procalcitonin,CRP, LDH, D-dimer levels in patients groups the higher than those in the controls highly significant. Conclusion. In the early stage of COVID-19 procalcitonin levels were positively correlated with CRP, D-dimer, ferritin, LDH and negative correlated with B12.