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Aim of study. To study the total level of 25-hydroxyvitamin D in children with SARS-CoV-2 infection (COVID-19). Material and Methods. A total of 82 children aged 0-17 diagnosed with SARS-CoV-2 infection were enrolled. Depending on the severity of clinical symptoms, all children were divided into three groups according to the COVID-19 severity: asymptomatic, mild and moderate. The serum level of vitamin D in all patients was tested via the immunochemical method. Results. It was found that children with SARS-CoV-2 infection had lower serum level of vitamin D (29.92 [22.22;28.07] ng/ml) as compared with the control group (36.43 [32.05;44.08] ng/ml;p<0.001). A total of 90% of the children with SARS-CoV-2 infection were diagnosed with insufficiency or deficiency of vitamin D (<30 ng/ml). Only 10 % of the patients had normal levels of vitamin D. The insufficiency of vitamin D was found more often amongst children aged 0-11 and deficiency of total 25-hydroxyvitamin D was more common for children aged 12-17. The difference in serum levels of vitamin D depending on the severity of SARS-CoV-2 infection was not found. Male children with SARS-CoV-2 infection showed lower levels of vitamin D (p=0.013). Conclusion. A total of 90 % of the children with SARS-CoV-2 infection had insufficiency or deficiency of vitamin D regardless of the severity of clinical symptoms.Copyright © 2021, Krasnoyarsk State Medical University. All rights reserved.
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It is well known that vitamin D's general immunomodulatory actions are helpful in viral infections and that a shortage is linked to a more serious prognosis for Covid-19. In this sistematic review, we examined the existing literature on evidence as to whether there is also link between vitamin D range levels in pediatric population and the outcome of the Covid-19 infection. We looked for studies that measured vitamin D blood concentrations and examined the effects of vitamin D supplementation in young infected patients. Vitamin D may decrease the risk of respiratory infections in a number of ways through its interactions with numerous cells, including by decreasing viral survival and replication, reducing the cytokine storm, raising angiotensin-converting enzyme 2 concentrations (ACE2) while not damaging the endothelial integrity. The incidence or severity of Covid-19 is linked with blood 25-hydroxyvitamin D concentrations, according to many observational studies. However experimental verification is still needed. Given their safety and broad therapeutic window, vitamin D supplements seem to be an effective way for individuals and doctors to prevent or treat Covid-19. Nonetheless, the outcomes of significant vitamin D randomized controlled trials are further needed.Copyright © 2022 Maria Nicolae et al., published by Sciendo.
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The article presents current data on the prevalence of vitamin D deficiency and criteria for its deficiency in children in different countries. Vitamin D is recognized as one of the most important vitamins involved in many biochemical processes in the body. Its active metabolites play a key role in calcium absorption, bone mineralization and promote phosphate and magnesium metabolism. At the same time, in addition to affecting mineral metabolism, there is a wide range of conditions in which vitamin D also plays a preventive role. Vitamin D has been shown to play a vital role in innate immunity maintenance and is important in prevention of several diseases, including infections, autoimmune diseases, certain forms of cancer, type 1 and 2 diabetes, and cardiovascular diseases. Vitamin D is of particular importance for newborns and young children. This vitamin is involved in important physiological regulatory processes such as bone metabolism, lung development, maturation of the immune system and differentiation of the nervous system. Vitamin D deficiency increases risks of neonatal sepsis, necrotizing enterocolitis, respiratory distress syndrome, and bronchopulmonary dysplasia. Adequate intake of vitamin D and calcium during childhood can reduce the risk of osteoporosis and other diseases associated with vitamin D deficiency in adults. Recently, vitamin D deficiency has shown to be a potential risk factor for COVID-19 propensity. It has been established that to date most scientific pediatric societies have recognized the need to prevent vitamin D deficiency in healthy children of all ages, but data on the dosage of vitamin D in its prophylactic use differ. Most scientific societies recommend an average of 400-600 IU per day of vitamin D for prophylactic purposes. The analysis of published data shows the need to follow a strategy based on an individual approach, taking into account physiological characteristics, individual requirements and lifestyle.Copyright © 2021 University of Tartu Press. All rights reserved.
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The proceedings contain 115 papers. The topics discussed include: clinical and genetic predictors of sickle cell nephropathy in Malawi;clinicohematological characteristics of iron deficiency anemia and hemoglobinopathies in Pakistan;an experience of non-hospital based laboratory;assessment of hematological parameters of petrol filling workers at petrol stations in Ethiopia: a comparative cross-sectional study;burden and risk factor to acute myocardial ischemia in children with sickle cell anemia;dyslipidemia in transfusion-dependent-thalassemia patients and its correlation with serum vitamin D level;impact of COVID-19 pandemic to pre-transfusion hemoglobin level and frequency of transfusion in transfusion-dependent thalassemia patients in Indonesia;retinopathy in Egyptian patients with sickle cell disease;and dietary pattern, socio-demographic characteristics and nutritional status of pregnant women attending Barau Dikko teaching hospital and the need to develop recommended dietary allowance and dietary reference intakes for sickle cell disease patients.
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History: We present a 15-year-old right hand dominant high school swimmer with no significant past medical history, who complains of right elbow pain along the distal biceps' tendon for a 2 months. Pain was insidious in onset, sharp, intermittent, and described as a 0 to 6 out of 10. The patient has been swimming more frequently over the last few months to prepare for competition and noticed progressive pain with swimming. He went on vacation and then was diagnosed with a COVID-19 infection and took an additional 2 weeks off due to fatigue. He returned to sport without re-integration and increased his swimming intensity to 1 to 2 hours daily, which worsened his pain. Performing the butterfly and breaststroke provoke symptoms and cessation of activity reduces the pain. Denies pain at rest. He took Advil which did not reduce his pain. Denies acute trauma, prior injuries, or paresthesias. Physical Exam: Inspection of right elbow: no swelling or signs of discoloration. Palpation: Tenderness at the distal biceps tendon but can hook the tendon without pain. No shoulder or wrist tenderness. Active Range of Motion: Elbow extension 0 degrees, elbow flexion 130 degrees, supination and pronation normal. Normal shoulder and wrist ROM. Muscle strength: 5/5 grip, wrist extension, and wrist flexion. Pain elicited with resisted elbow flexion at the distal humerus. Maneuvers: pain with distal humerus squeeze. Negative Maudsley and negative Cozen test. Differential Diagnosis: 36. Distal Biceps Tendonitis/Tear 37. Stress Reaction of the Distal Humerus 38. Medial Epicondyle Apophysitis 39. Capitellar Osteochondritis Dissecans 40. Radiocapitellar Plica Syndrome Test Results: x-ray right elbow: AP and Lateral views indicate no abnormalities to the bones, alignment, or soft tissue structures. MRI right elbow No IVCON: Biceps tendon intact. There is periosteal edema and endosteal aspect marrow edema along the medial aspect of the distal diaphysis and metaphysis of the humerus. Several small foci of increased cortical signal. No fractures, joint effusion, or chondral defects. Findings comparable to Fredrickson grade 4a distal humerus diametaphysis stress injury. Final Diagnosis: Right Elbow Supracondylar Grade 4a Stress Reaction. Discussion(s): Actives that involve repetitive motion are susceptible to overuse injuries. Cases of upper extremity stress reactions in swimmers have been documented along the inferior angle of the scapula, upper ribs, and olecranon. Stress reactions along the distal humerus in swimmers is not well documented. This pathology has been seen in baseball players, cricket bowlers, and tennis players. In swimming, the butterfly technique requires significant endurance and athletic strength. During a sprint, fast synchronized upper extremity revolutions occurring up to 60 cycles perminute counterforcewater surface area friction leading to excessive loading forces even at 50 meter distances. Outcome(s): The patient was withheld from upper body work outs and swimming for 6 weeks. VitaminDand Calcium levels were drawn revealing a normal calcium level (10.2), but a vitamin D level of 28.1. Patient was started on 600 IU of Vitamin D and 1300 mg of Calcium daily. The patient started a return to swim program and returned to full competition at 7 months post presentation. Follow-Up: At 6 weeks, started an upper extremity low impact non-aquatic physical therapy program. Then a slow progressive return to swimming was initiated at 50% effort for 4 weeks. At 10 weeks, a return to sport plan including 200 m all strokes except butterfly, progressed to 250 m at week 2, 300 m at week 3, and 350 m at week 4. Finally, initiated speed work in =0 to 100 m increments and elbow loading workouts.
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Background: Total parenteral nutrition (TPN) is a life-saving therapy for patients with chronic intestinal failure. TPN typically consists of macronutrients (amino acids, dextrose, and lipids) as well as micronutrients (multi-vitamins [MVI] and trace elements) to meet fluid, calorie, and micronutrient needs. With the early years of PN administration, multiple deficiencies were noted leading to guidelines regarding need for daily use of essential trace element and MVI preparation for parenteral use. Unfortunately, during the last few years we have seen multiple shortages of PN related supplies including the most recent shortage of parenteral MVI preparation. Major organizations such as ASPEN have developed recommendations regarding management of shortages, however their clinical impact has not been fully evaluated. The current study evaluated the impact of MVI shortage on change in clinical practice and the prevalence of deficiency. Method(s): A retrospective review of electronic medical records for patients who received TPN during time of shortage in IV multivitamins supply due to COVID-19 crisis between January 2021 and June 2021. In our program, the shortage affected one TPN supplier. We included patients who received their TPN from affected supplier and who were tested for micronutrients including Vitamins A, B12, C, and D in the 6 months preceding the shortage in supply (period 1) as well as during the shortage period (period 2). Period 1 was defined as from July 1, 2020, to December 31, 2020, and period 2 was defined as from January 1, 2021, to June 30, 2021. In addition to baseline clinical characteristics, we captured changes in studied micronutrients. Result(s): Current retrospective analysis of a prospectively maintained database noted 21 patients (mean age of 63.3 +/- 13.8, 62% female) were impacted by MVI shortage during study period (Table 1). Most common primary diagnosis was Crohn's disease (33.3%) followed by enterocutaneous fistula (19%), and gastrointestinal dysmotility (14.3%). In 19/21 (90%) patients, MVI was administered 3 days per week in PN. In the remaining two patients who had short bowel,MVI was continued 7 days per week. Additionally, 19/21 (90%) patients also were supplemented orally with Vitamin D (17/21), Vitamin B12 (5/21), MVI (3/21), Vitamin C (1/21). There was a decline in average Vitamin C levels between the two study periods (Table 2) with a trend towards a decline in average 25-hydroxy vitamin D levels, while mean vitamin A and B12 levels did not change significantly. There was a significant increase in Vitamin D and C deficiencies, while no increase in deficiencies in Vitamin E, A, and B12 levels was noted (Figure 1). Conclusion(s): Unfortunately, shortages of key PN related supplies have become commonplace in the last few years. The most recent shortage affected MVI supplies. Our group managed the shortage through a combination of reduction of parenteral MVI administration to 3 days per week along with additional supplementation of specific micronutrients orally. Although with this strategy, there was an increase in Vitamin D and C levels falling below reference range, no significant deficiencies were noted. (Table Presented).
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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).
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Background ACE is a potent pro-inflammatory modulator that controls chemokines and adhesion molecules, and elevated ACE activity associated with immunoinflammatory conditions, including cardiovascular diseases (CVD) and diabetes. The ACE inhibitors are recommended as primary treatment for these illnesses. ACE is a peptidyl-dipeptidase that catalyses Angiotensin I to Angiotensin II, whilst inactivating bradykinin during blood pressure regulation via the Renin-Angiotensin System. The purpose of this study is to establish a reference interval (RI) for ACE in the Irish population after COVID, and to examine if there is an underlying correlation between ACE concentrations and a range of biomarkers. Methods Serum samples of 200 randomly selected patients were obtained from several Irish hospitals in March 2022 (in compliance withGuidance on Anonymisation and Pseudonymisation, June 2019). We analysed for ACE (Buhlmann reagents), HBA1C, 25OHD and other biomarkers on the Abbott Architect ci8200. Full Blood Count was measured on Sysmex CS-2500. The statistical analysis used the EP Evaluator 11.3.0.23 and SPSS 22.0 software. Results The RI based on the central 95% of data was 8-78 U/L. This is higher than the RI proposed by the manufacturer (20-70 U/L) but is very close to our RI (5-79 U/L) from 2019. We found a significant positive correlation between ACE concentration and HBA1c, Urea, Creatinine, White Blood Cells (p<0.0001), Glucose (p=0.02), LDL (p=0.03), Neutrophils (p=0.003), Lymphocytes (p=0.001). A significant negative correlation was observed with 25OHD (p<0.0001). Conclusions This study did not show any notable change in the RI for ACE after COVID in Ireland. The significant positive correlations with HBA1c and other biomarkers may indicate the importance for ACE testing for diabetic management and progression, but further studies will be needed. Patients' overall health and medical history should always be considered when evaluating ACE results, including Vitamin D levels.
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Before the COVID-19 pandemic started Vitamin D was discussed as a preventative strategy in acute respiratory tract infections. There is a growing evidence of beneficial effects of vitamin D supplementation in COVID-19 patients. The term post-COVID-19 syndrome (PCS) describes new, returning or ongoing symptoms more than 12 weeks after COVID-19 infection which cannot be explained by any other disorders or illnesses. The most common symptoms of PCS includes fatigue, difficulty breathing, memory/concentration/sleep problems persistent cough, muscle aches, depression, and others. We conducted a retrospective analysis of vitamin D level in a PCS cohort without hospitalisation. Taking of blood samples was part of the routine assessment in PCS consultation hours. We found significant lower vitamin D levels in the PCS cohort compared to a non-COVID control group. Within the non-COVID cohort there were no differences regarding vitamin D levels. Our results recorded for the first-time decreased vitamin D values in a PCS cohort compared to a control group. There are several potential reasons for these observations. The decrease could be the consequence of overcoming the infection by consumption of vitamin D. The reduction could also be the consequence of a longer duration of illness without exposure to sunlight or malnutrition. Similarly, reduced outdoor exercise during the pandemic with its restriction could have influenced vitamin D levels. Finally, reduced physical activity because of ongoing PCS symptoms like fatigue or exercise intolerance might be a possible explanation for the drop in vitamin D levels.
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Introduction: The entire population is susceptible to COVID-19, and the course of the disease is in a wide spectrum between asymptomatic clinical and critical illness. In this study, it was aimed to see whether the laboratory level CRP, ferritin, D-dimer, lymphocyte and vitamin D values and sociodemographic characteristics are related to the clinical course of the disease in COVID-19 disease, which emerged at the end of 2019 and caused a pandemic all over the world. Material(s) and Method(s): The study was carried out with a total of 100 participants, 50 patients who applied to Kahramanmaras Sutcu Imam University Health Practice and Research Hospital, adult COVID-19 outpatient clinic and 50 patients who applied to the family medicine outpatient clinic between 25.01.2021 and 28.02.2021. The first part of the questionnaire was applied by face-to-face interview method during the application to the hospital and the second part was applied one month later to the participants who applied to the adult COVID-19 outpatient clinic with a positive RT-PCR test. In addition to the CRP, lymphocyte, ferritin and D-dimer values measured in the blood taken at the first visit, the serum vitamin D level was studied. Statistical evaluation of the obtained data was made using SPSS 22 program. For statistical significance, p value below 0.05 was considered significant. Result(s): A total of 100 people were included in this study. Fifty people with COVID-19 infection constitute the case group, and 50 people who have not had COVID-19 infection before constitute the control group. While the mean age was 51.14 +/- 19.36 years in the case group, it was 37.12 +/- 12.64 in the control group. The mean age of the patients in the case group was higher than the mean age of the patients in the control group (p< 0.05). Serum vitamin D result was 14.19 +/- 10.63 ng/mL in the case group and 17.48 +/- 12.69 ng/mL in the control group. Although the vitamin D results of the case group were lower, no statistically significant difference was found between the patient groups (p= 0.179). It was determined that there was a statistically significant relationship between the status of having chronic diseases and the case-control group. Persons with chronic diseases constitute 70.7% of the case group and 29.3% of the control group, while persons without chronic diseases constitute 35.6% of the case group and 64.4% of the control group (p= 0.001). While 14.6% of those with chronic disease had mild 34.1% and 22.0% had a critical illness;23.7% of those without chronic disease had mild 6.8%, severe 5.1% had critical illness. In the study, the rate of severe or critical illness was found to be higher in those with chronic diseases than those without. The severe and critical patient group had higher CRP, Ferritin and D-dimer levels compared to the mildly severe patient group;It was observed that the lymphocyte level was lower (p< 0.05). The rate of severe and critical illness was found to be higher in those who partially pay attention to hand hygiene and mask rules (p< 0.05). Conclusion(s): Laboratory parameters such as CRP, ferritin, D-dimer and lymphocyte values were found to be significant predictors that could help in estimating the severity of the disease. Although it was lower in the case group, it was observed that there was a deficiency in vitamin D levels in both groups and insufficient doses of supplements were taken. In the study, it was observed that transmission was more common in social environments such as family and friends.Copyright © 2023 Bilimsel Tip Yayinevi. All rights reserved.
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Coronavirus disease 2019 was announced as a pandemic by the WHO on 11 February 2020. Since that time, challenges have arisen regarding the use of supplements to optimally support the immune system in the general population, and especially in older adults. The severity of severe acute respiratory syndrome coronavirus 2 infection varies significantly with age, being generally more severe in geriatric patients. There is evidence supporting the involvement of vitamin D in different processes related to the immune response. Some observational studies have related the decrease in vitamin D levels to the severity of coronavirus disease 2019, suggesting a protective role of vitamin D in this disease. In this narrative review, we analyze the possible role of vitamin D in modulating the immune mechanisms that are activated during severe acute respiratory syndrome coronavirus 2 infection, with special emphasis on older adults.Copyright © 2022 Lippincott Williams and Wilkins. All rights reserved.
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Introduction: Anosmia has emerged as a clinical feature of Covid-19. It is estimated over half of patients with Covid19 report anosmia. It is primarily transient, but can persist over a month in around 20% of cases. There is a hypothetical interaction between hypovitaminosis D and diminished smell. A deficiency may lead to neurologic decline in cranial nerves, including the olfactory nerve. Few studies investigating this are available. Loss of smell is a common occurrence through adulthood, with many physiologic and anatomic contributing factors. Limited data is available addressing anosmia post Covid-19. Aim(s): To assess the correlation between vitamin D (VD) and anosmia, in patients referred to post acute COVID syndrome (PACS) clinic, and to assess the variation of data across age groups. Method(s): A "Sniffin' Sticks" test was undertaken for all patients referred to the PACS clinic. This was correlated with a recent serum VD level. Result(s): 143 patients presented to the PACS clinic over a 10 month period. 84% were under 65 years. 60% of these patients who developed anosmia were found to have VD insufficiency. A similar proportion of patients with hyposmia, and patients with normal smell were found to be VD insufficient (36% vs 34.7%). Within the older cohort, none of the patients with anosmia were deficient in VD, and 7.7% of patients with smell dysfunction had insufficiency. Conclusion(s): There is an association between anosmia and VD deficiency in patients under 65 years of age seen at PACS clinic. This did not reflect in the cohort with hyposmia. In the older age group, the majority of patients had normal VD levels, which may indicate other contributing factors towards the decrease in smell.
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Background COVID-19 as a trigger for A-beta+ ketosis-prone diabetes (KPD) [1,2] in previously normoglycemic individuals presenting with new-onset DKA, has been sparsely studied. Aim To study prospective changes in insulin secretion and insulin resistance in suspected A-beta+ KPD patients presenting with COVID-associated new-onset DKA. Method 22 previously non-diabetic, antibody-negative patients with new-onset DKA and RT-PCR positive COVID-19 (suspected A-beta + KPD), were followed up for one year. They were compared with 20 Type 1A and 18 Type 2 DM patients, with serial assessments (0,6 and 12 months) of insulin secretion rates (ISR) and multi-tissue insulin resistance (IR). 75-g OGTT with serial glucose, insulin and C-peptide estimation (0,15, 30,45, 60,90,120, 150 and 180 minutes) was used to derive IS, while hepatic and peripheral IR was calculated based on study by Ghani et al. [3]. Results At baseline, ISR in suspected KPD (n = 22) was significantly reduced but similar to Type 1A DM(p = 0.15). Serial ISR demonstrated complete recovery in 17 (77%) patients who became insulin independent at one-year follow-up (remission), while 5(23%) patients continued to require insulin (non-remission). KPD patients showed significant hepatic and peripheral IR at baseline compared to Type 1A DM (p < 0.05). The remission group (n = 17) showed significantly enhanced recovery of hepatic and peripheral insulin sensitivity at 6 and 12 months follow-up (all p < 0.01) compared to the non-remission (n = 5) group, with IR in the latter being comparable to Type 2 DM at follow-up (all p > 0.05). Younger age, lower BMI, initial severity of DKA and inflammation (IL-6 levels), along-with reduced 25-hydroxy-Vitamin-D levels were factors associated with poorer recovery of beta-cell secretion amongst the KPD patients. Conclusion This is the first prospective study to demonstrate progressive recovery of p-cell secretion in new-onset A-beta + KPD provoked by COVID-19 infection in Indian adults, with a distinctly different profile from Type 1A DM.Copyright © 2023 Elsevier B.V.
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Vitamin D, a fat-soluble vitamin helps the body to absorb and retain calcium and phosphorus.Apart from this primary activity, it exhibits potent antimicrobial and antiinflammatory effects viaimmune-modulatory properties. Vitamin D has shown inhibitory effects on the production of pro-inflammatory cytokines, including TNF-alpha and IL- 6, by various mechanisms, includingdown-regulating viralinduced NFkB activation So, this present study aimed to study the relations of serum calcium, phosphorus and Vitamin D levels in association with severity and mortality in SARSCoV- 2 patients. A total of 150 individuals infected with COVID-19 and 50 healthy individuals were recruited. Cases were divided based on severity (mild, moderate and severe) and outcome (discharged or deceased). Serum Ca, Po4, and ALP were analysed by the direct colourimetric method. Vitamin D was measured using the chemiluminescent immunoassay (CLIA). The median serum calcium, Phosphorus, ALP and vitamin D levels in COVID 19 patients were 8.02 mgldL (IQR, 7.24-8.71), 3.93 mgldL (IQR, 2.97- 4.36), 115 IU/L(IQR, 94-146) and 17.2 ng/mL (IQR, 11.6- 25.9) respectively. On comparing the different severity groups a significant difference was found in Vitamin D (p<0.002), ALP (p<0.00001) and calcium (p<0.0001). The serum calcium levels were significantly positively correlated with Vitamin D levels and negative correlation with the inflammatory markers like IL-6. Similarly, patients with low calcium and vitamin D were found to have a fatal outcome. 838 The multivariable analysis showed that a combination of low calcium and vitamin D with higher age are associated with mortality in COVID-19 patients. Serum calcium and Vitamin D were associated with the clinical severity and prognosis of patients with COVID-19.
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Objective: The COVID-19 epidemic resulted in a global crisis of public health. Therefore, the possibility of prevention, leading to reduced infection and/or an improved disease state, is the subject of intensive attention. The novelty of this study is the direct evaluation of vitamin D levels with the risk of COVID-19 infection. Background(s): Currently, several nutraceuticals, including vitamin D, beta-glucan, and some minerals, are being studied for their role in stimulating immunity. Our study focused on the relationship between levels of vitamin D in immunodeficient patients and the risk of the development of COVID-19. Method(s): In this study, patients were supplemented with vitamin D. Result(s): In a group of 71 patients, we found that patients with vitamin D levels below 30 ng/ml had an increased risk of COVID-19 development and more severe disease progress. In patients with blood levels over 40 ng/ml, we consistently found high levels of protection against COVID-19 infection. Conclusion(s): The most important finding is that vitamin D levels above 40 ng/ml result in the reduction of risks of serious clinical manifestation of COVID-19 infection.Copyright © 2023 Richter et al.
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Background: COVID-19 still needs to be further investigated for risk and preventing factors. Various factors are known to negatively affect the course of disease in patients suffering from COVID-19. As it is known, vitamin D affects the immune system and a vitamin D deficiency is often seen in patients with ARDS. Thus, we hypothesize that vitamin D could be one of those influencing factors. However, an association between the vitamin D level and the severity of the disease remains unclear. Aim(s): This study aims to contribute to the clarification whether there is a correlation between the serum 25- hydroxyvitamin D level and the severity of COVID-19 disease in hospitalized SARS-CoV-2 positive patients. Method(s): This is a retrospective, observational study in a single-center setting in Switzerland. Data of approximately 1200 hospitalized patients between January 2020 and December 2021 with an available and current 25- hydroxyvitamin D value and a SARS-CoV-2 positive immune status will be analysed. Quantitative and descriptive statistics as well as multivariable regression are used to assess the relationships between the serum 25- hydroxyvitamin D level and the severity of COVID-19 disease, adjusted for known confounding variables of vitamin D deficiency and COVID-19 severity such as age, sex and comorbidities. Result(s): As the study is ongoing, no results are available yet, but will be by the time of the congress. Conclusion(s): The results of this study may contribute to new treatment and prevention methods of COVID-19 together with more evidence from clinical trials to assess the causality of the relationship between vitamin D level and the severity of COVID-19 disease.
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Chronic heart failure despite the development of new treatment methods, remains the most common and prognostic adverse complication of all cardiovascular diseases. Studies conducted in different countries over the past decades have convincingly proved that vitamin D deficiency is one of the important factors in the development of CCC diseases. Vitamin D (VDR) receptors were detected in more than 40 target tissues, including cardiomyocytes, smooth muscle and endothelial vascular cells and have convincingly proved, that eliminating vitamin D deficiency improves blood pressure in hypertension and also reduces myocardial hypertrophy. The above studies also confirmed the effect of vitamin D on the development of prediabetes, diabetes, metabolic disorders. The effect of vitamin D on the prevention of atherosclerosis has also been confirmed. One of the mechanisms for the development of atherosclerosis is currently considered an inflammatory process. The effect of vitamin D on the course of inflammatory processes in the body was clearly manifested during the pandemic caused by the new coronavirus infection COVID-19. There was a clear correlation between vitamin D levels and the severity of infection. In severe COVID-19, as a rule, either a deficiency or a lack of vitamin D in the body was determined. In addition, low vitamin D levels increase the risk of developing severe forms of coronary heart disease. The study involved 30 patients <n = 30>diagnosed with heart failure(I-III NYHA) In 12 < 40%> patients out of 30, vitamin D levels were below 20.0 ng/mL, consistent with this vitamin deficiency. In 14 < 46,67%>the level of vitamin D in the blood was between 20.0 ng/mL and 30.0 ng/mL and this corresponded about the lack of vitamin D. Only 4 < 13,33%> patients has level of vitamin D in reference values and this was due to the use vitamin D due to comorbid pathology: thyroid disease, autoimmune diseases or previously identified vitamin D hypovitaminosis. Vitamin D partially enters the body with food mainly found in animal productsliver, milk, eggs, butter, etc and is formed in the skin under the influence of ultraviolet rays. However, patients with CHF often have concomitant diseases:kidney disease, diabetes, disorders and others, forcing them to adhere to a strict diet poor in vitamin D. Also, due to CHF, these patients mainly lead a sedentary lifestyle, and, as a result, receive little ultraviolet rays. This explains the frequently detected deficiency and deficiency of vitamin D in patients with CHF, if, they do not receive drugs that compensate for its deficiency.
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Introduction: Vitamin D plays a role in the modulation of cytokine release, inflammation, innate and adaptive immunity. It has been frequently discussed that the hyperinflammatory response that causes acute respiratory distress syndrome or other organ damage due to SARS-CoV-2 at the beginning of the pandemic can be modulated by the adequacy of vitamin D. The relationship of vitamin D with many conditions such as mortality, number of intensive care unit stays, disease severity, and organ damage has been investigated, but the information on its effect on secondary infections that occur during the course of the disease is limited. In this study, it was aimed to reveal the relationship of vitamin D with secondary infections that occur during the course of COVID-19 disease. Materials and Methods: Medical records of patients hospitalized in the COVID-19 pandemic service with the diagnosis of COVID-19 were evaluated retrospectively. Results: One hundred eighty-one patients were included in the study. The mean of 25(OH) vitamin D was found to be 18.76 ± 9.82 ng/mL. When 25-hydroxy vitamin D was compared with gender, disease severity, mortality, need for mechanical ventilation and presence of symptoms, no statistically significant difference was found (p> 0.05). The medical data of the patients during their hospitalization were analyzed and secondary infection was detected in 14.9% (n= 27). When 25-hydroxy vitamin D and the presence of secondary infection were compared, the 25(OH)D vitamin level of those with secondary infection was found to be low and this was found to be statistically significant (p= 0.016). As a result of the evaluation made by ROC analysis, 25-hydroxy vitamin D was found to have a diagnostic value in predicting positive culture results in COVID-19 patients (AUC= 0.771, 95% Confidence Interval= 0.612-0.810, p= 0.003, p< 0.05). Conclusion: While vitamin D continues to be an important topic of discussion in COVID-19 disease due to its effects on the immune system, it should not be forgotten that low vitamin D increases the risk of secondary infection developing in the course of COVID-19 and this may have an impact on prognosis.
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In recent years, new data have been obtained on the significant prevalence of vitamin D (VD) deficiency in the population, and knowledge about the role of vitamin D in the regulation of many physiological processes in the body, including the functioning of the immune system, has increased. The SARS-CoV-2 pandemic has further highlighted the issue of an adequate immune response in vitamin D deficiency. Objective of the review. To present and summarize the evidence on the role of VD in different parts of the immune response in COVID-19, to analyze available studies of the VD status effect on the course and outcome of COVID-19 in patients from different population groups. Material and methods. A search of domestic and foreign literature on the role of VD in the immune response in respiratory viral infections and SARS-CoV-2, as well as practical measures of VD-status correction in COVID-19, was performed. We used Scopus, Web of Science, PubMed, Google Scholar, eLibrary, and Cyberleninka databases. Results. Numerous clinical and observational studies have found an association between 25-hydroxyvitamin D levels, COVID-19 severity, and mortality. This association can be explained by the multifaceted role of vitamin D in the physiology of the human immune and endocrine systems. On the immunological side, the active form of VD promotes the secretion of antimicrobial peptides responsible for inhibiting viral replication and stimulates autophagy by increasing the level of Beclin1 protein and decreasing the level of mTOR protein regulating cellular homeostasis. It leads to the presentation of antigens followed by activation of the antiviral pathway of type I interferons. VD also stabilizes intercellular junctions, including those in the airway epithelium, reducing their permeability to pathogens, stimulates the activity of angiotensin-converting enzyme-2, whose receptors are a conduit for SARS-CoV-2 into cells, and several pathophysiological responses associated with the disease symptoms and acute lung injury. Adequate vitamin D status can provide significant benefits during the pandemic. Conclusion. To date, ideas about the role of vitamin D in regulating the immune response in respiratory infections have significantly expanded. However, its use in the complex preventive measures and adjuvant therapy of viral infections, including COVID-19, should be the subject of further scientific research.
ABSTRACT
Introduction: Serum levels of vitamin D on the development and exacerbation of symptoms of Covid-19 disease have been expressed and discussed in several studies. The present study was performed aimed to systematically review the studies performed on the relationship between serum level of vitamin D with the incidence and severity of Covid-19 symptoms disease in women and children. Method(s): In this systematic review study, to obtain the related studies, the English databases of Pubmed, Scopus and Web of Science were searched up to April 4, 2021 with the English keywords of Vitamin D and Covid-19 with combination of operators "AND" and "OR". Inclusion criteria were: cohort articles, case-control or cross-sectional and English language articles and the study population were women or children. The quality of articles was assessed using the Strobe checklist. Based on the Strobe criteria, studies which scored moderate and good in the assessment were included in the study. Result(s): Out of 315 articles, 23 qualified articles were reviewed. In these studies, the association between serum vitamin D levels and the incidence, severity, and mortality of Covid-19 was assessed. Two studies included the population of children and 21 studies of women. Conclusion(s): Low serum levels of vitamin D are significantly associated with an increase in the incidence of Covid-19 and the severity of the disease, but this relationship with the mortality rate from the disease provides contradictory results in several studies;therefore, more studies in this field are necessary to achieve more definite results, especially in children. Copyright © 2022, Mashhad University of Medical Sciences. All rights reserved.