Vitamin-D deficiency, the hidden pandemic in sunshine sufficient countries, exacerbating hypocalcaemia in a health worker undergoing thyroidectomy - a global perspective and review of literature

Introduction: Vitamin D deficiency (VDD) is common in young adults even in sunlight sufficient countries. It manifests with subtle and trivial symptoms that are often ignored. Nutritional deficiency due to improper dietary habits, poverty, long hours at work and study are factors. The lockdown during COVID has exacerbated the incidence. We had a patient with VDD who became symptomatic after routine thyroidectomy prompting our review into literature on the global health perspective of VDD. Material and method: - A 21-year-old nursing student developed hypocalcaemia within 24 hours after a routine thyroidectomy. VDD was detected and patient improved after supplementation. Literature was reviewed from Pubmed database for the medical aspects of the problem, from Government archives like the Scientific Advisory Committee on Nutrition, ICMR etc for cause and medical archives including those of paediatric and general health for the impact of disease at the state, national and global level. A global health problem list was prepared and data was reviewed. Discussion: Vitamin D is protective against respiratory infections due to viral aetiology including COVID. However, complete lockdown to prevent spread of COVID, online learning, and work from home culture has reduced sunlight exposure and increased incidence of VDD. Post thyroidectomy hypocalcaemia is common in VDD. Conclusion: Since there is a high prevalence of asymptomatic VDD even in sunshine sufficient countries, it is recommended to screen all patients especially young adults for VDD during routine preoperative work up.

The biological role of vitamin D

Resume. The article discusses diseases that depend on the level of vitamin D in the body, possible methods of correcting its level and their consequences. The dependence of the body on the level of this vitamin in the blood is considered. At the moment, there is a global vitamin D deficiency worldwide, which was revealed during the global COVID-19 pandemic. The positive effect of vitamin D on the immune system has been proven, and therefore its deficiency can worsen the course of various diseases. Vitamin D also acts as a hormone, the lack of which leads to pathologies of the cardiovascular system, rickets, osteoporosis, diabetes, obesity, and other serious diseases. The influence of its level on postoperative recovery is also considered. In addition, the article provides methods of correction by means of UV treatment in winter, which, as the data has shown, is dangerous. The article describes neurodegenerative disorders, which are greatly influenced by the level of this vitamin and its prevention. The influence of its level on the health of postmenopausal patients, leading to undesirable consequences, including osteoporosis, is analyzed. Examples of the effect on the protective properties of the oral cavity in periodontal disease and caries are given. The article describes the effect on the course of acute respiratory diseases in children, as well as the effect on the course of the disease in diabetes mellitus.

Vitamin D poising androgen/androgen receptor signaling mediated suppression of TMPRSS2 expression in lungs epithelial cell of elderly male COVID-19 patients

On 2020, March 11, the WHO proclaimed the epidemic to be a global pandemic, since COVID-19 is circulating quickly across the world.In comparison, the COVID-19 gender-disaggregated findings in several European countries suggest a comparable more among the sexes, but more extreme results in the elderly men. The S protein is known to arise from the virus surface and is the most essential for host attachment and penetration. To penetrate the cells, SARS-Cov-2 attaches to the ACE-2 and the TMPRSS-2 cell serine protease to be priming by host cell.A recent studyfindsSARS-CoV-2 spike protein primer proteaseexpression. TMPRSS2 is most abundant protein in ciliated cells and type I epithelial alveolar cells and up-regulated in human and mouse with aging. Supplementation of vitamin D(1,25-D) has demonstrated beneficial benefits in viral diseases, including influenza and HIV. The amount of 1,25-D is substantially down in serious COVID-19 patients. Immune reaction in COVID-19 patients deficient in vitamin D is strong. All this factors in enhanced mortality in COVID-19 infected 1,25D3 deficient patients. Based on the versatile methodology in current COVID-19 pandemic, we hypothesized themolecular exploration of the potential therapeutic effectiveness in suppression of TMPRSS-2 expression via androgen/androgen receptor signalling.

Vitamin D serum levels and its association with COVID 19 infection in Babylon Governorate, Iraq

Background: Considering the role of the data that indicate the importance of Vitamin D adequacy in protecting human being against different pathogens in patients exposed to infectious agents, the role of this Vitamin in Covid-19 patients is a matter of debate. Objectives: to identify the association between vitamin D level and infection with SARS-COV-2 of adult patients attending or admitted to Merjan Teaching Hospital, Babylon, Iraq. Methodology: this was a cross sectional comparison study of 240 participants, the total sample mean ..SD age was 46.9..15.4 years, 120 confirmed diagnosed cases and admitted to coronavirus unit and 120 negative cases (comparison group). The study carried out from January to June 2021 in Merjan Teaching Hospital, Babylon, Iraq. A pretested questionnaire used to interview patients after obtaining their verbal consents. Serum 25(OH) vitamin D measured to both groups of participants using immunoassay method (maglumi instrument) and body mass index (BMI) measured. The questionnaire included demographic information, clinical symptoms, unhealthy habits, and underlying health conditions, (comorbidities related to each participant elicited and recorded).

Edible mushrooms: the potential game changer in alleviating vitamin D deficiency and improving human health. (Special issue:Edible mushroom bioactives in traditional and in novel foods.functional foods and bioactive compounds in the management of neurodegenerative disease.)

The present review attempts to critically examine and evaluate research findings on mushrooms as sources of vitamin D and other nutraceuticals. Recently, there is a growing concern about diseases associated with the deficiency of vitamin D in humans. As people tend to stay indoors, in present times, due to the COVID-19 pandemic, vitamin D levels are further affected. Research indicates vitamin D as a promising defensive or therapeutic agent against COVID, making this review more crucial. Mushrooms, as a rich source of vitamin D along with various bioactive compounds, perform a significant role in resolving health issues. Robust analyses of various strategies for enhancing vitamin D content in mushrooms holds significance in this study;moreover, this will help stakeholders of the mushroom industry in enriching the overall mushroom quality and human health. Mushroom-based medicinal formulations and functional foods serve to deliver vitamins and nutrients to humans, thus helping to combat malnutrition and other health problems, especially in developing countries. Evidence from pre-clinical and clinical analyses suggests that vitamin D2 bioavailability in mushrooms is comparable with vitamin D from other sources. The review also emphasises molecular findings from mushrooms related to genes responsible for morphology and metabolic production of pro-vitamin-D2.

Impaired Folate-Mediated One-Carbon Metabolism in Type 2 Diabetes, Late-Onset Alzheimer's Disease and Long COVID.

Impaired folate-mediated one-carbon metabolism (FOCM) is associated with many pathologies and developmental abnormalities. FOCM is a metabolic network of interdependent biosynthetic pathways that is known to be compartmentalized in the cytoplasm, mitochondria and nucleus. Currently, the biochemical mechanisms and causal metabolic pathways responsible for the initiation and/or progression of folate-associated pathologies have yet to be fully established. This review specifically examines the role of impaired FOCM in type 2 diabetes mellitus, Alzheimer's disease and the emerging Long COVID/post-acute sequelae of SARS-CoV-2 (PASC). Importantly, elevated homocysteine may be considered a biomarker for impaired FOCM, which is known to result in increased oxidative-redox stress. Therefore, the incorporation of hyperhomocysteinemia will be discussed in relation to impaired FOCM in each of the previously listed clinical diseases. This review is intended to fill gaps in knowledge associated with these clinical diseases and impaired FOCM. Additionally, some of the therapeutics will be discussed at this early time point in studying impaired FOCM in each of the above clinical disease states. It is hoped that this review will allow the reader to better understand the role of FOCM in the development and treatment of clinical disease states that may be associated with impaired FOCM and how to restore a more normal functional role for FOCM through improved nutrition and/or restoring the essential water-soluble B vitamins through oral supplementation.

An integrated multi-sector approach to improve the nutritional status among school-age children and adolescents in Malawi

MALAWI. What this article is about: This article outlines two programmes - weekly iron and folic acid supplementation for adolescent girls and a nutrition sensitive agriculture programme - which form part of the Malawian government's efforts to optimise adolescent nutrition behaviours. Key messages: * Weekly iron and folic acid supplementation achieved high coverage across many schools but was impacted by COVID-19-related restrictions. * The nutrition sensitive agriculture programme led to steady improvements in adolescent girls meeting minimum dietary diversity standards with the impact of COVID-19 being mitigated through creative learning solutions. * This integrated, multi-sector approach to adolescent nutrition has proven effective thus far and efforts to scale up are now warranted.

Weekly iron and folic acid supplementation and nutrition education for adolescent girls in Africa and Asia

ASIA & AFRICA. What this article is about: This article outlines the activities carried out by Nutrition International since 2015, providing weekly iron and folic acid (IFA) supplementation to adolescents residing in six separate high-risk countries. Key messages: * Despite regional supply chain challenges and the complications due to the COVID-19 pandemic, weekly programmes were successful in supporting governments to increase IFA supplementation coverage. * There remains a paucity of data on adolescent health outcomes which makes the design, implementation and monitoring of adolescent health projects particularly difficult. * Although school-based delivery models are effective at the population level, reaching adolescents who do not attend school - who are often at higher risk - remains a significant challenge. Governments should prioritise reaching these isolated groups in order to meet public health policy objectives.

Prevalence and clinical outcomes of vitamin D deficiency in COVID-19 hospitalized patients: a retrospective single-center analysis

Vitamin D attenuates inflammatory responses to viral respiratory infections. Hence, vitamin D deficiency may be a highly significant prognostic factor for severity and mortality in COVID-19 patients. To evaluate the complications and mortality in different vitamin D status groups in COVID-19 hospitalized patients, we conducted this retrospective study on 646 laboratory-confirmed COVID-19 patients who were hospitalized in Shahid Modarres Hospital, Tehran, Iran from 16th March 2020 until 25th February 2021. Overall, patients with vitamin D deficiency, insufficiency and sufficiency were 16.9%, 43.6% and 39.5%, respectively. The presence of comorbidity, length of hospitalization, ICU admission, and invasive mechanical ventilation requirement and overall complications were significantly more in patients with vitamin D deficiency (p-value < 0.001). 46.8% (51/109) of vitamin D deficient patients died due to the disease, whilst the mortality rate among insufficient and sufficient vitamin D groups was 29.4% (83/282) and 5.5% (14/255), respectively. In univariate analysis, age > 60 years (odds ratio (OR) = 6.1), presence of comorbidity (OR = 10.7), insufficient vitamin D status (OR = 7.2), and deficient vitamin D status (OR = 15.1) were associated with increase in COVID-19 mortality (p-value < 0.001). Finally, the multivariate analysis adjusted for age, sex, and comorbidities indicated vitamin D deficiency as an independent risk factor for mortality (OR = 3.3, p-value = 0.002). Vitamin D deficiency is a strong risk factor for mortality and severity of SARS-CoV-2 infection. Vitamin D supplementation may be able to prevent or improve the prognosis of COVID-19 during this pandemic.

Vitamin D3 - a fundamental component of human health and a potential supplement for COVID-19 prevention and therapy

Introduction and objective: Vitamin D3 is one of the most essential endogenous compounds synthesized in the human body. Originally, its deficiency was associated with the occurrence of rickets in children. However, a number of studies carried out over the last decades indicated that vitamin D3 is much more important than previously thought. The aim of this study was to analyze the available scientific literature on vitamin D3 and its effects on human health. Review methods. The following combinations of key words were used to search the Pubmed database: [vitamin D] + [synthesis, metabolism, receptor, epidemiology, deficiency, SARS-CoV-2]. After applying exclusion criteria, 67 articles were selected for review. Brief description of the state of knowledge. About 90% of vitamin D3 is produced in the skin as a result of exposure to UVB radiation. The remaining portion is supplied from food or dietary supplements. It is postulated that vitamin D3 deficiency is one of the most pressing health problems today. Literature data indicate that vitamin D3 deficiency severely disrupts the body's homeostasis and increases the risk of certain cancers, cardiovascular diseases, and type 2 diabetes. Since the 2019 outbreak of the SARS-CoV-2 coronavirus pandemic, clinical studies have been initiated on the effects of vitamin D3 on susceptibility to infection and disease course. It has been found to have beneficial effects in preventing infection and mitigating the effects of COVID-19. Summary. With the progress of medicine it has been understood how important vitamin D3 is for the proper functioning of the body and what health consequences its deficiency entails. Therefore, from the point of view of public health it is important to make the general public aware of the importance of this vitamin for health and the advantages of its regular intake.