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1.
Gastroenterology ; 162(7):S-1169, 2022.
Article in English | EMBASE | ID: covidwho-1967421

ABSTRACT

Introduction: Perinatal infection with Hepatitis B virus (HBV) becomes chronic in 90% of cases with subsequent risk of developing serious liver disease. To prevent this, American Academy of Pediatrics has set recommendations for 3 groups of newborns weighing $ 2,000 grams: (1) maternal Hepatitis B surface antigen (HbSAg) negative: administration of HBV vaccine by 24 hours of life (HoL);(2) maternal HbSAg unknown: administration of HBV vaccine by 12 HoL (and HBV immune globulin by hospital discharge if status remains unknown);and (3) maternal HbSAg positive: administration of HBV vaccine and immune by 12 HoL. These timings maximize effectiveness of the HBV vaccine in preventing vertical transmission. Given poor compliance with current HBV vaccination demonstrated by the National Immunization Survey, this study aims to better understand factors associated with vaccine implementation at a large women's and children's center during the SARS-CoV-2 pandemic. Methods: This study was a retrospective chart review of newborns born from January 2019-September 2021 at Texas Children's Hospital in Houston, Texas (n=17,294). All newborns$2,000 grams were included and stratified by maternal HbSAg result (negative, unknown, or positive by 12 HoL) (see Figure). Univariate analysis was used to identify factors associated with timely receipt of the HBV vaccine and/or HBV immune globulin. Results: In the group with negative maternal HbsAg (n=17,185), 70.3% (n=12,077) received the HBV vaccine by 24 HoL. Those not receiving the vaccine prior to discharge (6.9%, n= 1,180) were more likely to be Caucasian, have commercial insurance, and not receive vitamin K or erythromycin. In the group with unknown maternal HbSAg (n=74), 17.6% (n=13) received the HBV vaccine by 12 HoL while 75.7% (n=56) received it between 12 HoL and discharge. In the group with positive maternal HbSAg (n=35), 91.4% (n=31) received the HBV vaccine and immune globulin by 12 HoL. Overall deviation from vaccination guidelines was highest in newborns admitted to intensive care units, and similar vaccination rates occurred in the period before and during the SARS-CoV-2 pandemic. Conclusions: Newborn HBV vaccination practices are not meeting American Academy of Pediatrics recommendations, which suggests a need to reevaluate current hospital protocol. Given that newborns with maternal HBV positive or unknown status are at highest risk of vertical transmission, initial interventions to improve timely vaccination should target these groups first, especially in intensive care settings. While 30% of newborns born to HbSAg negative mothers were not vaccinated by the recommended 24 HoL, only 7% had not received HBV vaccination prior to discharge. Dialog to increase HBV vaccine acceptance with individual families will likely be required to improve these rates. (Figure Presented)

2.
Gastroenterology ; 162(7):S-459-S-460, 2022.
Article in English | EMBASE | ID: covidwho-1967306

ABSTRACT

Background and aims: Micronutrient supplements such as vitamin D, vitamin C, and zinc have been used in managing viral illnesses. However, the role of these micronutrients in reducing mortality in patients with Coronavirus disease 2019 (COVID-19) remains unclear. We conducted this meta-analysis to provide a quantitative assessment of the effect of these individual micronutrients on mortality in COVID-19. Methods: We performed a comprehensive literature search using MEDLINE, Embase, and Cochrane databases through November 5th, 2021. All individual micronutrients reported by ≥3 studies and compared with standardof- care (SOC) were included. The outcome was mortality. All statistical analyses were performed using the Review Manager. Pooled risk ratios (RR) and corresponding 95% confidence intervals (CI) were calculated using the random-effects model. Results: We involving 5573 COVID-19 patients that compared three individual micronutrient supplements (vitamin C, vitamin D, and zinc) with SOC. Eight studies evaluated vitamin C in 1338 patients (530 in vitamin C and 808 in SOC). Vitamin C supplementation had no significant effect on the risk of mortality (RR 1.06, 95% CI 0.63-1.80, P=0.82, Figure 1A). Fourteen studies assessed the impact of vitamin D supplementation on mortality risk among 3497 patients (927 in vitamin D and 2570 in SOC). Vitamin D did not reduce the mortality risk in patients (RR 0.75, 95% CI 0.49-1.17, P=0.21, Figure 1B). Subgroup analysis showed that vitamin D supplementation was not associated with a mortality benefit in patients receiving vitamin D pre or post COVID-19 diagnosis (Figure 1B). Five studies, including 738 patients, compared zinc intake with SOC (447 in zinc and 291 in SOC). Zinc supplementation was not associated with a significant reduction of mortality (RR 0.79, 95% CI 0.60- 1.03, P=0.08, Figure 1C). Subgroup analyses of RCTs for all three micronutrient supplements showed consistent findings (Figure 2). Conclusions: Individual micronutrient supplementations, including vitamin C, vitamin D, and zinc, did not reduce mortality in patients with COVID-19. Further research is needed to validate our findings. (Figure Presented)

3.
Gastroenterology ; 162(7):S-291-S-292, 2022.
Article in English | EMBASE | ID: covidwho-1967287

ABSTRACT

Background: Post-COVID-19 conditions are defined as new, recurring, or ongoing health issues which present weeks after SARS-CoV-2 infection. The gastrointestinal (GI) involvement of COVID-19 suggests that a group of patients with lingering GI symptoms may develop Post-COVID-19 DGBI including irritable bowel syndrome (IBS) (Schmulson M et al. Am J Gastroenterol. 2021;116:4-7). In this study, we aimed to determine the epidemiological features of Post-COVID-19 DGBI. Methods: Subjects with confirmed COVID-19 at least 6 months before the study who had sustained GI symptoms were invited to complete an internet-based survey on Qualtrics, between March and August 2021. The survey included demographics, acute symptoms, comorbidities, as well as Rome IV questionnaire, Generalized Anxiety Disorder questionnaire (GAD-7) and Patient Health Questionnaire (PHQ)-9 for depression. Data was analyzed using ANOVA and multivariate analysis. Findings were reported as percentage or [p-value;(95% odds ratio CI)]. Results: Overall, 164 subjects (70% female, 14% male, and others unknown) with a positive COVID-19 test completed the survey. Among them, 4% were >65 years old and 24% reported hospitalization. Body mass index ³30 was present in 38%, diabetes in 6.7%, and vitamin D deficiency in 11% of the participants. In total, 108 (66%) subjects fulfilled Rome IV criteria for at least one DGBI. Of 108 with DGBI, only 27 (25%) had DGBI before COVID-19;DGBI developed in 81 subjects after COVID-19. The most common Post-COVID-19 DGBI were functional dyspepsia observed in 38 (postprandial distress syndrome n=31, epigastric pain syndrome n=22) followed by IBS in 26 subjects (IBS with Diarrhea n=7, IBS with Constipation n=4, Mixed-IBS n=14, Unsubtyped IBS n=1) (Table-1). The risk factors of severe COVID-19 including age >65, diabetes, and obesity were not associated with developing Post-COVID- 19 DGBI. Seventy (86%) of subjects with Post-COVID-19 DGBI had at least one GI symptom (abdominal pain, nausea/vomiting, and/or diarrhea) in the acute phase of COVID-19. Nausea/ vomiting during the acute illness increased [p-value of 0.02 with 95% OR CI (0.7-10.4)], and BMI less than 25 also increased the odds [p-value of 0.03 (95% OR CI: 0.26-8.4)] for Post-COVID-19 IBS. Anxiety was present in 48% and depression in 65% of subjects with Post-COVID-19 DGBI. Conclusions: Post-COVID-19 DGBI are new entities associated with a high rate of anxiety and depression. Although the majority of those with Post-COVID-19 DGBI reported having GI symptoms in the acute illness, some appeared in subjects without acute GI symptoms. (Table Presented)

4.
J Orthop ; 34: 8-13, 2022.
Article in English | MEDLINE | ID: covidwho-1966872

ABSTRACT

Purpose: This study aimed to audit the effects of vitamin D3 on the early functional outcomes, the incidence of nosocomial COVID-19 infection and complications in patients undergoing elective Total Knee Arthroplasty (TKA). Methods: This was a retrospective study involving patients undergoing primary unilateral TKA between January 2020 to May 2021 operated by a single surgeon using a single implant. Participants were divided into two cohorts, Deficient-vitamin D3 level <20 ng/ml and Sufficient-vitamin D3 level ≥20 ng/ml. Assessment for Knee Society Score and Oxford Knee Score (OKS) was done preoperatively and one year after TKA. Nosocomial COVID-19 infection rate, 30-day re-admissions and complications were noted during the study. Results: 235 patients were divided into 2 cohorts matched by age, gender and ASA grades. 74 patients belonged to the deficient group and 161 belonged to the sufficient group. The mean preoperative scores in the sufficient group were higher than the deficient group (OKS = 15.74 vs 12.95; KSS = 88.91vs 85.62). Similarly, the one-year postoperative scores in the sufficient group were significantly higher (OKS = 36.54 vs 35.16; KSS = 164.01 vs 161.22). A linear correlation was present between preoperative score (r = 0.273) & post-operative scores (r = 0.141) with serum vitamin D3 levels. Vitamin D3 deficient individuals had higher nosocomial COVID-19 infection rate (10.81% vs 4.96%,p = 0.16). The incidence of complications like DVT, embolism, stroke, infection and fracture were not statistically different in the two groups. Conclusion: Vitamin D positively influences the outcomes of TKA and protects against nosocomial COVID-19 infection in patients undergoing elective TKA.

5.
Int J Biometeorol ; 2022 Aug 01.
Article in English | MEDLINE | ID: covidwho-1966145

ABSTRACT

In Poland, schools were closed from March to June 2020 due to the COVID-19 epidemic. During the lockdown (March-April), everyone was advised to stay at home. From May, students were allowed to spend time outdoors. We examine their exposure to solar UV radiation during the period of virtual learning at schools (May-June), vacations (July-August) and the first month of typical learning (September). Primary and high school students aged 12-18 completed a questionnaire on the details of their outdoor activities and the weather at the exposure site. A total of 146 anonymous questionnaires were registered for the study. The survey responses provided input to a radiative transfer model to estimate erythemal and vitamin D doses obtained by teenagers during outdoor activities. The results from 48% of the questionnaires indicated that students' exposure exceeded 1 minimal erythema dose (MED) during the day. Corresponding doses of sun-synthesized vitamin D, in excess of 1000 international units (IU) and 2000 IU, were found in 77% and 66% of the surveys, respectively. Only 12% of the teenagers declared that they use sunscreen. The overexposure (> 1 MED) increased with age. It was found in 72% and 26% of surveys among the students aged 17-18 and 12-14, respectively. Teenagers seem to have tried to compensate for the lack of sunlight during the lockdown by engaging in outdoor activities permitted since May. While those activities could have improved their vitamin D levels, they also put them at a higher risk of developing erythema.

6.
Medycyna Ogólna i Nauki o Zdrowiu ; 28(2):111-120, 2022.
Article in Polish | ProQuest Central | ID: covidwho-1965014

ABSTRACT

Introduction and objective: Currently, the world is affected by the pandemic caused by coronavirus disease (COVID-19), which strongly affects the health care system. Dietary habits and nutritional status of the body significantly influence the course and outcome of COVID-19 treatment. The aim of this study is the summary of the current knowledge about the impact of dietary habits and nutritional status on the development and course of coronavirus disease and the presentation of nutritional recommendations for the dietary management in COVID-19 treatment. Review methods: The PubMed database and the official websites of medical organizations and associations were searched for the English phrases ‘COVID-19’, ‘SARS-CoV-2’, ‘nutrition’, ‘diet’. Abbreviated description of the state of knowledge: Chronic inflammation, immune system disorders, chronic diseases, nutritional status disorders and deficiency of nutrients might present possible factors associated with the severity and course of COVID-19. The nutrients play a direct role as cofactors and regulators of the immune system and reveal antiinflammatory effects. The supply of zinc, selenium, copper, iron, vitamin D, A, C, and B-group, as well as probiotics is important for the optimal function of the immune system. Deficiency of this micronutrients plays a remarkable role in an adverse course of COVID-19. Summary: The nutritional status of the body, dietary habits including the supply of necessary nutrients can have an impact of the reduction of susceptibility and alleviate the adverse consequences of coronavirus disease. The role of diet and nutritional interventions in COVID-19 is highly promising. This area of study is innovative;therefore, further investigations are needed to justify specific benefits from these actions for combating coronavirus disease.

7.
Era's Journal of Medical Research ; 8(2):185-189, 2021.
Article in English | ProQuest Central | ID: covidwho-1964967

ABSTRACT

In China and India, Nelumbo nucífera, a perennial aquatic plant, has been used as a medicinal herb. The various sections of plants, such as leaves, seeds, flowers and rhizomes, have been reported to have beneficial effects in the treatment of pharyngopathy, pectoralgia, spermatorrhoea, leucoderma, smallpox, dysentery, cough, haematemesis, epistaxis, haemoptysis, haematuria, metrorrhagia, hyperlipidaemia, fever, cholera, hepatopathy and hyperdipsia in the traditional medicine system. Different pharmacological activities such as anti-ischaemic activity, antioxidant activity, hepatoprotective activity, anti-inflammatory activity, anti-fertility activity, antiarrhythmic activity, anti-fibrosis activity, antiviral activity, anti-proliferative activity, anti-diarrhoeal activity, psychopharmacological activity, antipyretic activity, immune-modulatory activity, hypoglycaemic activity, aldose reductase inhibitory activity, antibacterial, aphrodisiac activity, anti-platelet activity, cardiovascular activity, anti-obesity activity, lipolytic activity, hypo-cholesterolaemic activity, hepato-protective activity, anticancer activitydiuretic activity, antioxidant activity have been clinically evaluated for N.nucifera. Different pharmacological activities such as anti-ischaemic activity, antioxidant activity, hepato-protective activity, anti-inflammatory activity, anti-fertility activity, anti-arrhythmic activity, antifibrosis activity, antiviral activity, anti-proliferative activity, anti-diarrhoeal activity, psychopharmacological activity, diuretic activity, antioxidant activity have been clinically evaluated for N.nucifera. A wide number of phytoprinciples from the plant have been isolated. The present review seeks to consolidate the traditional, ethno-botanical, phytochemical and pharmacological data available on N.nucifera stem and to explore its role as an immunity booster and anti-inflammatory food.

8.
Family Medicine and Primary Care Review ; 24(2):151-155, 2022.
Article in English | Scopus | ID: covidwho-1964332

ABSTRACT

Summary Background. The Ministry of Health guidelines in Indonesia establish a protocol for administering vitamin D to people with COVID-19 as being 1,000 to 5,000 IU per day, both for adults and older adults. Objectives. This systematic review aims to investigate how much the optimal dose for patient COVID-19 within high-risk vitamin D deficiency is either geriatric population or have an underlying disease. Material and methods. A 32-year-old female patient came with positive RT-PCR nasopharyngeal swab with clinical anosmia with hypo-vitaminosis D, and a 60-year-old patient with shortness of breath and cough complaints, positive RT-PCR nasopharyngeal swab. Both patients were given 1,000 IU/day vitamin D. Results. A literature search was carried out from 2019 to 2021 on several search engines such as Pubmed, Clinical Trial.gov and Google Scholar. Four studies pooled and entered review synthesis. Conclusions. Supplementation with pulse dose vitamin D provides a clinically significant improvement, decreasing inflammatory cyto-kine markers in the non-geriatric population with hypovitaminosis. In the geriatric population, standard vitamin D has been shown to reduce the risk of frailty and worsening clinical features in COVID-19. As clinicians, it is important to enhance clinical awareness when recognising special populations with COVID-19 who require vitamin D supplementation above the guideline dose. © by Wydawnictwo Continuo.

9.
J Am Board Fam Med ; 35(4): 695-707, 2022.
Article in English | MEDLINE | ID: covidwho-1963338

ABSTRACT

This study aimed to help determine the effect of dietary supplements on symptom course and quality of life in patients with mild-to-moderate COVID-19 infection. DESIGN: We modified the Wisconsin Upper Respiratory Symptom Survey (WURSS) to conduct a 3 arm, parallel, randomized, double-blind, placebo-controlled trial, enrolling patients with mild-to-moderate symptoms of COVID-19 infection. Patients took placebo (n = 34), vitamin C 1000 mg (n = 32), or melatonin 10 mg (n = 32) orally for 14 days. OUTCOMES: Ninety Eight (98 out of 104 recruited; mean age = 52 years) patients completed the study. Outcomes were calculated as differences from baseline scores on each of 2 WURSS-derived surveys and analyzed using a spline regression analysis. Regarding symptom progression, those patients taking placebo and vitamin C progressed at the same rate. When compared with those taking placebo (coefficient = -1.09 (95% confidence interval [CI] = -1.39 to -0.8) the group taking melatonin had a faster resolution of symptoms (coefficient = -0.63 [95% CI -1.02 to -0.21] P = .003). By day 14 all 3 groups had reached plateau.Quality-of-life impact analysis demonstrated that the group taking vitamin C improved at the same rate as the group taking placebo (coefficient = -0.71 (95% CI = -1.11 to -0.3)). The group taking melatonin (coefficient = -1.16 (95% CI = -1.75 to - 0.57) P < .005) had a faster improvement in quality-of-life. By day 14 all 3 groups had reached plateau. CONCLUSION: Vitamin C 1000 mg once daily has no effect on disease progression. Melatonin 10 mg daily may have a statistically significant effect but it is unclear if this represents a clinically significant benefit to those with mild-to-moderate symptoms of COVID-19 infection. Further study is warranted.


Subject(s)
COVID-19 , Melatonin , Ascorbic Acid/therapeutic use , COVID-19/drug therapy , Double-Blind Method , Humans , Melatonin/adverse effects , Melatonin/therapeutic use , Middle Aged , Quality of Life , Vitamins/therapeutic use
10.
Int J Mol Sci ; 23(14)2022 Jul 16.
Article in English | MEDLINE | ID: covidwho-1964009

ABSTRACT

The microsomal cytochrome P450 3A4 (CYP3A4) and mitochondrial cytochrome P450 24A1 (CYP24A1) hydroxylating enzymes both metabolize vitamin D and its analogs. The three-dimensional (3D) structure of the full-length native human CYP3A4 has been solved, but the respective structure of the main vitamin D hydroxylating CYP24A1 enzyme is unknown. The structures of recombinant CYP24A1 enzymes have been solved; however, from studies of the vitamin D receptor, the use of a truncated protein for docking studies of ligands led to incorrect results. As the structure of the native CYP3A4 protein is known, we performed rigid docking supported by molecular dynamic simulation using CYP3A4 to predict the metabolic conversion of analogs of 1,25-dihydroxyvitamin D2 (1,25D2). This is highly important to the design of novel vitamin D-based drug candidates of reasonable metabolic stability as CYP3A4 metabolizes ca. 50% of the drug substances. The use of the 3D structure data of human CYP3A4 has allowed us to explain the substantial differences in the metabolic conversion of the side-chain geometric analogs of 1,25D2. The calculated free enthalpy of the binding of an analog of 1,25D2 to CYP3A4 agreed with the experimentally observed conversion of the analog by CYP24A1. The metabolic conversion of an analog of 1,25D2 to the main vitamin D hydroxylating enzyme CYP24A1, of unknown 3D structure, can be explained by the binding strength of the analog to the known 3D structure of the CYP3A4 enzyme.


Subject(s)
Steroid Hydroxylases , Vitamin D , Cytochrome P-450 CYP3A , Cytochrome P-450 Enzyme System/metabolism , Humans , Steroid Hydroxylases/metabolism , Vitamin D/metabolism , Vitamin D3 24-Hydroxylase/metabolism
11.
Clin Nutr ESPEN ; 50: 8-14, 2022 08.
Article in English | MEDLINE | ID: covidwho-1959411

ABSTRACT

COVID19 has emerged as one of the worst pandemics in the history of mankind. Several vaccines have been approved by different government agencies worldwide, but data on their efficacy and safety are limited, and distribution remains a massive challenge. As per WHO, personal immunity is vital for protection against COVID19. Earlier, Vitamin C-mediated pathways have been shown to play critical role in boosting immunity attributed to its antioxidant properties. Recently, the involvement of such pathways in protection against COVID19 has been suggested. The controlled doses of Vitamin C administered through intravenous (IV) injections are being studied for determining its role in the prognosis of COVID19. In this article, we have discussed the potential role of Vitamin C in the management in COVID19 patients and presented recent clinical trials data. Additionally, we have elaborated the possibility of administering Vitamin C through inhalers in order to achieve local high concentration and the challenges of such approach.


Subject(s)
COVID-19 , Ascorbic Acid/therapeutic use , COVID-19/drug therapy , Humans , Pandemics , SARS-CoV-2 , Vitamins/therapeutic use
12.
Aging Medicine and Healthcare ; 13(2):49-50, 2022.
Article in English | EMBASE | ID: covidwho-1957662
13.
Obstetrics, Gynecology and Reproduction ; 16(2):158-175, 2022.
Article in Russian | EMBASE | ID: covidwho-1957618

ABSTRACT

These days, anticoagulants are in great demand. They are used as a prophylaxis for thromboembolic complications in various diseases and conditions in general therapeutic practice, cardiology, neurology, as well as obstetrics to manage high-risk pregnancies. The relevance of anticoagulants competent use has come to the fore in connection with the emergence of a new disease – COVID-19 and its serious complications such as developing thrombotic storm, in which the timely applied anticoagulant therapy is the key to the success of therapy. The risk of bleeding should be considered when using any anticoagulant. Age, impaired renal function and concomitant use of antiplatelet agents are common risk factors for bleeding. Moreover, only vitamin K antagonists and heparin have specific antidotes – vitamin K and protamine, respectively. Inhibitors of other anticoagulants are universal presented as inactivated or activated prothrombin complex concentrate and recombinant factor VIIa. Hemodialysis effectively reduces dabigatran concentration, activated charcoal is effective in the case of recent oral administration of lipophilic drugs. Research on new antidotes of currently available anticoagulants is under way, similar to testing of new types of anticoagulants that are sufficiently effective in preventing and treating thromboembolic complications with minimal risk of hemorrhagic. The main contraindication to anticoagulants use is the doctor's ignorance of the mechanisms of drug action and opportunities for suppressing its effect.

14.
Journal of Pediatric Infectious Diseases ; 2022.
Article in English | EMBASE | ID: covidwho-1956442

ABSTRACT

Objective Vitamin D has many immune benefits and because its deficiency impacts most age groups, it became a nutrient of interest in the coronavirus disease 2019 (COVID-19) era. The objective of this study was to highlight the contribution of vitamin D status to the disease severity of hospitalized pediatric patients suffering from COVID-19 infection. Methods This was a cross-sectional study that was conducted on 42 children with documented positive polymerase chain reaction for COVID-19 infection. Detailed history taking and thorough clinical examination were done for each recruited patient. Besides the laboratory and radiological assessment done for COVID-19 patients, 25 hydroxy vitamin D levels [25(OH) D] in the serum were estimated using enzyme linked immunosorbent assay. Results Using the cutoff level of 10 ng/mL, only 40% of the patients were below this level and 60% had their vitamin D level more than or equal to 10 ng/mL. Significantly more patients of the first group needed oxygen support (denoting more severe COVID-19 infection and lung involvement). The older the patients, the more evident was vitamin D deficiency among them, and 25(OH) D values were not correlated to weight for length nor weight categories in the studied series of patients suffering from COVID-19. Conclusion Vitamin D deficiency affects the severity of pediatric COVID-19 infection in hospitalized patients. It is prudent to advise vitamin D level assessment in such cases and promptly manage the patients accordingly. We recommend further studies to assess the effect of vitamin D supplementation on the clinical outcome of COVID-19 in the pediatric population and other vulnerable groups.

15.
Journal of Pediatric Infectious Diseases ; 2022.
Article in English | EMBASE | ID: covidwho-1955805

ABSTRACT

Objective Multiple factors being overweight, asthmatic, or being of Asian or black ethnic origins have been reported vis-à-vis the multisystem inflammatory syndrome in children (MIS-C). There is an association between these conditions and vitamin D deficiency, which explains why MIS-C is more common in these patients. In the present study, we attempted to retrospective evaluate the 25-hydroxy vitamin D levels of patients with MIS-C, its association with acute phase reactants, its treatment, and clinical status. Methods Patients aged between 1.5 months to 18 years with MIS-C were included in the study. All of the laboratory parameters, treatment, and response to the treatment were evaluated retrospectively. Two groups were formed. Patients had 25-hydroxycholecalciferol D vitamin < 20 ng/mL in group 1 and ≥ 20 ng/mL in group 2. Results A total of 52 patients were included in the study. There was no statistical difference between groups in terms of acceptance of the intensive care unit treatment (p = 0.29) and response to the first-line treatment (p = 0.56). A lower median lymphocyte count (p = 0.01) and a higher median C-reactive protein (p = 0.04) and procalcitonin (p = 0.01) with N-terminal pro-B-type natriuretic peptide (p = 0.025) values were found in group 1. Conclusion Vitamin D deficiency was associated with an increased inflammatory response in children with MIS-C. More studies are required to determine the potential impact of vitamin D deficiency on the clinical outcome of MIS-C.

16.
International Journal of Pharmaceutical and Clinical Research ; 14(7):163-167, 2022.
Article in English | EMBASE | ID: covidwho-1955728

ABSTRACT

Introduction: Corona virus disease has several dermatological symptoms. Telogen effluvium is one of them. The present study presents a case series of post COVID Telogen effluvium from Central India region. Material and Method: This retrospective observational study included 72 patients (61 females & 11males), aged 29 to 62 years (median 49 yrs). The patient’s demography, history of hair fall, signs and symptoms, co morbidities and the treatment received for COVID-19 infection, Psychological perceived stress score, triggering factors for Telogen effluvium, Vitamin B12, Vitamin D and Ferritin levels were recorded & analysed. Result: The included patients were suffering from at least one co morbidity. Thirty patients had severe COVID-19 infection and were hospitalized. Psychological perceived stress score was low (12) in two, moderate (16-24) in twenty and high (29-38) in fifty patients. Vitamin B12 was low in twelve and Ferritin in ten patients. Seventy patients (97.2%) had positive hair pull test and 69 (95.8 %) had diffuse loss of hair. Discussion: Post covid Telogen effluvium was seen generally in females, and in middle aged. Most, 70/72 had moderate to severe psychological stress, Psychological perceived stress score was more than 16. Patients reported 2.2 to 6 months (median 3.5 months) after COVID-19 infection. Most 69 (95.8%) had diffuse hair loss. Post Covid patients may have several triggering factors for Telogen effluvium like psychological stress, nutritional deficiency or the drugs (heparin). Conclusion: Post Covid Telogen effluvium could be triggered by psychological stress, nutritional deficiencies (Vitamin B12, Iron) or drugs (heparin). Such cases could be managed by identification of triggering factors, proper counselling, high protein diet with vitamin supplementation.

17.
Pharmaceuticals (Basel) ; 15(8)2022 Jul 22.
Article in English | MEDLINE | ID: covidwho-1957411

ABSTRACT

There is increasing data regarding the association between vitamin D and COVID-19. This study aimed to reveal the alterations of vitamin D metabolism in the setting of COVID-19. We examined 119 adult COVID-19 inpatients and 44 apparently healthy adult individuals with similar serum 25OH-D3 levels as a reference group. The assessment included serum biochemical parameters (total calcium, albumin, phosphorus, creatinine), parathyroid hormone (PTH), vitamin D-binding protein (DBP), vitamin D metabolites (25OH-D3, 25OH-D2, 1,25(OH)2D3, 3-epi-25OH-D3, 24,25(OH)2D3 and D3) and free 25OH-D. COVID-19 patients had in general very low vitamin D levels (median 25OH-D3 equals 10.8 ng/mL), accompanied by an increased production of the active vitamin D metabolite (1,25(OH)2D3), estimated as higher 1,25(OH)2D3 serum levels (61 [44; 81] vs. 40 [35; 50] pg/mL, p < 0.001) and lower 25OH-D3/1,25(OH)2D3 ratio (175 [112; 260] vs. 272 [200; 433], p < 0.001) which is presumably aimed at preventing hypocalcemia. Patients with COVID-19 also had elevated DBP (450 [386; 515] vs. 392 [311; 433] mg/L, p < 0.001) and low free 25OH-D levels (<LoB vs. 3.9 [3.2; 4.4] pg/mL, p < 0.001). Follow-up assessment of the COVID-19 inpatients showed recovery of the observed changes. Overall, hospitalized patients with an acute course of COVID-19 have not only very low levels of 25OH-D but also profound abnormalities in the metabolism of vitamin D regardless of the clinical course of the disease. These alterations might exacerbate existing vitamin D deficiency and its negative impact.

18.
Nutrients ; 14(15)2022 Jul 26.
Article in English | MEDLINE | ID: covidwho-1957406

ABSTRACT

It is unclear whether vitamin D benefits inpatients with COVID-19. Objective: To examine the relationship between vitamin D and COVID-19 outcomes. Design: Cohort study. Setting: National COVID Cohort Collaborative (N3C) database. Patients: 158,835 patients with confirmed COVID-19 and a sub-cohort with severe disease (n = 81,381) hospitalized between 1 January 2020 and 31 July 2021. Methods: We identified vitamin D prescribing using codes for vitamin D and its derivatives. We created a sub-cohort defined as having severe disease as those who required mechanical ventilation or extracorporeal membrane oxygenation (ECMO), had hospitalization >5 days, or hospitalization ending in death or hospice. Using logistic regression, we adjusted for age, sex, race, BMI, Charlson Comorbidity Index, and urban/rural residence, time period, and study site. Outcomes of interest were death or transfer to hospice, longer length of stay, and mechanical ventilation/ECMO. Results: Patients treated with vitamin D were older, had more comorbidities, and higher BMI compared with patients who did not receive vitamin D. Vitamin D treatment was associated with an increased odds of death or referral for hospice (adjusted odds ratio (AOR) 1.10: 95% CI 1.05-1.14), hospital stay >5 days (AOR 1.78: 95% CI 1.74-1.83), and increased odds of mechanical ventilation/ECMO (AOR 1.49: 95% CI 1.44-1.55). In the sub-cohort of severe COVID-19, vitamin D decreased the odds of death or hospice (AOR 0.90, 95% CI 0.86-0.94), but increased the odds of hospital stay longer >5 days (AOR 2.03, 95% CI 1.87-2.21) and mechanical ventilation/ECMO (AOR 1.16, 95% CI 1.12-1.21). Limitations: Our findings could reflect more aggressive treatment due to higher severity. Conclusion: Vitamin D treatment was associated with greater odds of extended hospitalization, mechanical ventilation/ECMO, and death or hospice referral.


Subject(s)
COVID-19 , Adult , COVID-19/therapy , Cohort Studies , Hospitalization , Humans , Retrospective Studies , SARS-CoV-2 , Vitamin D/therapeutic use , Vitamins
19.
Nutrients ; 14(15)2022 Jul 26.
Article in English | MEDLINE | ID: covidwho-1957405

ABSTRACT

Vitamin D supplementation is linked to improved outcomes from respiratory virus infection, and the COVID-19 pandemic renewed interest in understanding the potential role of vitamin D in protecting the lung from viral infections. Therefore, we evaluated the role of vitamin D using animal models of pandemic H1N1 influenza and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. In mice, dietary-induced vitamin D deficiency resulted in lung inflammation that was present prior to infection. Vitamin D sufficient (D+) and deficient (D-) wildtype (WT) and D+ and D- Cyp27B1 (Cyp) knockout (KO, cannot produce 1,25(OH)2D) mice were infected with pandemic H1N1. D- WT, D+ Cyp KO, and D- Cyp KO mice all exhibited significantly reduced survival compared to D+ WT mice. Importantly, survival was not the result of reduced viral replication, as influenza M gene expression in the lungs was similar for all animals. Based on these findings, additional experiments were performed using the mouse and hamster models of SARS-CoV-2 infection. In these studies, high dose vitamin D supplementation reduced lung inflammation in mice but not hamsters. A trend to faster weight recovery was observed in 1,25(OH)2D treated mice that survived SARS-CoV-2 infection. There was no effect of vitamin D on SARS-CoV-2 N gene expression in the lung of either mice or hamsters. Therefore, vitamin D deficiency enhanced disease severity, while vitamin D sufficiency/supplementation reduced inflammation following infections with H1N1 influenza and SARS-CoV-2.


Subject(s)
COVID-19 , Influenza A Virus, H1N1 Subtype , Influenza, Human , Vitamin D Deficiency , Animals , Humans , Lung/metabolism , Mice , Pandemics , SARS-CoV-2 , Vitamin D/therapeutic use , Vitamin D Deficiency/epidemiology , Vitamins
20.
Nutrients ; 14(15)2022 Jul 26.
Article in English | MEDLINE | ID: covidwho-1957404

ABSTRACT

Retrospective studies showed a relationship between vitamin D status and COVID-19 severity and mortality, with an inverse relation between SARS-CoV-2 positivity and circulating calcifediol levels. The objective of this pilot study was to investigate the effect of vitamin D supplementation on the length of hospital stay and clinical improvement in patients with vitamin D deficiency hospitalized with COVID-19. The study was randomized, double blind and placebo controlled. A total of 50 subjects were enrolled and received, in addition to the best available COVID therapy, either vitamin D (25,000 IU per day over 4 consecutive days, followed by 25,000 IU per week up to 6 weeks) or placebo. The length of hospital stay decreased significantly in the vitamin D group compared to the placebo group (4 days vs. 8 days; p = 0.003). At Day 7, a significantly lower percentage of patients were still hospitalized in the vitamin D group compared to the placebo group (19% vs. 54%; p = 0.0161), and none of the patients treated with vitamin D were hospitalized after 21 days compared to 14% of the patients treated with placebo. Vitamin D significantly reduced the duration of supplemental oxygen among the patients who needed it (4 days vs. 7 days in the placebo group; p = 0.012) and significantly improved the clinical recovery of the patients, as assessed by the WHO scale (p = 0.0048). In conclusion, this study demonstrated that the clinical outcome of COVID-19 patients requiring hospitalization was improved by administration of vitamin D.


Subject(s)
COVID-19 , Cholecalciferol/therapeutic use , Dietary Supplements , Double-Blind Method , Hospitalization , Humans , Pilot Projects , Retrospective Studies , SARS-CoV-2 , Vitamin D , Vitamins/therapeutic use
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