Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 141
Filter
1.
Clin Lab ; 68(3)2022 Mar 01.
Article in English | MEDLINE | ID: covidwho-1716097

ABSTRACT

BACKGROUND: The SARS-CoV-2 outbreak started in March 2020 with more than 120,552,261 cases at present and having caused over 2,667,248 deaths worldwide at the time this paper was written. The clinical signs of SARS-CoV-2 infection are especially evident in the respiratory and cardiovascular systems. Patients can be asymptomatic or present mild respiratory symptoms to severe acute lung injury leading to multiorgan failure and death. The study aims to assess the levels of serum 25-hydroxyvitamin D (25-(OH)-D) in 20 hospitalized patients infected with SARS-CoV-2 and 20 deceased people and to analyze the influence of vitamin D status on the severity of their disease. METHODS: The present study was conducted on 40 patients who tested positive for SARS-CoV-2 infection. They were divided into two groups: 20 patients admitted to the "Victor Babes" Hospital of Infectious Diseases and 20 postmortem cases autopsied at the Institute of Legal Medicine Timisoara, Romania. During the autopsy, blood and bronchial fluid samples were collected for the laboratory. Automate Viral RNA extraction was performed on the Maxwell 48 RSC Extraction System (Promega, USA) using the Maxwell RSC Viral Total Nucleic Acid Purification kit (Promega, USA). After RNA extraction, the samples were amplified on a 7500 real-time PCR (Applied Biosystems, USA) using the genesig® Real-Time PCR Assay 2G (Primer Design, UK). RESULTS: The living and deceased patients selected for the research presented decreased vitamin D levels, which are associated with increased levels of D-dimers, C reactive protein (CRP), and interleukin-6 (IL-6). These patients had a severe form of the SARS-CoV-2 disease, which led to death. CONCLUSIONS: We conclude that deficiency of vitamin D in patients infected with SARS-CoV-2 presents a major risk factor related to the evolution and severity of the disease.


Subject(s)
COVID-19 , Vitamin D Deficiency , Humans , Risk Factors , SARS-CoV-2 , Vitamin D , Vitamin D Deficiency/diagnosis , Vitamin D Deficiency/epidemiology , Vitamins
2.
Clin Lab ; 68(3)2022 Mar 01.
Article in English | MEDLINE | ID: covidwho-1689821

ABSTRACT

BACKGROUND: Vitamin D is known to suppress the release of proinflammatory cytokines, increase the release of anti-inflammatory cytokines, and present an immunomodulatory effect. In light of the foregoing, it is suggested that vitamin D may play an important role in the course of COVID-19 infection. This study, therefore, aimed to examine the relationship between vitamin D levels and length of hospital stay of COVID-19 patients. METHODS: This retrospective study was conducted between March 15th and October 15th, 2020, among 768 patients who were hospitalized due to the diagnosis of COVID-19 infection confirmed with PCR tests taken at the Health Sciences University, Antalya Training and Research Hospital. The study included 39 patients aged 18 - 65 years, whose 25 (OH) vitamin D levels were examined within 3 months prior to the diagnosis with PCR, and whose results were found ≥ 30 ng/mL, and those patients whose 25 (OH) vitamin D levels were examined within 3 months after the diagnosis with PCR, and whose results were found < 30 ng/mL. The patients were grouped according to 25 (OH) vitamin D levels and evaluated in terms of length of hospital stay. RESULTS: Of all the 39 patients in this study, 61.5% were female, 38.5% were male, with a mean age of 48.64 ± 11.79 years. The average of 25 (OH) vitamin D levels of the patients was 21.44 ± 11.17 ng/mL, the average length of hospital stay was 9.41 ± 8.90 days. The length of stay was found to increase significantly in participants who were 45 years and older, who were male, those with chronic diseases, and those with lung involvement detected on thoracic CT imaging at the time of admission. No statistically significant difference appeared with respect to the length of hospital stay when the patients were evaluated according to their 25 (OH) vitamin D levels. CONCLUSIONS: No statistically significant relationship was found between the patients' length of hospital stay due to the COVID-19 infection and their 25 (OH) vitamin D levels in patients aged 18 - 65 years. Further prospective clinical studies still need to be conducted with large numbers of patients excluding independent risk factors such as the presence of a chronic disease.


Subject(s)
COVID-19 , Vitamin D Deficiency , Adolescent , Adult , Aged , Female , Humans , Length of Stay , Male , Middle Aged , Retrospective Studies , SARS-CoV-2 , Vitamin D , Vitamin D Deficiency/diagnosis , Vitamin D Deficiency/epidemiology , Young Adult
3.
BMJ Open Qual ; 11(1)2022 02.
Article in English | MEDLINE | ID: covidwho-1685602

ABSTRACT

SETTING: Based at a busy city hospital, the alcohol care team is a drug and alcohol specialist service, taking referrals for a wide range of patients with substance use disorders (SUD). OBJECTIVES: Patients with SUD are at high risk of vitamin D deficiency; this relates to frequent fractures and proximal myopathy. The coronavirus pandemic brought vitamin D into focus. Local guidelines advise that patients at high risk of vitamin D deficiency are offered replacement. There were no local data on vitamin D deficiency prevalence or any mention of patients with SUD in local vitamin D guidelines. The main aim of this project was to offer vitamin D checks and replacement to all appropriate patients. RESULTS: We collected data on 207 patients, [pilot study (n=50) and two subsequent samples (n=95 and n=62)]. Our pilot study showed that no patients were offered vitamin D testing or replacement. We then offered vitamin D checks to 95 patients. Most had low vitamin D (30 patients were vitamin D deficient and 26 were vitamin D insufficient). We provided vitamin D replacement and follow-up advice. Quality improvement was demonstrated 6 months later. We collected data on a further 62 patients who were all on our current or recent caseload. Following exclusions, nearly half (48%) of patients had had a vitamin D check. Almost all of these (95%) had low vitamin D (60% being classified as deficient). CONCLUSIONS: Patients had not been offered vitamin D replacement despite often having multiple risk factors for vitamin D deficiency. Vitamin D checks (and subsequent replacement) rose in frequency since the outset of this project. Local guidelines should add SUD as a risk factor for vitamin D deficiency. Hospital admission provides a rich opportunity to offer this simple intervention to patients who are often poorly engaged with community services.


Subject(s)
Substance-Related Disorders , Vitamin D Deficiency , Hospitals , Humans , Pilot Projects , Substance-Related Disorders/diagnosis , Substance-Related Disorders/epidemiology , Vitamin D , Vitamin D Deficiency/diagnosis , Vitamin D Deficiency/epidemiology
4.
Int J Environ Res Public Health ; 19(3)2022 02 08.
Article in English | MEDLINE | ID: covidwho-1674648

ABSTRACT

The coronaviruses disease 2019 (COVID-19) spreads continuously worldwide. The new vaccines and drugs have been approved. The prevention of disease is crucial, and some studies reveal the promising effect of alternative therapies such as vitamin D supplementations on COVID-19 prevention, but they still require sufficient evidence. Therefore, the current retrospective multicenter cross-sectional study aims to determine the primary association between the vitamin D status of hospitalized COVID-19 and its severity as well as mortality. A total of 197 COVID-19 were admitted at King Faisal Hospital, Al Noor Specialist Hospital in Makkah, and at Complex King Faisal Hospital in Taif in the Westering region of Saudi Arabia (SA) between June and August 2020. The demographic and clinical characteristics, laboratory tests included serum 25(OH)D and admission for intensive care unit (ICU), length of stay in the hospital, mechanical ventilation (MV) support, and mortality were recorded and analyzed. Vitamin D deficiency (25(OH)D < 20 ng/mL) was found in 73.10% of all study population. Multiple logistic regression was used after adjusted covariances such as age, gender, diabetes, hypertension, and chronic kidney disease (CKD). No statistically significant was shown for ICU admission [Odd Ratio, OR 1.25 (95% confidence interval, CI 0.41-3.88) p = 0.70], MV support [Odd Ratio, OR 3.12 (95% confidence interval, CI 0.74-13.21) p = 0.12] and mortality [Odd Ratio, OR 2.39 (95% confidence interval, CI 0.31-18.11), p = 0.40]. These data didn't support the association between serum 25(OH)D and the severity of the disease among hospitalized COVID-19 patients.


Subject(s)
COVID-19 , Vitamin D Deficiency , Cross-Sectional Studies , Humans , Retrospective Studies , SARS-CoV-2 , Saudi Arabia/epidemiology , Vitamin D , Vitamin D Deficiency/epidemiology
5.
PLoS One ; 17(2): e0263069, 2022.
Article in English | MEDLINE | ID: covidwho-1666765

ABSTRACT

OBJECTIVE: Studies have demonstrated a potential correlation between low vitamin D status and both an increased risk of infection with SARS-CoV-2 and poorer clinical outcomes. This retrospective study examines if, and to what degree, a relationship exists between pre-infection serum 25-hydroxyvitamin D (25(OH)D) level and disease severity and mortality due to SARS-CoV-2. PARTICIPANTS: The records of individuals admitted between April 7th, 2020 and February 4th, 2021 to the Galilee Medical Center (GMC) in Nahariya, Israel, with positive polymerase chain reaction (PCR) tests for SARS-CoV-2 (COVID-19) were searched for historical 25(OH)D levels measured 14 to 730 days prior to the positive PCR test. DESIGN: Patients admitted to GMC with COVID-19 were categorized according to disease severity and level of 25(OH)D. An association between pre-infection 25(OH)D levels, divided between four categories (deficient, insufficient, adequate, and high-normal), and COVID-19 severity was ascertained utilizing a multivariable regression analysis. To isolate the possible influence of the sinusoidal pattern of seasonal 25(OH)D changes throughout the year, a cosinor model was used. RESULTS: Of 1176 patients admitted, 253 had records of a 25(OH)D level prior to COVID-19 infection. A lower vitamin D status was more common in patients with the severe or critical disease (<20 ng/mL [87.4%]) than in individuals with mild or moderate disease (<20 ng/mL [34.3%] p < 0.001). Patients with vitamin D deficiency (<20 ng/mL) were 14 times more likely to have severe or critical disease than patients with 25(OH)D ≥40 ng/mL (odds ratio [OR], 14; 95% confidence interval [CI], 4 to 51; p < 0.001). CONCLUSIONS: Among hospitalized COVID-19 patients, pre-infection deficiency of vitamin D was associated with increased disease severity and mortality.


Subject(s)
COVID-19/blood , COVID-19/epidemiology , SARS-CoV-2/genetics , Severity of Illness Index , Vitamin D Deficiency/blood , Vitamin D Deficiency/epidemiology , Vitamin D/analogs & derivatives , Adult , Aged , Aged, 80 and over , COVID-19/mortality , COVID-19/virology , Comorbidity , Female , Humans , Israel/epidemiology , Male , Middle Aged , Patient Admission , Prognosis , Retrospective Studies , Risk Factors , Vitamin D/blood
6.
J Virol Methods ; 301: 114418, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1637383

ABSTRACT

The coronavirus pandemic has lasted for more than a year now and still remains the leading cause of concern, worldwide. The causal agent; SARS- CoV-2, leads to the development of respiratory distress in the lower respiratory tract, sometimes leading to fatalities. Keeping in mind the discovery of mutant strains across the world, as well as the delay in vaccinations across vast populations, most people speculate boosting their immune systems as a preventive and precautionary measure. One of the most commonly observed conditions that hamper immunity; Vitamin D deficiency has been linked to the onset and the alteration of course of the disease in patients and is also being explored as a potential drug supplement. These surmises make it essential to study deep into the speculations. This review aims to overview the possible correlations between Vitamin D and COVID-19.


Subject(s)
COVID-19 , Vitamin D Deficiency , Humans , Pandemics , SARS-CoV-2 , Vitamin D , Vitamin D Deficiency/epidemiology
7.
J Clin Endocrinol Metab ; 107(1): e348-e360, 2022 01 01.
Article in English | MEDLINE | ID: covidwho-1592846

ABSTRACT

CONTEXT: A high prevalence of vitamin D (VD) deficiency in COVID-19 patients has been reported and hypothesized to increase COVID-19 severity likely because of its negative impact on immune and inflammatory responses. Furthermore, clear associations between hypovitaminosis D and fat body mass excess and diabetes, factors associated with COVID-19 severity, have been widely recognized. OBJECTIVE: The aim of this study was to evaluate in COVID-19 patients the relationship between VD levels and inflammatory response, body mass index (BMI), blood glucose (GLU), and disease severity. METHODS: Patients admitted to San Raffaele-Hospital for COVID-19 were enrolled in this study, excluding those with comorbidities and therapies influencing VD metabolism. 25-Hydroxyvitamin D levels, plasma GLU levels, BMI, and inflammatory parameters were evaluated at admission. RESULTS: A total of 88 patients were included. Median VD level was 16.3 ng/mL and VD deficiency was found in 68.2% of patients. VD deficiency was found more frequently in male patients and in those affected by severe COVID-19. Regression analyses showed a positive correlation between VD and PaO2/FiO2 ratio, and negative correlations between VD and plasma GLU, BMI, neutrophil/lymphocyte ratio, C-reactive protein, and interleukin 6. Patients with both hypovitaminosis D and diabetes mellitus, as well those with hypovitaminosis D and overweight, were more frequently affected by a severe disease with worse inflammatory response and respiratory parameters, compared to those without or just one of these conditions. CONCLUSION: We showed, for the first-time, a strict association of VD levels with blood GLU and BMI in COVID-19 patients. VD deficiency might be a novel common pathophysiological mechanism involved in the detrimental effect of hyperglycemia and adiposity on disease severity.


Subject(s)
Adiposity/immunology , COVID-19/diagnosis , Hyperglycemia/epidemiology , Vitamin D Deficiency/epidemiology , Vitamin D/analogs & derivatives , Aged , Biomarkers/blood , Blood Glucose/analysis , Body Mass Index , COVID-19/blood , COVID-19/immunology , COVID-19/virology , Female , Humans , Hyperglycemia/blood , Hyperglycemia/diagnosis , Hyperglycemia/immunology , Male , Middle Aged , Retrospective Studies , Risk Factors , SARS-CoV-2/immunology , SARS-CoV-2/isolation & purification , Severity of Illness Index , Vitamin D/blood , Vitamin D Deficiency/blood , Vitamin D Deficiency/diagnosis , Vitamin D Deficiency/immunology
8.
J Clin Endocrinol Metab ; 107(5): 1484-1502, 2022 Apr 19.
Article in English | MEDLINE | ID: covidwho-1566540

ABSTRACT

PURPOSE: Vitamin D deficiency/insufficiency may increase the susceptibility to coronavirus disease 2019 (COVID-19). We aimed to determine the association between vitamin D deficiency/insufficiency and susceptibility to COVID-19, its severity, mortality, and role of vitamin D in its treatment. METHODS: We searched CINAHL, Cochrane library, EMBASE, PubMED, Scopus, and Web of Science up to May 30, 2021, for observational studies on association between vitamin D deficiency/insufficiency and susceptibility to COVID-19, severe disease, and death among adults, and, randomized controlled trials (RCTs) comparing vitamin D treatment against standard care or placebo, in improving severity or mortality among adults with COVID-19. Risk of bias was assessed using Newcastle-Ottawa scale for observational studies and AUB-KQ1 Cochrane tool for RCTs. Study-level data were analyzed using RevMan 5.3 and R (v4.1.0). Heterogeneity was determined by I2 and sources were explored through prespecified sensitivity analyses, subgroup analyses, and meta-regressions. RESULTS: Of 1877 search results, 76 studies satisfying eligibility criteria were included. Seventy-two observational studies were included in the meta-analysis (n = 1 976 099). Vitamin D deficiency/insufficiency increased the odds of developing COVID-19 (odds ratio [OR] 1.46; 95% CI, 1.28-1.65; P < 0.0001; I2 = 92%), severe disease (OR 1.90; 95% CI, 1.52-2.38; P < 0.0001; I2 = 81%), and death (OR 2.07; 95% CI, 1.28-3.35; P = 0.003; I2 = 73%). The 25-hydroxy vitamin D concentrations were lower in individuals with COVID-19 compared with controls (mean difference [MD] -3.85 ng/mL; 95% CI, -5.44 to -2.26; P ≤ 0.0001), in patients with severe COVID-19 compared with controls with nonsevere COVID-19 (MD -4.84 ng/mL; 95% CI, -7.32 to -2.35; P = 0.0001) and in nonsurvivors compared with survivors (MD -4.80 ng/mL; 95% CI, -7.89 to -1.71; P = 0.002). The association between vitamin D deficiency/insufficiency and death was insignificant when studies with high risk of bias or studies reporting unadjusted effect estimates were excluded. Risk of bias and heterogeneity were high across all analyses. Discrepancies in timing of vitamin D testing, definitions of severe COVID-19, and vitamin D deficiency/insufficiency partly explained the heterogeneity. Four RCTs were widely heterogeneous precluding meta-analysis. CONCLUSION: Multiple observational studies involving nearly 2 million adults suggest vitamin D deficiency/insufficiency increases susceptibility to COVID-19 and severe COVID-19, although with a high risk of bias and heterogeneity. Association with mortality was less robust. Heterogeneity in RCTs precluded their meta-analysis.


Subject(s)
COVID-19 , Vitamin D Deficiency , Adult , Humans , Prognosis , Vitamin D/therapeutic use , Vitamin D Deficiency/complications , Vitamin D Deficiency/drug therapy , Vitamin D Deficiency/epidemiology , Vitamins/therapeutic use
9.
Arch Razi Inst ; 76(5): 1545-1549, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1560378

ABSTRACT

Outbreaks of a respiratory ailment in Wuhan, China, known as the Corona virus Disease-2019 (COVID-19), began in late December 2019. Since then, several pieces of advice have been made to boost the immune system to fight more efficiently with this infection. Previously published studies showed that vitamin D3 (Vit D3) level was low in COVID-19 patients. One of the most important factors in COVID-19 severity would be the inflammatory response. It is well documented that the inflammatory cytokine storm increases the severity of COVID-19. Cytokine storm results from dysregulation of the innate immune system with an outpouring of proinflammatory cytokines and chemokines, leading to abnormal activation of the adaptive immune pathway. It has been approved that Vit D3 has immunomodulatory functions and plays an anti-inflammatory role, particularly in viral infections. Therefore, the current study was designed to investigate the possible role of Vit D3 deficiency in the COVID-19 patients' innate immunity. This study included 180 participants who were divided into group (A) consisted of 60 COVID-19 positive patients with normal level of Vit D3, group (B) consisted of 60 COVID-19 positive patients with Vit D3 deficiency, and group (C) consisted of 60 COVID-19 positive patients that had received Vit D3 therapy. The results showed that the rate of hospitalization in the group (B) (41.3%) was significantly increased, compared to group (A) (12.5%). In this regard, Vit D3 therapy led to a significant increase in the level of Vit D3, and the patients who received Vit D3 were recovered from hospital 5 days on average sooner than those in the group (B). Therefore, the consumption of Vit D3 as a daily supplement would be a reasonable suggestion for these days of the COVID-19 pandemic to increase the power of immunity of the body.


Subject(s)
COVID-19 , Vitamin D Deficiency , Animals , COVID-19/veterinary , Cholecalciferol/therapeutic use , Dietary Supplements , Humans , Pandemics , Vitamin D Deficiency/epidemiology , Vitamin D Deficiency/veterinary
10.
Pak J Biol Sci ; 24(11): 1169-1174, 2021 Jan.
Article in English | MEDLINE | ID: covidwho-1542850

ABSTRACT

<b>Background and Objective:</b> In recent years, respiratory tract viral infections have caused many pandemics that impact the whole world. To investigate the seropositivity of <i>Toxoplasma gondii</i>, rubella, CMV, HSV-1 and group A <i>Streptococcus</i> in recovered COVID-19 patients and correlate these findings with vitamin D levels. <b>Materials and Methods:</b> A total of 417 COVID-19 patients with diarrhoea were enrolled in this study. Vitamin D and seroprevalence for <i>Toxoplasma gondii</i>, rubella, CMV, HSV-1 and group A <i>Streptococcus</i> were evaluated and correlated. <b>Results:</b> It was found that recent infection in COVID-19 patients with HSV-1, rubella, <i>Toxoplasma</i> and CMV, respectively. IgG was detected indicating the development of adaptive immunity with all microbes. <b>Conclusion:</b> Current study detected a correlation between vitamin D levels and HSV-1 and no correlation between this infection and vitamin D deficiency with the other microbes.


Subject(s)
COVID-19 Serological Testing , COVID-19/diagnosis , Calcifediol/blood , Herpes Simplex/diagnosis , Herpesvirus 1, Human/immunology , Immunoglobulin G/blood , Vitamin D Deficiency/diagnosis , Adaptive Immunity , Adult , Biomarkers/blood , COVID-19/blood , COVID-19/epidemiology , COVID-19/immunology , Cytomegalovirus/immunology , Cytomegalovirus Infections/blood , Cytomegalovirus Infections/diagnosis , Cytomegalovirus Infections/epidemiology , Cytomegalovirus Infections/immunology , Female , Herpes Simplex/blood , Herpes Simplex/epidemiology , Herpes Simplex/immunology , Humans , Male , Middle Aged , Predictive Value of Tests , Prevalence , Rubella/blood , Rubella/diagnosis , Rubella/epidemiology , Rubella/immunology , Rubella virus/immunology , Saudi Arabia/epidemiology , Seroepidemiologic Studies , Streptococcal Infections/blood , Streptococcal Infections/diagnosis , Streptococcal Infections/epidemiology , Streptococcal Infections/immunology , Streptococcus/immunology , Toxoplasma/immunology , Toxoplasmosis/blood , Toxoplasmosis/diagnosis , Toxoplasmosis/epidemiology , Toxoplasmosis/immunology , Vitamin D Deficiency/blood , Vitamin D Deficiency/epidemiology
11.
Zhongguo Dang Dai Er Ke Za Zhi ; 23(11): 1091-1096, 2021 Nov 15.
Article in English, Chinese | MEDLINE | ID: covidwho-1513019

ABSTRACT

OBJECTIVES: To investigate vitamin D nutritional status in children after outbreak of coronavirus disease 2019 (COVID-19), as well as the effect of strict epidemic prevention and control measures for the COVID-19 epidemic on vitamin D nutritional status in children. METHODS: A total of 7 460 children who underwent routine physical examinations from February to August, 2020 and had normal results were retrospectively enrolled as the observation group, and 10 102 children who underwent routine physical examinations from February to August, 2019 (no epidemic of COVID-19) and had normal results were enrolled as the control group. The serum level of 25-hydroxy vitamin D [25(OH)D] was compared between the two groups. The children in the observation and control groups who underwent physical examinations in March and April were selected as the epidemic prevention subgroup (n=1 710) and non-epidemic subgroup (n=2 877) respectively. The subjects were divided into five age groups (infancy, early childhood, preschool, school age and adolescence), and serum 25(OH)D levels of children of all ages were compared between the epidemic prevention and non-epidemic subgroups. RESULTS: The observation group had a lower serum level of 25(OH)D than the control group in March and April (P<0.001). The epidemic prevention subgroup had a lower serum level of 25(OH)D than the non-epidemic subgroup in all age groups (P<0.001). The vitamin D sufficiency rate in early childhood, preschool, school and adolescent children from the epidemic prevention subgroup was lower than the non-epidemic subgroup (P<0.001), with a reduction of 10.71%, 18.76%, 59.63% and 56.29% respectively. CONCLUSIONS: Strict prevention and control measures for the COVID-19 epidemic may lead to a significant reduction in vitamin D level in children, especially school-aged and adolescent children. It is recommended to timely monitor vitamin D level in children, take vitamin D supplements, and increase the time of outdoor sunshine as far as possible under the premise of adherence to epidemic prevention regulations.


Subject(s)
COVID-19 , Vitamin D Deficiency , Adolescent , Child , Child, Preschool , Disease Outbreaks , Humans , Nutritional Status , Retrospective Studies , SARS-CoV-2 , Vitamin D , Vitamin D Deficiency/epidemiology
12.
QJM ; 114(7): 447-453, 2021 Nov 05.
Article in English | MEDLINE | ID: covidwho-1506797

ABSTRACT

We aim to study the relationship between vitamin D level, risk and severity of Coronavirus disease of 2019 (COVID-19) infection in pediatric population through systematic review. We searched PubMed, CINAHL, EMBASE, Cochrane Library and Google Scholar from December 2019 to June 2021 for retrieving articles studying association between vitamin D deficiencies with COVID-19. Qualitative details were synthesized in evidence table and quantitative data was used for deriving pooled estimate through meta-analysis. After initial search of 2261 articles, eight eligible studies (two reviews) were included in the systematic review. Meta-analysis of the quantitative data (six studies) showed pooled prevalence of vitamin D deficiency as 45.91% (95% CI: 25.148-67.450). In infected pediatric patients, low levels of vitamin D increased the risk of severe disease (odds ratio-5.5; 95% CI: 1.560-19.515; P = 0.008). It was also found that children and adolescents having vitamin D deficiency had greater risk of COVID infection as compared to patients with normal vitamin D levels. Improvement in disease severity with vitamin D supplementation was also noted. The systematic review showed that almost half of the pediatric COVID patients suffer from vitamin D deficiency. It is also clear that the low level of vitamin D is associated with greater risk of infection and poorer outcome in pediatrics.


Subject(s)
COVID-19 , Pediatrics , Vitamin D Deficiency , Adolescent , Child , Humans , Prognosis , SARS-CoV-2 , Vitamin D , Vitamin D Deficiency/epidemiology
14.
BMJ Open ; 11(10): e055435, 2021 10 22.
Article in English | MEDLINE | ID: covidwho-1480255

ABSTRACT

OBJECTIVES: The steroid hormone vitamin D has roles in immunomodulation and bone health. Insufficiency is associated with susceptibility to respiratory infections. We report 25-hydroxy vitamin D (25(OH)D) measurements in hospitalised people with COVID-19 and influenza A and in survivors of critical illness to test the hypotheses that vitamin D insufficiency scales with illness severity and persists in survivors. DESIGN: Cross-sectional study. SETTING AND PARTICIPANTS: Plasma was obtained from 295 hospitalised people with COVID-19 (International Severe Acute Respiratory and emerging Infections Consortium (ISARIC)/WHO Clinical Characterization Protocol for Severe Emerging Infections UK study), 93 with influenza A (Mechanisms of Severe Acute Influenza Consortium (MOSAIC) study, during the 2009-2010 H1N1 pandemic) and 139 survivors of non-selected critical illness (prior to the COVID-19 pandemic). Total 25(OH)D was measured by liquid chromatography-tandem mass spectrometry. Free 25(OH)D was measured by ELISA in COVID-19 samples. OUTCOME MEASURES: Receipt of invasive mechanical ventilation (IMV) and in-hospital mortality. RESULTS: Vitamin D insufficiency (total 25(OH)D 25-50 nmol/L) and deficiency (<25 nmol/L) were prevalent in COVID-19 (29.3% and 44.4%, respectively), influenza A (47.3% and 37.6%) and critical illness survivors (30.2% and 56.8%). In COVID-19 and influenza A, total 25(OH)D measured early in illness was lower in patients who received IMV (19.6 vs 31.9 nmol/L (p<0.0001) and 22.9 vs 31.1 nmol/L (p=0.0009), respectively). In COVID-19, biologically active free 25(OH)D correlated with total 25(OH)D and was lower in patients who received IMV, but was not associated with selected circulating inflammatory mediators. CONCLUSIONS: Vitamin D deficiency/insufficiency was present in majority of hospitalised patients with COVID-19 or influenza A and correlated with severity and persisted in critical illness survivors at concentrations expected to disrupt bone metabolism. These findings support early supplementation trials to determine if insufficiency is causal in progression to severe disease, and investigation of longer-term bone health outcomes.


Subject(s)
COVID-19 , Influenza A Virus, H1N1 Subtype , Influenza, Human , Vitamin D Deficiency , Critical Illness , Cross-Sectional Studies , Humans , Influenza, Human/complications , Influenza, Human/epidemiology , Pandemics , SARS-CoV-2 , Survivors , Vitamin D , Vitamin D Deficiency/complications , Vitamin D Deficiency/epidemiology
15.
Epidemiol Health ; 43: e2021074, 2021.
Article in English | MEDLINE | ID: covidwho-1450908

ABSTRACT

OBJECTIVES: Although vaccination has started, coronavirus disease 2019 (COVID-19) poses a continuing threat to public health. Therefore, in addition to vaccination, the use of supplements to support the immune system may be important. The purpose of this study was to synthesize evidence on the possible effect of low serum vitamin D levels (25[OH]D<20 ng/mL or 50 nmol/L) on COVID-19 infection and outcomes. METHODS: We searched Google Scholar, PubMed, Scopus, Web of Science, and ScienceDirect without any language restrictions for articles published between January 1 and December 15, 2020. We performed 3 meta-analyses (called vitamin D and COVID-19 infection meta-analysis [D-CIMA], vitamin D and COVID-19 severity meta-analysis [D-CSMA], and vitamin D and COV ID-19 mortality meta-analysis [D-CMMA] for COVID-19 infection, severity, and mortality, respectively) to combine odds ratio values according to laboratory measurement units for vitamin D and the measured serum 25(OH)D level. RESULTS: Twenty-one eligible studies were found to be relevant to the relationship between vitamin D and COVID-19 infection/outcomes (n=205,869). The D-CIMA meta-analysis showed that individuals with low serum vitamin D levels were 1.64 times (95% confidence interval [CI], 1.32 to 2.04; p<0.001) more likely to contract COVID-19. The D-CSMA meta-analysis showed that people with serum 25(OH)D levels below 20 ng/mL or 50 nmol/L were 2.42 times (95% CI, 1.13 to 5.18; p=0.022) more likely to have severe COVID-19. The D-CMMA meta-analysis showed that low vitamin D levels had no effect on COVID-19 mortality (OR, 1.64; 95% CI, 0.53 to 5.06, p=0.390). CONCLUSIONS: According to our results, vitamin D deficiency may increase the risk of COVID-19 infection and the likelihood of severe disease. Therefore, we recommend vitamin D supplementation to prevent COVID-19 and its negative outcomes.


Subject(s)
COVID-19 , Vitamin D Deficiency , Humans , SARS-CoV-2 , Vitamin D , Vitamin D Deficiency/epidemiology , Vitamins
16.
Endocrine ; 74(2): 219-225, 2021 11.
Article in English | MEDLINE | ID: covidwho-1442182

ABSTRACT

BACKGROUND: Hypocalcemia has been identified as a major distinctive feature of COVID-19, predicting poor clinical outcomes. Among the mechanisms underlying this biochemical finding, high prevalence of vitamin D (VD) deficiency in COVID-19 patients reported so far in several studies was advocated. However, robust data in favor of this hypothesis are still lacking. Therefore, aim of our study was to investigate the role of hypovitaminosis D and parathyroid hormone (PTH) levels in the development of hypocalcemia in COVID-19 patients. METHODS: Patients admitted to IRCCS Ospedale San Raffaele for COVID-19 were enrolled in this study, excluding those with comorbidities and therapies influencing calcium and VD metabolism. Serum levels of total calcium (tCa), ionized calcium (Ca2+), 25-OH-VD, and PTH were evaluated at admission. We defined VD deficiency as VD below 20 ng/mL, hypocalcemia as tCa below 2.2 mmol/L or as Ca2+ below 1.18 mmol/L, and hyperparathyroidism as PTH above 65 pg/mL. RESULTS: A total of 78 patients were included in the study. Median tCa and Ca2+ levels were 2.15 and 1.15 mmol/L, respectively. Total and ionized hypocalcemia were observed in 53 (67.9%) and 55 (70.5%) patients, respectively. VD deficiency was found in 67.9% of patients, but secondary hyperparathyroidism was detected in 20.5% of them, only. tCa levels were significantly lower in patients with VD deficiency and regression analyses showed a positive correlation between VD and tCa. CONCLUSIONS: In conclusion, we confirmed a high prevalence of hypocalcemia in COVID-19 patients and we showed for the first time that it occurred largely in the context of marked hypovitaminosis D not adequately compensated by secondary hyperparathyroidism.


Subject(s)
COVID-19 , Hyperparathyroidism, Secondary , Hypocalcemia , Parathyroid Hormone/physiology , Vitamin D Deficiency , COVID-19/complications , Calcium , Humans , Hyperparathyroidism, Secondary/epidemiology , Hyperparathyroidism, Secondary/virology , Hypocalcemia/epidemiology , Hypocalcemia/virology , Italy , Vitamin D/blood , Vitamin D Deficiency/complications , Vitamin D Deficiency/epidemiology
19.
Clin Med (Lond) ; 21(1): e119-e120, 2021 01.
Article in English | MEDLINE | ID: covidwho-1384014
SELECTION OF CITATIONS
SEARCH DETAIL