Clinical and Prognostic Significance of Baseline Serum Vitamin D Levels in Hospitalized Egyptian Covid-19 Patients.

Background and Aim: Vitamin D is a hormone with essential roles in both cellular metabolism and immunity. It controls calcium homeostasis and modulates innate and adaptive immune system responses. Many studies suggested an association between vitamin D deficiency and clinical outcomes of covid-19 infection, while others failed to document such a relation. The present study aimed to evaluate the clinical and prognostic significance of baseline vitamin D levels in hospitalized Egyptian covid-19 patients. Patients and Methods: The present retrospective study included 300 hospitalized covid-19 patients. Patients were submitted to standard clinical, laboratory, and radiological assessment. According to vitamin D levels, patients were classified to have normal levels (≥30), insufficient levels (20-29) or deficient levels (<20). Results: According to their vitamin D levels, patients were classified into those with normal vitamin D (n=135), others with vitamin D insufficiency (n=114), and a third group with vitamin D deficiency (n=51). Patients with normal vitamin D levels and vitamin D insufficiency are significantly younger [median (IQR): 49.0 (39.0-57.0) versus 51.0 (40.0-61.0) and 55.0 (43.0-62.0) years, respectively, p=0.012] and had less frequency of severe disease (24.4% versus 40.4% and 51.0%, respectively) when compared with those with vitamin D deficiency. Moreover, they had significantly lower levels of D dimer [median (IQR): 1.5 (0.9-2.5) versus 1.8 (0.9-3.1) and 2.0 (1.0-3.2)], CRP [median (IQR): 58.0 (30.0-120.0) versus 76.0 (42.5-160.0) and 105.0 (74.0-208.0), respectively, p<0.001], ferritin [median (IQR): 458.0 (240.0-759.0) versus 606.0 (433.8-897.8) and 820.0 (552.0-1087.0), respectively, p<0.001], and procalcitonin [median (IQR): 290.0 (152.0-394.0) versus 372.5 (227.0-530.5) and 443.0 (272.0-575.0), respectively, p<0.001]. Only lower vitamin D levels were significant predictors of mortality in multivariate analysis [OR (95% CI): 0.88 (0.84-0.92), p<0.001]. Conclusion: Low vitamin D levels are related to exaggerated inflammatory response, disease severity, and poor clinical outcome in hospitalized covid-19 patients.

Effect of COVID-19 on gastrointestinal endoscopy practice: a systematic review.

BACKGROUND: Since the emergence of the novel corona virus (SARS-Cov-2) in the late 2019 and not only the endoscopy practice and training but also the health care systems around the globe suffers. This systematic review focused the impact of Corona Virus Disease (COVID-19) on the endoscopy practice. METHODS: A web search of different databases combining different search terms describing the endoscopy practice and the COVID-19 pandemic was done. Articles were screened for selection of relevant articles in two steps: title and abstract step and full-text screening step, by two independent reviewers and any debate was solved by a third reviewer. RESULTS: Final studies included in qualitative synthesis were 47. The data shown in the relevant articles were evident for marked reduction in the volume of endoscopy, marked affection of colorectal cancer screening, impairments in the workflow, deficiency in personal protective equipment (PPE) and increased likelihood of catching the infection among both the staff and the patients. CONCLUSION: The main outcomes from this review are rescheduling of endoscopy procedures to be suitable with the situation of COVID-19 pandemic in each Country. Also, the endorsement of the importance of PPE use for health care workers and screening of COVID-19 infection pre-procedure.Key messagesThe data focussing Gastrointestinal Endoscopy and COVID-19 emerged from different areas around the globe. The data presented on the published studies were heterogeneous. However, there were remarkable reductions in the volume of GI endoscopy worldwideStaff reallocation added a burden to endoscopy practiceThere was a real risk for COVID-19 spread among both the staff and the patients.

COVID-19 screening before gastrointestinal procedures

Background: In March 2020, the World Health Organization declared coronavirus 2019 (COVID-19) a global pandemic. We aimed to assess the ability of COVID-19 screening to detect preprocedural infection at the gastrointestinal units. One hundred and three patients indicated for gastrointestinal tract interventional procedures were included. All patients surveyed for COVID-19-related symptoms and COVID-19 rapid IgM/IgG antibodies. Symptomatic and COVID-19 antibody-positive patients further tested for COVID-19 reverse transcriptase by polymerase chain reaction (RT-PCR). All patients contacted, 14 days after the procedure and asked about the possible development of COVID-19. All health care workers (HCWs) (n=18) were screened weekly for COVID-19-related symptoms. Results: The mean age was 46.11 ± 17.16 years of them 58.25% were males. 2.9% patients had COVID-19-related symptoms and 97.1% were asymptomatic. All symptomatic patients tested positive for COVID-19 IgM antibody and RT-PCR. Among asymptomatic patients 23% had positive COVID-19 antibodies, of them 56.5%patients had positive RT-PCR. One HCW developed COVID-19 during the study. None of the included patients developed new onset of COVID-19 infection, two weeks after the procedure. Conclusion: COVID-19 antibody test may be a reasonable preprocedural screening method for low-income countries and COVID-19 RT-PCR screening for symptomatic patients and those with positive COVID-19 antibody test. [ FROM AUTHOR] Copyright of Egyptian Liver Journal is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)