Should Young Covid-19 Patients be Suplemented with Vitamin D?

It is well known that vitamin D's general immunomodulatory actions are helpful in viral infections and that a shortage is linked to a more serious prognosis for Covid-19. In this sistematic review, we examined the existing literature on evidence as to whether there is also link between vitamin D range levels in pediatric population and the outcome of the Covid-19 infection. We looked for studies that measured vitamin D blood concentrations and examined the effects of vitamin D supplementation in young infected patients. Vitamin D may decrease the risk of respiratory infections in a number of ways through its interactions with numerous cells, including by decreasing viral survival and replication, reducing the cytokine storm, raising angiotensin-converting enzyme 2 concentrations (ACE2) while not damaging the endothelial integrity. The incidence or severity of Covid-19 is linked with blood 25-hydroxyvitamin D concentrations, according to many observational studies. However experimental verification is still needed. Given their safety and broad therapeutic window, vitamin D supplements seem to be an effective way for individuals and doctors to prevent or treat Covid-19. Nonetheless, the outcomes of significant vitamin D randomized controlled trials are further needed.Copyright © 2022 Maria Nicolae et al., published by Sciendo.

Concomitant presence of COVID-19 infection and inaugural diabetic ketoacidosis in children and adolescents

Introduction: The COVID-19 pandemic, which has left its mark all over the world, has led to a decrease in the addressability to health care professionals, due to people's fear of becoming infected with COVID-19. This delays a correct diagnosis that can have lifethreatening consequences. Objectives: To establish if type 1 diabetes is triggered by COVID-19 Methods: We will present 3 cases pf type 1 diabetes at onset with ketoacidosis, triggered by the COVID-19 infection, diagnosed between December 2020 and April 2021. The diagnosis of SARSCoV2 infection was established based on RT-PCR (a reversetranscription polymerase-chain-reaction) positive for SARS-CoV2. Results: Case 1: 14 years old, boy, presented with Kussmaul breathing, abdominal pain, polyuria, polydipsia, weight loss (5 kg in 2 weeks), fever (38 C). The laboratory test showed a bicarbonate: 5 mEq/L, pH: 7.08, alkaline reserve: 6 mmol/l, glucose: 454 mg/dl, HbA1c: 14.5%. Case 2: 7 years old, boy presented with Kussmaul breathing, shock hypovolemic, hypotensive (Blood pressure 60/30 mmHg), fever, tachypnea, polyuria, polydipsia. The laboratory test showed a bicarbonate: 3 mEq/L, pH: 6,95, alkaline reserve: 2 mmol/l, glucose: 567 mg/dl, HbA1c: 12.6 %. Case 3: 10 years old, boy presented with similar clinical findings. The laboratory test showed a bicarbonate: 5 mEq/L, pH: 6,90, alkaline reserve: 3 mmol/l, glucose: 457 mg/dl, HbA1c: 16.6 %. All patients received treatment according to the diabetic ketoacidosis protocol treatment and switched to basal-bolus insulin treatment after an average of 48 hours. In all 3 cases the SARS-CoV2 infection was mild, with no changes in the lungs (lung x-rays being within normal limits). Conclusions: Due to the general fear of appearing in a hospital during the COVID-19 pandemic, there are delays in the diagnosis of lifethreatening conditions, such as ketoacidosis. The link between SARSCoV2 infection and type 1 diabetes in children and adolescents remains unknown and further studies are needed to gather more data.

Hypertrigliceridemia in children and adolescents with onset of type 1 diabetes in the pandemic COVID-19

Introduction: The rapid spread of SARS-COV2 infection has led to a pandemic affecting people of all ages. Objectives: Hypertriglyceridemia is a complication that can occur when diagnosing diabetes, especially the onset of ketoacidosis Methods: The cases of diabetes at onset during the March-October 2020 pandemic were analyzed and were compared with the same period of 2019 Results: During the pandemic there were 14 cases of type 1 diabetes at onset, compared to the same period in 2019, when there were 10 cases of type 1 diabetes. Of these, 7 (50%) had ketoacidosis at onset in 2020, compared to 2019-3 cases (30%) with ketoacidosis at onset. In 2019, 1 single patient had triglyceride levels> 500 mg/dl. 6 patients (85%) in 2020 presented triglycerides> 500 mg/dl as follows: 2 had> 2000 mg/dl, 2> 1000 mg/dl, 3> 500 mg/dl. Conclusions: Diabetic ketoacidosis is a common form of diabetes in the pediatric population. When accompanied by severe hypertriglyceridemia, it must be managed with great care by the medical team to prevent complications, thus reducing the mortality of cases of diabetic ketoacidosis.