Prevalence of vitamin D deficiency among patients attending Post COVID-19 follow-up clinic: a cross-sectional study.

OBJECTIVE: Post-COVID-19 syndrome appears to be a multi-organ illness with a broad spectrum of manifestations, occurring after even mild acute illness. Limited data currently available has suggested that vitamin D deficiency may play a role in COVID-19 cases. However, to our knowledge, no study has examined the frequency of vitamin D deficiency in post-COVID-19 cases and its effect on the symptom severity. The aim of this study is to both screen the frequency of vitamin D deficiency in post-COVID-19 syndrome patients and to study its relation to persistent symptoms. PATIENTS AND METHODS: A cross-sectional, single-center study was conducted involving all cases attending post-COVID-19 follow-up clinic from November 2020 to May 2021. Complete history, clinical examination, and laboratory analysis [kidney functions, serum calcium, C-reactive protein, serum ferritin, Serum 25-(OH) vitamin D] was done as well as HRCT chest. RESULTS: The study included 219 post-COVID-19 cases, 84% had deficient vitamin D levels (< 20 ng/dL); 11.4% had insufficient level (20-30 ng/dL) and only 4.9 % reported normal level. There was no link between levels of vitamin D with either the acute or post-COVID-19 symptoms in the studied groups. CONCLUSIONS: Despite the prevalence of vitamin D deficiency among the study population, no association was observed between the levels of vitamin D and post-COVID-19 symptoms. It appears that post-COVID-19 syndrome pathophysiology involves a more complex interaction with the immune system. Dedicated clinical trials are advised to better study vitamin D levels and the related disease severity in COVID-19 patients.

Non-hospitalised COVID-19 patients have more frequent long COVID-19 symptoms.

BACKGROUND: Long COVID-19 syndrome refers to the persistence of symptoms for more than 12 weeks after the start of acute symptoms. The pathophysiology of this syndrome is not yet clear.OBJECTIVE: To assess long COVID-19 symptoms in hospitalised and non-hospitalised patients.METHODS: A cross-sectional survey was used. The study included 262 patients who were divided into two groups based on their hospital admission history: 167 (63.7%) were not hospitalised, while 95 (36.3%) were hospitalised.RESULTS: Long-COVID was reported in 157 out of 262 patients (59.9%), and was significantly more frequent in non-hospitalised patients (68.3% vs. 45.3%; P < 0.001). During the acute phase, hospitalised patients had more respiratory symptoms (95.9% vs. 85.6%), while non-hospitalised patients had more neuropsychiatric symptoms (84.4% vs. 69.5%; P < 0.05). Constitutional and neuropsychiatric symptoms were the most frequently reported persistent symptoms in both groups, but all persistent symptoms were more frequent in the non-hospitalised group (P < 0.005).CONCLUSION: Long COVID-19 symptoms affect both hospitalised and non-hospitalised patients. Neuropsychiatric manifestations were the most common persistent COVID-19 symptoms. Rehabilitation and psychotherapy could be advised for all recovered COVID-19 patients. Non-hospitalised COVID-19 patients should be counselled to contact healthcare providers whenever needed.

Leptin levels in Arabs with primary hyperthyroidism.

BACKGROUND: The aim of this report was to study leptin status in hyperthyroid men and women (prior to and after medical treatment) and in matched controls in Arabs. SUBJECTS AND METHODS: Twenty-nine hyperthyroid patients (19 women and 10 men) and 32 controls (20 women and 12 men) matched for age, ethnic status and body mass index (BMI) were studied. The patients were studied at the time of diagnosis and six months after antithyroid treatment with carbimazole-titrating dose, which rendered them euthyroid. On each study occasion, the subjects fasting blood was collected for the measurement of leptin, glucose, insulin and C-peptide. RESULTS: Fasting leptin level was significantly lower in women with hyperthyroidism at baseline (mean+/-SEM, 15.8+/-2.9 microg/L, P=0.01), and after six months of antithyroid treatment (13.4+/-1.7 microg/L, P=0.004) than in control women (25.6+/-2.7 microg/L), but the difference was not significant in the men. Women in each group had significantly higher leptin concentrations than men (patients: 15.8+/-2.9 vs. 4.9+/-0.9 microg/L, P=0.009; controls: 25.67+/-2.7 vs. 7.9+/-1.4 microg/L, P=0.0005). The differences in women leptin remained significant even when expressed in relation to BMI. Baseline fasting glucose (P=0.01), insulin (P=0.007), and C-peptide (P=0.02) were significantly higher in the patients than controls. After six months of antithyroid therapy, fasting glucose, insulin and C-peptide levels were similar in the patients and controls. Within the patients, baseline leptin concentrations correlated positively with BMI (rho=0.65, P=0.02) and negatively with free T3 (rho=0.62, P=0.03). It neither demonstrated an association with baseline nor with six-month values of fasting glucose, insulin and C-peptide. CONCLUSION: Leptin concentration is decreased in Arab women with hyperthyroidism. Six months of antithyroid therapy is not associated with alterations in leptin levels.

Laparoscopy: routine pneumoperitoneum via the posterior fornix.

To induce pneumoperitoneum for laparoscopic examination, a transvaginal route and a modified Verres needle were used in an effort to reduce the failure rate of the subumbilical route and to avoid some of its dangers. The technic not only reduces the rate of complications, but its precision and simplicity make it easier to learn and execute.