Correlation of Plasma 25(OH)D3 and Vitamin D Binding Protein Levels with COVID-19 Severity and Outcome in Hospitalized Patients.

BACKGROUND: The Coronavirus Disease-19 (COVID-19) caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has been declared a worldwide pandemic. The severity of COVID-19 varies greatly across infected individuals. Possible factors may include plasma levels of 25(OH)D and vitamin D binding protein (DBP), as both are involved in the host immune response. Other possible nutrition-related factors include malnutrition and/or obesity which disrupt the optimal host immune response to infections. Current literature shows inconsistent evidence about the association of plasma 25(OH)D3 and DBP on infection severity and clinical outcomes. OBJECTIVES: This study aimed to measure plasma 25(OH)D3 and DBP in hospitalized COVID-19 cases and assess their correlation with infection severity, inflammatory markers, and clinical outcome. METHODS: 167 patients were included in this analytical cross-sectional study, of which 81 were critical and 86 were non-critical hospitalized COVID-19 patients. Plasma levels of 25(OH)D3, DBP, and the inflammatory cytokines, IL-6, IL-8, IL-10, and TNF-α were assessed using the Enzyme-linked Immunosorbent Assay (ELISA). Information regarding biochemical and anthropometrical indices, hospital length of stay (LoS), and illness outcome was obtained from the medical records. RESULTS: Plasma 25(OH)D3 level was found to be significantly lower in critical compared to non-critical patients (Median = 8.38 (IQR = 2.33) vs. 9.83 (IQR = 3.03) nmol/L, respectively; p < 0.001), and it positively correlated with hospital LoS. However, plasma 25(OH)D3 did not correlate with mortality or any of the inflammatory markers. DBP on the other hand correlated positively with mortality (rs = 0.188, p = 0.015) and hospital LoS (rs = 0.233, p = 0.002). DBP was significantly higher in critical than non-critical patients (Median = 1262.18 (IQR = 463.66) vs. 1153.35 (IQR = 418.46) ng/mL, respectively; p < 0.001). Furthermore, IL-6 and IL-8 were significantly higher in critical than non-critical patients. However, no differences were found in IL-10, TNF-α, IL-10/TNF-α, TNF-α/IL-10, IL-6/IL-10, or CRP between groups. CONCLUSION: The current study found that critical COVID-19 patients had lower 25(OH)D3 than non-critical patients, yet, levels were found to be suboptimal in both groups. Further, critical patients had higher DBP levels as compared to non-critical patients. This finding may encourage future research to unravel the effects of this understudied protein that appears to have significant associations with inflammation, even though the precise mechanism is unknown.

The Arabic Version of the Adult Eating Behavior Questionnaire among Saudi Population: Translation and Validation.

Inherited individual differences in eating behaviors known as "appetitive traits" can be measured using the Adult Eating Behavior Questionnaire (AEBQ). The AEBQ can be used to assess individuals that require intervention regarding their weight, eating habits, and for the identification of eating disorders. Arabic eating behavior assessment tools are few. This study, therefore, aimed to translate and validate the AEBQ in Arabic language (AEBQ-Ar) and to confirm the factor structure while assessing the internal consistency of all subscales. Participants completed the AEBQ-Ar and reported their sociodemographic data online. Exploratory factor analysis (EFA) was used and internal reliability was assessed using Cronbach's α. Correlations between AEBQ-Ar subscales and body mass index (BMI) were done using Pearson's correlation. A sample of 596 adults, mean age of 35.61 ± 12.85 years, was recruited from Saudi Arabia. The 6-factor structure was the best model, excluding emotional under- eating subscale and merging enjoyment of food and food responsiveness subscales. Internal consistency was acceptable for all subscales (Cronbach's α = 0.89-0.66). Emotional over- eating was positively associated with BMI, and slowness in eating was negatively associated with BMI. The AEBQ-Ar with 6-subscales appears to be a valid and reliable psychometric questionnaire to assess appetitive traits in Arabic speakers.