Effect of Oral and parenteral routes of vitamin D supplementation on serum 25(OH) vitamin D levels in patients with non-alcoholic fatty liver disease.

BACKGROUND: Due to the interruption of the EHC pathway in NAFLD patients, we hypothesized that parenteral vitamin D supplementation is superior to oral in vitamin D insufficient patients with NAFLD. Therefore, this study aimed to compare the efficacy of oral and parenteral routes of vitamin D supplementation on serum 25(OH) vitamin D levels in patients with NAFLD. METHODS: In this prospective randomized trial, 66 NAFLD cases with vitamin D deficiency were studied. For 33 cases, oral vitamin D was supplemented, whereas the other 33 patients were given an intramuscular injection of vitamin D. Laboratory tests and liver ultrasound were performed at the beginning and the end of the trial for each subject. RESULTS: Regardless of the drug administration route, at the end of this trial the mean of serum 25-hydroxy vitamin D level increased from 8.74±2.47 to 33.16±17.61 (P=0.00), and the mean±SD for serum triglyceride decreased from 191.46±92.79 to 166.00±68.30 (P=0.02), both were statistically significant. Liver ultrasound reported statistically significant changes in the grade of fatty liver disease (P=0.003). In the comparison between the two groups, serum 25-hydroxy vitamin D level changes were not statistically significant (P=0.788). CONCLUSION: The intramuscular method of supplementation was not better than the oral route in improving serum 25(OH) vitamin D levels in NAFLD patients. In this study, the impaired EHC and vitamin D absorption inhibitor factors in NAFLD patients did not affect the final result of serum vitamin D levels significantly.

Predicting Severity of Novel Coronavirus (COVID-19) Pneumonia based upon Admission Clinical, Laboratory, and Imaging Findings.

Background: The purpose of this study was to investigate the prognostic factors in hospitalized COVID-19 pneumonia patients according to the baseline clinical, laboratory, and imaging manifestations. Materials and Methods: In this retrospective study on the SARS-CoV-2 laboratory-confirmed cases, clinical and laboratory data were collected from 156 hospitalized patients during August to October, 2020. Baseline chest CT was assessed, and the CT severity score was then calculated. Data were compared between the two groups of patients with moderate and severe/critical conditions. Results: Of the 156 participants with the age range of 25-95 years (56.87±16.88), 70 and 86 patients were in the moderate and severe/critical groups, respectively. Most patients had typical imaging features on chest CT. Compared to the moderate group, the severe/critical group were older and were mainly suffering from underlying comorbidities. The rate of confusion on admission (P=0.008) and pulse rate≥100 (p=0.04) were significantly higher in the severe/critical group. According to the CT manifestations, consolidation, central and diffuse peripheral and central distribution, patchy/segmental morphology, crazy paving pattern, pleural effusion, aorta, and coronary artery calcification were more likely to emerge in the severe/critical group (p<0.05). In contrast, round/nodular morphology mainly appeared in the moderate group (p= 0.002). The chest CT severity scores were 10.24±7.91 and 6.13±4.42 in the severe/critical and moderate groups, respectively, indicating statistically significant values. Conclusion: The clinical, laboratory, and chest CT findings can be used for the prognosis of COVID-19 pneumonia. Predicting the outcomes for the patients on admission can play a critical role in decision making.