No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Patterns of COVID-19 Mortality and Vitamin D: An Indonesian Study
... 11 Another Indonesian retrospective cohort study of 780 Covid-19 patients indicated that the majority of death cases had low vitamin D levels and that vitamin D status was strongly associated with Covid-19 mortality. 12 Recently, some articles also have suggested the possible involvement of vitamin D in reducing the risk of respiratory tract infections, especially from influenza, rhinovirus and previous coronaviruses by enhancing immune response. 13 Observational studies have frequently reported that higher levels of vitamin D were associated with low levels of inflammatory markers including CRP, IL-6 and TNFα in healthy populations and in those with proinflammatory conditions, such as diabetes, arteriosclerosis and inflammatory conditions. ...
... 90.32% of patients had ARDS as assessed by PaO 2 /FiO 2 ratio lower than 300 mmHg (Fig 2) and a major proportion of patients with severe ARDS had Vitamin D levels of < 20 ng/ml. The median number of days of stay in the hospital was found to be 11 (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17), with a minimum of 2 days and a maximum of 41 days. Other clinical characteristics of patients admitted to the Intensive Care Unit has been represented in Table 1. ...
... 19 An Indonesian retrospective cohort study by Raharusun P et al has reported that vitamin D status is strongly associated with COVID-19 mortality outcome of cases after controlling for age, sex, and comorbidities. 12 In a report, Alipio M observes a significant association between vitamin D status and clinical outcomes (p<0.001) and suggested that serum 25(OH) D level was low in critical cases when compared to mild cases indicating increased odds of having a mild clinical outcome rather than a critical outcome by approximately 19.61 times. 20 Recent experimental evidence has shown that deficiency in vitamin D is associated with increased susceptibility to infection and autoimmune disorders. ...
... 2 The economic and social crisis triggered following the declaration of COVID-19 as a pandemic by the World Health Organization (WHO) in March 2020 negatively affected nutrition, especially in low-income countries, increasing mortality rates among such vulnerable populations as children and the elderly. 1 The continuation of the pandemic suggests that these insufficiencies are likely to increase. 3 The elimination of micronutrient deficiencies and the provision of optimum nutrition are known to affect bodily resistance and strengthen the immune system positively. Vitamins A, C, E, and D, as well as zinc, selenium, folate, iron, and copper as trace elements, are all known to play roles in this phase. ...
... COVID-19 tests in studies of patients over 65 years, and the simultaneous presence of chronic disease and low vitamin D3 levels has been associated with higher mortality. [3][4][5][6][7][8][9][10][11][12][13] In contrast, no association was found between the initial serum vitamin D3 level and disease severity, mortality, need for intensive care, inflammatory markers, and oxygen and inotropic support requirement in studies evaluating the association between vitamin D3 levels and disease severity in pediatric patients. 27,28 Treatment with cholecalciferol led to no change in the results, and no significant difference was found in the vitamin D3 levels of patients with COVID-19 and the control group. ...
Objective Vitamin D, due to its immunomodulating effect, zinc, and vitamin A, which affect cellular and humoral immunity, are thought to affect the clinical severity of coronavirus disease 2019 (COVID-19) infection. The present study evaluates the association between vitamin A, D, and zinc deficiencies and disease severity in pediatric patients with COVID-19 infections.
Methods The levels of vitamin A, D, and zinc at the time of diagnosis of 123 pediatric patients who presented to our hospital and were diagnosed as having hospitalized, nonhospitalized COVID-19 infection group, and multisystem inflammatory syndrome in children (MIS-C) were evaluated. The correlations of the measured levels with the disease severity and the need for intensive care or hospitalization were analyzed.
Results Among the 123 patients, 21.1% (n = 26), 42.2% (n = 52), and 36.7% (n = 45) had a diagnosis of MIS-C, belonged to the hospitalized COVID-19 infection group, or belonged to the nonhospitalized COVID-19 infection group, respectively. Zinc levels were significantly lower in the MIS-C group than in the nonhospitalized group (p < 0.05). Vitamin A levels were found to be significantly lower in the MIS-C group than in the nonhospitalized group (p < 0.01) and significantly lower in the hospitalized group when compared with the nonhospitalized group (p < 0.001). Deficiencies in vitamin A, vitamin D, and zinc levels were found to be most common in the MIS-C group (42.3%) and in hospitalized COVID-19 group (15.3%). In the nonhospitalized COVID-19 group, it was found to be the lowest at 6.6%.
Conclusion Based on the results of the present study and a literature review, it can be said that vitamin A, D, and zinc deficiencies may associate with the severity of COVID-19, although more studies are required to clarify this subject further.
... The first reports on the role of vitamin D serum levels in the course of COVID-19 showed that infected patients had lower serum levels of vitamin D than those without COVID-19 (16). Raharusun et al. reported that in 780 patients with COVID-19 in Indonesia, vitamin D status was an independent predictor of mortality (17). Based on a meta-analysis study in Iran in 2018, the rate of vitamin D deficiency in men and women was 55.2% and 64.7%, respectively (18). ...
Background: Vitamin D is a multifunctional hormone essential in the immune system. Vitamin D deficiency may increase the disease burden in patients with COVID-19. Objectives: We investigated the effect of vitamin D administration as an adjunctive therapy on treating children with COVID-19. Methods: Children with confirmed or probable COVID-19 who were admitted to 17th Shahrivar Hospital in Rasht from October 2022 to April 2023 were selected by random sampling method. They were divided into two groups by random blocks: the intervention group with vitamin D administration and the placebo-controlled group. The patient data were recorded and analyzed, including age, sex, and the required clinical and laboratory information, including the time required to recover from fever and respiratory distress and the length of hospitalization. Results: In this study, 60 patients (30 in each group) were evaluated. At the beginning of hospitalization, fever was significantly more observed in the intervention group (90% vs. 53.3%, P = 0.002). The average time required to recover from fever and respiratory distress was less in the intervention group, although this difference was not significant between the two groups (P = 0.591 and P = 0.192, respectively). The hospitalization duration was also similar in both groups, and no complications or death were observed in the two groups. Conclusions: Administering vitamin D at a dose of 1000 IU daily showed no significant efficacy for recovering children with COVID-19. Further studies are suggested to investigate the high dose of vitamin D supplementation in treating children with COVID-19.
... Research allows to assume that a diet containing the above-mentioned ingredients may contribute to alleviation of inflammation occurring as a result of cytokinin activity during infection caused by SARS-CoV-2 (Iddir et al., 2020). In a retrospective analysis of over 700 cases of SARS-CoV-2 infection among men living in Indonesia, it was suggested that low levels of vitamin D (20-30 ng/ml) increase the risk of mortality due to COVID-19 up to 13 times (Raharusun et al., 2020). A similar trend was observed in Switzerland, where patients infected with the virus had significantly lower levels of vitamin D compared to those who were not detected with the SARS-CoV-2 virus (11.1 ng/ml vs. 24.6 ng/ml) (D'Avolio et al., 2020). ...
Introduction. The government's public health recommendations to contain the spread of the coronavirus may have affected various areas of everyday life. Study aim. The aim of the study was to assess the level of physical activity and quality of life among people after rehabilitation due to COVID-19. Material and methods. The research comprised 200 people (110 women aged 50.4±14.8 years and 90 men aged 53.2±13.9 years) from selected medical facilities providing a post-COVID rehabilitation programme under the reimbursement of the National Health Fund (NFZ). Selected somatic indices were measured, on the basis of which BMI (Body Mass Index) and WHR (Waist-to-Hip Ratio) were calculated. The research was carried out using an original, author-designed questionnaire. A shortened version of the IPAQ (International Physical Activity Questionnaire) was applied to assess the level of physical activity before and after the disease, and quality of life was assessed using the WHOQOL-BREF scale (World Health Organization Quality of Life Test-Bref). Results. In the opinion of 61.1% of the female respondents and 67.1% of the male respondents, their current level of physical activity differed from the period prior to the disease. Additionally, in the study group, it was shown that the quality of life among people prior to the rehabilitation was lowered, while 1/4 of the respondents considered it unsatisfactory. Conclusions. In the group of people infected with COVID-19, a decrease in the level of physical activity undertaken after rehabilitation was observed. Sars-CoV-2 resulted in a post-disease decrease in the quality of life of the subjects.
... [24] Vitamin D prevents cytokine storm, which is the culprit involved in immunological damage to the endothelium, and denudation of the alveolar membrane, which then causes a vicious cycle in moderate to severely ill COVID-19 patients causing mortality. [23] Though many therapies aiming at mitigation of the inammatory response are being evaluated, strong evidence of benet is lacking. Corticosteroids offer benets in subsiding hyperinammation, and ARDS but the disadvantages are dose-dependent on acute and delayed side effects like delayed viral clearance, and opportunistic infections. ...
Introduction: The micronutrients in our body play a pivotal role in combating infection. Of them, Zinc, Vitamin C, and Vitamin D have crucial roles. COVID infection results in raised CRP (C-reactive protein) and D-dimer in response to infection. This study aimed to know the progression of disease in the individuals who consumed and who did not consume these micronutrients before admission. Along with this, the effects of highdose steroids in this study population with no comorbidities have also been analyzed. It is a hospital-based Materials And Methods: observational study. The study group includes 1130 cases who were diagnosed and conrmed with COVID-19. Blood samples were processed on the day of admission for CRP, and D-dimer values. Patients administered steroids have been followed during treatment. The clinical Results: parameters recorded during the study period CRP (2.36+/-1.46 mg/dl), (9.16+/-6.44mg/dl) and D-dimer (1.20+/-5.99mg/L), (2.48+/-3.13mg/L) for the consumed group, and non-consumed group respectively, with 95% condent interval and p-value less than 0.05 were statistically signicant. A patient who had taken micronutrients before admission had stati Conclusion: stically shown mild disease progression and fewer side effects of steroids compared to their counterparts.
... (4,9,10). Normalin altında vitamin D seviyeleri ile yüksek ölüm oranlarının ilişkili olduğunu gösteren çalışmalar vardır (3, 11,12).Yapılan bir çalışmada bazal vitamin D düzeylerinden bağımsız olarak yüksek doz kolekalsiferol tedavisinin COVID-19 hastalarında mortaliteyi azalttığı gösterilmiştir (13). Ancak Brezilya'da yapılan bir başka çalışma ise yüksek doz vitamin D verilmesinin hastanede yatış süresi, yoğun bakım ihtiyacı ve mortalite üzerine etkisiz olduğu tespit edilmiştir (14). ...
AMAÇ: Koronavirüs Hastalığı 2019 (COVID-19) akut solunum yetmezliğinin eşlik ettiği ve ölümle sonuçlanabilen bir klinik tabloya yol açabilir. Her ne kadar Polimeraz Zincir Reaksiyon (PCR) testi COVID-19’un teşhisinde altın standart olsa da, hastalığın teşhisini koymak için daha hızlı ve düşük maliyetli teknikler araştırılmaktadır. Tedavi açısından ise hastaların immün sistemlerini güçlendirmeyi amaçlayan tedavi yöntemlerinin, COVID-19'un klinik seyrini hafifletmede etkili olabileceği ileri sürülmektedir. Çalışmadaki ana amacımız COVID-19 hastalarında vitamin D düzeyleri ile nötrofil/lenfosit oranı(NLR) oranlarını araştırmak ve karşılaştırmaktır. Ayrıca çalışmada COVID-19 hastalarında vitamin D ve NLR'nin mortalite için öngörücü olup olamayacağını da araştırmayı hedefliyoruz. GEREÇ VE YÖNTEM: Retrospektif olarak yapılan bu çalışmaya acil servise başvuran, daha sonrasında yoğun bakım yatış kararı verilen 317 COVID-19 hastası alındı. Her hasta için hastadan sorumlu hekim tarafından kaydedilen bir demografik bilgi formu oluşturuldu. Hastalara ait kaydedilen verilerin hepsi vitamin D ve NLR oranları ile karşılaştırıldı. BULGULAR: Çalışmada vitamin D düzeyleri ile COVID-19 hastalarının hastanede kalış süreleri, bilgisayarlı tomografi (BT) bulguları ve mortalitesi arasındaki ilişki incelendi. Analiz sonucunda vitamin D düzeyleri ve yukarıda bahsedilen parametreler arasında bir ilişki bulunamamıştır. Benzer şekilde NLR ile hastalarının hastanede kalış süreleri, BT bulguları ve mortalitesi arasındaki ilişki incelenmiş olup, anlamlı bir ilişki saptanmamıştır. SONUÇ: Bu çalışmanın sonuçlarına baktığımızda vitamin D ve NLR düzeylerinin COVID-19 tanısı alan hastaların hastanede yatış süresini veya hastane içi mortalitesini öngörmede yardımcı olmadığı söylenebilir. Ancak hem vitamin D hem de NLR düzeylerinin hastanede yatış süresi ve hastane içi mortalite ile ilişkili olduğunu gösteren çalışmalarda vardır. Bu nedenle bu hipotezleri test etmek için daha fazla randomize kontrollü çalışmalar ve büyük ölçekli kohort çalışmalarının gerekli olduğunu düşünmekteyiz.
... Recently, a few studies have demonstrated a potential link between the deficiency of VD 3 and several diseases (Dankers et al., 2017;Mamani et al., 2017;Bouillon et al., 2019;Pagano et al., 2020;Sulli et al., 2021). Some authors hypothesised that VD 3 insufficiency may compromise respiratory immune function, increasing the risk of COVID-19 severity and mortality (Daneshkhah et al., 2020;Darling et al., 2020;Raharusun et al., 2020;Grant et al., 2020;Hastie et al., 2020;Ilie et al., 2020;Watkins, 2020). It seems that, at sufficient levels, VD 3 controls the release of antiviral peptides, able to directly prevent viral replication (Gombart et al., 2005;Wang et al., 2010;Greiller and Martineau, 2015). ...
The role of steroid hormones against infectious diseases has been extensively studied. From immunomodulatory action to direct inhibition of microorganism growth, hormones D 3 (VD 3) and 17β-estradiol (E 2), and the genetic pathways modulated by them, are key targets for a better understanding pathogenesis of infectious respiratory diseases (IRD) such as tuberculosis (TB) and the coronavirus disease-19 (COVID-19). Currently, the world faces two major public health problems, the outbreak of COVID-19, accounting for more than 6 million so far, and TB, more than 1 million deaths per year. Both, although resulting from different pathogens, the Mtb and the SARS-CoV-2, respectively, are considered serious and epidemic. TB and COVID-19 present similar infection rates between men and women, however the number of complications and deaths resulting from the two infections is higher in men when compared to women in childbearing age, which may indicate a role of the sex hormone E 2 in the context of these diseases. E 2 and VD 3 act upon key gene pathways as important immunomodulatory players and supporting molecules in IRDs. This review summarizes the main roles of these hormones (VD 3 and E 2) in modulating immune and inflammatory responses and their relationship with TB and COVID-19.
... Recently, a few studies have demonstrated a potential link between the deficiency of VD 3 and several diseases (Dankers et al., 2017;Mamani et al., 2017;Bouillon et al., 2019;Pagano et al., 2020;Sulli et al., 2021). Some authors hypothesised that VD 3 insufficiency may compromise respiratory immune function, increasing the risk of COVID-19 severity and mortality (Daneshkhah et al., 2020;Darling et al., 2020;Raharusun et al., 2020;Grant et al., 2020;Hastie et al., 2020;Ilie et al., 2020;Watkins, 2020). It seems that, at sufficient levels, VD 3 controls the release of antiviral peptides, able to directly prevent viral replication (Gombart et al., 2005;Wang et al., 2010;Greiller and Martineau, 2015). ...
The role of steroid hormones against infectious diseases has been extensively studied. From immunomodulatory action to direct inhibition of microorganism growth, hormones D3 (VD3) and 17β-estradiol (E2), and the genetic pathways modulated by them, are key targets for a better understanding pathogenesis of infectious respiratory diseases (IRD) such as tuberculosis (TB) and the coronavirus disease-19 (COVID-19). Currently, the world faces two major public health problems, the outbreak of COVID-19, accounting for more than 6 million so far, and TB, more than 1 million deaths per year. Both, although resulting from different pathogens, the Mtb and the SARS-CoV-2, respectively, are considered serious and epidemic. TB and COVID-19 present similar infection rates between men and women, however the number of complications and deaths resulting from the two infections is higher in men when compared to women in childbearing age, which may indicate a role of the sex hormone E2 in the context of these diseases. E2 and VD3 act upon key gene pathways as important immunomodulatory players and supporting molecules in IRDs. This review summarizes the main roles of these hormones (VD3 and E2) in modulating immune and inflammatory responses and their relationship with TB and COVID-19.
... Four-hundred-thirteen studies were then excluded as they were case reports (n = 2), reviews (n = 137), meta-analysis (n = 9), editorial/letters (n = 112), or because they were not relevant for the aims of the present meta-analysis (n = 153). Two studies available as preprints until August 2020 were excluded since they were subsequently retracted (30)(31)(32). In addition, 7 studies were excluded due to incomplete data, mainly due to the lack of information concerning disease outcomes in relation to 25OHD thresholds (33)(34)(35)(36)(37)(38)(39) or because severe COVID-19 cases requiring intubation or mechanical respiratory support were not considered for 25OHD measurement (40). ...
... Another analysis revealed that there was a lower incidence of COVID-19 and influenza infections along with death (Grant et al., 2020). A recent retrospective analysis of confirmed cases of SARS-CoV-2 infection had shown that low vitamin D levels were significantly linked to a higher risk of mortality, particularly, in geriatric and male individuals with prior illnesses (Raharusun et al., 2020). ...
The Coronavirus disease 2019 (COVID‐19) has spread across the globe and is causing widespread disaster. The impact of gut microbiota on lung disease has been widely documented. Diet, environment, and genetics all play a role in shaping the gut microbiota, which can influence the immune system. Improving the gut microbiota profile through customized diet, nutrition, and supplementation has been shown to boost immunity, which could be one of the preventative methods for reducing the impact of various diseases. Poor nutritional status is frequently linked to inflammation and oxidative stress, both of which can affect the immune system. This review emphasizes the necessity of maintaining an adequate level of important nutrients to effectively minimize inflammation and oxidative stress, moreover to strengthen the immune system during the COVID‐19 severity. Furthermore, the purpose of this review is to present information and viewpoints on the use of probiotics, prebiotics, and synbiotics as adjuvants for microbiota modification and its effects on COVID‐19 prevention and treatment. This review emphasizes the necessity of maintaining an adequate level of important nutrients to effectively minimize inflammation and oxidative stress, and also to strengthen the immune system during the COVID‐19 severity.
... Clinical studies showed that the most vulnerable populations to COVID -19 are the elderly populations and those with vitamin D deficiency" [20]. "older patients with comorbidities and below normal vitamin D have a higher rate of mortality" [21]. "Vitamin D deficiency has also been reported to be associated with an increased risk of severity in COVID -19" [22]. ...
Background: COVID-19 is associated with a weak immune system in the human body. Vitamin D plays a role in the body’s immune system and is known to enhance the function of immune cells. In this case, vitamin D inhibits some of the inflammation that can make COVID-19 more severe. The is study aims to determine the serum levels of vitamin D, calcium, and phosphorus in COVID-19 patients. Methods: This was a cross sectional study conducted during the period from January 2021 to July 2021. 50 COVID-19 patients as a case study and 50 healthy individuals as a control group were included in this study. Blood samples were collected from the study group and measured for vitamin D using Enzyme-linked immunosorbent assay (ELISA) technique. Calcium and phosphate were measured by the Cobas 6000 fully automated analyzer (Roche, Germany). Results: The study result showed that in COVID-19 patients, vitamin D (27 ± 5 ng/mL), p-value = 0.000, and calcium (10.2 ± 4 mg/dL), p-value = 0.000, in comparison with control. There was a correlation between vitamin D (r = -.771; p =.000) and calcium (r = -.752; p =.000) and the severity of disease. Conclusions: According to our research, vitamin D deficiency may increase the risk of developing COVID-19 and the risk of developing severe illnesses.
... In a retrospective cohort study conducted in Indonesia, 780 patients were examined and a correlation was established between low 25(OH) vitamin D levels and mortality due to COVID-19. 6 A similar study was conducted retrospectively on health records in the United States of America and very large patient populations were examined. Exposure to sunlight, vitamin D levels, and COVID-19 infection and mortality were compared over the latitude lived. ...
Objectives: The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) virus, was identified as the cause of a severe respiratory illness in Wuhan, China three years ago. The COVID-19 infection, which was declared a pandemic in March 2020, caused more than 600 million people to get sick and close to 7 million people to die. Which people have the disease more severely and who have higher mortality are still the subject of research. We investigated whether vitamin D, whose role in immunity has been known for a long time, also affects the prognosis of COVID-19 infection. COVID-19 is currently the leading cause of death worldwide. Vitamin D is an important micronutrient and has been reported to protect against respiratory diseases by improving immunity. In this study, we aimed to reveal whether the 25-hydroxyvitamin D (25 (OH) D) concentration is associated with the risk and severity of COVID-19 by evaluating vitamin D levels in outpatients or hospitalized patients with the diagnosis of COVID-19. Methods: In the study, vitamin D levels in 124 COVID-19 cases and clinical course and laboratory findings were analyzed retrospectively between March 11-May 31 2020. Statistical analysis was done using IBM SPSS 23. Kolmogorov Smirnov, Man Whitney U, Kruskal Wallis Test, Chi-square, and fisher extract and risk analysis tests were used. Categorical variables were expressed as %. P value < 0.05 was considered significant. Results: Vitamin 25 (OH) D level in 32 patients (median 10.2) who were given antiviral treatment and needed oxygen. It was found to be significantly lower than the other 92 patients (median 16.25). When patients who needed oxygen treatment during COVID-19 treatment were examined in terms of vitamin D levels; It was observed that patients with 25 (OH) vitamin D level < 10 needed more O2 (OR: 2,833 CI 95% 1,230-6,528, p = 0.013). In patients with 25 (OH) vitamin D < 10, more patients had pulmonary involvement with thorax CT (OR: 2.225 CI 95% 0.999-4.952 p = 0.048) and these patients had more back pain symptoms (OR: 4,765 CI 95% 1,126-20,163 p = 0.022). Patients with 25 (OH) vitamin D
... Another study collected data sets from various regions of the world and reported a 15% decrease in disease rate after taking vitamin D supplementation.81 In Indonesia, a retrospective cohort study was performed among 780 patients and found a higher death rate in patients with low levels of vitamin D.82 Another retrospective study from the USA concluded that sunlight and vitamin D might reduce the risks of SARS-CoV-2 infection.83 10 | B ENEFI CIAL EFFEC TS OF VITAMIN D UP TAKEAccording to previous evidence, no data indicates that supplementing vitamin D can minimize the relative severity and high mortal-ity rate of COVID-19. ...
COVID-19 remains a life-threatening infectious disease worldwide. Several bio-active agents have been tested and evaluated in an effort to contain this disease. Unfortunately, none of the therapies have been successful, owing to their safety concerns and the presence of various adverse effects. Various countries have developed vaccines as a preventive measure; however, they have not been widely accepted as effective strategies. The virus has proven to be exceedingly contagious and lethal, so finding an effective treatment strategy has been a top priority in medical research.
... Such responses had a chilling effect on free experimentation using available knowledge and approved medications for other purposes (i.e., repurpose agents). Some publications may have been suppressed, and others were forced to withdraw [7]. The catchphrase "lack of evidence" implicitly pointed to the belief that randomized controlled trials (RCTs) are the only acceptable standard of proof that a remedy was effective. ...
With the advent of COVID19, the attitude of health authorities around the world, led mainly by the West, demanded a level of proof as evidence for cheap, non-patented remedies while promoting expensive, patented, and untested remedies by using emergency use authorization and special provisions afforded to the status of a pandemic emergency. Western science has neither a tested nor a valid historical basis of a logical system that informs to authenticate scientific practices. Here we use a logical heuristic derived from ancient Buddhist logic, which is consistent with the conduct of modern science. We applied the heuristic to show that enough evidence was available for using cost-effective early therapies such as vitamin D supplementation as a public health measure during the first half of 2020. Strong supporting evidence has since accumulated. Apart from political and financial decisions incompatible with science and other conflicts of interest, a critical barrier to evaluating and approving early therapies appears to be the fallacy that the randomized controlled trial (RCT) is the superior proof method in medical hypotheses, including those for nutrients. Logically, no reason exists why properly designed retrospective, ecological, and naturalistic studies with adequate sample sizes and applied appropriate statistical methods would not be as valid as RCTs, especially when elucidating a causative factor instead of treatment. That assertion is particularly true for nutrient deficiencies, interventions, and other cost-effective therapies. Leading health authorities’ failure or refusal to consider other study types (because of either poor logic or vested interest) probably contributed to the spread of misinformation, symptomatic disease, complications, and deaths from COVID19. Partial immunity derived from vaccines and the later development of more contagious variants—and thus a sense of acceptance that SARS-CoV-2 had progressed from a pandemic to an endemic—shows the hollowness of the initial promotions and mandates of vaccines as a cure. Adequate knowledge was available in 2020 to advise that SARS-CoV-2 will continue to mutate, with variants emerging a few times per year, making the vaccine less effective. Emerging evidence confirms that natural immunity better protects against new variants than vaccination against the spike protein. Had vitamin D been adopted as part of the public health measure through a broader supplementation program in 2020 or even today (through sun exposure or as a prophylactic or adjunct therapy early on), the viral spread and symptomatic disease may have been suppressed, with minimal lockdowns and quarantine, and economic harm. The pandemic could have been halted with a significantly reduced need for hospitalization, complications, and deaths, potentially saving millions of lives.
... A retrospective Indonesian study revealed that older males with comorbidities were at a higher risk of COVID-19 death [126]. Furthermore, in Italy, reduced 25-hydroxyvitamin D levels were observed in hospitalized COVID-19 patients [127]. ...
The highly transmittable and infectious COVID-19 remains a major threat worldwide, with the elderly and comorbid individuals being the most vulnerable. While vaccines are currently available, therapeutic drugs will help ease the viral outbreak and prevent serious health outcomes. Epigenetic modifications regulate gene expression through changes in chromatin structure and have been linked to viral pathophysiology. Since epigenetic modifications contribute to the life cycle of the virus and host immune responses to infection, epigenetic drugs are promising treatment targets to ameliorate COVID-19. Deficiency of the multifunctional secosteroid hormone vitamin D is a global health threat. Vitamin D and its receptor function to regulate genes involved in immunity, apoptosis, proliferation, differentiation, and inflammation. Amassed evidence also indicates the biological relations of vitamin D with reduced disease risk, while its receptor can be modulated by epigenetic mechanisms. The immunomodulatory effects of vitamin D suggest a role for vitamin D as a COVID-19 therapeutic agent. Therefore, this review highlights the epigenetic effects on COVID-19 and vitamin D while also proposing a role for vitamin D in COVID-19 infections.
... The higher symptom score may be a reflection of the older demographics associated with vitamin D usage, who may have more underlying co-morbidities. One pre-print study that appeared in April of 2020 that garnered a lot of press and was shared widely on social media claimed that a majority of COVID-19 cases in vitamin D-deficient patients had worse outcomes and higher mortality rates (18). However, many news outlets did not disclaim that this study was only a pre-print and subsequent investigation found numerous faults in the study design, bringing into question the validity of the claims (19,20). ...
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus responsible for the COVID-19 pandemic that can lead to severe respiratory distress requiring hospitalization and can be fatal. Media have reported that various dietary supplements (DS) or their combination with different medications can prevent infection or decrease disease severity. Here, we analyzed data collected from 15,830 patient follow-up telephone interviews from the University of Arkansas for Medical Sciences COVID-19 testing sites from March 15 to August 1, 2020. Within the REDCap database, we recorded patient demographics and DS and medication use. In total, data on DS and medication use was available for 8,150 study participants, of whom 21.9% and 4.1% reported using DS or medications, respectively, to either prevent or treat COVID-19. The majority of respondents were female (64%) and non-Hispanic whites (44.5%). Most individuals (64.5%) who took DS were younger than 50 years of age. Products such as vitamin C (1,013, 33.2%), multivitamins (722, 23.6%), and vitamin D (294, 9.6%) were the most commonly used DS among the responders. Analysis of the DS use and symptom scores association did not provide a strong evidence of beneficial health effects of DS. The results of this study demonstrate that a significantly higher proportion of study participants considered usage of DS to mitigate or prevent COVID-19-related symptoms compared to those who preferred medications. However, lack of observable health benefits associated with ingestion of DS suggests that more rigorous research is needed to substantiate the label claims.
... 12,13,33 In another study, it was determined that the vitamin D levels of 780 adults who died due to COVID-19 were lower than the normal reference values. 34 It was determined in our study that mothers used a wide variety of herbs and spices, the number of which was 33, to protect their children from COVID-19. Limited information is available about the benefits and risks of these products in the pediatric population. ...
ABSTRACT Objective: The study aimed to examine the practices of mothers regarding the use of supplements, herbs-spices and child nutrition during the coronavirus disease-2019 (COVID-19) pandemic lock-down in a sample of Turkish mothers. Material and Methods: This descriptive and cross-sectional was study conducted in Karabük province of Türkiye. Five hundred and sixty five mothers with children aged 2-18 participated in the study. For data collection, a questionnaire was used to evaluate the foods consumed by children and the practices of mothers on child nutrition. Descriptive statistical methods, and the chi-square test for differences between groups in terms of categorical variables was used. Results: Eighty-nine percent of mothers had used at least one product to protect their children from COVID-19. While the use of supplements by the mothers was 62%, the use of herbs and spices was 74%. A significant difference was found between the type of product used by the mothers and the state of mothers' being informed about the use of any product (Psupplement<0.001; Pherbs-spices<0.001). Conclusion: Especially the mothers who resorted to these products used them without getting any information. In order for parents to access evidence-based information on child nutrition, training given by health professionals in a virtual learning environment is important for mothers to learn proper nutrition practices.
... With the recent findings of the immunomodulatory effect of 25-hydroxyvitamin D [25(OH)D] (i.e., decreased pro-inflammatory cytokines and increased anti-inflammatory cytokines 5 ), a possible association between serum vitamin D levels and the clinical course due to COVID-19 has been hypothesized. Thus, some studies demonstrate a relationship between 25(OH)D deficiency severity and mortality from COVID-19 6,7 ; however, data on this association in pediatric patients are still lacking. ...
... Several studies have reported the association between the low vitamin D levels with the clinical outcomes of COVID-19 patients. Raharusuna et al. reported that vitamin D insufficiency and deficiency increased the COVID-19 mortality risk by 7.63 times and 10.12 times, respectively [11]. Macaya et al. reported vitamin D deficiency as a predictor for the severity risk of COVID-19. ...
Coronavirus Disease 2019 (COVID-19) causes immune system dysregulation and an exaggerated systemic inflammatory response. Vitamin D acts as an immunomodulator that enhances the immunity defense. Low levels of vitamin D affect the severity of COVID-19 infection. This study aims to determine vitamin D levels in hospitalized and non-hospitalized COVID-19 patients. A case-control study was conducted involving 62 COVID-19 patients, equally divided into hospitalized and non-hospitalized groups at RSUP dr. M. Djamil, Padang from February to September 2020. Serum vitamin D levels were measured using the Chemiluminescent Microparticle Immunoassay. Vitamin D deficiency was defined as a level less than 20 ng/mL. The hospitalized group consisted of moderate to critical COVID-19 patients, whereas the non-hospitalized group consisted of the asymptomatic and mild COVID-19 patients according to the Indonesian Ministry of Health Guidelines. All data were analyzed using a T-test and Chi-square with a significant p-value of 0.05. The results showed that most subjects were women between 21–60 years. The mean level of vitamin D (ng/mL) in the hospitalized group was lower than in the non-hospitalized group (15.5 ± 7.72 vs. 19.2 ± 14.30; 95% CI -9.509–2.167; p=0.213). Vitamin D deficiency affected hospitalized group more than the non-hospitalized group, but not statistically significant (71% vs. 64.5%, p=0.566). It indicated the role of vitamin D in preventing immune system hyperactivation causing COVID-19 cytokine storm. This study concluded no difference in vitamin D levels among the study groups. Nevertheless, further research on vitamin D is needed to determine its role and benefits against COVID-19 infection.
... (9) Contoh lainnya dapat dilihat dari sebuah preprint paper yang berjudul Patterns of COVID-19 Mortality and Vitamin D: An Indonesian Study January 2020 yang penulisnya berasal dari Indonesia. (10) Artikel ini dipertanyakan validitasnya di dalam letter to the editor dari British Journal of Nutrition (11) terkait beberapa isu antara lain; penulis artikel tidak menyebutkan secara spesifik nama rumah sakit tempat studi dilakukan, ethical review board, maupun cara pengambilan data. Pada saat dilakukan konfirmasi, saat artikel ditulis hanya ada 2 kasus terkonfirmasi COVID-19 di rumah sakit umum daerah Sukamara. ...
Dunia medis belakangan ini digemparkan dengan dilaporkan adanya temuan kasus pneumonia tipe baru di kota Wuhan, Provinsi Hubei, Cina pada akhir Desember 2019.(1)Belakangan diketahui bahwapenyakit pneumonia tersebut disebabkanoleh patogen varian baru coronavirus yang disebut sebagai 2019-novel coronavirus (2019-nCoV)/severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) yang selanjutnya dikenal sebagai coronavirus disease 2019 (COVID-19)dan oleh the World Health Organization dinyatakan sebagai pandemi global pada tanggal 11 Maret 2020.(2)Semenjak itupara ilmuan mulai memfokuskan penelitian yang dilakukan pada topikyang berkaitan dengan COVID-19. Kondisi ini juga membawa dampak terdapatnya peningkatan volume publikasi artikel tentang COVID-19 yang sangat mencolok di mana dalam 6 bulan sejak terjadinya pandemi jumlah publikasi berbentuk riset, letters, reviews, notes, dan editorial yang berhubungan dengan COVID-19 dilaporkan berjumlah lebih dari 23.500 artikel.(3)
... Four-hundred-thirteen studies were then excluded as they were case reports (n = 2), reviews (n = 137), meta-analysis (n = 9), editorial/letters (n = 112), or because they were not relevant for the aims of the present meta-analysis (n = 153). Two studies available as preprints until August 2020 were excluded since they were subsequently retracted (30)(31)(32). In addition, 7 studies were excluded due to incomplete data, mainly due to the lack of information concerning disease outcomes in relation to 25OHD thresholds (33)(34)(35)(36)(37)(38)(39) or because severe COVID-19 cases requiring intubation or mechanical respiratory support were not considered for 25OHD measurement (40). ...
Background: Several studies suggest an association between serum 25-hydroxyvitamin D (25OHD) and the outcomes of Severe Acute Respiratory Syndrome Corona-Virus-2 (SARS-CoV-2) infection, in particular Coronavirus Disease-2019 (COVID-19) related severity and mortality. The aim of the present meta-analysis was to investigate whether vitamin D status is associated with the COVID-19 severity, defined as ARDS requiring admission to intensive care unit (ICU) or mortality (primary endpoints) and with the susceptibility to SARS-CoV-2 and COVID-19-related hospitalization (secondary endpoints).
Methods: A search in PubMed, ScienceDirect, Web of Science, Google Scholar, Scopus, and preprints repositories was performed until March 31th 2021 to identify all original observational studies reporting association measures, or enough data to calculate them, between Vitamin D status (insufficiency <75, deficiency <50, or severe deficiency <25 nmol/L) and risk of SARS-CoV-2 infection, COVID-19 hospitalization, ICU admission, or death during COVID-19 hospitalization.
Findings: Fifty-four studies (49 as fully-printed and 5 as pre-print publications) were included for a total of 1,403,715 individuals. The association between vitamin D status and SARS-CoV2 infection, COVID-19 related hospitalization, COVID-19 related ICU admission, and COVID-19 related mortality was reported in 17, 9, 27, and 35 studies, respectively. Severe deficiency, deficiency and insufficiency of vitamin D were all associated with ICU admission (odds ratio [OR], 95% confidence intervals [95%CIs]: 2.63, 1.45–4.77; 2.16, 1.43–3.26; 2.83, 1.74–4.61, respectively), mortality (OR, 95%CIs: 2.60, 1.93–3.49; 1.84, 1.26–2.69; 4.15, 1.76–9.77, respectively), SARS-CoV-2 infection (OR, 95%CIs: 1.68, 1.32–2.13; 1.83, 1.43–2.33; 1.49, 1.16–1.91, respectively) and COVID-19 hospitalization (OR, 95%CIs 2.51, 1.63–3.85; 2.38, 1.56–3.63; 1.82, 1.43–2.33). Considering specific subgroups (i.e., Caucasian patients, high quality studies, and studies reporting adjusted association estimates) the results of primary endpoints did not change.
Interpretations: Patients with low vitamin D levels present an increased risk of ARDS requiring admission to intensive care unit (ICU) or mortality due to SARS-CoV-2 infection and a higher susceptibility to SARS-CoV-2 infection and related hospitalization.
... Analysis of preliminary medical statistics [1][2][3][4] has shown an important role of this vitamin in the regulation of the immune system in viral infections caused by coronavirus SARS-CoV-2. A large number of recent studies suggest that the status of vitamin D in the blood can determine both the risk of COVID-19 infection and the severity of the disease, as well as affect mortality from COVID-19 [5][6][7][8][9][10][11]. Vitamin D deficiency has been shown to be more likely to be observed in patients with laboratory-proven cases of COVID-19 [6]. ...
The aim of the work was to form ideas about rational nutrition as an element of ecological education of students by studying and discussing their eating behavior in relation to foods rich in vitamin D using quantitative descriptor-profile analysis. Quantitative descriptor-profile analysis showed that the “poorest” profiles have foods with the highest vitamin D. Thus, foods with a high vitamin D content do not fall into the circle of students’ dietary preferences. The results of the survey showed that the most frequently consumed foods for young people are fried potatoes, pizza, dumplings and cheese. Products such as cheese, butter, artificial red caviar, mushrooms (chanterelles) can be successfully used as a base for fortification with vitamin D, since they are positively perceived by students and affordable. It was shown that cheese is the only product that, when surveyed by 59 young people, was included both in the list of 5 most favorite and frequently consumed foods, and was selected from the list of 22 foods offered to the respondents containing significant amounts of vitamin D. The research carried out is the basis for forming students’ understanding of the importance of a balanced diet in the context of environmental education.
... Prabowo Raharusuna et al. 53 has done retrospective cohort study which determine the vitamin-D level and COVID-19 mortality outcome. The key findings of the research is that most of the COVID-19 patients with deficient vitamin-D level have high mortality. ...
An impasse in the realm of public health has been undergoing since December due to outbreak of COVID-19. As a consequence of this impasse, different countries are tumbling into an even deeper recession. The life of economically backward people came to a grinding halt on account of the recurrent lockdown. To bear the cost for the treatment of COVID-19 is nearly to impossible for them. It is well known fact that the best preventive measure against COVID-19 should be vitamin-D supplementation for those who are vitamin-D insufficient or deficient. Nearly 1 billion people worldwide have low level of vitamin-D. We know vitamin-D plays a vital role to the function of immune system and vitamin-D supplements have previously been proven safe and effective to reduce the risk of viral respiratory tract infection. Recently, some study have shown a strong relation between severe vitamin-D deficiency and death rate in COVID-19. It has been recorded that patients with lower level of vitamin-D had higher risk of death than patients having no deficiency in vitamin-D. Mortality rate is quite high in 20 European countries and in USA because the people of this countries are vitamin-D deficient. Thus, vitamin-D supplementation can be a very good preventive treatment against COVID-19.
... In a sample of 780 hospitalized patients testing positive for COVID-19 in Indonesia, the odds ratio of death was higher in older and male cases with pre-existing conditions and below normal vitamin D levels. After controlling for age, sex, and comorbidity, both insufficient (OR ¼ 7.63) and deficient 25(OH)D levels (OR ¼ 10.12) were significantly associated with COVID-19 mortality (p < 0.001 for each) [58]. These similar findings were also observed in a large US cohort study (n ¼ 191,779) where SARS-CoV-2 positivity was inversely associated with circulating 25(OH)D levels after adjusting for latitudes, races/ethnicities, both sexes, and age ranges. ...
The pathogenicity of the current coronavirus disease (COVID-19) shows postulates that optimal status of essential nutrients is crucial in supporting both the early viraemic and later hyperinflammatory phases of COVID-19. Micronutrients such as vitamin C, D, zinc, and selenium play roles in antioxidant, anti-inflammatory, antithrombotic, antiviral, and immuno-modulatory functions and are useful in both innate and adaptive immunity. The purpose of this review is to provide a high-level summary of evidence on clinical outcomes associated with nutritional risk of these micronutrients observed in patients with COVID-19. A literature search was performed on PubMed and Google Scholar to obtain findings of cross-sectional and experimental studies in humans. The search resulted in a total of 1212 reports including all nutrients, but only 85 were included according to the eligibility criteria. Despite the diversity of studies and the lack of randomized clinical trials and prospective cohorts, there is evidence of the potential protective and therapeutic roles of vitamin C, D, zinc, and selenium in COVID-19. The findings summarized in this review will contribute to guide interventions in clinical practice or in future clinical studies.
... 26 Another retrospective study reported a mortality rate of 98.9% in vitamin deficient covid cases. 27 Patients with COVID-19 are also at risk for a number of thrombotic complications and coagulopathy which is related to poor prognosis and increased mortality. 28 Their serum levels of cytokines are highly increased which is associated with morbidity and mortality. ...
The surge in the spread of the corona virus disease (COVID-19) pandemic alerted us to opt for the preventive medicine, as prevention is always better than cure. Apart from wearing mask, frequent hand washing and social distancing, strengthening our immune response plays a pivotal role in preventing infections. Vitamin D not only aids in calcium and phosphate homeostasis but also acts as an immunomodulator; the deficiency of which is linked with various respiratory and systemic infections. Hence we took up this review to study the effect of vitamin D in corona illness. Vitamin D exerts the expression of pro-inflammatory cytokines, hinders zinc metabolism, lowers Interleukin 6 levels and thereby inhibits cytokine storm in covid patients. Studies have proved that the covid patients have vitamin D deficiency and its supplementation improves the disease severity as well as the length of hospital stay. To conclude, Vitamin D supplementation can protect as well as halt the progression of corona virus disease. Further trials are needed to set the therapeutic levels in various stages of corona illness.
... A second observatory study from Egypt investigated both NTproBNP and vitamin D levels in 100 COVID-19 patients and monitored disease progression [25]. Reduced vitamin D levels have been linked to disease severity [26][27][28]. High-dose vitamin D has shown to be antiviral, and, amongst other effects, it seems to stimulate the production of antimicrobial peptides in hosts; therefore, high-dose vitamin D is being studied in another clinical trial in Egypt [29]. A similar observational study performed in France evaluated NTproBNP and the high-sensitive cardiac troponin T (hs-cTnT) as potential markers for disease prognosis [30]. ...
Since the beginning of the COVID-19 pandemic, there has been a strong drive and desire to find effective treatments for and protection against the disease. On the webpage ClinicalTrials.gov, a total of 6505 clinical trials currently (September 2021) investigating various aspects of COVID-19 are registered. Of these, 124 studies involving peptides were identified. These 124 were further evaluated, and 88 trials that used peptides only for routine diagnostics were excluded. The remaining 36 trials were classified into 5 different classes according to their function: immunomodulatory (5 trials), regain homeostasis (10 trials), diagnostics/biomarkers (8 trials), vaccination (9 trials), and antiviral activity (4 trials, all overlap with immunomodulatory activities). In the current review, these 36 trials are briefly described and tabularly summarised. According to the estimated finish date, 14 trials have not yet finished. All of the finished trials are yet to report their results. Seven trials were based in the USA, and Egypt, France, the UK, Turkey, and the Russian Federation conducted three trials each. This review aims to present a snapshot of the current situation of peptides in COVID-19 clinical trials and provides a template to follow up on trials of interest; it does not claim to be a complete overview.
... In recent days numbers of reviews supported the possible role of vitamin D in decreasing the risk of COVID-19 infections and mortality [155,157,[191][192][193][194]. Vitamin D supplementation is also found to increase gene expression related to anti-oxidation (glutathione reductase modifier subunit) and by doing this, glutathione spares the use of vitamin C, which has potential antimicrobial activities [195][196][197], and has been suggested to prevent and treat COVID-19 infection [198,199]. The serum response to the given dose is largely varied between the individuals due to differences in demographic and biological variables, such as ethnicity, age, duration of exposure, seasonal variations, Body Mass Index (BMI), intake of certain medications, base-line concentration of vitamin D, genetics and type of vitamin D supplements [153,200,201]. ...
As of now, there is no specific preventive and curative medicine available to treat coronavirus disease 2019 (COVID-19), the best weapon to fight against this highly contagious disease is to boost our immune system. There are two paths of the immune system in our body, the innate and adaptive immune axis working 24/7 with their specialized sentinels capable of orchestrating responses against invading agents. These components of the immune system cannot work optimally in a nutrients deficient consortium. Micronutrient deficiency, called the hidden hunger occurs unknowingly when the quality of food people used to consume daily is not meeting the optimum requirement of vitamins and trace elements. In terms of immunity, the importance of crosstalk between the gastrointestinal (GI) tract microbiome with other distant organs, especially the respiratory system is a recent area of understanding. This review highlighted the contribution of macronutrients as well as the potential role of few vitamins, trace elements, and probiotics on preventive and therapeutic applications to strengthen the immune system along with gut homeostasis.
... The results of a meta-analysis revealed that serum 25(OH)D levels below 50 nmol/l (i.e.<20 ng/ml) increases the risk of community-acquired pneumonia up to 64% (68), Thus, a hypothesis has been put forward that vitamin D deficiency can increase the severity of COVID-19 infection as well as the mortality rate in these individuals (69,70). The association between vitamin D levels and the severity of COVID-19 mortality has already been reported in several retrospective studies (71,72). Vitamin D follows different mechanisms in reducing the risk of viral infections including COVID-19 and its resulting mortality; these mechanisms include maintaining cell junctions and gap junctions, increasing cellular immunity by decreasing the cytokine storm with an influence on interferon γ and tumor necrosis factor α and regulating adaptive immunity through inhibiting T helper cell type 1 responses and stimulating T cells (69). ...
The COVID-19 virus has caused many deaths of people worldwide since the pandemic began. However, no definitive treatment for this infection has been discovered so far. It has been shown that comorbidities such as diabetes, hypertension and cardiovascular diseases are associated with an increased risk of SARS-COV-2 infection. Interestingly, SARS-COV-2, like SARS-COV, uses the ACE2 gene to enter the host cell. Also, changes or imbalance in ACE2.ACE can affect SARS-COV-2 susceptibility, related outcomes and mortality. Regarding the crucial role of ACE2 protein in COVID-19 infection, the effect of different factors such as age, BMI, physical activity levels, nutritional status, altitude, as well as blood group was assessed on the level of this protein. Further, to our knowledge, no study has been conducted to examine factors that increase or decrease the risk of COVID-19 and its related severity and outcome in normal subjects emphasizing the pivotal role of ACE2. Therefore, the primary purpose of this study was to investigate the involved mechanisms of ACE2 protein and other risk factors causing infection in different situations and finally, to introduce a safe, accurate, and cost-effective approach to prevent SARS-COV-2 infection and hard clinical outcomes in normal subjects.
Amaç :Although some recent studies have shown that serum 25-hydroxyvitamin D (25(OH)D) may be effective on the course of Covid-19 disease, the results obtained are still controversial. Therefore, in this study, it was aimed to examine whether there are differences in terms of age, gender, length of hospital stay, biochemical and hematological parameters between those with and without serum 25(OH)D deficiency in Covid-19 patients. Gereç ve Yöntem: The data of 413 patients hospitalized in Ankara Pursaklar State Hospital whose covid-19 positivity was revealed by PCR test were evaluated retrospectively. Those with less than serum 25(OH)D (
Background:
The COVID-19 pandemic has highlighted the importance of information sources (e.g., Internet, social media) and their role in spreading misinformation.
Purpose:
To describe the information sources and frequency of use by health professional students and to compare users of dependable and nontrustworthy news sources on stressors, stress relievers, safety, and preventative activities, worries, and attitudes toward COVID-19.
Methods:
123 students from nursing (38%), medicine (33%), and health professions (28%) completed online surveys on disaster preparedness training, knowledge of the COVID-19 virus, and safety and prevention practices. Students were mostly female (81%), white (59%), and aged 21-30 yrs (72%).
Results:
Students who relied on credible news sources scored higher on knowledge of the COVID-19 condition and reported less stress than their counterparts.
Conclusion:
The findings emphasize the importance of students avoiding untrustworthy news sources. Informed students are less stressed and can help initiate necessary safety measures in the areas they serve.
Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) with clinical outcome ranging from asymptomatic to severe disease, and even death to some. It posed a terrifying challenge to healthcare system worldwide. Several observational and clinical trials has reported that, Vitamin D deficiency has contributed to acute respiratory distress syndrome. Case fatality rate increases with age and comorbidities, both of which are associated with decreased Vitamin D level. Therefore, this study is done to study the prevalence of 25(OH)Vitamin D in RT-PCR positive COVID-19 cases and RT-PCR negative controls.
This is a hospital based cross-sectional study conducted at Jawaharlal Nehru Institute of Medical Sciences, Manipur on 88 RT-PCR positive Covid-19 cases and 88 COVID-19 negative controls over a period of 2 years. Analysis of the sample was done by Liaison 25(OH) Vitamin D Total Chemiluminescence assay(CLIA).
In this study, statistically significant (p-0.018) lower plasma 25(OH)Vitamin D level is seen in COVID-19 positive cases (median 28±20.47) when compared to Covid-19 negative controls(median 33.50±10.66). The number of 25(OH) Vitamin D deficient is higher in Covid-19 positive cases when compared to Covid-19 negative controls -46(52.3%) and 30(34%) respectively with a high statistically significant value (p-0.015).
COVID-19 positive cases have higher tendency to have suboptimal plasma 25(OH) Vitamin D level which may contribute to the high hospitalization risk in COVID-19 infection. This finding is important as it can identify population at risk, and contribute to interventions in reducing the risk of hospitalization associated with COVID-19 infection.
Most diseases are preventable, and they are related to what we eat. Moreover, most doctor visits are for lifestyle-based diseases, which means they can be prevented by adopting a healthy lifestyle. Treating the causes of illness rather than symptoms of the disease is not only safer and cheaper, but it can work better. In this context, the Special Issue on “Nutraceuticals in Immune System” for the journal Molecules was launched in January 2020. Soon after that, the world was ravaged by the COVID-19 pandemic causing a grave health threat. Paradoxically, the immune system can be both friend and foe of COVID-19. The COVID-19 manifests only mild to moderate symptoms for most infected people who recover without hospitalisation, demonstrating the proper functioning of the immune system in fighting such an infection. For some, however, the overactivation of the immune response causing “cytokine storm” has dire consequences, with severe respiratory failure leading to multiple organ failure, which could be fatal. In fact, most deaths from COVID-19 came from organ inflammation due to undesirable immune system responses. As such, the COVID-19 is a good case in point, demonstrating the importance of a healthy immune system.
Nutraceuticals are products derived from food sources with health benefits in addition to the basic nutritional values. Many of them can positively affect and enhance the immune system, which is particularly pertinent in the current turbulent times of COVID-19. Not surprisingly, nutraceutical sales rose dramatically during the pandemic period. However, much research is still needed to understand how natural products interact with the immune system to clarify their chemical compositions, mechanisms of action and effects on health and illnesses.
This Special Issue provided an open forum for researchers to share their research findings in the growing interest of nutraceuticals. We received an overwhelming response with a total of 33 submissions, of which only nine original research papers and ten reviews were accepted after rigorous peer-review. The included articles research into natural substances of interest in nutraceuticals ranging from herbal medicine to vitamins to microbiota-derived metabolites. The investigated immune-related responses include cancer, neurological diseases, gastroenterological disorders, inflammatory conditions, and infections.
We thank the publisher for this excellent opportunity to serve the research community. As academic editors for this Special Issue, it is our pleasure to review these insightful manuscripts first-hand. We thank all the authors for their contributions. The collected works represent our current understanding and latest findings of nutraceuticals in immune system, which we hope will continue to inspire knowledge quests into the field of nutraceuticals.
Despite many efforts around the world to control the outbreak of COVID- 19 virus, this issue has become a pandemic. According to the latest research on the global spread of COVID- 19, researchers have found that adequate vitamin D3 increases resistance to viral infections, reduces the severity of symptoms of the disease, and ultimately mortality rate. However, the results are still contradictory. There are receptors in the human body called ACE2. The COVID- 19 virus can enter the body by binding to these receptors, and the symptoms of the disease develop gradually. Meanwhile, vitamin D3 can attach to these receptors and prevent the corona virus from attaching to the body’s organs. Thus, people who have lower levels of vitamin D3 absorbed during this epidemic should take vitamin D supplements to maintain an optimal level of 25 (OH) D in the blood. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations. There is insufficient evidence between level of vitamin D3 intake and mortality rate of COVID-19 in patients. This review summarizes some of the latest findings about the role of vitamin D3 in COVID-19 infections, severity, and mortality.
Retraction Watch maintains a "running list" of retracted papers on Covid-19 related research. By the end of September 2020, thirty-three retracted Covid-19 papers were listed. We analysed these retracted papers, focusing specifically on how they have been cited by review papers, and subsequently how they have penetrated and potentially distorted public discourse and legitimate research on Covid-19. The study demonstrates the need for more in-depth studies that focus on the phenomenon of citation pollution. We show that the "Covid-19 publication race", amplified by a pressure-to-publish research culture, distorted published science on Covid-19. We highlight the urgency to engage popular media and critical decision-makers on how to distinguish between questionable and legitimate science. We also emphasise the importance of dealing with illegitimate research timely, both from scholarly communications and research quality perspectives.
El propósito de este estudio es determinar las características y cantidad de publicaciones biomédicas retractadas sobre la covid-19, a través de la revisión de las bases de datos PubMed y Retraction Watch, para determinar autores, título, revista, fecha de publicación, fecha de retractación y motivo de la retractación. La literatura sobre la covid-19 ya alcanza más de 280.000 artículos, de los cuales 63 ya han sido retractados. Se observan rápidos procesos editoriales tanto para la publicación como para la retractación. Se destacan 25 artículos donde no se proporciona el motivo de la retractación. Dentro de los que sí lo señalan se encuentran publicaciones duplicadas, plagios, falta de aprobación del comité de ética, problemas de datos y metodológicos.
A novel coronavirus (severe acute respiratory syndrome coronavirus 2 [SARS‐CoV‐2]) that was initially reported from Wuhan, China in December 2019, was declared a pandemic by the WHO in March 2020. Considering the current COVID-19 pandemic, where there are no specific effective preventive or therapeutic drugs available, a healthy immune system is one of the most important tools that should be considered. Vitamins and minerals supplements have been well known to help the immune system in battling viral infections in general. Physicians worldwide are largely interested in vitamin and mineral supplements to help them battle COVID-19 whether through protection or treatment. Dietary supplementations especially vitamin D, vitamin C, and Zinc offer good prophylactic and therapeutic support to the currently available treatment regimens. They are relatively safe and were proven to aid recovery in other respiratory infections. Further studies should be encouraged especially those examining their role in prophylaxis from COVID-19 while maintaining current recommendations for social distancing and proper protective gear.
Ergonomi, insanların kullanımı için verimli ve güvenli bir şekilde etkileşime girecek ve verimliliği artıracak şekilde şeyleri tasarlamak ve düzenlemek için kullanılan uygulamalı bir bilimdir. Çalışmamız kesitsel türde olup evrenini Mühendislik Mimarlık Fakültesi öğrencilerinden 85 Endüstri Mühendisliği öğrencisi ve 66 Makine Mühendisliği öğrencisi olarak toplam 151 kişinin oluşturduğu ve verilerin online olarak toplanıp analiz edilmiştir. Bu çalışmada ergonominin temel ve bilimsel ilkelerini mühendislik fakültelerinde COVID-19 pandemisinin ergonomik koşullar ve buna bağlı gelişen sonuçlar üzerine olan etkisi incelenmiş olup pandemi öncesi ve sonrası olarak mukayese edilmiştir. Çalışmamızda katılımcıların %50’sinden fazlası endüstri mühendisliği öğrencisi olan, 18-22 yaş aralığında, genel akademik not ortalaması (GANO) 2,1-2,9 olan, masa başında 5 saatten fazla vakit geçiren, sigara kullanmayan, pandemi öncesi D vitamini takviyesi almayan, düzenli egzersiz ve spor alışkanlığı olmayan, herhangi bir bel ağrısı şikayeti olmayan ve ergonomik koşullara kısmen de olsa önem gösteren profildedir. Pandemi sonrasında da yine katılımcıların %50’sinden fazlasında pandemi öncesi gösterilen profil devamlılık gösterip D vitamini takviyesi alımı, bel ağrısı şikayetleri, ergonomik koşullara gösterdikleri özen ve kilo alımları artarken düzenli egzersiz-spor alışkanlıkları ise azalmıştır.
Background and objective: Some studies have suggested a potential protective role of vitamin D in coronavirus disease 2019 (COVID- 19) patients, and this has led to a debate on the topic in the medical community. However, the reported data on the number of hospitalized patients who were vitamin D-deficient is not convincing. In light of this, the aim of the present study was to explore if vitamin D deficiency is correlated with severity and mortality rates of COVID-19 infection in hospitalized COVID-19 patients at a tertiary care hospital in Greece.
Methods: We conducted a single-center retrospective study involving 71 patients hospitalized with COVID-19 from August to October 2020. Serum 25-hydroxyvitamin D (25(OH)D) level was assessed in all patients within 48 hours of hospital admission. Serum 25(OH)D level ≤20 ng/ml was defined as a deficiency, while that >20 ng/ml as repletion. The primary outcomes of the infection were classified as partial/complete recovery and mortality during hospitalization. The secondary outcomes were blood markers of inflammation and thrombosis.
Results: Among the 71 COVID-19-positive patients [mean age: 63 years, range: 20-97; male (n=47; 66.2%): female (n=24; 33.8%)] who were enrolled in the study, 46 (64.8%) patients had 25(OH)D levels ≤20 ng/ml and 25 (35.2%) had a level >20 ng/ml. According to the patients' medical history, 55 patients (77.5%) had comorbidities. It appears that vitamin D deficiency (<20 ng/ml) significantly correlated with elevated biochemical markers such as procalcitonin and troponin (p<0.001). Moreover, male gender, advanced age (>60 years), and comorbidities were positively associated with more severe COVID-19 infection (elevated inflammation markers, radiographic findings on X-rays, and increased length of hospital stay).
Conclusion: These preliminary findings show that vitamin D status among the patients was not related to the severity of COVID-19 infection.
The world is foreseeing an ever-increasing human health crisis by virtue of threats from viral disease outbreaks recently showcased by COVID-19 and also those in the previous two decades by other coronaviruses. Many lives have been lost and various world economies have been constrained with the effect from the current pandemic. Corona-warriors, as the name is floating in the air, have also emerged in the shape of the medical and healthcare practitioners, fundraising charity trusts, and sanitation workforces, who are variously catering to the cause. On this mission, most scientific communities and pharmaceutical giants are also investing their best efforts toward studying the molecular biology of these pathogens and discovering and/or designing potential vaccine candidates against the notorious killers. The scenarios, however, have been felt graver with new mutant SARS-2 CoV strains hitting with sporadic emergence, complicating development and contradicting efficacies of these putative vaccines and standard therapies up close to dissemination into the public. Many viral and other pathogenic entities have been found to correlate their bases of pathogenesis and disease severity to, besides other factors, the development of pronounced oxidative stress. Abnormally generated and ill-regulated oxidative stress profiles are reported to effectuate severity, as seen in COVID-19 cases that may trigger cytokine/chemokine storms, ill-orchestrated NETosis, pyroptosis, and others that culminate into symptoms like colitis, ARD/DIC, endothelial dysfunction, coagulopathies, and graver chances of sepsis. Here, we narrate important studies with some of the potent antioxidant molecules which have surfaced with their promises at directly and/or indirectly evading the chances of COVID-19 and possibly other viral diseases. We present a compelling view of the various mechanistic networks within which CoV-led oxidative stress could detriment the homeostatic harmony within the cell/tissue systems by interfering with inflammatory and immunological stimuli and how the antioxidants emerge as a highly sought therapy.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-a novel coronavirus has 28 rapid spread, and caused community infection around the globe. During the absence of a 29 vaccine, people focused more on an immunity-boosting diet and needed clear knowledge about 30 immunity-boosting foods. However, after the vaccination drive, the importance of food as a 31 natural source of immunomodulation cannot be neglected. So, the purpose of this review was 32 to describe the role of vital nutrient in boosting immune system of body apart from other factors 33 like adequate sleep, exercise, and low stress levels. Macrophages, neutrophils, natural killer 34 cells, dendritic cells, B-cells, and T-cells are the important components having important role 35 in maintaining immunity of the human body. The first four-act as the initial mediator of innate 36 host defense, and the latter two produced antibodies for pathogen destruction. The review 37 investigated vital nutrients like vitamin-C, A, E and D, iron, zinc, folic acid, probiotics, and 38 prebiotics affecting these immune components in some extent. Fruits, vegetables, spices, herbs, 39 seeds, nuts, cereals, millets, and superfoods like chlorella and spirulina are good sources of 40 these nutrients. However, fortified foods, functional foods, encapsulated foods with bioactive 41 compounds and plant-based foods have shown immense potential in boosting immunity against 42 viral infection like COVID-19. Some clinical trials and retrospective cohort study have shown 43 reduction in the severity of COVID-19 patients with relation to plant-based diet, vitamin D and 44 C doses, probiotic, and zinc salts application.
Bu kitap bölümünün amacı SARS-CoV-2 virüsü için kullanılan ilaçlar ve tedaviler, geliştirilen aşılar ve beslenme destekleri dâhil olmak üzere besin maddeleri ile geliştirilmeye çalışılan tedavi çalışmaları hakkında bilgi vermek, yeni çalışmaları geniş şekilde ele almak ve viral hastalıklarda beslenmenin önemini vurgulamaktır.
Background
Retraction of published research can reduce the dissemination of incorrect or misleading information, but concerns have been raised about the clarity and rigor of the retraction process. Failure to clearly and consistently retract research has several risks, for example discredited or erroneous research may inform health research studies (e.g. clinical trials), policies and practices, potentially rendering these unreliable.
Objective
To investigate consistency and clarity of research retraction, based on a case study of retracted Covid-19 research.
Study design
A cross-sectional study of retracted Covid-19 articles reporting empirical research findings, based on searches of Medline, Embase and Scopus on 10 th July and 19 th December 2020.
Key results
We included 46 retracted Covid-19 articles. The number eligible for inclusion nearly doubled, from 26 to 46, in five months. Most articles (67%) were retracted from scientific journals and the remainder from preprint servers. Key findings: (1) reasons for retraction were not reported in 33% (15/46) of cases; (2) time from publication to retraction could not be determined in 43% (20/46) of cases; (3) More than half (59%) of retracted Covid-19 articles (27/46) remained available as original unmarked electronic documents after retraction (33% as full text and 26% as an abstract only). Sources of articles post-retraction were preprint servers, ResearchGate and, less commonly, websites including PubMed Central and the World Health Organization. A retracted journal article which controversially claimed a link between 5G technology and Covid-19 remains available in its original full text from at least 60 different websites.
Conclusions
The retraction process is inconsistent and often ambiguous, with more than half of retracted Covid-19 research articles remaining available, unmarked, from a wide range of online sources. There is an urgent need to improve guidance on the retraction process and to extend this to cover preprint servers. We provide structured recommendations to address these concerns and to reduce the risks that arise when retracted research is inappropriately cited.
Vitamin D attenuates inflammatory responses to viral respiratory infections. Hence, vitamin D deficiency may be a highly significant prognostic factor for severity and mortality in COVID-19 patients. To evaluate the complications and mortality in different vitamin D status groups in COVID-19 hospitalized patients, we conducted this retrospective study on 646 laboratory-confirmed COVID-19 patients who were hospitalized in Shahid Modarres Hospital, Tehran, Iran from 16th March 2020 until 25th February 2021. Overall, patients with vitamin D deficiency, insufficiency and sufficiency were 16.9%, 43.6% and 39.5%, respectively. The presence of comorbidity, length of hospitalization, ICU admission, and invasive mechanical ventilation requirement and overall complications were significantly more in patients with vitamin D deficiency (p-value < 0.001). 46.8% (51/109) of vitamin D deficient patients died due to the disease, whilst the mortality rate among insufficient and sufficient vitamin D groups was 29.4% (83/282) and 5.5% (14/255), respectively. In univariate analysis, age > 60 years (odds ratio (OR) = 6.1), presence of comorbidity (OR = 10.7), insufficient vitamin D status (OR = 7.2), and deficient vitamin D status (OR = 15.1) were associated with increase in COVID-19 mortality (p-value < 0.001). Finally, the multivariate analysis adjusted for age, sex, and comorbidities indicated vitamin D deficiency as an independent risk factor for mortality (OR = 3.3, p-value = 0.002). Vitamin D deficiency is a strong risk factor for mortality and severity of SARS-CoV-2 infection. Vitamin D supplementation may be able to prevent or improve the prognosis of COVID-19 during this pandemic.
Introduction: Coronavirus disease 2019 (COVID-19) from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is one of the most important epidemiological events in the past 100 years has become, the consequences for public health and economic systems around the world. Vitamin D is an important micronutrient that has been reported to improve immunity and protect against respiratory diseases. In this study, we intend to review articles that examine the relationship between COVID-19 and vitamin D. Methods: This is a review that uses articles from studies published in 2020 on the relationship between COVID-19 and vitamin D in databases such as; Web of Science, Science Direct, SID, Magiran, Google Scholar and PubMed. Keywords used included; serum levels of 25-hydroxyvitamin D, vitamin D, COVID-19, SARS-COV-2 and coronavirus 2. With this search, 32 articles were finally selected for this purpose and their results were reviewed Results: Of the 32 studies reviewed, only three showed no association between vitamin D levels in the blood and COVID-19 disease. Other studies had a relationship between the severity of the disease, mortality rate and length of hospital stay, in different age, gender and location groups. Conclusion: It seems that the level of vitamin D in the blood has a potential effect on COVID-19 disease. Checking the serum vitamin D levels and supplementation in people with hypovitaminosis D can be a good solution to reduce the complications and problems caused by COVID-19.
Severely ill COVID-19(Corona Virus Disease of 2019) patients have a hyperinflammatory condition with a high concentration of pro-inflammatory cytokines termed the cytokine storm. This milieu is reported to cause acute lung injury, oxygen deprivation, multiorgan damage, critical illness, and often death. Post SARS-CoV-2(Severe Acute Respiratory Syndrome Coronavirus 2) infection, the fight between the invading virus and the host's immune system would either terminate in recovery, with eradication of the infection and regulation of the immune system; or there would be a continuation of immune attacks even after the virus has been cleared, leading to immune dysregulation and disease. This outcome is chiefly dependent on two factors: (1) the patient's immune response, and (2) sufficiency plus efficiency of the regulator(s). Concerning the first, the present research introduces a framework based on different types of immune responses to COVID-19 along with known disease examples,and how this relatesto varying clinical outcomes and treatment needs for COVID-19 patients. About the second factor of 'regulator(s)', part 1 of the manuscript described in depth the regulatory role of progesterone in COVID-19.The present study investigates the two immunity patterns and the status of the regulatory hormone progesterone with respect to the two established demographic risk factors for high-severity COVID-19: male sex, and old age. The study evaluates the status of progesterone as a credible participant of immune regulationand dysregulation. It duly relates the immunity patterns to clinical outcomes and evinces indications for clinical use of progesterone in COVID-19.It proposes a clear answer to the question: why are males and old patients most likely to have critical illness due to COVID-19? The study highlights clinical domains for the use of progesterone in COVID-19. Part 2 of this research introducing the concept of immunity patterns and immunity grading. These concepts herewith provided for the clinical course of COVID-19 also applies to other hyperinflammatory conditions. Possible clinical applications of progesterone to treat critically ill COVID-19 patients will open an avenue for hormonal treatments of infections and other immune-related diseases.
Objectives/Hypothesis
To investigate the association of vitamin D level and perioperative complications in patients undergoing major head and neck surgery.
Study Design
Retrospective Cohort Study.
Methods
A retrospective chart review was performed for all patients undergoing reconstructive head and neck surgery between December 2017 and December 2019. Data regarding patient demographics, serum 25-hydroxyvitamin D (calcidiol) level, hospital course, prior radiation, and fistula formation were collected. Patients were categorized by serum calcidiol level as deficient (<20 ng/mL) or sufficient (≧20 ng/mL) and outcomes were compared between groups.
Results
Fifty-seven patients were included in the analysis. Average age at time of surgery was 62.6 ± 10.6 years. Patients with vitamin D levels <20 ng/mL were considered deficient and ≧20 ng/mL were considered sufficient. Individuals in the deficient group (n = 29) had a mean serum calcidiol level of 13.95 ± 3.95 ng/mL, whereas those in the sufficient group (n = 28) had a mean calcidiol level of 28.53 ± 5.73 ng/mL. The rate of fistula was 41.4% in the deficient group, whereas patients in the sufficient group had a rate of fistula of 14.3% (P = .038). On multivariate analysis, higher serum calcidiol level above 20 ng/mL was associated with a lower likelihood of developing fistulae with an odds ratio 0.830 (95% confidence interval: 0.718–0.960, P = .012).
Conclusion
Vitamin D deficiency may play a role in development of fistula after major head and neck surgery.
Level of Evidence
4 Laryngoscope, 2021
LINKED CONTENT
This article is linked to Al‐Ani et al and Garg et al papers. To view these articles, visit https://doi.org/10.1111/apt.15779 and https://doi.org/10.1111/apt.15796.
Background/Aims: WHO declared SARS-Cov-2 a global pandemic. The aims of this paper are to assess if there is any association between mean levels of vitamin D in various countries and cases respectively mortality caused by COVID-19.
Methods: We have identified the mean levels of vitamin D for 20 Europeans Countries for which we have also got the data regarding the morbidity and mortality caused by COVID-19.
Results: The mean level of vitamin D (average 56mmol/L, STDEV 10.61) in each country was strongly associated with the number of cases/1M (mean 295.95, STDEV 298.73 p=0.004, respectively with the mortality/1M (mean 5.96, STDEV 15.13, p < 0.00001).
Discussion: Vitamin D levels are severely low in the aging population especially in Spain, Italy and Switzerland. This is also the most vulnerable group of population for COVID-19.
Conclusions: We believe, that we can advise Vitamin D supplementation to protect against SARS-CoV2 infection.
The world is in the grip of the COVID-19 pandemic. Public health measures that can reduce the risk of infection and death in addition to quarantines are desperately needed. This article reviews the roles of vitamin D in reducing the risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19, and how vitamin D supplementation might be a useful measure to reduce risk. Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increasing concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced the risk of influenza, whereas others did not. Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D (25(OH)D) concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome; and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce the risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40–60 ng/mL (100–150 nmol/L). For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.
The world is in the grips of the COVID-19 pandemic. Public health measures that can reduce the risk of infection and death in addition to quarantines are desperately needed. This article reviews the roles of vitamin D in reducing risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19, and how vitamin D supplementation might be a useful measure to reduce risk. Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increase concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced risk of influenza, whereas others did not. Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D [25(OH)D] concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome, and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40–60 ng/ml (100–150 nmol/l). For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.
The 2019 coronavirus outbreak started in Hubei Province in China. Despite major travel restrictions, the virus spread across all China’s provinces. Based on the rapidity of the dispersion, coronavirus has become a severe public health concern in China and many other countries. Coronavirus belongs to a large family of viruses that usually affect wild animals. Following gene mutations or close exposure to infected animals, these viruses are occasionally transmitted to humans and subsequently spread among humans. Coronaviruses cause the common cold and more severe diseases, such as Middle East Respiratory Syndrome (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS-CoV). Such diseases are infectious at close range and spread via air and person-to-person contact, with an approximate death rate of 3%. An effective vaccine against the 2019/20 coronavirus is expected to be available within 6 months. Precautions taken to prevent the spread of the COVID-19 are is similar to those used to lessen the transmission of the common cold and flu-like illnesses, but more stringent quarantining is required. Apart from wearing facemasks, social distancing, limiting time in public places and transportation, frequent washing hands with soap in running water is essential to prevent its spread. COVID-19 is going to be a global problem: economically, socially, and a pandemic. This article is intended to provide a general description of the current situation related to the coronavirus outbreak and not to provide medical advice.
Maintaining a normal healthy immune defense system lowers the incidence and/or the severity of symptoms and/or the duration of common cold (CC). Physical barriers and innate and adaptive immunity have been involved during a CC episode. Vitamins C and D, zinc, and Echinacea have evidence-based efficacy on these immune system barriers. This review includes 82 eligible studies to consider the preventive role of these nutrients in immune clusters and in CC to provide advice on dosage and assumption of these nutrients. Regarding vitamin C, regular supplementation (1 to 2 g/day) has shown that vitamin C reduces the duration (in adults by 8%, in children by 14%) and the severity of CC. Considering zinc, the supplementation may shorten the duration of colds by approximately 33%. CC patients may be instructed to try zinc within 24 hours of onset of symptoms. As for vitamin D, the supplementation protected against CC overall, considering baseline levels and age. Patients with vitamin D deficiency and those not receiving bolus doses experienced the most benefit. Regarding Echinacea , prophylactic treatment with this extract (2400 mg/day) over 4 months appeared to be beneficial for preventing/treating CC. In conclusion, the current evidence of efficacy for zinc, vitamins D and C, and Echinacea is so interesting that CC patients may be encouraged to try them for preventing/treating their colds, although further studies are needed on this topic.
Higher vitamin D concentrations have been proposed as a protective 'seasonal stimulus' against influenza, and there are suggestions for associations with other aspects of respiratory health. The aim of the present study was to investigate the relationship of current vitamin D status (measured by 25-hydroxyvitamin D, 25(OH)D) with respiratory infections and lung function. We used cross-sectional data from 6789 participants in the nationwide 1958 British birth cohort who had measurements of 25(OH)D, lung function (forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC)) and respiratory infections available from the age of 45 years. In this population, the prevalence of respiratory infections had a strong seasonal pattern in the opposite direction to the pattern for 25(OH)D concentrations. Each 10 nmol/l increase in 25(OH)D was associated with a 7 % lower risk of infection (95 % CI 3, 11 %) after adjustment for adiposity, lifestyle and socio-economic factors. For FEV1 and FVC, each 10 nmol/l increase in 25(OH)D was associated with 8 (95 % CI 3, 13) ml and 13 (95 % CI 7, 20) ml higher volume, respectively, after controlling for covariates. Associations of 25(OH)D with FEV1 and FVC were only slightly attenuated after further adjustment for infection and other respiratory illness. In conclusion, vitamin D status had a linear relationship with respiratory infections and lung function. Randomised controlled trials are warranted to investigate the role of vitamin D supplementation on respiratory health and to establish the underlying mechanisms.
Twenty-eight patients with anaerobic pleuropulmonary infections were treated with clindamycin alone or clindamycin with gentamicin.
Sixteen of the patients presented with pneumonitis, nine with necrotizing pneumonia, and three with lung abscesses. The average
length of treatment was 13.8 days, and the duration of temperature after initiation of therapy was 3.1 days. The predominant
isolates were anaerobic gram-positive cocci (23 isolates), Bacteroides melaninogenicus (14), Bacteroides fragilis (9), and Fusobacterium nucleatum (11). The most frequent aerobic isolates were alpha-hemolytic streptococci (12), Diplococcus pneumoniae (12), Pseudomonas aeruginosa (9), Klebsiella pneumoniae (7), group A beta-hemolytic streptococci (5), Staphylococcus aureus (9), and Escherichia coli (6). All patients responded to the therapy and were cured of the infection. There were no side effects observed from the
administration of clindamycin. None of the patients developed any blood dyscrasia, liver damage, diarrhea, or colitis. Clindamycin
appears to be effective in the treatment of mixed aerobic and anaerobic pleuropulmonary infections in children, alone or with
an aminoglycoside when indicated.
Background:
Ulcerative Colitis (UC) is a chronic recurrent inflammation of the colon. It has been proposed that the UC pathogenesis may be related to vitamin D deficiency and/or vitamin D administration in UC patients may have an ameliorating effect on the intestinal inflammation. The aim of this study was to assess the effect of vitamin D on the serum levels of immune cytokines in UC patients.
Methods:
In this double-blind randomized controlled trial 90 mild to moderate UC patients were assigned to get either a single muscular injection of 7.5 mg vitamin D3 or 1 ml normal saline as placebo. Three months later serum levels of IL-4, IL-10, IL-12p70, IFN-γ, and TNF-α were measured. Two group variables were compared using independent t-test and analysis of covariance (ANCOVA).
Results:
There was a significant increase in vitamin D only in the vitamin D group. Compared to placebo, vitamin D had significant decreasing effects on serum TNF-α, IFN-γ, and IL12p70 levels, but it had no significant effect on serum levels of IL4 and IL10.
Conclusion:
Vitamin D seems to inhibit Th1 immune responses, and have no effect on Th2 responses. The findings of this study support several in vitro studies, which suggest a therapeutic immunomodulatory potential of vitamin D. This article is protected by copyright. All rights reserved.
We hypothesized that deficiency in 25-hydroxyvitamin D before hospital admission would be associated with all-cause mortality in the critically ill.
Multicenter observational study of patients treated in medical and surgical intensive care units.
A total of 209 medical and surgical intensive care beds in two teaching hospitals in Boston, MA.
A total of 2399 patients, age ≥ 18 yrs, in whom 25-hydroxyvitamin D was measured before hospitalization between 1998 and 2009.
None.
Preadmission 25-hydroxyvitamin D was categorized as deficiency in 25-hydroxyvitamin D (≤ 15 ng/mL), insufficiency (16-29 ng/mL), and sufficiency (≥ 30 ng/mL). Logistic regression examined death by days 30, 90, and 365 post-intensive care unit admission, in-hospital mortality, and blood culture positivity. Adjusted odds ratios were estimated by multivariable logistic regression models. Preadmission 25-hydroxyvitamin D deficiency is predictive for short-term and long-term mortality. At 30 days following intensive care unit admission, patients with 25-hydroxyvitamin D deficiency have an odds ratio for mortality of 1.69 (95% confidence interval of 1.28-2.23, p < .0001) relative to patients with 25-hydroxyvitamin D sufficiency. 25-Hydroxyvitamin D deficiency remains a significant predictor of mortality at 30 days following intensive care unit admission following multivariable adjustment (adjusted odds ratio of 1.69, 95% confidence interval of 1.26-2.26, p < .0001). At 30 days following intensive care unit admission, patients with 25-hydroxyvitamin D insufficiency have an odds ratio of 1.32 (95% confidence interval of 1.02-1.72, p = .036) and an adjusted odds ratio of 1.36 (95% confidence interval of 1.03-1.79, p = .029) relative to patients with 25-hydroxyvitamin D sufficiency. Results were similar at 90 and 365 days following intensive care unit admission and for in-hospital mortality. In a subgroup analysis of patients who had blood cultures drawn (n = 1160), 25-hydroxyvitamin D deficiency was associated with increased risk of blood culture positivity. Patients with 25-hydroxyvitamin D insufficiency have an odds ratio for blood culture positivity of 1.64 (95% confidence interval of 1.05-2.55, p = .03) relative to patients with 25-hydroxyvitamin D sufficiency, which remains significant following multivariable adjustment (odds ratio of 1.58, 95% confidence interval of 1.01-2.49, p = .048).
Deficiency of 25-hydroxyvitamin D before hospital admission is a significant predictor of short- and long-term all-cause patient mortality and blood culture positivity in a critically ill patient population.
Vitamin D and the vitamin D receptor (VDR) have been shown to be important regulators of the immune system. In particular, vitamin D and VDR deficiency exacerbates experimental autoimmune diseases such as inflammatory bowel disease (IBD). IBD develops due to an immune-mediated attack by pathogenic T-cells that overproduce IL-17 and IFN-gamma and a few regulatory cells. VDR knockout mice have twice as many T-cells making IL-17 and IFN-gamma than wild-type mice. In addition, vitamin D and the VDR are required for normal numbers of regulatory T-cells (iNKT and CD8alphaalpha) that have been shown to suppress experimental IBD. In the absence of vitamin D and the VDR, autoimmunity occurs in the gastrointestinal tract due to increased numbers of IL-17 and IFN-gamma secreting T-cells and a concomitant reduction in regulatory T-cells.