Corona Studies

Corona Studies

Biomedicine & Pharmacotherapy

Lithium salts as a treatment for COVID-19: Pre-clinical outcomes

Authors: Soriano-Torresa, O, Noa Romerob, E, González Sosab, NL, et al.

“Identifying effective drugs for Coronavirus disease 2019 (COVID-19) is urgently needed. An efficient approach is to evaluate whether existing approved drugs have anti-SARS-CoV-2 effects. The antiviral properties of lithium salts have been studied for many years. Their anti-inflammatory and immune-potentiating effects result from the inhibition of glycogen synthase kinase-3. To obtain pre-clinical evidence on the safety and therapeutic effects of lithium salts in the treatment of COVID-19. Six different concentrations of lithium, ranging 2–12 mmol/L, were evaluated. Lithium inhibited the replication of SARS-CoV-2 virus in a dose-dependent manner with an IC50 value of 4 mmol/L. Lithium-treated wells showed a significantly higher percentage of monolayer conservation than viral control, particularly at concentrations higher than 6 mmol/L, verified through microscopic observation, the neutral red assay, and the determination of N protein in the supernatants of treated wells. Hamsters treated with lithium showed less intense disease with fewer signs. No lithium-related mortality or overt signs of toxicity were observed during the experiment. A trend of decreasing viral load in nasopharyngeal swabs and lungs was observed in treated hamsters compared to controls. These results provide pre-clinical evidence of the antiviral and immunotherapeutic effects of lithium against SARS-CoV-2, which supports an advance to clinical trials on COVID-19′s patients. ”

Keywords: lithium, pre-clinical trial, inflammation

Nanomedicine. Nanotechnology, Biology and Medicine

Bioavailability by design – Vitamin D3 liposomal delivery vehicles

Authors: Shetty, SS, Kamath, V, Shetty, S, et al.

“Vitamin D3 deficiency has serious health consequences, as demonstrated by its effect on severity and recovery after COVID-19 infection. Because of high hydrophobicity, its absorption and subsequent redistribution throughout the body are inherently dependent on the accompanying lipids and/or proteins. The effective oral vitamin D3 formulation should ensure penetration of the mucus layer followed by internalization by competent cells. Isothermal titration calorimetry and computer simulations show that vitamin D3 molecules cannot leave the hydrophobic environment, indicating that their absorption is predominantly driven by the digestion of the delivery vehicle. In the clinical experiment, liposomal vitamin D3 was compared to the oily formulation. The results obtained show that liposomal vitamin D3 causes a rapid increase in the plasma concentration of calcidiol. No such effect was observed when the oily formulation was used. The effect was especially pronounced for people with severe vitamin D3 deficiency. ”

Keywords: liposomes, bioavailability, digestion

The American Journal of Emergency Medicine

Clinical update on COVID-19 for the emergency and critical care clinician: Medical management

Authors: Long, B, Chavez, S, Carius, BM, et al.

“Coronavirus disease of 2019 (COVID-19) has resulted in millions of cases worldwide. As the pandemic has progressed, the understanding of this disease has evolved. This is the second part in a series on COVID-19 updates providing a focused overview of the medical management of COVID-19 for emergency and critical care clinicians. COVID-19, caused by Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), has resulted in significant morbidity and mortality worldwide. A variety of medical therapies have been introduced for use, including steroids, antivirals, interleukin-6 antagonists, monoclonal antibodies, and kinase inhibitors. These agents have each demonstrated utility in certain patient subsets. Prophylactic anticoagulation in admitted patients demonstrates improved outcomes. Further randomized data concerning aspirin in outpatients with COVID-19 are needed. Any beneficial impact of other therapies, such as colchicine, convalescent plasma, famotidine, fluvoxamine, ivermectin, and vitamins and minerals is not present in reliable medical literature. In addition, chloroquine and hydroxychloroquine are not recommended. This review provides a focused update of the medical management of COVID-19 for emergency and critical care clinicians to help improve care for these patients. ”

Keywords: medical management, drugs

International Journal of Molecular Sciences

The Role of Vitamin D in Supporting Health in the COVID-19 Era

Authors: Albergamo A, Apprato G, Silvagno F.

“The genomic activity of vitamin D is associated with metabolic effects, and the hormone has a strong impact on several physiological functions and, therefore, on health. Among its renowned functions, vitamin D is an immunomodulator and a molecule with an anti-inflammatory effect, and, recently, it has been much studied in relation to its response against viral infections, especially against COVID-19. This review aims to take stock of the correlation studies between vitamin D deficiency and increased risks of severe COVID-19 disease and, similarly, between vitamin D deficiency and acute respiratory distress syndrome. Based on this evidence, supplementation with vitamin D has been tested in clinical trials, and the results are discussed. Finally, this study includes a biochemical analysis on the effects of vitamin D in the body’s defense mechanisms against viral infection. In particular, the antioxidant and anti-inflammatory functions are considered in relation to energy metabolism, and the potential, beneficial effect of vitamin D in COVID-19 is described, with discussion of its influence on different biochemical pathways. The proposed, broader view of vitamin D activity could support a better-integrated approach in supplementation strategies against severe COVID-19, which could be valuable in a near future of living with an infection becoming endemic.”

Keywords: vitamin D, inflammation, oxidative stress, redox imbalance, immunomodulation, vitamin D deficiency, vitamin D supplementation, mitochondrial uncoupling

BMC Geriatrics

Sarcopenia and its association with objectively measured life-space mobility and moderate-to-vigorous physical activity in the oldest-old amid the COVID-19 pandemic when a physical distancing policy is in force

Authors: Kwan, RYC, Liu, JYW, Yin, YH, et al.

“The oldest-old are highly vulnerable to sarcopenia. Physical distancing remains a common and effective infection-control policy to minimize the risk of COVID-19 transmission during the pandemic. Sarcopenia is known to be associated with impaired immunity. Moderate-to-vigorous physical activity (MVPA) and life-space mobility (LSM) are potential strategies for minimizing the risk of sarcopenia. However, a physical distancing policy might jeopardize the practice of MVPA and LSM. The purposes of this study were to identify the prevalence of sarcopenia and examine the association between MVPA and LSM with sarcopenia in the community-dwelling oldest-old during the COVID-19 pandemic. This study employed a cross-sectional and observational design. The study was conducted in 10 community centres for older people in Hong Kong during the period of the COVID-19 pandemic (September to December 2020). Eligible participants were the oldest-old people aged ≥85 years, who were community-dwelling and had no overt symptoms of cognitive impairment or depression. Key variables included sarcopenia as measured by SARC-F, LSM as measured by a GPS built into smartphones, and MVPA as measured by a wrist-worn ActiGraph GT3X+. Variables were described by mean and frequency. A multiple linear regression was employed to test the hypotheses. The dependent variable was sarcopenia and the independent variables included LSM and MVPA. This study recruited 151 eligible participants. Their mean age was 89.8 years and the majority of them were female (n = 93/151, 61.6%). The prevalence of sarcopenia was 24.5% (n = 37/151) with a margin of error of 6.86%. MVPA was negatively associated with sarcopenia in older people. However, LSM was not associated with sarcopenia. The prevalence of sarcopenia in the community-dwelling oldest-old population is high. MVPA is negatively associated with sarcopenia. LSM is unrelated to sarcopenia. Sarcopenia should be recognized and the oldest-old with sarcopenia should be accorded priority treatment during the COVID-19 pandemic. ”

Keywords: sarcopenia, moderate-to-vigorous physical activity, life-space mobility, physical distancing

Preventive Medicine

Self-perception of health and physical activity among adults before and amidst the COVID-19 pandemic: United States, 2019–2020

Authors: AlDukhail, S, Bahdila, D

“The compounded impact of the COVID-19 lockdowns on self-perception of health (SPoH) and physical activity (PA) levels among U.S. adults remains to be explored. We sought to: (1) describe the SPoH and PA levels among U.S. adults; (2) explore the relationship between SPoH and PA before and amidst the COVID-19 pandemic. We analyzed data from the 2019 and 2020 Health Information National Trends Survey (HINTS). COVID-19 was declared a pandemic by the World Health Organization on March 11th, 2020. This date was chosen to demarcate the responses as before and amidst the COVID-19 pandemic. Weighted prevalence estimates were presented alongside adjusted odds ratios from multivariable logistic regression of general SPoH and PA levels for U.S. adults before and amidst COVID-19 pandemic. We analyzed data for 9328 participants. Over half of the U.S. adult population reported performing no muscle strengthening exercise in 2019. The number of inactive people has slightly increased in 2020 (27.8%), compared to 2019 (26.5%). Overall, levels of PA for active people were comparable in 2020 pre and post the WHO pandemic declaration date (36.4% and 39.8%; respectively). Higher odds of negative SPoH were observed among black individuals, current cigarettes smokers, with annual income less than $35,000, physically inactive individuals, people who do not perform muscle-strengthening exercise, and who were very obese. Negative SPoH were associated with lack of moderate exercise, and lack of muscle-strengthening training among U.S. adults before and amidst the pandemic. Pandemic policies and recommendations should include and facilitate PA, specifically among vulnerable populations. ”

Keywords: diagnostic self evaluation, self concept, exercise, health perception, physical activity

Lancet

Physical activity, mental and physical health during the Covid-19 outbreak: longitudinal predictors of suicide ideation in Germany

Authors: Brailovskaia, J, Truskauskaite-Kuneviciene, I, Kazlauskas, E, et al.

“Suicide ideation has increased since the outbreak of Covid-19 in many countries. The present longitudinal study investigated potential predictors of suicide ideation. Data of 406 participants from Germany (age M = 27.69, SD = 6.88) were assessed via online surveys in spring 2020 (baseline, BL) and in spring 2021 (follow-up, FU). The current results reveal a significant increase in symptoms of depression, anxiety, and stress between 2020 and 2021. Positive mental health (PMH), sense of control, and physical health significantly decreased. Depression symptoms (BL), PMH (BL), and consciously enhanced physical activity since the pandemic outbreak (FU) significantly predicted 12-month suicide ideation (FU). In a moderated mediation analysis, the positive relationship between depression and suicide ideation was significantly mediated by PMH. Consciously enhanced physical activity significantly moderated the negative association between PMH and suicide ideation. The context of Covid-19 could negatively impact mental health and physical health. This might increase the risk for suicide ideation. However, PMH and physical activity might serve as protective factors. The protective effect of physical activity could be especially important in people with high depression symptoms and low PMH, such as clinical patients. Potential ways of how PMH and physical activity could be enhanced in the Covid-19 context to prevent suicide ideation are discussed. ”

Keywords: suicide ideation, mental health, physical health, physical activity

Egyptian Journal of Medical Human Genetics

The potential application of probiotics for the prevention and treatment of COVID-19

Authors: Elekhnawy, E, Negm, WA

“Given the severe infection, poor prognosis, and the low number of available effective drugs, potential prevention and treatment strategies for COVID-19 need to be urgently developed. Herein, we present and discuss the possible protective and therapeutic mechanisms of human microbiota and probiotics based on the previous and recent findings. Microbiota and probiotics consist of mixed cultures of living microorganisms that can positively affect human health through their antiviral, antibacterial, anti-inflammatory, and immunomodulatory effect. In the current study, we address the promising advantages of microbiota and probiotics in decreasing the risk of COVID-19. Thus, we recommend further studies be conducted for assessing and evaluating the capability of these microbes in the battle against COVID-19. ”

Keywords: antiviral, beneficial microbes, gut microbiota, immunomodulatory, probiotics

PLoS ONE

Impact of the COVID-19 pandemic on BMI: Its changes in relation to socio-demographic and physical activity patterns based on a short period

Authors: Akter, T, Zeba, Z, Hosen, I, et al.

“The COVID-19 pandemic is undoubtedly a major threat to the world. The preventive strategies designed to minimize the virus transmission by remaining at home, being isolated, and keeping social distance, which would substantially reform people’s lifestyle, physical activity, eating habits, etc. Consequently, those measures might create a disturbance in weight management and overweight. Therefore, how the COVID-19 pandemic has changed the physical activities of individuals and its impacts on the Body Mass Index (BMI) is explored herein. An online-based cross-sectional study collected data from 338 Bangladeshi adults in November 2020. The questionnaire included socio-demographics, health-related variables, physical activity-related variables, and diet measurement. Inferential statistics (i.e., chi-square test, McNemar test) were used to measure the associations between BMI and studied variables with a consideration of two scenarios (‘before’ and ‘during’ the pandemic inception), where p<0.05 was considered statistically significant. Results showed that the prevalence of overweight was 30.5% ‘before’ the COVID-19 pandemic, which increased to 34.9% ‘during’ the pandemic; that means 4.4% of the participants significantly gained weight after the pandemic inception. There was no significant role of socio-demographic (e.g., gender, age, current residence, occupation) or physical activity-related factors (e.g., unavailability of outdoor space, not performing regular physical exercise, exercising with a partner) in changing the BMI status after the pandemic inception. However, following a proper diet plan during the COVID-19 pandemic was observed to decrease BMI status significantly. The present study suggests that a minor portion of the participants reported increasing their overweight status after the pandemic inception, whereas having a proper diet plan during the pandemic can significantly decrease BMI status. Therefore, the importance of the appropriate diet plan should be considered while implementing any policies. ”

Keywords: socio-demography, physical activity, body mass index

Nutrition and Health

The effects of high dose vitamin D supplementation as a nutritional intervention strategy on biochemical and inflammatory factors in adults with COVID-19: Study protocol for a randomized controlled trial

Authors: Khorasanchi, Z, Jafazadeh Esfehani, A, Sharifan, P, et al.

“Low serum vitamin D has been shown to be a risk factor for Coronavirus 2019 (COVID-19). The aim of this study was to assess the effects of high dose vitamin D supplementation on hs-CRP, ESR and clinical outcomes, including duration of hospitalization, quality of life and New York Heart Association (NYHA) Functional Classification, in adults with COVID-19. This double-blind, randomized control trial will be conducted on patients with RT-PCR and/or chest CT scan diagnosis of COVID-19 admitted in Imam Reza Hospital, Mashhad, Iran. Participants will be randomized into control and intervention groups based on randomization sampling. The intervention group will receive soft gel containing 50,000 IU vitamin D on the first day followed by 10,000 IU/day through a supplement drop daily for 29 days. The control group will receive 1000 IU vitamin D daily through supplement drop and a placebo soft gel. All participants will undergo laboratory assessment including inflammatory markers, serum 25)OH)D, complete blood count (CBC), liver and renal profile, lipid profile and erythrocyte sedimentation rate (ESR) at baseline and at day 30. The mortality rate will be recorded in both groups. Data will be presented using descriptive statistics. Comparison of changes in study parameters over the study period will be performed using analysis of covariance adjusting for possible confounders. The findings of this will provide evidence on the effects of high dose vitamin D supplementation on inflammatory markers in hospitalized COVID-19 patients. ”

Keywords: inflammation, vitamin D

European Journal of Nutrition

Nutritional and health behaviour predictors of the weight gain during the COVID-19 pandemic

Authors: Urhan, M, Okut Aysin, E

“This study aims to examine the effects of the COVID-19 pandemic on the body weight, nutritional habits, physical activity, and food consumption of adults living in Turkey and evaluate the effects of changes in these health behaviours on body weight. A cross-sectional study was conducted with an online questionnaire. Data were collected through social media platforms using the snowball sampling method. A self-reported questionnaire included socio-demographic information, anthropometric data, dietary habits, food consumption, and lifestyle changes. In this study, 4181 people were included. Logistic regression analysis was used to evaluate the variables associated with the increase in body weight. The findings obtained in this study showed that the bodyweight of 58.5% of the participants increased during the COVID-19 pandemic, and this increase was the highest (66.3%) among the obese. The rate of those who stated that their physical activity decreased was 69.5%. The foods consumed the most by individuals were homemade desserts (54%), nuts (53.8%) and fresh fruits (52.3%). Those whose serving size increased, those whose physical activity decreased or increased or 2.52, respectively], and those whose number of main meals consumed increased, those with increased consumption of white bread and those with increased consumption of packaged sweet products were more likely to gain weight. The results of this study show that there are significant changes in the body weight, physical activities, and eating habits of the participants during the COVID-19 pandemic. It is necessary to provide and follow-up specific guidance and support services for different groups to protect public health, improve and prevent nutrition-related diseases. ”

Keywords: nutritional habits, change in health behaviours, bodyweight changes, physical activity

European Journal of Clinical Nutrition

Low serum levels of zinc and 25-hydroxyvitmain D as potential risk factors for COVID-19 susceptibility: a pilot case-control study

Authors: Ghanei, E, Baghani, M, Moravvej, H, et al.

“This study aimed to evaluate serum 25-hydroxyvitmain D and zinc levels in coronavirus disease 2019 (COVID-19) patients in comparison to healthy subjects. This was a single-center case-control study performed from March 20, 2020, to January 20, 2021, in Tehran, Iran. All patients diagnosed with COVID-19 based on a positive nasopharyngeal swab polymerase chain reaction (PCR) test were included in the case group. Controls were selected from patients referred for routine checkups who had a negative COVID-19 PCR test. Age, sex, marital and educational status, comorbidities, and serum 25-hydroxyvitmain D and zinc levels of patients were recorded. Ninety patients in the case group and 95 subjects in the control group who were sex and age-matched were studied. 25-hydroxyvitmain D levels lower than 20 ng/ml were observed in 58 (64%) cases and 72 (76%) controls. The median 25-hydroxyvitmain D level in the case group was significantly lower than controls (26 (interquartile range [IQR] = 24) ng/ml vs. 38 (IQR = 22) ng/ml, respectively). The median zinc level in the case group was 56 (IQR = 23) ng/ml, while it was 110 (IQR = 27) ng/ml among the controls. There was no significant difference in the level of 25-hydroxyvitmain D and zinc between cases with and without comorbidities (P > 0.05). Susceptibility to SARS-CoV-2 infection could be predicted by serum 25-hydroxyvitmain D levels below 25.2 ng/ml (81% sensitivity; 48% specificity) or zinc levels below 86.3 mmol/ml (93% sensitivity; 92% specificity). Low serum zinc and 25-hydroxyvitmain D levels appear to be risk factors for COVID-19 affliction; thus, the treatment of individuals with such deficiencies is recommended. ”

Keywords: vitamin D, zinc, risk factors

Global Cardiology Science and Practice

Myocarditis and pericarditis in association with COVID-19 mRNA-vaccination: cases from a regional pharmacovigilance centre

Authors: Istampoulouoglou, I, Dimitriou, G, Späni, S, et al.

“In this article we summarize suspected adverse events following immunization (AEFI) of pericarditis, myocarditis and perimyocarditis that were reported by our regional pharmacovigilance centre after COVID-19 mRNA-vaccination and discuss their association with these vaccines. Seventeen cases were reported between March and July 2021. Of these, nine had perimyocarditis, five myocarditis and three pericarditis. Twelve patients were male (71 %). The median age was 38 years (range 17 - 88). The most commonly observed presenting symptom was acute chest pain (65%). While 47% of the patients were previously healthy, 53% had at least one pre-existing comorbidity, with hypertension being the most prevalent (24%). The European Society of Cardiology diagnostic criteria for the reported AEFIs were fulfilled in twelve cases (71%). The AEFIs occurred after the first vaccine dose in six cases (35%), after the second vaccine dose in ten cases (59%) and after both doses in one case (6%). The median latency of all AEFIs taken together was 14 days (range 1 - 28) after the first vaccination and 3 days (range 1 - 17) after the second one. All patients except one were hospitalized (94%) with a median length of stay of 7.5 days (range 3 - 13). The majority of patients (n = 11, 65%) did not experience any complications, and 13 (77%) of the patients were recovered or recovering at the time of discharge. In 16 of the 17 cases (94%), the association between the AEFI and mRNA-vaccination was considered possible by the pharmacovigilance centre.”

Keywords: COVID-19, SARS-CoV-2, Myocarditis, Pericarditis

PLoS One

COVID-19 and screen-based sedentary behaviour: Systematic review of digital screen time and metabolic syndrome in adolescents

Authors: Musa, S, Elyamani, R, Dergaa, I

“The COVID-19 pandemic has prompted governments around the globe to implement various restriction policies, including lockdown, social distancing, and school closures. Subsequently, there has been a surge in sedentary behaviour particularly screen time (ST) together with a significant decline in physical activity that was more marked amongst children and adolescents. Excessive screen exposure in adolescents has been correlated with cardio-metabolic risk factors including obesity, hypertension, high cholesterol, and glucose intolerance that may have adverse morbidity and mortality implications in adulthood. Thus, the current study aimed to synthesize the literature on the relationship between ST of various types and the risk of metabolic syndrome (MetS) in adolescents in the context of the COVID-19 pandemic. In August 2021, a systematic search of the literature was undertaken using electronic databases: PubMed, PsycINFO, and the Cochran library. Studies were considered if they met the following key eligibility criteria: (i) Measure of ST as an exposure (TV, computer, videogames, internet, smartphone, tablet), using quantified duration/frequency either self-reported or observed; (ii) Measure of MetS as an outcome with standard definition and/or criteria required to establish MetS diagnosis. The Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies was used to assess the risk of bias. A total of ten studies met the inclusion criteria, and the majority were cross sectional studies. Most studies met fair bias scoring. Overall, the review revealed considerable evidence that suggests a significant negative association between ST and components of MetS among adolescents with dose-response association. During the pandemic, screen usage may become more prevalent through periods of school closures, lockdowns, social isolation, and online learning classes. Public health policies and health promotion strategies targeting parents are needed to raise awareness of the adverse health effects associated with screen-based sedentary behaviour as a precursor of NCDs. Parent or home focused interventions might be effective in limiting adolescents’ screen exposure, alternatively substituted with an appropriate level of physical activity.”

Keywords: sedentary behaviour, adolescents, physical activity, metabolic syndrome

Clinics in Geriatric Medicine

Inflamm-aging at the time of COVID-19

Authors: Zazzara, M, Bellieni, A, Calvani R, et al.

“Severe COVID-19 is associated with overproduction of pro-inflammatory cytokines. The ensuing cytokine storm contributes to the development of severe pneumonia and, possibly, to long-term symptom persistence (long COVID). The chronic state of low-grade inflammation that accompanies aging (inflamm-aging) might predispose older adults to severe COVID-19. Inflamm-aging may also contribute to symptom persistence following acute COVID-19. Anti-inflammatory drugs and immunomodulatory agents can achieve significant therapeutic gain during acute COVID-19. Lifestyle interventions (e.g., physical activity, diet) may be proposed as strategies to counteract inflammation and mitigate long-term symptom persistence. ”

Keywords: inflammation, immunosenescence, cytokines, older adults, physical activity, diet

Recent Advances in Inflammation & Allergy Drug Discovery

Increased ACE2, sRAGE, and immune activation, but lowered calcium and magnesium in COVID-19

Authors: Al-Hakeim, HK, Al-Jassas, HK, Morris, G, et al.

“The characterization of new biomarkers that could help to externally validate the diagnosis of COVID-19 and to optimize treatments is extremely important. Many studies established changes in immune-inflammatory and antibody levels, but few studies measured the soluble receptor for advanced glycation end product (sRAGE), angiotensin-converting enzyme 2 (ACE2), calcium and magnesium in COVID-19. To evaluate serum advanced glycation end-product receptor (sRAGE) and angiotensin converting enzyme (ACE)2 and peripheral oxygen saturation (SpO2) and chest CT scan abnormalities (CCTA) in COVID-19. sRAGE, ACE2, interleukin (IL)-6, IL-10, C-reactive protein (CRP), calcium, magnesium, and albumin were measured in 60 COVID-19 patients and 30 healthy controls. COVID-19 is characterized by significantly increased IL-6, CRP, IL-10, sRAGE, ACE2, and lowered SpO2, albumin, magnesium and calcium. COVID-19 with CCTAs showed lower SpO2 and albumin. SpO2 was significantly inversely correlated with IL-6, IL-10, CRP, sRAGE, and ACE2, and positively with albumin, magnesium and calcium. Neural networks showed that a combination of calcium, IL-6, CRP, and sRAGE yielded an accuracy of 100% in detecting COVID-19 patients with calcium being the most important predicter followed by IL-6, and CRP. Patients with positive IgG results showed a significant elevation in the serum level of IL-6, sRAGE, and ACE2 compared to the negatively IgG patient subgroup.The results show that immune-inflammatory and RAGE pathways biomarkers may be used as external validating criterion for the diagnosis COVID-19. Those pathways coupled with lowered SpO2, calcium and magnesium are drug targets that may help to reduce the consequences of COVID-19. ”

Keywords: ACE2, sRAGE, interleukin, albumin, magnesium, calcium

Clinical Nutrition ESPEN

Nutritional Support Protocol for patients with COVID-19

Authors: Hinkelmann, JV, de Oliveira, NA, Marcato, DF, et al.

“Covid-19 is a hypercatabolic disease with possible pulmonary and gastrointestinal symptoms, and consequent deterioration of the nutritional status and worse clinical prognosis. This study presents a protocol to guide the nutritional care of adult and elderly people non-critically and critically ill with COVID-19. A critical review of the literature was carried out in the databases PubMed, Scielo, Bireme, and Science Direct, in search of articles and guidelines that presented assessment criteria and nutritional conduct for COVID-19 and Severe Acute Respiratory Syndrome (SARS), as well as guidelines for managing the symptoms presented by patients. The results are recommendations based on the literature and the professional experience of nutritionists who provide nutritional assistance to individuals hospitalized with COVID-19 since the beginning of the pandemic in Brazil. We present tools and suggestions for assessing the nutritional status, calculating nutritional needs, initiating nutritional therapy and monitoring tolerance to it, nutritional monitoring during hospitalization, and guidelines for hospital discharge. Patients with COVID-19 are at nutritional risk. A complete nutritional assessment (anthropometric, dietary, and laboratory assessment) enables the establishment of an individualized nutritional approach in order to contribute to better clinical and nutritional prognoses.”

Keywords: nutrition therapy, nutritional assessment

Nutrients

Calcifediol (25OH Vitamin D 3) Deficiency: A Risk Factor from Early to Old Age

Authors: Bouillon, R, Antonio, L, Olarte, OR

“Vitamin D deficiency is the main cause of nutritional rickets in children and osteomalacia in adults. There is consensus that nutritional access to vitamin D can be estimated by measuring serum concentrations of 25OHD and vitamin D deficiency can thus be considered as calcifediol deficiency. However, the threshold for vitamin D/calcifediol sufficiency remains a matter of debate. Vitamin D/calcifediol deficiency has been associated with musculoskeletal effects but also multiple adverse extra-skeletal consequences. If these consequences improve or if they can be treated with vitamin D supplementation is still unclear. Observational studies suggest a higher infection risk in people with low calcifediol levels. There is also a consistent association between serum calcifediol and cardiovascular events and deaths, but large-scale, long-term intervention studies did not show any benefit on cardiovascular outcomes from supplementation, at least not in subjects without clear vitamin D deficiency. Cancer risk also did not change with vitamin D treatment, although there are some data that higher serum calcifediol is associated with longer survival in cancer patients. In pregnant women, vitamin D supplementation decreases the risk of pre-eclampsia, gestational diabetes mellitus, and low birth weight. Although preclinical studies showed that the vitamin D endocrine system plays a role in certain neural cells as well as brain structure and function, there is no evidence to support a beneficial effect of vitamin D in neurodegenerative diseases. Vitamin D supplementation may marginally affect overall mortality risk especially in elderly subjects with low serum calcifediol concentrations.”

Keywords: calcifediol, immunology, osteomalacia, osteoporosis, rickets, vitamin D

The Egyptian Journal of Bronchology

Endocrine, metabolic, and hepatic dysfunction in patients with COVID-19 pneumonia with severe and critically ill status

Authors: Elesdoudy, A

“Management of endocrine and hepatic disorders is very important for better management of patient with COVID-19 infections. Hepatic and endocrine dysfunction needs clinical assessment, continued monitoring, and specific treatment. It is important to understand clearly the potential mechanisms causing hepatic and endocrine injury. To assess the endocrine and hepatic dysfunctions in patient with COVID-19 pneumonia with severe and critically ill status. This retrospective analytical study was performed on 75 patients admitted to intensive care or high dependency units (ICU/HDU) in Obaidullah Hospital, Ministry of Health, United Arab Emirates. All patients were subjected to the following on admission: history taking, general and local examinations, routine laboratory studies (CBC, liver function tests, and kidney function tests), and other laboratory tests: C-reactive protein (CRP), D-dimer, Chest X-ray. Endocrine and hepatic function tests and other laboratory studies are repeated daily to show the progress of endocrine and hepatic functions. The age range of the studied group was between 35 years and 107 years with mean age 59.98 ± 12.88. The sex distribution was (42 male, 56%) and (33 female, 44%). The associated comorbidities were 4 patients had bronchial asthma (5.3%), 12 patients had chronic kidney disease (16%), 30 patients had diabetes mellitus (40%), 26 patients had hypertension (34.7%), 2 patient had hypothyroidism (2.7%), 12 patient had ischemic heart disease (16%), and 21 patients did not have any comorbidities (28%). There was significant difference between glucose level, thyroid stimulating hormone and free t4 before and after admission. There was significant difference between serum electrolytes before and after admission. There was significant difference between liver function test before and after admission. Hepatic, pancreatic, thyroid functions, and electrolytes are affected by COVID-19 infection. These could act as surrogate biomarkers for better management of hepatic, pancreatic, thyroid functions and electrolytes disturbances in patients with COVID-19 infection.”

Keywords: electrolytes, hepatic, pancreatic, thyroid

Nutrients

Calcifediol (25OH Vitamin D 3) Deficiency: A Risk Factor from Early to Old Age

Authors: Bouillon, R, Antonio, L, Olarte, OR

“Vitamin D deficiency is the main cause of nutritional rickets in children and osteomalacia in adults. There is consensus that nutritional access to vitamin D can be estimated by measuring serum concentrations of 25OHD and vitamin D deficiency can thus be considered as calcifediol deficiency. However, the threshold for vitamin D/calcifediol sufficiency remains a matter of debate. Vitamin D/calcifediol deficiency has been associated with musculoskeletal effects but also multiple adverse extra-skeletal consequences. If these consequences improve or if they can be treated with vitamin D supplementation is still unclear. Observational studies suggest a higher infection risk in people with low calcifediol levels. There is also a consistent association between serum calcifediol and cardiovascular events and deaths, but large-scale, long-term intervention studies did not show any benefit on cardiovascular outcomes from supplementation, at least not in subjects without clear vitamin D deficiency. Cancer risk also did not change with vitamin D treatment, although there are some data that higher serum calcifediol is associated with longer survival in cancer patients. In pregnant women, vitamin D supplementation decreases the risk of pre-eclampsia, gestational diabetes mellitus, and low birth weight. Although preclinical studies showed that the vitamin D endocrine system plays a role in certain neural cells as well as brain structure and function, there is no evidence to support a beneficial effect of vitamin D in neurodegenerative diseases. Vitamin D supplementation may marginally affect overall mortality risk especially in elderly subjects with low serum calcifediol concentrations.”

Keywords: calcifediol, immunology, osteomalacia, osteoporosis, rickets, vitamin D

Clinical Endocrinology

Letter to the Editor: Subacute thyroiditis following COVID-19 vaccination: Case report and Society for Endocrinology survey

Authors: Bennet, WM, Elamin, A, Newell-Price, JD

“We report a case of subacute thyroiditis which developed following COVID-19 vaccination and 17 additional cases also presenting after COVID-19 vaccination. … Case reports and small case series of subacute thyroiditis following COVID-19 vaccination have recently been described. Endocrinologists need to be aware of potential vaccine sequalae when managing thyrotoxic patients, including the heightened risk that thyrotoxicosis following COVID-19 vaccination will result from a potentially self-limiting subacute thyroiditis. It has also been reported that Graves’ disease can develop shortly following COVID-19 vaccination. With billions of COVID-19 vaccine doses administered to date, and a background subacute thyroiditis incidence of 4.9 per 100,000, there remains a caveat that the cases in our survey may have arisen by chance. However, SARS-CoV-2 vaccines were developed under emergency conditions and the original clinical trials exceptionally consisted of simultaneous phases 1, 2 and 3. Furthermore, the individuals in the placebo arms of the trials have been offered the vaccine, thus randomized control groups do not exist. Systematic monitoring of the general population has not occurred so potential side effects may have been overlooked. Clinicians managing diseases other than COVID-19 do not usually document the COVID-19 vaccination history. Accordingly, a possible link may easily be missed, and adverse effects underestimated.”

Keywords: COVID-19, SARS-CoV-2, subacute thyroiditis

Journal of Personalized Medicine

Therapeutic Vitamin D Supplementation Following COVID-19 Diagnosis: Where Do We Stand?-A Systematic Review

Authors: Bania, A, Pitsikakis, K, Mavrovounis, G, et al.

“Vitamin D has known immunomodulatory activity and multiple indications exist supporting its potential use against SARS-CoV-2 infection in the setting of the current pandemic. The purpose of this systematic review is to examine the efficacy of vitamin D administered to adult patients following COVID-19 diagnosis in terms of length of hospital stay, intubation, ICU admission and mortality rates. Therefore, PubMed and Scopus databases were searched for original articles referring to the aforementioned parameters. Of the 1376 identified studies, eleven were finally included. Vitamin D supplements, and especially calcifediol, were shown to be useful in significantly reducing ICU admissions and/or mortality in four of the studies, but not in diminishing the duration of hospitalization of COVID-19 patients. Due to the large variation in vitamin D supplementation schemes no absolute conclusions can be drawn until larger randomized controlled trials are completed. However, calcifediol administered to COVID-19 patients upon diagnosis represents by far the most promising agent and should be the focus of upcoming research efforts.”

Keywords: ICU admission, hospitalization, intubation, mortality, vitamin D

OSFPreprints

Preprint

Lessons from the self-terminating COVID-19 pandemic: Vaccination, vitamin A deficiency and a brief epidemiological view

Authors: Sarohan, AR

“Declared a pandemic by WHO in March 2020, COVID-19 infected more than 460 million people, causing the death of more than six million people. With the Omicron variant becoming the dominant form, COVID-19 ended on its own, leaving behind serious socioeconomic traumas and dozens of chronic inflammatory diseases. With the transformation of COVID-19 into seasonal flu, it is predicted that it will no longer cause serious socioeconomic and health problems on a societal scale. During the pandemic process, it was tried to stop the epidemic with extraordinary measures such as hygiene, quarantine, closure of schools, travel restrictions, filiation practices, financial and psychosocial support, and effective use of mass media. These measures undoubtedly slowed the pace of the epidemic somewhat. It was anticipated that vaccines would not provide long-term protection against COVID-19 due to mutations that develop so frequently in SARS-CoV-2. Despite this, researchers focused heavily on vaccine development throughout the process. With the vaccines developed in this process, at least one dose of the COVID-19 vaccine was given to approximately 4.9 billion people as of April 2021. The dictation of vaccines as the only and most effective solution in the fight against the pandemic prevented the detection of micronutrient deficiencies such as vitamin A deficiency, which facilitated the epidemic, on a societal scale and other alternative solutions. Some studies show that vitamin A deficiency may have played a role in the transmission of COVID-19 and the development of the severe clinical picture. The pandemic is coming to an end before the main reason or reasons underlying the fact that COVID-19, the biggest epidemic of our age, mostly affects western societies and is fatal in the elderly population living in big cities, are not clarified. In order to find the answer to this intriguing question, community-based dietary habits and epidemiological scans for micronutrient deficiency such as Vitamin A deficiency were not conducted. At a time when people began to lose their confidence in COVID-19 vaccines, SARS-CoV-2 underwent a heavy mutation, as the evolutionary process required, and COVID19 turned into a flu-like infection. ”

Keywords: vitamin A, vitamin D, WHO, CDC, FDA, pandemic, big pharma, vaccines, drugs, epidemiology, medical ethics, medicolegal, public health, relations of interest

Applied Geography

Geospatial evaluation of COVID-19 mortality: Influence of socio-economic status and underlying health conditions in contiguous USA

Authors: Akinwumiju, AS, Oluwafemi, O, Mohammed, YD, et al.

“Since its outbreak, COVID-19 disease has claimed over one hundred thousand lives in the United States, resulting to multiple and complex nation-wide challenges. In this study, we employ global and local regression models to assess the influence of socio-economic and health conditions on COVID-19 mortality in contiguous USA. For a start, stepwise and exploratory regression models were employed to isolate the main explanatory variables for COVID-19 mortality from the ensemble 33 socio-economic and health parameters between January 1st and 16th of September 2020. Preliminary results showed that only five out of the examined variables (case fatality rate, vulnerable population, poverty, percentage of adults that report no leisure-time physical activity, and percentage of the population with access to places for physical activity) can explain the variability of COVID-19 mortality across the Counties of contiguous USA within the study period. Consequently, we employ three global and two local regression algorithms to model the relationship between COVID-19 and the isolated socio-economic and health variables. The outcomes of the regression analyses show that the adopted models can explain 61%–81% of COVID-19 mortality across the contiguous USA within the study period. However, MGWR yielded the highest R2 (0.81) and lowest AICc values (4031), emphasizing that it is the most efficient among the adopted regression models. The computed average adjusted R2 values show that local regression models (mean adj. R2 = 0.80) outperformed the global regression models (mean adj. R2 = 0.64), indicating that the former is ideal for modeling spatial causal relationships. The GIS-based optimized cluster analyses results show that hotspots for COVID-19 mortality as well as socioeconomic variables are mostly delineated in the South, Mid-West and Northeast of contiguous USA. COVID-19 mortality exhibited positive and significant association with black race (0.51), minority (0.48) and poverty (0.34). Whereas, the percentage of persons that attended college was negatively associated with poverty (−0.51), obesity (−0.50) and diabetes (−0.45). Results show that education is crucial to improve socio-economic and health conditions of the Americans. We conclude that investing in people’s standard of living would reduce the vulnerability of an entire population.”

Keywords: mortality, poverty, case fatality rate

Frontiers in Pharmacology

Understanding a Low Vitamin D State in the Context of COVID-19

Authors: Walsh, JB, McCartney, DM, Laird, É, et al.

“While a low vitamin D state has been associated with an increased risk of infection by SARS-CoV-2 in addition to an increased severity of COVID-19 disease, a causal role is not yet established. Here, we review the evidence relating to i) vitamin D and its role in SARS-CoV-2 infection and COVID-19 disease ii) the vitamin D status in the Irish adult population iii) the use of supplemental vitamin D to treat a deficient status and iv) the application of the Bradford-Hill causation criteria. We conclude that reverse causality probably makes a minimal contribution to the presence of low vitamin D states in the setting of COVID-19. Applying the Bradford-Hill criteria, however, the collective literature supports a causal association between low vitamin D status, SARS-CoV-2 infection, and severe COVID-19 (respiratory failure, requirement for ventilation and mortality). A biologically plausible rationale exists for these findings, given vitamin D’s role in immune regulation. The thresholds which define low, deficient, and replete vitamin D states vary according to the disease studied, underscoring the complexities for determining the goals for supplementation. All are currently unknown in the setting of COVID-19. The design of vitamin D randomised controlled trials is notoriously problematic and these trials commonly fail for a number of behavioural and methodological reasons. In Ireland, as in most other countries, low vitamin D status is common in older adults, adults in institutions, and with obesity, dark skin, low UVB exposure, diabetes and low socio-economic status. Physiological vitamin D levels for optimal immune function are considerably higher than those that can be achieved from food and sunlight exposure alone in Ireland. A window exists in which a significant number of adults could benefit from vitamin D supplementation, not least because of recent data demonstrating an association between vitamin D status and COVID-19. During the COVID pandemic, we believe that supplementation with 20-25ug (800–1000 IU)/day or more may be required for adults with apparently normal immune systems to improve immunity against SARS-CoV-2. We expect that higher monitored doses of 37.5–50 ug (1,500–2,000)/day may be needed for vulnerable groups (e.g., those with obesity, darker skin, diabetes mellitus and older adults). Such doses are within the safe daily intakes cited by international advisory agencies. ”

Keywords: vitamin D, severity, mortality, immune system

Clinical Infectious Diseases

Molnupiravir and Nirmatrelvir-Ritonavir: Oral COVID Antiviral Drugs

Authors: Saravolatz, LD, Depcinski, S, Sharma, M

“At a crucial time with rapid spread of Omicron SARS-CoV-2 virus variant globally, the United States Food and Drug Administration has issued an emergency use authorization for two oral antivirals molnupiravir (>18 years) and nirmatrelvir-ritonavir (Paxlovid) (≥12 years; >40kg ) for the outpatient treatment of mild to moderate COVID–19 patients who are at risk for progression. Molnupiravir is a nucleoside analogue, whereas nirmatrelvir is a SARS-CoV-2 main protease inhibitor, and ritonavir is an HIV-1 protease inhibitor. Drug interactions are a major concern for nirmatrelvir-ritonavir. Nirmatrelvir-ritonavir demonstrated a greater risk reduction in hospitalization and death than molnupiravir compared to placebo. Both drugs need to be started within five days of symptoms onset and given for five days duration. This article will review the two oral COVID-19 antiviral drugs including the mechanisms of action, antiviral activity, pharmacokinetics, drug interactions, clinical experience including trials, adverse events, recommended indications, and formulary considerations. ”

Keywords: nirmatrelvir, molnupiravir, Paxlovid, ritonavir

Infectious Disease Reports

Efficacy and Safety of Ivermectin and Hydroxychloroquine in Patients with Severe COVID-19: A Randomized Controlled Trial

Authors: Beltran Gonzalez, JL, González Gámez, M, Mendoza Enciso, EA, et al.

“During the first year of the COVID-19 pandemic, unauthorized drugs were widely used. Ivermectin and hydroxychloroquine are drugs that inhibit viral replication in vitro and that have been used in several medical centers. This clinical trial analyzes their efficacy in hospitalized patients with moderate COVID-19. This a controlled, clinical, randomized, double-blind trial that included hospitalized patients with COVID-19-induced pneumonia, without severe respiratory failure. Patients were randomized to one of three groups: Group 1-hydroxychloroquine, 400 mg every 12 h on the first day and, subsequently, 200 mg every 12 h for 4 days; Group 2-ivermectin, 12 mg or 18 mg, according to patient weight; and Group 3-placebo. At inclusion, blood samples for arterial blood gases and biochemical markers were obtained. The primary outcome was established as the length of stay due to patient improvement and the rate of respiratory deterioration or death. During the month of August 2020, the admission of patients requiring hospitalization mostly encompassed cases with severe respiratory failure, so we ended the recruitment process and analyzed the data that was available at the time. One hundred and six (106) patients with an average age of 53 yrs (±16.9) were included, with a greater proportion of males (n = 66, 62.2%). Seventy-two percent (72%) (n = 76) had an associated comorbidity. Ninety percent (90%) of patients were discharged due to improvement (n = 96). The average duration of hospitalization was 6 days (IQR, 3-10). No difference in hospitalization duration was found between the treatment groups (Group1: 7 vs. Group 2: 6 vs. Group 3: 5) nor in respiratory deterioration or death (Group 1: 18% vs. Group 2: 22.2% vs. Group 3: 24.3%). In non-critical hospitalized patients with COVID-19 pneumonia, neither ivermectin nor hydroxychloroquine decreases the number of in-hospital days, respiratory deterioration, or deaths. ”

Keywords: Hydroxychloroquine, Ivermectin

The Journals of Gerontology Series A

The impact of the COVID-19 pandemic on older women in the Women’s Health Initiative Get access Arrow

Authors: VoPham, T, Harris, HR, Tinker, LF, et al.

“The COVID-19 pandemic is a health crisis of which older adults are a high-risk group for severe illness and mortality. The objectives of this paper are to describe the methods and responses to a COVID-19 survey administered by the Women’s Health Initiative (WHI) to assess the impact of the pandemic on older women. WHI is an ongoing prospective cohort study that recruited 161,808 postmenopausal women from 1993-1998. From June-October 2020, participants in active follow-up were surveyed by mail, phone, or online to assess health and well-being, living situations, lifestyle, health care, and self-reported COVID-19 testing, treatment, and preventive behaviors. Of 64,061 eligible participants, 49,695 (average age 83.6 years ± 5.6) completed the COVID-19 survey (response rate 77.6%). Many participants reported very good or good well-being (75.6%). Respondents reported being very concerned about the pandemic (51.1%) (more common in urban compared to rural areas), with 6.9% reporting disruptions in living arrangements and 9.7% reporting changes in medication access. Participants (54.4%) reported physical activity levels were much less or somewhat less compared to levels before the pandemic, and this was more pronounced in urban areas vs. rural areas (55.3% vs. 44.4%). Participants engaged in preventive behaviors including wearing a face mask (93.2%). A total of 18.9% reported testing for SARS-CoV-2, among whom 3.5% (n=311) reported testing positive. In this nationwide survey of older US women, the COVID-19 pandemic was associated with impacts on health and well-being, living situations, lifestyle, health care access, and SARS-CoV-2 testing and preventive behaviors.”

Keywords: living arrangements, well-being, cohort study

Pharmaceuticals

Vitamin D Status and Immune Response in Hospitalized Patients with Moderate and Severe COVID-19

Authors: Karonova, TL, Kudryavtsev, IV, Golovatyuk, KA, et al.

“A low 25-hydroxyvitamin D (25(OH)D) level is considered as an independent risk factor for COVID-19 severity. However, the association between vitamin D status and outcomes in COVID-19 is controversial. In the present study we investigate the association between the serum 25(OH)D level, immune response, and clinical disease course in patients with COVID-19. A total of 311 patients hospitalized with COVID-19 were enrolled. For patients with a vitamin D deficiency/insufficiency, the prevalence of severe COVID-19 was higher than in those with a normal 25(OH)D level. The threshold of 25(OH)D level associated with mortality was 11.4 ng/mL (p = 0.003, ROC analysis). The frequency of CD3+CD4+ T helper (Th) cells was decreased in patients with 25(OH)D level ≤ 11.4 ng/mL, compared to healthy controls (HCs). There were no differences in the frequency of naive, central memory (CM), effector memory (EM), and terminally differentiated effector memory Th cells in patients with COVID-19 compared to HCs. The frequency of T-follicular helpers was decreased both in patients with 25(OH)D level > 11.4 ng/mL and 25(OH)D level ≤ 11.4 ng/mL (p = 0.003) compared to HCs. Patients with 25(OH)D level > 11.4 ng/mL had an increased frequency of Th2 CM and decreased Th17 CM. While the frequency of Th2 EM was significantly increased, the frequency of Th17 EM was significantly decreased in both groups compared to HCs. Thus, 25(OH)D level is an independent risk factor for the disease severity and mortality in patients with COVID-19. We demonstrate that the serum 25(OH)D level ≤ 11.4 ng/mL is associated with the stimulation of Th2 and the downregulation of Th17 cell polarization of the adaptive immunity in patients with COVID-19. ”

Keywords: vitamin D, Th cell subsets, T-follicular helpers, immune response

Behavioral Sciences

Sleep, Diet, Physical Activity, and Stress during the COVID-19 Pandemic: A Qualitative Analysis

Authors: Orr, K, Ta, Z, Shoaf, K, et al.

“The COVID-19 pandemic has changed routines and habits, raising stress and anxiety levels of individuals worldwide. The goal of this qualitative study was to advance the understanding of how pandemic-related changes affected sleep, diet, physical activity (PA), and stress among adults. We conducted semi-structured, qualitative interviews with 185 participants and selected 33 interviews from a represented sample based on age, race, and gender for coding and analysis of themes. After coding for thematic analysis, results demonstrated four primary themes: sleep, diet, PA, and stress. Sleep sub-themes such as poorer sleep quality were reported by 36% of our participants, and 12% reported increased an frequency of vivid dreams and nightmares. PA was decreased in 52% of our participants, while 33% experienced an increase and 15% experienced no change in PA. Participants also reported having an improved diet, mostly among women. Stress was elevated in 79% of our participants and was more likely to be discussed by women. Many participants reported how stress was involved in precipitating health behavior change, especially for sleep. Increased stress was also linked to elevated anxiety and depression among participants. The results of this qualitative study demonstrate how managing stress could have a beneficial effect on promoting health behaviors and mental health during the COVID-19 pandemic and beyond. ”

Keywords: diet, physical activity, sleep, stress

Journal of Pharmacy & Pharmaceutical Sciences

Effects of Vitamin D Serum Level on Morbidity and Mortality in Patients with COVID-19: A Systematic Review and Meta-Analysis

Authors: Hu, Kung, JY, Cave, A, et al.

“ It has been shown that low Vitamin D serum concentration is associated with increased pneumonia and viral respiratory infections. Vitamin D is readily available, inexpensive, and easy to administer to subjects infected with COVID-19. If effective in reducing the severity of COVID-19, it could be an important and feasible therapeutic intervention. Methods: We performed a systematic review and meta-analysis of the literature to determine the effects of Vitamin D serum concentration on mortality and morbidity in COVID-19 patients. The primary objectives were to determine if Vitamin D serum concentration decrease mortality, ICU admissions, ventilator support, and length of hospital stay in COVID-19 patients. Results: A total of 3572 publications were identified. Ultimately, 20 studies are included. A total of 12,806 patients aged between 42 to 81 years old were analyzed. The pooled estimated RR for mortality, ICU admission, ventilator support and length of hospital stay were 1.49, 0.87, 1.29, and 0.84. There is no statistical difference in mortality, ICU admission rate, ventilator support requirement, and length of hospital stay in COVID-19 patients with low and high Vitamin D serum concentration. ”

Keywords: vitamin D, mortality, morbidity

Nutrition and Health

Associations among Self-Reported Mental Health, Physical Activity, and Diet during the COVID-19 Pandemic

Authors: Andersen, JA, Rowland, B, Gloster, E, et al.

“Understanding the relationship between physical activity, diet, and mental health during the COVID-19 pandemic may help inform resources encouraging healthy lifestyle choices during the time of an increased threat to health and wellbeing. Aim: Our objective was to examine how self-rated mental health was associated with engagement in physical activity and consumption of fruits and vegetables during the COVID-19 pandemic. Methods: The study utilized cross-sectional survey data from adults (≥18 years of age) living, working, and/or receiving healthcare in Arkansas (n  =  754). Multivariable regression models were used to examine the associations between self-rated mental health and the number of days respondents engaged in 30 min of physical activity and the number of days respondents consumed five or more servings of fruits and vegetables. Results: Respondents who reported somewhat poor/poor mental health reported engaging in at least 30 min of physical activity fewer days per week compared with those reporting excellent mental health, after controlling for sociodemographic factors and self-rated health. The significant association observed in the first two models between mental health and number of days consuming five or more servings of fruits and vegetables became non-significant after inclusion of self-rated health. Conclusion: The relationship between mental health and physical activity and diet reaffirms a need for healthcare providers to promote the importance of maintaining both a healthy physical activity level and a nutrient-rich diet in the face of challenging circumstances, such as a global pandemic. ”

Keywords: dietary consumption, mental health assessment, self-reported health, pandemic, physical activity

The New England Journal of Medicine

Covid-19 Vaccine Effectiveness against the Omicron (B.1.1.529) Variant

Authors: Andrews, N, Stowe, J, Kirsebom, F, et al.

“Background: A rapid increase in coronavirus disease 2019 (Covid-19) cases due to the omicron (B.1.1.529) variant of severe acute respiratory syndrome coronavirus 2 in highly vaccinated populations has aroused concerns about the effectiveness of current vaccines. – Conclusions: Primary immunization with two doses of ChAdOx1 nCoV-19 or BNT162b2 vaccine provided limited protection against symptomatic disease caused by the omicron variant. A BNT162b2 or mRNA-1273 booster after either the ChAdOx1 nCoV-19 or BNT162b2 primary course substantially increased protection, but that protection waned over time.”

Keywords: COVID-19, SARS-CoV-2, Omicron, B.1.1.529, BNT162b2, ChAdOx1 nCoV-19, mRNA-1273

The Journal of Immunology

Cutting Edge: Serum but Not Mucosal Antibody Responses Are Associated with Pre-Existing SARS-CoV-2 Spike Cross-Reactive CD4+ T Cells following BNT162b2 Vaccination in the Elderly

Authors: Meyer-Arndt, L, Schwarz, T, Loyal, L, et al.

“Advanced age is a main risk factor for severe COVID-19. However, low vaccination efficacy and accelerated waning immunity have been reported in this age group. To elucidate age-related differences in immunogenicity, we analyzed human cellular, serological, and salivary SARS-CoV-2 spike glycoprotein-specific immune responses to the BNT162b2 COVID-19 vaccine in old (69–92 y) and middle-aged (24–57 y) vaccinees compared with natural infection (COVID-19 convalescents, 21–55 y of age). Serological humoral responses to vaccination excee-ded those of convalescents, but salivary anti-spike subunit 1 (S1) IgA and neutralizing capacity were less durable in vaccinees. In old vaccinees, we observed that pre-existing spike-specific CD4+ T cells are associated with efficient induction of anti-S1 IgG and neutralizing capacity in serum but not saliva. Our results suggest pre-existing SARS-CoV-2 cross-reactive CD4+ T cells as a predictor of an efficient COVID-19 vaccine-induced humoral immune response in old individuals.”

Keywords: COVID-19, SARS-CoV-2, BNT162b2, CD4+ T cells

Healthcare

Measuring the Physical Activity of Seniors before and during COVID-19 Restrictions in the Czech Republic

Authors: Janovský, V, Piorecký, M, Včelák, J, et al.

“Social workers require a better understanding of the impact of pandemic measures on the level of physical activity of their clients to better target client activation. In this retrospective tracker-based study (two years of measurement), we examined changes in the physical activity of the elderly population (204 participants with an average age of 84.5 years) in the Czech Republic as a result of measures to prevent the spread of COVID-19. Physical activity was statistically compared according to the physical, demographic and social conditions of the participants. In addition to observing the expected activity decrease during the COVID-19 pandemic, we made several hypotheses based on the sex, age group, body mass index, type of housing (apartment or house) and size of the city of residence. We found that 33% of the 204 participants had increased levels of physical activity in the period following the COVID-19 pandemic outbreak in Central Europe. We found that the size of the city where the seniors lived and the type of housing did not affect the general level of physical activity. When comparing physical acquisition rates in each month of 2019 and 2020, we saw the largest declines in April and May 2020, that is, one month after the start of the lockdown. ”

Keywords: physical health, physical activity, motion tracker

Frontiers in Public Health

Ivermectin and the Integrity of Healthcare Evidence During COVID-19

Authors: O’Mathúna, DP

“The COVID-19 pandemic has been characterized by a lack of clear evidence to guide healthcare professionals, the public and policymakers. The resulting uncertainty, coupled with changing guidelines as additional evidence became available, added to the stress and anxiety reported by decision-makers. Research results are key to providing evidence to guide healthcare decisions. Important questions have arisen about whether various interventions are safe and effective. The evidence found guides those making treatment decisions, and influences those selecting interventions for further evaluation in research studies. As the COVID-19 pandemic intensified, the effectiveness and safety of many pharmaceuticals was queried. Ivermectin will be used to explore the ethics of how healthcare evidence must be critically appraised, even, or especially, during a pandemic. This drug is alleged to be effective in treating COVID-19, with various studies and systematic reviews finding supportive evidence. Some of these have now been linked to concerns about fraud or poor research reporting. This article will focus on the scientific literature and how apparently fraudulent studies were published and influenced treatment decisions, on-going research and public health guidelines. Research evidence is critical during emergencies like pandemics, but urgency should not overtake ethical responsibilities to critically appraise (or evaluate) studies as they become available. These responsibilities apply in various ways to editors, peer-reviewers, news media reporters, and those making treatment decisions, including clinicians, policymakers and the general public. While research article authors have the primary ethical responsibility to reject fraudulent or inaccurate claims, the readers of health research must carefully evaluate all publications. To detect and reject fraudulent healthcare claims, readers need critical appraisal skills that match their level of engagement with those articles. The core principles of critical appraisal will be described in the article, and how they can be adapted for different types of readers. Exemplar tools that develop critical appraisal skills will be noted, with reviews of ivermectinns efficacy explored as examples. As stakeholders in healthcare evidence are increasingly able to identify well-conducted and ethical research they will simultaneously be able to spot and reject fraudulent reports and prevent them from influencing healthcare decisions.”

Keywords: critical appraisal of literature, ethics, healthcare fraud, integrity, ivermectin, systematic review and meta-analysis

Journal of Women & Aging

Gender differences in coping with long-term COVID-19 impacts among older adults

Authors: Emerson, K, Mois, G, Kim, D, et al.

“Initial COVID-19 pandemic research suggests that during the first few weeks of the pandemic women were disproportionately impacted by restrictions compared to men. This study explored whether these gender differences in coping with pandemic restrictions were present among older adults 8–9 months into the COVID-19 pandemic. Data are based on online survey responses (n = 781) from respondents aged 60 and older. The survey was fielded from November 2 to December 4, 2020. Compared to older men, a greater proportion of older women self-reported an increase in being lonely, anxious, scared, sad, stressed, hopeless, and frustrated as compared to the beginning of the pandemic. More women reported engaging in healthy coping behaviors compared to men and self-reported more decreases in sleeping and in eating compared to the first few weeks of the pandemic. A greater proportion of older women reported a decline in physical activity since the first few weeks of the pandemic compared to older men. Self-reported changes in communication did not differ by gender, except for text messaging. More women compared to men reported that their use of text messaging increased since the initial stages of the pandemic. Results showed significant gender differences among older adults in coping with long-term COVID-19 restrictions 8–9 months into the pandemic. ”

Keywords: coping behavior, gender, older adults

Inflammopharmacology

Advancing combination treatment with glycyrrhizin and boswellic acids for hospitalized patients with moderate COVID-19 infection: a randomized clinical trial.

Authors: Gomaa, A.A., Mohamed, H.S., Abd-ellatief, R.B. et al.

“Recent evidence points to a potential therapeutic role for glycyrrhizin(GR) and boswellic acids (BA) in the treatment of COVID-19 but conclusive evidence is lacking. Our aim is to investigate the efficacy of GR + BA versus placebo for the treatment of hospitalized patients with moderate SARS-CoV-2 or COVID-19 variants infection. The current study is a randomized, double-blind, placebo-controlled, single-center trial. Patients with SARS-CoV-2 or COVID-19 variants diagnosed by PCR test who were admitted to Sohag University hospital were eligible if they were at least 18 years of age and had moderate symptoms. Patients were randomly assigned to receive oral GR capsule (60 mg) and BA (200 mg) twice daily for 14 days or a matching placebo. All patients also received treatment with the institutional protocol for COVID-19. The primary outcome was mortality and time to recovery. Secondary outcome was clinical status score, 14 days after receiving study drugs. Adverse events from use of study drugs have been evaluated for up to 14 days.During the 6-month enrollment period (June-November, 2021) only 50 patients (54% women; median age 60 years, IQR 54–65) met eligibility and were randomly assigned. Evaluation of the primary outcome at 14 days showed that there were five deaths in the placebo group and no deaths in the GR + BA group. With regard to recovery time, it was significantly shorter (p = 0.0001) in the group receiving GR + BA capsule compared to the placebo group (median 7.0; IQR 6.0–8.0 days vs. median 12.5; IQR 12–20 days). Clinical status on the ordinal score scale as a secondary outcome showed a significant difference between the GR + BA group (median (IQR) score, 2 [2–3]) and placebo groups (mean (IQR) score, 3 [3–5.5]). There was a significant decrease in CRB in GR + BA compared with the placebo group. In conclusion, this safe, inexpensive, antiviral, immunomodulating and anti-inflammatory combination may be considered for use in mild to moderate infections of SARS-CoV-2 or COVID-19 variants. The study is limited by the small sample size; therefore, larger randomized trials are required. ”

Keywords: glycyrrhizin, boswellic acids, mortality rate, time to recovery, clinical status score

Journal of Food Science and Nutrition Research

Coronasomnia: A Hidden Problem of the COVID era. Is Melatonin a Potential Solution?

Authors: Supriya1, R, Singh, KP, Dutheil, F, et al.

“Globally, changes in work cultures have impacted on all life, and individuals have reported increased insomnia “Coronasomnia” as a result of COVID-19. Correct nutrition, in relation to micronutrient concentration, may have beneficial effects in controlling our biological sleep clocks. Specifically, melatonin supplementaions are being recommended for the COVID generation. However, there have been mixed reports regarding melatonin supplementation using high dosages for certain population groups, and there may be disadvantages in using melatonin as an exogenous supplement (oral tablet or injectable drug) in the long term. As a result, melatonin may not be suitable for all post COVID generations without further clinical trials. However, melatonin as a dietary supplement could have significant health benefits without causing any adverse effects. Therefore, the main aim of this opinion article is to highlight the challenges of “Coronasomnia” related to COVID 19, which has been overlooked. In addition, we highlight the research need for clinical trials on melatonin supplementation for inclusion in the diets of the COVID generation. Supplementation regimes using naturally occurring melatonin obtained from dietary sources will regulate central biological cycle naturally. Consequently, future research is needed to investigate whether melatonin containing foods are clinically beneficial to the COVID generation by increasing the bioavailability of melatonin using dietary supplementation. ”

Keywords: coronasomnia, covidsomnia, melatonin, diet, work culture

medRxiv

Preprint

SARS-CoV-2 mRNA Vaccination-Associated Myocarditis in Children Ages 12-17: A Stratified National Database Analysis

Authors: Høeg, TB, Krug, A, Stevenson, J, et al.

“Objectives: Establishing the rate of post-vaccination cardiac myocarditis in the 12-15 and 16-17-year-old population in the context of their COVID-19 hospitalization risk is critical for developing a vaccination recommendation framework that balances harms with benefits for this patient demographic. … Conclusions: Post-vaccination CAE rate was highest in young boys aged 12-15 following dose two. For boys 12-17 without medical comorbidities, the likelihood of post vaccination dose two CAE is 162.2 and 93.0/million respectively. This incidence exceeds their expected 120-day COVID-19 hospitalization rate at both moderate and high COVID-19 hospitalization incidence. Further research into the severity and long-term sequelae of post-vaccination CAE is warranted. Quantification of the benefits of the second vaccination dose and vaccination in addition to natural immunity in this demographic may be indicated to minimize harm.”

Keywords: COVID-19, SARS-CoV-2, Myocarditis

Clinical Toxicology

Ivermectin: a mini-review

Authors: Johnson-Arbor, K

“Avermectins are common antiparasitic drugs, derived from Streptomyces bacteria that exhibit activity against arthropods and nematodes. Ivermectin, an avermectin derivative, is used as a treatment for parasitic infections in humans and domesticated animals. Ivermectin’s mechanism of action involves binding to ligand-gated ion channel receptors including glutamate, GABA, and glycine, resulting in parasitic paralysis and death. Due to varying expression of these ion channel receptors in vertebrate species, ivermectin toxicity is rarely reported in mammals. Ivermectin is also a substrate for P-glycoprotein, which limits its neurological toxicity in humans. Genetic polymorphisms in P-glycoprotein or coadministration of P-glycoprotein inhibitors may increase the neurotoxicity of ivermectin. Other toxic effects of ivermectin after therapeutic oral use include edema, rash, headache, and ocular complaints. Most of these effects are mild and short in duration. Ivermectin exhibits antiviral effects in-vitro at very high concentrations. This has led to suggestions of ivermectin as a potential treatment for SARS-CoV-2 (COVID-19) infection, although the drug’s pharmacokinetic parameters reduce the likelihood that high concentrations of the drug can be achieved in-vivo. Due to concern for adverse events, specifically neurotoxicity, as well as a paucity of supporting evidence, the use of ivermectin as a routine treatment or preventive measure for COVID-19 infection is not recommended at this time. ”

Keywords: Avermectin, Ivermectin, poisoning, P-glycoprotein

International Journal of Infectious Diseases

Surveillance of Immunological Status after Vaccination by two Serological Assays based on SARS-CoV-2 Spike Protein

Authors: Fresco-Taboada, A, Garcia-Duran, M, Aira1, C, et al.

“Two serological assays, an Enzyme-Linked Immunosorbent Assay (ELISA) and a Lateral Flow Assay (LFA), have been developed based on the SARS-CoV-2 recombinant Receptor Binding Domain (RBD-ELISA) and the combination of Trimeric Spike (S) and Nucleoprotein (N), S-LFA and N-LFA, respectively, as candidate tools for both indirect measurement of virus circulation and assessment of infection and vaccine-induced immunity. A total of 1272 human serum samples collected from volunteers (SARS-CoV-2 infected, non-infected or vaccinated) were evaluated by the two assays. For the RBD-ELISA, plates were coated with RBD, sera were added at 1/5 dilution and bound antibodies were detected with RBD labelled with Horseradish Peroxidase. For the LFA, two parallel strips were used: one for detection of N-specific antibodies; and another one for detection of S-specific antibodies, using S both as capture and detector reagent. Twenty microliters of blood or ten microliters of serum were applied to each cassette and results were interpreted after ten minutes. A seroneutralization assay was used as reference for the detection of neutralizing antibodies with RBD-ELISA and Reference sera (World Health Organization), for determination of the Limit of detection (LoD). MedCalc® 10 software was used for statistical analysis. The potential diagnostic application with sera from naturally infected and non-infected volunteers showed sensitivity, specificity and agreement (kappa) values of 95.1%, 99.0% and 0.94 respectively for RBD-ELISA; while 97.2%, 99.3% and 0.967 respectively for N-LFA; or 93.2% 98.3 %, 0.923, respectively for S-LFA. Serum samples from vaccinated individuals were analyzed for the specific detection of antibodies to the S protein: for vaccinated but non-infected individuals, sensitivity reached 97.3% after 15 days post-second vaccination dose whereas for previously infected people reached 100% after only 15 days post-first dose. The performance of RBD-ELISA showed good agreement with seroneutralization and excellent agreement with S-LFA (kappa 0.979). The dual N/S LFA represents a valuable tool to detect SARS-CoV-2 infection due to its complementary information on N and S-specific antibody response. Furthermore, the S-LFA and RBD-ELISA are both proven to be able to determine the extent of antibody response after vaccination. ”

Keywords: immune status, immune system, spike protein, antibody response

International Journal of Infectious Diseases

Treatment with Ivermectin Is Associated with Decreased Mortality in COVID-19 Patients: Analysis of a National Federated Database

Authors: Efimenko, I, Nackeeran, S, Jabori, S, et al.

“To evaluate the difference in mortality of patients treated with ivermectin vs patients treated with remdesivir with COVID-19 in United States using TriNetX Research network, a federated EMR network of over 44 healthcare organizations and 68 million patients from US, from 2009-2021. We retrospectively identified adults (≥18 years) with a recorded COVID-19 infection between January 1, 2020 and July 11, 2021. We compared those with recorded use of ivermectin, but not remdesivir, against those with recorded use of remdesivir, but not ivermectin. We controlled for the following demographics, comorbidities, and treatments that may affect COVID-19 survival outcomes: age, gender, race, ethnicity, nicotine use diabetes mellitus, obesity, chronic lower respiratory disease, ischemic heart diseases, tocilizumab, glucocorticoids, or ventilator use. We measured association with mortality as the primary outcome. There were a total of 1,761,060 possible COVID-19 patients based on ICD-10 diagnostic terms and confirmatory lab results. Prior to controlling, our analysis yielded 41,608 patients who had COVID-19 resulting in two unique cohorts that were treated with either ivermectin (1,072) or remdesivir (40,536). Within the ivermectin cohort, average age was 51.9 + 17.8 years, 43% were male, 60% had glucocorticoids and 1% required ventilator support. In the remdesivir cohort, average age was 62.0 + 16.0 years, 54% were male, 64% had glucocorticoids and 2% required ventilator support. After using propensity score matching and adjusting for potential confounders, ivermectin was associated with reduced mortality vs remdesivir. Ivermectin use was associated with decreased mortality in patients with COVID-19 compared to remdesivir. To our knowledge, this is the largest association study of patients with COVID-19, mortality and ivermectin. Further double-blinded placebo-controlled RCTs with large samples are required for definite conclusion. In the future, if more publications are published with the similar result to the current analyses, the certainty of evidence will increase.”

Keywords: Ivermectin, mortality

Nutrients

Healthy Immunity on Preventive Medicine for Combating COVID-19

Authors: Manna, PR, Gray, ZC, Reddy, PH, et al.

“Immunomodulation is influenced by the consumption of nutrients, and healthy immunity is pivotal to defending an individual from a variety of pathogens. The immune system is a network of intricately regulated biological processes that is comprised of many organs, cellular structures, and signaling molecules. A balanced diet, rich in vitamins, minerals, and antioxidants, is key to a strengthened immune system and, thus, crucial to proper functioning of various physiological activities. Conversely, deficiencies of these micronutrients, involving impaired immunity, are linked to numerous health complications, along with a host of pathologies. Coronavirus disease 2019 (COVID-19) is a dangerous infectious disease caused by a β-form of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its genomic variants, which enter host cells upon binding to the angiotensin converting enzyme 2 receptors, and is associated with substantial morbidities and mortalities globally. Patients afflicted with COVID-19 display asymptomatic to severe symptoms, occurrences of which are multifactorial and include diverse immune responses, sex and gender differences, aging, and underlying medical conditions. Geriatric populations, especially men in comparison to women, regardless of their states, are most vulnerable to severe COVID-19-associated infections and complications, with fatal outcomes. Advances in genomic and proteomic technologies help one understand molecular events, including host–pathogen interactions and pathogenesis of COVID-19 and, subsequently, have developed a variety of preventive measures urgently, ranging from mask wearing to vaccination to medication. Despite these approaches, no unique strategy is available today that can effectively prevent and/or treat this hostile disease. As a consequence, the maintenance of a boosted immune system could be considered a high priority of preventive medicine for combating COVID-19. Herein, we discuss the current level of understanding underlining the contribution of healthy immunity and its relevance to COVID-19 molecular pathogenesis, and potential therapeutic strategies, in the management of this devastating disease.”

Keywords: nutrition, vitamins, immune health, aging and underlying medical conditions, therapeutic strategies

Beneficial Microbes

Into the third year with COVID-19. Will gut microbiota be shown to play a role?

Authors: Venema, K

“The third year with the corona virus daily on our retina has started. We’ve seen many variants of the virus. All very infectious, some apparently more life-threatening than others. Apparently, because I think it is hard to compare the number of cases during the first waves, when people were not yet vaccinated, to the current omicron wave, where clever people have had several vaccine shots. In some countries already up to 4. No matter what antivaxers say about this, all credible scientific data shows that these shots protect against the virus and although they don’t stop you from getting sick, you get less sick. Most people that still end up in hospital are those that refused to get a vaccine, or are somehow compromised, e.g. because of a non-functioning immune system. Yet, still some people that have had their vaccine shots end up in the hospital. And although for antivaxers this is the ultimate proof that vaccines don’t work, this of course is rubbish... (I usually use stronger phrases, but this gets printed black on white, if you know what I mean) ... It would be pertinent to study why the virus breaks through the immune protection of these unfortunate people. Some believe it may be because of the microbiota. Several studies have shown a role of the gut microbiota composition in disease severity, together with vitamin D, cholesterol and other factors. Last year, it was a hype to write a ‘review’ on gut microbiota and the effect on COVID-19, and also the board of Beneficial Microbes has received several submissions of so-called reviews on the topic. However, all of these were rejected, as they were mere speculations about how the gut microbiota might affect virus infection and diseases severity, without any data whatsoever. However, there are now some good studies out there that have shown that a proper gut microbiota may indeed influence disease severity, recently reviewed. And in small studies, certain taxa (like Bifidobacterium adolescentis) and microbial pathways (like carbohydrate metabolism) have been correlated to higher neutralising antibodies against the virus. Very little cause-and-effect evidence still. However, as I stated last year, it may not be too surprising for the knowledgeable reader that the microbiota plays a role in COVID, as the microbiota plays a role in everything that can be wrong with us! We just need to understand the mechanisms better to be able to make use of the microbiota for better disease outcome and perhaps even treatment. ”

Keywords: gut microbiota, vaccines, severity

Nutrients

The Role of Nutrients in Prevention, Treatment and Post-Coronavirus Disease-2019 (COVID-19)

Authors: Motti, ML, Tafuri, D, Donini, L, et al.

“SARS-CoV-2 virus, infecting human cells via its spike protein, causes Coronavirus disease 2019 (COVID-19). COVID-19 is characterized by shortness of breath, fever, and pneumonia and is sometimes fatal. Unfortunately, to date, there is still no definite therapy to treat COVID-19. Therefore, the World Health Organization (WHO) approved only supportive care. During the COVID-19 pandemic, the need to maintain a correct intake of nutrients to support very weakened patients in overcoming disease arose. The literature available on nutrient intake for COVID-19 is mainly focused on prevention. However, the safe intake of micro- and/or macro-nutrients can be useful either for preventing infection and supporting the immune response during COVID-19, as well as in the post-acute phase, i.e., “long COVID”, that is sometimes characterized by the onset of various long lasting and disabling symptoms. The aim of this review is to focus on the role of nutrient intake during all the different phases of the disease, including prevention, the acute phase, and finally long COVID. ”

Keywords: nutritional supplement, Long-COVID, ARDS, inflammation, immune system

Health Promotion International

Change in health, wellbeing and physical activity levels during the COVID-19 pandemic: a longitudinal cohort of parkrun participants in the United Kingdom

Authors: Quirk, H, Haake, S, Goyder, E, et al.

“Lockdown restrictions imposed across the UK in response to the coronavirus disease 2019 (COVID-19) pandemic had a profound impact on many people’s health and wellbeing. People were encouraged to be active, but population surveys suggest some groups found this easier than others. We explored the changes in health, wellbeing and physical activity levels among a sample in the UK who experienced the sudden loss of a weekly community-based physical activity opportunity, parkrun. A sample of UK parkrun participants responded to two surveys: pre-COVID-19 in January/February 2019 and during the COVID-19 pandemic in September 2020. Outcomes were happiness, life satisfaction, connections with others, physical health, mental health and physical activity. The sample was stratified by gender, age, deprivation status, physical activity and number of parkruns completed. Demographics were reported using descriptive statistics; distributions between sub-groups were compared using Chi-square tests while differences in outcomes were determined using the Mann–Whitney U test. Open text responses were also analysed. Happiness, life satisfaction, connections with others, physical health and mental health of 450 parkrun participants were negatively impacted for all sub-groups, although the impact was not experienced equally. Physical activity fell by 6% while happiness and life satisfaction fell by 12%. People experienced the worst negative impact on their connections with others. The COVID-19 pandemic negatively impacted the wellbeing of a greater proportion of females, younger adults, inactive people, those from higher deprivation areas, and those who had completed fewer parkruns. There is evidence that the wellbeing of those who were more active, and those more involved in a community-based physical activity initiative pre-pandemic, was less negatively affected during the COVID-19 lockdown. ”

Keywords: mental health, physical activity, longitudinal study, parkrun, community, inequalities

Maturitas

Effects of malnutrition on mortality in oldest-old inpatients with COVID-19 in the GERIA-COVID cohort

Authors: Sanchez-Rodriguez, C, Sacco, G, Gautier, J, et al.

“We assessed the impact of malnutrition on 14-day, 28-day, and 3-month mortality risk in oldest-old inpatients aged ≥80 years with COVID-19 in the hospital-based GERIA-COVID cohort. Malnutrition was assessed on hospital admission using the Geriatric Nutritional Risk Index (GNRI). Potential confounders were age, sex, functional abilities, number of acute health issues, CRP level, hypertension, cardiomyopathy, malignancies, use of antibiotics, and respiratory treatments. Seventy-eight participants (88.9 ± 4.3 years old, 55% women) were included. Of these, 82.1% had survived at day 14, 78.2% at day 28, and 70.5% after 3 months. No association between malnutrition according to the GNRI and 14-day, 28-day, or 3-month mortality was found. Thus, malnutrition according to the GNRI was not associated with mortality within the first 3 months of diagnosis of COVID-19 among oldest-old inpatients. ”

Keywords: malnutrition, GNRI, mortality, oldest-old

Journal of Trace Elements in Medicine and Biology

Trace element homeostasis in the neurological system after SARS-CoV-2 infection: Insight into potential biochemical mechanisms

Authors: de Jesus, JR, Galazzi, RM, Júnior, CAL, et al.

“Several studies have suggested that COVID-19 is a systemic disease that can affect several organs, including the brain. In the brain, specifically, viral infection can cause dyshomeostasis of some trace elements that promote complex biochemical reactions in specialized neurological functions. Understand the neurovirulence of SARS-CoV-2 and the relationship between trace elements and neurological disorders after infection, and provide new insights on the drug development for the treatment of SARS-CoV-2 infections. The main databases were used to search studies published up September 2021, focusing on the role of trace elements during viral infection and on the correct functioning of the brain. The imbalance of important trace elements can accelerate SARS-CoV-2 neurovirulence and increase the neurotoxicity since many neurological processes can be associated with the homeostasis of metal and metalloproteins. Some studies involving animals and humans have suggested the synapse as a vulnerable region of the brain to neurological disorders after viral infection. Considering the combined evidence, some mechanisms have been suggested to understand the relationship between neurological disorders and imbalance of trace elements in the brain after viral infection. Trace elements play important roles in viral infections, such as helping to activate immune cells, produce antibodies, and inhibit virus replication. However, the relationship between trace elements and virus infections is complex since the specific functions of several elements remain largely undefined. Therefore, there is still a lot to be explored to understand the biochemical mechanisms involved between trace elements and viral infections, especially in the brain. ”

Keywords: viral infection, trace elements, neurological disorders, immunity system, antiviral

Nutrients

High-Dose Vitamin C Supplementation as a Legitimate Anti-SARS-CoV-2 Prophylaxis in Healthy Subjects—Yes or No?

Authors: Gruber-Bzura, BM

“Vitamin C has a number of acitvities that could contribute to its immune-modulating effects. The only question is whether we should provide ourselves with only the right level of it, or do we need much more during a pandemic? The possibility of reducing the incidence of viral diseases in a well-nourished population through the use of dietary supplements based on vitamin C is not supported in the literature. Despite this, the belief that an extra intake of vitamin C can increase the efficacy of the immune system is still popular and vitamin C is advertised as a remedy to prevent infectious disease. This article refers to the justification of the use of vitamin C in high doses as an anti-SARS-CoV-2 prophylaxis in healthy subjects. Does it make sense or not? As it turns out, any effects of vitamin C supplementation may be more prominent when the baseline vitamin C level is low, for example in physically active persons. People with hypovitaminosis C are more likely to respond to vitamin C administration. No studies regarding prevention of COVID-19 with high-dose vitamin C supplementation in healthy subjects were found. ”

Keywords: vitamin C, immune function, immune system

Research Square

Preprint

A comparison of Ivermectin and Non Ivermectin based regimen for covid 19 in Abuja: effects on virus clearance, Days-to-Discharge and Mortality

Authors: Thairu, Y, Babalola, OE, Ajayi, AA, et al.

“To compare outcomes from ivermectin (IVM)- and non-ivermectin (NIVM)-based treatments for COVID-19 in Abuja, Nigeria. Sixty-one consecutive virology-proven cases were recruited and managed with IVM-based regimes. A subsequent cohort of 26 patients was treated with NIVM due to physician preference, with varying combinations of lopinavir/ritonavir (Alluvia), remdesivir, azithromycin, and enoxapramin. All patients received zinc sulfate, vitamin C and supportive therapy. Propensity matching was carried out as indicated, and Repeat Measures Analysis of Variance (RMANOVA) allowing for time*treatment interaction was carried out for time dependent variables, deriving Likelihood Ratio (LR) and P values. Change in cycle threshold (viral load) over time, positivity status by day 5, improvement in clinical status using myalgia scores, days to discharge (DTD), change in SpO2 and death. IVM was associated with a greater and faster reduction in viral clearance (LR=64.2): 31% and 95% were negative by days 5 and 14, respectively, versus 0% on NIVM. The mean DTD on IVM was 8.8 days versus 19.4 days, p= 0.000. IVM proved significantly superior for Myalgia scores, LR= 23.45. The mortality rate was 0/61 (0%) in IVM but 4/26 (15.3%) in NIVM. Three of the 4 deaths were in females, and 2 had been vaccinated, one fully. The SP02% increased significantly more on IVM than the NIVM group. C-reactive protein and D-dimer levels dropped significantly more sharply during IVM, suggesting anti-inflammatory and antifibrinolytic activity. The IVM-based regimen caused earlier discharge from treatment and reduced mortality, in addition to clinical and laboratory improvements. Vaccination did not protect some patients from SARS-CoV-2 breakthrough infection and mortality”

Keywords: Ivermectin, non-ivermectin, viral load

Medical Cannabis and Cannabinoids

Will Cannabis or Cannabinoids Protect You from SARS-CoV-2 Infection or Treat COVID-19?

Authors: Brown, JD, Goodin, AJ

“A recent study reported that two cannabinoids, cannabidiolic acid (CBDA) and cannabigerolic acid (CBGA), could block cellular entry of the virus that causes COVID-19 during in vitro experiments using cell cultures in a laboratory. There is a low likelihood of translating these preclinical research findings to cannabinoid-based therapies due to clinical and pragmatic concerns with dosing that render CBDA and CBGA (as well as other cannabinoids) to be unlikely candidates for further drug development. These include, for example, a short half-life of CBDA, requiring frequent dosing intervals; high doses required at each interval to match the inhibitory concentrations studied; and high cost and lack of availability of CBDA and CBGA. Replicating the observed effects in the complex human body is unlikely due to the interplay of these compounds within the endocannabinoid system, and there are known and hypothesized safety concerns for the doses required. Cannabinoids, including CBDA and CBGA, are not recommended for the treatment or prevention of SARS-CoV-2 infection. Recreational or medical use of currently available cannabis-derived products are at doses much lower than those studied and are unlikely to provide any benefit against SARS-CoV-2 infection. ”

Keywords: Cannabis, Cannabinoids

Journal for the Measurement of Physical Behaviour

COVID-19 Highlights the Potential for a More Dynamic Approach to Physical Activity Surveillance

Authors: Rowlands, AV, Saint-Maurice, PF, Dall, PM

“The emergence of severe acute respiratory syndrome coronavirus 2, has urged the scientific community and industry to obtain population snapshots of lifestyle behaviors to characterize changes in behaviors during relatively short windows of time (e.g., weekly) so that the impact of lockdowns and other related public health measures could be assessed. Consumer device companies have taken the lead with wearables, tracking ambulatory movement worldwide by harnessing the data from their millions of users and exemplified how it can be used to monitor trends. ”

Keywords: physical activity, sleep, health behaviour

Journal of Microbiology, Immunology and Infection

A Randomized Trial of Vitamin D Supplementation to Prevent Seasonal Influenza and Enterovirus Infection in Children

Authors: Huang, Y-N, Chi, H, Chiu, N-C, et al.

“This study aimed to evaluate whether vitamin D supplementation can reduce the incidence of influenza and enterovirus infection in Taiwanese children. This randomized, double-blind, controlled trial included children aged two to five years between April 2018 and October 2019 from daycare centers. All the participants were randomly assigned to a vitamin D supplementation group (2000 IU/day) or placebo group for one month. The primary outcome was the incidence of influenza and enterovirus infection in the following six months, and the secondary outcome was the incidence of influenza and enterovirus infection in the children’s household members. Two hundred and forty-eight children participated. The vitamin D group showed a relative risk reduction of 84% against influenza compared to the placebo group but did not reach statistical significance. Kaplan-Meier curves revealed that the placebo group had a higher probability of influenza infection than the vitamin D group, but the incidence of enterovirus infection was similar between the two groups among children. Among children’s household members, the incidence of influenza and enterovirus infection were both similar between the two groups. All children who were tested for serum 25(OH)D levels after vitamin D intervention had 25(OH)D levels above 30 ng/ml. Vitamin D supplementation may have a small preventative effect against influenza infection but does not affect enterovirus infection among preschool children. A high-dose short-term vitamin D intervention might be a way to elevate children’s serum vitamin D levels in the first month of starting kindergarten.”

Keywords: vitamin D, children, influenza, enterovirus

Food and Chemical Toxicology

The prognostic role of micronutrient status and supplements in COVID-19 outcomes: A systematic review

Authors: Pechlivanidoua, E, Vlachakis, D, Tsarouhas, K, et al.

“Micronutrients constitute an adjuvant treatment for respiratory viral infections. Since there is no effective antiviral therapy for COVID-19 yet, adjuvant intervention for the survival of critically ill patients may be significant. Search of the PubMed, CINAHL and Cochrane databases was carried out to find human studies investigating the prognostic role of micronutrient status and the effects of micronutrient supplementation intervention in COVID-19 outcomes of adult patients. Patients with certain comorbidities (diabetes mellitus type 2, obesity, renal failure, liver dysfunction etc.) or pregnant women were excluded. 31 studies (27 observational studies and 4 clinical trials) spanning the years 2020–2021, pertaining to 8624 COVID-19 patients (mean age ± SD, 61 ± 9 years) were included in this systematic review. Few studies provided direct evidence on the association of serum levels of vitamin D, calcium, zinc, magnesium, phosphorus and selenium to patients’ survival or death. Vitamin D and calcium were the most studied micronutrients and those with a probable promising favorable impact on patients. This review highlights the importance of a balanced nutritional status for a favorable outcome in COVID-19. Micronutrients’ deficiency on admission to hospital seems to be related to a high risk for ICU admission, intubation and even death. Nevertheless, evidence for intervention remains unclear.”

Keywords: vitamins, supplements, micronutrients

JAMA

Research Letter: Myocarditis Following COVID-19 BNT162b2 Vaccination Among Adolescents in Hong Kong

Authors: Li, X, Tsz Tsun Lai, F, Chua, GT, et al.

“Cases of myocarditis following the second dose of messenger RNA (mRNA) vaccine are accruing worldwide, especially in younger male adults and adolescents. In weighing the risk of myocarditis against the benefit of preventing severe COVID-19, Norway, the UK, and Taiwan have suspended the second dose of mRNA vaccine for adolescents. Similarly, adolescents (aged 12-17 years) in Hong Kong have been recommended to receive 1 dose of BNT162b2 instead of 2 doses 21 days apart since September 15, 2021.”

Keywords: COVID-19, SARS-CoV-2, Myokarditis, BNT162b2

Nutrients

The CO-VID D-Lemma: A Call for Action

Authors: Holick, MF

“It is remarkable how an invisible, inanimate particle—severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19)—that is hell-bent on reproducing itself was able to bring our modern civilization to its knees. History, however, continues to repeat itself, even in the era of modern medicine and RNA vaccines. Although in the past two years there has been a plethora of publications documenting that vitamin D deficiency increases the risk for infectivity, morbidity and mortality, this documentation has fallen on deaf ears for most health care providers and healthcare regulators.”

Keywords: vitamin D

Nutrients

Changes in Physical Activity, Healthy Diet, and Sleeping Time during the COVID-19 Pandemic in South Korea

Authors: Mun, H, So, ES

“The coronavirus disease 2019 (COVID-19) pandemic and subsequent social distancing orders may have changed health behaviors adversely. This study aims to examine changes in physical activity, diet, and sleep patterns during the pandemic in South Korea and to identify the factors influencing adverse changes in these behavioral indicators. Data from the Community Health Survey conducted in 2020 with a total of 229,269 adults were used, employing multivariate logistic regression and a classification and regression tree model. Participants reported decreased physical activity (49.6%), an increase in unhealthy diet (17.0%), and decreased sleep time (9.4%). Changes in adverse health behaviors were significantly related to being female, being in poor subjective health, not having hypertension or diabetes, engaging in other unhealthy behaviors, and complying with COVID-19 prevention guidelines. While those with adverse physical activity and unhealthy diet changes were younger and concerned about COVID-19 infection, the participants with adverse sleep changes were older, experienced economic stress (unemployed or recipients of basic living benefits), and had other unhealthy behaviors (obesity, severe stress, current smoking, and binge alcohol consumption). Public health efforts to intervene in these adverse health behaviors during the COVID-19 pandemic should target the variables shown to be significant in this study.”

Keywords: health behavior, physical activity, physical inactivity, unhealthy diet, sleep time

Science Briefs of the Ontario COVID-19 Science Advisory Table

Evidence-Based Recommendations on the Use of Nirmatrelvir/Ritonavir (Paxlovid) for Adults in Ontario

Authors: Komorowski, AS, Tseng, A, Vandersluis, S, et al.

“Nirmatrelvir and ritonavir are two co-administered antiviral medications, marketed under the name Paxlovid in Canada, for the treatment of SARS-CoV-2 infection. Nirmatrelvir is an inhibitor of SARS-CoV-2 3CL-like protease that prevents polyprotein cleavage of proteins necessary for SARS-CoV-2 genome replication. Nirmatrelvir has been studied in combination with ritonavir, a medication that has no known activity against SARS-CoV-2 but slows the metabolism of nirmatrelvir by inhibiting hepatic enzymes, thus “boosting” concentrations of nirmatrelvir. ”

Keywords: Paxlovid, adults, antiviral

International Journal of Environmental Research and Public Health

Adolescents’ Behaviors, Fitness, and Knowledge Related to Active Living before and during the COVID-19 Pandemic: A Repeated Cross-Sectional Analysis

Authors: Chen, S, Wang, B, Imagbe, S, et al.

“Nearly all schools in the United States experienced shutdown followed by phased reopening during the COVID-19 pandemic, thereby limiting students’ opportunities for physical activity (PA). This study aimed to examine adolescents’ PA at school (PAS) and PA out-of-school (PAO), screen-based sedentary behaviors (SbSB), health-related fitness, and knowledge understanding about PA and fitness before and during the pandemic. Three rounds of data were collected: Time 1 pre-pandemic (January 2020; n = 405), Time 2 schools partially reopened (February 2021; n = 412), and Time 3 schools fully reopened (March 2021; n = 450). Adolescents completed the Youth Activity Profile, the 20 m Progressive Aerobic Cardiovascular Endurance Run (PACER) test and Plank test, and a written test, to measure the behaviors (T1, T2, T3), fitness (T2–T3), and knowledge (T1, T2, T3), respectively. Inferential statistical analyses revealed a significant time effect for the behaviors and fitness. From T1 to T2 PAO decreased but PAS increased; whereas SbSB decreased at T3 compared to T1 and T2. Health-related fitness improved from T2 to T3. Further, the change patterns for SbSB varied by grade, and those for knowledge understanding varied by gender. The findings confirm the disruptive impact of the COVID-19 pandemic on adolescents’ active living but varied by school grade and gender. The favorable changes from T2 to T3 observed for fitness and other constructs may be partially attributable to an interrupted fitness education intervention. The findings may guide the design and evaluation of future interventions addressing the physical inactivity pandemic during public health crises (e.g., COVID-19). ”

Keywords: fitness education, middle school, physical activity, sedentary behaviour

International Journal of Environmental Research and Public Health

Changes in Physical Activity and Sedentary Behavior before and during the COVID-19 Pandemic: A Swedish Population Study

Authors: Elvén, M, Kerstis, B, Stier, J, et al.

“Governments have enforced measures to limit the spread of COVID-19 with varying degrees of success, which could affect people’s physical activity (PA) and sedentary behavior. This study aimed to examine changes in PA levels, types of PA, and sedentary behavior in the Swedish population before and during the COVID-19 pandemic. Associations between changed PA levels and demographical and behavioral determinants were also investigated. In December 2020, 1035 individuals (18–79 years old) completed a survey about their PA and sedentary behavior before and during the pandemic. Factors influencing their PA were also explored. Fifty-one percent of the sample reported reduced total PA, 18% had no change, and 31% increased their PA. Overall, organized PA decreased the most and sedentary behavior increased. The youngest and oldest age groups reported the greatest reduction in PA, while middle-aged groups reported the most increased PA. Men reported a larger increase in sedentary behavior than women. Mental and physical capability was associated with change in PA. In conclusion, this study indicates that, during the COVID-19 pandemic, the majority of the Swedish population have decreased PA levels with a concurrent increase in sedentary behavior, which may have negative health consequences. Interventions are recommended to address both PA and sedentary behavior, specifically to strengthen people’s ability to perform PA and focusing on the youngest and oldest age groups.”

Keywords: physical activity, sedentary behavior, behavior change

BMJ

Lack of physical activity is a global problem

Authors: Haseler, T, Haseler, C

“Physical activity has been more important than ever during the covid-19 pandemic. Insufficient physical activity is a global health problem and has itself been called a pandemic. Lockdowns have reduced time spent on physical activity and increased sedentary time, both of which are associated with risks to health. World Health Organization guidance (updated in 2020) recommends a minimum of 150-300 minutes of moderate intensity physical activity or 75-150 minutes of vigorous intensity physical activity weekly, and encourages people to exceed these targets. Healthcare professionals have an important role in helping people to make any necessary changes to their behaviour.”

Keywords: physical activity, physical inactivity, sedentary behaviour

MedNEXT Journal of Medical and Health Sciences

Use of ivermectin in the treatment of COVID-19: a review

Authors: Zanoti, EB, Porto, RM, Scriboni, AB

“SARS-CoV-2 produces a respiratory syndrome that can range from a mild, self-limiting inflammatory condition to severe, progressive pneumonia. Prevention and treatment strategies have become a priority since the emergence of COVID-19. Noteworthy is the use of ivermectin, an anti-parasitic agent, which has been widely recommended by some health professionals for the prevention and treatment of COVID-19. To assess the evidence on the efficacy and safety of using ivermectin for the prevention and treatment of COVID-19, identifying its mode of action and the benefits and adverse reactions of using this drug. The search strategy for articles was based on a search in the electronic databases MEDLINE (NationalLibrary of Medicine, United States), LILACS (Latin American and Caribbean Literature in Health Sciences), Scielo, specialized libraries of Universities, PubMed, and Google Academic. The selected articles will be from 2015 to 2021. Studies reveal that ivermectin is a broad-spectrum drug with high-fat solubility and has numerous effects on several parasites. In addition to having antiviral and antiparasitic effects, this drug also causes immunomodulation in the host. Ivermectin has already demonstrated its potent antiviral effects in vitro against several RNA viruses, such as influenza A, Zika virus, Newcastle disease virus, yellow fever virus, Chikungunya virus, dengue virus, among others. One way to delay viral transmission would be to stop the virus from replicating, thus reducing the viral load in infected individuals. Thus, studies have shown that ivermectin may have the potential for inhibiting and replicating SARS-CoV-2. ”

Keywords: ivermectin

International Journal of Environmental Research and Public Health

The Association between Gender and Physical Activity Was Partially Mediated by Social Network Size during COVID-19

Authors: Kuzmik, A, Liu, Y, Cuffee, Y, et al.

“The COVID-19 pandemic has disrupted physical activity, particularly among women. Limited research has explored how social network support may explain gender-based variations in physical activity during COVID-19. The purpose of this study was to examine the mediating role of social networks in the association between gender and physical activity during a pandemic. This cross-sectional survey assessed whether social network characteristics (i.e., in-person social network size, frequency of in-person social network interactions, and online friend network size) mediate the relationship between gender and either past-week or past-year physical activity. Multiple mediation analyses were conducted to determine the indirect effect of gender on physical activity through social networks. Among 205 participants, women (n = 129) were significantly less physically active than men (n = 76) and reported significantly more Facebook friends than men, which was inversely associated with past-week physical activity. Additionally, the indirect effect of gender on past-week physical activity through Facebook friends was significant. Findings suggest that social media sites such as Facebook could be used to encourage physical activity among women during a pandemic. ”

Keywords: women’s health, physical activity, social networks

Chinese General Practice

Association of latitude, an indicator of vitamin D from sunlight, with infection and mortality

Authors: ChenXiaoYuan,Li, Q, Liu, Z

“The coronavirus disease (COVID-19) is an infectious disease caused by the most recently discovered coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aims to investigate associations between latitude, an indicator of vitamin D from sunlight, with COVID-19 cases and related deaths in the United States. General regression and Chi-square test were used to examine the associations between latitude and COVID-19 cases and deaths based on the data before the re-openings of most states near the end of May, 2020. The analyses indicated that latitudes were marginally associated with cases and deaths, with an increase of 2491 cases and 189 deaths of the total numbers in the mainland of US for every unit of increase of the latitude. When the states were classified into high latitude (>N 370) and low latitude (

Keywords: vitamin D, sunlight, mortality, latitude

Clinical Medicine Journal

Reduction of physical activity during the COVID-19 pandemic is related to increased neuropsychiatric symptoms in memory clinic patients

Authors: Wurm, R, Parvizi, T, Silvaeih, S, et al.

“The COVID-19 pandemic led to unprecedented restrictions on social contacts and mobility. Memory clinic patients were disproportionately affected when care was disrupted and routines were abruptly changed. This trial was designed as a pragmatic, prospective, observational study to evaluate the effects of lockdown on memory clinic patients. Outpatients were included when they returned in May to July 2020 for their first follow-up after the lockdown. Indicators of lockdown intensity and its effect on patients were recorded, patients and caregivers were interviewed, and neuropsychological tests were performed. We included 72 patients, most of them suffering from Alzheimer’s dementia or mild cognitive impairment. The median time of isolation was 8 weeks and social contacts were significantly reduced from five to two per week (p<0.001). Light physical activity was significantly reduced (3.8 hours to 3 hours, p=0.016) during the lockdown, and this reduction was significantly correlated with higher scores on the Neuropsychiatric Inventory score (R -0.43, p>0.001). Fears regarding the pandemic were common and mostly related to the patients’ health. Lockdown restrictions reduced physical activity in memory clinic patients which was associated with increased neuropsychiatric symptoms. Future restrictions should aim to mitigate the impacts on this vulnerable population. ”

Keywords: dementia, neuropsychiatric symptoms, physical activity

Nutrients

Populations in Low-Magnesium Areas Were Associated with Higher Risk of Infection in COVID-19’s Early Transmission: A Nationwide Retrospective Cohort Study in the United States

Authors: Tian, J, Tang, L, Liu, X, et al.

“Many studies have confirmed the important roles of nutritional status and micronutrients in the COVID-19 pandemic. Magnesium is a vital essential trace element that is involved in oxidative stress, inflammation, and many other immunological functions and has been shown to be associated with the outcome of COVID-19 infection. Here, we conducted a nationwide retrospective cohort study in the United States involving 1150 counties, 287,326,503 individuals, and 5,401,483 COVID-19 confirmed cases as of 30 September 2020 to reveal the infection risk of the populations distributed in low-magnesium areas in the early transmission of COVID-19. Our results indicate that the average county-level COVID-19 cumulative incidence in low-magnesium areas was significantly higher than in the control areas. Additionally, a significant negative nonlinear association was found between environmental magnesium concentration and the county-level COVID-19 cumulative incidence. Furthermore, the populations distributed in low environmental magnesium areas faced a higher COVID-19 infection risk, among which females, the 0–17 years subgroup, the 65+ years subgroup, black people, populations outside metro areas, and counties with a smaller population experienced higher risk of infection by COVID-19 than other subgroups. Considering that the magnesium intake of about half the population of the United States is below the daily required dose, our study will contribute to the creation of long-term public health strategies to help protect against COVID-19. ”

Keywords: micronutrients, environmental magnesium, magnesium deficiency, health risk

Immunotherapy

A global picture: therapeutic perspectives for COVID-19

Authors: Chavda, VP, Kapadia, C, Soni, S, et al.

“The COVID-19 pandemic is a lethal virus outbreak by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which has severely affected human lives and the global economy. The most vital part of the research and development of therapeutic agents is to design drug products to manage COVID-19 efficiently. Numerous attempts have been in place to determine the optimal drug dose and combination of drugs to treat the disease on a global scale. This article documents the information available on SARS-CoV-2 and its life cycle, which will aid in the development of the potential treatment options. A consolidated summary of several natural and repurposed drugs to manage COVID-19 is depicted with summary of current vaccine development. People with high age, comorbity and concomitant illnesses such as overweight, metabolic disorders, pulmonary disease, coronary heart disease, renal failure, fatty liver and neoplastic disorders are more prone to create serious COVID-19 and its consequences. This article also presents an overview of post-COVID-19 complications in patients.”

Keywords: drug discovery process, drug repurposing, drug target, pandemic, vaccines

Nutricion Hospitalaria

Severe COVID-19 patients have severe vitamin D deficiency in Northeast Mexico

Authors: Rodríguez Vidales, EP, Garza Carrillo, D, Salinas Martínez, AM, et al.

“The association between vitamin D and COVID-19 severity is not consistent. We compared prevalences and analyzed the association between vitamin D deficiency and COVID-19 severity in Northeast Mexico. This was a cross-sectional study with individuals consecutively included at a referral diagnostic center during March-September 2020 (n = 181). Concurrently, every patient admitted to intensive care was also consecutively included (n = 116). Serum 25(OH)D < 20 ng/mL was considered vitamin D deficiency. Descriptive, ANOVA, and multivariate ordinal regression analyses were performed. Vitamin D deficiency prevalence was 63.8 % in severe COVID-19; 25.6 % in mild COVID-19; and 42.4 % in non-diseased individuals. Vitamin D deficiency increased 5 times the odds of severe COVID-19, independently of sex, age, body mass index, and inflammatory markers. This study is the first report of vitamin D deficiency in Northeast Mexico. Vitamin D deficiency was associated with COVID-19 severity. ”

Keywords: vitamin D, vitamin D deficiency, severity

The Egyptian Journal of Internal Medicine

Cholecalciferol level and its impact on COVID-19 patients

Authors: Saeed, MAM, Mohamed, AH, Owaynat, AH

“Cholecalciferol is an important nutrient and essential to build body, maintain strong bones, and improves immunity. The main source for vitamin D is the body’s skin which absorbs the sun’s ultraviolet rays and convert them into vitamin D; at the same time, deficiency can occur or people may not get enough supplementation; this occurs mainly in old age, not taking healthy food, or have darker skin, and this deficient cases can raise the risk of severe COVID-19 if infected. Vitamin D boosts immunity and decreases inflammation. Poorer outcome of corona virus—disease (COVID-19) has been suggested to be due to vitamin D deficiency. We suggested to find the effect of cholecalciferol levels 25-hydroxy vitamin D (25 OHD) on the severity and mortality in patients suffering from COVID-19. Our study is a prospective following of 414 patients admitted in Helwan University Hospitals in the period of June 2020 till October 2021 for severely symptomatic. COVID-19 patients with median of age 54.55 ± 14.27, with a definite range of APACHE II score ranging from 15 to 19 where we measured vitamin D3 level (cholecalciferol level), correlating the assay level to the inflammatory cytokine storm markers on admission, on the fifth day and after 10 days also the level of vitamin D3 was correlated to the length of stay mechanical ventilation days and mortality. Lower level of vitamin D3 on admission was strongly evident in patients with severely symptomatic and in mortality of COVID-19 patients 58.25 ± 24.59 nmol/L when compared with patients who survived 103.97 ± 36.14 nmol/L. Also, when correlating the initial level of vitamin D3 on admission with the level of the inflammatory cytokine storm markers on admission, on fifth day from admission and on the tenth day, it shows a strong inverse correlation between vitamin D3 level on admission and ferritin level on fifth day also on the tenth day, in comparing also with D-dimer on fifth day also showing a strong inverse correlation with a highly significant p value this also evident on the D-dimer level on the tenth day, CRP at fifth and tenth day, also in correlating the LDH level on the fifth and tenth day with the initial level of vitamin D3 it shows a strong inverse correlation with a highly significant p value in the fifth and tenth day. Neutrophil to lymphocyte ratio was strongly, inversely correlated to the vitamin D3 level (cholecalciferol). Also, chest computed tomography in the fifth and tenth day of admission showed a very strong inverse correlation with vitamin D level and a highly significant statistical difference. Length of stay and mechanical ventilation days were also strongly inversely correlated to the cholecalciferol level curve of vitamin D3 to predict mortality, with cut off-value for vit. D3 < 60 nmol/L, regardless of other factors like age, gender, and presence of other co-morbidities. Low level of cholecalciferol was strongly inversely correlated with cytokine storm markers and independent predictor of severity and mortality in COVID-19 patients. ”

Keywords: vitamin D, cholecalciferol, cytokine storm markers, chest computed tomography, mortality

Osteologie

Role of Vitamin D as a Preventive Treatment in COVID-19 Pandemia

Authors: Bischoff-Ferrari, HA

“Currently, the evidence on vitamin D and COVID-19 is promising, but due to the lack of data from a large randomized intervention trial, the evidence is not comprehensive. Several smaller intervention studies in COVID-19 patients show inconsistent results with a signal that single high bolus doses of vitamin D have a neutral effect, whereas lower doses of calcifediol at multi-day intervals may reduce the risk of ICU treatment and mortality. At the same time, based on large observational studies, the literature shows a strong signal that people with vitamin D deficiency have a higher susceptibility with respect to COVID-19 infection and also an increased risk of complications and mortality. However, these epidemiologic studies do not provide a causal claim, especially because among other reasons vitamin D deficiency is more common in people with obesity and chronic diseases such as diabetes and cardiovascular disease, and these factors also coin the risk profile for more severe courses of COVID-19 infection. At the mechanistic level, vitamin D is an established factor in immunomodulation, with evidence that vitamin D administration in the setting of COVID-19 infection reduces the potent inflammatory response 'cytokine storm.' Albeit not COVID-specific, but supporting an effect of vitamin D on acute inflammation, a meta-analysis of 46 randomized clinical trials published in 2021 found that daily administration of vitamin D, compared with placebo, reduced the risk of any acute respiratory infection by 20 percent. Taking this evidence into the current crisis of a global pandemic situation, a prudent risk-benefit analysis supports that an immediate public health recommendation to take vitamin D daily as a preventive treatment in the context of the COVID pandemic is reasonable. This is analogous to current recommendations for vitamin D supplementation because, in addition, in high-risk populations, COVID infection introduces an important risk factor for developing sarcopenia and osteoporosis. Economically and in terms of risk, daily vitamin D supplementation is also justified by the cost-effective broad availability and its high safety profile. ”

Keywords: vitamin D, musculoskeletal health, immunomodulation, cytokine storm

Infection

The association between micronutrients and the SARS-CoV-2-specific antibodies in convalescent patients

Authors: Panahibakhsh, M, Amiri, F, Doroudi, T, et al.

“Various micronutrients play key roles in the immune responses to viral infection, antibody synthesis, and susceptibility to infection. This study aimed to investigate the role of micronutrients on the immune responses following SARS-CoV-2 infection. To evaluate humoral immunity following SARS-CoV-2 infection, the levels of SARS-CoV-2-specific IgM and IgG, as well as the concentrations of different micronutrients, were determined in 36 convalescent COVID-19 patients 60 days after infection. Furthermore, the correlation between biochemical and hematological parameters, clinical features, and the changes in adiposity with SARS-CoV-2 antibodies was evaluated. Serum IgM and IgG antibodies were detected in 38.8% and 83.3% of recovered patients after 60 days of COVID-19 infection, respectively. The values of SARS-CoV-2-specific IgG were negatively correlated with the number of the platelet. Moreover, the values of SARS-CoV-2-specific IgM were positively correlated with LDH and the vitamin B12 concentration. Furthermore, a gender-specific association of SARS-CoV-2-specific IgG and IgM with vitamins D as well as with B9 and zinc was observed. A significant negative correlation was observed between the values of IgG with vitamin D in male participants and a positive correlation was detected between IgG values and B9 in female participants. Moreover, IgM levels with serum zinc values in females were negatively correlated. Our study suggests the potential role of micronutrients in gender-specific humoral immunity following SARS-CoV-2 infection. Further studies are required with a greater sample of subjects to substantiate the validity and robustness of our findings. ”

Keywords: healthcare workers, pandemics, viral infection, immune system, antibodies

Drugs

Molnupiravir: First Approval

Authors: Syed, YY

“Molnupiravir (Lagevrio®) is an orally-administered antiviral prodrug that inhibits replication of RNA viruses through viral error induction. It is being developed by Merck and Ridgeback Biotherapeutics for the prevention and treatment of Coronavirus disease 2019 (COVID-19). Molnupiravir received its first approval on 4 November 2021 in the UK for the treatment of mild to moderate COVID-19 in adults with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) diagnostic test and who have at least one risk factor for developing severe illness. Molnupiravir is filed for approval and has emergency use authorization for the treatment of COVID-19 in several countries, including the USA, Japan and those in the EU. This article summarizes the milestones in the development of molnupiravir leading to this first approval for COVID-19. ”

Keywords: Molnupiravir, oral drugs

Cureus

The Relationship Between Vitamin D Status and the Clinical Severity of COVID-19 Infection: A Retrospective Single-Center Analysis

Authors: Zidrou, C, Vasiliadis, AV, Tsatlidou, M, et al.

“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. 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. 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. 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). These preliminary findings show that vitamin D status among the patients was not related to the severity of COVID-19 infection.”

Keywords: vitamin D, severity

Journal of Clinical Medicine

High Levels of Sedentary Time in Patients with COVID-19 after Hospitalisation

Authors: van Bakel, BMA, van den Heuvel, FMA, Vos, JL, et al.

“Many patients with COVID-19 experience severe and even fatal disease. Survivors may have long-term health consequences, but data on physical activity and sedentary behaviour are scarce. Therefore, we objectively assessed physical activity (PA) patterns among post-hospitalised patients with COVID-19 and explored associations with patient characteristics, disease severity and cardiac dysfunction. We objectively assessed PA, sedentary behaviour and sleep duration for 24 h/day during 8 days at 3-6 months after COVID-19 hospitalisation. PA and sedentary time were compared across pre-defined subgroups based on patient and disease characteristics, cardiac biomarker release during hospitalisation, abnormal transthoracic echocardiogram at 3-6 months post-hospitalisation and persistence of symptoms post-discharge. PA and sedentary behaviour were assessed in 37 patients (60 ± 10 years old; 78% male). Patients spent 4.2 [3.2; 5.3] h/day light-intensity PA and 1.0 [0.8; 1.4] h/day moderate-to-vigorous intensity PA. Time spent sitting was 9.8 [8.7; 11.2] h/day, which was accumulated in 6 [5; 7] prolonged sitting bouts (≥30 min) and 41 [32; 48] short sitting bouts (<30 min). No differences in PA and sedentary behaviour were found across subgroups, but sleep duration was higher in patients with versus without persistent symptoms (9.1 vs. 8.3 h/day). Taken together, high levels of sedentary time are common at 3–6 months after COVID-19 hospitalisation, whilst PA and sedentary behaviour are not impacted by patient or disease characteristics. ”

Keywords: physical activity, sedentary behaviour

Bioengineered

Prevention, treatment and potential mechanism of herbal medicine for Corona viruses: A review

Authors: Liu, Y-X, Zhou, Y-H, Jiang, C-H, et al.

“The pandemic of coronavirus disease 2019 (COVID-19) caused by the SARS-coronavirus 2(SARS-CoV-2) virus has become the greatest global public health crisis in recent years,and the COVID-19 epidemic is still continuing. However, due to the lack of effectivetherapeutic drugs, the treatment of corona viruses is facing huge challenges. In thiscontext, countries with a tradition of using herbal medicine such as China have beenwidely using herbal medicine for prevention and nonspecific treatment of corona virusesand achieved good responses. In this review, we will introduce the application of herbalmedicine in the treatment of corona virus patients in China and other countries, andreview the progress of related molecular mechanisms and antiviral activity ingredients ofherbal medicine, in order to provide a reference for herbal medicine in the treatment ofcorona viruses. We found that herbal medicines are used in the prevention and fightagainst COVID-19 in countries on all continents. In China, herbal medicine has beenreported to relieve some of the clinical symptoms of mild patients and shorten the length of hospital stay. However, as most herbal medicines for the clinical treatment of COVID-19still lack rigorous clinical trials, the clinical and economic value of herbal medicines in theprevention and treatment of COVID-19 has not been fully evaluated. Future work basedon large-scale randomized, double-blind clinical trials to evaluate herbal medicines andtheir active ingredients in the treatment of new COVID-19 will be very meaningful. ”

Keywords: traditional herbal medicine, viral prevention, viral treatment

Expert Review of Clinical Immunology

The (apparent) antibody paradox in COVID-19

Authors: Ameratunga, R, Woon, S-T, Lea, E, et al.

“The immunological response to COVID-19 is only partly understood. It is increasingly clear that the virus triggers an inappropriate host inflammatory reaction in patients experiencing severe disease. The role of antibodies in COVID-19, remains to be fully defined. There is evidence for both protection and harm in different clinical syndromes triggered by SARS-CoV-2. Many patients dying from COVID-19 had both high titres of antibodies to SARS-CoV-2 and elevated viral loads. The uncertain protective role of humoral immunity is mirrored by the lack of benefit of therapeutic convalescent plasma infusions in COVID-19. In contrast, there is increasing evidence a vigorous T cell response is protective. Delayed or low avidity T cell reactions were seen in patients suffering severe COVID-19. These observations suggest T cell responses to SARS-CoV-2 are the dominant long-term protective mechanism following either infection or vaccination. The magnitude and quality of the antibody response is likely to reflect underlying T cell immunity to SARS-CoV-2. Much of what has been learned about COVID-19 will need to be revised following the recent rapid emergence and dominance of the omicron variant of SARS-CoV-2. ”

Keywords: antibodies, monoclonal antibodies, vaccination, T cells

Drug Discovery Today

Efficacy of repurposed antiviral drugs: Lessons from COVID-19

Authors: Martinez, MA

“The clinical, social, and economic impacts of the coronavirus disease 2019 (COVID-19) pandemic, originated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have motivated a massive search and investment to find treatments for this new disease. Repurposing drugs has been an appealing strategy for the rapid translation of in vitro and ex vivo drug discovery to the clinic. Several repurposed drugs have been assessed clinically, but no effective repurposed antiviral has been identified so far. Of note, no effective treatments for COVID-19 or for any other viral disease have been found by repurposing drugs identified through hypothesis-free screens. Here, I discuss whether drug repurposing is the best strategy for developing effective therapies to eradicate COVID-19 and other viral human infections. ”

Keywords: antiviral drugs

BMC Medicine

A single-oral bolus of 100,000 IU of cholecalciferol at hospital admission did not improve outcomes in the COVID-19 disease: the COVID-VIT-D-a randomised multicentre international clinical trial

Authors: Cannata-Andía, JB, Díaz-Sottolano, A, Fernández, P, et al.

“Vitamin D status has been implicated in COVID-19 disease. The objective of the COVID-VIT-D trial was to investigate if an oral bolus of cholecalciferol (100,000 IU) administered at hospital admission influences the outcomes of moderate-severe COVID-19 disease. In the same cohort, the association between baseline serum calcidiol levels with the same outcomes was also analysed. The COVID-VIT-D is a multicentre, international, randomised, open label, clinical trial conducted throughout 1 year. Patients older than 18 years with moderate-severe COVID-19 disease requiring hospitalisation were included. At admission, patients were randomised 1:1 to receive a single oral bolus of cholecalciferol (n=274) or nothing (n=269). Patients were followed from admission to discharge or death. Length of hospitalisation, admission to intensive care unit (ICU) and mortality were assessed. In the randomised trial, comorbidities, biomarkers, symptoms and drugs used did not differ between groups. Median serum calcidiol in the cholecalciferol and control groups were 17.0 vs. 16.1 ng/mL at admission and 29.0 vs. 16.4 ng/mL at discharge, respectively. The median length of hospitalisation (10.0 vs. 9.5 days), admission to ICU (17.2% vs. 16.4%) and death rate (8.0% vs. 5.6%) did not differ between the cholecalciferol and control group. In the cohort analyses, the highest serum calcidiol category at admission (>25ng/mL) was associated with lower percentage of pulmonary involvement and better outcomes. The randomised clinical trial showed the administration of an oral bolus of 100,000 IU of cholecalciferol at hospital admission did not improve the outcomes of the COVID-19 disease. A cohort analysis showed that serum calcidiol at hospital admission was associated with outcomes. ”

Keywords: cholecalciferol, vitamin D

International Journal of Environmental Research and Public Health

Functional and Psychological Changes after Exercise Training in Post-COVID-19 Patients Discharged from the Hospital: A PRISMA-Compliant Systematic Review.

Authors: Ahmadi Hekmatikar, AH, Ferreira Júnior, JB, Shahrbanian, S, et al.

“Millions of people worldwide are infected with COVID-19, and COVID-19 survivors have been found to suffer from functional disabilities and mental disorders such as depression and anxiety. This is a matter of concern because COVID-19 is still not over. Because reinfection is still possible in COVID-19 survivors, decreased physical function and increased stress and anxiety can lower immune function. However, the optimal exercise intensity and volume appear to remain unknown. Therefore, the current systematic review aimed to evaluate the effect of resistance or aerobic exercises in post-COVID-19 patients after hospital discharge. We conducted searches in the Scopus, SciELO, PubMed, Web of Science, Science Direct, and Google Scholar databases. Studies that met the following criteria were included: (i) English language, (ii) patients with COVID-19 involved with resistance or aerobic exercise programs after hospital discharge. Out of 381 studies reviewed, seven studies met the inclusion criteria. Evidence shows that exercise programs composed of resistance exercise (e.g., 1-2 sets of 8-10 repetitions at 30-80% of 1RM) along with aerobic exercise (e.g., 5 to 30 min at moderate intensity) may improve the functional capacity and quality of life (reduce stress and mental disorders) in post-COVID-19 patients. In addition, only one study reported reinfection of three subjects involved with the exercise program, suggesting that exercise programs may be feasible for the rehabilitation of the patients. A meta-analysis was not conducted because the included studies have methodological heterogeneities, and they did not examine a control group. Consequently, the results should be generalized with caution. ”

Keywords: mental health, psychological changes, rehabilitation, exercise, physical activity

Journal of Trace Elements in Medicine and Biology

Zinc augments the antiviral potential of HCQ/CQ and ivermectin to reduce the risks of more serious outcomes from COVID-19 infection

Authors: Boretti, A

“Treatments do not replace vaccinations or restrictions, but are practical, effective, and safe means to help to reduce the fatality associated with COVID-19 infection. While no treatment is available and effective for all the current and future variants of COVID-19, treatments reduce the risk of COVID-19 becoming endemic and reduce mortality and collateral damages. The use of Zinc (Zn) for COVID-19 infection is here reviewed. Zn supplementation may help in prevention as well as during the administration of therapies. Zn supplementation reduces the risks of serious outcomes from Covid19 infection. Evidence also suggests that Zn helps in treatments of COVID-19 infection if taken in conjunction with antiviral drugs. The literature supports the use of Zn, with improvements towards a lower risk ranging from 37% in late treatment, to 78% in sufficiency. ”

Keywords: chloroquine, hydroxychloroquine, zinc, ivermectin

Nutrition & Food Science

The association of dietary inflammatory index, functional foods and some antioxidants intake with COVID-19 vaccine side effects in Iranian adults

Authors: Mohajeri, M

“This study aims to assess the association of dietary inflammatory index (DII), consumption of functional food and some antioxidants with COVID-19 vaccine side effects in Iranian adults. This was a case–control study conducted among the 1,067 Iranian adults who were invited to participate through WhatsApp software. The dietary intake was assessed using the food frequency questionnaire. There was a significant difference in vitamin D consumption between healthy people and persons with a vaccine side effect. Vitamin E intake in healthy participants was significantly more than case group. There was a significant difference in the consumption of zinc, selenium and vitamin C, between persons without vaccine side effects and the case group. Consumption of onion (82.5 ± 9.5 g/day vs 32.2 ± 6.3), garlic (6 ± 0.3 g/day vs 0.2 ± 0.08) and oat (2.2 ± 0.05 g/day vs 0.5 ± 0.01) in the control group was significantly more than persons with vaccine side effects. With the increase in each unit in the score of the DII, the risk of COVID-19 vaccine side effect incidence increased 1.7 times. To the best of the authors’ knowledge, this study is the first that investigated the association between functional food intake and side effects of the COVID-19 vaccine.”

Keywords: vaccine, side effect, dietary inflammatory index, functional food, antioxidants

International Journal of Environmental Research and Public Health

Changes in Physical Activity Patterns Due to the Covid-19 Pandemic: A Systematic Review and Meta-Analysis

Authors: Wunsch, K, Kienberger, K, Niessner, C

“With the outbreak of the Corona Virus Disease 19 (Covid-19) in late 2019, governments increasingly imposed containment strategies, including social distancing as well as restricted population movement, potentially having negative impacts on mental and physical health. A growing number of studies have examined the impact of the pandemic on different facets of physical activity (PA); an overview combining these (mixed) results, however, is missing. Thus, the objective of this systematic review and meta-analysis was to investigate whether and to which extent PA changed from before to during the Covid-19 pandemic, taking age, gender, and measurement method into account. The literature search was conducted using PubMed, Web of Science, and Scopus. Results of the main characteristics were descriptively synthesized and analyzed in a meta-analysis quantifying effects of the pandemic on PA divided by age groups, with additional subgroup analyses of the characteristics age, gender, and measurement method being narratively synthesized. Overall, 57 studies with a total sample size of 119,094 participants (N between 10 and 60,560 subjects) from 14 countries worldwide with participants aged between four and 93 years were included. Thirty-two studies revealed a significant decline in PA, whereas only five studies found a significant increase in PA during the Covid-19 pandemic. Fourteen studies revealed mixed results. PA decreased in all age groups, independent of gender. Most self-reported and all device-based measurement methods showed a reduction in PA. However, effects were not found to be significant in all age groups. Nevertheless, the declining trend should be noted and governments should strive to enable PA within periods of pandemic restrictions, or promote alternatives such as digital training to avoid negative health consequences within the population. ”

Keywords: exercise, physical activity, training

BMC Complementary Medicine and Therapies

Prevalence and predictive factors of complementary medicine use during the first wave of the COVID-19 pandemic of 2020 in the Netherlands

Authors: Mulder, LTC, Busch, M, Kristoffersen, AE, et al.

“Major life changing events such as the COVID-19 pandemic may have major impact on one’s health and general well-being. This study aimed to determine the prevalence and predictive factors, including gender specific differences, of Complementary Medicine (CM) use (including CM consultations, self-care management and self-help techniques) during the first wave of the COVID-19 pandemic in 2020 in the Netherlands. CM use was studied among a random representative sample (n = 1004) of the adult Dutch population using an online survey conducted from 22–27 May 2020. The survey included a modified version of I-CAM-Q and additional questions on demographic characteristics, reasons for CM use, perceived effectiveness and side effects. 68.0% of the participants reported to have used CM (CM consultations (13.3%), self-management strategies (59.4%), self-help techniques (30.0%)). Most frequently reported reason of CM use was to improve general well-being (61.6%), prevention and/or treatment of COVID-19 was only reported by 10%. Perceived effectiveness of CM was high and number of experienced side effects low. Being a women, worried to get infected with COVID-19, higher education and living in northern/ middle region of the Netherlands were predictive factors to use CM.In the Netherlands, specific groups (e.g. women/ highly educated) use CM, mainly to improve general wellbeing, and seem to benefit of it during the first months of the pandemic. The high perceived effectiveness and low reporting of side effects should encourage medical professionals and policy makers for more openness towards considering CM as being part of an integrative approach to public health in times life changing events occur.”

Keywords: prevalence, CM provider, self-management strategies, self-care techniques

medRxiv

Preprint

Users’ Reactions on Announced Vaccines against COVID-19 Before Marketing in France: Analysis of Twitter posts

Authors: Dupuy-Zini, A, Audeh, B, Gagneux-Brunon, A, et al.

“Within a few months, the COVID-19 pandemic has spread to many countries and has been a real challenge for health systems all around the world. This unprecedented crisis has led to a surge of online discussions about potential cures for the disease. Among them, vaccines have been at the heart of the debates, and have faced lack of confidence before marketing in France. This study aims to identify and investigate the opinion of French Twitter users on the announced vaccines against COVID-19 through sentiment analysis. This study was conducted in two phases. First, we filtered a collection of tweets related to COVID-19 from February to August 2020 with a set of keywords associated with vaccine mistrust using word embeddings. Second, we performed sentiment analysis using deep learning to identify the characteristics of vaccine mistrust. The model was trained on a hand labeled subset of 4,548 tweets. A set of 69 relevant keywords were identified as the semantic concept of the word “vaccin” (vaccine in French) and focus mainly on conspiracies, pharmaceutical companies, and alternative treatments. Those keywords enabled to extract nearly 350k tweets in French. The sentiment analysis model achieved a 0.75 accuracy. The model then predicted 16% of positive tweets, 41% of negative tweets and 43% of neutral tweets. This allowed to explore the semantic concepts of positive and negative tweets and to plot the trends of each sentiment. The main negative rhetoric identified from users’ tweets was that vaccines are perceived as having a political purpose, and that COVID-19 is a commercial argument for the pharmaceutical companies. Twitter might be a useful tool to investigate the arguments of vaccine mistrust as it unveils a political criticism contrasting with the usual concerns on adverse drug reactions. As the opposition rhetoric is more consistent and more widely spread than the positive rhetoric, we believe that this research provides effective tools to help health authorities better characterize the risk of vaccine mistrust. ”

Keywords: vaccine misstrust

QJM An International Journal of Medicine

Does vitamin D supplementation reduce COVID-19 severity?: a systematic review

Authors: Shah, K, Varna, VP, Sharma, U, et al.

“The evidence regarding the efficacy of vitamin D supplementation in reducing severity of COVID-19 is still insufficient. This is partially due to the lack of primary robust trial-based data and heterogeneous study designs. This evidence summary, aims to study the effect of vitamin D supplementation on morbidity and mortality in hospitalized COVID-19 patients. Evidence summary of systematic reviews. For this study, systematic reviews and meta-analysis published from December 2019 to January 2022 presenting the impact of vitamin D supplementation on COVID-19 severity were screened and selected from PubMed and Google scholar. After initial screening, 10 eligible reviews were identified and quality of included reviews were assessed using AMSTAR and GRADE tools and overlapping among the primary studies used were also assessed. The number of primary studies included in the systematic reviews ranged from 3 to 13. Meta-analysis of seven systematic reviews showed strong evidence that vitamin D supplementation reduces the risk of mortality in COVID patients. It was also observed that supplementation reduces the need for intensive care and mechanical ventilation requirement. The findings were robust and reliable as level of heterogeneity was considerably low. However the included studies were of varied quality. Qualitative analysis showed that supplements (oral and IV) are well tolerated, safe and effective in COVID patients. The findings of this study show that vitamin D supplementation is effective in reducing the COVID-19 severity. Hence, vitamin D should be recommended as an adjuvant therapy for COVID-19. However, more robust and larger trials are required to substantiate it further.”

Keywords: vitamin D, supplementation, severity, adjuvant therapy

Nature Scientific Reports

Titanium dioxide particles frequently present in face masks intended for general use require regulatory control

Authors: Verleysen, E., Ledecq, M., Siciliani, L. et al.

“Although titanium dioxide (TiO2) is a suspected human carcinogen when inhaled, fiber-grade TiO2 (nano)particles were demonstrated in synthetic textile fibers of face masks intended for the general public. STEM-EDX analysis on sections of a variety of single use and reusable face masks visualized agglomerated near-spherical TiO2 particles in non-woven fabrics, polyester, polyamide and bi-component fibers. Median sizes of constituent particles ranged from 89 to 184 nm, implying an important fraction of nano-sized particles (< 100 nm). The total TiO2 mass determined by ICP-OES ranged from 791 to 152,345 µg per mask. The estimated TiO2 mass at the fiber surface ranged from 17 to 4394 µg, and systematically exceeded the acceptable exposure level to TiO2 by inhalation (3.6 µg), determined based on a scenario where face masks are worn intensively. No assumptions were made about the likelihood of the release of TiO2 particles itself, since direct measurement of release and inhalation uptake when face masks are worn could not be assessed. The importance of wearing face masks against COVID-19 is unquestionable. Even so, these results urge for in depth research of (nano)technology applications in textiles to avoid possible future consequences caused by a poorly regulated use and to implement regulatory standards phasing out or limiting the amount of TiO2 particles, following the safe-by-design principle.”

Keywords: masks, non-medical interventions

Psychology & Health

First test of the theory of reasoned goal pursuit: predicting physical activity

Authors: Hamilton, K, Phipps, DJ, Schmidt, P, et al.

“This study applied the theory of reasoned goal pursuit (TRGP) in predicting physical activity among Australian undergraduate students, providing the first empirical test of the model.Methods: The research comprised an elicitation study (N = 25; MAge= 25.76, SDAge= 11.33, 20 female, 5 male) to identify readily accessible procurement and approval goal beliefs and behavioural, normative, and control beliefs; and, a two-wave prospective online survey study (N = 109; MAge = 21.88, SDAge = 7.04, 63 female, 46 male) to test the tenets of the TRGP in relation to meeting World Health Organization physical activity guidelines during the COVID-19 pandemic among first year university students.Results: A linear PLS-SEM model displayed good fit-to-data, predicting 38%, 74%, and 48% of the variance in motivation, intention, and physical activity, respectively. The model supported the majority of hypothesised pattern of effects among theory constructs; in particular, the proposition that beliefs corresponding to procurement and approval goals would be more consequential to people’s motivation and, thus, their intentions and behaviour, than other behavioural and normative beliefs, respectively.Conclusions: Results lend support for the TRGP and sets the agenda for future research to systematically test the proposed direct, indirect, and moderation effects for different health behaviours, populations, and contexts.”

Keywords: physical activity

Physiotherapy Theory and Practice

The impact of COVID-19 lockdown on the general health status of people with chronic health conditions in Belgium: a cross-sectional survey study

Authors: De Groef, A, Hallemans, A, Gebruers, N, et al.

“Patients with chronic health conditions risk aggravation of their health status due to reduced access to health services during the COVID-19 related lockdown. To investigate the impact of Belgian COVID-19 measures on general health status (i.e. worse or stable/better) of patients, adult and pediatric, with chronic health conditions and how this change in health status relates to personal and health behavior-related factors. A cross-sectional study using an online survey was conducted during the first COVID-19 related lockdown in Belgium.Associations between change in health status since the lockdown and (change in) personal and health behavior-related factors (including physical activity, access to health-care services and social activities) were investigated. In adults (n = 561), almost all personal factors, including feelings of distress, depression, anxiety, somatization, and low self-efficacy, were significantly worse in patients with a worse health status during the lockdown (n = 293, 52%) compared to patients reporting a stable/better health status. Also, these patients reported lower physical activity levels, more tele-consultations and less social activities. In children (n = 55), all surveys were completed by a proxy (parent(s)/guardian) who reported a worse health status in 38% of the children. Level of distress of the child since the lockdown and somatization of the parent(s) were significantly worse in children with a worse versus a stable/better health status. 52% of the adults and 38% of children with chronic health conditions reported worsening of their general health status during the lockdown in March–May 2020 in Belgium. Negative personal factors and unhelpful health behavior seems to be associated with a worse health status.”

Keywords: chronic diseases, rehabilitation, health status, physical activity

Journal of Trace Elements in Medicine and Biology

Evaluation of zinc, copper, and Cu:Zn ratio in serum, and their implications in the course of COVID-19

Authors: Ivanova, ID, Pal, A, Simonelli, I, et al.

“The dynamics of essential metals such as Copper (Cu) and Zinc (Zn) may be associated with the novel coronavirus disease 2019 (COVID-19) that has spread across the globe. The aim of this study is to investigate the relationship between serum levels of Cu and Zn, as well as the Cu:Zn ratio in the acute phase of COVID-19 along with the assessment of their connection to other laboratory parameters (hematological, biochemic al, hemostatic). Serum levels of Cu and Zn were measured by atomic absorption spectrometry in 75 patients in the acute COVID-19 phase and were compared with those of 22 COVID-19 patients evaluated three months after the acute phase of the disease (‘non-acute’ group) and with those of 68 healthy individuals. In comparison with both the non-acute patients and the healthy controls, the acute patients had lower levels of hemoglobulin and albumin, and higher levels of glucose, creatinine, liver transaminases, C-reactive protein (CRP), and higher values of the neutrophils to lymphocytes ratio (NLR) at the hospital admission. They also exhibited increased levels of Cu and decreased of Zn, well represented by the Cu:Zn ratio which was higher in the acute patients than in both non-acute patients and healthy controls, with no statistical difference between the last two groups. The Cu:Zn ratio positively correlated with CRP and NLR. Current results demonstrate that abnormal dynamics of Cu and Zn levels in serum occur early during the course of COVID-19 disease, and are mainly associated with the inflammation response. ”

Keywords: essential metals, copper, zinc, CRP

JBIC Journal of Biological Inorganic Chemistry

Major trace elements and their binding proteins in the early phase of Covid-19 infection

Authors: Nedić, O, Šunderić, M, Robajac, D, et al.

“Metal ions seem to play important roles in the pathogenesis of the novel coronavirus disease of 2019 (Covid-19) and are under investigation as potential prognostic markers and supplements in therapeutic procedures. The present study was aimed at assessing the relationship between the most abundant essential microelements (iron, zinc and copper) and their major binding proteins in the circulation in the early stage of infection. The concentration of zinc ions was measured to be higher in infected than in healthy persons, as well as ratios zinc/albumin and zinc/alpha-2-macroglobulin. Increased zinc levels could be attributed to cellular redistribution of zinc ions or to a use of zinc supplementation (zinc concentration was above the upper reference limit in one-third of infected individuals). Immunoblot analysis of protein molecular forms revealed that infected persons had greater amounts of proteinase-bound alpha-2-macroglobulin tetramer and albumin monomer than healthy individuals. The quantities of these forms were correlated with the concentration of zinc ions in healthy persons, but correlations were lost in infected individuals, most likely due to very high zinc concentrations in some participants which were not proportionally followed by changes in the distribution of protein species. Although we still have to wait for a firm confirmation of the involvement of zinc in beneficial defense mechanisms in patients with Covid-19, it seems that this ion may contribute to the existence of circulating protein forms which are the most optimal.”

Keywords: alpha-2-macroglobulin, albumin, zinc

Healthcare

Changes in Physical Fitness during COVID-19 Pandemic Lockdown among Adolescents: A Longitudinal Study

Authors: Zhou, T, Zhai, X, Wu, N, et al.

“The negative impact of COVID-19 on physical activity has been improved, while the research on changes in physical fitness that may be caused by physical inactivity is still scarce. This study aims to explore the impact of the COVID-19 pandemic lockdown on physical fitness, and the impact of initial physical fitness indicators on their changes during the lockdown in adolescents. A longitudinal study including 265 adolescents aged 14.1 ± 0.4 years old was conducted in China. Physical fitness measurement at baseline and follow-up were respectively measured before (November 2019) and after the lockdown (July 2020). Several physical fitness indicators including aerobic fitness (i.e., 800-m or 1000-m run) and explosive force (i.e., 50-m sprint) deteriorated during the lockdown. Whereas the performances of vital capacity, flexibility (i.e., sit and reach), and muscular strength (i.e., pull-ups) were significantly improved during the lockdown. Furthermore, the reduction in physical fitness for adolescents with higher physical fitness before the lockdown was greater than that for others. These findings may contribute to the development of targeted intervention strategies for physical fitness promotion during the lockdown caused by the public health emergency. ”

Keywords: lockdown, physical fitness, growth, adolescents

Journal of Medicinal Food

Exploring the Link Between Vitamin D Deficiency and Cytokine Storms in COVID-19 Patients: An In Silico Analysis

Authors: Maigoro, AY, An, D, Lee, S

“COVID-19 has become a global infectious pandemic affecting the entire world with complications related to the lungs and compromised immune systems. Recently, cytokine storms, which are hallmarks of the disease, have been identified in most COVID-19 patients. In addition, vitamin D deficiency is increasingly appearing to be another element exposing COVID-19 patients to a preferential increase in their symptoms. In an effort to identify a possible link between cytokine storms and vitamin D deficiency to streamline a possible treatment, an in silico analysis using bioinformatics approach was performed using collections of highly expressed cytokines in both severe acute respiratory syndrome and COVID-19 patients (commonly elevated cytokines) as well as vitamin D deficiency-associated genes (VD). Gene Multiple Association Network Integration Algorithm was used for network interactions, whereas the Enrichr enrichment analysis tool was used for biological functions. The network analysis GLay clustering results indicated the vitamin D receptor as a possible link between these two groups. Furthermore, cell chemotaxis and chemotactic-related features were identified as significantly affected pathways, which serve as possible key players mitigating cytokine storms under low vitamin D availability.”

Keywords: chemotaxis, cytokine storm, in silico analysis, vitamin D deficiency

Life Sciences

The therapeutic potential of regulatory T cells in reducing cardiovascular complications in patients with severe COVID-19

Authors: Saghafi, N, Rezaee, SA, Momtazi-Borojeni, AA, et al.

“The SARS coronavirus 2 (SARS CoV-2) causes Coronavirus Disease (COVID-19), is an emerging viral infection. SARS CoV-2 infects target cells by attaching to Angiotensin-Converting Enzyme (ACE2). SARS CoV-2 could cause cardiac damage in patients with severe COVID-19, as ACE2 is expressed in cardiac cells, including cardiomyocytes, pericytes, and fibroblasts, and coronavirus could directly infect these cells. Cardiovascular disorders are the most frequent comorbidity found in COVID-19 patients. Immune cells such as monocytes, macrophages, and T cells may produce inflammatory cytokines and chemokines that contribute to COVID-19 pathogenesis if their functions are uncontrolled. This causes a cytokine storm in COVID-19 patients, which has been associated with cardiac damage. Tregs are a subset of immune cells that regulate immune and inflammatory responses. Tregs suppress inflammation and improve cardiovascular function through a variety of mechanisms. This is an exciting research area to explore the cellular, molecular, and immunological mechanisms related to reducing risks of cardiovascular complications in severe COVID-19. This review evaluated whether Tregs can affect COVID-19-related cardiovascular complications, as well as the mechanisms through which Tregs act.”

Keywords: tregs, cardiovascular complications, vitamin C, vitamin D

Therapeutic Innovation & Regulatory Science

Ivermectin in COVID-19: The Case for a Moratorium on Prescriptions

Authors: Molnar, A, Lau, S, Berges, M, et al.

“In treatment or prevention of COVID-19, ivermectin is not approved by the United States (US) Food and Drug Administration (FDA). Nonetheless, in the US, prescriptions of ivermectin by healthcare providers have increased > tenfold from 3589 per week pre-COVID-19 to 39,102. Ivermectin is FDA approved for animals to treat parasites and for humans to treat intestinal strongyloidiasis and onchocerciasis orally, and ectoparasites and skin conditions topically. It is not a benign drug, with reported side effects including cutaneous, gastrointestinal, and cardiovascular symptoms. The evidence to support ivermectin to treat or prevent COVID-19 includes some basic research and inconsistent clinical observations that contribute to the formulation of a hypothesis of efficacy in COVID-19. At present, data from peer-reviewed published randomized trials of sufficient size, dose, and duration to reliably test the hypothesis of the most plausible small to moderate benefits on clinically relevant endpoints are sparse. In addition to the US FDA, the US National Institutes of Health, World Health Organization, and European Medicines Agency have all advised against ivermectin for treatment or prevention of COVID-19 outside of randomized trials. For ivermectin in treatment or prevention of COVID-19, healthcare providers should reassure all patients that if sufficient evidence were to emerge, then this drug could be considered a therapeutic innovation and regulatory authorities would approve the drug. In the meanwhile, we strongly recommend a moratorium on the prescription of ivermectin for the treatment or prevention of COVID-19 except in randomized trials to provide the most reliable test of the hypothesis.”

Keywords: Ivermectin, therapeutic innovation, regulatory science, prescription moratorium

International Journal of Medical Science and Clinical Research Studies

Risk Factors That Increases Covid-19 Severity

Authors: Fregoso, M, Laines, MF, Zepeda, JM, et al.

“The relation between some risk factors and its impact on COVID 19 progression was described; as well as the effectiveness of certain vaccines. Recent articles from different digital platforms were consulted for this manuscript. Several studies have shown that some of the main risk factors for COVID 19 were age, hypertension and obesity. From the studies reviewed in this article, it is concluded that hypertension is one of the aggravating factors in COVID 19 disease due to ACE receptors; vitamin D and the use of different vaccines were also discussed.”

Keywords: vitamin D, risk factors, age, hypertension, obesity, ACE receptors, vaccines

Frontiers in Microbiology

The Complexity of SARS-CoV-2 Infection and the COVID-19 Pandemic

Authors: da Silva Torres, MK, Bichara, CDA, de Almeida, MNDS, et al.

“The pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) led to the death of millions of people worldwide and thousands more infected individuals developed sequelae due to the disease of the new coronavirus of 2019 (COVID-19). The development of several studies has contributed to the knowledge about the evolution of SARS-CoV2 infection and the disease to more severe forms. Despite this information being debated in the scientific literature, many mechanisms still need to be better understood in order to control the spread of the virus and treat clinical cases of COVID-19. In this article, we carried out an extensive literature review in order to bring together, in a single article, the biological, social, genetic, diagnostic, therapeutic, immunization, and even socioeconomic aspects that impact the SAR-CoV-2 pandemic. This information gathered in this article will enable a broad and consistent reading of the main aspects related to the current pandemic. ”

Keywords: biological aspects, social aspects, genetic aspects, diagnostic aspects, therapeutic aspects, immunization aspects, socioeconomic aspects

International Journal of Pediatrics

A survey of the COVID-19 Challenges in Sport for all Case study: Children’s Sport and Physical Activity

Authors: Fallah, Z

“The COVID-19 pandemic has significantly impacted people’s sports and physical activities. Many studies examined these effects from different points of view. The study examines the challenges of COVID-19 in sport for all, emphasizing children’s sports. The research is applied in terms of purpose and descriptive-analytical in terms of data collection, and the field method was used. The population was all experts in children’s sports, kindergarten teachers, primary school teachers, and managers of clubs active in children’s sports in Gorgan (N = 750). The sample was determined based on the statistical population and Morgan table (n = 257). The correlated t-test was used to measure the effect. Friedman’s test was used to prioritize the challenges of COVID-19 in sport for all, emphasizing children’s sports. The results showed that the challenges of COVID-19 in sport for all with an emphasis on children’s sports and physical activities are jeopardizing the physical health of children, increasing the issues related to holding competitions and festivals, increasing unemployment of sports coaches, increasing Government restrictions for the operation of sports facilities, reducing investment in children’s sports, endangering the physical health of individuals, loss of human resources, the financial crisis of sports centers, reducing the income of health-related sports centers and increasing psychological problems (Social Phobia, anxiety and fear of Sports). The results showed that one could manage the challenges of COVID-19 in children’s sports and physical activity by giving priority to low-risk sports in open spaces, games, and competitions without spectators, providing unemployment insurance services to children’s sports activists, providing support packages and banking facilities for sports center owners and observing health practices.”

Keywords: physical activity, sport for all, children

Journal of Pediatric Endocrinology and Metabolism

Obesity after the Covid-19 pandemic and beyond

Authors: Kiess, W, Kirstein, AS, Stein, R, et al.

“Childhood obesity is still a major challenge for an individual’s health and a society’s health care system. The COVID-19 pandemic has spurred weight gain patterns across a wide range of age- and weight groups: measures aiming to halt the spread of COVID-19, e.g., school closures and social distancing, may have caused an aggravation of the childhood obesity epidemic by increasing sedentary behavior, reducing physical activity, and altering food habits of children, adolescents, and their families.”

Keywords: obesity, children, adolescents, family

British Journal of Sports Medicine

Small steps, strong shield: directly measured, moderate physical activity in 65 361 adults is associated with significant protective effects from severe COVID-19 outcomes

Authors: Steenkamp, L, Saggers, RT, Bandini, R, et al

“To determine the association between directly measured physical activity and hospitalisation, intensive care unit (ICU) admission, ventilation and mortality rates in patients with a confirmed diagnosis of COVID-19. Directly measured physical activity data from 65 361 adult patients with a COVID-19 diagnosis from 19 March 2020 to 30 June 2021, were grouped by activity level: low (<60 min/week), moderate (60–149 min/week) and high activity (≥150 min/week). The association of physical activity levels and the risk of adverse outcomes was analysed using modified Poisson regression. We accounted for demographics and comorbidities including conditions known to influence COVID-19 outcomes, as well as patient complexity as measured by the Johns Hopkins Adjusted Clinical Group system. The regression approach was further validated with a Bayesian network model built off a directed acyclic graph. High physical activity was associated with lower rates of hospitalisation, ICU admission, ventilation and death due to COVID-19 than those who engaged in low physical activity. Moderate physical activity also was associated with lower rates of hospitalisation, admission to ICU, ventilation, and death. Adults with high and moderate physical activity levels had significantly better outcomes than those with low activity when contracting COVID-19. The apparent protective effects of regular physical activity extended to those with concomitant chronic medical conditions.”

Keywords: physical activity, hospitalisation, intensive care unit, mortality rates

Neurological Research and Practice

Guillain-Barré syndrome and fulminant encephalomyelitis following Ad26.COV2.S vaccination: double jeopardy

Authors: Stefanou, MI, Karachaliou, E, Chondrogianni, M, et al.

“This correspondence comments on a published article presenting a case of rhombencephalitis following SARS-CoV-2-vaccination with the mRNA vaccine BNT162b2 (Pfizer/BioNTech). We also present the case of a 47-year-old man who developed Guillain-Barré-syndrome and a fulminant encephalomyelitis 28 days after immunization with Ad26.COV2.S (Janssen/Johnson & Johnson). Based on the presented cases, we underscore the importance of clinical awareness for early recognition of overlapping neuroimmunological syndromes following vaccination against SARS-CoV-2. Additionally, we propose that that role of autoantibodies against angiotensin-converting enzyme 2 (ACE2) and the cell-surface receptor neuropilin-1, which mediate neurological manifestations of SARS-CoV-2, merit further investigation in patients presenting with neurological disorders following vaccination against SARS-CoV-2.”

Keywords: encephalomyelitis, Guillain-Barré syndrome, transverse myelitis

Proceedings of the Nutrition Society

A systematic review investigating the risk of COVID-19 severity and mortality associated with vitamin D sufficiency and deficiency within the adult population

Authors: Mahmood, R, McLaren, S

“COVID-19 has caused a global pandemic and resulted in 230 million cases and 4.72 million deaths worldwide as of 24 Sep 2021. Vitamin D (VitD) affects the immune system through the regulation of cathelicidin and Th1 cytokine synthesis. Cathelicidin prevents respiratory illnesses by damaging viral cell membranes. COVID-19 infection is associated with an inflammatory cytokine storm. Activated VitD (VDR) receptors down-regulate the synthesis of pro-inflammatory cytokines and increase synthesis of anti-inflammatory cytokines. VitD may decrease the infection risk of COVID-19 by down-regulating ACE2 receptors. Down-regulation of these cytokines by VDRs could mean that VitD can reduce complications associated with COVID-19. Approximately 29% of the UK adult population is VitD deficient and there is a lack of large-scale randomised control trials (RCT’s) on VitD status and COVID-19 mortality and severity. Therefore, this systematic review (SR) aimed to assess the risk of COVID-19 mortality and severity according to VitD status within the adult population (>18 years).”

Keywords: vitamin D, cathelicidin, cytokine storm, mortality, severity

International Journal of Environmental Research and Public Health

Why Physical Activity Should Be Considered in Clinical Trials for COVID-19 Vaccines: A Focus on Risk Groups

Authors: Bortolini, MJS, Petriz, B, Mineo, JR, et al.

“Since the World Health Organization declared the global COVID-19 state of emergency in early 2020, several vaccine candidates have emerged to control SARS-CoV-2, and some of them have been approved and implemented in vaccination campaigns worldwide. Although clinical trials for these vaccines have been carried out using highly controlled methods with accurate immunological tests, clinical questionnaires did not include questions concerning the physical activity profile among volunteers. It has been well established that physical activity plays a pivotal role in the immune response after vaccination, led by the activation of cytokines, antibodies, and cells. This concept should have been considered when evaluating the efficacy of COVID-19 vaccine candidates, particularly in elderly and obese people. Here, we discuss data from the literature providing strong evidence regarding the importance of analyzing physical activity parameters to improve the accuracy of clinical trials on assessing the efficacy of vaccine candidates. ”

Keywords: physical activity, vaccines, clinical trials

Journal of Cellular Biochemistry

A computational comparative analysis of the binding mechanism of molnupiravir’s active metabolite to RNA-dependent RNA polymerase of wild-type and Delta subvariant AY.4 of SARS-CoV-2

Authors: Celik, I, Tallei, TE

“The antiviral drug molnupiravir targets the SARS-CoV-2 RNA-dependent RNA polymerase (RdRP) enzyme. Early treatment with molnupiravir reduced the risk of hospitalization or death in at-risk, unvaccinated adults with COVID-19, according to phase 3 clinical trials. Many mutations have occurred within this virus as a result of its widespread distribution. The current study sought to determine whether mutations in the RdRP of Delta subvariant AY.4 (D-AY.4 RdRP) influence the interaction of the enzyme with molnupiravir triphosphate (MTP), the active metabolite of molnupiravir. The interactions between the wild-type (WT) RdRP and D-AY.4 RdRP with MTP were evaluated based on molecular docking and dynamic simulation (MD) studies. The results show that the MTP interaction is stronger and more stable with D-AY.4 RdRP than with WT RdRP. This study provides insight into the potential significance of administering MTP to patients infected with D-AY.4 RdRP, which may have a more favorable chance of alleviating the illness. According to the findings of this study, MTP has a high likelihood of becoming widely used as an anti-SARS-CoV-2 agent. The fact that MTP is not only cytotoxic but also mutagenic to mammalian cells, as well as the possibility that it may cause DNA damage in the host, have all been raised as potential concerns. ”

Keywords: Mulnupiravir, antiviral medication, wild type, Delta variant

Researchgate

Preprint

Strictly regular use of ivermectin as prophylaxis for COVID-19 leads to a 90% reduction in COVID-19 mortality rate, in a dose-response manner: definitive results of a prospective observational study of a strictly controlled 223,128 population from a city-wide program in Southern Brazil.

Authors: Kerr, L, Baldi, F, Barbosa Lôbo, R, et al.

“Previously, we demonstrated that ivermectin use as prophylaxis for COVID-19 was associated with reductions in COVID-19 infection, hospitalization, and mortality rates, and in the risk of dying from COVID-19, irrespective of regularity and accumulated use of ivermectin, in an observational, prospectively obtained data from a strictly controlled city-wide program in a city in Southern Brazil (Itajaí, SC, Brazil) of medically-based, optional use of ivermectin as prophylaxis for COVID-19. In this study, our objective was to explore the data obtained from the program to evaluate whether the level of regularity of ivermectin use impacted in the reductions in these outcomes, aiming to determine if ivermectin showed a progressive dose-, regularity-response in terms of protection from COVID-19 and COVID-19 related outcomes. Non-use of ivermectin was associated with a 10-times increase in mortality risk and 7-times increased risk of dying from COVID-19, compared to strictly regular use of ivermectin in a prospectively collected, strictly controlled population. A progressive dose-response pattern was observed between level of ivermectin use and level of protection from COVID-19 related outcomes and consistent across different levels of ivermectin use.”

Keywords: ivermectin, prophylaxis, prevention

Vaccines

How do Vaccinators Experience the Pandemic? Lifestyle Behaviors in a Sample of Italian Public Health Workers during the COVID-19 Era

Authors: Gallé, F, Quaranta, A, Napoli, C, et al.

“Public health workers (PHWs) have experienced substantial workload changes because of their role in managing measures to limit the spread of COVID-19. The study’s aim was to assess lifestyle changes in Italian PHWs during the pandemic. PHWs attending an annual meeting completed an anonymous questionnaire assessing their sociodemographic and behavioral characteristics and lifestyle changes during the pandemic. A total of 1000 questionnaires were completed. Most participants (63.5% women, mean age 40 ± 13.1 years) were of normal weight (61.5%), non-smokers (81.9%), had a total screen time of ≥5 h/day (83.1%), and slept at least 6 h/night (88.7%). Approximately one-third consumed sweet foods every day (30%) and did not engage in physical activity (34.6%). Current sweet food consumption, physical activity, and sleep were associated with changes in these behaviors in the last 2 years. An increase in remote working was associated with worse sleep and diet, and increased tablet/PC use. Health promotion measures are needed to support the adoption of healthy lifestyles in this population during the current pandemic.”

Keywords: lifestyle, public health worker

International Journal of Environmental Research and Public Health

Changes in Active Behaviours, Physical Activity, Sedentary Time, and Physical Fitness in Chilean Parents during the COVID-19 Pandemic: A Retrospective Study

Authors: Hernández-Jaña, S, Escobar-Gómez, D, Cristi-Montero, C, et al.

“Strategies to reduce the spread of coronavirus disease 2019 (COVID-19) have caused different behavioural modifications in all populations. Therefore, this study aimed to determine changes in active commuting, moderate-to-vigorous physical activity (MVPA), physical fitness, and sedentary time during the COVID-19 pandemic in Chilean parents. Eighty-six fathers (41.30 ± 6.82 years) and 294 mothers (40.68 ± 6.92 years) of children from different schools from Valparaíso, Chile, participated. Inclusion criteria were adults with schoolchildren who were resident in Chile during the research period. Convenience sampling was used as a non-probabilistic sampling technique. Respondents completed a self-reported online survey about active commuting, MVPA, self-perceived physical fitness, and sedentary time July–September 2020 during the first pandemic period. Comparisons between before and during the pandemic were performed using t-tests and covariance analysis (ANCOVA). Most participants stayed at home during the pandemic, whereas active and passive commuting significantly decreased in both fathers and mothers. MVPA and physical fitness scores reduced considerably, while sedentary time significantly increased, independent of the sex of parents and children’s school type. Differences by age groups and the number of children were more heterogeneous, as younger parents showed a larger decrease in MVPA and physical fitness score. Additionally, parents with one child showed a larger decrease in sedentary time than those with two or more children. The COVID-19 pandemic significantly affected healthy behaviours. Hence, health policies should promote more strategies to mitigate the long-term health effects of the pandemic on Chilean parents. ”

Keywords: healthy behaviour, family, quarantine, isolation, lockdown

Research Gate

Preprint

Analytical modelling of the Europe autumn 2021 covid-19 surge supports that seasonal vitamin D decline reduces the contamination control of the vaccination

Authors: Walrand, S

“Despite vaccination, Europe repeats dramatic covid-19 surges this autumn 2021, imposing safety rules. Autumn 2020 dynamics showed a clear correlation of the surge date with country latitude pointing out the vitamin D seasonal decline as contributing factor. We investigate the autumn 2021 surge dynamic. Countries surge dates were assessed and the correlation with the latitude analysed. Analytical equations governing the summer-autumn dynamics in vaccinated and unvaccinated subpopulations of teens, adults and senior were developed. After shifting the country latitude towards the south proportionally to its vaccination rate, a linear correlation of the surge date is observed, with a slope similar to that of autumn 2020. Furthermore, this surge is present in the vaccinated population while this population was rather unsensitive to the delta variant spreading and to the safety rules removal in July. The analytical model evidenced an autumnal vaccination efficiency decline increasing with the sub-population age. All the observations support that vitamin D deficiency reduces the vaccination efficiency in controlling contaminations. There was no observation supporting a reduction of the vaccination efficiency in preventing severe covid illness. Europe will continue the seasonal low vitamin D status up to April. It makes sense to screen vitamin D status and fix individual deficiencies. The vaccination efficiency in controlling contamination should be restored which could mechanically reduce the hospital load and limit economics burden.”

Keywords: vitamin D, vaccination, autumn surge

Research Gate

Preprint

Strictly regular use of ivermectin as prophylaxis for COVID-19 leads to a 90% reduction in COVID-19 mortality rate, in a dose-response manner: definitive results of a prospective observational study of a strictly controlled 223,128 population from a city-wide program in Southern Brazil

Authors: Kerr, L, Baldi, F, Lôbo, RB, et al.

“Previously, we demonstrated that ivermectin use as prophylaxis for COVID-19 was associated with reductions in COVID-19 infection, hospitalization, and mortality rates, and in the risk of dying from COVID-19, irrespective of regularity and accumulated use of ivermectin, in an observational, prospectively obtained data from a strictly controlled city-wide program in a city in Southern Brazil (Itajaí, SC, Brazil) of medically-based, optional use of ivermectin as prophylaxis for COVID-19. In this study, our objective was to explore the data obtained from the program to evaluate whether the level of regularity of ivermectin use impacted in the reductions in these outcomes, aiming to determine if ivermectin showed a progressive dose- and regularity-response in terms of protection from COVID-19 and COVID-19 related outcomes. This is a prospective observational study of the program mention above, that used ivermectin at a dose of 0.2mg/kg/day for two consecutive days, every 15 days. We obtained and analyzed the data regarding the accumulated dose of ivermectin use, in addition to age and comorbidities, to analyze the patterns of reduction of COVID-19 infection, hospitalization, and mortality rates, and risk of dying from COVID-19, according to the regularity and amount of ivermectin used in a 5-month period. Following definitions of regularity, we considered as strictly regular subjects that used at least 180mg of ivermectin (180mg = 30 tablets), and as sporadic users subjects that used 60mg (= 10 tablets) or less during the 5-month period. Comparisons between subjects that did not use ivermectin and these two levels of regularity of ivermectin use were performed. Analysis of the intermediate levels of ivermectin use are present in the supplement appendix of this study. To analyze hospitalization and mortality rates, we utilized the database of COVID-19 infections of all participants, from Itajaí and outside. To analyze COVID-19 infection rate and risk of dying from COVID-19 we utilized the Itajaí city database. Propensity score matching (PSM) was employed, followed by multivariate adjusted analysis for residual differences (doubly adjusted analysis). COVID-19 infection rate within the city of Itajaí was 49% lower among strict users [283/8,325 cases; 3.40% infection rate) than in non-users [3,034/45,716 cases; 6.64% infection rate), and 25% lower compared to sporadic users (1,542/33,971 cases; 4.54% infectionrate), and sporadic users had 32% lower infection rate than non-users. Non-use of ivermectin was associated with a 10-times increase in mortality risk and 7-times increased risk of dying from COVID-19, compared to strictly regular use of ivermectin in a prospectively collected, strictly controlled population. A progressive dose-response pattern was observed between level of ivermectin use and level of protection from COVID-19 related outcomes, and was consistent across different levels of ivermectin use.”

Keywords: ivermectin

Tropical Journal of Pharmaceutical Research

Immune-boosting effect of natural remedies and supplements on progress of, and recovery from COVID-19 infection

Authors: Shehab, NG, Dortaj, S, Orthman, M, et al.

“To investigate the effect of natural remedies and supplements on the progress of and recovery from COVID-19 infection, and the role of safety precautions in controlling the spread of its causative pathogen. A questionnaire was designed and electronically distributed among previously infected individuals across countries. The survey included questions about the participants’ demographic information, medical history, how they were infected, symptoms they have experienced, where they were isolated, the degree of precautions taken against the virus, and their consumption of natural remedies or supplements before and during the infection period. The results showed that natural remedies and supplements are widely consumed among COVID-19 patients both before and during infection, either as a single remedy or in combination with other remedies. As the age of the participants increased, the incidence of their hospitalization increased. Significant results were observed when comparing the severity of infection with the number of natural remedies and supplements taken before and during the infection. Increasing the intake of natural remedies and/or supplements before and during COVID19 infection lowers the severity of the infection. Vitamin C, honey, and citrus fruits such as orange and lemon were the major remedies consumed before and during infection. A large number of the participants that experienced severe COVID-19 conditions, did not consume any natural remedies or supplements. ”

Keywords: natural remedies, supplements, risk of hospitalization, immune system

European Journal of Medical Research

Repurposing the drug, ivermectin, in COVID-19: toxicological points of view

Authors: Shirazi, FM, Mirzaei, R, Nakhaee, S, et al.

“The global COVID-19 pandemic has affected the world’s population by causing changes in behavior, such as social distancing, masking, restricting people’s movement, and evaluating existing medication as potential therapies. Many pre-existing medications such as tocilizumab, ivermectin, colchicine, interferon, and steroids have been evaluated for being repurposed to use for the treatment of COVID-19. None of these agents have been effective except for steroids and, to a lesser degree, tocilizumab. Ivermectin has been one of the suggested repurposed medications which exhibit an in vitro inhibitory activity on SARS-CoV-2 replication. The most recommended dose of ivermectin for the treatment of COVID-19 is 150–200 µg/kg twice daily. As ivermectin adoption for COVID-19 increased, the Food and Drug Administration (FDA) issued a warning on its use during the pandemic. However, the drug remains of interest to clinicians and has shown some promise in observational studies. This narrative reviews the toxicological profile and some potential therapeutic effects of ivermectin. Based on the current dose recommendation, ivermectin appears to be safe with minimum side effects. However, serious questions remain about the effectiveness of this drug in the treatment of patients with COVID-19. ”

Keywords: Ivermectin

medRxiv

Preprint

Results From the REsCue Trial: A Randomized Controlled Trial with Extended-Release Calcifediol in Symptomatic Outpatients with COVID-19

Authors: Bishop, CW, Ashfaq, A, Melnick, JZ, et al.

“The benefit of vitamin D treatment for coronavirus disease 2019 (COVID-19) remains unclear. To investigate the effect of raising serum total 25-hydroxyvitamin D (25D) to 50-100 ng/mL with oral extended-release calcifediol (ERC) on time to symptom resolution in mild to moderate COVID-19. A multicenter, randomized, double-blind, placebo-controlled study evaluated treatment of 160 outpatients with COVID-19 diagnosed between November 2020 and October 2021.Patients were treated for 4 weeks with ERC (30 mcg/capsule; 300 mcg on Days 1-3 and 60 mcg on Days 4-27) or placebo. Primary endpoints were raising serum 25D to ≥50 ng/mL at Day 14 and resolution time for five aggregated symptoms. Secondary endpoints included resolution time for aggregated and individual symptoms as a function of serum 25D and changes in clinical biomarkers. 171 subjects randomized, 160 treated and 134 (65 ERC and 69 placebo) retained. Average age was 43 (range: 18-71); 59% female, 92% White, 80% Hispanic, 7% African-American, 1% Other, 76% overweight, 40% obese, 26% comorbidities, mean baseline 25D of 37±1 (SE) ng/mL. ERC increased mean 25D to 82±4 ng/mL by Day 7; 88% of subjects attained a level ≥50 ng/mL; the placebo group trended lower. Resolution time for five aggregated symptoms was unchanged by ERC given that two composite non-respiratory symptoms responded poorly. Prespecified analyses showed that respiratory symptoms tended to resolve earlier when serum 25D levels reached ≤50 ng/mL, but statistical significance was limited by small sample size and non-compliance: 25D increased in seven placebo subjects (unauthorized supplementation) and none occurred in five ERC subjects (failure to dose). A post-hoc composite of three respiratory symptoms (trouble breathing, chest congestion and dry or hacking cough) resolved 3.0 days faster when 25D was elevated at Days 7 and 14; chest congestion resolved 4.0 days faster with 25D increases of ≥25 ng/mL. Safety concerns including hypercalcemia were absent with ERC treatment. ERC was effective in increasing serum 25D in outpatients with COVID-19, which may have accelerated resolution of respiratory symptoms suggesting mitigation of COVID-19 pneumonia risk, findings which warrant further study. ”

Keywords: vitamin D, respiratory symptoms, supplementation

Clinical Complementary Medicine and Pharmacology

Herbal Remedies, Nutraceuticals, and Dietary Supplements for COVID-19 Management: An update

Authors: Chavda, VP, Patel, AP, Vihol, D, et al.

“Currently, the world is facing a coronavirus pandemic with a grave deficiency of specific therapy for coronavirus disease (COVID-19). Moreover, scientists attempt to discover the most refined approach to prevent this condition. Regarding COVID-19 infection, herbal medicines with immunomodulatory effects may offer patients a promising preventive treatment option. Several ayurvedic and traditional Chinese medicines (TCM) are effective during this worrisome coronavirus pandemic i.e. Tinospora cordifolia (Willd.) Miers, Withania somnifera (L.) Dunal, Scutellaria baicalensis Georgi, Curcuma longa L. etc. TCM was shown to be utilized with over 90% efficacy when the COVID-19 pandemic broke out in early 2020. In addition to herbal treatments and nutraceutical drugs, dietary supplements such as vitamins and amino acid derivatives also play a significant part in COVID-19 management. Diet can assist in regulating inflammation, while nutraceuticals can aid in the prevention of viral invasion. Functional amino acids (e.g., arginine, cysteine, glutamate, glutamine, glycine, taurine and tryptophan) and glutathione, which are all abundant in animal-sourced foodstuffs, are crucial for optimum immunity and health in humans and animals. The goal of this article is to thoroughly evaluate recent statistics on the effectiveness of herbal medicines in COVID-19, the antiviral activity of nutraceuticals, and the significance of these results in creating dietary supplements that would enhance innate immunity and contribute as preventive measures against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). ”

Keywords: herbal drugs, ayurvedic remedies, nutraceutical drugs, chines herbs, traditional Chinese medicine, dietary supplements

Cureus

Neurological Conditions Following COVID-19 Vaccinations: Chance or Association?

Authors: Fernandes, J, Jaggernauth, S, Ramnarine, V, et al.

“Coronavirus disease 2019 (COVID-19) has been labeled a global pandemic with the first reported case of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) occurring in Wuhan, China in December 2019. To combat the alarming, increasing rate of those affected by the virus, vaccine development ensued. As mass vaccination initiatives against COVID-19 ensued, adverse reactions began emerging. This non-consecutive, population-based case series focuses on four vaccine-associated neurological adverse events across the central and peripheral nervous system detailing the diagnosis, treatment and subsequent follow-up management. These four patients presented to public and private hospitals in Trinidad and Tobago with new-onset neurological diseases soon after their first doses of a COVID-19 vaccine: two after the Pfizer-BioNTech vaccine (one case of new-onset seizures and one case of longitudinally extensive transverse myelitis) and two after the ChAdOx1 nCoV-19 vaccine (one case of Guillain-Barre syndrome and one case of meningitis-retention syndrome). The background incidence rates of neurological conditions in the population and the large numbers of persons being vaccinated means that some of these conditions will appear in the post-vaccination window by chance. Hence, establishing causal links is difficult. The close temporal relationship between vaccination and the presenting symptoms, the biological plausibility, and the extensive diagnostic workup to exclude other causes fulfill criteria provided by the World Health Organization for causality assessment of an adverse event following immunization on an individual level. On this basis, it was determined that these adverse events were likely due to the vaccines. However, establishing causal links on a population level requires large epidemiological studies and cannot be done on individual case reports alone. While physicians should be cognizant of even these rare adverse events of vaccines, it should be reiterated that the overall safety profile of vaccines is well established.”

Keywords: astra zeneca, neurological side effects, pfizer-biontech, mrna, adverse events, side effects

Viruses

Cell-Free DNA: Potential Application in COVID-19 Diagnostics and Management

Authors: Stawski, R, Nowak, D, Perdas, E

“WHO has declared COVID-19 as a worldwide, public health emergency. The elderly, pregnant women, and people with associated co-morbidities, including pulmonary disease, heart failure, diabetes, and cancer are the most predisposed population groups to infection. Cell-free DNA is a very commonly applied marker, which is elevated in various pathological conditions. However, it has a much higher sensitivity than standard biochemical markers. cfDNA appears to be an effective marker of COVID-19 complications, and also serves as a marker of certain underlying health conditions and risk factors of severe illness during COVID-19 infection. We aimed to present the possible mechanisms and sources of cfDNA released during moderate and severe infections. Moreover, we attempt to verify how efficiently cfDNA increase could be applied in COVID-19 risk assessment and how it corresponds with epidemiological data.”

Keywords: cell-free DNA marker, vitamin D

International Journal of Environmental Research and Public Health

Physical Activity, Mental Health and Wellbeing of Adults within and during the Easing of COVID-19 Restrictions, in the United Kingdom and New Zealand

Authors: Faulkner, J, O’Brien, WJ, Stuart, B, et al.

“Physical activity (PA) participation was substantially reduced at the start of the COVID-19 pandemic. The purpose of this study was to assess the association between PA, mental health, and wellbeing during and following the easing of COVID-19 restrictions in the United Kingdom (UK) and New Zealand (NZ). In this study, 3363 adults completed online surveys within 2–6 weeks of initial COVID-19 restrictions (April/May 2020) and once restrictions to human movement had been eased. Outcome measures included the International Physical Activity Questionnaire Short-Form, Depression Anxiety and Stress Scale-9 (mental health) and World Health Organisation-5 Wellbeing Index. There were no differences in PA, mental health or wellbeing between timepoints. Individuals engaging in moderate or high volume of PA had significantly better mental health and wellbeing than individuals who engaged in low PA. Mental health was better once COVID-19 restrictions were eased. NZ had better mental health and wellbeing than the UK. Participation in moderate-to-high volumes of PA was associated with better mental health and wellbeing, both during and following periods of COVID-19 containment, compared to participation in low volumes of PA. Where applicable, during the current or future pandemic(s), moderate-to-high volumes of PA should be encouraged.”

Keywords: lifestyle, exercise, depression, lockdown

Italian Journal of Pediatrics

The impact of the COVID-19 pandemic on lifestyle behaviors in children and adolescents: an international overview

Authors: Scapaticci, S, Neri, CR, Marseglia, GL, et al.

“The adverse effects of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) are not limited to the related infectious disease. In children and adolescents, serious risks due to the coronavirus disease 2019 (COVID-19) pandemic are also related to its indirect effects. These include an unbalanced diet with an increased risk of weight excess or nutritional deficiencies, increased sedentary lifestyle, lack of schooling, social isolation, and impaired mental health. Pediatricians should be aware of the side effects of the COVID-19 pandemic on children’s diet, physical mental health and advise the families according to their nutritional needs and financial resources. Moreover, the lack of a targeted therapy able to offer protection against the deleterious effects of SARS-CoV-2 infection should require a greater effort by scientific societies to find a more effective prevention strategy. In this context, much interest should be given to nutritional support, able to contrast malnutrition and to stimulate the immune system. ”

Keywords: children, nutrition, lifestyle

Journal of Applied Gerontology

Impact of COVID-19 Stay-At-Home Restrictions on Falls in One Community of High-Risk Older Adults

Authors: McIntyre, CC, Prichett, L, McNabney, MK

“ To examine the relationship between falls among high-risk older adults at one Program of All-Inclusive Care for the Elderly (PACE) and the COVID-19 closure of its Day Health Center (DHC), which provides participants with social and rehabilitative services and contributes to their weekly physical activity. Self-reported falls during the 3 months before the DHC’s closure (“pre–COVID-19”) were compared in number and in character to falls during its closure (“COVID-19”). One thirty five participants were enrolled during the entire 6-month period; 37% (n=50) fell during this time. These participants experienced fewer falls during COVID-19 (mean=0.64) than they did pre–COVID-19 (mean=1.24). In this population of high-risk, community-dwelling older adults, an abrupt reduction in activity levels may have reduced falls. Physical activity has been shown to both increase and protect against falls in older adults. The long-term consequences of a comparably prolonged period of inactivity merit further study. ”

Keywords: falls, frailty, physical activity

bioRxiv

Preprint

mRNA-1273 or mRNA-Omicron boost in vaccinated macaques elicits comparable B cell expansion, neutralizing antibodies and protection against Omicron

Authors: Gagne, M, Moliva, JI, Foulds, KE, et al.

“SARS-CoV-2 Omicron is highly transmissible and has substantial resistance to antibody neutralization following immunization with ancestral spike-matched vaccines. It is unclear whether boosting with Omicron-specific vaccines would enhance immunity and protection. Here, nonhuman primates that received mRNA-1273 at weeks 0 and 4 were boosted at week 41 with mRNA-1273 or mRNA-Omicron. Neutralizing antibody titers against D614G were 4760 and 270 reciprocal ID50 at week 6 (peak) and week 41 (pre-boost), respectively, and 320 and 110 for Omicron. Two weeks after boost, titers against D614G and Omicron increased to 5360 and 2980, respectively, for mRNA-1273 and 2670 and 1930 for mRNA-Omicron. Following either boost, 70-80% of spike-specific B cells were cross-reactive against both WA1 and Omicron. Significant and equivalent control of virus replication in lower airways was observed following either boost. Therefore, an Omicron boost may not provide greater immunity or protection compared to a boost with the current mRNA-1273 vaccine.”

Keywords: mRNA-Omicron, mRNA-1273, antibodies

bioRxiv

Preprint

mRNA-1273 or mRNA-Omicron boost in vaccinated macaques elicits comparable B cell expansion, neutralizing antibodies and protection against Omicron

Authors: Gagne, M, Moliva, JI, Foulds, KE, et al.

“SARS-CoV-2 Omicron is highly transmissible and has substantial resistance to antibody neutralization following immunization with ancestral spike-matched vaccines. It is unclear whether boosting with Omicron-specific vaccines would enhance immunity and protection. Here, nonhuman primates that received mRNA-1273 at weeks 0 and 4 were boosted at week 41 with mRNA-1273 or mRNA-Omicron. Neutralizing antibody titers against D614G were 4760 and 270 reciprocal ID50 at week 6 (peak) and week 41 (pre-boost), respectively, and 320 and 110 for Omicron. Two weeks after boost, titers against D614G and Omicron increased to 5360 and 2980, respectively, for mRNA-1273 and 2670 and 1930 for mRNA-Omicron. Following either boost, 70-80% of spike-specific B cells were cross-reactive against both WA1 and Omicron. Significant and equivalent control of virus replication in lower airways was observed following either boost. Therefore, an Omicron boost may not provide greater immunity or protection compared to a boost with the current mRNA-1273 vaccine. ”

Keywords: Omicron, vaccines, antibodies

Sport in Society

New spatial practices in organised sport following COVID-19: the Swedish case

Authors: Book, K, Hedenborg, S, Andersson, K

“Following the outbreak of COVID-19 in 2020, the majority of European countries imposed lockdowns, whereas Sweden introduced comparatively moderate constraints. The Public Health Agency of Sweden stated that sports and physical activity could continue if conducted ‘safely’ and recommended outdoor activities. This article aims to identify new spatial practices and strategies developed by organised recreational sport providers (i.e. sport clubs, commercial providers) following the outbreak of the pandemic. Further, it identifies obstacles and opportunities for new spatial solutions, as well as possible long-term (lasting) effects of the strategies imposed. Also, it discusses these obstacles and opportunities in relation to contemporary sport facility challenge. The data draws upon 24 semi-structured interviews with sport coaches and leaders. All interviews were transcribed verbatim and analysed using a thematic analysis. The results suggest that most respondents show adaptability by moving their activities outdoors. Generally, for-profit organisations have been more innovative and adaptive. Obstacles for new spatial solutions include localisation, weather, (perceived) need of equipment, leadership, competing interests in public space, and notably the perception of what sport is. Positive examples of spatial adaptability show that there is a potential for sport providers to open up for different spatial solutions and more flexibility in relation to their activities, in order to ease the pressure on formal indoor (and, to some extent, outdoor) sport facilities while amending the perception of sport activities. ”

Keywords: spatial practices, spatial strategies, sport and space, sport providers

African Identities

Vaccine nationalism and the quest for indigenous COVID-19 vaccine in Nigeria

Authors: Ashindorbe, K, Olaifa, T, Udegbunam, KC

“This paper discusses the panic-buying of COVID-19 vaccines by wealthy countries for their citizens, otherwise known as ‘vaccine nationalism’, and the quest to develop local capacity for the production of vaccines in Nigeria. The paper argues that in the light of the global race, and attempts by countries to urgently secure the COVID-19 vaccines for their citizens, it behoves on the government of Nigeria to invest in the health security of its citizens and put aside the over-dependency on charity and goodwill of Western countries at every turn. The paper concludes that vaccine nationalism can spur the development of home-grown capabilities not just for vaccine against COVID-19 but vaccines and other novel therapeutic or prophylactic products for the prevention and treatment of endemic and emerging disease. This will in turn create jobs, improve healthcare delivery, curb medical tourism and stem the tide of migration of health professionals. The methodology is descriptive in approach, relying on personal observation and data gleaned from journals, magazines and Newspapers. ”

Keywords: vaccine nationalism, health security, local capacity

Annals of Medicine

Efficacy and safety of three new oral antiviral treatment (molnupiravir, fluvoxamine and Paxlovid) for COVID-19: a meta-analysis

Authors: Wen, W, Chen, C, Tang, J, et al.

“The coronavirus disease (COVID-19) epidemic has not been completely controlled. Although great achievements have been made in COVID-19 research and many antiviral drugs have shown good therapeutic effects against COVID-19, a simple oral antiviral drug for COVID-19 has not yet been developed. We conducted a meta-analysis to investigate the improvement in mortality or hospitalization rates and adverse events among COVID-19 patients with three new oral antivirals (including molnupiravir, fluvoxamine and Paxlovid). We searched scientific and medical databases, such as PubMed, Web of Science, Embase and Cochrane Library for relevant articles and screened the references of retrieved studies on COVID-19. A total of eight studies were included in this study. The drug group included 2440 COVID-19 patients, including 54 patients who died or were hospitalized. The control group included a total of 2348 COVID-19 patients, including 118 patients who died or were hospitalized. The overall odds ratio (OR) of mortality or hospitalization was 0.33 (95% confidence interval [CI], 0.22–0.49) for COVID-19 patients in the drug group and placebo group, indicating that oral antiviral drugs were effective for COVID-19 patients and reduced the mortality or hospitalization by approximately 67%. This study showed that three novel oral antivirals (molnupiravir, fluvoxamine and Paxlovid) are effective in reducing the mortality and hospitalization rates in patients with COVID-19. In addition, the three oral drugs did not increase the occurrence of adverse events, thus exhibiting good overall safety. These three oral antiviral drugs are still being studied, and the available data suggest that they will bring new hope for COVID-19 recovery and have the potential to be a breakthrough and very promising treatment for COVID-19.”

Keywords: molnupiravir, fluvoxamine, Paxlovid

European Journal of Medicinal Chemistry

Antioxidant, anti-inflammatory and immunomodulatory roles of vitamins in COVID-19 therapy

Authors: Pisoschi, AM, Pop, A, Iordache, F, et al.

“oxidative stress is caused by an abundant generation of reactive oxygen species, associated to a diminished capacity of the endogenous systems of the organism to counteract them. Activation of pro-oxidative pathways and boosting of inflammatory cytokines are always encountered in viral infections, including SARS-CoV-2. So, the importance of counteracting cytokine storm in COVID-19 pathology is highly important, to hamper the immunogenic damage of the endothelium and alveolar membranes. Antioxidants prevent oxidative processes, by impeding radical species generation. It has been proved that vitamin intake lowers oxidative stress markers, alleviates cytokine storm and has a potential role in lowering disease severity, by lowering pro-inflammatory cytokines, hampering hyperinflammation and organ failure. For the approached compounds, direct antiviral roles are also discussed in this review, as these activities encompass secretion of antiviral peptides, modulation of angiotensin-converting enzyme 2 receptor expression and interaction with spike protein, inactivation of furin protease, or inhibition of pathogen replication by nucleic acid impairment induction. Vitamin administration results in beneficial effects. Nevertheless, timing, dosage and mutual influences of these micronutrients should be carefullly regarded.”

Keywords: cytokine storm, vitamins, antioxidants, immunomodulation, viral infections

Current Research in Pharmacology and Drug Discovery

Therapeutics for COVID-19 and post COVID-19 complications: An update

Authors: Dzielska

“Since its inception in late December 2020 in China, novel coronavirus has affected the global socio-economic aspect. Currently, the world is seeking safe and effective treatment measures against COVID-19 to eradicate it. Many established drug molecules are tested against SARS-CoV-2 as a part of drug repurposing where some are proved effective for symptomatic relief while some are ineffective. Drug repurposing is a practical strategy for rapidly developing antiviral agents. Drug repurposing typically begins with virtual screening of existing drugs using docking experiments. Many drugs are presently being repurposed utilizing basic understanding of disease pathogenesis and drug pharmacodynamics, as well as computational methods. In the present situation, drug repositioning could be viewed as a new treatment option for COVID-19. Several new drug molecules and biologics are engineered against SARS-CoV-2 and are under different stages of clinical development. A few biologics drug products are approved by USFDA for emergency use in the covid management. Due to continuous mutation, many of the approved vaccines are not much efficacious to render the individual immune against opportunistic infection of SARS-CoV-2. Hence, there is a strong need for the cogent therapeutic agent for covid management. In this review, a consolidated summary of the therapeutic development against SARS-CoV-2 is depicted along with an overview of effective management of post COVID-19 complications.”

Keywords: drug delivery, emergency use approval, monoclonal antibodies, post COVID complications

The Lancet

Effectiveness of Covid-19 Vaccination Against Risk of Symptomatic Infection, Hospitalization, and Death Up to 9 Months: A Swedish Total-Population Cohort Study

Authors: Nordström, P, Ballin, M, Nordström, A

“Vaccine effectiveness against COVID-19 beyond 6 months remains incompletely understood. We aimed to investigate the effectiveness of COVID-19 vaccination against the risk of infection, hospitalisation, and death during the first 9 months after vaccination for the total population of Sweden. This retrospective, total population cohort study was done using data from Swedish nationwide registers. The cohort comprised all individuals vaccinated with two doses of ChAdOx1 nCoV-19, mRNA-1273, or BNT162b2, and matched unvaccinated individuals, with data on vaccinations and infections updated until Oct 4, 2021. Two outcomes were evaluated. The first was SARS-CoV-2 infection of any severity from Jan 12 to Oct 4, 2021. The second was severe COVID-19, defined as hospitalisation for COVID-19 or all-cause 30-day mortality after confirmed infection, from March 15 to Sept 28, 2021. Between Dec 28, 2020, and Oct 4, 2021, 842 974 individuals were fully vaccinated (two doses), and were matched (1:1) to an equal number of unvaccinated individuals (total study cohort n=1 685 948). For the outcome SARS-CoV-2 infection of any severity, the vaccine effectiveness of BNT162b2 waned progressively over time, from 92% at 15–30 days, to 47% at 121–180 days, and to 23% from day 211 onwards. Waning was slightly slower for mRNA-1273, with a vaccine effectiveness of 96% at 15–30 days and 59% from day 181 onwards. Waning was also slightly slower for heterologous ChAdOx1 nCoV-19 plus an mRNA vaccine, for which vaccine effectiveness was 89% at 15–30 days and 66% from day 121 onwards. By contrast, vaccine effectiveness for homologous ChAdOx1 nCoV-19 vaccine was 68% at 15–30 days, with no detectable effectiveness from day 121 onwards. For the outcome of severe COVID-19, vaccine effectiveness waned from 89% at 15–30 days to 64% from day 121 onwards. Overall, there was some evidence for lower vaccine effectiveness in men than in women and in older individuals than in younger individuals. We found progressively waning vaccine effectiveness against SARS-CoV-2 infection of any severity across all subgroups, but the rate of waning differed according to vaccine type. With respect to severe COVID-19, vaccine effectiveness seemed to be better maintained, although some waning became evident after 4 months. The results strengthen the evidence-based rationale for administration of a third vaccine dose as a booster.”

Keywords: effectiveness, risk of infection, hospitalisation, mRNA

PLoS ONE

Pre-infection 25-hydroxyvitamin D3 levels and association with severity of COVID-19 illness

Authors: Dror, AA, Morozov, N, Daoud, A, et al.

“Studies have demonstrated a potential correlation between low vitamin D status and both an increased risk of infection with SARS-CoV-2 and poorer clinical outcomes. This retrospective study examines if, and to what degree, a relationship exists between pre-infection serum 25-hydroxyvitamin D (25(OH)D) level and disease severity and mortality due to SARS-CoV-2. The records of individuals admitted between April 7th, 2020 and February 4th, 2021 to the Galilee Medical Center (GMC) in Nahariya, Israel, with positive polymerase chain reaction (PCR) tests for SARS-CoV-2 (COVID-19) were searched for historical 25(OH)D levels measured 14 to 730 days prior to the positive PCR test. Patients admitted to GMC with COVID-19 were categorized according to disease severity and level of 25(OH)D. An association between pre-infection 25(OH)D levels, divided between four categories (deficient, insufficient, adequate, and high-normal), and COVID-19 severity was ascertained utilizing a multivariable regression analysis. To isolate the possible influence of the sinusoidal pattern of seasonal 25(OH)D changes throughout the year, a cosinor model was used. Of 1176 patients admitted, 253 had records of a 25(OH)D level prior to COVID-19 infection. A lower vitamin D status was more common in patients with the severe or critical disease (<20 ng/mL [87.4%]) than in individuals with mild or moderate disease (<20 ng/mL [34.3%]). Patients with vitamin D deficiency (<20 ng/mL) were 14 times more likely to have severe or critical disease than patients with 25(OH)D ≥40 ng/mL. Among hospitalized COVID-19 patients, pre-infection deficiency of vitamin D was associated with increased disease severity and mortality.”

Keywords: vitamin D, pre-infection, severity

medRxiv

Preprint

Device-assessed sleep and physical activity in individuals recovering from a hospital admission for COVID-19: a prospective, multicentre study

Authors: Plekhanova, T, Rowlands, AV, Evans, RA, et al.

“To describe physical behaviours following hospital admission for COVID-19 including associations with acute illness severity and ongoing symptoms. 1077 patients with COVID-19 discharged from hospital between March and November 2020 were recruited. Using a 14-day wear protocol, wrist-worn accelerometers were sent to participants after a five-month follow-up assessment. Acute illness severity was assessed by the WHO clinical progression scale, and the severity of ongoing symptoms was assessed using four previously reported data-driven clinical recovery clusters. Two existing control populations of office workers and type 2 diabetes were comparators. Valid accelerometer data from 253 women and 462 men were included. Women engaged in a mean±SD of 14.9±14.7 minutes/day of moderate-to-vigorous physical activity (MVPA), with 725.6±104.9 minutes/day spent inactive and 7.22±1.08 hours/day asleep. The values for men were 21.0±22.3 and 755.5±102.8 minutes/day and 6.94±1.14 hours/day, respectively. Over 60% of women and men did not have any days containing a 30-minute bout of MVPA. Variability in sleep timing was approximately 2 hours in men and women. More severe acute illness was associated with lower total activity and MVPA in recovery. The very severe recovery cluster was associated with fewer days/week containing continuous bouts of MVPA, longer sleep duration, and higher variability in sleep timing. Patients post-hospitalisation with COVID-19 had lower levels of physical activity, greater sleep variability, and lower sleep efficiency than a similarly aged cohort of office workers or those with type 2 diabetes. Physical activity and regulating sleep patterns are potential treatable traits for COVID-19 recovery programmes. ”

Keywords: physical activity, sleep, office workers, type 2 diabetes

bioRxiv

Preprint

Unraveling the Enzymatic Mechanism of the SARS-CoV-2 RNA-Dependent-RNA-Polymerase. An Unusual Active Site Leading to High Replication Rates

Authors: Bignon, E, Monari, A

“Viral infection relies on the hijacking of cellular machineries to enforce the reproduction of the infecting virus and its subsequent diffusion. In this context the replication of the viral genome is a key step performed by specific enzymes, i.e. polymerases. The replication of SARS-CoV-2, the causative agent of the COVID-19 pandemics, is based on the duplication of its RNA genome, an action performed by the viral RNAdependent-RNA polymerase. In this contribution, for the first time and by using twodimensional enhanced sampling quantum mechanics/ molecular mechanics, we have determined the chemical mechanisms leading to the inclusion of a nucleotide in the nascent viral RNA strand. We prove the high efficiency of the polymerase, which lowers the activation free energy to less than 10 kcal/mol. Furthermore, the SARS-CoV-2 polymerase active site is slightly different from those found usually found in other similar enzymes, and particularly it lacks the possibility to enforce a proton shuttle via a nearby histidine. Our simulations show that this absence is partially compensate by lysine, whose proton assist the reaction opening up an alternative, but highly efficient, reactive channel. Our results present the first mechanistic resolution of SARS-CoV-2 genome replication and shed light on unusual enzymatic reactivity paving the way for future rational design of antivirals targeting emerging RNA viruses.”

Keywords: RNA-Dependent-RNA-Polymerase

Scientific Reports

Shared genomic architecture between COVID-19 severity and numerous clinical and physiologic parameters revealed by LD score regression analysis

Authors: Byun, J, Han, Y, Walsh, KM, et al.

“The COVID-19 pandemic has produced broad clinical manifestations, from asymptomatic infection to hospitalization and death. Despite progress from genomic and clinical epidemiology research, risk factors for developing severe COVID-19 are incompletely understood and identification of modifiable risk factors is desperately needed. We conducted linkage disequilibrium score regression (LDSR) analysis to estimate cross-trait genetic correlation between COVID-19 severity and various polygenic phenotypes. To attenuate the genetic contribution of smoking and BMI, we further conducted sensitivity analyses by pruning genomic regions associated with smoking/BMI and repeating LDSR analyses. We identified robust positive associations between the genetic architecture of severe COVID-19 and both BMI and smoking. We observed strong positive genetic correlation with diabetes and shortness of breath walking on level ground and novel protective associations with vitamin E, calcium, retinol, Apolipoprotein A, and HDL, but no association with vitamin D. Removing genomic regions associated with smoking and BMI generally attenuated the associations, but the associations with nutrient biomarkers persisted. This study provides a comprehensive assessment of the shared genetic architecture of COVID-19 severity and numerous clinical/physiologic parameters. Associations with blood and plasma-derived traits identified biomarkers for Mendelian randomization studies to explore causality and nominates therapeutic targets for clinical evaluation.”

Keywords: risk factors, BMI, smoking, diabetes, vitamins, vitamin D, vitamin E, calcium, retinol

Obesity Surgery

Evaluating Possible Mechanisms Linking Obesity to COVID-19: a Narrative Review

Authors: Vasheghani, M, Hessami, Z, Rekabi, M, et al.

“Currently, pneumonia caused by the coronavirus disease 2019 (COVID-19) is a pandemic. To date, there is no specific antiviral treatment for the disease, and universal access to the vaccine is a serious challenge. Some observational studies have shown that COVID-19 is more common in countries with a high prevalence of obesity and that people with COVID-19 have a higher body mass index. In these studies, obesity increased the risk of disease, as well as its severity and mortality. This study aimed to review the mechanisms that link obesity to COVID-19.”

Keywords: obesity, adipokines, inflammation, cardiovascular system, insulin resistance, thromboembolism, respiratory

JAMA

Prevalence and Durability of SARS-CoV-2 Antibodies Among Unvaccinated US Adults by History of COVID-19

Authors: Alejo, JL, Mitchell, J, Chang, A, et al.

“As of December 28, 2021, approximately 27% of the US population was unvaccinated against SARS-CoV-2, yet the prevalence of natural immunity remains unknown. Blood donor studies may have selection bias and lack clinical information. Previous COVID-19 infection is a possible surrogate for natural immunity, but 1 study suggested that 36% of COVID-recovered individuals are serologic nonresponders. Even among individuals who develop antibodies, durability of this response beyond 6 months remains unknown. We characterized natural immunity and long-term durability among unvaccinated individuals using anti–spike antibodies, the first line of defense against SARS-CoV-2. ”

Keywords: unvaccinated people, natural immunity, antibodies

Research Square

Preprint

Efficacy and safety of ivermectin in the treatment of mild-to-moderate COVID-19 infection: A randomized, double blind, placebo, controlled trial

Authors: Manomaipiboon, A, Pholtawornkulchai, K, Pupipatpab, S, et al.

“The emergent outbreak of coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has emphasized the requirement for therapeutic opportunities to overcome this pandemic. Ivermectin is an antiparasitic drug that has shown to be effective against various agents, including SARS-CoV-2, and is under extensive research in clinical trials. In this randomized, double-blind, placebo-controlled trial among adult hospitalized patients with mild-to-moderate COVID-19, 72 patients (mean age 48.57 ± 14.80 years) were randomly assigned to either the ivermectin (n=36) or placebo (n=36) group, along with receiving standard care. The primary outcomes were a negative reverse transcription polymerase chain reaction (RT-PCR) result at day 7 and 14 of enrolment. The secondary outcomes were duration of hospitalization, frequency of clinical worsening, survival on day 28, and adverse events. At day 7 and 14, a negative RT-PCR result was not significantly different between the two groups. The other secondary outcomes were reported to be comparable. However, the time to resolution of many symptoms were shorter in the ivermectin group, albeit not significantly. No adverse events were reported. In conclusion, early symptomatic recovery was observed with no side effects after treatment with ivermectin and standard care in mild-to-moderate COVID-19 patients. ”

Keywords: efficacy, Ivermectin, RT-PCR

Life Sciences

Mechanisms and clinical evidence to support melatonin’s use in severe COVID-19 patients to lower mortality

Authors: Tan, D-X, Reiter, RJ

“The fear of SARS-CoV-2 infection is due to its high mortality related to seasonal flu. To date, few medicines have been developed to significantly reduce the mortality of the severe COVID-19 patients, especially those requiring tracheal intubation. The severity and mortality of SARS-CoV-2 infection not only depend on the viral virulence, but are primarily determined by the cytokine storm and the destructive inflammation driven by the host immune reaction. Thus, to target the host immune response might be a better strategy to combat this pandemic. Melatonin is a molecule with multiple activities on a virus infection. These include that it downregulates the overreaction of innate immune response to suppress inflammation, promotes the adaptive immune reaction to enhance antibody formation, inhibits the entrance of the virus into the cell as well as limits its replication. These render it a potentially excellent candidate for treatment of the severe COVID-19 cases. Several clinical trials have confirmed that melatonin when added to the conventional therapy significantly reduces the mortality of the severe COVID-19 patients. The cost of melatonin is a small fraction of those medications approved by FDA for emergency use to treat COVID-19. Because of its self-administered, low cost and high safety margin, melatonin could be made available to every country in the world at an affordable cost. We recommend melatonin be used to treat severe COVID-19 patients with the intent of reducing mortality. If successful, it would make the SARS-CoV-2 pandemic less fearful and help to return life back to normalcy.”

Keywords: Melatonin, Innate immunity, Adaptive immunity, Inflammation, Main protease, Nirmatrelvir, Ritonavir

Clinical Nutrition ESPEN

COVID-19 and Micronutrient Deficiency symptoms – is there some overlap?

Authors: Lewis, SL, Chizmar, LR; Liotta, S

“COVID-19 is highly inflammatory and when it affects the elderly who have multiple comorbidities, the risk of malnutrition is high. The aim of this review is to highlight the evidence for COVID-19 and risk for malnutrition (macro- and micro-nutrient deficiency) sharing two case reports. We report two cases of patients with COVID-19. The first case includes a 75-year-old male with increasing confusion, delirium and malnutrition once he had clinically resolved from his COVID-19 diagnosis. The patient had a number of comorbidities and was treated with diuretics before and after his hospital admission. He was treated with intravenous thiamine and enteral nutrition. The second case includes a 77-year-old male with diabetes who presented with suspected vitamin C deficiency likely due to chronic aspirin use nearly two weeks prior to being diagnosed with pneumonia and COVID-19. The patient recovered from his COVID-19 diagnosis but continued to decline nutritionally and was readmitted sixty days later with failure to thrive. The first case had significant improvements in his appetite and neurological conditions following thiamine infusion and enteral nutrition and was discharged to home after a 19-day hospital stay. The second case presented with a vitamin C deficiency before testing positive for COVID-19. Although he did recover from COVID-19 he struggled to meet nutritional needs post-COVID and passed away 60 days after his COVID-19 diagnosis with pneumonia and failure to thrive. Elderly patients with chronic diseases who use nutrient depleting medications are particularly high risk for micronutrient deficiency when they also experience the inflammatory insult of COVID-19. Patients who continue to have poor nutrition intake even after they appear to be clinically resolved from the virus should be closely monitored.”

Keywords: malnutrition, ascorbic acid, thiamine, micronutrients

The Israel Medical Association Journal

Vitamin D as a Protective Factor in COVID-19 Infection in Elderly Schizophrenia and Dementia Inpatients: A Case Series

Authors: Shelef, A, Dahan, S, Weizman, S, et al.

“Risk factors for severe coronavirus disease-2019 (COVID-19) infection include old age, chronic illness, and neurological conditions. In contrast, high vitamin D levels are known to augment immune activity and to reduce the severity of viral infections. Recently, a possible association between the likelihood of COVID-19 infection, COVID-19 severity, and vitamin D blood levels was reported. To assess the possible association between vitamin D long-term supplementation and COVID-19 symptomatic severity and complications of COVID-19 infection in elderly psychiatric inpatients, a high at-risk group. We conducted a retrospective case series study. Data of 14 elderly COVID-19 positive inpatients, presenting with dementia or schizophrenia and other medical conditions were extracted from medical records. All patients maintained a 800 IU daily dose of vitamin D prior to the infection. Most of the inpatients were asymptomatic or presented very few symptoms. No need for intensive care unit intervention or deaths were reported. Cognitive functioning of the patients remained unchanged. Pre-existing vitamin D supplementation may reinforce immunity and reduce COVID-19 severity in elderly psychiatric inpatients. ”

Keywords: vitamin D, risk factors, severity

Advances in Microbiology

SARS-CoV-2 Infection Is Associated with Vitamin D Deficiency in Côte d’Ivoire

Authors: Boyvin, L , Yayé, Y , Bahi, G, et al.

“In 2019, the coronavirus pandemic broke out as a serious public health issue worldwide. In Côte d’Ivoire, the number of cases of COVID-19 has increased rapidly. The Severe Acute Respiratory Syndrome virus (SARS-CoV-2) binds to angiotensin converting enzyme 2 (ACE2) receptors in the respiratory tracts and enters the respiratory and alveolar cells of infected patients. Deficiency of fat-soluble vitamin D3 is associated with respiratory distress syndrome and pulmonary fibrosis by activation of the renin-angiotensin system. In Côte d’Ivoire, very little research is being done on SARS-CoV-2 and vitamin D. The objective of this study was to assess the vitamin D status of people infected and suffering from COVID-19 in order to contribute to their medical treatment. The study involved 100 adults infected with SARS-CoV-2 (24 women and 76 men). After confirmation of the patient’s SARS-CoV-2 status by RT-PCR, the 25 (OH) vitamin D assay was performed on the Cobas 6000 device and compared to control subjects, the non-COVID-19 positive. A significant decrease in 25-hydroxy vitamin D3 concentrations (44 ± 1.29 nmole/L) was observed in patients infected with SARS-CoV-2, compared to control (78 ± 0.68 nmole/L). The 25-hydroxy vitamin D3 deficiency requires vitamin D supplementation in the management of hospitalized patients infected with SARS-CoV-2.”

Keywords: vitamin D, vitamin D deficiency

Pathogens

The Association between TNF-α, IL-6, and Vitamin D Levels and COVID-19 Severity and Mortality: A Systematic Review and Meta-Analysis

Authors: Halim, C, Mirza, AF, Sari, MI

“An increasing number of scientific journals have proposed a connection between tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) and the severity of COVID-19. Vitamin D has been discussed as a potential therapy for COVID-19 due to its immunomodulatory effects. This meta-analysis aims to determine the relationship, if any, between TNF-α, IL-6, vitamin D, and COVID-19 severity and mortality. The design of the study is a systematic review and meta-analysis. A literature search is performed using PubMed, Cochrane, ProQuest, and Google Scholar. TNF-α insignificantly increases the risk of COVID-19 severity but significantly increases the risk of COVID-19 mortality. IL-6 significantly increases the risk of COVID-19 severity and mortality. There is a statistically insignificant difference of the mean vitamin D levels between patients with severe COVID-19 and non-severe COVID-19. A vitamin D deficiency insignificantly increases the risk of mortality of COVID-19 patients. Conclusion: IL-6 is an independent prognostic factor towards COVID-19 severity and mortality.”

Keywords: TNF-α, IL-6, vitamin D

Nutrients

Influence of Nutritional Intakes in Japan and the United States on COVID-19 Infection

Authors: Kagawa, Y

“The U.S. and Japan are both democratic industrialized societies, but the numbers of COVID-19 cases and deaths per million people in the U.S. (including Japanese Americans) are 12.1-times and 17.4-times higher, respectively, than those in Japan. The aim of this study was to investigate the effects of diet on preventing COVID-19 infection. An analysis of dietary intake and the prevalence of obesity in the populations of both countries was performed, and their effects on COVID-19 infection were examined. Approximately 1.5-times more saturated fat and less eicosapentaenoic acid/docosahexaenoic acid are consumed in the U.S. than in Japan. Compared with food intakes in Japan (100%), those in the U.S. were as follows: beef 396%, sugar and sweeteners 235%, fish 44.3%, rice 11.5%, soybeans 0.5%, and tea 54.7%. The last four of these foods contain functional substances that prevent COVID-19. The prevalence of obesity is 7.4- and 10-times greater in the U.S. than in Japan for males and females, respectively. Mendelian randomization established a causal relationship between obesity and COVID-19 infection. Large differences in nutrient intakes and the prevalence of obesity, but not racial differences, may be partly responsible for differences in the incidence and mortality of COVID-19 between the U.S. and Japan.”

Keywords: obesity, saturated fat, EPA/DHA, soybean, diabetes, mortality

ChemRxiv

Preprint

Virtual Screening of Cyanobacterial Metabolites as Inhibitors of SARS-CoV-2 Host Cell Entry, Viral Replication, and Host Immunity Modulation. Infective Mechanisms

Authors: Fellizar, VA, Concepcion, AC, Furaque, EL, et al.

“The novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) emerged in December 2019 leading to a global pandemic and lockdowns in different countries including the Philippines. There is an oral antiviral treatment, Paxlovid, produced by Pfizer that is currently authorized for emergency use to treat COVID-19. However, there is still a necessity to discover specific antiviral drugs due to increasing cases worldwide. In this study, 56 cyanobacterial secondary metabolites were virtually screened for in silico inhibitory prospects against five main targeted proteins of SARS-CoV-2 involved in viral attachment, viral replication, and host immunity modulation mechanisms. Pharmacokinetic properties and toxicity predictions were also performed. Of the fifty-six secondary metabolites molecularly docked, compounds 1–7 showed favorable binding energy ranging from -10.9 to -8.0 kcal/mol against the spike’s ACE2 (angiotensin-converting enzyme 2) and GRP 78 (glucose-related protein 78) receptor binding domains, 3CLPRO (3-chymotrypsin-like protease), PLPRO (papain-like protease), and RdRp (RNA-dependent RNA-polymerase). Three compounds, scytonemin (1) a bisindole alkaloid dimer, cryptophycin (5) a macrolactam, and tjipanazole A2 (6) an indole alkaloid glucoside exhibited highest the binding affinities with BE’s ranging from -10.4 to -8.6 kcal/mol. Top-ranked ligands 1–7 also demonstrated favorable pharmacokinetics with low toxicity risks.”

Keywords: cyanobacterial metabolites, binding affinities, SARS-CoV-2 proteins, antiviral, molecular docking

Aging and Disease

Protective Effects of Exercise Become Especially Important for the Aging Immune System in The Covid-19 Era

Authors: Domaszewska, K, Boraczyński, M, Tang, Y, et al.

“Aging is a complex, multietiological process and a major risk factor for most non-genetic, chronic diseases including geriatric syndromes that negatively affect healthspan and longevity. In the scenario of 'healthy or good aging', especially during the COVID-19 era, the proper implementation of exercise as 'adjuvant' or 'polypill' to improve disease-related symptoms and comorbidities in the general population is a top priority. However, there is still a gap concerning studies analyzing influence of exercise training to immune system in older people. Therefore, the aim of this review is to provide a brief summary of well-established findings in exercise immunology and immunogerontology, but with a focus on the main exercise-induced mechanisms associated with aging of the immune system (immunosenescence). The scientific data strongly supports the notion that regular exercise as a low-cost and non-pharmacological treatment approach, when adjusted on an individual basis in elderly, induce multiple rejuvenating mechanisms: (1) affects the telomere-length dynamics (a 'telo-protective' effect), (2) promote short- and long-term anti-inflammatory effects (via e.g., triggering the anti-inflammatory phenotype), 3) stimulates the adaptive immune system (e.g., helps to offset diminished adaptive responses) and in parallel inhibits the accelerated immunosenescence process, (4) increases post-vaccination immune responses, and (5) possibly extends both healthspan and lifespan.”

Keywords: aging process, exercise, immune system, immunosenescence

BMC Public Health

The association between physical activity and mental health during the first year of the COVID-19 pandemic: a systematic review

Authors: Marconcin, P, Werneck, AO, Peralta, M, et al.

“The Coronavirus disease-19 (COVID-19) pandemic affected countries worldwide and has changed peoples’ lives. A reduction in physical activity and increased mental health problems were observed, mainly in the first year of the COVID-19 pandemic. Thus, this systematic review aims to examine the association between physical activity and mental health during the first year of the COVID-19 pandemic. In July 2021, a search was applied to PubMed, Scopus, and Web of Science. Eligibility criteria included cross-sectional, prospective, and longitudinal study designs and studies published in English; outcomes included physical activity and mental health (e.g., depressive symptoms, anxiety, positive and negative effects, well-being). Thirty-one studies were included in this review. Overall, the studies suggested that higher physical activity is associated with higher well-being, quality of life as well as lower depressive symptoms, anxiety, and stress, independently of age. There was no consensus for the optimal physical activity level for mitigating negative mental symptoms, neither for the frequency nor for the type of physical activity. Women were more vulnerable to mental health changes and men were more susceptive to physical activity changes. Physical activity has been a good and effective choice to mitigate the negative effects of the COVID-19 pandemic on mental health during the first year of the COVID-19 pandemic. Public health policies should alert for possibilities to increase physical activity during the stay-at-home order in many countries worldwide.”

Keywords: pandemic, exercise, mental health, anxiety

Expert Opinion on Pharmacotherapy

Current and emerging immunomodulators for treatment of SARS-CoV2 infection (COVID-19)

Authors: McCarthy, MW

“SARS-CoV-2, the virus that causes COVID-19, elicits a variety of host responses ranging from asymptomatic or mild illness in most people, to severe disease and critical illness in a subset of patients with systemic inflammation and hypoxemic respiratory failure. Heterogeneous clinical presentations are often driven by disparate responses of the host immune system, with severe disease associated with aberrant interferon signaling or cytokine storm syndrome. This manuscript examines current therapeutic approaches, including the use of immunomodulators such as corticosteroids, interleukin inhibitors, kinase inhibitors, fluvoxamine, and ivermectin, and also explores the ways that these therapies and others may be used to treat COVID-19 in the future. Modulation of the immune response has become a mainstay of treatment of COVID-19, although the optimal mechanism has not yet been defined and there is considerable controversy regarding clinical management. As time progresses, the therapeutic approach to COVID-19 will undoubtedly change, particularly as we learn more about the pathophysiology of SARS-CoV-2 infection.”

Keywords: immunomodulator, inflammation, cytokine storm, ivermectin

Reproductive Toxicology

Reproductive and developmental safety of nirmatrelvir (PF-07321332), an oral SARS-CoV-2 Mpro inhibitor in animal models

Authors: Catlin, NR, Bowman, CJ, Campion, SN, et al.

“Nirmatrelvir (PF-07321332; NMV) the antiviral component of PAXLOVID™ is a potent and selective inhibitor of the SARS-CoV-2 main protease (Mpro), which plays a critical role in viral replication. PAXLOVID, comprised of nirmatrelvir and ritonavir (used as a pharmacokinetic enhancer), is an oral therapy currently in development as a therapeutic option for those infected with SARS-CoV-2 to prevent progression to severe disease, hospitalization, and death. PAXLOVID has been shown to be efficacious against hospitalization and death in two Phase 2/3 clinical studies that evaluated non hospitalized patients both with and without high risk factors for progression to severe illness. Given that males and females of reproductive age are included in the intended patient population, we assessed the potential effects of NMV up to the limit dose of 1000 mg/kg/day in ICH guideline embryo-fetal development studies in rats and rabbits, and a fertility and early embryonic development study in rats. There were no effects on male and female fertility or early embryonic development in rats, and no severe manifestations of developmental toxicity in rats or rabbits. The lack of adverse findings reported here in nonclinical species is consistent with the intended therapeutic target of NMV (a virus specific protein not present in mammalian cells), the favorable off-target selectivity profile, and lack of genetic toxicity. The results of these nonclinical studies with NMV along with existing ritonavir safety information indicate that there are no clinically relevant risks associated with PAXLOVID administration during pregnancy and in males and females of reproductive age.”

Keywords: Nirmatrelvir, NMV, PAXLOVID, embryo-fetal development, fertility, genetic toxicity, rat, rabbit, oral COVID-19 therapy

Pharmacy Today

Here’s what we know about FDA-authorized COVID-19 antivirals

Authors: Bonner, L

“While FDA has authorized two COVID-19 antiviral medications—Paxlovid from Pfizer and molnupiravir from Merck, Americans may not have the easiest time accessing these medications, which are aimed at preventing hospitalizations and deaths in high-risk patients. At press time, Paxlovid and molnupiravir will only be available in a limited number of pharmacies. Patients will need a prescription from specific licensed health care providers to get the medications. While PREP Act authority allows pharmacists to order and dispense COVID-19 therapeutics, including oral and subcutaneous medication, FDA specifically prevents pharmacists from writing prescriptions for these anti-virals. In a press statement, APhA noted that oral antivirals are most effective when taken early in a COVID-19 infection. “Requiring patients to make an appointment with another prescriber just to get a prescription that their pharmacist will fill adds time, cost, and inconvenience but most concerning of all, it could cause hospitalizations and even deaths. The ability of pharmacies to be a one-stop-shop for testing, patient assessment, ordering, and dispensing would be a game-changer for timely access to these needed treatments—just as it has been for the administration of COVID vaccines,” stated APhA. ”

Keywords: antiviral medication, Paxlovic, Molnupiravir

Cogent

COVID-19 and Physical Activity Behaviour in People with Neurological Diseases: A Systematic Review

Authors: Abasıyanık, Z, Kurt, M, Kahraman, T

“The COVID-19 pandemic has led to a radical lifestyle change, which may unintendedly change physical activity levels. We aimed to perform a systematic review to investigate the physical activity changes in people with neurological diseases, and to examine the relationship between physical activity and disease symptoms, and psychosocial factors. The review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A systematic search of the literature across five databases (PubMed, CINAHL, Web of Science, SCOPUS, and Cochrane Library) was carried out using the keywords relating to COVID-19, physical activity, sedentary behaviour, exercise, and the name of the neurological diseases. The systematic search was updated on 4 February 2021 with the same keywords. Fourteen studies (n = 7662 persons with neurological diseases, n = 1663 healthy controls) were eligible for this review. The study populations were Parkinson disease (n = 7), dementia (n = 1), multiple sclerosis (n = 1), spinal cord injury (n = 1), hereditary spastic paraplegia (n = 1), neuromuscular diseases (n = 1), Charcot-Marie-Tooth neuropathy (n = 1), and epilepsy (n = 1). Thirteen studies reported a decreased physical activity level, one study reported a high interruption rate of physiotherapy/rehabilitation. Furthermore, the physical activity reduction was associated with worse disease symptoms, depression, perceived health, and mental and physical components of quality of life. The COVID-19 pandemic has a negative impact on the physical activity levels of people with neurological diseases, and this change was related to the worsening of disease symptoms and psychosocial factors. ”

Keywords: physical activity, sedentary behaviour, exercise, neurological disease

Nutrients

Convenience Food Options and Adequacy of Nutrient Intake among School Children during the COVID-19 Pandemic

Authors: Rahman, N, Ishitsuka, K, Piedvache, A, et al.

“The COVID-19 pandemic has caused changes in the family food environment, resulting in more families relying on convenience food options. This study aimed to investigate diet quality by convenience food options (namely instant, frozen, and take-out foods) among Japanese school children during the COVID-19 pandemic. We examined the relationship between the frequency of consumption of convenience food options and nutritional status of the school children. The participants (671 children, 10–14 years old) were chosen to form a nationally representative sample of the Japanese population. Using questionnaires completed by the participants’ guardians, information was collected on the frequency of instant, frozen, and take-out food consumption. Habitual food and nutrient intake were collected using a validated food frequency questionnaire, completed by the children with help from their guardian(s). “Frequent” consumption was defined as consumption of instant, frozen, and/or take-out foods on more than 5 days per week. Using 19 nutrients and their respective dietary reference intake (DRI) values, an index was created to label each child’s nutrient intake as “Adequate”, “Inadequate”, “Excess”, or “Deficient.” Compared to children with non-frequent consumption, school children with frequent instant food consumption had significantly higher rates of inadequate nutrient intake and excess nutrient intake, while school children with frequent take-out food consumption had significantly higher rates of inadequate nutrient intake. There were no significant differences for children with frequent frozen-food intake. These associations did not change when adjusting for sociodemographic factors. Our results suggest that the frequent consumption of instant or take-out foods among school children results in non-adequate nutritional intake.”

Keywords: convenience food, take-out food, diet quality, school children, nutrition, Japan

International Journal of Environmental Research and Public Health

The Evaluation of Physical Activity Habits in North Italian People before and during COVID-19 Quarantine: A Pilot Study

Authors: Mauro, M, Grigoletto, A, Zambon, MC, et al.

“COVID-19 caused a global pandemic state. Many governments enforced quarantines which had several negative effects on peoples’ health. The present study aimed to investigate the social restriction effects on the physical activity (PA) habits of north Italian people and understand whether PA was a healthy support during lockdown. Moreover, it analysed some possible strategies which could promote an active lifestyle when the pandemic ends. A new questionnaire was proposed, and 309 surveys were collected in people from two Italian regions (53.72% from Emilia-Romagna and 46.28% from Veneto; 62.46% were female and 37.54% were male; and the age range was 46.67 ± 15.45 years). The number of younger people (≤ 25 years) who practiced PA increased during lockdown; in addition, they were more active than people who were 26–35 years old. The training frequency before COVID-19 was higher in females than males, and the frequency of weekly PA increased during lockdown in groups aged 26–35 years. Despite the fact that PA was a psychological support during lockdown, performing forced home-based PA demotivated people. Finally, people thought to practice outdoor PA (OPA) at the end of lockdown because they wanted to retain contact with nature, which can improve psychological well-being. Future strategies to promote OPA may increase participation in PA, especially in older people. ”

Keywords: physical activity, quarantine, health, green spaces

International Journal of Clinical Practice

Micronutrient Level Is Negatively Correlated with the Neutrophil-Lymphocyte Ratio in Patients with Severe COVID-19

Authors: Scicchitano, P, Zhou, S, Zhang, F, et al.

“To explore the potential relationship between NLR and micronutrient deficiency in patients with severe COVID-19 infection. Sixteen patients were categorized into the mild group (mild COVID-19) and severe group (severe COVID-19) based on the guideline of the management of COVID-19. The lactate dehydrogenase (LDH); superoxide dismutase (SOD), the inflammatory markers (neutrophil lymphocyte ratio (NLR)), erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), selenium (Se), iron (Fe), zinc (Zn), nickel (Ni), copper (Cu), chromium (Cr), cadmium (Cd), arsenic (As), and manganese (Mn) were measured in the blood. Results. Compared to the mild group, the NLR () and the level of Se, Fe, and Zn were significantly decreased in the severe group. The level of Se, Fe, and Zn was significantly correlated to NLR levels. Furthermore, close positive correlation was found between NLR and severity of COVID-19. Conclusion. The micronutrient deficiency in the blood is associated with NLR in the severity of COVID-19 patients. ”

Keywords: micronutrient deficiency, severity, CRP, selenium, iron, zinc, nickel, copper, chromium

Educational Gerontology

Home confinement during COVID-19 pandemic reduced physical activity but not health-related quality of life in previously active older women

Authors: Teixeira do Amaral, V, Roque Marçal, I, da Cruz Silva, T, et al.

“We investigate the effect of COVID-19 home confinement on levels of physical activity, sedentary behavior, and health-related quality of life (HRQL) in older women previously participating in exercise and educational programs. Our hypothesis was that home confinement would result in a reduction in levels of physical activity, an increase in sedentary behavior, and a reduction in HRQL. Sixty-four older women (age = 72 ± 5 yrs) under home confinement who participated in a physical exercise/educational program had their levels of physical activity, sedentary behavior, and HRQL assessed before and during (11 to 13 weeks after the introduction of government recommendations to reduce virus transmission) COVID-19 pandemic. There were significant reductions in total physical activity (−259 METs/week), as a result of a ~17.0% reduction in walking (−30.8 min/week) and ~41.8% reduction in vigorous-intensity activity (−29.6 min/week). Sedentary behavior also increased (2.24 h/week, 1.07 h/week days; and 1.54 h/weekend days). However, no significant change occurred in moderate-intensity physical activity, and HRQL domains and facets, except for an improvement in the environment domain. Home confinement due to COVID-19 pandemic decreased levels of physical activity and increased levels of sedentary behavior in previously active older women. However, there were no significant changes in HRQL. These results suggest that educational programs promoting healthy behaviors may attenuate the impact of home confinement in older women. ”

Keywords: physical activity, quality of life, older women

Sports Medicine and Health Science

The effect of two COVID-19 lockdowns on physical activity of school-age children

Authors: Yelizarova, O, Stankevych, T, Parats, A, et al.

“The introduction of strict quarantine restrictions in many countries initiated a direction in science to study the behavioral characteristics of children and adolescents during the social isolation at the population level. We present our observations during the two lockdowns in Ukraine. The objective of this study was to determine: a) the level of light (LPA) and moderate-to-vigorous (MVPA) physical activity among school-age children, and b) the impact of the external and internal factors on their physical activity during the lockdown. Global Physical Activity Questionnaire (GPAQ) as part of our questionnaire Q-RAPH was used. Parents of 1091 children 6-18 years old (54% boys) filled Q-RAPH at two measurement points in 2020 and 2021. After performing ANCOVA and logistic regression, we found a significant decrease in MVPA by 12.7% in 2021 compared to 2020 while LPA was about 1.5 ​h a day during both periods. The proportion of children who reach the recommended levels of MVPA also decreased by 13.7% in 2021. Factors negatively affecting the achievement of 60 ​min a day of MVPA were female gender, chronic diseases, overweight/obesity, non-participation in organized sports, and a decrease in the average air temperature. This study evidences the insufficient level of preventive measures and requires an intensification of health education among the Ukrainian population. When developing preventive measures, special attention should be paid to groups vulnerable to MVPA reduction as children who have chronic diseases and/or overweight/obesity as well as non-participation in sports. ”

Keywords: adolescents, children, lockdown, physical activity, school-age

Lebensmittel-Wissenschaft + [i.e. und] Technologie. Food science + technology.

Food nutrients as inherent sources of immunomodulation during COVID-19 pandemic

Authors: Vishwakarma, S, Panigrahi, C, Barua, S, et al.

“Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) - a novel coronavirus has rapid spread, and caused community infection around the globe. During the absence of a vaccine, people focused more on an immunity-boosting diet and needed clear knowledge about immunity-boosting foods. However, after the vaccination drive, the importance of food as a natural source of immunomodulation cannot be neglected. So, the purpose of this review was to describe the role of vital nutrient in boosting immune system of body apart from other factors like adequate sleep, exercise, and low stress levels. Macrophages, neutrophils, natural killer cells, dendritic cells, B-cells, and T-cells are the important components having important role in maintaining immunity of the human body. The first four-act as the initial mediators of innate host defense, and the latter two produce antibodies for pathogen destruction. The review investigated vital nutrients like vitamin-C, A, E and D, iron, zinc, folic acid, probiotics, and prebiotics affecting these immune components in some extent. Fruits, vegetables, spices, herbs, seeds, nuts, cereals, millets, and superfoods like chlorella and spirulina are good sources of these nutrients. However, fortified foods, functional foods, encapsulated foods with bioactive compounds and plant-based foods have shown immense potential in boosting immunity against viral infections like COVID-19. Some clinical trials and retrospective cohort studies have shown reduction in the severity of COVID-19 patients with relation to plant-based diet, vitamin D and C doses, probiotic, and zinc salts application. ”

Keywords: food, immune components, nutrients, vitamin D, vitamin C, zinc

Clinical Nutrition ESPEN

COVID-19 confinement impact on weight gain and physical activity in the older adult population: data from the LOST in Lombardia study

Authors: Stival, C, Lugo, A, Bosetti, C, et al.

“COVID-19 containment measures significantly impacted lifestyle of the general population, including physical activity. Although the older adults are particularly susceptible to the potential consequences of sedentary lifestyle and inactivity, few studies investigated pandemic effects in this segment of the population. We aimed to evaluate COVID-19 pandemic effects on weight gain and physical activity in the Italian older adults, and assess the impact of possible changes in physical activity on mental health wellbeing. In November 2020, a cross-sectional survey was conducted on a representative sample of 4,400 older adults (aged 65 or more) from the Lombardy region, Northern Italy. Changes in body mass index (BMI) and physical activity were assessed, compared to the previous year. Using unconditional multiple logistic models, we estimated the odds ratios (OR) and the corresponding 95% confidence intervals (CI) of a decrease in physical activity during COVID-19 pandemic and we evaluated if decreased physical activity was a determinant of a worsening in psychological wellbeing. Neither weight gain nor increase in obesity prevalence occurred during the pandemic. Mean time spent in physical activity significantly decreased, with 43.8% of participants reporting a decrease of one hour/week or more during COVID-19 pandemic. A decreased physical activity was determinant of a worsening of selected mental health outcomes, such as: sleep quality and quantity, anxiety and depressive symptoms. During the COVID-19 pandemic, while no major changes in BMI were observed, physical activity significantly declined in the older adults. In this population, the lack of physical activity might have contributed to the observed worsening in mental health. During emergency periods, encouraging physical activity might be effective also to preserve psychological wellbeing. ”

Keywords: physical activity, overweight, obesity, older adults, lockdown

Jurnal Respirasi

Vitamin D Supplementation and COVID-19

Authors: Tanaya1, GD, Tanya, WM, Syarif, AH

“Coronavirus Disease 2019 (COVID-19) happened due to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. It is the third coronavirus causing a pandemic. Cases of COVID-19 have increased rapidly. Epidemiological studies show droplets as a medium of transmission of this virus. The high rate of transmission and the death rate create urgency on the management of COVID-19. Unfortunately, until now there is no definitive therapy for the SARS-CoV-2 virus. Several potential therapies, including antivirals, immunomodulatory agents, convalescent plasma transfusions, and supportive therapies such as vitamin D supplementation, have been applied in the management of COVID-19. As a hormone, vitamin D has an immunomodulatory effect used in supportive therapy for various immune-related diseases and respiratory system infections. The immunomodulatory effects of vitamin D are strengthening the physical barrier (cell junction), the specific immune system (adaptive immunity), and the non-specific immune system (innate immunity). Vitamin D is known to suppress pro-inflammatory cytokines and increase the production of anti-inflammatory cytokines. In addition, vitamin D also performs as a substantial part in the induction of ACE2 receptors which gives a weighty influence on pathogenesis of COVID-19. Vitamin D deficiency can amplify the risk of infections including COVID-19. Presently, clinical trials of vitamin D supplementation and COVID-19 are limited. This literature review further examined the role of vitamin D supplementation in COVID-19.”

Keywords: immunomodulatory effect, immunopathogenesis, infectious disease, vitamin D

Morbidity and Mortality Weekly Report

Cases and Hospitalizations by COVID-19 Vaccination Status and Previous COVID-19 Diagnosis — California and New York, May–November 2021

Authors: León, TM, Dorabawila, V, Nelson, L, et al.

“Data are limited regarding the risks for SARS-CoV-2 infection and hospitalization after COVID-19 vaccination and previous infection. During May–November 2021, case and hospitalization rates were highest among persons who were unvaccinated without a previous diagnosis. Before Delta became the predominant variant in June, case rates were higher among persons who survived a previous infection than persons who were vaccinated alone. By early October, persons who survived a previous infection had lower case rates than persons who were vaccinated alone. What are the implications for public health practice?Although the epidemiology of COVID-19 might change as new variants emerge, vaccination remains the safest strategy for averting future SARS-CoV-2 infections, hospitalizations, long-term sequelae, and death. Primary vaccination, additional doses, and booster doses are recommended for all eligible persons. Additional future recommendations for vaccine doses might be warranted as the virus and immunity levels change.”

Keywords: vaccination status, vaccinated, unvaccinated, virus variants

Proceeding of The 6th ICE on IMERI 2021

Curcumin as Adjuvant Therapy in Mild-Moderate COVID-19

Authors: Kartika, RW, Tendean, M, Yong, BJC, et al.

“Coronavirus (Covid-19) has spread rapidly to more than 200 countries, including Indonesia. Adjuvant therapy of Vitamin C, D, Zinc has become beneficial for Covid-19 treatment to improve the immune system, while Curcumin is still not standard therapy. Curcumin can stimulate specific immune cells and can reduce oxidative stress. There is currently no scientific evidence showing that the addition of Curcumin can protect COVID-19, especially as an anti-inflammation and anticoagulant effect. This cross-sectional study was conducted at Ukrida Hospital from January -June 2021. The inclusion criteria are Mild-Moderate Covid-19 use on Curcumin and Supplement therapy ( Vitamin C, Vitamin D, and zinc). Data analyses with SPSS v.20 use Anova test and Kruskall Walis test. This study had been approved by The Institutional Board of the Faculty of Medicine Universitas Krida Wacana, Indonesia. To see the effect of Curcumin as an additional therapy from Covid-19 by clinical and laboratory inflammation indicators of the usefulness of Curcumin are such as ratio neutrophil/lymphocyte, ratio platelet/lymphocyte, erythrocyte sedimentation rate (ESR), C-Reactive Protein ( CRP), and D Dimer. There were 246 cases, with 62.6% male and 56.5% female taking Curcumin. Curcumin has a good effect in reducing inflammation and coagulation in mild-moderate Covid-19. Patient who got Curcumin or without Curcumin as additional supplement therapy shows patient that got Curcumin has decreased inflammatory markers, and CRP. Curcumin also has an anticoagulant effect that shows a decrease of D-Dimer. Curcumin is beneficial in mild-moderate Covid-19 as an anti-inflammatory and anticoagulant.”

Keywords: adjuvant therapy, curcumin, anti-inflammatory, anticoagulant

Journal of Liaquat University of Medical & Health Sciences

Evaluation of Pattern and Impact of Electrolytes Abnormalities in Critically Ill Covid-19 Patients

Authors: Haroon, A, Abbas, SA, Khan, A, et al.

“To evaluate the pattern of serum electrolytes abnormalities and their impact on ICU admitted Covid-19 patient outcomes. This retrospective study was carried out at OMI hospital and Dr. Ziauddin Hospital, Karachi, Pakistan, between August to December 2020. Total 102 PCR positive, ICU admitted with severe Covid-19 patients as per WHO criteria were included. The patient’s demographic characteristics, clinical features including co-morbidities, electrolytes reports at the time of admission, length of ICU and/or hospital stay, and outcome (expired/survived) were evaluated. Biochemical testing found abnormal electrolyte levels in 90.2% ICU admitted Covid-19 patients. Electrolytes abnormalities including hyponatremia 45.1%, hypermagnesemia 40.2%, hypocalcemia 31.4%, hyperchloremia23.5% and hyperphosphatemia in 20.6% patients. Out of the total, 28.4% of patients needed invasive respiratory support, and 37.3% of patients could not survive. A higher incidence of mortality (39.1% vs. 20%) was seen in patients with electrolytes abnormalities as compared to the patients presented with normal values. Electrolyte abnormalities were found in 90% of the ICU Admitted Covid-19 patients. The most common abnormalities found among the patients were hyponatremia, hypermagnesemia, and hypocalcemia. The findings revealed that several electrolytes imbalances appear to harm patients’ in-hospital outcomes. Electrolyte assessment of Covid-19 patients at the time of admission would be helpful in risk stratification for adverse outcomes.”

Keywords: critically ill, ICU, serum electrolytes, abnormalities, respiratory support, death

The New England Journal of Medicine

A Possible Role for Anti-idiotype Antibodies in SARS-CoV-2 Infection and Vaccination

Authors: Murphy, WJ, Longo, DL

“The pathogenesis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is incompletely understood, with its effects on multiple organ systems and the syndrome of “long Covid” occurring long after the resolution of infection. The development of multiple efficacious vaccines has been critical in the control of the pandemic, but their efficacy has been limited by the appearance of viral variants, and the vaccines can be associated with rare off-target or toxic effects, including allergic reactions, myocarditis, and immune-mediated thrombosis and thrombocytopenia in some healthy adults. Many of these phenomena are likely to be immune-mediated.3 How can we understand this diversity in immune responses in different persons?”

Keywords: antibodies, immune system, adverse effects

Neurological Sciences

Rare cerebral vein thrombosis and COVID-19 vaccine: the role of orbit ultrasound

Authors: Lochner, P, Fousse, M, Goi Junior, JR et al.

“Vaccine-induced immune thrombotic thrombocytopenia (VITT) and cerebral venous sinus thrombosis (CVST) after viral vector vaccines (ChAdOx1 nCoV-19 vaccine, Ad26.COV2 vaccine) are a rare occurrence for which there is an emerging evidence base [1]. Here, we present a case of CVST without VITT after vaccination with ChAdOx1 nCoV-19 vaccine (AstraZeneca) and discuss the non-invasive diagnostics used to confirm the case.”

Scientific Reports

COVID-19 reinfections among naturally infected and vaccinated individuals

Authors: Rahman, S, Rahman, MM, Miah, M, et al.

“The protection against emerging SARS-CoV-2 variants by pre-existing antibodies elicited due to the current vaccination or natural infection is a global concern. We aimed to investigate the rate of SARS-CoV-2 infection and its clinical features among infection-naïve, infected, vaccinated, and post-infection-vaccinated individuals. A cohort was designed among icddr,b staff registered for COVID-19 testing by real-time reverse transcriptase-polymerase chain reaction (rRT-PCR). Reinfection cases were confirmed by whole-genome sequencing. From 19 March 2020 to 31 March 2021, 1644 (mean age, 38.4 years and 57% male) participants were enrolled; where 1080 (65.7%) were tested negative and added to the negative cohort. The positive cohort included 750 positive patients (564 from baseline and 186 from negative cohort follow-up), of whom 27.6% were hospitalized and 2.5% died. Among hospitalized patients, 45.9% had severe to critical disease and 42.5% required oxygen support. Hypertension and diabetes mellitus were found significantly higher among the hospitalised patients compared to out-patients; risk ratio 1.3 and 1.6 respectively. The risk of infection among positive cohort was 80.2% lower than negative cohort (95% CI 72.6–85.7%; p < 0.001). Genome sequences showed that genetically distinct SARS-CoV-2 strains were responsible for reinfections. Naturally infected populations were less likely to be reinfected by SARS-CoV-2 than the infection-naïve and vaccinated individuals. Although, reinfected individuals did not suffer severe disease, a remarkable proportion of naturally infected or vaccinated individuals were (re)-infected by the emerging variants.”

Lechaschi Vrach

Vitamins D, C and COVID-19

Authors: Rusnak, FI

“In the absence of effective treatment for COVID- 19, various drugs were empirically used. Contradictory literature data, from adherents to complete denial of the use of vitamins D and C in COVID-19, prompted us to analyze the literature data and express our opinion on this issue. In our country and abroad, many medical centers include vitamins D and C in the therapy of a new coronavirus infection. Almost all organs and systems of our body have receptors for vitamin D. This fact indicates the active participation of vitamin D in protecting against infection, allergies, and prolonging human life. People with vitamin D deficiency are more likely to have respiratory infections, anemia, muscle hypotension, and bone fragility. The use of vitamin D in coronavirus infection is effective with daily intake of physiological doses of vitamin D. Compensation for vitamin D deficiency is important for the activation of interferon-dependent antiviral immunity, and for the prevention of «cytokine storm», normalization of the coagulation system, and for the reduction of chronic inf lammation in the presence of concomitant chronic pathologies in the patient. Even the transition from a severe deficiency of vitamin D (25(OH)D < 20 ng/ml) to a moderate deficiency of 25(OH)D (a metabolite of vitamin D, which is used to judge its supply of the body) in the range of 20-30 ng/ml, in Reduces the risk of admission of a patient with pneumonia to the intensive care unit by 3 times and the risk of transfer to mechanical ventilation by 11 times. The use of vitamin C in coronavirus infection is effective by compensating for its existing deficiency and by interacting with other vitamins. An effective way to maintain the level of vitamins D and C in the population is to fortify these vitamins and other nutrients in foods of mass consumption, as well as to take vitamins in other forms. Multivitamins produced in Western countries are mainly designed for people living in these territories, taking into account the common method of fortifying food. For our country, the norms of consumption of vitamins have been substantiated, confirmed by massive studies of the population of different regions. ”

Keywords: vitamin D, vitamin C, vitamins

Nutrients

Changes of 25(OH)D Concentration, Bone Resorption Markers and Physical Performance as an Effect of Sun Exposure, Supplementation of Vitamin D and Lockdown among Young Soccer Players during a One-Year Training Season

Authors: Jastrzębska, J, Skalska, M, Radzimiński, Ł, et al.

“The main purpose of this research was to demonstrate the changes in 25(OH)D concentration, bone resorption markers, and physical fitness along the one-year training season in young soccer players. A total of 24 young soccer players (age: 17.2 ± 1.16 years, mass: 70.2 ± 5.84, height: 179.1 ± 4.26 cm) were tested at four different time points across one year (T1—September 2019; T2—December 2019; T3—May 2020; T4—August 2020). After T2 (during COVID-19 lockdown), players were divided into a supplemented (GS) group and a placebo group (GP). Variables such as 25(OH)D, calcium (Ca), phosphorus (P), parathyroid hormone (PTH), aerobic capacity, speed, and explosive power were measured. Analyses performed for all participants indicated significant changes in all selected blood markers and running speed. The highest values in 25(OH)D were noted during summertime in T1 and T4. After individuals were split into two groups, a two-factorial ANOVA demonstrated a significant time interaction for 25(OH)D, Ca, P, PTH, 30 m sprint, and counter-movement jump. Significant time x group effect was calculated for aerobic capacity. This study confirmed that 25(OH)D concentration varies between four seasons, with the greatest decreases in the low sunlight periods. Vitamin D supplementation did not cause a preventive and long-lasting effect of increasing the 25(OH)D concentration in the young soccer players.”

Keywords: seasonal variation, blood parameters, training load, home isolation

GYMNASIUM Scientific Journal of Education, Sports and Health

Determining the Relationship Between Coronavirus Anxiety Level and Physical Activity in Adults

Authors: Ergin, E, Lok, N, Lok, S

“The aim of this study is to determine the coronavirus anxiety level of individuals, their physical activity levels and to evaluate the relationship between them. The study was carried out in Konya city center, Selçuklu district. Individuals who resided in all neighborhoods of Selçuklu district of Konya province and had not been diagnosed with Covid-19 before or who did not enter contact quarantine due to Covid-19 constituted the study. When the physical activity level of the individuals was evaluated, it was determined that 64.8% of them were not physically active, 19% of them had a low physical activity level and 16.2% had sufficient physical activity level. The coronavirus anxiety scale mean score of the individuals was found to be 11.87 ± 3.85. As a result, while women were in the risk group in terms of physical activity, perceiving their health badly and having any chronic diseases were determined as risk factors. ”

Keywords: physical activity level, anxiety, adults

Revista Virtual de la Sociedad Paraguaya de Medicina Interna

Vitamin D and its role in the COVID-19 pandemic

Authors: Colmán Mc Leod, N

“Vitamin D is now recognised as a hormone, and the last two decades have seen a significant change in the way its influence on human health is viewed. For example, the vitamin D receptor (VDR) and the vitamin D activating enzyme 1-α-hydroxylase (CYP27B1) have been found to be expressed in many cell types such as the intestine, pancreas, prostate and cells of the immune system. This shows that the effect of vitamin D goes far beyond the known connection with phosphocalcium metabolism and bone health.”

Keywords: vitamin D, pandemic

MOJ Biology and Medicine

Current knowledge on the treatment of COVID-19

Authors: Pal, M, Gutama, KP

“COVID-19 is a novel infectious disease that has spread over the world, causing severe morbidity and mortality. Coronavirus-2 (SARS-CoV-2) causes this severe acute respiratory disease. Corona viruses are primarily transmitted from person to person through inhaled or deposited respiratory droplets on the mucosal surfaces, such as aerosols produced during coughing and speaking. COVID-19 and its therapeutic management were poorly understood early in the pandemic, forcing a rush to create experimental medicines, and repurposed pharmaceuticals to combat this unique viral disease. Treatment options include antiviral pharmaceuticals, anti-SARS-CoV-2 monoclonal antibodies, anti-inflammatory drugs, and immunomodulator agents. This mini review focuses on the current developments in the treatment of COVID-19 that has seriously affected the developed as well as developing nations of the world. ”

Keywords: anti-inflammatory drugs, anti-SARS-CoV-2 monoclonal antibodies, antiviral drugs, immunomodulators agents

RSC Medicinal Chemistry

An insight into SARS-CoV2 structure, Pathogenesis, target hunting for drug development and vaccine initiatives

Authors: Ghosh, A, Kar, PK, Gautam, A, et al.

“SARS CoV 2, the virus responsible for the pandemic has been confirmed to be a new coronavirus having 79% and 50% similarity with SARS CoV and MERS CoV respectively. For better understanding of the features of the new virus SARS CoV 2 we have discussed possible correlation between some unique features of the genome of SARS CoV 2 in relation to pathogenesis and transmission. We have also reviewed structural druggable viral and host targets for possible clinical application if any as the cases of reinfection and compromised protection due to emergence of new strains with increased infectivity even after vaccination. We have also discussed on the types of vaccines that are being developed SARS-CoV-2. In this review we have tried to give a brief overview on the fundamental factors of Covid 19 research like basic virology, virus strains and as well as the new emerging techniques and learning-based approaches that can be applied to develop advanced treatment strategies for the management of Covid-19 disease. We further focused on the socioeconomic and demographic factors, oviding some statistical tools that can be useful to control the transmission of the disease.”

Keywords: virus

Annals of Medicine and Surgery

SARS-CoV-2 vaccine-associated-tinnitus: A review

Authors: Ahmed, SH, Waseem, S, Shaikh, TG, et al.

“The global vaccination drive against severe acute respiratory syndrome coronavirus-2 is being pursued at a historic pace. Unexpected adverse effects have been reported following vaccination, including thrombotic thrombocytopenia, myocarditis, amongst others. More recently, some cases of tinnitus are reported post-vaccination. According to the Vaccine Adverse Events Reporting System (VAERS), 12,247 cases of coronavirus post-vaccination tinnitus have been reported till September 14, 2021. To the best of our knowledge, this is the first review evaluating any otologic manifestation following vaccine administration and aims to evaluate the potential pathophysiology, clinical approach, and treatment. Although the incidence is infrequent, there is a need to understand the precise mechanisms and treatment for vaccine-associated-tinnitus.”

Keywords: Vaccines, mRNA

JAMA Network

Myocarditis Cases Reported After mRNA-Based COVID-19 Vaccination in the US From December 2020 to August 2021

Authors: Oster, ME, Shay, DK, Su, JR, et al

“Based on passive surveillance reporting in the US, the risk of myocarditis after receiving mRNA-based COVID-19 vaccines was increased across multiple age and sex strata and was highest after the second vaccination dose in adolescent males and young men. This risk should be considered in the context of the benefits of COVID-19 vaccination.”

JAMA

Myocarditis Cases Reported After mRNA-Based COVID-19 Vaccination in the US From December 2020 to August 2021

Authors: Oster, ME, Shay, DK, Su, JR, et al.

“Question: What is the risk of myocarditis after mRNA-based COVID-19 vaccination in the US? – Findings: In this descriptive study of 1626 cases of myocarditis in a national passive reporting system, the crude reporting rates within 7 days after vaccination exceeded the expected rates across multiple age and sex strata. The rates of myocarditis cases were highest after the second vaccination dose in adolescent males aged 12 to 15 years (70.7 per million doses of the BNT162b2 vaccine), in adolescent males aged 16 to 17 years (105.9 per million doses of the BNT162b2 vaccine), and in young men aged 18 to 24 years (52.4 and 56.3 per million doses of the BNT162b2 vaccine and the mRNA-1273 vaccine, respectively). – Meaning: Based on passive surveillance reporting in the US, the risk of myocarditis after receiving mRNA-based COVID-19 vaccines was increased across multiple age and sex strata and was highest after the second vaccination dose in adolescent males and young men.”

Keywords: COVID-19, SARS-CoV-2, Myocarditis, BNT162b2, mRNA-1273

International Journal of Medical Sciences

Potential Genes Associated with COVID-19 and Comorbidity

Authors: Feng, S, Song, F, Guo, W, et al.

“Hypertension, diabetes mellitus, and coronary artery disease are common comorbidities and dangerous factors for infection and serious COVID-19. Polymorphisms in genes associated with comorbidities may help observe susceptibility and disease severity variation. However, specific genetic factors and the extent to which they can explain variation in susceptibility of severity are unclear. Therefore, we evaluated candidate genes associated with COVID-19 and hypertension, diabetes mellitus, and coronary artery disease. In particular, we performed searches against OMIM, NCBI, and other databases, protein-protein interaction network construction, and GO and KEGG pathway enrichment analyses. Results showed that the associated overlapping genes were TLR4, NLRP3, MBL2, IL6, IL1RN, IL1B, CX3CR1, CCR5, AGT, ACE, and F2. GO and KEGG analyses yielded 302 GO terms and 29 signaling pathways, respectively, mainly including coronavirus disease-COVID-19 and cytokine-cytokine receptor interaction. IL6 and AGT were central in the PPI, with 8 and 5 connections, respectively. In this study, we identified 11 genes associated with both COVID-19 and three comorbidities that may contribute to infection and disease severity. The key genes IL6 and AGT are involved in regulating immune response, cytokine activity, and viral infection. Therefore, RAAS inhibitors, AGT antisense nucleotides, cytokine inhibitors, vitamin D, fenofibrate, and vaccines regulating non-immune and immune factors could be potential strategies to prevent and cure COVID-19. The study provides a basis for further investigation of genes and pathways with predictive value for the risk of infection and prognosis and could help guide drug and vaccine development to improve treatment efficacy and the development of personalised treatments, especially for COVID-19 individuals with common comorbidities.”

Keywords: comorbidity, bioinformatics, susceptibility gene, disease severity

Life

Case Report of Cerebral Sinus Thrombosis Related to Immune Thrombotic Thrombocytopenia Following Administration of ChAdOx1 nCoV-19 for Vaccination against COVID-19

Authors: Szypowski, W, Debiec, A, Swistak, J, et al.

“Vaccine-induced immune thrombotic thrombocytopenia (VITT) with cerebral venous sinus thrombosis (CVST) has been recently reported after vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We present a case of a patient with fulminant CVST and thrombocytopenia after receiving the ChAdOx1 nCoV-19 vaccine. Although the patient received immediate anticoagulant and intravenous immune globulin treatment, he died within 24 h after hospital admission. VITT and CVST are rare conditions; however, the course may be fatal. Therefore, clinicians should be familiarized with the clinical and laboratory features of VITT.”

Keywords: COVID-19 vaccine, CVST, VITT, thrombocytopenia

Frontiers in Immunology

Is There a Crucial Link Between Vitamin D Status and Inflammatory Response in Patients With COVID-19?

Authors: Saponaro, F, Franzini, M, Okoye, C, et al.

“ Hypovitaminosis D has been suggested to play a possible role in coronavirus disease 2019 (COVID-19) infection. The aim of this study is to analyze the relationship between vitamin D status and a biochemical panel of inflammatory markers in a cohort of patients with COVID-19. A secondary endpoint was to evaluate the correlation between 25OHD levels and the severity of the disease. Ninety-three consecutive patients with COVID-19-related pneumonia were evaluated from March to May 2020 in two hospital units in Pisa, in whom biochemical inflammatory markers, 25OHD levels, P/F ratio at nadir during hospitalization, and complete clinical data were available. Sixty-five percent of patients presented hypovitaminosis D (25OHD ≤ 20 ng/ml) and showed significantly higher IL-6 [20.8 (10.9–45.6) vs. 12.9 (8.7–21.1) pg/ml], CRP [10.7 (4.2–19.2) vs. 5.9 (1.6–8.1) mg/dl], TNF-α [8.9 (6.0–14.8) vs. 4.4 (1.5–10.6) pg/ml], D-dimer [0.53 (0.25–0.72) vs. 0.22 (0.17–0.35) mg/l], and IL-10 [3.7 (1.8–6.9) vs. 2.3 (0.5–5.8) pg/ml]. A significant inverse correlation was found between 25OHD and all these markers, even adjusted for age and sex. Hypovitaminosis D was prevalent in patients with severe ARDS, compared with the other groups (75% vs. 68% vs. 55%), and 25OHD levels were lower in non-survivor patients. The relationship between 25OHD levels and inflammatory markers suggests that vitamin D status needs to be taken into account in the management of these patients. If vitamin D is a marker of poor prognosis or a possible risk factor with beneficial effects from supplementation, this still needs to be elucidated.”

Keywords: vitamin D, hypovitaminosis, severity

AIDS Reviews

Oral antivirals for the prevention and treatment of SARS-CoV-2 infection

Authors: Soriano, V, de-Mendoza, C, Edagwa, B, et al.

“Vaccines and antivirals are the classical weapons deployed to contain, prevent, and treat life-threatening viral illnesses. Specifically, for SARS-CoV-2 infection, vaccines protect against severe COVID-19 disease manifestations and complications. However, waning immunity and emergence of vaccine escape mutants remains a growing threat. This is highlighted by the current surge of the omicron COVID-19 variant. Thus, there is a race to find treatment alternatives. We contend that oral small molecule antivirals that halt SARSCoV- 2 infection are essential. Compared to currently available monoclonal antibodies and remdesivir, where parenteral administration is required, oral antivirals offer treatments in an outpatient setting with dissemination available on a larger scale. In response to this need at 2021’s end, regulatory agencies provided emergency use authorization for both molnupiravir and nirmatrelvir. These medicines act on the viral polymerase and protease, respectively. Each is given for 5 days and can reduce disease progression by 30% and 89%, respectively. The advent of additional oral antivirals, the assessment of combination therapies, the formulation of extended-release medications, and their benefit for both early treatment and prophylaxis will likely transform the landscape of the COVID-19 pandemic.”

Keywords: antiviral therapy, combination therapy, long-acting antivirals, Molnupiravir, mutagenesis, Nirmatrelvir, oral Remdesivir, prophylaxis, protease inhibitors

Human Vaccines & Immunotherapeutics

Immunomodulatory and therapeutic implications of vitamin D in the management of COVID-19

Authors: Dhawan, M, Priyanka, Choudhary, OP

“COVID-19 has caused severe financial, clinical, and sociological consequences besides posing a burden on healthcare. Many nutritional approaches have been employed to manage the deleterious consequences of COVID-19. Among the several micronutrients, vitamin D deprivation has been linked to an increased likelihood of hospitalization of COVID-19 patients. Vitamin D has been reported to be a critical regulator of the renin-angiotensin system, which is used by the SARS-CoV-2 to access the host cell. Vitamin D also modulates the multiple immune system mechanisms to contain the virus, including the curtailment of the viral entry into the host cell. The adequate levels of vitamin D in the host have been associated with the reduced release of proinflammatory cytokines, thus lowering the risk of a cytokine storm; increased levels of anti-inflammatory cytokines and enhanced secretion of natural antimicrobial peptides. It may also be involved in the enhancement of the Th2 immune response and activation of defensive cells such as macrophages. Contrary to these findings, several studies have concluded that there is no direct association between vitamin D concentrations and poor prognosis of the disease. Hence, this paper aims to decipher the immunoregulatory properties of vitamin D and its possible involvement in management of COVID-19.”

Keywords: immunomodulation, therapeutic, vitamin D

Cell

Immune imprinting, breadth of variant recognition, and germinal center response in human SARS-CoV-2 infection and vaccination

Authors: Röttgen, K, Nielsen, SCA, Silva, O, et al.

“During the SARS-CoV-2 pandemic, novel and traditional vaccine strategies have been deployed globally. We investigated whether antibodies stimulated by mRNA vaccination (BNT162b2), including third-dose boosting, differ from those generated by infection or adenoviral (ChAdOx1-S and Gam-COVID-Vac) or inactivated viral (BBIBP-CorV) vaccines. We analyzed human lymph nodes after infection or mRNA vaccination for correlates of serological differences. Antibody breadth against viral variants is lower after infection compared with all vaccines evaluated but improves over several months. Viral variant infection elicits variant-specific antibodies, but prior mRNA vaccination imprints serological responses toward Wuhan-Hu-1 rather than variant antigens. In contrast to disrupted germinal centers (GCs) in lymph nodes during infection, mRNA vaccination stimulates robust GCs containing vaccine mRNA and spike antigen up to 8 weeks postvaccination in some cases. SARS-CoV-2 antibody specificity, breadth, and maturation are affected by imprinting from exposure history and distinct histological and antigenic contexts in infection compared with vaccination.”

Keywords: BNT162b2, Moderna, mRNA-1273, ChAdOx1-S, Sputnik V, Gam-COVID-Vac, Sinopharm, BBIBP-CorV, imprinting, Delta variant, endemic coronaviruses, antibodies, lymph node germinal center, Vaccines, AstraZeneca

German Journal of Exercise and Sport Research

Perceiving reduced physical activity during COVID-19 lockdown is related to lower quality of life: a cross-sectional study with young adults

Authors: Niermann, C, Bollenbach, L, Kanning, M

“Physical activity and social participation are positively related to mental health and represent resources that strengthen individuals’ resilience. However, the measures aiming to contain the coronavirus disease 2019 (COVID-19) pandemic included restrictions regarding these health resources. For many people, stay-at-home orders had a negative effect on mental health and health-related behaviors such as physical activity. Young adults seem to be a particularly vulnerable group. The study aimed to examine the relationship between changes in physical activity and perceived quality of life in young adults during lockdown conditions. We conducted an online survey during the second lockdown in Germany and assessed perceived changes in physical activity, social activities, quality of life (QoL), the perceived burden of changes in social activities, and current QoL in 212 young adults (63.7% women, mean age = 23.46, standard deviation = 3.63). Young adults that maintained or increased their physical activity level under lockdown conditions, rated their current QoL higher and perceived a less negative change of their QoL during lockdown compared to those with decreased physical activity. Furthermore, those who rated that their physical activity levels did not change or increased, perceived the reduction of their social activities as less burdening. The results indicate that physical activity is a beneficial health resource during lockdown conditions. This highlights the importance of gaining knowledge regarding the antecedents of reducing physical activity and developing strategies that support young adults to be physically active in challenging times such as the pandemic (e.g. ehealth/mhealth approaches). ”

Keywords: mental health, well-being, sports exercise, pandemic

Journal of Risk and Financial Management

COVID-19: Barriers to Physical Activity in Older Adults, a Decline in Health or Economy?

Authors: Jiao, J, Supriya, R, Chow, BC, et al.

“Since spring 2020, in response to the global threat of the Coronavirus Disease 2019 (COVID-19) pandemic, several governments implemented emergency policies and regulations to prevent further transmission of the disease. Social distancing, isolation or lock-downs have been adopted to control the transmission and protect citizens. These regulations involve typically restricting the mobility of citizens and the closure of activity destinations. Although the measures could “flatten the curve” of new cases and minimize the infection rates, the restrictions have also had significant impacts on citizens’ health and well-being due to the amplification of the barriers to physical activity (PA). The impacts may be more obvious and impactful to vulnerable populations, namely, the elderly and those with chronic medical conditions and individuals with sedentary behaviors. Evidence has shown that the decline in PA could represent an increased risk of developing functional limitations and daily living disabilities, chronic diseases such as cardiovascular disease, obesity, cognitive decline, dementia, depression and the rate of all-cause mortality. In contrast, there are numerous benefits for improving PA, which have been thoroughly reported in previous studies. The level of and engagement in PA are also associated with the economy of a country, especially from the aspects of healthcare and medication. According to a previous report from Australia, almost 7% of Australia’s health burden was attributed to physical inactivity, with the main contributors being ischemic heart disease (51%), type 2 diabetes (20%) and stroke (14%). The diseases usually occur in elderly adults. This indicates that elderly populations would be badly affected by COVID-19 but would also gain the most benefit from increased levels of PA. The increased PA levels would result in a decreased occurrence of the disease and facilitate a decline in future economic demands of healthcare and medication.”

Keywords: pandemic, physical activity, older adults

International Journal of Environmental Research and Public Health

The Biological Role of Vitamins in Athletes’ Muscle, Heart and Microbiota

Authors: Brancaccio, M, Mennitti, C, Cesaro, A, et al.

“Physical activity, combined with adequate nutrition, is considered a protective factor against cardiovascular disease, musculoskeletal disorders, and intestinal dysbiosis. Achieving optimal performance requires a significantly high energy expenditure, which must be correctly supplied to avoid the occurrence of diseases such as muscle injuries, oxidative stress, and heart pathologies, and a decrease in physical performance during competition. Moreover, in sports activities, the replenishment of water, vitamins, and minerals consumed during training is essential for safeguarding athletes’ health. In this scenario, vitamins play a pivotal role in numerous metabolic reactions and some muscle biochemical adaptation processes induced by sports activity. Vitamins are introduced to the diet because the human body is unable to produce these micronutrients. The aim of this review is to highlight the fundamental role of vitamin supplementation in physical activity. Above all, we focus on the roles of vitamins A, B6, D, E, and K in the prevention and treatment of cardiovascular disorders, muscle injuries, and regulation of the microbiome. ”

Keywords: micronutrients, athletic performance, nutrition, gut microbiota, cardiac pathologies, muscle damage

International Journal of Infectious Diseases

COVID-19 pneumonia patients with 25(OH)D levels lower than 12 ng/ml are at increased risk of death

Authors: Juralj, S, Martin, K, Brázdilová, et al.

“There is no consensus about specific serum 25(OH)D levels associated with higher risk of severe outcome in COVID-19 patients. According to the literature patients with serum 25(OH)D levels < 12 ng/ml are clearly deficient at all ages. Our aim was to assess COVID-19 mortality in the settings of severe 25(OH)D deficiency. A cohort study of 357 COVID-19 patients was conducted. Subjects were monitored until discharge or in-hospital death. At admission, severity parameters (CRP, IL-6, Charlson Comorbidity Index etc.) were assessed. These parameters were compared regarding 25(OH)D levels threshold 12 ng/ml, where values below 12 ng/ml were considered absolute vitamin D deficiency. 25(OH)D levels at the time of admission were independently associated with mortality. Non-survivors (N=168) had lower 25(OH)D levels, SO2, higher age, CRP, viral load, and Charlson Comorbidity Index in comparison to survivors. Patients with serum 25(OH)D levels < 12 ng/ml had higher mortality (55% vs. 45 %), viral load (21.5 vs 23.1) and Charlson Comorbidity Index (5.3 vs 4.4) in comparison to those with serum 25(OH)D levels >12 ng/ml. COVID-19 patients with serum 25(OH)D levels < 12 ng/ml have higher mortality. Among other factors, severe vitamin D deficiency likely leads to poor outcome.”

Keywords: vitamin D, mortality

Biological Trace Element Research

Comparative Analysis of Serum Zinc, Copper and Magnesium Level and Their Relations in Association with Severity and Mortality in SARS-CoV-2 Patients

Authors: PVSN, KK, Tomo, S, Purohit, P, et al.

“The deficiencies of trace elements and infectious diseases often coexist and exhibit complex interactions. Several trace elements such as zinc (Zn), copper (Cu) and magnesium (Mg) have immunomodulatory functions and thus influence the susceptibility to the course and outcome of a variety of viral infections. So, this present study was aimed to study relations of trace metals in association with severity and mortality in SARS-CoV-2 patients. A total of 150 individuals infected with COVID-19 and 50 healthy individuals were recruited. Cases were divided based on severity (mild, moderate and severe) and outcome (discharged or deceased). Serum Zn, Mg and Cu levels were analysed by direct colourimetric method. Both serum Cu and Zn levels were significantly decreased in cases when compared to those in controls. Serum magnesium levels although not significant were found to be slightly decreased in controls. On comparing the trace elements between the deceased and discharged cases, a significant difference was found between serum copper and zinc levels, but for magnesium, both groups have similar levels. The receiver operating characteristic (ROC) curve results indicate that a serum Cu/Zn ratio along with the age of patient provides some reliable information on COVID-19 course and survival odds by yielding an AUC of 95.1% with a sensitivity of 93.8% and specificity of 89.8%. Therefore, we would like to emphasize that measuring the serum copper and zinc along with their ratio can be used as routine investigations for COVID-19 patients in proper identification and management of severe cases in upcoming new waves of COVID-19. ”

Keywords: magnesium, zinc, copper, severity, mortality

Researchgate

Preprint

Innate Immune Suppression by SARS-CoV-2 mRNA Vaccinations: The role of G-quadruplexes, exosomes and microRNAs

Authors: Seneff, S, Nigh, G, Kyriakopoulos, AM, et al

“The mRNA SARS-CoV-2 vaccines were brought to market in response to the widely perceived public health crises of Covid-19. The utilization of mRNA vaccines in the context of infectious disease had no precedent, but desperate times seemed to call for desperate measures. The mRNA vaccines utilize genetically modified mRNA encoding spike proteins. These alterations hide the mRNA from cellular defenses, promote a longer biological half-life for the proteins, and provoke higher overall spike protein production. However, both experimental and observational evidence reveals a very different immune response to the vaccines compared to the response to infection with SARS-CoV-2. As we will show, the genetic modifications introduced by the vaccine are likely the source of these differential responses. In this paper, we present the evidence that vaccination, unlike natural infection, induces a profound impairment in type I interferon signaling, which has diverse adverse consequences to human health. We explain the mechanism by which immune cells release into the circulation large quantities of exosomes containing spike protein along with critical microRNAs that induce a signaling response in recipient cells at distant sites. We also identify potential profound disturbances in regulatory control of protein synthesis and cancer surveillance. These disturbances are shown to have a potentially direct causal link to neurodegenerative disease, myocarditis, immune thrombocytopenia, Bell’s palsy, liver disease, impaired adaptive immunity, increased tumorigenesis, and DNA damage. We show evidence from adverse event reports in the VAERS database supporting our hypothesis. We believe a comprehensive risk/benefit assessment of the mRNA vaccines excludes them as positive contributors to public health, even in the context of the Covid-19 pandemic.”

Sustainability

Effects of a Three-Month COVID-19 Lockdown on Body Mass and Nutritional Status of Lebanese Students Who Study Physical Education

Authors: El Zoghbi, A, Milanović, I, Janić, SR, et al.

“This study investigated the effects of a three-month COVID-19 lockdown on the body mass of Lebanese students who study physical education and whether these changes reflected in distribution changes in underweight, normal weight, and overweight/obese status. Furthermore, the study investigated whether lockdown affected physical activity behavior and if students who reduced the frequency of training sessions were more likely to increase their body mass. Body mass and body height were assessed in 174 Lebanese physical education students immediately before and at the end of COVID-19 lockdown. Their training routine was assessed using by questionnaire. Wilcoxon signed-rank order assessed the effects of lockdown on body mass, while Chi square test tested the differences in distribution of underweight, normal weight, and overweight/obese status before and after the lockdown. In general, there was a significant (p < 0.001) small increase in body mass. However, about 27% of participants had a moderate to major increase in body mass. This was reflected in a significant shift in nutritional status as the number of overweight/obese students increased by 5.2%. In addition, students who reduced their training frequency due to lockdown were three times more likely to increase body mass than those who remained active (i.e., 38 vs. 5 with moderate to major increase). Given that an increase in body mass increases all health risks, remaining physically active is of high importance for health prevention, especially considering all other positive effects of physical activity on cardio-respiratory and muscle function.”

Keywords: physical activity, sustainable health, education, obesity

Nutrients

The Immunologic Profile of Vitamin D and Its Role in Different Immune-Mediated Diseases: An Expert Opinion

Authors: Giannini, S, Giusti, A, Minisola, S, et al.

“Historically, vitamin D is recognized as an essential component for the maintenance of the musculoskeletal system. The immunomodulatory role of vitamin D in health and disease has gained much interest in recent years due to the many pathologies that share underlying immunological features where vitamin D has been shown to exert a potential role. Evidence from pre-clinical studies show that vitamin D elicits biological effects on both the innate and adaptive immune systems. Furthermore, in vivo studies have shown that administration of vitamin D can lead to changes in or the development of a range of immune-related diseases. This encourages the hypothesis that data derived from clinical and epidemiological studies connect vitamin D with the incidence and severity of many immune-mediated disorders such as rheumatoid arthritis, diabetes, and infectious diseases. Since some other immune-mediated diseases share similar features to that of viral infection such as COVID-19, in this review, we examined these other areas and the role of vitamin D in these diseases. ”

Keywords: vitamin D, immune-mediated disease, cholecalciferol

International Journal of Molecular Sciences

Metallic Structures: Effective Agents to Fight Pathogenic Microorganisms

Authors: Pereira, D, Carreira, TS, Alves, N, et al.

“The current worldwide pandemic caused by coronavirus disease 2019 (COVID-19) had alerted the population to the risk that small microorganisms can create for humankind’s wellbeing and survival. All of us have been affected, directly or indirectly, by this situation, and scientists all over the world have been trying to find solutions to fight this virus by killing it or by stop/decrease its spread rate. Numerous kinds of microorganisms have been occasionally created panic in world history, and several solutions have been proposed to stop their spread. Among the most studied antimicrobial solutions, are metals (of different kinds and applied in different formats). In this regard, this review aims to present a recent and comprehensive demonstration of the state-of-the-art in the use of metals, as well as their mechanisms, to fight different pathogens, such as viruses, bacteria, and fungi.”

Keywords: antimicrobial agents, bacteria, fungi, metals, virus

International Journal of Environmental Research and Public Health

Changes in Physical Activity and the Occurrence of Specific Symptoms of “Long-COVID Syndrome” in Men Aged 18–25

Authors: Sojka, A, Machniak, M, Andrzejewski, W, et al.

“The aim of this study was to assess the occurrence of non-specific symptoms of “long-COVID syndrome” depending on the physical activity undertaken resulting from the imposed forms of study (distance learning–contact learning); 136 men aged 21.5 ± 1.58 from universities educating students of medical faculties were examined. The difference between the universities was mainly due to the nature of the classes undertaken (classes remotely-hybrid form) in the period from March 2020 to February 2021. Among the respondents, 17% in Group I and 16% in Group II were infected with the SARS-CoV-2 virus, including 50% in Group I with moderate symptoms, and in Group II—most people 45% with mild symptoms. The conducted research clearly shows the impact of the COVID-19 pandemic on students. They show a number of important problems, such as reduced physical activity, as well as increased body weight and time spent in front of the monitor. They also make it clear that the health consequences of the pandemic affect both people who were infected with the SARS-CoV-2 virus and those who did not suffer from this infection.”

Keywords: COVID-19 restrictions, physical activity after the pandemic, long-COVID syndrome

International Journal of Environmental Research and Public Health

Change in Depression and Its Determinants during the COVID-19 Pandemic: A Longitudinal Examination among Racially/Ethnically Diverse US Adults

Authors: Zhang, Y, Janda, KM, Ranjit, N, et al.

“This study examined longitudinal data to identify changes in the occurrence of depressive symptoms, and to explore if such changes were associated with socio-demographic, movement behaviors, and health variables during the COVID-19 pandemic, among a diverse sample of central Texas residents. Participants who completed two online surveys in 2020 (in June and November) from an on-going longitudinal study were included. Depressive symptoms were measured by Patient Health Questionnaire-2. Change in depressive symptoms’ occurrence status between the two time points was categorized into (1) stable/improved, and (2) consistent depressive symptoms/declined. Sociodemographic factors, movement behaviors and health data were self-reported. Statistical analyses utilized descriptive statistics and logistical regression. Among a total of 290 individuals (84.1% female; 71.0% racial/ethnic minorities), 13.5% were categorized as consistent depressive symptoms/declined. Multivariable logistic regression indicated that racial/ethnic minorities, older age, and increased physical activity were associated with a lower likelihood, while greater sedentary time was associated with higher likelihood of consistent depressive symptoms/declined status. Between 3 months and 8 months into the pandemic, various socio-demographic and behavioral variables were associated with changes in depressive symptoms’ occurrence status. Future research should explore the longer-term impacts of COVID-19 on depression among a diverse population and identify risk factors for depression. ”

Keywords: depression, racial/ethnic minorities, health behaviors, longitudinal design, mental health, physical activity, sedentary time

JMIR Formative Research

Designing an Adaptive Adolescent Physical Activity and Nutrition Intervention for COVID-19–Related Health Challenges: Formative Research Study

Authors: Grimes, A, Lightner, JS, Pina, K, et al.

“With rates of childhood obesity continually increasing, effective physical activity and nutrition interventions are needed. Formative research is used to tailor interventions to different cultural and geographic contexts and can be vital in adapting intervention strategies in the face of significant disruptive circumstances (like COVID-19). We conducted formative research via in-person and web-based focus groups among middle schoolers and parents to better understand the facilitators and barriers to physical activity and fruit and vegetable consumption and to inform the design of a large intervention for a low-income, urban setting in the US Midwest. We conducted 2 phases of qualitative focus groups with parents (n=20) and 6th-9th grade middle schoolers (n=23). Phase 1 was conducted prior to the COVID-19 pandemic in late 2019, and phase 2 was conducted during the COVID-19 pandemic in the summer of 2020. Focus groups were transcribed and thematically coded using the Dedoose software. The main facilitators of physical activity prior to the pandemic included the opportunity to have fun, peer influence, competition (for some), and incentives, while the main barriers to physical activity were time constraints and social discomfort. The main facilitators of eating fruits and vegetables included parental influence, preparation technique, and convenience, while barriers included dislike of vegetables, time constraints, and preparation or freshness. During the pandemic, facilitators of physical activity remained the same, while additional barriers to physical activity such as lack of motivation and limited time spent outside of the home were reported. For fruit and vegetable consumption, both facilitators and barriers remained the same for both time periods. Additionally, for some participants, the pandemic offered an opportunity to offer more fruits and vegetables to middle schoolers throughout the day. Some themes identified were common to those reported in previous studies, such as peer influence on physical activity and parental influence on fruit and vegetable consumption. Novel themes such as lack of motivation to be active and limited time outside the home helped improve intervention adaptation, specifically during the COVID-19 pandemic. The continuity of formative research after a major unexpected change in the intervention context can be essential in targeting areas of an intervention that can be retained and those that need to be adjusted. ”

Keywords: intervention, physical activity, nutrition, exercise, young adult, teenager

BMC Public Health

Impact of Dutch COVID-19 restrictive policy measures on physical activity behavior and identification of correlates of physical activity changes: a cohort study

Authors: Schoofs, MCA, Bakker, EA, de Vries, F, et al.

“Identification of characteristics of individuals that are related to decreases in physical activity (PA) levels during lockdown is needed to develop targeted-interventions. This study aims to evaluate changes in domain-specific (i.e. leisure time, transportation, occupational, and household) and total PA due to the Dutch COVID-19 lockdown, which started on March 15 2020. Furthermore, we aim to identify demographic, health-related, and psychological correlates of these changes. Individuals who participated in the Nijmegen Exercise Study during 2017-2019 were invited to this study, which was conducted between April 16 and May 12 2020. Participant characteristics (i.e. age, sex, body mass index (BMI), marital status, education, household composition, and occupation status), living environment (i.e. housing type and degree of urbanization), psychological characteristics (i.e. resilience, outcome expectations, vitality, and mental health), and medical history were collected via an online questionnaire. Short Questionnaire to Assess Health-enhancing physical activity was used to assess PA behavior before and during lockdown. Wilcoxon signed-rank test was used to compare PA levels, in metabolic equivalent of task (MET)-minutes per week (min/wk), before and during lockdown. Multivariable linear regression analyses were performed to examine correlates of PA changes. 4033 participants (57% male; 59 ± 13 years) were included. PA decreased significantly during lockdown with mean ± SD changes of 393 ± 2735 MET-min/wk for total, 133 ± 785 MET-min/wk for transportation, 137 ± 1469 MET-min/wk for occupation, and 136 ± 1942 MET-min/wk for leisure time PA. Household PA did not change significantly. Unemployment, COVID-19-related occupational changes, higher BMI, and living in an apartment or semi-detached/terraced house were significantly related to larger decreases in total and domain-specific PA. Higher vitality was related to smaller decreases in total and domain-specific PA. Higher age was significantly associated with a larger decrease in leisure time PA. Lower education was associated with smaller decreases in transportation and occupational PA compared to higher education. PA levels significantly reduced during lockdown compared to before lockdown. Declines were observed during transportation and occupation, but were not compensated by an increase in leisure time PA. We identified subgroups that were more susceptible to reductions in domain-specific or total PA levels and should therefore be encouraged to increase their PA levels during lockdown.”

Keywords: lockdown, physical activity

Nano Today

Principles for optimization and validation of mRNA lipid nanoparticle vaccines against COVID-19 using 3D bioprinting

Authors: Papi, M, Pozzi, D, Palmieri, V, et al.

“BioNTech/Pfizer’s Comirnaty and Moderna’s SpikeVax vaccines consist in mRNA encapsulated in lipid nanoparticles (LNPs). The modularity of the delivery platform and the manufacturing possibilities provided by microfluidics let them look like an instant success, but they are the product of decades of intense research. There is a multitude of considerations to be made when designing an optimal mRNA-LNPs vaccine. Herein, we provide a brief overview of what is presently known and what still requires investigation to optimize mRNA LNPs vaccines. Lastly, we give our perspective on the engineering of 3D bioprinted validation systems that will allow faster, cheaper, and more predictive vaccine testing in the future compared with animal models.”

Keywords: Vaccines, Lipid nanoparticles, Bioprinting, Administration route, mRNA

IDCases

Multisystem Inflammatory Syndrome after Ad26.COV2.S vaccination

Authors: Bova, C, Vigna, E, Gentile, M

“The multisystem inflammatory syndrome (MIS) is a rare and sometime life-threatening post-infectious complication of coronavirus disease 2019 (Covid-19) in children and adults. To date, only a very few reports have associated such systemic reaction with SARS-CoV-2 vaccination. Case report. We describe a case that resembled MIS, in a 46-year-old White man, 12 days after vaccination with Ad26. COV2. S vaccine (Johnson &Johnson/Janssen), a recombinant adenovirus serotype 26 vector encoding the SARS-CoV-2 spike glycoprotein. The patient experienced high grade fever, cutaneous rash, severe weakness, pericardial effusion and raised inflammatory markers, which met the criteria for definition of MIS. The symptoms improved with steroidal therapy. Our case suggests that MIS could occur after SARS-CoV-2 vaccination.”

Keywords: Multisystem inflammatory syndrome, Vaccines

arXiv

Preprint

Insights from a computational analysis of the SARS-CoV-2 Omicron variant: Host-pathogen interaction, pathogenicity, and possible therapeutics

Authors: Parvez, SA, Saha, MK, Ibrahim, et al.

“Prominently accountable for the upsurge of COVID-19 cases as the world attempts to recover from the previous two waves, Omicron has further threatened the conventional therapeutic approaches. Omicron is the fifth variant of concern (VOC), which comprises more than 10 mutations in the receptor-binding domain (RBD) of the spike protein. However, the lack of extensive research regarding Omicron has raised the need to establish correlations to understand this variant by structural comparisons. Here, we evaluate, correlate, and compare its genomic sequences through an immunoinformatic approach with wild and mutant RBD forms of the spike protein to understand its epidemiological characteristics and responses towards existing drugs for better patient management. Our computational analyses provided insights into infectious and pathogenic trails of the Omicron variant. In addition, while the analysis represented South Africa’s Omicron variant being similar to the highly-infectious B.1.620 variant, mutations within the prominent proteins are hypothesized to alter its pathogenicity. Moreover, docking evaluations revealed significant differences in binding affinity with human receptors, ACE2 and NRP1. Owing to its characteristics of rendering existing treatments ineffective, we evaluated the drug efficacy against their target protein encoded in the Omicron through molecular docking approach. Most of the tested drugs were proven to be effective. Nirmatrelvir (Paxlovid), MPro 13b, and Lopinavir displayed increased effectiveness and efficacy, while Ivermectin showed the best result against Omicron.”

Keywords: Omicron variant, ACE2, NRP1, drugs efficacy, host-pathogen interaction

International Journal of Environmental Research and Public Health

Micronutrient Deficiency as a Confounder in Ascertaining the Role of Obesity in Severe COVID-19 Infection

Authors: Chu, BA, Sarampudi, V, Li, Z, et al.

“Food insecurity in the United States has been exacerbated due to the socioeconomic strain of the coronavirus disease 2019 (COVID-19) pandemic. Populations experiencing poverty and, as a consequence, food insecurity in the United States are disproportionately affected by obesity, which was identified early in the pandemic as a major risk factor for increased susceptibility to COVID-19 infection and mortality. Given the focus on obesity and its role in immune dysregulation, it is also important to note the role of micronutrient deficiency, another sequalae of food insecurity. Micronutrients play an important role in the ability of the immune system to mount an appropriate response. Moreover, OBESE individuals are more likely to be micronutrient deficient. This review will explore the role of micronutrients, vitamin A, vitamin D, vitamin C, and zinc in respiratory immunity and COVID-19 and how micronutrient deficiency may be a possible confounder in obesity’s association with severe outcomes. By illuminating the role of micronutrients in COVID-19, this paper expands the discussion from food insecurity and obesity to include micronutrient deficiency and how all of these interact in respiratory illnesses such as COVID-19. ”

Keywords: micronutrients, vitamin D, vitamin A, respiratory infections, obesity, food insecurity

Disease Markers

The Prognostic Role of Metabolic and Endocrine Parameters for the Clinical Severity of COVID-19

Authors: Bonakdaran, S, Layegh, P, Hasani, S, et al.

“An outbreak of coronavirus disease-19 (COVID-19) began in December 2019 and spread globally, overwhelming the entire world. COVID-19 is a public health emergency of international concern. Due to its high morbidity and mortality rate, recognition of its risk and prognostic factors is important. We aimed to understand the relationship between metabolic and endocrine parameters and the prognosis of COVID-19. This was a cross-sectional clinical study. A total of 70 patients with severe COVID-19 were enrolled. Laboratory results at the first admission time (including complete blood count, C-reactive protein, lactate dehydrogenase, blood glucose, calcium, phosphate, albumin, creatinine, magnesium, lipid profiles, liver enzymes, thyroid hormones, cortisol, and vitamin D) and outcome data were recorded. We divided patients into (1) intensive care unit- (ICU-) admitted and non-ICU-admitted and (2) survivors and nonsurvivors for estimation of severity and prognosis. We determined the risk factors associated with critical illness and poor prognosis. Patients with higher white blood cell (WBC) count and phosphate levels had significantly higher ICU admission rates. According to univariate analysis, serum levels of T3, phosphate, and WBC as well as the duration of hospitalization were associated with mortality. Multivariate analysis revealed that only WBC and duration of hospitalization were independent predictors for mortality rate in COVID-19 patients. Our findings suggest that longer duration of hospitalization and higher WBC count are associated with poor outcomes in patients with COVID-19. ”

Keywords: clinical severity, laboratory results, blood count, CRP, glucose, calcium, magnesium, vitamin D

Journal of Food Biochemistry

Epigenetic modifications associated with genes implicated in cytokine storm: The potential biotherapeutic effects of vitamins and minerals in COVID-19

Authors: Muhammad, A, Forcados, GE, Sani, H, et al.

“Cytokine storm is a phrase used to refer to an abrupt upsurge in the circulating levels of various pro-inflammatory cytokines, causing increased stimulation and activity of immune cells during disease conditions. The binding of pattern recognition receptors to pathogen-associated molecular patterns during COVID-19 infection recruits response machinery involving the activation of transcription factors and proteins required for a robust immune response by host cells. These immune responses could be influenced by epigenetic modifications as evidenced by significant variations in COVID-19 pathophysiology and response to therapy observed among patients across the globe. Considering that circulating levels of interleukin 1, tumor necrosis factor-α, and interleukin 6 are significantly elevated during cytokine storm in COVID-19 patients, genetic and epigenetic variations in the expression and function of these proteins could enhance our understanding of the disease pathogenesis. Treatment options that repress the transcription of specific cytokine genes during COVID-19 infection could serve as possible targets to counteract cytokine storm in COVID-19. Therefore, the present article reviews the roles of cytokines and associated genes in the COVID-19 cytokine storm, identifies epigenetic modifications associated with the disease progression, and possible ameliorative effects of some vitamins and minerals obtained as epigenetic modifiers for the control of cytokine storm and disease severity in COVID-19 patients. ”

Keywords: cytokines, epigenetics, minerals, storm, vitamins

Prescriber

Molnupiravir: an antiviral for the prevention of severe COVID-19

Authors: Chaplin, S

“Molnupiravir (Lagevrio) is an oral antiviral agent for the treatment of mild to moderate COVID-19 in patients who are at higher risk of developing severe illness. This article outlines its indications, efficacy and adverse effects. ”

Keywords: Molnupiravir, Lagevrio, agents

International Journal of Environental Research and Public Health

The COVID-19 Pandemic Lowers Active Behavior of Patients with Cardiovascular Diseases, Healthy Peoples and Athletes

Authors: Kirsch, M, Vitiello, D

“The paper aims to describe the impact of the increasing sedentary lifestyle due to the coronavirus disease-2019 (COVID-19) pandemic restrictions in patients with cardiovascular diseases (CVDs), healthy individuals, and athletes. A review of studies investigating the impact of the COVID-19 restrictions on patients with CVDs, healthy subjects, and athletes has been conducted in the PubMed, Medline, and Google Scholar medical databases. The review highlighted the significant decrease of active behavior in patients with CVDs and mainly heart-failure patients, illustrated by a reduction of their daily steps and hours of being active during the COVID-19 pandemic. This review also enlightened a significant increase of the time spent in sedentary behavior and the sleep in healthy individuals. Finally, this review reported that the COVID-19 pandemic restrictions induced detraining periods in athletes, altering their health. These periods might also lead to a decrease of their future performances. Staying active and maintaining sufficient levels of physical activity during the COVID-19 pandemic are essential to preserve good health, despite the circumstances of quarantine. Alternatives such as completing a cardiac telerehabilitation for CVD patients or training at home for healthy subjects and athletes may be taken into consideration to maintain a regular active behavior in this sanitary context and potential future pandemics. ”

Keywords: lockdown, cardiovascular disease, detraining, sedentary behavior

Infectoius Disorders Drug Targets

Ivermectin in COVID-19 Management: What is the current evidence?

Authors: Eerike, M, Raj, GM, Priyadarshini, R, et al.

“Ivermectin (IVM), an approved anthelminthic drug, has been reported to have antiviral, antibacterial, and anticancer activities. Antiviral activity is due to the inhibition of nuclear cargo importin (IMP) protein. The anti-SARS CoV-2 activity through in vitro study was first reported by an Australian team. Later, many studies were conducted, and most of the study results were available as non-peer reviewed preprints. In this narrative review, literature on the clinical studies conducted with ivermectin from published articles, preprints, and unpublished evidence are collected till 13th June 2021 and they are discussed based on the severity of COVID-19 disease. Out of the 23 peer-reviewed published articles, 13 studies were randomized controlled trials and the remaining were either prospective interventional, prospective observational, retrospective cohort, cross-sectional, or case series type of studies; additionally, there were 10 randomized controlled trials available as preprints. In most of the studies, ivermectin was used in combination with doxycycline, azithromycin or other drugs. Some of the studies suggested either higher dose and/ or increased duration of ivermectin use to achieve favorable effects. In this review, articles on the prophylactic role of ivermectin in COVID-19 are also discussed - wherein the results are more promising. Despite accumulating evidence suggest the possible use of ivermectin, the final call to incorporate ivermectin in the management of COVID-19 is still inconclusive. ”

Keywords: anthelminthic, antiviral, importin protein, Ivermectin

Therapeutic Advances in Musculoskeletal Disease

Poor health and functioning in patients with axial spondyloarthritis during the COVID-19 pandemic and lockdown: REUMAVID study (phase 1)

Authors: Benavemt, D, Garrido-Cumbrera, M, Plasencia-Rodríguez, C, et al.

“To evaluate the overall health and functioning in patients with axial spondyloarthritis (axSpA) and related factors affecting these during the COVID-19 pandemic and lockdown measures. : Data from 587 axSpA patients participating in the first phase (April–July 2020) of the REUMAVID study who completed the ASAS Health Index (ASAS-HI) were analysed. REUMAVID is a cross-sectional study that collects data through an online survey to assess the impact of the COVID-19 pandemic on patients with rheumatic and musculoskeletal diseases across seven European countries. Poor health was defined as ASAS-HI⩾12. The World Health Organization Five well-being index, self-perceived health status and change in health status during COVID-19 pandemic were evaluated as secondary outcomes. Logistic regression models were used to identify the factors associated with poor health. According to the ASAS-HI, 147 (25.0%) patients reported poor health. Pain and moving around were the main affected categories. In addition, 14.0% reported their selfperceived health status as ‘bad’ or ‘very bad’ and 46.8% as worse than before the pandemic. In the multivariate analysis, smoking, diabetes and taking painkillers or corticosteroids use were significantly associated with poor health, while engaging in physical activity and being actively employed were inversely associated with this. During the first wave of the COVID-19 pandemic, one in four axSpA patients reported poor health and functioning, while the self-perceived health status of almost half of these patients worsened. Nonsmoking, physical activity and being employed were associated with better outcomes.”

Keywords: ASAS-HI, axial spondyloarthritis, pandemic, patient-reported outcomes

International Journal of Biological Sciences

Hypersensitivity reaction to hyaluronic acid dermal filler after COVID-19 vaccination: A series of cases in São Paulo, Brazil

Authors: Ortigosa LCM, Lenzoni FC, Suárez MV, et al.

“Brazil ranked second in the world for the number of aesthetic procedures carried out in 2019. Five case reports of delayed hypersensitivity reaction to hyaluronic acid dermal filler after COVID-19 vaccination are presented in this paper. Additional vaccination for new variants, including omicron, will be necessary; therefore, aesthetic professionals should be aware of this possibility and advise patients accordingly.”

Keywords: COVID-19 vaccine, hyaluronic acid, aesthetic procedure, delayed hypersensitivity, dermal filler

PLoS ONE

The impact of Movement Control Order during the COVID-19 pandemic on lifestyle behaviours and body weight changes: Findings from the MyNutriLifeCOVID-19 online survey

Authors: Chin, YS, Woon, FC, Chan, YM

“The COVID-19 pandemic lockdowns have affected daily lives of the communities worldwide. This study aims to determine the lifestyle behaviours and their associations with body weight changes among Malaysian adults during the Movement Control Order (MCO) due to COVID-19 pandemic. A total of 1319 Malaysian adults participated in this cross-sectional online survey. Information on anthropometric data including body weight and height, and lifestyle behaviours including eating pattern, physical activity, and sleep pattern were self-reported by the respondents. A multivariable generalised linear mixed model was used to assess the associations between lifestyle behaviours and body weight changes with adjustment of confounding factors; namely, age, sex, ethnicity, and body weight status before MCO. During MCO, 41.2% of the respondents perceived that their eating patterns were healthier, but 36.3% reduced their physical activities, and 25.7% had a poorer sleep quality. Further, the proportion of adults who reported having lose weight (32.2%) was almost similar to those who reported having gained weight (30.7%). Lifestyle behaviours including less frequent practice of healthy cooking methods and lunch skipping were associated with weight gain, while less frequent consumption of high fat foods, more frequent physical activity, and good sleep latency were associated with lower risk of weight gain. In contrast, practicing healthy eating concept, skipped lunch, and more frequent physical activity were significantly associated with weight loss. Lifestyle behaviours were associated with body weight changes during MCO. While the COVID-19 pandemic lockdown is necessary to prevent further spread of the disease, promoting healthy lifestyle practices during lockdown should be implemented for a healthy weight and better health. ”

Keywords: body weight, physical activity, weight gain, food, nutrition, overweight, pandemics

Antimicrobial Agents and Chemotherapy

Preprint

The anti-COVID-19 Drug Remdesivir Promotes Oncogenic Herpesviruses 2 Reactivation through Regulation of Intracellular Signaling Pathways

Authors: Chen, J, Dai1, L, Kendrick, S, et al.

“Recently, Remdesivir and Molnupiravir were approved for treating COVID-19 caused by SARS16 CoV-2 infection. However, little is known about the impact of these drugs on other viruses pre existed in COVID-19 patients. Here we report that Remdesivir but not Molnupiravir induced lytic reactivation of KSHV and EBV, two major oncogenic herpesviruses. Remdesivir induced mature virion production from latently infected cells. Mechanistic studies showed that Remdesivir induced KSHV and EBV reactivation by regulating several intracellular signaling pathways.”

Keywords: KSHV, EBV, Remdesivir, Molnupiravir

Heart & Lung

Newer oral antivirals for COVID-19: Are they the real game changer?

Authors: Kunal, S, Sakthivel, P, Malhotra, N, et al.

“The unprecedented increase in COVID-19 cases globally following the emergence of novel variants such as Delta and Omicron has led to a focus on the concept of “Hit early, Hit hard” to prevent the progression of mild/moderate illness by accelerating viral clearance into a more severe one. Remdesivir, the only FDA approved antiviral against COVID-19, has its own limitations necessitating hospital visit. Similarly, monoclonal antibodies are plagued by its high cost, limited availability and need for a hospital-based administration. Owing to the urgent need for treatment of critically ill COVID-19 patients, research on drugs for use in the outpatient setting has understandably lagged behind. Given it seems likely that COVID-19 will become endemic, research should focus on identifying safe, affordable, and globally accessible oral drugs for treatment. This letter tends to address the rationale, unmet need, scientific evidence and the associated controversies surrounding the novel oral antiviral therapies in COVID-19 treatment.”

Keywords: Molnupiravir, Favipiravir, evidence, Omicron

Acta Scientiarum. Health Sciences

Nutrition, physical activity and psychological status during lockdown due to covid-19

Authors: Tyagi, R, Dhall, M, Tungdim, MG, et al.

“Aim of the present study was to assess physical activity, nutrition and psychological status of the population during lockdown due to covid-19. Online survey was conducted among 534 participants within the age range of 16-78 years using convenient sampling. Participants from varied regions within India and abroad were enrolled for the present study. Volunteered participants were solicited to take part in a survey that has to be carried out by filling an online questionnaire form available to them as a URL link in the invitation through WhatsApp/Messenger. The gathered data has been compiled, coded and cleaned using Microsoft Excel. Analysis has been carried out employing descriptive and inferential statistics in SPSS 17.0. Majority of participants in the studied population showed significant change in their nutrition and physical activity status due to lockdown. Covid-19 lockdown did limit their daily activities. It also had impacted their psychological status. The current investigation accentuates the need to pursue suitable life style for the maintenance of optimum metabolism and physiology. Sticking to more regular timetable of meals, effective management of stress levels and continued physical activity during the quarantine and in all the following phases of living is desirable. ”

Keywords: physical activity, nutrition, lockdown, health, behavioral changes

Rare Metals

Potential metal-related strategies for prevention and treatment of COVID-19

Authors: Ni, YQ, Zeng, HH, Song, XW, et al.

“The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has posed severe threats to human health, public safety, and the global economy. Metal nutrient elements can directly or indirectly take part in human immune responses, and metal-related drugs have served as antiviral drugs and/or enzyme inhibitors for many years, providing potential solutions to the prevention and treatment of COVID-19. Metal-based drugs are currently under a variety of chemical structures and exhibit wide-range bioactivities, demonstrating irreplaceable advantages in pharmacology. This review is an intention to summarize recent progress in the prevention and treatment strategies against COVID-19 from the perspective of metal pharmacology. The current and potential utilization of metal-based drugs is briefly introduced. Specifically, metallohydrogels that have been shown to present superior antiviral activities are stressed in the paper as potential drugs for the treatment of COVID-19.”

Keywords: metal-related drugs, metal nutrient elements, metallohydrogel, zinc, selenium, magnesium, copper, ferrum

Cureus

Ivermectin Prophylaxis Used for COVID-19: A Citywide, Prospective, Observational Study of 223,128 Subjects Using Propensity Score Matching

Authors: Kerr, L, Cadegiani, FA, Baldi, F, et al.

“Ivermectin has demonstrated different mechanisms of action that potentially protect from both coronavirus disease 2019 (COVID-19) infection and COVID-19-related comorbidities. Based on the studies suggesting efficacy in prophylaxis combined with the known safety profile of ivermectin, a citywide prevention program using ivermectin for COVID-19 was implemented in Itajaí, a southern city in Brazil in the state of Santa Catarina. The objective of this study was to evaluate the impact of regular ivermectin use on subsequent COVID-19 infection and mortality rates. We analyzed data from a prospective, observational study of the citywide COVID-19 prevention with ivermectin program, which was conducted between July 2020 and December 2020 in Itajaí, Brazil. Study design, institutional review board approval, and analysis of registry data occurred after completion of the program. The program consisted of inviting the entire population of Itajaí to a medical visit to enroll in the program and to compile baseline, personal, demographic, and medical information. In the absence of contraindications, ivermectin was offered as an optional treatment to be taken for two consecutive days every 15 days at a dose of 0.2 mg/kg/day. In cases where a participating citizen of Itajaí became ill with COVID-19, they were recommended not to use ivermectin or any other medication in early outpatient treatment. Clinical outcomes of infection, hospitalization, and death were automatically reported and entered into the registry in real time. Study analysis consisted of comparing ivermectin users with non-users using cohorts of infected patients propensity score-matched by age, sex, and comorbidities. COVID-19 infection and mortality rates were analyzed with and without the use of propensity score matching (PSM). Of the 223,128 citizens of Itajaí considered for the study, a total of 159,561 subjects were included in the analysis: 113,845 (71.3%) regular ivermectin users and 45,716 (23.3%) non-users. Of these, 4,311 ivermectin users were infected, among which 4,197 were from the city of Itajaí (3.7% infection rate), and 3,034 non-users (from Itajaí) were infected (6.6% infection rate), with a 44% reduction in COVID-19 infection rate. Using PSM, two cohorts of 3,034 subjects suffering from COVID-19 infection were compared. The regular use of ivermectin led to a 68% reduction in COVID-19 mortality. When adjusted for residual variables, reduction in mortality rate was 70%. There was a 56% reduction in hospitalization rate. After adjustment for residual variables, reduction in hospitalization rate was 67%. In this large PSM study, regular use of ivermectin as a prophylactic agent was associated with significantly reduced COVID-19 infection, hospitalization, and mortality rates.”

Keywords: Ivermectin, infection rate, mortality rate, hospitalization

PsyArXiv

Preprint

Associations Between Physical Activity, Affect Regulation Difficulties, and Mental Health Among Canadian Adolescents at Two Different Points of the COVID-19 Pandemic

Authors: Ames, M, Robillard, CL, Turner, B, et al.

“Although physical activity declined with social distancing measures and stay-at-home orders during the COVID-19 pandemic, youth who engaged in more physical activity experienced fewer mental health problems. If and how physical activity maintained its protective role throughout the ongoing pandemic remains unclear. This study models associations between three types of physical activity (indoor, outdoor, with parents), affect regulation, and anxious and depressive symptoms in two adolescent samples (W1: Summer 2020; W2: Winter 2020/21). 662 Canadian adolescents (W1: Mage = 15.69, SD = 1.36; 52% girls; 5% trans+) and 675 Canadian adolescents (W2: Mage = 15.80, SD = 1.46; 50% girls; 6% trans+) participated in an online survey. Data included frequency of physical activity indoors, outdoors, and with parents, affect regulation and measures of anxious and depressive symptoms. Multiple-group path analysis showed indoor physical activity had an indirect effect on anxiety and depressive symptoms, but only in W1. Physical activity with parents was protective for adolescent anxiety and depressive symptoms at both W1 and W2 and had an indirect effect through affect regulation. Findings contribute to our understanding of how physical activity protects adolescent mental health, and point to strengthening family supports and recreation opportunities.”

Keywords: physical activity, mental health, adolescents, affect regulation

Gene Reports

Serum levels of vitamin D and immune system function in patients with COVID-19 admitted to intensive care unit

Authors: Soltani-Zangbar, MS, Mahmoodpoor, A, Dolati, S, et al.

“Vitamin D is believed to affect the functionality of the immune system for the prevention of coronavirus disease. To investigate the role of this vitamin against the Coronavirus, this study analyzed the serum levels of vitamin D, the transcription pattern of inflammatory cytokines, and the frequency of total lymphocytes, TCD4+, TCD8+, and NK cells in 50 COVID-19-affected subjects in comparison to 50 healthy participants. This study diagnosed and evaluated 100 patients. Frequency of lymphocytes was determined using flow cytometry. Cytokine expression levels were measured using Real-Time PCR. Serum levels of vitamin D and cytokines levels in cultured cell supernatant were measured by ELISA. Patients with COVID-19 exhibited decreased serum levels of vitamin D versus the healthy participants. The total number of lymphocytes, TCD4+, TCD8+, and NK cells was significantly reduced in patients with COVID-19. Considerable upregulation of IL-12, IFN-γ, and TNF-α was seen in COVID-19 patients compared to the control group, whereas IFN-α was downregulated in COVID-19 patients. ELISA results also had increased levels of IL-12, TNF-α, and IFN-γ, and decreased level of IFN-α in patients with COVID-19 compared to the control group. These findings suggest a probable association among vitamin D concentrations, immune system function, and risk of COVID-19 infection. As a result, it is recommended that vitamin D be considered as a candidate for handling and controlling COVID-19 because of its ability to target the cytokine storm and its antiviral effects.”

Keywords: SARS, vitamin D, immune Response. lymphocytes, cytokine

Gene Reports

Global data analysis and risk factors associated with morbidity and mortality of COVID-19

Authors: Tazerji, SS, Shahabinejad, F, Tokasi, M, et al.

“This review was focused on global data analysis and risk factors associated with morbidity and mortality of coronavirus disease 2019 from different countries, including Bangladesh, Brazil, China, Central Eastern Europe, Egypt, India, Iran, Pakistan, and South Asia, Africa, Turkey and UAE. Male showed higher confirmed and death cases compared to females in most of the countries. In addition, the case fatality ratio (CFR) for males was higher than for females. This gender variation in COVID-19 cases may be due to males’ cultural activities, but similar variations in the number of COVID-19 affected males and females globally. Variations in the immune system can illustrate this divergent risk comparatively higher in males than females. The female immune system may have an edge to detect pathogens slightly earlier. In addition, women show comparatively higher innate and adaptive immune responses than men, which might be explained by the high density of immune-related genes in the X chromosome. Furthermore, SARS-CoV-2 viruses use angiotensin-converting enzyme 2 (ACE2) to enter the host cell, and men contain higher ACE2 than females. Therefore, males may be more vulnerable to COVID-19 than females. In addition, smoking habit also makes men susceptible to COVID-19. Considering the age-wise distribution, children and older adults were less infected than other age groups and the death rate. On the contrary, more death in the older group may be associated with less immune system function. In addition, most of these group have comorbidities like diabetes, high pressure, low lungs and kidney function, and other chronic diseases. Due to the substantial economic losses and the numerous infected people and deaths, research examining the features of the COVID-19 epidemic is essential to gain insight into mitigating its impact in the future and preparedness for any future epidemics.”

Keywords: pandemic, one-health, epidemiology, mortality

Lancet

A systematic review of cases of CNS demyelination following COVID-19 vaccination

Authors: Franco

“ Since the emergency use approval of different types of COVID-19 vaccines, several safety concerns have been raised regarding its early and delayed impact on the nervous system. This study aims to systematically review the reported cases of CNS demyelination in association with COVID-19 vaccination, which has not been performed, to our knowledge. A systematic review was performed by screening published articles and preprints of cases of CNS demyelination in association with COVID-19 vaccines in PubMed, SCOPUS, EMBASE, Google Scholar, Ovid and medRxiv databases, until September 30, 2021. This study followed PRISMA guidelines. Descriptive findings of reported cases were reviewed and stratified by demographic and clinical findings, diagnostic work-up, management, and overall outcome. A total of 32 cases were identified, with female predominance (68.8%) and median age of 44 years. Eleven cases were reported after Pfizer vaccine, 8 following AstraZeneca vaccine, 6 following Moderna, 5 following Sinovac/ Sinopharm vaccines, and one following each of Sputnik and Johnson&Johnson vaccines. The majority of cases (71.8%) occurred after the first dose of the vaccine, with neurological symptoms manifesting after a median of 9 days. The most common reported presentations were transverse myelitis (12/32) and MS-like pictures (first diagnosis or a relapse) in another 12/32 cases, followed by ADEM- like (5/32), and NMOSD- like (3/32) presentations. History of a previous immune-mediated disease was reported in 17/32 (53.1%) cases. The mRNA-based vaccines resulted in the greatest number of demyelinating syndromes (17/32), followed by viral vector vaccines (10/32), and inactivated vaccines (5/32). Most MS-like episodes (9/12) were triggered by mRNA-based vaccines, while TM occurred following both viral vector and mRNA-based vaccines. Management included high dose methylprednisolone, PLEX, IVIg, or a combination of those, with a favorable outcome in the majority of case; marked/complete improvement (25/32) or stabilized/ partial recovery in the remaining cases. This systematic review identified few cases of CNS demyelination following all types of approved COVID-19 vaccines so far. Clinical presentation was heterogenous, mainly following the first dose, however, half of the reported cases had a history of immune-mediated disease. Favorable outcome was observed in most cases. We suggest long-term post-marketing surveillance for these cases, to assess for causality, and ensure the safety of COVID-19 vaccines.”

Keywords: demyelinating disease, multiple sclerosis, transverse myelitis

Hormones

Painless thyroiditis following mRNA vaccination for COVID-19

Authors: Nakaizumi, N, Fukata, S, Akamizu, T

“Recently, cases of subacute thyroiditis and Graves’ disease following coronavirus disease 2019 (COVID-19) vaccine immunization have been reported [1,2,3,4]. Herein, we present two cases of painless thyroiditis (PT) after the administration of the mRNA COVID-19 vaccine.”

Keywords: Vaccines, mRNA

Nutrients

Associations of Nutritional Behavior and Gut Microbiota with the Risk of COVID-19 in Healthy Young Adults in Poland

Authors: Jagielski, P, Łuszczki, E, Wnęk, D, et al.

“The numerous consequences of the coronavirus disease 2019 (COVID-19) pandemic in healthy young people and the lack of clarity as to the long-term disease outcomes have spurred the search for risk factors for SARS-CoV-2 infection. We aimed to evaluate the associations of nutritional behaviors, gut microbiota, and physical activity with the risk of COVID-19 in healthy young nonobese people. Data on body composition, anthropometric measurements, physical activity, dietary intake, and gut microbiota were obtained from 95 adults (mean age, 34.66 ± 5.76 years). A balanced diet rich in vegetables and fruit, including nuts, wholegrain cereal products, and legumes, covers the need for vitamins and minerals. Such a diet can be an effective measure to reduce the risk of COVID-19 in nonobese healthy physically active young people with normal immune function. People with balanced diet and an average daily consumption of >500 g of vegetables and fruit and >10 g of nuts had an 86% lower risk of COVID-19 compared with those whose diet was not balanced and who consumed lower amounts of these products. It is well documented that proper nutrition, physical activity, and maintenance of normal weight facilitate good health by ensuring optimal immune function. The beneficial effects of these interventions should be strongly emphasized during the COVID-19 pandemic. ”

Keywords: pandemic, dietary intake, dietary inflammatory index, gut microbiota, nutrition, physical activity

International Journal of Astrobiology

The impact of the COVID-19 lockdown on human psychology and physical activity; a space analogue research perspective

Authors: Van Cutsem, J, Abeln, V, Schneider, S, et al.

“Astronauts will encounter isolated, confined and extreme (ICE) conditions during future missions, and will have to be able to adapt. Until recently, however, few places on Earth could serve as acceptable space analogues (i.e., submarine and polar regions). The coronavirus disease-2019 (COVID-19)-related lockdowns around the globe provided a good opportunity to obtain more comprehensive datasets on the impact of prolonged isolation on human functioning in a very large sample. Seven hundred forty-eight individuals (Belgium 442, Spain 183, Germany 50, Italy 50, US 23; Mean age ± SD: 41 ± 14 years, with an age range of 18–83 years; 66% women) filled out an online survey assessing the impact of the COVID-lockdown on psychological, exercise and general health variables a first time near the beginning of the initial lockdown (hereafter ‘T1’; 24 ± 13 days after the start of the first lockdown; i.e., 3 weeks after the start of the first lockdown) and a second time a couple of weeks thereafter (hereafter ‘T2’; 17 ± 5 days after the first online survey; i.e., 6 weeks after the start of the first lockdown). From T1 to T2 an improvement of subjective sleep quality was observed, that was related to an increase in subjective sleep efficiency and a decrease in sleep latency and disturbance. Weekly sitting time decreased, and the weekly amount of moderate and vigorous physical activity increased from T1 to T2. No differences from T1 to T2 were observed in terms of mood, loneliness and state anxiety. A lower amount of sitting time was significantly correlated with improved subjective sleep quality and with an increased amount of moderate and vigorous physical activity. Compared to 3 weeks into the first COVID-imposed lockdown, 6-weeks after the start of the first COVID-imposed lockdown, physical activity and subjective sleep scores were positively impacted. The present, large sample size study further confirms exercise as a worthwhile countermeasure to psycho-physiological deconditioning during confinement.”

Keywords: isolated and confined environment, lockdown, physical activity, sleep, space analogue

Journal of Transport & Health

The emergence of recreational cycling in Hanoi during the Covid-19 pandemic

Authors: Nguyen, MH, Pojani, D

“This study examined recreational cycling in Hanoi, Vietnam, with a particular focus on changes brought about by the Covid-19 pandemic. The research questions were: (1) Has recreational cycling increased during the Covid-19 pandemic?; (2) If so, what factors have led to the increase?; and (3) What are some of the typical traits and behaviors of recreational cyclists?Face-to-face surveys of 356 recreational cyclists were carried out in March–April 2021 in four areas of inner Hanoi. The survey data were modelled through two binary and one ordinal logit regression.Recreational cycling has become much more popular in Hanoi during the Covid-19 pandemic, with early morning being the preferred time for this activity (to avoid heavy traffic). A quarter of the participants had starting cycling recreationally since the first lockdown in April 2020, and about three quarters reported having noticed an increase in cycling activity around them. Nearly half of the participants cycled regularly (more than four times per week). The groups that were most likely to have taken up cycling for recreations during the pandemic included men, those living with children in the home, and those not working or studying. Age and income were not significant. People have been embracing cycling as a way to maintain or increase physical activity levels, and to safely socialize at the time when social gatherings are limited, walking is prohibited in some zones, and social distancing rules apply everywhere. To sustain the growth in recreational cycling and widen the time-window for this activity while ensuring everyone’s safety, Hanoi’s planning and public health sectors should join forces to adopt a combination of ‘hard’ and ‘soft’ measures. The authors recommend creating multi-use paths for micromobility modes, launching a public bikesharing scheme, regulating motorised modes, and social marketing that promotes recreational cycling as trendy.”

Keywords: tecreational cycling, Hanoi, Vietnam, active transport, global south, pandemic

Nutrients

Nutritional Behaviors, Vitamin Supplementation and Physical Activity among Polish Adults during the COVID-19 Pandemic

Authors: Gryszczyńska, B, Budzyń, M, Grupińska, J, et al.

“The COVID-19 pandemic and its consequences, including social isolation, movement restrictions and work instability have altered many people’s nutritional behaviors and daily lifestyle. The aim of the study was to evaluate the influence of the COVID-19 pandemic on selected eating habits, physical activity and daily lifestyle changes of Polish adults (n = 145). The self-designed and anonymous questionnaire was available online from the 1 May 2021 to the 15 May 2021. In general, 60% of respondents declared that the COVID-19 pandemic did not affect their dietary habits, whereas 26% of surveyed individuals answered in the affirmative. The effect of the COVID-19 pandemic on changing dietary habits was differentiated by age. The number of meals consumed by respondents per day differed across gender groups. An increase in body weight during the COVID-19 pandemic was reported by 43% of women and 7.6% of surveyed men. Additionally, hybrid working women declared most often an increase in body mass independent of age, education level and living place. Moreover, the majority of respondents who reported the effect of the pandemic on changing dietary habits also declared more frequent sweets consumption. The study revealed that respondents who stated more frequent sweets consumption during the COVID-19 pandemic were more likely associated with an increase in body mass. No increase in the consumption of vitamin D, C and Mg supplements and pickled products was found.”

Keywords: pandemic, eating habits, vitamin supplementation, pickled food consumption, physical activity, daily lifestyle

Nutrients

Vitamin D and Pigmented Skin

Authors: Carlberg, C

“The default supply of vitamin D3 to humans is its endogenous production in UV-B-exposed skin. However, changes in lifestyle such as predominant indoor activities combined with textile coverage outdoors necessitate the uptake of this pre-hormone by fatty fish or supplemented dietary products, such as milk and margarine, or direct supplementation via pills. Insufficient vitamin D3 production or supplementation causes vitamin D deficiency, which in the long term can lead to bone malformations, such as those observed in rickets. In addition, an insufficient vitamin D status (determined as a 25-hydroxyvitamin D3 (25(OH)D3) serum level below 50 nM (20 ng/mL)) may cause a malfunctional immune system, which manifests as an increased risk for severe consequences of infectious diseases such as tuberculosis or COVID-19 (coronavirus), as well as for the onset and progression of autoimmune diseases such as multiple sclerosis and type 1 diabetes.”

Keywords: vitamin D, UV-B, skin, supplementation

Journal of Cardiovascular Development and Disease

Vitamin D Inhibits IL-6 Pro-Atherothrombotic Effects in Human Endothelial Cells: A Potential Mechanism for Protection against COVID-19 Infection?

Authors: Cimmino, G, Conte, S, Morello, M, et al.

“Thrombosis with cardiovascular involvement is a crucial complication in COVID-19 infection. COVID-19 infects the host by the angiotensin converting enzyme-2 receptor (ACE2r), which is expressed in endothelial cells too. Thus, COVID-related thrombotic events might be due to endothelial dysfunction. IL-6 is one of the main cytokines involved in the COVID-19 inflammatory storm. Some evidence indicates that Vitamin D (VitD) has a protective role in COVID-19 patients, but the molecular mechanisms involved are still debated. Thus, we investigated the effect of VitD on Tissue Factor and adhesion molecules (CAMs) in IL-6-stimulated endothelial cells (HUVEC). Moreover, we evaluated levels of the ACE2r gene and proteins. Finally, we studied the modulation of NF-kB and STAT3 pathways. Methods: HUVEC cultivated in VitD-enriched medium were stimulated with IL-6 (0.5 ng/mL). The TF gene (RT-PCR), protein (Western blot), surface expression (FACS) and procoagulant activity (FXa generation assay) were measured. Similarly, CAMs soluble values (ELISA) and ACE2r (RT-PCR and Western blot) levels were assessed. NF-kB and STAT3 modulation (Western blot) were also investigated. Results: VitD significantly reduced TF expression at both gene and protein levels as well as TF-procoagulant activity in IL-6-treated HUVEC. Similar effects were observed for CAMs and ACE2r expression. IL-6 modulates these effects by regulating NF-κB and STAT3 pathways. Conclusions: IL-6 induces endothelial dysfunction with TF and CAMs expression via upregulation of ACE2r. VitD prevented these IL-6 deleterious effects. Thus, it might be speculated that this is one of the hypothetical mechanism(s) by which VitD exerts its beneficial effects in COVID-19 infection.”

Keywords: atherothrombosis, IL-6, tissue factor, vitamin D

European Journal of Medical Research

Potential therapeutic options for COVID-19: an update on current evidence

Authors: Niknam, Z, Jafari, A, Golchin, A, et al.

“SARS-CoV-2, a novel coronavirus, is the agent responsible for the COVID-19 pandemic and is a major public health concern nowadays. The rapid and global spread of this coronavirus leads to an increase in hospitalizations and thousands of deaths in many countries. To date, great efforts have been made worldwide for the efficient management of this crisis, but there is still no effective and specific treatment for COVID-19. The primary therapies to treat the disease are antivirals, anti-inflammatories and respiratory therapy. In addition, antibody therapies currently have been a many active and essential part of SARS-CoV-2 infection treatment. Ongoing trials are proposed different therapeutic options including various drugs, convalescent plasma therapy, monoclonal antibodies, immunoglobulin therapy, and cell therapy. The present study summarized current evidence of these therapeutic approaches to assess their efficacy and safety for COVID-19 treatment. We tried to provide comprehensive information about the available potential therapeutic approaches against COVID-19 to support researchers and physicians in any current and future progress in treating COVID-19 patients.”

Keywords: repurposed drugs, convalescent plasma, monoclonal antibodies, immunoglobulins, cell therapy

Clinical Nutrition ESPEN

Clinical Significance of Micronutrient Supplements in Patients with Coronavirus Disease 2019: A Comprehensive Systematic Review and Meta-Analysis

Authors: Beran, A, Mhanna, M, Srour, O, et al.

“Micronutrient supplements such as vitamin D, vitamin C, and zinc have been used in managing viral illnesses. However, the clinical significance of these individual micronutrients in patients with Coronavirus disease 2019 (COVID-19) remains unclear. We conducted this meta-analysis to provide a quantitative assessment of the clinical significance of these individual micronutrients in COVID-19. We performed a comprehensive literature search using MEDLINE, Embase, and Cochrane databases through December 5th, 2021. All individual micronutrients reported by ≥3 studies and compared with standard-of-care (SOC) were included. The primary outcome was mortality. The secondary outcomes were intubation rate and length of hospital stay (LOS). Pooled risk ratios (RR) and mean difference (MD) with corresponding 95% confidence intervals (CI) were calculated using the random-effects model. We identified 26 studies (10 randomized controlled trials and 16 observational studies) involving 5633 COVID-19 patients that compared three individual micronutrient supplements (vitamin C, vitamin D, and zinc) with SOC. Nine studies evaluated vitamin C in 1488 patients (605 in vitamin C and 883 in SOC). Vitamin C supplementation had no significant effect on mortality, intubation rate, or LOS. Fourteen studies assessed the impact of vitamin D on mortality among 3497 patients (927 in vitamin D and 2570 in SOC). Vitamin D did not reduce mortality but reduced intubation rate and LOS. Subgroup analysis showed that vitamin D supplementation was not associated with a mortality benefit in patients receiving vitamin D pre or post COVID-19 diagnosis. Five studies, including 738 patients, compared zinc intake with SOC (447 in zinc and 291 in SOC). Zinc supplementation was not associated with a significant reduction of mortality. Individual micronutrient supplementations, including vitamin C, vitamin D, and zinc, were not associated with a mortality benefit in COVID-19. Vitamin D may be associated with lower intubation rate and shorter LOS, but vitamin C did not reduce intubation rate or LOS. Further research is needed to validate our findings.”

Keywords: micronutrient supplements, vitamin D, vitamin C, zinc, mortality

International Journal of Mental Health and Addiction

A Latent Class Analysis of Mental Health Severity and Alcohol Consumption: Associations with COVID-19-Related Quarantining, Isolation, Suicidal Ideations, and Physical Activity

Authors: Lardier, DT, Zuhl, MN, Holladay, KR, et al.

“The present study examined latent class cluster group patterns based on measures of depression and anxiety symptom severity and alcohol consumption during the COVID-19 pandemic. Hypothesized correlates with latent class cluster groups including quarantining, self-isolation, suicidal ideations, sitting hours per day, and physical activity (vigorous intensity exercise in minutes per week) were examined. The delimited participant sample consisted of 606 university young adults 18 to 25 years of age (M = 21.24 ± 1.62). Latent cluster analysis (LCA) modeled patterns of depression and anxiety symptom severity and alcohol consumption during the COVID-19 pandemic. Between group analysis and multinomial logistic regression analysis were used to examine relationships between latent class clusters and correlates including quarantining, self-isolation, suicidal ideations, sitting hours per day, and physical activity (vigorous intensity exercise in minutes per week). LCA results showed that six latent cluster groups provided optimal model-to-date fit based on mental health symptom severity and alcohol consumption. Identified latent class clusters were as follows: cluster one = moderate anxiety and depression severity and moderate alcohol consumption (n = 156; 25.7%); cluster two = high mental health severity and alcohol consumption (n = 133; 21.9%); cluster three = low mental health symptoms and moderate alcohol consumption (n = 105; 17.3%); cluster four = lowest mental health severity and alcohol consumption (n = 95; 15.7%); cluster five = moderate depression severity, low anxiety severity, and low alcohol consumptions (n = 74; 12.2%); and cluster six = moderate anxiety severity, low depression severity, and low alcohol consumption (n = 43; 7.1%). Multinomial logistic regression analysis results found that quarantining, self-isolation, suicidal ideations, sedentary behavior, and physical activity were differentially associated with cluster group membership. Findings from this study demonstrate associations between COVID-19 public health restrictions, suicidal ideations, and declines in mental health and increases in alcohol consumption among young adult university students.”

Keywords: mental health, depression, anxiety, alcohol use, quarantining, suicidality, physical activity

JAMA

Report

US Insurer Spending on Ivermectin Prescriptions for COVID-19

Authors: Chua, K-P, Conti, RM, Becker, NV

“Ivermectin dispensing surged in the US in December 2020, even though evidence suggests ivermectin is ineffective for COVID-19.1,2 Studies have not assessed the degree to which insurers cover the costs of ivermectin prescriptions for COVID-19 or estimated wasteful US insurer spending on these prescriptions. We addressed these gaps by using national claims data from December 1, 2020, through March 31, 2021.”

Keywords: Ivermectin

SciELO

Preprint

COVID-19 incidence, severity, medication use, and vaccination among dentists: Staggering body of evidence obtained from a survey during the second wave in Brazil

Authors: Moraes, R, Correa, M, Martins-Filho, P, et al.

“This cross-sectional survey investigated the pandemic impact on dental practice in May 2021 (second wave in Brazil). COVID-19 incidence and severity among respondents, vaccination status, and level of confidence in vaccines were surveyed, in addition to medications used for preventing or treating COVID-19, including controversial drugs/substances (vitamin D, ivermectin, zinc, and chloroquine). Dentists were recruited by email and responded to a pretested questionnaire until May 31, 2021. In total, 1,907 responses were received (21.2% return rate). Bivariate and multivariate regression analyses were performed. Prevalence Ratios were calculated for the association between professional characteristics and two outcomes: report of SARS-CoV-2 infection and use of controversial drugs. One third of dentistsreported intermediate levels of confidence in safety/efficacy of vaccines, but 96% received at least one vaccine dose, mainly CoronaVac. The impact of the pandemic on dental practice was rated as lower/much lower compared with one-year before (first wave) by 46% of respondents; 27% of dentists reported to have had a positive COVID-19 test, ~50% had relatives or friends who had been hospitalized or died from COVID-19. At least one medication was used by 59% of respondents, 43% used two or more drugs and substances. Vitamin D (41%), (35%), and zinc (29%) were the most frequent drugs/substances. More experienced dentists (≥21 years in practice) were 42% more likely to use controversial medications than less experienced respondents. Dentists with residency/advanced training as postgraduate education had 30% higher prevalence of controversial medication use than respondents holding MSc/PhD degrees. Respondents with low confidence in vaccines were 2.1 times more likely to use controversial medications than participants with very high confidence. The overall findings of this survey highlight the high severity of the pandemic in Brazil, and raised questions about the use of scientific evidence by dentists in their decision to take controversial COVID-19 medications.”

Keywords: Vaccines, vitamin D, zinc, ivermectin, chloroquine, evidence-based practice

Psychogeriatrics

Impact of physical activity on response to stress in people aged 65 and over during COVID-19 pandemic lockdown

Authors: Radino, A, Tarantino, V

“The outbreak of the COVID-19 pandemic has negatively affected the lives of many people. In particular, restrictions of physical activity (PA) due to pandemic-related lockdown have impacted their psychological status. The aim of this work was to investigate the relationship between PA habits, before the pandemic and during the lockdown, and responses to stress due to home isolation during the lockdown, in older people. To this aim, an online survey addressed to people aged 65 years and over was conducted during the first pandemic wave in Italy (Study 1). To explore the effect of PA restrictions on responses to stress over time, the survey was replicated during the second wave (Study 2). A group of 72 and 43 participants, from 65 to 88 years, completed the two studies, respectively. The survey required the completion of the International Physical Activity Questionnaire, and of two questionnaires on stress response, namely, the Impact of Event Scale-Revised and the Perceived Stress Scale. The correlation between the questionnaires’ scores was examined. Study 1 demonstrated that higher levels of PA during the lockdown, related to working and walking activities, were associated with fewer stress-related symptoms and lower stress perception. In parallel, greater reduction of PA, during lockdown compared to the pre-pandemic period, was associated with more stress-related symptoms. People who spent more time at rest (sitting) before and during the pandemic lockdown were those who showed higher psychological impact. Study 2 confirmed the benefits of maintaining working activities during lockdown, but also showed that during the second pandemic wave people were more resilient to PA restrictions and home isolation, even if conducting a sedentary lifestyle. Maintaining good levels of PA during lockdown was a protective factor against developing stress-related symptoms in older people. On the other hand, more resilient response to stress emerged in this population during the second wave.”

Keywords: physical activity, stress, pandemic, lockdown, elderly

European Journal of Public Health

Are we underestimating the impact of COVID-19 on children’s physical activity in Europe? - a study of 24,302 children

Authors: Kovacs, VA, Brandes, M, Suesse, T, et al.

“ This repeat cross-sectional study investigated the impact of lockdown in Europe in Winter (Jan-Feb 2021) on children’s and adolescent’s physical activity (PA) and recreational screen time (RST), and compared PA to the lockdown in Spring 2020. An online survey was administered (n = 24,302; 6-18 years; 51.7% boys) in nine countries. PA and RST were assessed by 7-day recall. 9.3% of children met WHO PA recommendation, which was half of the proportion observed in Spring 2020 (19.0%). Sixty percent exceeded the RST recommendations. This suggests that winter lockdown could have a more negative impact on PA than in spring.”

Keywords: children, physical activity, screen time, Europe

European Journal of Integrative Medicine

Dietary supplements intake during the second wave of COVID-19 pandemic: A multinational Middle Eastern study

Authors: Mukattash, TL, Alkhalidy, H, Alzu’bi, B, et al.

“Despite the controversy about the benefits of dietary supplements in treating or preventing COVID-19, their use has increased worldwide even with the introduction of relevant vaccines. Thus, this study aimed to investigate the perception of the Middle Eastern Arab public of dietary supplements as prophylactic or therapeutic agents against COVID-19, and their consumption during the second wave of the COVID-19 pandemic. A validated, pilot tested online survey was distributed through social networking platforms in Lebanon, the Kingdom of Saudi Arabia, Palestine, Jordan, and the United Arab Emirates. Responses underwent various statistical analyses. A total of 2,100 responses were included. Around 44% of participants reported changes in their dietary behavior during COVID-19, and 70% believed that healthy habits may prevent the infection. Moreover, 21% believed that dietary supplements surely protect against COVID-19 and 45% thought they aid in treating it. Users of supplements during the second wave of the pandemic counted for 47%, who declared they were influenced by the media, healthcare providers, or close contacts. The most used supplements included Vitamins C and D and zinc. Only 34% of participants read supplement leaflets. The use of supplements was significantly correlated with being female and exercising, as revealed by the odds ratio and logistic regression analysis. In line with other areas of the world, the use of dietary supplements in the Middle East against COVID-19 is not evidence-based. Competent health authorities should play their role in spreading sound awareness among the public regarding this issue.”

Keywords: dietary supplements, vitamins, prophylaxis, Middle East

International Journal of Clinical Pharmacy

Self medication practices and its determinants in health care professionals during the coronavirus disease-2019 pandemic: cross-sectional study

Authors: Okoye, OC, Adejumo, OA, Opadeyi, AO, et al.

“The exposure of health care professionals (HCP) to patients with coronavirus disease-2019 (COVID-19) in the course of performing their professional duties may expose them to contracting the virus. This may likely increase their tendency to self-medicate for prevention or treatment of perceived infection. Aim This study determined the prevalence of COVID-19 related self-medication and its determinants among HCPs in three tertiary hospitals in Southern Nigeria. Method This was a cross-sectional study that enrolled 669 adult HCPs from three tertiary hospitals in three Southern Nigerian States using a non-probability convenience sampling method. A structured self-administered questionnaire was used for data collection. Data entry and analysis were done using IBM SPSS version 22. Results The mean age of the respondents was 35.6 ± 8.7 years. Two hundred and forty-three respondents (36.3%) reported having practiced COVID-19 related self-medication. The commonly used medications were ivermectin, azithromycin, vitamin C, chloroquine and zinc. Factors associated with self-medication were older age, being pharmacist, higher income, previous COVID-19 testing. Predictors of self medication were > 44 years, previous COVID-19 testing. Conclusion About one-third of HCPs practiced COVID-19 related self-medication. HCPs that are often assumed to be health literate may not necessarily practice safe health behavior. Regular health education of the HCPs on implications of self-medications is highly recommended. There should also be formulation and effective implementation of policies that regulate purchase of medications.”

Keywords: health care professionals, Nigeria, Self-medication

medRxiv

Preprint

The Psychosocial Benefits of Sport Participation During COVID-19 Are Only Partially Explained by Increased Physical Activity

Authors: Watson, AM, Biese, K, Reardon, C, et al.

“The purpose of this study was to determine whether physical activity (PA) increases were responsible for the improvements in mental health and quality of life (QOL) seen among adolescents who returned to sport during the COVID-19 pandemic.Adolescent athletes were asked to complete a survey in October 2020 regarding demographic information, whether they had returned to sport participation (no [DNP], yes [PLY]), school instruction type (virtual, in-person, hybrid), anxiety, depression, QOL, and PA. Anxiety, depression, QOL and PA were compared between PLY and DNP using least squares means from linear models adjusted for age, gender, and instruction type. Mediation analysis assessed whether the relationship between sport status and anxiety, depression, and QOL was mediated by PA. 171 athletes had returned to play, while 388 had not. PLY athletes had significantly lower anxiety and depression, and significantly higher QOL and PA. PA explained a significant, but relatively small portion of the difference in depression and QOL between PLY and DNP athletes, but did not explain the difference in anxiety. Increased PA is only responsible for a small portion of the improvements in depression and QOL among athletes who returned to sports and unrelated to improvements in anxiety. This suggests that the majority of the mental health benefits of sport participation for adolescents during the COVID-19 pandemic are independent of, and in addition to, the benefits of increased PA.”

Keywords: sport participation, physical aqctivity, mental health, quality of life

medRxiv

Preprint

Clinical outcomes among patients infected with Omicron (B.1.1.529) SARS-CoV-2 variant in southern California

Authors: Lewnard, JA, Hong, VX, Patel, MM, et al

“Our analyses included 52,297 cases with SGTF (Omicron) and 16,982 cases with non-SGTF (Delta [B.1.617.2]) infections, respectively. Hospital admissions occurred among 235 (0.5%) and 222 (1.3%) of cases with Omicron and Delta variant infections, respectively. Among cases first tested in outpatient settings, the adjusted hazard ratios for any subsequent hospital admission and symptomatic hospital admission associated with Omicron variant infection were 0.48 (0.36-0.64) and 0.47 (0.35-0.62), respectively. Rates of ICU admission and mortality after an outpatient positive test were 0.26 (0.10-0.73) and 0.09 (0.01-0.75) fold as high among cases with Omicron variant infection as compared to cases with Delta variant infection. Zero cases with Omicron variant infection received mechanical ventilation, as compared to 11 cases with Delta variant infections throughout the period of follow-up (two-sided p<0.001). Median duration of hospital stay was 3.4 (2.8-4.1) days shorter for hospitalized cases with Omicron variant infections as compared to hospitalized patients with Delta variant infections, reflecting a 69.6% (64.0-74.5%) reduction in hospital length of stay.”

medRxiv

Preprint

General anxiety and depression are associated with the physical activity and social interaction levels: Study in Argentinean university students during the COVID-19 outbreak

Authors: Barbuzza, A, Benedetti, P, Goyeneche, C, et al.

“Due to the coronavirus disease 2019 (COVID-19), the planet is going through a historical time of exceptional concern and uncertainty, which impacts people’s mental health. Here, we explored the levels of depression and Generalized Anxiety Disorder (GAD) and their relation with the degree of physical activity and social interaction during the pandemic. We performed a structured survey containing the PHQ-9 and GAD-7 tests to evaluate depressive symptoms and GAD levels. We also asked about weekly physical activity and the level of social interaction. We surveyed two groups of University students in the Buenos Aires Metropolitan Area: an internal group from the Instituto Tecnológico de Buenos Aires (ITBA), and an external group of students from multiple universities. The survey was conducted in late October/early-November 2020, after a peak of contagions. Some of the participants were surveyed again in January 2021, during academic holidays and after a valley of contagion, for longitudinal analysis. Our data show that men and women of both groups exhibited a significant positive linear correlation between depression and GAD levels. Moreover, low levels of depression and anxiety were associated with performing physical activity for more than two days a week and to longer periods of social interaction. Finally, the second survey revealed a decrease of the symptoms. Our results suggest that performing regular physical activity and avoiding long periods of social isolation gave benefits to mental health. We suggest that public policies could consider protecting these behaviors under health and safety standards.”

Keywords: general anxiety, depression, physical activity, social interaction level, Argentina

Global Public Healt

Unresolved COVID Controversies: ‘Normal science’ and potential non-scientific influences

Authors: Cáceres, CF

“The COVID-19 health crisis has so far involved enormous consequences in human pain, suffering and death. While biomedical science responded early, its response has been marked by several controversies between what appeared to be mainstream perspectives, and diverse alternative views; far from leading to productive debate, controversies often preceded polarisation and, allegedly, exclusion and even censorship of alternative views, followed by the pretense of scientific consensus. This paper describes and discusses the main controversies in the production of COVID biomedical knowledge and derived control measures, to establish if alternative positions are also legitimate from a ‘normal science’ perspective (rather than comparing them for superiority); explores potential non-scientific explanations of the alleged exclusion of certain views; and analyzes ethical issues implied. The operation of non-scientific factors in scientific and regulatory processes (e.g. various forms of subtle corruption) has been documented in the past; the intervention of such influences in the mishandling of controversies (i.e. on early management, non-pharmacological prevention and vaccination) cannot be ruled out and deserves further investigation. Some of these controversies, increasingly visible in the public domain, also involve ethical challenges that need urgent attention. Polarisation, censorship and dogma are foreign to true science and must be left behind.”

Keywords: controversy, scientific method, scientific integrity, medical practice, academic freedom, media, evidence, epistemology, ethics

AIP Conference Proceedings

Vitamin D deficiency and COVID-19 severity

Authors: Abdalrudha Al-Baka, HA, Al-Mousawi, JK, Al-Sharifi, MRA

“COVID-19 which emerged suddenly with wide and deep effect on the life was stained by different clinical severity. Multiple studies had noted a relationship between the severity of COVID-19 and levels of vitamin D. The aim of this study was to detect the effect of vitamin D on impact of COVID-19 severity. In our endeavor we depended on data concern the subject which were obtained from a hospital interested in COVID-19 pandemic. Data of 121 COVID-19 patients (98 men and 23 women) were reviewed carefully and arranged into three groups. Group A patients were asymptomatic and with vitamin D level of 28.61ng /ml ± 3.18. Group B had moderate symptoms and 16.42ng/ml ± 4.74 level of vitamin D. Group C was 8.35ng/ml ± 4.67 and suffered the highest severity of COVID-19 symptoms which caused death of two member of this group. The fatality rate in group C was 33.33%.”

Keywords: vitamin d, deficiency, severity, pandemic

Nature Communications

Cross-reactive memory T cells associate with protection against SARS-CoV-2 infection in COVID-19 contacts

Authors: Kundu, R, Narean, JS, Wang, L, et al.

“Cross-reactive immune responses to SARS-CoV-2 have been observed in pre-pandemic cohorts and proposed to contribute to host protection. Here we assess 52 COVID-19 household contacts to capture immune responses at the earliest timepoints after SARS-CoV-2 exposure. Using a dual cytokine FLISpot assay on peripheral blood mononuclear cells, we enumerate the frequency of T cells specific for spike, nucleocapsid, membrane, envelope and ORF1 SARS-CoV-2 epitopes that cross-react with human endemic coronaviruses. We observe higher frequencies of cross-reactive, and nucleocapsid-specific IL-2-secreting memory T cells in contacts who remained PCR-negative despite exposure (n = 26), when compared with those who convert to PCR-positive (n = 26); no significant difference in the frequency of responses to spike is observed, hinting at a limited protective function of spike-cross-reactive T cells. Our results are thus consistent with pre-existing non-spike cross-reactive memory T cells protecting SARS-CoV-2-naïve contacts from infection, thereby supporting the inclusion of non-spike antigens in second-generation vaccines.”

Keywords: immune response, T cells, SARS-CoV-2 infection, vaccines

Journal of Natural Products

Cannabinoids Block Cellular Entry of SARS-CoV-2 and the Emerging Variants

Authors: van Breemen, RB, Muchiri, RN, Bates, TA, et al.

“As a complement to vaccines, small-molecule therapeutic agents are needed to treat or prevent infections by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and its variants, which cause COVID-19. Affinity selection–mass spectrometry was used for the discovery of botanical ligands to the SARS-CoV-2 spike protein. Cannabinoid acids from hemp (Cannabis sativa) were found to be allosteric as well as orthosteric ligands with micromolar affinity for the spike protein. In follow-up virus neutralization assays, cannabigerolic acid and cannabidiolic acid prevented infection of human epithelial cells by a pseudovirus expressing the SARS-CoV-2 spike protein and prevented entry of live SARS-CoV-2 into cells. Importantly, cannabigerolic acid and cannabidiolic acid were equally effective against the SARS-CoV-2 alpha variant B.1.1.7 and the beta variant B.1.351. Orally bioavailable and with a long history of safe human use, these cannabinoids, isolated or in hemp extracts, have the potential to prevent as well as treat infection by SARS-CoV-2.”

Keywords: complement to vaccines, prevention, cannabinoids

Journal of Vascular Nursing

Impact of the COVID-19 Pandemic on Health Lifestyle in Patients with Peripheral Artery Disease: A Cross-sectional Study

Authors: Ritti-Dias, RM, de Almeida Correia, M, de Carvalho, JF, et al.

“Social isolation has been one of the main strategies to prevent the spread of Coronavirus 2019 (COVID-19). However, the impact of social isolation on the lifestyle of patients with peripheral artery disease (PAD) and claudication symptoms remains unclear. To analyze the perceptions of patients with PAD of the impact of social isolation provoked by COVID-19 pandemic on health lifestyle. The database of studies developed by our group involving patients with PAD from public hospitals in São Paulo. In this cross-sectional survey study, 136 patients with PAD (61% men, 68±9 years old, 0.55±0.17 ankle-brachial index, 82.4% with a PAD diagnosis ≥5 years old) were included. Health lifestyle factors were assessed through a telephone interview using a questionnaire containing questions related to: (a) COVID-19 personal care; (b) mental health; (c) health risk habits; (d) eating behavior; (e) lifestyle; (f) physical activity; (g) overall health; and (h) peripheral artery disease health care. The majority of patients self-reported spending more time watching TV and sitting during the COVID-19 pandemic and only 28.7% were practicing physical exercise. Anxiety and unhappiness were the most prevalent feelings self-reported among patients and 43.4% reported a decline in walking capacity. Most patients with PAD self-reported increased sedentary behavior, lower physical activity level, and worse physical and mental health during the COVID-19 pandemic. Thus, it is necessary to adopt strategies to improve the quality of life of these patients during this period.”

Keywords: social isolation, peripheral artery disease, physical activity, mental health

International Journal of Disaster Risk Reduction

Physical activity and depressive symptoms among community-dwelling older adults in the COVID-19 pandemic era: A three-wave cross-lagged study

Authors: Li, Y, Su, S, Luo, B, et al.

“The aim of the study is to determine the trajectories of physical activity and depressive symptoms and their reciprocal relationship among community-dwelling older adults in the COVID-19 pandemic era. The study population consisted of a cohort of 511 participants aged 60 years and over, who were recruited from eight community health centers in Yaan, China. The Physical Activity Scale for the Elderly and the Patient Health Questionnaire were respectively used to measure physical activity and depressive symptoms at three time points: before the COVID-19 outbreak (T0), during the outbreak period (T1), and after the subsidence of COVID-19 (T2). The results revealed that physical activity and depressive symptoms fluctuated substantially across T0, T1, and T2. In addition, more severe depressive symptoms at T0 and T1 were significantly associated with lower levels of physical activity at T1 and T2, but the obverse direction of physical activity being associated with subsequent depressive symptoms was not observed in the current study. These findings highlight the importance of supporting old people to remain physically active and combat mental distress early in a pandemic, and prevention and management of depressive symptoms may also be beneficial to promote physical activity.”

Keywords: physical activity, depressive symptoms, older adults, cross-lagged panel model, longitudinal design

HeilberufeScience

Perceived restrictions during the COVID-19 pandemic by older persons in Switzerland

Authors: Seifert, A, Hassler, B, Pfeuffer, A

“The current coronavirus pandemic has had various effects on older people’s everyday lives. Within the framework of pandemic-related protective measures, people over 65 years of age in particular were asked to stay away from public places and avoid direct physical contact. This paper examines how the pandemic affected the feelings of people over 50 years of age with regard to the limited daily supply of everyday things, outdoor physical activity and social contact. In May and June 2020, telephone interviews were conducted with 1011 people aged 50 years and over living in Switzerland. The average respondent age was 65 years and 53% of the respondents were women. The results show that the respondents hardly felt any negative changes in their supply of everyday things or outdoor activity; however, 43% of those surveyed stated that during the pandemic, with its associated protective measures, they more often felt that they were unable to spend enough time with people they cared about. The multivariate results show that education played a role in the respondents’ evaluation of everyday life considered in the interviews. This study identifies older people’s feelings about possible everyday restrictions and should stimulate discussion in practical gerontological work to better consider older people’s subjective perceptions.”

Keywords: aging, physical activity, restrictions, social contact, well-being

Internal and Emergency Medicine

Vitamin D deficiency is associated with higher risks for SARS-CoV-2 infection and COVID-19 severity: a retrospective case–control study

Authors: Israel, A, Cicurel, A, Feldhamer, I, et al.

“Robust evidence of whether vitamin D deficiency is associated with COVID-19 infection and its severity is still lacking. The aim of the study was to evaluate the association between vitamin D levels and the risks of SARS-CoV-2 infection and severe disease in those infected. A retrospective study was carried out among members of Clalit Health Services (CHS), the largest healthcare organization in Israel, between March 1 and October 31, 2020. We created two matched case–control groups of individuals for which vitamin D levels and body mass index (BMI) were available before the pandemic: group (A), in which 41,757 individuals with positive SARS-CoV-2 PCR tests were matched with 417,570 control individuals without evidence of infection, and group (B), in which 2533 patients hospitalized in severe condition for COVID-19 were matched with 2533 patients who were tested positive for SARS-CoV-2, but were not hospitalized. Conditional logistic models were fitted in each of the groups to assess the association between vitamin D levels and outcome. An inverse correlation was demonstrated between the level of vitamin D and the risks of SARS-CoV-2 infection and of severe disease in those infected. Patients with very low vitamin D levels (< 30 nmol/L) had the highest risks for SARS-CoV-2 infection and also for severe COVID-19. In this large observational population study, we show a significant association between vitamin D deficiency and the risks of SARS-CoV-2 infection and of severe disease in those infected.”

Keywords: vitamin D, risk of infection, severity

Healthcare

Participation in Sports Activities before and after the Outbreak of COVID-19: Analysis of Data from the 2020 Korea National Sports Participation Survey

Authors: Lee, O, Park, S, Kim, Y, et al.

“The present study aimed to describe the characteristics and rate of participation in sports activities, changes in sports, and the causes of these changes before and after the COVID-19 out-break in Korea using data from the 2020 Korea National Sports Participation Survey (KNSPS). Furthermore, evidence from this study could be used as basic data to maintain and promote sports activities given the current situation, in which the continued spread of infectious diseases, such as COVID-19, is likely. The KNSPS is an annual survey of subjective health and fitness, sports activities and conditions, and participation in sports activities, conducted among a sample comprising the entire Korean population. The current study analyzed data for 9000 participants, and descriptive statistical analysis was performed to calculate the frequency of each item and sample weight. The rate of regular participation in sports activities at least once a week was found to be 60.10% in 2020, representing a decrease of 6.48% from the rate observed in 2019. Among the types of sports facilities frequently used within the residential area, the most common facilities were private sports facilities (22.97%), other sports facilities (20.60%), and public sports facilities (18.97%), although the utilization rate for other sports facilities increased after the COVID-19 outbreak. After the COVID-19 outbreak, 34.12% of men and 29.72% of women responded that there had been a change in their participation in regular sports activities. Both before and after the COVID-19 outbreak, walking was the most common activity, although the participation rate increased from 29.23% in 2019 to 35.70% in 2020. The rankings and participation rates for indoor sports activities (bodybuilding, swimming, etc.) tended to decrease, while those for outdoor sports activities (climbing, cycling, etc.) tended to increase. These changes may be explained in part by the increasing concern regarding infection with increasing age, except among teenagers, and by economic factors. While participation in physical activity provides numerous health benefits, the COVID-19 pandemic has had a negative impact on regular participation in sports activities. The results of this survey suggest that government action is required to enhance participation in sports activities, even in the face of a pandemic.”

Keywords: Korea, sports activity, sports participation

BMC Public Health

The impact of COVID-19 on physical activity behaviour in Italian primary school children: a comparison before and during pandemic considering gender differences

Authors: Dallolio, L, Marini, S, Masini, A, et al.

“The World Health Organization stated an average of 60 min of Moderate to Vigorous Physical Activity (MVPA) that children should accumulate every day. Nevertheless physical inactivity is growing and, due to restrictions imposed during pandemic, PA levels of children might be more negatively affected. The study aimed to analyse the impact of COVID-19 on the PA of an Italian sample of primary school children by comparing it before and during COVID-19 considering gender differences. A pre-post analysis (October 2019–January 2021) was conducted using a randomized sample (N = 77) from the I-MOVE study settled in an Italian primary school. Both objective (Actigraph accelerometers) and self-reported (PAQ-c questionnaires) assessments of PA were performed. Changes were compared using T-Student and Chi-Square test. Gender differences were calculated using Anova. Weekly and daily minutes time spent in MVPA significantly decreased respectively by − 30.59 ± 120.87 and − 15.32 ± 16.21 from before to during pandemic while the weekly time spent in sedentary behaviour increased (+ 1196.01 ± 381.49). PAQ-c scores followed the same negative trend (− 0.87 ± 0.72). Boys seem to have suffered more than girls from the imposed restrictions. These findings outline the need for strategies to promote PA and reduce sedentary behaviours in children to prevent COVID-19 restriction long-term effects.”

Keywords: Physical inactivity, Children, Accelerometer, Sedentary behaviour

BMC Geriatrics

Changes in healthcare seeking and lifestyle in old aged individuals during COVID-19 lockdown in Germany: the population-based AugUR study

Authors: Brandl, C, Zimmermann, ME, Günther, F, et al.

“Containment measures in the COVID-19 pandemic protected individuals at high risk, particularly individuals at old age, but little is known about how these measures affected health-related behavior of old aged individuals. We aimed to investigate the impact of the spring 2020 lockdown in Germany on healthcare-seeking and health-related lifestyle in the old aged and to identify susceptible subgroups. We conducted a follow-up survey among the pre-pandemically well-characterized participants of our AugUR cohort study, residents in/around Regensburg aged 70+ years and relatively mobile. A self-completion questionnaire on current behavior, perceived changes, and SARS-Cov-2 infection was mailed in May 2020, shortly before contact restrictions ended. Pre-pandemic lifestyle and medical conditions were derived from previous study center visits. Among 1850 survey participants (73–98 years; net-response 89%), 74% were at increased risk for severe COVID-19 according to medical conditions; four participants reported SARS-CoV-2 infection (0.2%). Participants reported changes in behavior: 29% refrained from medical appointments, 14% increased TV consumption, 26% reported less physical activity, but no systematic increase of smoking or alcohol consumption. When comparing during- and pre-lockdown reports of lifestyle within participant, we found the same pattern as for the reported perceived changes. Women and the more educated were more susceptible to changes. Worse QOL was perceived by 38%. Our data suggest that the spring 2020 lockdown did not affect the lifestyle of a majority of the mobile old aged individuals, but the substantial proportions with decreased physical activity and healthcare-seeking are markers of collateral damage.”

Keywords: AugUR, Population-based study, Old aged population, Lifestyle factors, Quality of life, Proportion at risk for COVID-19, Physical activity, smoking, alcohol consumption

SAGE Open Medical Case Reports

The clinical course of a 79-year-old stroke survivor in the setting of a late-onset COVID-19 infection

Authors: Ahmeti, S, Lokaj-Berisha, V, Lumezi, BG

“Although several therapeutic agents have been evaluated for the treatment of coronavirus disease 2019 (COVID-19), no specific antiviral drug has been proven effective for the treatment of patients with severe complications. However, a nucleoside prodrug remdesivir (GS-5734) was recently approved by the Food and Drug Administration for the treatment of hospitalized patients with COVID-19. Preclinical data in animal models of coronavirus diseases have demonstrated that early treatment with remdesivir leads to improved survival and decreased lung injury. Recent clinical data have demonstrated the clinical activity of remdesivir in terms of shorter recovery period and higher odds of improved clinical status in patients with COVID-19. Here, the story of a 79-year-old patient, with 11-year-old left hemiparesis, concomitant cardiovascular disease, infected with SARS-CoV-2, and the clinical improvement after administration of remdesivir during his second hospitalization period is reported.”

Keywords: respiratory medicine, remdesivir, comorbidity, Infectious Diseases

Journal of Cellular Biochemistry

Iron dysregulation in COVID-19 and reciprocal evolution of SARS-CoV-2: Natura nihil frustra facit

Authors: Gupta, Y, Maciorowski, D, Medernach, B, et al.

“After more than a year of the COVID-19 pandemic, SARS-CoV-2 infection rates with newer variants continue to devastate much of the world. Global healthcare systems are overwhelmed with high positive patient numbers. Silent hypoxia accompanied by rapid deterioration and some cases with septic shock is responsible for COVID-19 mortality in many hospitalized patients. There is an urgent need to further understand the relationships and interplay with human host components during pathogenesis and immune evasion strategies. Currently, acquired immunity through vaccination or prior infection usually provides sufficient protection against the emerging variants of SARS-CoV-2 except Omicron variant requiring recent booster. New strains have shown higher viral loads and greater transmissibility with more severe disease presentations. Notably, COVID-19 has a peculiar prognosis in severe patients with iron dysregulation and hypoxia which is still poorly understood. Studies have shown abnormally low serum iron levels in severe infection but a high iron overload in lung fibrotic tissue. Data from our in-silico structural analysis of the spike protein sequence along with host proteolysis processing suggests that the viral spike protein fragment mimics Hepcidin and is resistant to the major human proteases. This functional spike-derived peptide dubbed “Covidin” thus may be intricately involved with host ferroportin binding and internalization leading to dysregulated host iron metabolism. Here, we propose the possible role of this potentially allogenic mimetic hormone corresponding to severe COVID-19 immunopathology and illustrate that this molecular mimicry is responsible for a major pathway associated with severe disease status. Furthermore, through 3D molecular modeling and docking followed by MD simulation validation, we have unraveled the likely role of Covidin in iron dysregulation in COVID-19 patients. Our meta-analysis suggests the Hepcidin mimetic mechanism is highly conserved among its host range as well as among all new variants to date including Omicron. Extensive analysis of current mutations revealed that new variants are becoming alarmingly more resistant to selective human proteases associated with host defense.”

Keywords: pandemic, iron

Indian Journal of Critical Care Medicine

Assessment of Risk Factors for Mortality in Patients in Medical Intensive Care Unit of a Tertiary Hospital

Authors: Kalın, BS, Özçaylak, S, Solmaz, İ, et al.

“Knowing the risk factors for patients in intensive care units (ICUs) facilitates patients management. The goal of this study was to determine the risk agents that influence our medical ICU mortality. This 11-month retrospective trial was managed in the medical ICU. In this study, 340 patients who were followed up for at least 24 hours in ICUs were accepted. The clinical data on patients were recorded retrospectively, and the mortality-related factors were analyzed. A regression analysis was also performed to determine the independent risk factors for ICU mortality. The median age was 73 (53–82) years. The death rate was 23.8%. Length of stay (LOS) in ICU was 3 (2–5) days, and APACHE-II (acute physiologic and chronic health evaluation) score was 19 (13–25). The prevalence of chronic diseases was not dissimilar except acute and chronic renal failures among survivors and deceased patients. Acute and chronic renal failures were higher in deceased patients than in survivors and were statistically important [107 (41.3%) vs 47 (58%) and 38 (14.7%) vs 22 (27.2%)], respectively. In the binary logistic regression analysis, age, APACHE II score, need for invasive mechanical ventilation (IMV), decreased serum albumin levels, and increased creatinine levels were established to be independent risk factors for death, respectively. The most significant risk agents of death were determined through high APACHE II score, decreased serum albumin levels, and increased creatinine levels.”

Keywords: risk factors, mortality, intensive care unit

International Journal of General Medicine

The Impact of Vitamin D Level on the Severity and Outcome of Hospitalized Patients with COVID-19 Disease

Authors: Al Khafaji, D, Al Argan, R, Albaker, W, et al.

“The world is experiencing a life-altering and extraordinary situation in response to the COVID-19 pandemic. There are limited data and controversies regarding the relationship between vitamin D (Vit D) status and COVID-19 disease. Thus, this study was designed to investigate the association between Vit D levels and the severity or outcomes of COVID-19 disease. A cross-sectional observational study was conducted in the Eastern province of Saudi Arabia from January to August 2021. All the admitted patients who were diagnosed with COVID-19 infection were distributed into three groups depending on their Vit D levels: normal, insufficiency, and deficiency. For the three groups, demographic data, and laboratory investigations as well as data regarding the severity of COVID-19 were collected and analysed. A total of 203 diagnosed cases of COVID-19 were included in this study. The Vit D level was normal (> 30) in 31 (15.3%) cases, insufficient in 45 (22.2%) cases and deficient in 127 (62.6%) cases. Among the included cases, 58 (28.6%) were critical cases, 109 (53.7%) were severe and 36 (17.7%) had a mild-moderate COVID-19 infection. The most prevalent comorbidity of patients was diabetes mellitus 117 (57.6%), followed by hypertension 70 (34.5%), cardiac disease 24 (11.8%), chronic kidney disease 19 (9.4%) and chronic respiratory disease in 17 (8.4%) cases. Importantly, the current study did not detect any significant association between Vit D status and COVID-19 severity (p-value=0.371) or outcomes (hospital stay, intensive care units admission, ventilation, and mortality rate) (p-value > 0.05), even after adjusting the statistical model for the confounders. In hospital settings, Vit D levels are not associated with the severity or outcomes of COVID-19 disease. Further, well‐designed studies are required to determine whether Vit D status provides protective effects against worse COVID-19 outcomes.”

Keywords: vitamin D, severity, observational, Saudi Arabia

BMJ Open

COVID-19 collateral damage—psychological burden and behavioural changes among older adults during the first outbreak in Stockholm, Sweden: a cross-sectional study

Authors: Beridze, G, Triolo, F, Grande, G, et al.

“To explore the indirect negative effects of COVID-19 restrictions (collateral damage) on the lives and health of older adults living in central Stockholm, and to characterise the sociodemographic profile of those with the highest susceptibility to this damage. Cross-sectional study, District of Kungsholmen in Stockholm, Sweden. Older adults aged 68 years and above (n=1231) who participated in the ad hoc COVID-19-related phone questionnaire administered by trained staff between May and June 2020 and who had previously attended the regular follow-up assessment of the Swedish National study on Aging and Care in Kungsholmen (SNAC-K) during 2016–2019. Three dimensions of collateral damage: psychological burden (feelings of worry, stress and loneliness), reductions in social and physical activities, and reductions in medical and social care use since the beginning of the pandemic. Logistic regression models were used to test the association between age, sex, education and living arrangement, and the risk of collateral damage. Vast majority of participants adhered to the national public health recommendations, with over three-quarters practising self-isolation (n=928). Half of the sample reported psychological burden, 55.3% reported reductions in social or physical activity, and 11.3% reported decreased medical or social care use. Over three quarters of participants (77.8%) were affected by at least one of the three collateral damage dimensions. Female sex was the strongest sociodemographic predictor of both individual and co-occurring dimensions of collateral damage. COVID-19 and its restrictions during the first half of 2020 had a negative effect on the health and lives of a majority of the elderly living in central Stockholm. Women were at a higher risk of these negative consequences. We emphasise the need for predefined, evidence-based interventions to support those who are most susceptible to these consequences, both during the pandemic and once the outbreak is overcome.”

Keywords: collateral damage, psychological burden, behavioural changes, Sweden

Sport Sciences for Health

“Wearables on vogue”: a scoping review on wearables on physical activity and sedentary behavior during COVID-19 pandemic

Authors: Panicker, RM, Chandrasekaran, B

“Wearables are intriguing way to promote physical activity and reduce sedentary behavior in populations with and without chronic diseases. However, the contemporary evidence demonstrating the effectiveness of wearables on physical health during the COVID-19 pandemic has yet to be explored. The present review aims to provide the readers with a broader knowledge of the impact of wearables on physical health during the pandemic. Five electronic databases (Web of Science, Scopus, Ovid Medline, Cumulative Index to Nursing and Allied Health Literature and Embase) were searched. The eligibility criteria of the studies to be included were based on PICOT criteria: population (adults, children and elderly), intervention (wearable, smartphones), comparison (any behavioral intervention), outcome (physical activity or sedentary behavior levels) and time frame (between December 1st, 2019 and November 19th, 2021). The present scoping review was framed as per the guidelines of the Arksey and O’Malley framework. Of 469 citations initially screened, 17 articles were deemed eligible for inclusion and potential scoping was done. Smartphone-based applications with inbuilt accelerometers were commonly used, while a few studies employed smart bands, smartwatches for physical health monitoring. Most of the studies observed the increased use of wearables in healthy adults followed by elderly, children and pregnant women. Considerable reduction (almost—50%) in physical activity during the pandemic: daily step count (− 2812 steps/min), standing (− 32.7%) and walking (− 52.2%) time was found. Wearables appears to be impending means of improving physical activity and reducing sedentary behavior remotely during the COVID-19 pandemic.”

Keywords: Physical activity, Wearable, Smartwatch, Sedentary behavior, Lockdown

Signals

Wearable Device for Observation of Physical Activity with the Purpose of Patient Monitoring Due to COVID-19

Authors: Daskalos, A-C, Theodoropoulos, P, Spandonidis, C, et al.

“In late 2019, a new genre of coronavirus (COVID-19) was first identified in humans in Wuhan, China. In addition to this, COVID-19 spreads through droplets, so quarantine is necessary to halt the spread and to recover physically. This modern urgency creates a critical challenge for the latest technologies to detect and monitor potential patients of this new disease. In this vein, the Internet of Things (IoT) contributes to solving such problems. This paper proposed a wearable device that utilizes real-time monitoring to detect body temperature and ambient conditions. Moreover, the system automatically alerts the concerned person using this device. The alert is transmitted when the body exceeds the allowed temperature threshold. To achieve this, we developed an algorithm that detects physical exercise named “Continuous Displacement Algorithm” based on an accelerometer to see whether a potential temperature rise can be attributed to physical activity. The people responsible for the person in quarantine can then connect via nRF Connect or a similar central application to acquire an accurate picture of the person’s condition. This experiment included an Arduino Nano BLE 33 Sense which contains several other sensors like a 9-axis IMU, several types of temperature, and ambient and other sensors equipped. This device successfully managed to measure wrist temperature at all states, ranging from 32 °C initially to 39 °C, providing better battery autonomy than other similar devices, lasting over 12 h, with fast charging capabilities (500 mA), and utilizing the BLE 5.0 protocol for data wireless data transmission and low power consumption. Furthermore, a 1D Convolutional Neural Network (CNN) was employed to classify whether the user is feverish while considering the physical activity status. The results obtained from the 1D CNN illustrated the manner in which it can be leveraged to acquire insight regarding the health of the users in the setting of the COVID-19 pandemic.”

Keywords: body temperature, wearable devices, 9-axis IMU, temperature sensors, indoor condition, activity recognition, BLE, Arduino nano 33 BLE sense

Emerging Microbes and Infections

Age-associated SARS-CoV-2 breakthrough infection and changes in immune response in mouse model

Authors: Chen Y, Li C, Liu F, et al.

“Older individuals are at higher risk of SARS-CoV-2 infection and severe outcome but the underlying mechanisms are incompletely understood. In addition, how age modulates SARS-CoV-2 re-infection and vaccine breakthrough infections remains largely unexplored. Here, we investigated age-associated SARS-CoV-2 pathogenesis, immune responses, and the occurrence of re-infection and vaccine breakthrough infection utilizing a wild type C57BL/6N mouse model. We demonstrated that interferon and adaptive antibody response upon SARS-CoV-2 challenge are significantly impaired in aged mice in comparison to young mice, which results in more effective virus replication and severe disease manifestations in the respiratory tract. Aged mice also showed increased susceptibility to re-infection due to insufficient immune protection acquired during primary infection. Importantly, two-dose COVID-19 mRNA vaccination conferred limited adaptive immune response among the aged mice which rendered them susceptible to SARS-CoV-2 infection. Collectively, our findings call for tailored and optimized treatment and prevention strategies against SARS-CoV-2 among the older individuals.”

Biomolecules

Calcium Signaling Pathway Is Involved in the Shedding of ACE2 Catalytic Ectodomain: New Insights for Clinical and Therapeutic Applications of ACE2 for COVID-19

Authors: García-Escobar, A, Vera-Vera, S, Jurado-Román, A, et al.

“The angiotensin-converting enzyme 2 (ACE2) is a type I integral membrane that exists in two forms: the first is a transmembrane protein; the second is a soluble catalytic ectodomain of ACE2. The catalytic ectodomain of ACE2 undergoes shedding by a disintegrin and metalloproteinase domain-containing protein 17 (ADAM17), in which calmodulin mediates the calcium signaling pathway that is involved in ACE2 release, resulting in a soluble catalytic ectodomain of ACE2 that can be measured as soluble ACE2 plasma activity. The shedding of the ACE2 catalytic ectodomain plays a role in cardiac remodeling and endothelial dysfunction and is a predictor of all-cause mortality, including cardiovascular mortality. Moreover, considerable evidence supports that the ACE2 catalytic ectodomain is an essential entry receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Additionally, endotoxins and the pro-inflammatory cytokines interleukin (IL)-1β and tumor necrosis factor-alpha (TNFα) all enhanced soluble catalytic ectodomain ACE2 shedding from the airway epithelia, suggesting that the shedding of ACE2 may represent a mechanism by which viral entry and infection may be controlled such as some types of betacoronavirus. In this regard, ACE2 plays an important role in inflammation and thrombotic response, and its down-regulation may aggravate COVID-19 via the renin-angiotensin system, including by promoting pathological changes in lung injury. Soluble forms of ACE2 have recently been shown to inhibit SARS-CoV-2 infection. Furthermore, given that vitamin D enhanced the shedding of ACE2, some studies reported that vitamin D treatment is associated with prognosis improvement in COVID-19. This is an updated review on the evidence, clinical, and therapeutic applications of ACE2 for COVID-19.”

Keywords: angiotensin-converting enzyme 2, calmodulin, soluble ACE2, ACE2 shedding, soluble catalytic ectodomain of ACE2, calcium signaling, vitamin D, COVID-19 thromboembolic events, neuropilin-1

medRxiv

Preprint

COVID-19 vaccination status is associated with physical activity in German-speaking countries: the COR-PHYS-Q cohort study

Authors: Schwendinger, F, Boeck, HT, Infanger, D, et al.

“To examine the association between COVID-19 vaccination status and physical activity (PA), sporting behavior, as well as barriers to PA in adults in Switzerland, Germany, and Austria. A total of 1516 adults provided complete responses to our online questionnaire sent out in August 2021. Information about self-reported PA categories, sporting behavior, barriers to PA, and COVID-19 vaccination status were gathered. Main analyses were done using multiple linear regression adjusted for relevant parameters. We found a significant association of vaccination status with total PA, vigorous PA, and moderate PA but not transport-related PA or sedentary time. Unvaccinated adults tended to have more total and vigorous PA than those vaccinated once or twice. Yet, not sufficient evidence was available to confirm this. There was no between-group difference in the contribution of leisure time, work-related, or transport-related PA to total PA. Vaccination status was not associated with sporting behavior except for jogging as the primary intensive type of sports. Finally, there were no significant differences in any of the COVID-19 specific barriers to PA between groups. Our data showed that vaccination status is associated with PA even in summer, where the number of COVID-19 cases was low and the severity of safety measures was mild. These findings may enhance future research and improve/extend COVID-19-specific PA guidelines.”

Keywords: vaccination status, physical activity, sports

VitaminDWiki

Vitamin D and COVID-19: a narrative review

Authors: Bae, JH, Choe, HJ, Holick, MF, et al.

“Vitamin D is associated with biological activities of the innate and adaptive immune systems, as well as inflammation. In observational studies, an inverse relationship has been found between serum 25-hydroxyvitamin D (25(OH)D) concentrations and the risk or severity of coronavirus disease 2019 (COVID-19). Several mechanisms have been proposed for the role of vitamin D in COVID-19, including modulation of immune and inflammatory responses, regulation of the renin-angiotensin-aldosterone system, and involvement in glucose metabolism and cardiovascular system. Low 25(OH) D concentrations might predispose patients with COVID-19 to severe outcomes not only via the associated hyperinflammatory syndrome but also by worsening preexisting impaired glucose metabolism and cardiovascular diseases. Some randomized controlled trials have shown that vitamin D supplementation is beneficial for reducing severe acute respiratory syndrome coronavirus 2 RNA positivity but not for reducing intensive care unit admission or all-cause mortality in patients with moderate-to-severe COVID-19. Current evidence suggests that taking a vitamin D supplement to maintain a serum concentration of 25(OH)D of at least 30 ng/mL (preferred range 40-60 ng/mL), can help reduce the risk of COVID-19 and its severe outcomes, including mortality. Although further well designed studies are warranted, it is prudent to recommend vitamin D supplements to people with vitamin D deficiency/insufficiency during the COVID-19 pandemic according to international guidelines.”

Keywords: vitamin D, coronavirus disease 2019, risk, severity

Journal of Clinical Immunology

First Identified Case of Fatal Fulminant Necrotizing Eosinophilic Myocarditis Following the Initial Dose of the Pfizer-BioNTech mRNA COVID-19 Vaccine (BNT162b2, Comirnaty): an Extremely Rare Idiosyncratic Hypersensitivity Reaction

Authors: Ameratunga, R, Woon, S-T, Sheppard, MN, et al.

“Transient myopericarditis has been recognised as an uncommon and usually mild adverse event predominantly linked to mRNA-based COVID-19 vaccines. These have mostly occurred in young males after the second dose of mRNA COVID-19 vaccines. The clinical and pathological observations from a case of fatal fulminant necrotising myocarditis in a 57-year-old woman, following the first dose of the Pfizer-BioNTech vaccine, are described. Other causes have been discounted with reasonable certainty.”

Trends in Food Science & Technology

Evidences and perspectives of the use of probiotics, prebiotics, synbiotics, and postbiotics as adjuvants for prevention and treatment of COVID-19: A bibliometric analysis and systematic review

Authors: Xavier-Santos, D, Padilha, M, Fabiano, GA, et al.

“Coronavirus disease-19 (COVID-19) is an infectious disease transmitted by the virus responsible for the severe acute respiratory syndrome 2 (SARS-CoV-2), which exhibit several clinical manifestations including gastrointestinal symptoms. This review aimed to provide insights and perspectives for the use of probiotics, prebiotics, synbiotics, and postbiotics as adjuvants for prevention/treatment and/or modulation of the microbiota in COVID-19 patients. Eighty-four studies published in the Scopus database from the onset of the pandemic until December 2021 were assessed and submitted to a bibliometric analysis adapted from VOSviewer software. Through bibliometric analysis, it might be suggested that the modulation of the gut/lung microbiome is promising as an adjuvant for the prevention/treatment of COVID-19 patients, due to immunomodulation properties related to probiotics and prebiotics. So far, few clinical studies involving the application of probiotics in COVID-19 patients have been completed, but reduction in the duration of the disease and the severity of symptoms as fatigue, olfactory dysfunction and breathlessness, nausea and vomiting and other gastrointestinal symptoms were some of the main findings. However, probiotics are not recommended to immunocompromised patients in corticosteroid therapy. The future perspectives point to the modulation of the intestinal microbiota by probiotics, prebiotics, synbiotics, and postbiotics represent a promising adjuvant approach for improving the health of patients with COVID-19.”

Keywords: Diet, Functional foods, Gut-lung axis, Immunomodulation, Microbiome, Pandemic

Research Gate

Preprint

Ivermectin Prophylaxis Used for COVID-19 Reduces COVID-19 Infection and Mortality Rates: A City-Wide, Prospective Observational Study of 223,128 Subjects Using Propensity Score Matching

Authors: Kerr, L, Flávio, C, Baldi, F, et al.

“Updated manuscript: In January 8, 2022, we posted an updated version of our manuscript, with a few corrections. The most relevant correction was the analysis of the COVID-19 infection rates among ivermectin users and non-users. Third-party, independent analysis was performed on the two datasets used for the present analysis. The detailed description of the employment of the data used is illustrated in Figure 1 of the main manuscript. We also updated the Supplement Appendix 1 in the same date. Changes are highlighted in bold for an easier visualization. || Abstract. Background: Ivermectin has demonstrated different mechanisms of action that potentially protect from both COVID-19 infection and COVID-19-related comorbidities. Based on the studies suggesting efficacy in prophylaxis combined with the known safety profile of ivermectin, a citywide prevention program using ivermectin for COVID-19 was implemented in Itajai, a Southern city in Brazil in the state of Santa Catarina. The objective of this study was to evaluate the impact of regular ivermectin use on subsequent COVID-19 infection and mortality rates. Materials and methods: We analyzed data from a prospective, observational study of the citywide COVID-19 prevention with ivermectin program which occurred between July 2020 to December of 2020 in Itajaí, Brazil. Study design, institutional review board approval, and analysis of registry data occurred after completion of the program. The program consisted of inviting the entire population of Itajaí to a medical visit in order to enroll in the program and to compile baseline, personal, demographic and medical information. In the absence of contraindications, ivermectin was offered as an optional treatment to be taken 2 consecutive days every 15 days at a dose of 0.2mg/kg/day. In cases where a participating citizen of Itajai became ill with COVID-19, they were recommended to not use ivermectin or any other medication in early outpatient treatment. Clinical outcomes of infection, hospitalization, and death were automatically reported and entered into the registry in real time. Study analysis consisted of comparing ivermectin users with non-users using cohorts of infected patients propensity score matched (PSM) by age, sex, and comorbidities. COVID-19 infection and mortality rates were analyzed with and without use of propensity score matching. Results: Of the 223,128 citizens of Itajaí considered for the study, a total of 159,561 subjects were included in the analysis; 113,845 (71.3%) regular ivermectin users and 45,716 (23.3%) non-users. Of these, 4,311 ivermectin users were infected, among which 4,194 from the city of Itajaí (3.7% infection rate) and 3,034 non-users (from Itajaí) were infected (6.6% infection rate), a 44% reduction in COVID-19 infection rate (Risk ratio (RR), 0.56; 95% confidence interval (95%CI), 0.53 – 0.58; p < 0.0001). Using PSM, two cohorts of 3,034 subjects suffering COVID-19 infection were compared. The regular use of ivermectin led to a 68% reduction in COVID-19 mortality [25 (0.8%) versus 79 (2.6%) among ivermectin non-users; risk ratio (RR), 0.32; 95% confidence interval (CI), 0.20 – 0.49; p < 0.0001]. When adjusted for residual variables, reduction in mortality rate was 70% (RR, 0.30; 95%CI 0.19 – 0.46; p < 0.0001). There was a 56% reduction in hospitalization rate (44 versus 99 hospitalizations among ivermectin users and non-users, respectively; RR, 0.44; 95%CI, 0.31 – 0.63; p < 0.0001). After adjustment for residual variables, reduction in hospitalization rate was 67% (RR, 0.33; 95%CI 023 – 0.66; p < 0.0001). Conclusion: In this large, propensity score matched study, regular use of ivermectin as a prophylactic agent was associated with significantly reduced COVID-19 infection, hospitalization, and mortality rates.”

Keywords: COVID-19, SARS-CoV-2, ivermectin, prophylaxis, prevention, coronavirus

Research Gate

Preprint

Ivermectin Prophylaxis Used for COVID-19 Reduces COVID-19 Infection and Mortality Rates: A City-Wide, Prospective Observational Study of 223,128 Subjects Using Propensity Score Matching

Authors: Kerr, L, Flávio, C, Baldi, F, et al.

“Updated manuscript: In January 8, 2022, we posted an updated version of our manuscript, with a few corrections. The most relevant correction was the analysis of the COVID-19 infection rates among ivermectin users and non-users. Third-party, independent analysis was performed on the two datasets used for the present analysis. The detailed description of the employment of the data used is illustrated in Figure 1 of the main manuscript. We also updated the Supplement Appendix 1 in the same date. Changes are highlighted in bold for an easier visualization. || Abstract. Background: Ivermectin has demonstrated different mechanisms of action that potentially protect from both COVID-19 infection and COVID-19-related comorbidities. Based on the studies suggesting efficacy in prophylaxis combined with the known safety profile of ivermectin, a citywide prevention program using ivermectin for COVID-19 was implemented in Itajai, a Southern city in Brazil in the state of Santa Catarina. The objective of this study was to evaluate the impact of regular ivermectin use on subsequent COVID-19 infection and mortality rates. Materials and methods: We analyzed data from a prospective, observational study of the citywide COVID-19 prevention with ivermectin program which occurred between July 2020 to December of 2020 in Itajaí, Brazil. Study design, institutional review board approval, and analysis of registry data occurred after completion of the program. The program consisted of inviting the entire population of Itajaí to a medical visit in order to enroll in the program and to compile baseline, personal, demographic and medical information. In the absence of contraindications, ivermectin was offered as an optional treatment to be taken 2 consecutive days every 15 days at a dose of 0.2mg/kg/day. In cases where a participating citizen of Itajai became ill with COVID-19, they were recommended to not use ivermectin or any other medication in early outpatient treatment. Clinical outcomes of infection, hospitalization, and death were automatically reported and entered into the registry in real time. Study analysis consisted of comparing ivermectin users with non-users using cohorts of infected patients propensity score matched (PSM) by age, sex, and comorbidities. COVID-19 infection and mortality rates were analyzed with and without use of propensity score matching. Results: Of the 223,128 citizens of Itajaí considered for the study, a total of 159,561 subjects were included in the analysis; 113,845 (71.3%) regular ivermectin users and 45,716 (23.3%) non-users. Of these, 4,311 ivermectin users were infected, among which 4,194 from the city of Itajaí (3.7% infection rate) and 3,034 non-users (from Itajaí) were infected (6.6% infection rate), a 44% reduction in COVID-19 infection rate (Risk ratio (RR), 0.56; 95% confidence interval (95%CI), 0.53 – 0.58; p < 0.0001). Using PSM, two cohorts of 3,034 subjects suffering COVID-19 infection were compared. The regular use of ivermectin led to a 68% reduction in COVID-19 mortality [25 (0.8%) versus 79 (2.6%) among ivermectin non-users; risk ratio (RR), 0.32; 95% confidence interval (CI), 0.20 – 0.49; p < 0.0001]. When adjusted for residual variables, reduction in mortality rate was 70% (RR, 0.30; 95%CI 0.19 – 0.46; p < 0.0001). There was a 56% reduction in hospitalization rate (44 versus 99 hospitalizations among ivermectin users and non-users, respectively; RR, 0.44; 95%CI, 0.31 – 0.63; p < 0.0001). After adjustment for residual variables, reduction in hospitalization rate was 67% (RR, 0.33; 95%CI 023 – 0.66; p < 0.0001). Conclusion: In this large, propensity score matched study, regular use of ivermectin as a prophylactic agent was associated with significantly reduced COVID-19 infection, hospitalization, and mortality rates.”

Keywords: COVID-19, SARS-CoV-2, ivermectin, prophylaxis, prevention, coronavirus

International Journal of Research in Engineering, Science and Management

Role of Vitamin-D in COVID-19 Treatment

Authors: Prasanna, KS, Raju, B, Sharma, JVC

“The COVID-19 epidemic has triggered a global public health emergency. Little is known about the infection’s protective factors. As a result, preventative health interventions to lower the risk of infection, progression, and severity are critical. The potential function of vitamin D in lowering the risk of COVID-19 and other acute respiratory tract infections, as well as their severity, was examined in this review. Furthermore, as of May 20, 2020, this study evaluated the relationship between vitamin D levels and COVID-19 instances and deaths in 20 European nations. There was a significant negative correlation between mean vitamin D levels and COVID-19 cases per million population in European countries. In these countries, however, there was no significant connection between vitamin D and COVID-19 mortality. substantial link between vitamin D and COVID-19 mortality in these countries. Some retrospective investigations indicated a link between vitamin D level and COVID-19 severity and mortality, whereas others found no link when confounding factors were taken into account.”

Keywords: infections, risk factors, antiviral mechanisms, Renin-Angiotensin axis, biological activity, vitamin D

BEACON Medical Journal

Role of Dietary Habit and Nutritional Status on The Severity of Covid-19 Treatment: A Hospital Based Cross-sectional Study

Authors: Eva, MA, Islam K, Afrin M, et al.

“: The severe acute respiratory syndrome coronavirus (SARS-CoV)-2 disease (COVID)-19 is having unusal outcome on the worldwide economy and nutrition commerce. Narrow data are obtainable on how this pandemic is touching our dietary and nutritional behaviors in Bangladesh. Aim of this study is to determine the relationship between history of dietary habits and nutritional status on the severity of covid-19 treatment. This descriptive cross-sectional study was done among the adult resident of Dhaka city during the Covid-19 pandemic. Several sociodemographic, dietary patterns, nutritional status, and behavioral factors have been found in this study. In this study, 16-85 years old people were included, and under 15 years old children were excluded. In this study, it was found that about 83% of patients were male and 17% patients were female, and the mean and SD of age were 45.24 and ±7.24, respectively. It was found thatBMI(Body Mass Index), skip their meals, how many meals are eaten in a day, how does the food was eaten, take extra salt (pickles, chips, sauce, Chana Chur, salted biscuits etc.), eat protein everyday, eat carbohydrate everyday and eat carbohydrate everyday and eat vitamin D containing food (liver, Orange juice, butter, cheese, milk, egg etc.)were significantly associated with severity of the treatment. This study has a limitation of time and funds to conduct more extensively. However, this study will enhance the knowledge on the role of dietary habits and nutritional status on the severity of covid-19 treatment. ”

Keywords: dietary habit, nutritional status, severity

Haydarpaşa Numune Medical Journal

The Effect Of Serum Cortisol And Vitamin D Level On Mortality In Covid-19 Patients Admitted To The Intensive Care Unit

Authors: Uzun, U, Güneş, M, Arslan, FD, et al.

“One of the methods to decrease deaths due to Coronavirus-19 disease is to recognize the factors that increase the mortality of the disease. It is thought that the deficiency of vitamin D, the vitamin which supports the immune system, and corticosteroids which are administered to suppress excessive response may be risk factors that may affect mortality. In our study, we evaluated serum vitamin D and cortisol levels in COVID-19 patients during their admission to the intensive care unit, together with their demographic data and its comorbidities, and examined their effects on mortality and their relationship with intensive care scores. 101 Covid-19 patients were examined. Serum vitamin D and cortisol levels do not affect mortality statistically. Intensive care unit admission was more common in patients with low vitamin D levels. Cortisol levels were higher in deceased patients. Vitamin D deficiency increases the risk of admission to the intensive care unit, and serum vitamin D and cortisol levels measured during admission to the intensive care unit do not affect the prediction of mortality. ”

Keywords: vitamin D, cortisol, intensive care unit

Lancet

miRNAs and COVID-19 Therapy

Authors: Naser, M, Naser, MM, Sheheta, LH

“The novel Covid disease 2019 (COVID-19) is caused because of SARS-CoV-2 infection which has been declared a pandemic. The significance of miRNAs in the pathogenesis of this viral disease is summed up. Right now, there is no approved treatment or immunization for COVID-19 and miRNAs can come to become a potential therapeutic tool. This work depicts the idea of developing Nano formulation(s) of the SARS-CoV-2-related miRNAs. Multi-targeting methods are needed for miRNA Nano-therapy for effectively tackling SARS-CoV-2. The Nanoparticles-based miRNAs could be utilized in the form of Nano-vaccines for the prevention from SARS-CoV-2. These days, the extreme intense respiratory condition Coronavirus 2 (SARS-CoV-2) disease is recognised on the grounds that the primary cause behind mortality in people. SARS-CoV-2 is transmitted through human-to-human contact and is a symptomless in many patients. furthermore, to approved vaccines against SARS-CoV-2 infection, miRNAs may additionally be promising decisions against the current new virus. miRNAs are small and noncoding RNAs 18–25 nucleotides in length that focus on the mRNAs to degrade them or block their interpretation miRNAs go about as an observer in cells. This review in regards to evaluated the writing on the potential role of cellular miRNAs inside the SARS-CoV-2-have collaboration as a therapeutic option in COVID-19 patients. ”

Keywords: mRNA

International Journal of Science and Research

Role of Physical Activity in the Battle with Coronavirus Pandemic

Authors: Gupta, S, Sharma, P

“Physical activity is one of the important tools for good health. It helps prevent and/or treat many physical and mental health conditions by improving functioning of numerous physiological systems. In this article we will discuss how physical activity could help ease the foreseen trauma of the coronavirus pandemic in many ways. ”

Keywords: immune, physical inactivity

Journal of Digital Social Research

#Vachina: How Politicians help to spread Disinformation about COVID-19 Vaccines

Authors: Recuero, R, Soares, FB

“This paper focuses on how Brazilian politicians helped to spread disinformation about Covid-19 vaccines, discussing legitimation strategies and actors that played a significant role on Twitter and Facebook. Based on data gathered through CrowdTangle and Twitter API, we selected the 250 most shared/retweeted posts for each dataset (n=500) and examined if they contained disinformation, who posted it, and what strategy was used to legitimize this discourse. Our findings indicate that politicians and hyperpartisan accounts have a key influence in validating the Brazilian president’s populist discourse through rationalization (pseudo-science) and denunciation (against the vaccine). The political frame also plays an important role in disinformation messages.”

Keywords: anti-vaccine, disinformation, social media, discourse

arxiv

Preprint

Insights from a computational analysis of the SARS-CoV-2 Omicron variant: Host-pathogen interaction, pathogenicity, and possible therapeutics

Authors: Parvez, SA, Saha, MK, Ibrahim, M, et al.

“Prominently accountable for the upsurge of COVID-19 cases as the world attempts to recover from the previous two waves, Omicron has further threatened the conventional therapeutic approaches. Omicron is the fifth variant of concern (VOC), which comprises more than 10 mutations in the receptor-binding domain (RBD) of the spike protein. However, the lack of extensive research regarding Omicron has raised the need to establish correlations to understand this variant by structural comparisons. Here, we evaluate, correlate, and compare its genomic sequences through an immunoinformatic approach with wild and mutant RBD forms of the spike protein to understand its epidemiological characteristics and responses towards existing drugs for better patient management. Our computational analyses provided insights into infectious and pathogenic trails of the Omicron variant. In addition, while the analysis represented South Africa’s Omicron variant being similar to the highly-infectious B.1.620 variant, mutations within the prominent proteins are hypothesized to alter its pathogenicity. Moreover, docking evaluations revealed significant differences in binding affinity with human receptors, ACE2 and NRP1. Owing to its characteristics of rendering existing treatments ineffective, we evaluated the drug efficacy against their target protein encoded in the Omicron through molecular docking approach. Most of the tested drugs were proven to be effective. Nirmatrelvir (Paxlovid), MPro 13b, and Lopinavir displayed increased effectiveness and efficacy, while Ivermectin showed the best result against Omicron.”

Keywords: Omicron variant, ACE2, NRP1, drugs efficacy, host-pathogen interaction, Ivermectin, Paxlovid, Lopinavir

International Journal of Biological Sciences

Cytokine storm in COVID-19: from viral infection to immune responses, diagnosis and therapy

Authors: Jiang Y, Rubin L, Peng T, et al.

“The COVID-19 outbreak is emerging as a significant public health challenge. Excessive production of proinflammatory cytokines, also known as cytokine storm, is a severe clinical syndrome known to develop as a complication of infectious or inflammatory diseases. Clinical evidence suggests that the occurrence of cytokine storm in severe acute respiratory syndrome secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is closely associated with the rapid deterioration and high mortality of severe cases. In this review, we aim to summarize the mechanism of SARS-CoV-2 infection and the subsequent immunological events related to excessive cytokine production and inflammatory responses associated with ACE2-AngII signaling. An overview of the diagnosis and an update on current therapeutic regimens and vaccinations is also provided.”

Keywords: cytokine storm, immune response, cytokines, diagnosis, therapy, vaccination

Pakistan Journal of Biological Sciences

COVID-19: A Review on the Role of Trace Elements Present in Saudi Arabian Traditional Dietary Supplements

Authors: A Alfheeaid, H, Imam Rabbani, S

“The novel coronavirus infection is also called COVID-19 (coronavirus disease 2019). The infection has affected millions of people worldwide and caused morbidity as well mortality in patients with pre-existing chronic conditions such as metabolic, respiratory and cardiovascular disorders. The severity of the disease is mostly seen in people with low immunity and chronic sufferers of respiratory, cardiovascular and metabolic disorders. To date, there is no specific treatment available for COVID-19. Precaution and prevention are the most recommended options followed for controlling the spread of infection. Trace elements such as zinc, calcium, iron and magnesium play an important role in boosting the immunity of the host system. These components assist in the development and functioning of lymphocytes, cytokines, free radicals, inflammatory mediators and endothelial functioning. This review summarizes the common dietary supplements that are regularly consumed in Saudi Arabia and are known to contain these vital trace elements. Data available in Google Scholar, NCBI, PUBMED, EMBASE and Web of Science about COVID-19, micronutrients, trace elements and nutritional supplements of Saudi Arabia was collected. By highlighting the traditionally used dietary components containing the essential elements, this review could provide useful knowledge crucial for building immunity in the population.”

Keywords: dietary supplements, immunity, population, trace elements

Pakistan Journal of Biological Sciences

Treatment and Prevention of Viral Infections through Nutrition and Strengthened Immunity: The COVID-19 Pandemic Case Scenario

Authors: Ibrahim Alhazmi, A, Saleh Al-Sowayan, N

“The cause of the ongoing massive pandemic, the SARS-CoV-2 virus, originated in Wuhan, China and spread rapidly worldwide. The pandemic has helped identify the difficulties associated with devising best practices necessary to augment the immune system to prevent the contraction of viral infections, as well as enhance the process of recovery if an infection does occur. Medical scholars and researchers have been actively assessing dietary aspects that may improve the health of immune systems. It is already well-established that malnourishment can lead to increased oxidative stress and cause inflammation. Such conditions weaken the immune system and make people vulnerable to bacterial and infectious illnesses. In the current scenario, scientists have confirmed that some dietary components can enhance immunity in COVID-19 patients. Empirical evidence suggested that the condition of COVID-19 patients is largely attributable to increased metabolic rates that drain the body’s glucose supplies. This highlights the necessity of improving the quality of enteral nutrition provided to COVID-19 patients. Despite being dietarily sensitive, these individuals require regular monitoring and assessments to discern their nutritional deficiencies. In general, the diet should include foodstuffs with anti-inflammatory properties and micronutrients, including polyphenols, carotenoids, vitamin C, vitamin E, etc. Considering nutrition in the overall treatment provided will greatly fortify the immunity of COVID-19 patients and increase the probability of survival.”

Keywords: dietary therapy, enteral nutrition, immune system, inflammation, oxidative stress

National Institute of Public Health NIH

Vitamin D in SARS-CoV-2-Infection

Authors: Decyk, A, Kobylińska, M, Antosik, K, et al.

“SARS-CoV-2 virus is one of the largest RNA viruses, included in the coronavirus group, showing tropism to airway epithelial cells. SARS-CoV-2 causes an acute espiratory infectious disease, Covid-19. According to WHO reports, mortality due to Covid-19 is higher in the elderly and in those burdened with comorbidities such as diabetes, obstructive pulmonary disease, coronary artery disease, cancer, hypertension, hepatitis B, obesity or chronic kidney disease. The aim of the study was to review the current literature on the influence and importance of vitamin D levels on the course of SARS-CoV-2 infection. A systematic review of studies published from January 1, 2009 to June 31, 2021 has been performed. For this purpose, bibliographic databases such as PubMed and Scopus were searched. The following keywords and combinations were used: Covid-19, vitamin D, 25-hydroxy-vitamin D, vitamin D supplementation, SARS-CoV-2. It has been shown that vitamin D plays an important role in the mechanisms of the innate immunity in the course of the acute respiratory infections. The overlapping factors of the severity of COVID-19 disease, vitamin D deficiency, and the prevalence of obesity, age scare, ethnicity, has led some researchers to hypothesize that vitamin D supplementation may be promising as a preventive or therapeutic measure for COVID-19. A very important factor that has an immunomodulatory character is vitamin D, the adequate supplementation of which can be a preventive or therapeutic measure in case of SARS-CoV-2 infection, especially in elderly people, with obesity and other chronic diseases.”

Keywords: vitamin D3, supplementation

Journal of Anthropology of Sport and Physical Education

Gender Differences in Physical Activity, Physical Fitness and Well-being of Students During The Lock-Down Due to Covid-19 Pandemic

Authors: Bajramovic, I, Bjelica, D, Krivokapić, D, et al.

“Restricting movement for the population and the impact of preventative measures due to the COVID-19 pandemic have spurred research interests in analyzing the healthy lifestyle of the student population. The aim of the study was to examine gender differences between students in physical activity, and the perceptions of physical fitness and well-being during lock-down due to COVID-19. The sample consisted of male (n=268; 25.9%; age 22.56±2.12) and female students (n=768; 74.1%; age 22.12±1.73) at the University of Sarajevo (UNSA). The questionnaire included questions and scales constructed to measure: physical activity, physical fitness, and the acute effects on well-being. χ² independence test were used to determine gender differences (p<0.05). Prior to the declaration of the COVID-19, there was a significant difference in the level of regular physical activity between male and female students at UNSA. The data indicated that at that time 65% of male students were regularly physically active, while 45% of female students had regular physical activity. During the lock-down measures at UNSA: 46% of male and 40% of female students reported being regularly physically active and no significant differences were found in relation to gender; 65% of male and 58% of female students reported a decline in physical fitness and significant gender differences were found. After exercising male students reported better concentration and mood, more energy and motivation, and less nervousness in the range of 62–79%, while female students reported better concentration and mood, more energy and motivation, and less nervousness in the range of 62-81%. No significant differences were found in the physical activity acute effects on students’ well-being in relation to gender. Although gender differences in physical activity disappeared during the early phase of COVID-19 and lockdown measures, a more pronounced decrease in physical fitness was present in female students. The reported physical activity had equally positive acute effects on students’ well-being.”

Keywords: lockdown, active lifestyle, physical exercise

European Review for Medical and Pharmacological Sciences

Social inequalities and nutritional disparities: the link between obesity and COVID-19

Authors: De Lorenzo, A, Cenname, G, Marchetti, M, et al.

“Cohort studies, clinical audits of patients with COVID-19 in hospital and routine primary care records provided evidence-based insights on the relationship between excess weigh, obesity and COVID-19. The purpose of this umbrella review is to highlight the relationship between nutritional quality and social inequalities related to CDNCD, obesity and SARS-CoV-2 infection. Only articles published from 2008 to the present were included in the search to show an updated picture of the topic. The search for published studies was conducted in February 2021 in the scientific databases PubMed (MEDLINE). The terms used for the search were “COVID-19”, “Obesity”, “Disparities”, “Nutritional inequalities”, “Chronic degenerative non-communicable diseases” and “review” OR “systematic review” OR “meta-analysis” separated by the Boolean operator AND. 1874 reviews were found, but only 99 met the objective. Obese or dysmetabolic patients are those who had a worse course of disease following COVID-19. This data was observed not only for Chinese and Caucasians, but also and above all among Africans, African Americans, Latinos and indigenous people. Plausible mechanisms to explain the association between obesity and COVID-19 outcomes, included the role of excess adipose tissue on respiratory function, metabolic dysfunction, the cardiovascular system, enhanced inflammatory response and impaired response to infection. Today, chronic non-communicable degenerative diseases (CDNCDs) are responsible for 70% of public health expenditure, affecting 30% of the population (one or more chronic diseases). Unfortunately, given the health emergency due to SARS-CoV-2, infectious diseases are currently more at the center of attention. However, the spread of infectious communicable diseases and CDNCDs is facilitated in situations of social disparity. In fact, in the poorest countries there are the highest rates of malnutrition and there is a greater risk of contracting viral infections, as well as, paradoxically, a risk of comorbidity, due to access to cheaper food and qualitatively poor, with high caloric density.”

Keywords: obesity, disparities, nutritional inequalities, chronic degenerative non-communicable diseases

Asian Pacific Journal of Health Sciences

Quality and Content of Online Information Related to “Immunity Boosting” During COVID-19 Pandemic: Comparison of Google and DuckDuckGo

Authors: Shrivastava, A, Agarwal, A, Jain, S

“Use of internet for assessing health-related information has been growing exponentially in the past few years. The objective of this study was to assess the quality of information on the websites on Google and DuckDuckGo. A total of 120 URLs were recorded from Google and DuckDuckGo using the search terms “immunity booster,” “immunity boosting foods,” and “immunity boosting drinks.” These were rated by three independent raters using DISCERN tool. The average ratings for the DISCERN questions were in the range of 2.01–3.82. More than 85% of the websites were of moderate quality. There was excellent inter-rater reliability among the raters. About 47% of the websites depicted immunity boosting as beneficial. About 11% of the websites recommended use of supplements for immunity boosting. Diet, exercise, and adequate sleep were the most commonly recommended strategies for immunity boosting. Vitamin C, Vitamin A, and gingerol were the most commonly recommended dietary components for immunity boosting. Overall, there was no statistically significant difference in the quality of websites on Google and DuckDuckGo. Most of the websites suffered from shortcomings in the quality of information based on DISCERN quality criteria. ”

Keywords: DISCERN tool, Immunity boosting, information quality, Internet, Online health information

Chinese Journal of Pharmacovigilance

Giant progress in small molecule antiviral drugs for SARS-CoV-2

Authors: Zhao, Z, Zhang, Q, Ge, Z, et al.

“ To study anti-SARS-CoV-2 drugs of protease inhibitors and RNA-dependent RNA polymerase inhibitors. Methods The mechanism of action, pharmacokinetics and clinical trials of two kind of drugs are reviewed. Small molecule drugs have the advantages of easy absorption, small molecular volume, ability to penetrate cell membrane, and easy large-scale industrial production, which are the focus of drug research and development. In the small-molecule drugs for SARS-CoV-2, breakthroughs have been made in protease inhibitors (such as Paxlovid) that target the viral protein splicing step and RNA-dependent RNA polymerase inhibitors (such as molnupiravir). It is expected that these drugs can be widely used in early treatment in the future to reduce the rate of severe illness and mortality. ”

Keywords: small molecule drugs, protease inhibitor, polymerase inhibitor, clinical trials

Journal of Applied Nutritional Sciences

COVID-19: A Review of Immuneenhancing Nutrients and Supplements

Authors: Forsan, HF, Rahman, ARA, Safwat, M, et al.

“In the era of COVID-19 infection, there is an urgent need to use immune-enhancing nutrients. The frequency of COVID-19 infection is largely affected by an individual’s nutritional status. This review summarizes the available nutrients and supplements that help enhance the immune system against infections especially COVID-19. They have antiviral activities, especially against SARS-CoV-2, or even can ameliorate the undesired consequences of COVID-19 by their anti-inflammatory and antioxidant properties. It mentions many nutrients and supplements that aid in fighting or protecting from this pandemic infection such as probiotics, milk including breastfeeding, camel’s milk, and supplements including vitamins and minerals. It discusses their role as an antiviral, immunostimulant, or even their role as antioxidant and anti-inflammatory COVID-19 protection. Until our time, the pieces of evidence determining the use of dietary supplements in COVID-19 protection and treatment are insufficient and restricted. So, the use of dietary supplements cannot be used alone to treat COVID-19 but to support the current management of COVID-19. ”

Keywords: immunostimulants, minerals, probiotics, vitamins

Physical Education of Students

Association between physical activity and sleep quality in Algerian adults during COVID-19 lockdown

Authors: Oudjedi, A, Derouiche, M, Allali, A, et al.

“There is no doubt that the Coronavirus disease (COVID-19) pandemic, and its related containment measures such as lockdown and social distancing, is affecting physical activity and sleep quality of the general population worldwide. Algeria, one of the most affected countries in Africa, entered the lockdown on March 9, 2020. Numerous studies have explored the interaction between physical activity and sleep quality showing the effect of physical activity levels on sleep, yet previous researches have not investigated the relationship between physical activity and sleep quality during lockdown. The main purpose of the present study was to investigate the association between physical activity and sleep quality in quarantined individuals. A national Google online survey was conducted between 16th April and 25th May 2020. 1002 Participants responded to the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the short form of the International Physical Activity Questionnaire (IPAQ). Of the 1002 participants who completed the survey, 358 were students. The final data were collected from the respondents. The COVID-19 home confinement led to a decrease in physical activity levels. However, the majority of the study population had good sleep quality (61.9%), while only (38.1%) had poor sleep quality. In addition, women are less physically active than men. Moreover, there was a significant difference in sleep quality between sufficient and insufficient physical activity groups. Our results show that Algerian adults have low levels of physical activity, good sleep quality, and poor sleep quality is associated with insufficient physical activity in adults during lockdown. ”

Keywords: adults, sleep quality, physical activity, students

Higeia Journal of Public Health Research and Development

Vitamin D Deficiency with Mortality Rate of Hospitalized COVID-19 Patients

Authors: Puspitasari, G, Nurlistyani, DP, Hartono, F, et al.

“Globally, Coronavirus Disease–19 (COVID–19) pandemics have led to 4.2 million deaths. Vitamin D deficiency is suspected as one factor of COVID-19 high mortality. This study aims to analyze the relationship between vitamin D deficiency and COVID-19 mortality rate. This research is a systematic review study conducted in April - June 2021, at Public Health and Preventive Medicine Department, FK Unair Surabaya. By using Pubmed and Science Direct, we found a total of 86 related scientific articles. An analysis was performed using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) method with 17 articles qualified for further analysis. A total of two articles that fulfilled eligibility criteria were included in this study. One article found that vitamin D deficiency was associated with mortality in hospitalized COVID-19 patients, while another article found that vitamin D deficiency was associated with COVID-19 mortality in patients over 65 years old. This study concludes that vitamin D deficiency is associated with COVID-19 mortality rates. ”

Keywords: mortality, vitamin D

Journal of Tropical Life Science

Toxicity of Food Supplements as An Adjuvant for COVID-19 Treatment or Prevention

Authors: Zhivikj, Z, Ivanovska, TP, Petrushevska-Tozi, L, et al.

“Commercially available food supplements, especially vitamins and minerals, are becoming increasingly popular in the era of COVID-19 pandemic. Sales of food supplements increased dynamically because of the belief that they could be more effective than conventional antiviral or corticosteroid drugs as well as missing the specific medical therapy for preventing or treating this disease. The greatest interest is associated with immune-related nutrients and antioxidant agents, including vitamin C, vitamin D, vitamin E, selenium (Se), and zinc (Zn). These are currently under clinical investigation for possible application in the prevention and management of COVID-19. This review summarizes postulated mechanisms of commonly used supplements suggested reducing the duration and severity of viral infections by improving immune response. Their toxicity in the context of potential adverse effects is also discussed. Whether these molecules and the amount could hurt patients with COVID-19 are research questions worth evaluating. Considering both efficacy and safety, evidence supporting larger intakes of specific nutrients with immune-boosting and/or antioxidant properties needs further research. Until relevant responses are provided, age and gender related tolerable upper intake levels for vitamins and minerals should be considered to avoid weight gaining as an additional risk factor of developing complications during the disease course, besides the risk of inappropriate doses associated with toxicity. Herein, high-quality information respecting specific nutrients proposed to have positive effect against COVID-19 is disseminated and certain research gaps are addressed, requiring the research on the health effects of supplements to be tightly correlated to age, nutritional status, wellbeing and particular to existing co-morbidities. ”

Keywords: mineral, nutrient, supplementation, vitamins, vitamin D, vitamin C, vitamin E, selenium, zinc

medRxiv

Preprint

Effectiveness of COVID-19 vaccines against Omicron or Delta infection

Authors: Buchan, SA, Chung, H, Brown, KA, et al.

“The incidence of SARS-CoV-2 infection, including among those who have received 2 doses of COVID-19 vaccines, has increased substantially since Omicron was first identified in the province of Ontario, Canada. We included 3,442 Omicron-positive cases, 9,201 Delta-positive cases, and 471,545 test-negative controls. After 2 doses of COVID-19 vaccine, vaccine effectiveness against Delta infection declined steadily over time but recovered to 93% (95%CI, 92-94%) ≥7 days after receiving an mRNA vaccine for the third dose. In contrast, receipt of 2 doses of COVID-19 vaccines was not protective against Omicron. Vaccine effectiveness against Omicron was 37% (95%CI, 19-50%) ≥7 days after receiving an mRNA vaccine for the third dose. Two doses of COVID-19 vaccines are unlikely to protect against infection by Omicron. A third dose provides some protection in the immediate term, but substantially less than against Delta. Our results may be confounded by behaviours that we were unable to account for in our analyses. Further research is needed to examine protection against severe outcomes.”

The Lancet

Transmissibility of SARS-CoV-2 among fully vaccinated individuals

Authors: Franco-Paredes, C

“Vaccine effectiveness studies have conclusively demonstrated the benefit of COVID-19 vaccines in reducing individual symptomatic and severe disease, resulting in reduced hospitalisations and intensive care unit admissions. However, the impact of vaccination on transmissibility of SARS-CoV-2 needs to be elucidated. A prospective cohort study in the UK by Anika Singanayagam and colleagues2 regarding community transmission of SARS-CoV-2 among unvaccinated and vaccinated individuals provides important information that needs to be considered in reassessing vaccination policies. This study showed that the impact of vaccination on community transmission of circulating variants of SARS-CoV-2 appeared to be not significantly different from the impact among unvaccinated people. The scientific rationale for mandatory vaccination in the USA relies on the premise that vaccination prevents transmission to others, resulting in a “pandemic of the unvaccinated”. Yet, the demonstration of COVID-19 breakthrough infections among fully vaccinated health-care workers (HCW) in Israel, who in turn may transmit this infection to their patients, requires a reassessment of compulsory vaccination policies leading to the job dismissal of unvaccinated HCW in the USA. Indeed, there is growing evidence that peak viral titres in the upper airways of the lungs and culturable virus are similar in vaccinated and unvaccinated individuals. A recent investigation by the US Centers for Disease Control and Prevention of an outbreak of COVID-19 in a prison in Texas showed the equal presence of infectious virus in the nasopharynx of vaccinated and unvaccinated individuals. Similarly, researchers in California observed no major differences between vaccinated and unvaccinated individuals in terms of SARS-CoV-2 viral loads in the nasopharynx, even in those with proven asymptomatic infection. Thus, the current evidence suggests that current mandatory vaccination policies might need to be reconsidered, and that vaccination status should not replace mitigation practices such as mask wearing, physical distancing, and contact-tracing investigations, even within highly vaccinated populations.”

Keywords: virus transmission, vaccinated

Re-imagining Educational Futures in Developing Countries

Physical Activity Among African Academics in a Post-COVID-19 Era: The Terrain for Action

Authors: Asiamah, N

“University workers are among the most physically inactive workforces in the world and consequently face a higher health risk, including vulnerability to chronic health conditions. New work patterns necessitated by the outbreak of coronavirus disease 2019 (COVID-19) and its social distancing measures are expected to increase the foregoing risks. For this reason, interventions aimed at maintaining physical activity (PA) are necessary. This chapter draws on recent data to specify interventions to physical inactivity as well as stakeholders who may lead these interventions. The data used came from a cross-sectional study involving 1,064 academics from four African countries. It was found that PA and its association with academic job tasks depend on neighbourhood walkability and whether academics lived on their university campuses. This result unfolded the need for universities, university staff, and governments to take specific actions to improve neighbourhood walkability and its utilization for PA.”

Keywords: neighbourhood walkability, physical activity, work, stakeholders

Turkish Journal of Physiotherapy and Rehabilitation

The association of vitamin d status with interleukin-6 (IL-6), d-dimer and severity of covid-19 disease in a sample of iraqi population

Authors: Taher, NA, Salah-Alden, RS, Al-Bustany, DA

“Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a recently emerged, highly transmissible, and pathogenic coronavirus that has created global public health and economic crisis. Since December 2019, when Covid-19 emerged in Hunan seafood market in Wuhan, South China, and rapidly spread throughout the world, the virus outbreak has been declared a public health emergency of international concern by the World Health Organization (WHO). This research included several parameters (Vit-D, IL-6, and D-Dimer) to evaluate the association between these biomarkers and outcomes in COVID-19 hospitalized and non-hospitalized patients, to guide potential COVID-19 Diagnosis, Treatments, and Prevention of COVID-19 disease. Aim of the study 1. To determine if there is an association between the status of vitamin D level in blood and the severity of COVID19 disease. 2. To determine the association between vit-D level and (IL-6, and D-Dimer) levels in serum and their effect on these markers in the hospitalized COVID19 disease. 3. to evaluate the association between (IL-6, and D-Dimer) and the severity of COVID19 disease. A Cross-sectional study consisted of 40 patients with age range (18-90 years) that collected from ICU (hospitalized patients) in (West Irbil Governmental Hospital and Lalaf Governmental Hospital) in Erbil city/ Iraq, at admission to the hospital, and 40 patients with age range (18-90 year)there were non-hospitalized patients from the same place in Erbil city/Iraq, from December 2020 to April 2021. Serum(Vit-D, and IL-6), and plasma D-Dimer concentrations were measured, firstly to comparing them with (age, gender, and the severity of SARS-CoV-2 virus infection) to demonstrate the association of them with the severity of COVID-19 disease, and secondly to compered them with vit-D and demonstrate the effect of this vitamin on these parameters. In the present study, the data showed A significant decrease in Vit-D concentration in sera of patients with SARS-CoV-2 virus infection in both groups, which determines the strong correlation in (two-tailed) between vit-D concentration and the severity of SARS-CoV-2 virus infection P-value (0.00001), as while as, there is a statistical correlation between the severity of COVID-19 disease and D-Dimer in both groups P-value (6.2E-9). while statistically non-significant relation between the severity of COVID-19 disease in both groups and age P-value (0.79), also non-significant relation between vit-D and age p-value (0.08), and Non-significant correlation between gender and the severity of COVID-19 disease in both groups P-value (0.82). In both groups, there is a significant negative correlation between vitamin-D and D-dimer concentrations in H group correlation P-value (0.0001), in the non-H group P-value(0.025). Statistical analysis showed a significantly strong correlation between high IL-6 level and the severity of SARS-CoV-2 virus infection in both study groups non-H and H, P-value (0.00001).in comparison with severe deficiency of Vit-D that determines the strong correlation in (two-tailed) between vit-D concentration and IL-6 Conc. of SARS-CoV-2 virus infection. 1. The results of this study reveal that vitamin D deficiency presents an association with the severity of COVID-19, Anecdotal and observational data indicate that vitamin D deficiency may play a significant role in the progression of the COVID-19 disease state. In conclusion, the results confirm the high prevalence of vitamin D deficiency in people with COVID-19, we observed a positive association between vitamin D deficiency and the severity of the disease. 2. The current study revealed a significantly strong correlation between IL-6 and D-dimer with Vit-D levels, in hospitalized patients and non-hospitalized patients suggesting that Vit-D blood levels have an important effect on IL-6 and D-dimer levels that’s maybe a biomarker of disease severity and progression in patients with COVID-19. 3. According to the severity of COVID-19 disease, the present study showe a significant correlation between (vitamin-D, IL-6, and D-dimer) with the severity of COVID-19 disease suggesting that these parameters may be biomarkers of disease severity and progression in patients with COVID-19.”

Keywords: vitamin d, interleukin-6, IL-6, d-dimer, covid-19 disease

Nutrition Today

Therapeutic Potential of Flavonoids and Zinc in COVID-19

Authors: Landis, HE, Getachew, B, Tizabi, Y

“The Coronavirus Disease 2019 (COVID-19) is a devastating global pandemic. Although control of inflammation and supportive care is a common practice, effective and safe disease-modifying or preventive treatments are not yet available. Recent studies demonstrate that small natural molecules belonging to polyphenol family can interfere with various stages of coronavirus entry and replication. These bioactive phytoconstituents, available as natural components in foods and medicinal plants may provide preventive and other benefits against COVID-19, particularly in older adults with micronutrient deficiencies. Another age-related nutritional deficiency may be inadequate levels of the trace metal zinc (Zn), rendering this population more susceptible to COVID-19. Here, following a brief review of 2 select flavonoids; quercetin as a potent antioxidant, and dihydromyricetin (DHM) as an effective antiviral agent together with Zn, essential for immune function, we suggest potential use of a combination of these compounds as an added prevention and/or treatment modality in COVID-19. ”

Keywords: dihydromyricetin, flavonoids, quercetin, zinc

Journal of Nursing and Health Sciences

The Relationship between Physical Activity and Immune Improvement in Covid-19 Prevention in Sebelimbingan Village Rt.03, Pulau Laut Utara District, Kotabaru Regency

Authors: Lutfi, M, Harun, L, Mulyani, R

“During the Covid-19 pandemic, as it is today, it is necessary to increase the bodys immunity, one of which is by doing physical activity. Physical activity is one of the efforts to prevent Covid-19. Objective was to determine the relationship between physical activity and immune improvement in the prevention of Covid-19 in Sebelimbingan village Rt.03 Pulau Laut Utara District, Kotabaru Regency. The research design used in this study was an analytical research design with a Cross Sectional design. The population in this study was the village community of Sebelimbingan Rt.03 with a sample of 56 respondents who met the inclusion and exclusion criteria using the purposive sampling technique. Data analysis used univariate and bivariate analysis with Spearman Rank test. This study shows that there is a relationship between physical activity and immune improvement in the prevention of Covid-19 in Sebelimbingan Village Rt.03, Pulau Laut Utara District, Kotabaru Regency. The results of this study can be used as initial information for further researchers. It is recommended for further research to examine other factors in preventing Covid-19, such as the influence of culture in the community”

Keywords: immune, Physical Activity

ResearchGate

Dietary supplements, OTC drugs and other alternative treatment options in fighting the COVID-19 pandemic

Authors: Tabarkiewicz, J, Frączek, P

“The COVID-19 pandemic poses an enormous challenge to health care professionals, as well as researchers and scientists, seeking effective and safe ways to prevent SARS-CoV-2 infection and treat COVID-19 in a variety of clinical conditions. In addition to antivirals, inflammatory inhibitors, or anticoagulants currently used in therapy, dietary supplements and OTC – over-the-counter – medications are also being considered in these deliberations. This paper presents a review of studies and available literature on the usefulness of selected medicinal preparations in the prevention of new coronavirus infection and in the treatment of patients suffering from COVID-19. Biological mechanisms of their effect on body cells are presented, which justifies their postulated usefulness in the fight against COVID-19 pandemic according to the authors of the cited works. A critical analysis of available source materials allows us to conclude that there is a great need for multicenter clinical trials of high quality, in accordance with the principles of Evidence Based Medicine. They will allow to obtain the best reliable up-to-date data, thanks to which the available scientific evidence can be accurately and precisely used in everyday clinical practice. In the preparation of this paper, source materials were used from PubMed, a publicly available database of articles in medicine and the life sciences, and the U.S. National Institutes of Health website, which contains information on registered clinical trials conducted around the world.”

Keywords: COVID-19 pandemic, dietary supplements, OTC drugs

Studējošo pētnieciskie darbi

Report

Student’s Physical Activity Level and how it Affects their Mental Health and Academic Performance during Covid-19

Authors: Kaļužnaja, D, Otter, BME

“Several reports indicate that increased physical activity has a positive effect on mental health. Some data suggests these two factors can be associated with improved academic performance. The novelty of the study is to investigate these associations during the Covid-19 pandemic among medical and dental students who study in Latvia. Objective – To explore a possible link between students’ level of physical activity, academic performance, and mental health condition Methods – A questionnaire was offered to students who study Medicine or Dentistry in Latvia. The questionnaire surveyed age, gender, semester/ year of studies, level of physical activity, amount of sedentary activity, average grade, number of failed courses/semesters, questions about mental health and social support system. Collected data was evaluated using IBM SPSS Statistics 26 software: descriptive methods, including Chi-square analysis. Results – 70 participants were included in the study: two thirds were female students, and one third - male students. 97.1% (n=68) students were from Rīga Stradiņš University and 2.9% (n=2) from Latvian University. 98% (n=69) studied Medicine and 1.4% (n=1) Dentistry. 60% (n=42) were physically highly active, 37.1% (n=26) medium active and 2.9% (n=2) fell into the low activity group. Results show, that ~7% of participants have low social support. Physically highly active and less active students were with a similar mental health condition and academic performance level, as a statistically significant difference between groups was not found. Conclusions – A link between increased physical activity, improved academic performance and better mental health was not proven in this study setting. More research with a higher number of participants should be conducted on this topic.”

Keywords: physical activity, mental health, academic performance, physical activity, mental health, academic performance

Open Access Library Journal

Preprint

COVID-19: From Cough to Coffin

Authors: Chambers, PW

“he primary determinants of Covid severity are ACE genotype, the falciparum antigen (CD147), and vitamin D status. Specifically the I (insertion) and D (deletion) alleles, ACE polymorphisms, determine the balance between the RAS (Renin Angiotensin System) and the KKS (Kallikrein Kinin System) in the response to SARS CoV2 (SARS2). CD147, the falciparum antigen, mediates the damage. Vitamin D modulates the immune response. The RAS and KKS connect Covid-19 to Kawasaki’s Disease (KD) and Toxic Shock Syndrome (TSS). Covid 19 pathogenesis is embroiled in a nature versus nurture debate, as it seems to target people of color, unless you live in sub Saharan Africa. There are only three plausible explanations for the latter and they have all been selectively ignored/suppressed by mainstream medicine. This article speaks to the genotypic nature of Covid-19. Angiotensin II, bradykinin, ACE2, ACE and its two polymorphic alleles play vital roles. They predict disease severity. They portend the ARDS variants. They portend extra pulmonary disease or not. The heavily glycosylated CD147 epitope on the spike protein S is key. It has been dismissed as non-existent by flawed studies. Yet its interaction with CD147 receptors on erythrocytes and T lymphocytes cannot be denied and is at the heart of the myocarditis conundrum. Using this key, multiple dots are connected and a red alert issued, whether Covid19 or vaccine related. These include thrombosis, immune deficit, cancer progression, autoimmune disease, and ADE (Antibody Dependent Enhancement) for those at risk. In susceptible vaccinees its deleterious effects are accelerated. Assessment of this and preventative approaches are explored.”

Keywords: vitamin D, CD147, CD8, lectin, glycan, epitope, angioedema

Journal of Global Health Science

COVID-19 vaccine injury compensation programs

Authors: Ro D, Ro D, Kim SY

“Raising awareness about the urgency of using a coronavirus disease 2019 (COVID-19) vaccine that has not undergone sufficient clinical trials and safety that has not been secured due to this, and compensating for the responsibility of the state to inoculate the public with a COVID-19 vaccine that has not sufficiently verified safety After examining the medical limitations in proving the causal relationship between vaccination and the occurrence of harm in. I would like to point out the problem that the causal relationship must be recognized according to policy considerations such as budget or worsening public opinion, as the screening criteria for causality judgment can be decided at the discretion of the Minister of Disease Control. As a way to improve these problems, it is necessary to relax the screening standards so that people think that the government is sufficiently compensating for the damage to the people. We would like to replace the conclusion by suggesting a way for damage investigators to figure out the amount of compensation.”

Keywords: AstraZeneca, Anaphylaxis, VACC, Vaccine, Pfizer vaccine

Nutrients

Vitamin D’s Role in Reducing Risk of SARS-CoV-2 and COVID-19 Incidence, Severity, and Death

Authors: Grant, W

“The article by D’Avolio and colleagues on patients with a positive polymerase chain reaction (PCR) test for SARS-CoV-2 was the first to report that 25-hydroxyvitamin D [25(OH)D] concentrations were lower in PCR-positive patients than in PCR-negative patients or in historical controls. As a result, that report has the most citations in its category (201 according to SCOPUS on 17 December 2021). Thus, the article likely helped considerably stimulate investigation of vitamin D’s role in reducing risk of SARS-CoV-2 infection and ensuing COVID-19. A later article on 25(OH)D concentration and risk of SARS-CoV-2 positivity was based on more than 190,000 PCR tests on patients in the U.S. with serum 25(OH)D concentration measurements from the previous 12 months on file by quest diagnostics. According to that report, positivity was inversely correlated with seasonally adjusted 25(OH)D concentration, posing a risk for patients with concentrations of ~55 ng/mL have about half the positivity of those with concentrations of <20 ng/mL. A recent meta-analysis involving 76 studies reported inverse correlations for COVID-19 risk with respect to serum 25(OH)D concentrations for risk of developing the disease, its severity, and risk of death, thus offering support for the role of vitamin D in reducing risk of COVID-19.”

Keywords: vitamin D, incidence, severity, death

International Journal of Environmental Research and Public Health

The Interaction of Vitamin D and Corticosteroids: A Mortality Analysis of 26,508 Veterans Who Tested Positive for SARS-CoV-2

Authors: Efird, JT, Anderson, EJ, Jindal, C, et al.

“This data-based cohort consisted of 26,508 (7%) United States veterans out of the 399,290 who tested positive for SARS-CoV-2 from 1 March to 10 September 2020. We aimed to assess the interaction of post-index vitamin D (Vit D) and corticosteroid (CRT) use on 30-day mortality among hospitalized and non-hospitalized patients with coronavirus disease 2019 (COVID-19). Combination Vit D and CRT drug use was assessed according to four multinomial pairs (−|+, −|−, +|+, +|−). Respective categorical effects were computed on a log-binomial scale as adjusted relative risk (aRR). Approximately 6% of veterans who tested positive for SARS-CoV-2 died within 30 days of their index date. Among hospitalized patients, a significantly decreased aRR was observed for the use of Vit D in the absence of CRTs relative to patients who received CRTs but not Vit D. Among patients receiving systemically administered CRTs (e.g., dexamethasone), the use of Vit D was associated with fewer deaths in hospitalized patients compared with non-hospitalized patients. Evaluating the effect of modification of these compounds in the context of hospitalization may aid in the management of COVID-19 and provide a better understanding of the pathophysiological mechanisms underlying this and future infectious disease outbreaks. ”

Keywords: anti-inflammatory, corticosteroids, cytokine storm, vitamin D, veterans

Ahmad Dahlan Medical Journal

The Role of Magnesium Supplementation for Supportive Therapy in Covid-19 Infection

Authors: Solikhah, A, Ihsana, N, Sofro, ASM

“The coronavirus disease 19 (COVID-19) caused by SARS-CoV-2 created global pandemic conditions. A person infected with SARS-CoV-2 increases the probability of hospitalization and admission to intensive care, with high mortality. The most common symptoms of COVID-19 patients are fever and cough, although a variety of other symptoms may also be present. Patients admitted to the intensive care unit are known to have impaired organ function including acute respiratory distress syndrome (ARDS), cardiac injury, acute kidney injury, and liver dysfunction. Increasing evidence supports that magnesium supplementation (especially magnesium sulfate and magnesium oxide) prevents or treat various types of disorders or diseases related to the respiratory system, reproductive system, nervous system, digestive system, cardiovascular system, kidney injury, diabetes and cancer.”

Keywords: Magnesium supplementation, Supportive theraphy

International Maritime Health

A survey on relationship between Gendarmerie Coast Guard Academy (GCGA) students’ physical activity and COVID-19 infection

Authors: Güler, M, Nazl, Y, Öztürk, E

“The primary aim of this study was to reveal whether the Gendarmerie Coast Guard Academy (GCGA) students caught and went through the coronavirus disease 2019 (COVID-19) according to their physical activity levels during the COVID-19 pandemic process. The research group of the study consisted of 332 volunteer male students studying at the GCGA. International Physical Activity Questionnaire-Short Form (IPAQ-SF) and personal information form were used as data collection tools in the study. According to students’ body mass index scores, 73.49% of the students were of normal weight. The results of the analysis, showed that 29.82% of the GCGA students had COVID-19, and 70.18% of them did not have COVID-19. It was determined that 91.92% of those who had COVID-19 had mild illness and recovered at home. According to the metabolic equivalence classification of students, a negative and significant relationship between students’ physical activity levels (inactive < minimally active < very active) and the risk of getting the positive results for COVID-19 (yes < no) and the severity of COVID-19 (in intensive care < in the hospital < mildly at home) was found. It could be said that increasing the physical activity level of students can reduce the possibility of having COVID-19 and also increase the probability of mild illness not requiring hospitalisation in those with positive COVID-19 test result.”

Keywords: physical activity, catching COVID-19, overcome COVID-19

Indian Journal of Pharmacology

Chemoprophylaxis against COVID-19 among health-care workers using Ivermectin in low- and middle-income countries: A systematic review and meta-analysis

Authors: Azeez, TA, Lakoh, S, Adeleke, AA, et al.

“Coronavirus disease-2019 (COVID-19) is a novel viral infectious disease that the World Health Organization (WHO) has announced to be a pandemic. This meta-analysis was aimed at providing evidence for the use of ivermectin to prevent COVID-19 among hospital workers in low-resource countries. Medical databases including African Journals online, Google Scholar, PubMed, Cochrane library, EMBASE, COVID-19 research database (WHO), Clinicaltrials.gov, and SCOPUS were searched for studies on Ivermectin as a chemoprophylactic drug against COVID-19 among hospital personnel in settings with limited resources. Preprint servers such as bioRxiv and medRxiv as well as the gray literature were also searched. Studies adjudged to be eligible were identified using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses algorithm. Statistical analyses were done using Stata version 14.3. Seven studies were selected for the meta-analysis. The total sample size was 2652. There were two randomized controlled trials and five nonrandomized studies. Some studies dosed Ivermectin daily while some dosed it weekly. However, one of the studies dosed it monthly. The studies reported variable clinical benefits. 89% of the participants benefited from taking Ivermectin as a form of preexposure chemoprophylaxis. Ivermectin has a significant clinical benefit as a preventive drug against COVID-19 for hospital personnel in settings with limited resources.”

Keywords: Chemoprophylaxis, coronavirus disease-2019 prevention, health-care workers, Ivermectin, resource-limited settings

Vaccines

Sociodemographic Predictors Associated with the Willingness to Get Vaccinated against COVID-19 in Peru: A Cross-Sectional Survey

Authors: Vizcardo, D, Salvador, LF, Nole-Vara, A, et al.

“During the race for the development of a vaccine against COVID-19, even before its commercialization, part of the population has already shown a growing fear of its application. We designed an analytical cross-sectional study using an anonymous survey in the 25 departments of Peru. We surveyed whether the participants were planning on getting vaccinated, as well as other characteristics that were cross-checked in a uni-, bi- and multivariate manner. Of the 1776 respondents, 70% (1251) stated that they were planning to be vaccinated, 20% (346) did not know yet or doubted it, and 10% (179) did not want to be vaccinated. We observed that those who did not get infected with COVID-19 exhibited a higher frequency to not wanting or were uncertain about getting vaccinated. In contrast, there was a lower frequency of vaccine refusal among university students and healthcare workers; adjusted by place of residence. There is still an important percentage of respondents who do not want to be vaccinated or are hesitant to do it, which was associated with educational level, being a healthcare worker and if they were previously infected with COVID-19. Our results could offer useful information about COVID-19 vaccination campaigns.”

Keywords: Peru, vaccination, vaccines, pandemic, Vaccines

Journal of Infection and Chemotherapy

Ivermectin administration is associated with lower gastrointestinal complications and greater ventilator-free days in ventilated patients with COVID-19: A propensity score analysis

Authors: Shimizua, K, Hirata, H, Kabatac, D, et al.

“COVID-19 patients have been reported to have digestive symptoms with poor outcome. Ivermectin, an antiparasitic drug, has been used in COVID-19 patients. The objective of this study was to evaluate whether ivermectin has effects on gastrointestinal complications and ventilator-free days in ventilated patients with COVID-19. COVID-19 patients who were mechanically ventilated in the ICU were included in this study. The ventilated patients who received ivermectin within 3 days after admission were assigned to the Ivermectin group, and the others were assigned to the Control group. Patients in the Ivermectin group received ivermectin 200 μg/kg via nasal tube. The incidence of gastrointestinal complications and ventilator-free days within 4 weeks from admission were evaluated as clinical outcomes using a propensity score with the inverse probability weighting method. We included 88 patients in this study, of whom 39 patients were classified into the Ivermectin group, and 49 patients were classified into the Control group. Ivermectin improved gastrointestinal complications and the number of ventilator-free days in severe COVID-19 patients undergoing mechanical ventilation. Prevention of gastrointestinal symptoms by SARS-Cov-2 might be associated with COVID-19 outcome.”

Keywords: ivermectin, intensive care unit, ventilated, diarrhea, gastrointestinal, ventilator-free days

medRxiv

Preprint

Waning of SARS-CoV-2 booster viral-load reduction effectiveness

Authors: Levine-Tiefenbrun, M, Yelin, I, Alapi, H, et al

“The BNT162b2 COVID-19 vaccine has been shown to reduce viral load of breakthrough infections (BTIs), an important factor affecting infectiousness. This viral-load protective effect has been waning with time post the second vaccine and later restored with a booster shot. It is currently unclear though for how long this regained effectiveness lasts. Analyzing Ct values of SARS-CoV-2 qRT-PCR tests of over 22,000 infections during a Delta-variant-dominant period in Israel, we found that this viral-load reduction effectiveness significantly declines within months post the booster dose. Adjusting for age, sex and calendric date, Ct values of RdRp gene initially increased by 2.7 [CI: 2.3-3.0] relative to unvaccinated in the first month post the booster dose, yet then decayed to a difference of 1.3 [CI: 0.7-1.9] in the second month and became small and insignificant in the third to fourth months. The rate and magnitude of this post-booster decline in viral-load reduction effectiveness mirror those observed post the second vaccine. These results suggest rapid waning of the booster’s effectiveness in reducing infectiousness, possibly affecting community-level spread of the virus.”

medRxiv

Preprint

Serum Vitamin D levels are associated with increased COVID-19 severity and mortality independent of visceral adiposity

Authors: Vanegas-Cedillo, PE, Bello-Chavolla, OY, Ramírez-Pedraza, N, et al.

“Coronavirus disease (COVID-19) is a global pandemic. Vitamin D (25-OHD) deficiency has been associated with susceptibility to infectious disease. In this study, the association between COVID-19 outcomes and 25-OHD levels in patients attending a COVID-19 reference center in Mexico City are examined. Consecutive patients with confirmed COVID-19 were evaluated. All patients underwent clinical evaluation (including outcomes), laboratory measurements (including 25-OHD) and a thoracic computerized tomography (including the measurement of epicardial fat thickness). Low vitamin D was defined as levels <20ng/mL (<50nmol/L) and severely low (or deficient) 25-OHD as a level ≤12ng/mL (<30nmol/L). Of the 551 patients included, low 25-OHD levels were present in 45.6% and severely low levels in 10.9%. Severely low 25-OHD levels were associated with mortality but not with critical COVID-19, adjusted for age, sex, body-mass index and epicardial fat. Using model-based causal mediation analyses the increased risk of COVID-19 mortality conferred by 25-OHD levels was partly mediated by its effect on D-dimer and cardiac ultrasensitive troponins. Notably, increased risk of COVID-19 mortality conferred by low vitamin D levels was independent of BMI and epicardial fat. Vitamin D deficiency (≤12ng/mL or <30nmol/L), is independently associated with COVID-19 mortality after adjustment for visceral fat (epicardial fat thickness). Low 25-OHD may contribute to a pro-inflammatory and pro-thrombotic state, increasing the risk for adverse COVID-19 outcomes.”

Keywords: vitamin D, visceral adiposity

Metabolism Research and Reviews

The effect of vitamin D supplementation on mortality and Intensive Care Unit admission of COVID-19 patients. A systematic review, meta-analysis and meta-regression

Authors: Tentolouris, N, Samakidou, G, Eleftheriadou, I, et al.

“The aim of this systematic review and meta-analysis was to investigate the effect of vitamin D supplementation on mortality and admission to intensive care unit (ICU) of COVID-19 patients. A systematic search of PubMed, Google Scholar, Embase, Web of Science and medRxiv with terms relative to vitamin D supplementation and COVID-19 was conducted on March, 26th, 2021. Comprehensive Meta-Analysis software was used for the quantitative assessment of data and random-effects model was applied. To investigate the association between the dose of vitamin D and the outcomes of interest, meta-regression analysis was performed. 2,078 patients from 9 studies with data on mortality were included (583 received vitamin D supplementation, while 1,495 did not). 61 (10.46%) individuals in the treated group died, compared to 386 (25.81%) in the non-treated group. 860 patients from 6 studies with data on ICU admission were included (369 received vitamin D supplementation, while 491 did not). 45 (12.19%) individuals in the treated group were admitted to ICU, compared to 129 (26.27%) in the non-treated group. No significant linear relationship between vitamin D dose and log OR of mortality or log OR of ICU admission was observed.This meta-analysis indicates a beneficial role of vitamin D supplementation on ICU admission, but not on mortality, of COVID-19 patients. Further research is urgently needed to understand the benefit of vitamin D in Covid-19.”

Keywords: vitamin D, supplementation

International Journal of Environmental Research and Public Health

The Changes in Stress Coping, Alcohol Use, Cigarette Smoking and Physical Activity during COVID-19 Related Lockdown in Medical Students in Poland

Authors: Kosendiak, A, Król, M, Ściskalska, M, et al.

“The ongoing COVID-19 pandemic has significantly limited social contacts, thus contributing to deepening isolation. Therefore, SARS-CoV-2 exerted on humanity not only a physical impact but also a psychological one, often increasing the feeling of stress. The long-term effects of such a state could include the management of depression, so our study aimed to analyze groups of medical students in different periods of the pandemic (at the beginning of the pandemic, after half a year of the pandemic, after one year of the pandemic) in order to assess the impact of this situation on coping with stress. The impact of the pandemic on the development of stress factors such as alcohol consumption and smoking was also studied. The level of physical activity in the context of coping with an uncertain situation was also assessed. The impact of the above-mentioned factors on the behavior of students, including the Mini-COPE questionnaire, AUDIT test, the Fagerström test and the IPAQ questionnaire was analyzed. It has been shown that as the pandemic and the lockdown progressed, patients consumed more often or larger amounts of alcohol, smoked more cigarettes, and levels of physical activity decreased. All these factors may have had some impact on the deterioration of coping with stress among the respondents, which would indicate that the COVID-19 pandemic significantly contributed to an increase in the sense of stress among the students.”

Keywords: alcohol, distress, physical activity, smoking

BMC Rheumatology

Macrophage activation syndrome in a patient with adult-onset Still’s disease following first COVID-19 vaccination with BNT162b2

Authors: Muench, F, Krusche, M, Sander, LE, et al.

“Adult-onset Still’s disease (AOSD) is an autoinflammatory multi-systemic syndrome. Macrophage activation syndrome (MAS) is a potentially life-threatening complication of AOSD with a mortality rate of 10–20%. Especially viral infection is thought to be a common trigger for development of MAS. On the other hand, the occurrence of MAS following vaccinations is extremely rare and has been described in a few cases after measles or influenza vaccinations and more recently after ChAdOx1 nCoV-19 (COVID-19 viral vector vaccine, Oxford-AZ). Conclusions To the best of our knowledge, this is the first case report of development of MAS in a patient with preexisting AOSD after vaccination in general, and SARS-CoV-2 vaccination in particular. The new mRNA vaccines have generally shown a reassuring safety profile, but it has been shown that nucleic acids in general, including mRNA can act as pathogen-associated molecular patterns that activate toll-like receptors with extensive production of pro-inflammatory cytokines and further activation of immune cells. Proving an interferon 1 response in our patient directly after vaccination, we think that in this particular case the vaccination might have acted as trigger for the development of MAS. Even if it remains difficult to establish causality in the case of rare adverse events, especially in patients with autoimmune or autoinflammatory conditions, these complications are important to monitor and register, but do not at all diminish the overwhelming positive benefit-risk ratio of licensed COVID-19 vaccines.”

British Journal of Haematology

Life-changing consequences of vaccine-induced immune-mediated thrombosis with thrombocytopenia

Authors: Smith, S, Chandler, C, Brereton, A

“Several effective vaccines are now in use worldwide. The two-dose mRNA COVID-19 vaccines from Pfizer-BioNTech and Moderna have been approved for use in the UK and USA. The single-dose viral vector vaccine from Janssen is approved in the USA and the two-doses viral vector vaccine from Oxford-AstraZeneca is approved in the UK. Minor side effects included fever, headache, lethargy, myalgia, arthralgia, nausea, swelling and pain at the site of injection. Rare but serious side effects included anaphylactic reactions,myocarditis, Guillain–Barré Syndrome (GBS) and Thrombotic Thrombocytopenia Syndrome (TTS). Here, we report a case whose presentation to hospital coincided with electronic communication from the Medical Directors Office for the South East alerting hospital consultants of an emerging syndrome associated with low platelets, thromboses, elevated D-dimer and anti-platelet-factor 4 antibodies. More specific notification regarding the condition was released by the Medicines & Healthcare Products Regulatory Agency (MHRA) one week later. This reported a total of 79 cases of probable vaccine-induced immune-mediated thrombosis with thrombocytopenia (VITT) up to 31 March 2021, 44 cases of cerebral venous sinus thrombosis, 34 cases of other site venous thrombosis, and one case of arterial thrombosis subsequently described.”

Keywords: vaccines, thrombosis - arterial, thrombocytopenia, anticoagulation, anti-platelet factor 4

medRxiv

Preprint

Divergent SARS CoV-2 Omicron-specific T- and B-cell responses in COVID-19 vaccine recipients

Authors: GeurtsvanKessel, CH, Geers, D, Schmitz, KS, et al.

“The severe acute respiratory distress syndrome coronavirus-2 (SARS-CoV-2) Omicron variant (B.1.1.529) is spreading rapidly, even in vaccinated individuals, raising concerns about immune escape. Here, we studied neutralizing antibodies and T-cell responses to SARS-CoV-2 D614G (wildtype, WT), and the B.1.351 (Beta), B.1.617.2 (Delta), and B.1.1.529 (Omicron) variants of concern (VOC) in a cohort of 60 health care workers (HCW) after immunization with ChAdOx-1 S, Ad26.COV2.S, mRNA-1273 or BNT162b2. High binding antibody levels against WT SARS-CoV-2 spike (S) were detected 28 days after vaccination with both mRNA vaccines (mRNA-1273 or BNT162b2), which significantly decreased after 6 months. In contrast, antibody levels were lower after Ad26.COV2.S vaccination but did not wane. Neutralization assays with authentic virus showed consistent cross-neutralization of the Beta and Delta variants in study participants, but Omicron-specific responses were significantly lower or absent (up to a 34-fold decrease compared to D614G). Notably, BNT162b2 booster vaccination after either two mRNA-1273 immunizations or Ad26.COV.2 priming partially restored neutralization of the Omicron variant, but responses were still up to-17-fold decreased compared to D614G. CD4+ T-cell responses were detected up to 6 months after all vaccination regimens; S-specific T-cell responses were highest after mRNA-1273 vaccination. No significant differences were detected between D614G- and variant-specific T-cell responses, including Omicron, indicating minimal escape at the T-cell level. This study shows that vaccinated individuals retain T-cell immunity to the SARS-CoV-2 Omicron variant, potentially balancing the lack of neutralizing antibodies in preventing or limiting severe COVID-19. Booster vaccinations may be needed to further restore Omicron cross-neutralization by antibodies.”

Research & Reviews in Pharmacy and Pharmaceutical Sciences

Polypharmacy in Times of COVID-19: A Narrative Review

Authors: Gupta, S

“COVID-19 pandemic caused by the SARS-Cov-2 virus, has become a serious public health concern worldwide which spread across more than 200 countries in a matter of months. Amidst a deadly second COVID wave in India, the resources and the health infrastructure required to handle the situation was stretched to their limits. Furthermore, due to the non-specific nature of the disease and the plethora of symptoms and complications it presents, the medical management of COVID-19 became complicated and uncertain. Such a grim scenario evokes fear and panic among the citizens, leading to questionable and unnecessary practices such as stocking of medicines, hoarding oxygen cylinders and most importantly, self-medication with over-the-counter drugs, dietary supplements (so-called immune boosters), prescription-only drugs, along with combining the use of alternative systems of medicine. Due to all these reasons, the practice of ‘polypharmacy’ is becoming rampant among the general population, which in most cases is inappropriate and even harmful. This review summarizes the various patient and physician associated factors promoting polypharmacy, along with examples of the common drugs being prescribed and/or self-administered, and the various steps that can be taken to prevent such futile practices.”

Keywords: SARS-Cov-2 virus, pharma health infrastructure, medications

Journal of PeerScientist

A review of the use of persuasion and coercion to overcome COVID-19 vaccine hesitancy

Authors: Liester, MB

“Vaccines against COVID-19 have been available for about one year, but compliance with these vaccines has been less than expected. Vaccine hesitancy and refusal have limited vaccination rates, thus contributing to morbidity and mortality associated with COVID19. This review explores the history of vaccines, beginning with their use in India over 3,500 years ago to prevent smallpox, and continuing through their current use to combat COVID-19. The past efforts of governments to compel individuals to get vaccinated are reviewed as well as the problems that resulted from such actions. Historical and contemporary factors that contribute to vaccine hesitancy are examined. One such factor is concern about the risks of the vaccines. Most adverse effects associated with the COVID-19 vaccines are mild. However, rare but serious adverse effects also occur including anaphylaxis, thrombosis, and myocarditis. Concerns about these potentially life-threatening complications contribute to vaccine hesitancy. The lack of an adequate system for reporting adverse events as well as the absence of an effective compensatory system to assist those who suffer untoward problems resulting from COVID-19 vaccines also contribute to vaccine hesitancy. Still another factor impeding vaccine compliance is lack of trust. This includes lack of trust in the vaccines, the pharmaceutical companies who manufacture the vaccines, the healthcare providers who recommend the vaccines, the governmental agencies who determine policies about the vaccines, and the media who report on the vaccines. The basis for mistrust in each of these areas is examined and includes a lack of transparency, ulterior financial motives, and suppression of alternative viewpoints. The effects of rumors and conspiracy theories on attitudes about vaccines are assessed as well. Finally, tactics utilized to increase vaccination rates are reviewed. These include education, persuasion, incentivization, and coercion. When education and persuasion fail, governments may turn to the use of coercive strategies, such as imposing vaccine mandates and implementing penalties and restrictions on those who fail to comply. The potential adverse consequences of these approaches are reviewed and include an unexpected decrease in vaccination rates, failure to protect individual autonomy, lack of informed consent associated with vaccinations, and polarization between the vaccinated and the unvaccinated leading to ―vaccine tribalism. Evidence demonstrating the efficacy of these approaches for improving vaccination compliance is found to be lacking. Thus, further research is recommended to find improved methods for improving vaccination rates as well as exploring alternative strategies for ending the COVID19 pandemic, such as the concurrent use of effective antiviral treatments.”

Keywords: Vaccine hesitancy, vaccine refusal, persuasion, incentivization, mandates, coercion, natural immunity

medRxiv

Preprint

SARS-CoV-2 Omicron VOC Transmission in Danish Households

Authors: Lyngse, FP, Mortensen, LH, Denwood, MJ, et al.

“The Omicron variant of concern (VOC) is a rapidly spreading variant of SARS-CoV-2 that is likely to overtake the previously dominant Delta VOC in many countries by the end of 2021. We estimated the transmission dynamics following the spread of Omicron VOC within Danish households during December 2021. We used data from Danish registers to estimate the household secondary attack rate (SAR). Among 11,937 households (2,225 with the Omicron VOC), we identified 6,397 secondary infections during a 1-7 day follow-up period. The SAR was 31% and 21% in households with the Omicron and Delta VOC, respectively. We found an increased transmission for unvaccinated individuals, and a reduced transmission for booster-vaccinated individuals, compared to fully vaccinated individuals. Comparing households infected with the Omicron to Delta VOC, we found an 1.17 (95%-CI: 0.99-1.38) times higher SAR for unvaccinated, 2.61 times (95%-CI: 2.34-2.90) higher for fully vaccinated and 3.66 (95%-CI: 2.65-5.05) times higher for booster-vaccinated individuals, demonstrating strong evidence of immune evasiveness of the Omicron VOC.”

medRxiv

Preprint

Early estimates of SARS-CoV-2 Omicron variant severity based on a matched cohort study, Ontario, Canada

Authors: Ulloa, AC, Buchan, SA, Daneman, N, et al.

“While it is now evident that Omicron is rapidly replacing Delta, due to a combination of increased transmissibility and immune escape, it is less clear how the severity of Omicron compares to Delta. In Ontario, we sought to examine hospitalization and death associated with Omicron, as compared to matched cases infected with Delta. We conducted a matched cohort study, considering time to hospitalization or death as the outcome, and analyzed with a Cox proportional hazards model. Cases were matched on age, gender, and onset date, while vaccine doses received and time since vaccination were included as adjustment variables. We identified 6,314 Omicron cases that met eligibility criteria, of which 6,312 could be matched with at least one Delta case (N=8,875) based on age, gender, and onset date. There were 21 (0.3%) hospitalizations and 0 (0%) deaths among matched Omicron cases, compared to 116 (2.2%) hospitalizations and 7 (0.3%) deaths among matched Delta cases. The adjusted risk of hospitalization or death was 54% lower (HR=0.46, 95%CI: 0.27, 0.77) among Omicron cases compared to Delta cases. While severity may be reduced, the absolute number of hospitalizations and impact on the healthcare system could still be significant due to the increased transmissibility of Omicron.”

medRxiv

Preprint

Immunosequencing and epitope mapping reveal substantial preservation of the T cell immune response to Omicron generated by SARS-CoV-2 vaccines

Authors: May, DH, Rubin, BER, Dalai, SC, et al.

“The Omicron SARS-CoV-2 variant contains 34 mutations in the spike gene likely impacting protective efficacy from vaccines. We evaluated the potential impact of these mutations on the cellular immune response. Combining epitope mapping to SARS-CoV-2 vaccines that we have determined from past experiments along with T cell receptor (TCR) repertoire sequencing from thousands of vaccinated or naturally infected individuals, we estimate the abrogation of the cellular immune response in Omicron. Although 20% of CD4+ T cell epitopes are potentially affected, the loss of immunity mediated by CD4+ T cells is estimated to be slightly above 30% as some of the affected epitopes are relatively more immunogenic. For CD8+ T cells, we estimate a loss of approximately 20%. These reductions in T cell immunity are substantially larger than observed in other widely distributed variants. Combined with the expected substantial loss of neutralization from antibodies, the overall protection provided by SARS-CoV-2 vaccines could be impacted adversely. From analysis of prior variants, the efficacy of vaccines against symptomatic infection has been largely maintained and is strongly correlated with the T cell response but not as strongly with the neutralizing antibody response. We expect the remaining 70% to 80% of on-target T cells induced by SARS-CoV-2 vaccination to reduce morbidity and mortality from infection with Omicron.”

Keywords: COVID-19, SARS-CoV-2, CD4+ T cells

Preventive Medicine Reports

Moderate-to-vigorous intensity physical activity among adolescents in the USA during the COVID-19 pandemic

Authors: Nagata, JM, Cortez, CA, Dooley, EE, et al.

“This study aimed to evaluate adolescents’ moderate-to-vigorous intensity physical activity (MVPA) during the COVID-19 pandemic by sociodemographic characteristics, and to determine mental health and resiliency factors associated with MVPA among a diverse national sample of adolescents ages 10-14 years. Data were collected during the pandemic in May 2020 from the Adolescent Brain Cognitive Development Study (ABCD, N=5,153), a national prospective cohort study in the U.S. MVPA was quantified as the product of reported duration and frequency (hours per week), which was further summarized as the proportion meeting age-appropriate 2018 Physical Activity Guidelines for Americans. A similar estimate was generated using MVPA data collected prior to the pandemic. Mental health and resiliency measures were collected during the pandemic. Regression models examined associations between mental health or resiliency measures and MVPA during the pandemic. Median MVPA was 2 hours per week (IQR 0, 6). Overall, the percentage of the cohort meeting MVPA guidelines decreased from 16.1% (pre-pandemic) to 8.9% during the pandemic. Racial/ethnic minorities and adolescents from lower socioeconomic backgrounds were significantly less likely to meet MVPA guidelines during the pandemic. Poorer mental health, COVID-related worry, and stress were associated with lower MVPA, while more social support and coping behaviors were associated with higher MVPA during the pandemic. In this large, national sample of adolescents, the proportion of those meeting MVPA Guidelines was lower during the COVID-19 pandemic, with significant disparities by race and socioeconomic status. Interventions to promote social support and coping behaviors may improve MVPA levels among adolescents during the pandemic.”

Keywords: Physical activity, exercise, adolescents

Preventive Medicine Reports

Exercise frequency during the COVID-19 pandemic: A longitudinal probability survey of the US population

Authors: Wijngaards, I, del Pozo Cruz, D, Gebel, K, et al.

“Regular physical activity is important for general health and reduces the risk for COVID-19 infections and for severe outcomes among infected people. However, measures to mitigate COVID-19 likely decrease population physical activity. This study aimed to examine 1) changes in exercise frequency in a representative sample of US adults during the pandemic (04/01/2020–07/21/2021), and 2) how sociodemographic characteristics, pre-COVID health-related behaviors and outcomes, and state-level stringency of COVID-19 containment measures predict exercise frequency. Self-reported exercise frequency and its individual-level predictors were determined based on 151,155 observations from 6,540 adult participants (aged ≥ 18 years) in all US states from the Understanding America Study. State-level stringency of COVID-19 control measures was examined from the Oxford COVID-19 Government Response Tracker. Exercise frequency varied significantly over 28 survey waves across 475 days of follow-up, where exercise frequency decreased between April 2020 and January 2021, and then increased from January 2021 to July 2021. Those who were younger, living alone, non-White, had no college degree, lower household income, low pre-pandemic physical activity levels, obesity, diabetes, kidney disease and hypertension had lower exercise frequency. State-level stringency of COVID-19 control measures was inversely associated with exercise frequency between April and December 2020 when the overall stringency level was relatively high; but the association was non-significant between January and July 2021, during which the stringency index sharply declined to a low level. This longitudinal probability survey of the US population revealed significant fluctuations in exercise during COVID-19. Low exercise levels are concerning and deserve public health attention. Health inequalities from physical inactivity are likely to exacerbate because of COVID-19. Physical activity promotion in safe environments is urgently warranted, especially in at-risk population subgroups.”

Keywords: Exercise, Physical activity, Population representative survey, Public health policy

Maturitas

Accelerated Ageing in the COVID-19 Pandemic: A Dilemma for Healthy Ageing

Authors: Guo, X, Franco, OH, Laine, JE

“Shifts in distributions of countries’ populations towards older ages, population ageing, are occurring across the globe. Concurrently, accelerated ageing and age-related diseases are rising, with a wide range of effects on societies. In response to this, the World Health Organization, along with other stakeholders, aims to foster healthy ageing worldwide.[1] However, the ongoing coronavirus disease 2019 (COVID-19) pandemic has brought several challenges for achieving healthy ageing, where: population ageing is an important driving factor, as the disease poses disproportionate threats to older adults and consequently places with more rapidly ageing populations are affected worse; accelerated ageing, independent of chronological age, is linked to COVID-19 severity; and COVID-19 is directly and indirectly (i.e., through social distancing, quarantine and lockdown measures, among others) creating barriers to healthy ageing, including limiting engagement in healthy lifestyles and behaviors and increasing social isolation. Collectively, this may threaten societal healthy ageing goals. To achieve healthy ageing, especially during this and potential future pandemics, innovative public health research and research-based solutions are needed.”

Keywords: healthy ageing, population ageing, accelerated ageing, social isolation, diet, physical activity, information and communication technologies

medRxiv

Preprint

Are COVID-19 data reliable? The case of the European Union

Authors: Kolias, P

“Previous studies have used Benford’s distribution to assess whether there is misreporting of COVID-19 cases and deaths. Data inaccuracies provide false information to the media, undermine global response and hinder the preventive measures taken by countries worldwide. In this study, we analyze daily new cases and deaths from all the countries of the European Union and estimate the conformance to Benford’s distribution. For each country, two statistical tests and two measures of deviations are calculated to determine whether the reported statistics comply with the expected distribution. Four country-level developmental indexes are also included, the GDP per capita, health expenditures, the Universal Health Coverage index, and full vaccination rate. Regression analysis is implemented to show whether the deviation from Benford’s distribution is affected by the aforementioned indexes. The findings indicate that only three countries were in line with the expected distribution, Bulgaria, Croatia, and Romania. For daily cases, Denmark, Greece, and Ireland, showed the greatest deviation from Benford’s distribution and for deaths, Malta, Cyprus, Greece, Italy, and Luxemburg had the highest deviation from Benford’s law. Furthermore, it was found that the vaccination rate is positively associated with deviation from Benford’s distribution. These results suggest that overall official data provided by authorities are not confirming Benford’s law, yet this approach acts as a preliminary tool for data verification. More extensive studies should be made with a more thorough investigation of countries that showed the greatest deviation.”

medRxiv

Preprint

Risk of myocarditis following sequential COVID-19 vaccinations by age and sex

Authors: Patone, M, Mei, XW, Handunnetthi, L, et al.

“In an updated self-controlled case series analysis of 42,200,614 people aged 13 years or more, we evaluate the association between COVID-19 vaccination and myocarditis, stratified by age and sex, including 10,978,507 people receiving a third vaccine dose. Myocarditis risk was increased during 1-28 days following a third dose of BNT162b2. Associations were strongest in males younger than 40 years for all vaccine types with an additional 3 and 12 events per million estimated in the 1-28 days following a first dose of BNT162b2 and mRNA-1273, respectively; 14, 12 and 101 additional events following a second dose of ChAdOx1, BNT162b2 and mRNA-1273, respectively; and 13 additional events following a third dose of BNT162b2, compared with 7 additional events following COVID-19 infection. An association between COVID-19 infection and myocarditis was observed in all ages for both sexes but was substantially higher in those older than 40 years. These findings have important implications for public health and vaccination policy.”

Keywords: vaccinated, myocarditis, age, sex

Revue des Maladies Respiratoires Actualités

Dosage de la vitamine D chez les patients hospitalisés pour pneumopathie à Covid-19 dans le service de pneumologie du CH Chauny, France

Authors: Kone, A, Efio, M, Dongiovanni, S, et al.

“La Covid-19 est un problème de santé publique dans le monde. C’est une affection qui présente encore des zones d’ombre. Il n’existe à ce jour aucun traitement curatif d’où les nombreuses recherches. La vitamine D, hormone immunomodulatrice, semble avoir un effet anti-inflammatoire dans les infections respiratoires et la Covid-19. La présente étude a pour objectif d’évaluer l’impact de la vitamine D sur l’infection à Covid-19. Nous avons réalisé une étude prospective, descriptive et analytique qui s’est déroulée dans le service de pneumologie du centre hospitalier de Chauny (France) du 1er février au 30 avril 2021. Nous avons inclus tous les patients hospitalisés pour infection à Covid-19 durant cette période et chez qui le dosage de la vitamine D avait été réalisé. Nous avons inclus 49 patients sur un ensemble de 87 patients admis pendant la période soit 56,32 % de cas. Le sex-ratio était de 1,3. L’âge moyen était de 75 ± 14 ans. Les antécédents étaient l’hypertension artérielle 53,06 % (26/49), le diabète 26,53 % (13/49) et la BPCO 10,2 % (5/49). Les symptômes fréquemment retrouvés sont la dyspnée et la fièvre dans respectivement 75,51 % (37/49) et 44,9 % (22/49) des cas. Le surpoids était retrouvé dans 32,65 % (16/49) suivie de l’obésité 26,53 % (13/49). Le diagnostic de l’infection à Covid-19 était fait par le test antigénique 57,7 % (15/26), la RT- PCR 90,9 % (30/33) et le scanner thoracique 97,7 % (42/43). L’insuffisance en vitamine D était retrouvée dans 67,34 % des cas (33/49). L’évolution était favorable dans 85,7 % des cas. Nous avons noté 7 décès dont 5 chez des patients avec insuffisance de vitamine D. L’existence d’une insuffisance en vitamine D n’était pas statistiquement liée au sexe, à l’âge, à la durée de séjour, à l’existence d’une comorbidité, à la positivité des tests et à l’évolution de la maladie. La supplémentation en vitamine D permet de prévenir les infections respiratoires aiguës en modulant la réponse inflammatoire. Il apparaît nécessaire d’approfondir les recherches concernant son impact sur la Covid-19.”

Keywords: vitamin D

Life

Working Mode and Physical Activity as Factors Determining Stress and Sleep Quality during COVID-19 Pandemic Lockdown in Poland

Authors: Lipert, A, Musiał, K, Rasmus, P.

“The coronavirus pandemic and related government restrictions have a significant impact on peoples’ everyday functioning and working, which influences their physical and mental health. The aim of the study was to examine the associations between stress and sleep quality of people of different working modes: working in the workplace (WP), working remotely (RW), and nonworking (NW) in relation to their physical activity (PA) during COVID-19 pandemic lockdown in Poland. It was an online survey performed during governmental lockdown in April 2020. The data were collected form 1959 adults using International Physical Activity Questionnaire—Short Form (IPAQ-SF), Pittsburgh Sleep Quality Index (PSQI), and Perceived Stress Scale (PSS). The conducted analysis included t-Student test, analysis of variance (ANOVA), and mediation analysis (MANOVA). A moderate level of stress was reported in 57% of participants, and 34% of them reported a high stress level. Poor sleep quality was reported in 64% of participants. Total PA performed daily was, on average, 184.8 ± 170.5 min/day for WP, 120.6 ± 124.4 min/day for RW, and 124.6 ± 114.7 min/day for NW. There was a relationship observed between the stress and sleep quality vs. PA habit and working mode. Being physically active can be beneficial to perceive less stress and sleep disturbances influencing sleep quality, especially in remotely or nonworking people. Planning future pandemic restrictions, the policymakers should be aware of the appropriate guidelines of work planning and PA recommendations for people of different working modes. ”

Keywords: working mode, exercise, quality of sleep, health, stress

Advances in Social Science, Education and Humanities Research

Community Engagement to Increase Physical Activity During the Covid-19 Pandemic

Authors: Rahman, D, Kurniawati, RD, Wicaksono, NAB, et al.

“It is widely known that physical activity can improve quality of life and health. In addition, regular physical activity is also associated with the improvement of fitness and immunity. This community service activity aims to educate the community of Dusun Wangun about the importance of physical activity during the COVID-19 pandemic to increase immunity, maintain fitness, and introduce some sports that are not popular yet in remote areas villages. The method used in this community service activity is the Participatory Rural Appraisal (PRA) method. These community services results showed that the entire series of activities is carried out very well; this can be seen from the community’s enthusiasm during educational activities, socialization of new sports, and practical implementation. Additionally, in order to support the sustainability of the program to increase immunity, fitness, and public health in the wangun village, the society of Wangun is committed to implementing a physical activity program, which is carried out twice a week in the afternoon for 60-90 minutes coordinated by village apparatus and youth organizations (Karang Taruna).”

Keywords: Physical activity, Immunity, Education, Community services

Advances in Social Science, Education and Humanities Research

Analysis of Young People’s Physical Activity in East Java During the Covid-19 Pandemic

Authors: Tarigan, AR, Pramono, BA, Mustar, YS, et al.

“The COVID-19 pandemic has brought about significant changes in human movement activities. My activities, especially physical activity, are one of the non-pharmacological N77 treatments that can have a positive impact on humans. This study aims to determine the biological activities carried out by adolescents in East Java. One hundred twenty-eight youths in East Java aged 19-24 years participated in this study. This study uses a survey method in data collection. The questionnaire used the International Physical Activity Questionnaire (IPAQ). The results showed that, on average, the respondents did high and moderate-intensity physical activity three times a week. In comparison, the low intensity was carried out four times a week according to the duration of exercise that people did in 30 minutes of 60 minutes and only moved. An average of 2 hours per day for sitting activity. The conclusion in this study is that respondents combine physical exercise that aims to improve performance. This is very unprofitable if done during a pandemic if the respondent does not balance the training load and the volume of activity carried out with adequate rest and nutrition.”

Keywords: physical activity, intensity, IPAQ

Advances in Social Science, Education and Humanities Research

Physical Activity During the Covid-19 Pandemic in the State Civil Apparatus of Gresik Regency

Authors: Hafidz, A, Purnomo, MZ, Rusdiawan, A

“This study aims to describe three subject points, namely: a) What sports activities are selected by the State Civil Apparatus of Gresik Regency during the pandemic Covid-19, b) What percentage of sports are dominantly carried out by Gresik Government Employees during the Covid-19 pandemic, c) How much frequency of exercise the Civil Apparatus of the Gresik Regency Government before and during the Covid-19 pandemic. The type of research used is quantitative through a descriptive approach Exposure to the study results was obtained from collecting data from the dissemination of semi-open questionnaires online. Found field data as follows: a) Gymnastics, Basketball, Cycling, Volleyball, Badminton, Futsal, Road, Swimming, Fitness, Plank, Push Up, Static Bike, Running, Workout, Yoga, Squat Jump, Up-Down, Jogging, Tennis, Sit Up is a sports activity selected by Gresik Regency Government Employees. b) Jogging is a sports activity with a dominant percentage carried out by Gresik Regency Government Employees. c) During the pandemic, the physical activity of the Gresik district civil servants decreased, except for cycling and jogging. Furthermore, the frequency of exercise also tends to increase during a pandemic.”

Keywords: Activity, State civil apparatus, Gresik, Pandemic

Advances in Social Science, Education and Humanities Research

Analysis of Young People’s Physical Activity in East Java During the Covid-19 Pandemic

Authors: Tarigan, AR, Pramono, BA, Mustar, YS, et al.

“The COVID-19 pandemic has brought about significant changes in human movement activities. My activities, especially physical activity, are one of the non-pharmacological N77 treatments that can have a positive impact on humans. This study aims to determine the biological activities carried out by adolescents in East Java. One hundred twenty-eight youths in East Java aged 19-24 years participated in this study. This study uses a survey method in data collection. The questionnaire used the International Physical Activity Questionnaire (IPAQ). The results showed that, on average, the respondents did high and moderate-intensity physical activity three times a week. In comparison, the low intensity was carried out four times a week according to the duration of exercise that people did in 30 minutes of 60 minutes and only moved. An average of 2 hours per day for sitting activity. The conclusion in this study is that respondents combine physical exercise that aims to improve performance. This is very unprofitable if done during a pandemic if the respondent does not balance the training load and the volume of activity carried out with adequate rest and nutrition.”

Keywords: physical activity, intensity, IPAQ

Science Journal of Clinical Medicine

Fallout Following Unproven Prophylactic Use of Exogenous Vitamin D for COVID-19

Authors: Amadi, C, Amadi, B

“The ongoing COVID-19 (Coronavirus Disease of 2019) pandemic has devastated the human race socially, psychologically, mentally, medically, and economically. It has greatly impacted both developed and developing societies. No region of the earth has been spared of the adverse consequences of the disease. To date, the treatment of the disease has remained ill-defined. Additionally, there are no standard preventive regimens for the disease except for non-pharmacologic interventions and vaccinations. However, several unproven preventive medications are awash in social media including the use of chloroquine, Zinc, Ivermectin, Vitamin D, and so many others as prophylactic agents for COVID-19. This has led to the unregulated/unsupervised self-induced consumption of these unproven medications that may be deleterious to health if taken in excess. Herein is a case of a 24-year-old undergraduate who self-medicated with a high dosage of exogenous Vitamin D for unproven COVID-19 prophylaxis for 2 months. He developed Vitamin D Toxicity (VDT) and manifested with varying clinical (dehydration, hypertension, acute abdomen) and metabolic (hypercalcemia, hypokalemia, alkalosis, hyperphosphatemia, hypoparathyroidism, hypercalciuria, and crystalluria) consequences all related to VDT. However, hypercalcemia was the initiating metabolic disorder for all the clinical and the other metabolic derangements. He was admitted, managed accordingly, and discharged home in good clinical condition. Regulations and public health enlightenment of these unproven medications, including Vitamin D, for COVID-19 prophylaxis, should be prioritized to stem the deleterious effect of these agents. These measures will limit the current pandemic to a viral pandemic rather than a pandemic of drug misuse and overdose.”

Keywords: Hypervitaminosis D, Vitamin D Toxicity, Hypercalcemia

Journal of Clinical Medicine

COVID-19 Patient Management in Outpatient Setting: A Population-Based Study from Southern Italy

Authors: Crisafulli, S, Ientile, V, L’Abbate, L, et al.

“Evidence on treatments for early-stage COVID-19 in outpatient setting is sparse. We explored the pattern of use of drugs prescribed for COVID-19 outpatients’ management in Southern Italy in the period February 2020–January 2021. This population-based cohort study was conducted using COVID-19 surveillance registry from Caserta Local Health Unit, which was linked to claims databases from the same catchment area. The date of SARS-CoV-2 infection diagnosis was the index date (ID). We evaluated demographic and clinical characteristics of the study drug users and the pattern of use of drugs prescribed for outpatient COVID-19 management. Overall, 40,030 patients were included in the analyses, with a median (IQR) age of 44 (27–58) years. More than half of the included patients were asymptomatic at the ID. Overall, during the study period, 720 (1.8%) patients died due to COVID-19. Azithromycin and glucocorticoids were the most frequently prescribed drugs, while oxygen was the less frequently prescribed therapy. The cumulative rate of recovery from COVID-19 was 84.2% at 30 days from ID and it was lower among older patients. In this study we documented that the drug prescribing patterns for COVID-19 treatment in an outpatient setting from Southern Italy was not supported from current evidence on beneficial therapies for early treatment of COVID-19, thus highlighting the need to implement strategies for improving appropriate drug prescribing in general practice.”

Keywords: outpatients, Italy

Diseases

Epidemiological Characteristics of Hospitalized Patients with Moderate versus Severe COVID-19 Infection: A Retrospective Cohort Single Centre Study

Authors: Khamis, F, Al Awaidy, S, Shaaibi, MA, et al.

“COVID-19 has a devastating impact worldwide. Recognizing factors that cause its progression is important for the utilization of appropriate resources and improving clinical outcomes. In this study, we aimed to identify the epidemiological and clinical characteristics of patients who were hospitalized with moderate versus severe COVID-19 illness. A single-center, retrospective cohort study was conducted between 3 March and 9 September 2020. Following the CDC guidelines, a two-category variable for COVID-19 severity (moderate versus severe) based on length of stay, need for intensive care or mechanical ventilation and mortality was developed. Data including demographic, clinical characteristics, laboratory parameters, therapeutic interventions and clinical outcomes were assessed using descriptive and inferential analysis. A total of 1002 patients were included, the majority were male (n = 646, 64.5%), Omani citizen (n = 770, 76.8%) and with an average age of 54.2 years. At the bivariate level, patients classified as severe were older (Mean = 55.2, SD = 16) than the moderate patients (Mean = 51.5, SD = 15.8). Diabetes mellitus was the only significant comorbidity potential factor that was more prevalent in severe patients than moderate (n = 321, 46.6%; versus n = 178, 42.4%). Under the laboratory factors; total white cell count (WBC), C-reactive protein (CRP), Lactate dehydrogenase (LDH), D-dimer and corrected calcium were significant. All selected clinical characteristics and therapeutics were significant. At the multivariate level, under demographic factors, only nationality was significant and no significant comorbidity was identified. Three clinical factors were identified, including; sepsis, Acute respiratory disease syndrome (ARDS) and requirement of non-invasive ventilation (NIV). CRP and steroids were also identified under laboratory and therapeutic factors, respectively. Overall, our study identified only five factors from a total of eighteen proposed due to their significant values from the bivariate analysis. There are noticeable differences in levels of COVID-19 severity among nationalities. All the selected clinical and therapeutic factors were significant, implying that they should be a key priority when assessing severity in hospitalized COVID-19 patients. An elevated level of CRP may be a valuable early marker in predicting the progression in non-severe patients with COVID-19. Early recognition and intervention of these factors could ease the management of hospitalized COVID-19 patients and reduce case fatalities as well medical expenditure.”

Keywords: demographic factors, epidemiological factors, Oman

Experimental Gerontology

Covid-19 and the impact on the physical activity level of elderly people: A systematic review

Authors: Oliveira, MR, Sudati, IP, Konzen, VM, et al.

“Social isolation and lifestyle changes provoked by the COVID-19 pandemic have negatively affected the level of physical activity of the elderly people. To evaluate the available evidence related to the level of physical activity (PA) of elderly people during the COVID-19 pandemic. This is a systematic review, which included cross-sectional and cohort studies. Embase, Pubmed, Cochrane, Web of Science and Scopus databases were used to search for the studies. Finally, the New Castle-Ottawa Quality Assessment scale was used to measure the quality of the studies. 25 studies were found, being 14 cross-sectional and 11 cohort studies. The studies showed that the elderly population was highly affected in relation to the level of physical activity and lifestyle during restrictions, quarantine and lockdowns caused by the COVID-19. There was a significant reduction in physical activity levels, leading to declines in physical fitness and increased sedentary lifestyle, factors directly related to the increase in frailty in this population. The level of physical activity in the elderly population decreased during the quarantine period of COVID-19 worldwide. Strategies to maintain physical condition must be encouraged with physical exercises that meets the needs of the elderly in the current pandemic scenario, in order to maintain and improve the health of this population.”

Keywords: Physical activity, Physical exercise, Elderly people

Reviews in Endocrine and Metabolic Disorders

Vitamin D: Dosing, levels, form, and route of administration: Does one approach fit all?

Authors: Bilezikian, JP, Formenti, AM, Adler, RA, et al.

“The 4th International Conference on Controversies in Vitamin D was held as a virtual meeting in September, 2020, gathering together leading international scientific and medical experts in vitamin D. Since vitamin D has a crucial role in skeletal and extra-skeletal systems, the aim of the Conference was to discuss improved management of vitamin D dosing, therapeutic levels and form or route of administration in the general population and in different clinical conditions. A tailored approach, based on the specific mechanisms underlying vitamin D deficiency in different diseases that were discussed, was recommended. Specifically, in comparison to healthy populations, higher levels of vitamin D and greater amounts of vitamin D were deemed necessary in osteoporosis, diabetes mellitus, obesity (particularly after bariatric surgery), and in those treated with glucocorticoids. Emerging and still open issues were related to target vitamin D levels and the role of vitamin D supplementation in COVID-19 since low vitamin D may predispose to SARS-CoV-2 infection and to worse COVID-19 outcomes. Finally, whereas oral daily cholecalciferol appears to be the preferred choice for vitamin D supplementation in the general population, and in most clinical conditions, active vitamin D analogs may be indicated in patients with hypoparathyroidism and severe kidney and liver insufficiency. Parenteral vitamin D administration could be helpful in malabsorption syndromes or in states of vitamin D resistance. Specific guidelines for desired levels of vitamin D should be tailored to the different conditions affecting vitamin D metabolism with the goal to define disease-specific normative values.”

Keywords: vitamin D, bone, extraskeletal effects, obesity, parathyroid hormone

Nutrients

The Exposome and Immune Health in Times of the COVID-19 Pandemic

Authors: Morales, JS, Valenzuela, PL, Castillo-García, A, et al.

“Growing evidence supports the importance of lifestyle and environmental exposures-collectively referred to as the ’exposome’-for ensuring immune health. In this narrative review, we summarize and discuss the effects of the different exposome components (physical activity, body weight management, diet, sun exposure, stress, sleep and circadian rhythms, pollution, smoking, and gut microbiome) on immune function and inflammation, particularly in the context of the current coronavirus disease 2019 (COVID-19) pandemic. We highlight the potential role of ’exposome improvements’ in the prevention-or amelioration, once established-of this disease as well as their effect on the response to vaccination. In light of the existing evidence, the promotion of a healthy exposome should be a cornerstone in the prevention and management of the COVID-19 pandemic and other eventual pandemics.”

Keywords: environmental exposure, healthy lifestyle, infectious diseases, vaccines

Frontiers in Public Health

Vitamin D Status and SARS-CoV-2 Infection and COVID-19 Clinical Outcomes

Authors: Chiodini, I, Gatti, D, Soranna, D, et al.

“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). 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. 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, mortality, SARS-CoV-2 infection and COVID-19 hospitalization. Considering specific subgroups (i.e., Caucasian patients, high quality studies, and studies reporting adjusted association estimates) the results of primary endpoints did not change. 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.”

Keywords: SARS-CoV-2 infection, intensive care unit, mortality, respiratory distress syndrome, vitamin D

Frontiers in Public Health

Vitamin D Status and SARS-CoV-2 Infection and COVID-19 Clinical Outcomes

Authors: Chiodini, I, Gatti, D, Soranna, D, et al.

“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). 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. 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, mortality, SARS-CoV-2 infection and COVID-19 hospitalization. Considering specific subgroups (i.e., Caucasian patients, high quality studies, and studies reporting adjusted association estimates) the results of primary endpoints did not change. 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.”

Keywords: vitamin D, mortality, SARS-CoV-2 infection, respiratory distress syndrome, intensive care unit

Frontiers in Immunology

Role of Exercise Intensity on Th1/Th2 Immune Modulations During the COVID-19 Pandemic

Authors: Supriya, R, Gao, Y, Gu, Y, et al.

“The COVID-19 pandemic has led to several pioneering scientific discoveries resulting in no effective solutions with the exception of vaccination. Moderate exercise is a significant non-pharmacological strategy, to reduce the infection-related burden of COVID-19, especially in patients who are obese, elderly, and with additional comorbidities. The imbalance of T helper type 1 (Th1) or T helper type 2 (Th2) cells has been well documented among populations who have suffered as a result of the COVID-19 pandemic, and who are at maximum risk of infection and mortality. Moderate and low intensity exercise can benefit persons at risk from the disease and survivors by favorable modulation in Th1/Th2 ratios. Moreover, in COVID-19 patients, mild to moderate intensity aerobic exercise also increases immune system function but high intensity aerobic exercise may have adverse effects on immune responses. In addition, sustained hypoxia in COVID-19 patients has been reported to cause organ failure and cell death. Hypoxic conditions have also been highlighted to be triggered in COVID-19-susceptible individuals and COVID-19 survivors. This suggests that hypoxia inducible factor (HIF 1α) might be an important focus for researchers investigating effective strategies to minimize the effects of the pandemic. Intermittent hypoxic preconditioning (IHP) is a method of exposing subjects to short bouts of moderate hypoxia interspersed with brief periods of normal oxygen concentrations (recovery). This methodology inhibits the production of pro-inflammatory factors, activates HIF-1α to activate target genes, and subsequently leads to a higher production of red blood cells and hemoglobin. This increases angiogenesis and increases oxygen transport capacity. These factors can help alleviate virus induced cardiopulmonary hemodynamic disorders and endothelial dysfunction. Therefore, during the COVID-19 pandemic we propose that populations should engage in low to moderate exercise individually designed, prescribed and specific, that utilizes IHP including pranayama (yoga), swimming and high-altitude hiking exercise. This would be beneficial in affecting HIF-1α to combat the disease and its severity. Therefore, the promotion of certain exercises should be considered by all sections of the population. However, exercise recommendations and prescription for COVID-19 patients should be structured to match individual levels of capability and adaptability.”

Keywords: Th1/Th2 ratio, hypoxia, immunomodulation, intermittent hypoxic preconditioning

Malaysian Journal of Medical Sciences

Letter to the Editor: Vitamin D Supplementation Should Be Considered for the Treatment of COVID-19 Infection in Malaysia in View of the High Prevalence of Vitamin D Deficiency

Authors: Mohd Saffian, S

“Dear Editor, The significance of vitamin D requirements for bone and muscle health is well recognised and has been repeatedly discussed in the literature. However, many readers might not be aware of the role of vitamin D in the immune system and the growing evidence that vitamin D plays a crucial role in COVID-19 infection. This letter briefly describes observational and intervention studies on the relationship between vitamin D and COVID-19 infection and provides some insights into the local situation in Malaysia.”

Keywords: vitamin D, role in COVID-19 infection

medRxiv

Preprint

Vaccine effectiveness against SARS-CoV-2 infection with the Omicron or Delta variants following a two-dose or booster BNT162b2 or mRNA-1273 vaccination series: A Danish cohort study

Authors: Hansen, CH, Blicher Schelde, A, Rask Moustsen-Helm, I, et al.

“In this brief communication we are showing original research results with early estimates from Danish nationwide databases of vaccine effectiveness (VE) against the novel SARS-CoV-2 Omicron variant (B.1.1.529) up to five months after a primary vaccination series with the BNT162b2 or mRNA-1273 vaccines. Our study provides evidence of protection against infection with the Omicron variant after completion of a primary vaccination series with the BNT162b2 or mRNA-1273 vaccines; in particular, we found a VE against the Omicron variant of 55.2% (95% confidence interval (CI): 23.5 to 73.7%) and 36.7% (95% CI: 69.9 to 76.4%) for the BNT162b2 and mRNA-1273 vaccines, respectively, in the first month after primary vaccination. However, the VE is significantly lower than that against Delta infection and declines rapidly over just a few months. The VE is re-established upon revaccination with the BNT162b2 vaccine (54.6%, 95% CI: 30.4 to 70.4%).”

Nature Immunology

Children develop robust and sustained cross-reactive spike-specific immune responses to SARS-CoV-2 infection

Authors: Dowell, AC, Butler, MS, Jinks, E, et al.

“SARS-CoV-2 infection is generally mild or asymptomatic in children but a biological basis for this outcome is unclear. Here we compare antibody and cellular immunity in children (aged 3–11 years) and adults. Antibody responses against spike protein were high in children and seroconversion boosted responses against seasonal Beta-coronaviruses through cross-recognition of the S2 domain. Neutralization of viral variants was comparable between children and adults. Spike-specific T cell responses were more than twice as high in children and were also detected in many seronegative children, indicating pre-existing cross-reactive responses to seasonal coronaviruses. Importantly, children retained antibody and cellular responses 6 months after infection, whereas relative waning occurred in adults. Spike-specific responses were also broadly stable beyond 12 months. Therefore, children generate robust, cross-reactive and sustained immune responses to SARS-CoV-2 with focused specificity for the spike protein. These findings provide insight into the relative clinical protection that occurs in most children and might help to guide the design of pediatric vaccination regimens.”

medRxiv

Preprint

Fluvoxamine for Outpatient COVID-19 to Prevent Hospitalization: A Systematic Review and Meta-Analysis

Authors: Lee, TC, Vigod, S, Bortolussi-Courval, E, et al.

“Importance: Widely available and affordable options for the outpatient management of COVID-19 are needed, particularly therapies that prevent hospitalization. Objective: Perform a meta-analysis of the available randomized clinical trial evidence for fluvoxamine in the outpatient management of COVID-19. Data Sources: World Health Organization International Clinical Trials Registry Platform and ClinicalTrials.gov. Study Selection: Completed outpatient trials with available results which compared fluvoxamine to placebo. Data Extraction and Synthesis: We followed the PRISMA 2020 guidelines. We extracted study details in terms of inclusion criteria, trial demographics and the pre-specified outcome of all-cause hospitalization. Risk of bias was assessed by the Cochrane Risk of Bias 2 tool. We conducted a frequentist random effects meta-analysis, as well as two sensitivity analyses using a Bayesian random effects meta-analysis with different estimates of prior probability: a weakly neutral prior (50% chance of efficacy with 95% confidence interval for Risk Ratio [RR] between 0.5 and 2) and a moderately optimistic prior (85% chance of efficacy). We contextualized the results by estimating the probability of any effect (RR ≤1) and moderate effect (RR ≤0.9) on reducing hospitalization. Main Outcome(s) and Measure(s): All cause hospitalization. Results: 2196 participants were included from 3 identified trials. The risk ratios for hospitalization were 0.75 (95%CI, 0.57-0.97) for the frequentist analysis, 0.78 (95%CI 0.58-1.08) for the Bayesian weakly neutral prior, and 0.73 (95%CI, 0.53-1.01) for the Bayesian moderately optimistic prior. Depending on the scenario, the probability of any effect on hospitalization ranged from 94.1% to 98.3% and a moderate effect from 81.6% to 91.1%. Conclusions and Relevance: Under a variety of assumptions, fluvoxamine shows a high probability of preventing hospitalization in outpatients with COVID-19. While ongoing randomized trials are important to evaluate alternative doses, explore the effectiveness in vaccinated patients, and provide further refinement to these estimates, fluvoxamine could be recommended as a treatment option, particularly in resource-limited settings or persons without access to SARS-CoV-2 monoclonal antibody therapy or direct antivirals.”

Advances in Nutrition

The Role of Immunomodulatory Nutrients in Alleviating Complications Related to SARS-CoV-2: A Scoping Review

Authors: Jandaghi, P, Hosseini, Z, Chilibeck, P, et al.

“The recent coronavirus disease 2019 (COVID-19) pandemic has warranted the need to investigate potential therapies or prophylaxis against this infectious respiratory disease. There is emerging evidence about the potential role of nutrients on COVID-19 in addition to using medications such as hydroxychloroquine and azithromycin. This scoping review aims to explore the literature evaluating the effect of immunomodulatory nutrients on the outcomes including hospitalization, intensive care unit admission, oxygen requirement, and mortality in COVID-19 patients. A literature search of databases including Medline, EMBASE, CINAHL, Web of Science, Cochrane, Scopus, and PubMed, as well as hand-searching in Google Scholar (up to 10 February 2021) was conducted. All human studies with different study designs and without limitation on publication year were included except for non-English-language and review articles. Overall, out of 4412 studies, 19 met our inclusion criteria. Four studies examined the impact of supplementation with vitamin C, 4 studies – zinc, 8 studies – vitamin D, and 3 studies investigated the combination of 2 (zinc and vitamin C) or 3 (vitamin D, vitamin B-12, and magnesium) nutrients. Although limited data exist, available evidence demonstrated that supplementation with immune-supportive micronutrients such as vitamins D and C and zinc may modulate immunity and alleviate the severity and risk of infection. The effectiveness of vitamin C, vitamin D, and zinc on COVID-19 was different based on baseline nutrient status, the duration and dosage of nutrient therapy, time of administration, and severity of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease. This review indicated that supplementation with high-dose vitamin C, vitamin D, and zinc may alleviate the complications caused by COVID-19, including inflammatory markers, oxygen therapy, length of hospitalization, and mortality; however, studies were mixed regarding these effects. Further randomized clinical trials are necessary to identify the most effective nutrients and the safe dosage to combat SARS-CoV-2.”

Keywords: immunomodulatory nutrients, vitamin C, vitamin D, zinc

Frontiers in Bioscience-Elite

COVID-19: morphology and mechanism of the SARS-CoV-2, global outbreak, medication, vaccines and future of the virus

Authors: Bhattacharyya, P, Das, S, Aich S, et al.

“Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a lethal virus that was detected back on 31st December 2019 in Wuhan, Hubei province in China, and since then this virus has been spreading across the globe causing a global outbreak and has left the world fighting against the virus. The disease caused by the SARS-CoV-2 was named COVID-19 and this was declared a pandemic disease by the World Health Organization on 11th March 2020. Several nations are trying to develop a vaccine that can save millions of lives. This review outlines the morphological features of the virus describing the outer and inner structures of the virus along with the entry mechanism of the virus into the host body and the infection process. Detailed reports of global outbreak along with preventive measures have also been included, with special emphasis on China, the United States of America, India, Italy, and South Korea. Broad-spectrum antiviral drugs being used at various health care centres around the world, namely Remdesivir, Camostat & Nafamostat, Famotidine, Chloroquine & Hydroxychloroquine, Lopinavir/ritonavir, Ivermectin, and Tocilizumab & Sarilumab have also been included. World Health Organization guidelines on preventive measures and use of soaps, alcohol-based hand-rubs and wearing face masks have also been described. The vaccines that are in one of the phases of human trials, namely Oxford University’s vaccine, the United States-based Moderna’s vaccine, India’s Covaxin and the Russian vaccine, have also been incorporated in the review article.”

Keywords: global outbreak, morphology, oxford’s vaccine, remdesivir

iScience

Persistence of functional memory B cells recognizing SARS-CoV-2 variants despite loss of specific IgG

Authors: Winklmeier, S, Eisenhut, K, Taskin, D, et al.

“Although some COVID-19 patients maintain SARS-CoV-2-specific serum immunoglobulin G (IgG) for more than 6 months postinfection, others eventually lose IgG levels. We assessed the persistence of SARS-CoV-2-specific B cells in 17 patients, 5 of whom had lost specific IgGs after 5–8 months. Differentiation of blood-derived B cells in vitro revealed persistent SARS-CoV-2-specific IgG B cells in all patients, whereas IgA B cells were maintained in 11. Antibodies derived from cultured B cells blocked binding of viral receptor-binding domain (RBD) to the cellular receptor ACE-2, had neutralizing activity to authentic virus, and recognized the RBD of the variant of concern Alpha similarly to the wild type, whereas reactivity to Beta and Gamma were decreased. Thus, differentiation of memory B cells could be more sensitive for detecting previous infection than measuring serum antibodies. Understanding the persistence of SARS-CoV-2-specific B cells even in the absence of specific serum IgG will help to promote long-term immunity. ”

Keywords: IG B cells, IgG, IgA, ACE2

Nutrients

Placing a Well-Designed Vegan Diet for Slovenes

Authors: Jakše, B

“Interest in vegan diets has increased globally as well as in Slovenia. The quantity of new scientific data requires a thorough synthesis of new findings and considerations about the current reserved position of the vegan diet in Slovenia. There is frequently confusion about the benefits of vegetarian diets that are often uncritically passed on to vegan diets and vice versa. This narrative review aims to serve as a framework for a well-designed vegan diet. We present advice on how to maximize the benefits and minimize the risks associated with the vegan diet and lifestyle. We highlight the proper terminology, present the health effects of a vegan diet and emphasize the nutrients of concern. In addition, we provide guidance for implementing a well-designed vegan diet in daily life. We conducted a PubMed search, up to November 2021, for studies on key nutrients (proteins, vitamin B12, vitamin D, omega-3 long chain polyunsaturated fatty acids (eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)), calcium, iron, zinc, iodine and selenium) in vegan diets. Given the limited amount of scientific evidence, we focus primarily on the general adult population. A well-designed vegan diet that includes a wide variety of plant foods and supplementation of vitamin B12, vitamin D in the winter months and potentially EPA/DHA is safe and nutritionally adequate. It has the potential to maintain and/or to improve health. For physically active adult populations, athletes or individuals with fast-paced lifestyles, there is room for further appropriate supplementation of a conventional vegan diet according to individuals’ health status, needs and goals without compromising their health. A healthy vegan lifestyle, as included in government guidelines for a healthy lifestyle, includes regular physical activity, avoidance of smoking, restriction of alcohol and appropriate sleep hygiene.”

Keywords: barriers, education, environment, health, plant-based, sport, vegan diet

Journal of Clinical Epidemiology

Bias as a source of inconsistency in ivermectin trials for COVID-19: A systematic review. Ivermectin’s suggested benefits are mainly based on potentially biased results

Authors: Izcovich, A, Peiris, S, Ragusa, M, et al.

“he objective of this systematic review is to summarize the effects of ivermectin for the prevention and treatment of patients with COVID-19 and to assess inconsistencies in results from individual studies with focus on risk of bias due to methodological limitations. We searched the L.OVE platform through July 6, 2021 and included randomized trials (RCTs) comparing ivermectin to standard or other active treatments. We conducted random-effects pairwise meta-analysis, assessed the certainty of evidence using the GRADE approach and performed sensitivity analysis excluding trials with risk of bias. We included 29 RCTs which enrolled 5592 cases. Overall, the certainty of the evidence was very low to low suggesting that ivermectin may result in important benefits. However, after excluding trials classified as 'high risk' or 'some concerns' in the risk of bias assessment, most estimates of effect changed substantially: Compared to standard of care, low certainty evidence suggests that ivermectin may not reduce mortality (RD 7 fewer per 1000) nor mechanical ventilation (RD 6 more per 1000), and moderate certainty evidence shows that it probably does not increase symptom resolution or improvement (RD 14 more per 1000) nor viral clearance (RD 12 fewer per 1000). Ivermectin may not improve clinically important outcomes in patients with COVID-19 and its effects as a prophylactic intervention in exposed individuals are uncertain. Previous reports concluding important benefits associated with ivermectin are based on potentially biased results reported by studies with substantial methodological limitations. Further research is needed.”

Keywords: Coronavirus Infections, Systematic review, bias, ivermectin, severe acute respiratory syndrome coronavirus 2

Journal of Clinical Medical Research

Deficiency of Vitamin D in COVID-19 Patients

Authors: Yadav, SC, Yadav, DS

“Currently, the entire world is facing major health and economic crisis due to the novel coronavirus. At the moment, neither any medicines nor any vaccines are 100% efficacious; therefore, a healthy diet is essential for the normal function of the immune system. The main objective of this study was to find out the prev-alence of vitamin D in COVID-19 patients at the community level. This is a descriptive cross-sectional study that was carried out in Kathmandu, Nepal. 122 patients were included in this study whose polymerase chain reaction (PCR) test was positive and was in home isolation with mild to moderate symptoms. Vitamin D level was analyzed by quantitative Chemiluminescent Immunoassay (CLIA) methods and Statistical analysis was performed using Statistical Package for the Social Sciences (SPSS) 16.0 software. Out of total patients, vitamin D deficiency was found in 65.34% male and 74.46% female. Prevalence of Vitamin D deficiency is higher in coronavirus disease (COVID19) patients; in addition, the prevalence of Vitamin D deficiency is higher in coronavirus disease (COVID-19) females compared to coronavirus disease (COVID-19) males.”

Keywords: vitamin D, prevalence

iScience

The mRNA-LNP platform’s lipid nanoparticle component used in preclinical vaccine studies is highly inflammatory

Authors: Ndeupen, S, Qin, Z, Jacobsen, S

“Vaccines based on mRNA-containing lipid nanoparticles (LNPs) are a promising new platform used by two leading vaccines against COVID-19. Clinical trials and ongoing vaccinations present with varying degrees of protection levels and side effects. However, the drivers of the reported side effects remain poorly defined. Here we present evidence that Acuitas’ LNPs used in preclinical nucleoside-modified mRNA vaccine studies are highly inflammatory in mice. Intradermal and intramuscular injection of these LNPs led to rapid and robust inflammatory responses, characterized by massive neutrophil infiltration, activation of diverse inflammatory pathways, and production of various inflammatory cytokines and chemokines. The same dose of LNP delivered intranasally led to similar inflammatory responses in the lung and resulted in a high mortality rate, with mechanism unresolved. Thus, the mRNA-LNP platforms’ potency in supporting the induction of adaptive immune responses and the observed side effects may stem from the LNPs’ highly inflammatory nature.”

Keywords: Biological sciences, Biotechnology, Immunology

Journal of Pharmaceutical Research International

Vitamin D, A Predictor of Outcome in COVID-19 Patients

Authors: Lamture, YR, Gajbhiye, VP, Ambad, R, et al.

“ Hypovitaminosis D is a commonly associated with increased prevalence of pulmonary infections. High mortality rate of COVID 19 infections is associated with immune dysfunction like cytokine storm. Many studies show important function of vitamin D in proper functioning of immune system. Very few studies are available to associate vitamin D level and severity of Covid infection, Hence this study was undertaken to find a relation of vitamin D levels and outcome of COVID-19. Study design is retrospective observational analytical case control. A study population was hospital base cases and medical examination with clear definition of cases, medical examination, inclusion/ exclusion criteria, outcome and exposure. The Statistical analysis was done to measure the association of outcome (the death or severe disease risk) with exposure (low vitamin D) and that was determined by measuring Odds ratio. Most of the patients (45%) were in an age ranging from 40 to 59 years. Maximum number of the patients (68%) have one comorbidity. Diabetes mellitus and hypertension, both present in 28 % and other co morbidity in 40 % of patients and 32% of patient reported to have no comorbidities. Present study reveals vitamin D deficiency in around for 74% of patients. Most of the patients were managed without supplementation of oxygen, but few needed high flow oxygen and even invasive ventilation. However prognosis was good. COVID-19 deaths occurred only in 2% of the cases. All dead patients and patients with a severe disease had vitamin D deficiency. This association of hypovitaminosis D was more significant than other co morbidities including hypertension and diabetes mellitus. Our study concluded that, two third of patients were having vitamin D deficiency. Study clearly depicts severe vitamin D deficiency is associated with fatal cases, therefore vitamin D level can be used as a predictor of mortality.”

Keywords: poor prognosis, pandemic, respiratory diseases, cytokine storm

Cureus

Incomplete Subacute Transverse Myelitis Following Vaccination With Pfizer-BioNTech COVID-19 mRNA Vaccine: A Case Report

Authors: Alabkal, J, Rebchuk, AD, Lyndon, D, et al.

“In response to the coronavirus disease 2019 (COVID-19) pandemic, rapid development, clinical testing, and regulatory approval of vaccines occurred. The tozinameran COVID-19 vaccine is the first mRNA vaccine approved for use in humans. Transverse myelitis is a rare inflammatory disorder of the spinal cord that is associated with traditional vaccinations. There are rare case reports describing an association between mRNA vaccines and transverse myelitis. Herein, we describe a case of transverse myelitis following mRNA vaccination. A healthy 26-year-old woman developed saddle anesthesia, numbness, and allodynia in the S1-S4 distribution within three days of receiving the first dose of tozinameran COVID-19 vaccine. She had decreased sensation to pinprick, temperature, and light touch in S1-S4 distribution and a positive Rhomberg test. An MRI brain and spine demonstrated a short segment T2 hyperintense and diffusely enhancing lesion at T5. Cerebrospinal fluid studies demonstrated pleocytosis and elevated IgG index. A five-day course of IV methylprednisolone resulted in minimal improvements in her symptoms. Stage III clinical trials may be underpowered to detect more rare adverse effects such as transverse myelitis. Therefore, it is imperative to have ongoing surveillance and reporting of adverse events associated with COVID-19 vaccines to ensure transparency with regard to potential risks to patients obtaining the vaccine and algorithms in place for detection and urgent treatment if required. Nonetheless, the safety and efficacy of vaccination against COVID-19 are well established and greatly outweigh any potential risks associated with the vaccine. Given the individual, societal, and global health benefits of vaccination we strongly advocate for ongoing vaccinations against COVID-19.”

Keywords: bnt162b2, mrna, tozinameran, transverse myelitis

Physiological Research

Endocrine risk factors for COVID-19 in context of aging

Authors: Máčová, L, Bičíková, M, Hampl, R

“Aged people are the most susceptible group to COVID-19 infection. Immunosenescence characterized by impairment of immune function with inflamm-aging contributes to pathophysiological alterations, among which endocrine and metabolic diseases are not exception. Diabetes, obesity along with impairment of disorders of thyroid functions are the most frequent ones, the common feature of which is failure of immune system including autoimmune processes. In the minireview we discussed how COVID-19 and aging impact innate and adaptive immunity, diabetes and selected neuroendocrine processes. Mentioned is also beneficial effect of vitamin D for attenuation of these diseases and related epigenetic issues. Particular attention is devoted to the role of ACE2 protein in the light of its intimate link with renin-angiotensin regulating system.”

Keywords: Aging, Endocrinopathy, Immunity, Vitamin D

The New England Journal of Medicine

Molnupiravir in unvaccinated patients with COVID-19

Authors: Jayk Bernal, A, Gomes da Silva, MM, Musungaie, DB, et al.

“Molnupirvair is a prodrug of N-hydroxycytidine, which is active against RNA viruses including SARS-CoV-2. Molnupiravir was compared with placebo in non-hospitalised unvaccinated adults with mild-to-moderate COVID-19 and at least one risk factor for severe COVID-19 illness. Treatment with oral molnupiravir within 5 days of the start of symptoms reduced the risk of hospitalisation or death. The full trial data showed that the risk of hospitalisation or death in non-hospitalised unvaccinated adults with mild-to-moderate COVID-19 was 6.8% with molnupiravir and 9.7% with placebo ”

Keywords: molnupiravir, unvaccinated, hospitalisation, death

BMJ Open

Relationship between self-care activities, stress and well-being during COVID-19 lockdown: a cross-cultural mediation model

Authors: Luis, E, Bermejo-Martins, E, Martinez, M, et al.

“To examine the mediation role of self-care between stress and psychological well-being in the general population of four countries and to assess the impact of sociodemographic variables on this relationship. Cross-sectional, online survey. A stratified sample of confined general population (N=1082) from four Ibero-American countries—Chile (n=261), Colombia (n=268), Ecuador (n=282) and Spain (n=271)—balanced by age and gender.Sociodemographic information (age, gender, country, education and income level), information related to COVID-19 lockdown (number of days in quarantine, number of people with whom the individuals live, absence/presence of adults and minors in charge and attitude towards the search of information related to COVID-19), Perceived Stress Scale-10, Ryff’s Psychological Well-Being Scale-29 and Self-Care Activities Screening Scale-14. Self-care partially mediates the relationship between stress and well-being during COVID-19 confinement in the general population in the total sample and in each country. On the other hand, among the evaluated sociodemographic variables, only age affects this relationship. The results have broad implications for public health, highlighting the importance of promoting people’s active role in their own care and health behaviour to improve psychological well-being if stress management and social determinants of health are jointly addressed first. The present study provides the first transnational evidence from the earlier stages of the COVID-19 lockdown, showing that the higher perception of stress, the less self-care activities are adopted, and in turn the lower the beneficial effects on well-being.”

Keywords: stress, well-being, health behaviour, stress management, impact of sociodemographic variables

Family Practice

Outpatient prescription patterns of COVID-19 drugs in the metropolitan area of Mexico City

Authors: Fuentes-Gonzalez, MF, Navarro, AO, Carmona-Aguilera, Z, et al.

“We aimed to describe the use of drugs with apparent efficacy in ambulatory patients with confirmed COVID-19 and the relationship of Google Trends searches with prescriptions and the total number of COVID-19 cases in Mexico City. Between March 2020 and February 2021, we surveyed 350 patients confirmed to have COVID-19 across 3 hospitals in Mexico City for their ambulatory prescriptions. We analysed the correlation between prescription patterns of 4 drugs with apparent efficacy against COVID-19, Google Trends searches for these drugs, and the overall number of confirmed COVID-19 cases in Mexico City. We included 350 patients, of whom 59% were women with a median age of 38 years (interquartile range, 29–51), and 72% had a bachelor’s degree or higher. There were ambulatory medical prescriptions in 172 (49%) patients, and self-prescriptions were reported in 99 (28%) patients. The prescription rate was high for hydroxychloroquine/azithromycin (19%) and dexamethasone (25%). There was a decrease in the prescription of hydroxychloroquine (P < 0.001) and a strong positive correlation between hydroxychloroquine prescription and online searches for hydroxychloroquine. There was a strong positive correlation between online searches for azithromycin, dexamethasone, ivermectin, and vitamin D and the number of confirmed COVID-19 cases. During the COVID-19 pandemic, there was a high proportion of prescriptions for hydroxychloroquine/azithromycin and dexamethasone despite their unproven efficacy. Analysis of Google Trends showed a strong correlation between the overall number of confirmed COVID-19 cases and searches for such drugs, suggesting a higher rate of prescriptions. Analysis of online searches could thus help to actively survey public health behaviours in the future.”

Keywords: health information, infectious diseases, medical errors/patient safety, prescription drug monitoring programs, self-management

Iranian Journal of Nutrition Sciences & Food Technology

Effects of Vitamin D in fighting COVID-19 disease

Authors: Nourazaran, M, Yousefi, R, Moosavi-Movahedi A

“Vitamin D is known for its roles in calcium metabolism and bone health. With the spread of COVID-19 epidemic, roles of this vitamin in strengthening host immune system has received more attention. Nearly 900 genes have been identified, whose expression is controlled by vitamin D. Most of these genes are involved in innate and adaptive immune systems. Vitamin D prohibits the penetration of viruses deep into tissues by maintaining intercellular connections. This characteristic of vitamin D prevents rapid spread of the coronavirus in the lungs. Stimulating immune cell differentiation, increasing killing capacity of macrophages and increasing production of antimicrobial peptides such as cathelicidin and β-defensin by vitamin D increase the immune system ability to fight coronavirus. Moreover, vitamin D decreases over secretion of inflammatory cytokines; thus, prohibiting cytokine storm and uncontrolled inflammation in the lungs. Modulating activity of the renin-angiotensin system and preventing over accumulation of angiotensin 2 are other functions of vitamin D in protecting tissues, especially lungs, against the coronavirus.”

Keywords: Immune system, Vitamin D, Antimicrobial peptides, Cytokine storm, Renin-angiotensin system

African Health Sciences

COVID-19 in Africa: rethinking the tools to manage future pandemics

Authors: Emahi, I, Watts, MCNC, Morrison, SAJF, et al.

“Corona virus disease 2019 (COVID-19) remains an incurable, progressive pneumonia-like illness characterized by fever, dry cough, fatigue, and headache during its early stages. COVID-19 has ultimately resulted in mortality in at least 2 million people worldwide. Millions of people globally have already been affected by this disease, and the numbers are expected to increase, perhaps until an effective cure or vaccine is identified. Although Africa was initially purported by the World Health Organization (WHO) to be severely hit by the pandemic, Africa recorded the least number of cases during the first wave, with lowest rates of infections, compared to Asia, Europe, and the Americas. This statistic might be attributed to the low testing capacity, existing public health awareness and lessons learnt during Ebola epidemic. Nonetheless, the relatively low rate of infection should be an opportunity for Africa to be better prepared to overcome this and future epidemics. In this paper, the authors provide insights into the dynamics and transmission of the severe acute respiratory syndrome corona virus (SARS-CoV-2) during the first wave of the pandemic; possible explanations into the relatively low rates of infection recorded in Africa; with recommendations for Africa to continue to fight Covid-19; and position itself to effectively manage future pandemics.”

Keywords: Ebola, Science Leadership in Africa, Preventative Health, Future Pandemics, Vaccines

Nutrients

Combatting Sedentary Behaviors by Delivering Remote Physical Exercise in Children and Adolescents with Obesity in the COVID-19 Era: A Narrative Review

Authors: Vandoni, M, Codella, R, Pippi, R, et al.

“The coexistence of childhood obesity (or its risk) and COVID-19 pandemic put children and adolescents in greater risk to develop respiratory and cardiovascular diseases. In fact, the restrictions introduced to limit the spread of the virus had detrimental effects on various lifestyle components, especially in young population. This resulted in augmented levels of physical inactivity and sedentary behaviors and a reduced time spent in play outdoors or sport practices. Contrariwise, the increased use of technology led clinicians, teachers, and trainers to maintain relations with obese children/adolescents so as to reduce sedentary behaviors and the associated health risks. This narrative review aims to describe the role of Telehealth and Tele-exercise as useful tools in the management of pediatric obesity during COVID-19 pandemic. Telehealth and Tele-exercise were effective in promoting self-monitoring and behavioral changes, including adherence to exercise training programs in children and adolescents. Moreover, tele-exercise platforms such as applications or exergames allowed flexible scheduling, limiting the infection risks.”

Keywords: children obesity, exercise, sedentary, online training program, telehealth, pediatrics

British Medical Journal

Feature

The end of the pandemic will not be televised

Authors: Robertso, D, Doshi, P

“As the year 2021 started, the covid-19 pandemic seemed to be receding. Discussions and predictions about “opening up,” a return to “normal,” and achieving herd immunity were in the air. But for many, optimism receded as cases and deaths surged in India, Brazil, and elsewhere. Attention turned to SARS-CoV-2 virus variants—most recently, the emergence of omicron. Just as the end seemed to be on the horizon, it was interrupted by a foreboding that the pandemic could be a long way from over.”

Bewegungstherapie Und Gesundheitssport

Physical Activity during Corona for Employees in the Home Office

Authors: Walle, O

“Lack of exercise is one of the leading risk factors for health challenges. This is why it is generally recommended to carry out at least 150 minutes per week of moderate or 75 minutes of intense physical activity. Even before the corona pandemic, national and international studies highlighted inadequate physical activity in the population. In the study groups, physical activity inadequacy applied to over 50 percent of the test persons. As a result of the pandemic, there has been increased home office activity due to infection protection and the associated physical distancing measures. This has led to changes in the working and living environment and therefore also to changes in health behaviour. The present study there- fore looks into the questions of the effects of home office work on the physical activity of employees, the factors that play a role as well as the findings that can be derived for workplace health promotion. Methodology In June 2021, an online survey was carried out using the Global Physical Activity Questionnaire (GPAQ) of the World Health Organization (WHO) aswell as an additional questionnaire on changes in movement and sitting behaviour and the underlying reasons, as well as examples of activities and wishes for further action. The evaluation was carried out for the GPAQ questionnaire on the basis of the WHO guidelines and subsequent descriptive parameters and frequencies. The other variables were primarily evaluated with frequency distributions and free text responses using the qualitative data analysis (QDA) method. Results 193 employees from different companies and industries took part in the survey, of which 183 valid responses could be used for an activity evaluation. 25 percent had a low, 51 percent a moderate and 24 percent a high activity level. The average sitting time was 8.9 hours per day. There was both an increase in activity behavior in some study participants during the pandemic and a decrease in others. Overall, there was a significant increase in terms of sitting time. The qualitative data shows reasons for the changes in movement behaviour. At the same time, possibilities for promoting physical activity are highlighted. Conclusions The study provides insights into the impact of working from home during the corona pandemic. At the same time, potential for the workplace health promotion in the home office becomes clearer.”

Keywords: home office, physical activity, workplace health promotion, potential, sports

Nature Medicine

Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection

Authors: Patone, M, Mei, XW, Handunnetthi, L, et al.

“Although myocarditis and pericarditis were not observed as adverse events in coronavirus disease 2019 (COVID-19) vaccine trials, there have been numerous reports of suspected cases following vaccination in the general population. We undertook a self-controlled case series study of people aged 16 or older vaccinated for COVID-19 in England between 1 December 2020 and 24 August 2021 to investigate hospital admission or death from myocarditis, pericarditis and cardiac arrhythmias in the 1–28 days following adenovirus (ChAdOx1, n = 20,615,911) or messenger RNA-based (BNT162b2, n = 16,993,389; mRNA-1273, n = 1,006,191) vaccines or a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive test (n = 3,028,867). We found increased risks of myocarditis associated with the first dose of ChAdOx1 and BNT162b2 vaccines and the first and second doses of the mRNA-1273 vaccine over the 1–28 days postvaccination period, and after a SARS-CoV-2 positive test. We estimated an extra two (95% confidence interval (CI) 0, 3), one (95% CI 0, 2) and six (95% CI 2, 8) myocarditis events per 1 million people vaccinated with ChAdOx1, BNT162b2 and mRNA-1273, respectively, in the 28 days following a first dose and an extra ten (95% CI 7, 11) myocarditis events per 1 million vaccinated in the 28 days after a second dose of mRNA-1273. This compares with an extra 40 (95% CI 38, 41) myocarditis events per 1 million patients in the 28 days following a SARS-CoV-2 positive test. We also observed increased risks of pericarditis and cardiac arrhythmias following a positive SARS-CoV-2 test. Similar associations were not observed with any of the COVID-19 vaccines, apart from an increased risk of arrhythmia following a second dose of mRNA-1273. Subgroup analyses by age showed the increased risk of myocarditis associated with the two mRNA vaccines was present only in those younger than 40.”

Journal of Virological Methods

Relation of Vitamin D to COVID-19

Authors: Saxena, P, Nigam, K, Mukherjee, S, et al.

“The coronavirus pandemic has lasted for more than a year now and still remains the leading cause of concern, worldwide. The causal agent; SARS- CoV-2, leads to the development of respiratory distress in the lower respiratory tract, sometimes leading to fatalities. Keeping in mind the discovery of mutant strains across the world, as well as the delay in vaccinations across vast populations, most people speculate boosting their immune systems as a preventive and precautionary measure. One of the most commonly observed conditions that hamper immunity; Vitamin D deficiency has been linked to the onset and the alteration of course of the disease in patients and is also being explored as a potential drug supplement. These surmises make it essential to study deep into the speculations. This review aims to overview the possible correlations between Vitamin D and COVID-19.”

Keywords: Vitamin D, Immunopathogenesis

Infectious Diseases

Pdefault

Global Percentage of Asymptomatic SARS-CoV-2 Infections Among the Tested Population and Individuals With Confirmed COVID-19 Diagnosis A Systematic Review and Meta-analysis

Authors: Qiuyue M, Jue L, Qiao L, et al.

“Question What is the percentage of asymptomatic individuals with positive test results for SARS-CoV-2 among tested individuals and those with confirmed COVID-19 diagnosis? Findings In this systematic review and meta-analysis of 95 unique studies with 29 776 306 individuals undergoing testing, the pooled percentage of asymptomatic infections was 0.25% among the tested population and 40.50% among the population with confirmed COVID-19. Meaning The high percentage of asymptomatic infections from this study highlights the potential transmission risk of asymptomatic infections in communities.”

Viral Immunology

Controlling the Burden of COVID-19 by Manipulating Host Metabolism

Authors: Miller, L, Berber, E, Sumbria, D, et al.

“The coronavirus disease 2019 (COVID-19) pandemic caused by the coronavirus—severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to cause global health problems, but its impact would be minimized if the many effective vaccines that have been developed were available and in widespread use by all societies. This ideal situation is not occurring so other means of controlling COVID-19 are needed. In this short review, we make the case that manipulating host metabolic pathways could be a therapeutic approach worth exploring. The rationale for such an approach comes from the fact that viruses cause metabolic changes in cells they infect, effective host defense mechanisms against viruses requires the activity of one or more metabolic pathways, and that hosts with metabolic defects such as diabetes are more susceptible to severe consequences after COVID-19. We describe the types of approaches that could be used to redirect various aspects of host metabolism and the success that some of these maneuvers have had at controlling other virus infections. Manipulating metabolic activities to control the outcome of COVID-19 has to date received minimal attention. Manipulating host metabolism will never replace vaccines to control COVID-19 but could be used as an adjunct therapy to the extent of ongoing infection.”

Keywords: long COVID, metabolism, immunity, consequence, outcome

Revista Española de Quimioterapia

Preprint

Pharmacological treatment of COVID-19: an opinion paper

Authors: García-Lledó, A., Gómez-Pavón, J., González Del Castillo, J., et al.

“The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.”

Keywords: AZD7442, Adalimumab, Anakinra, Azithromycin, BRII-196, BRII-198, Banlanivimab, Baricitinib, COVID-19, Canakinumab, Casirivimab, Certolizumab, Ciganilmab, Colchicine, Dexamethasone, Etanercept, Etesevimab, Evusheld, Favipiravir, Fluvoxamine, Golimumab, Hydroxychloroquine, Imdevinab, Infliximab, Itolizumab, Ivermectin, Lemilumab, Lopinavir/Ritonavir, Metformin, Molnupiravir, PF-07321332, Paxlovid, Ravulizumab, Remdesivir, Ruxolitinib, SARS-CoV-2, Sarilumab, Sotrovimab, Tixagevimab, Tocilizumab, Tofacitinib, Vitamin D, convalescent plasma, treatment

Revista Espanola de Quimioterapia

Preprint

Pharmacological treatment of COVID-19: an opinion paper

Authors: García-Lledó, A, Gómez-Pavón, J, González Del Castillo, J, et al.

“The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.”

Keywords: AZD7442, Adalimumab, Anakinra, Azithromycin, BRII-196, BRII-198, Banlanivimab, Baricitinib, Canakinumab, Casirivimab, Certolizumab, Ciganilmab, Colchicine, Dexamethasone, Etanercept, Etesevimab, Evusheld, Favipiravir, Fluvoxamine, Golimumab, Hydroxychloroquine, Imdevinab, Infliximab, Itolizumab, Ivermectin, Lemilumab, Lopinavir/Ritonavir, Metformin, Molnupiravir, PF-07321332, Paxlovid, Ravulizumab, Remdesivir, Ruxolitinib, Sarilumab, Sotrovimab, Tixagevimab, Tocilizumab, Tofacitinib, Vitamin D, convalescent plasma, treatment

Research Gate

Preprint

Ivermectin prophylaxis used for COVID-19 reduces COVID-19 infection and mortality rates: A 220,517-subject, populational-level retrospective citywide

Authors: Kerr, L, Flávio, C, Baldi, F, et al.

“Ivermectin has demonstrated different mechanisms of actions that could potentially protect from both COVID-19 infection and COVID-19-related comorbidities. Based on the existing literature and safety profile of ivermectin, a citywide program of prophylactic use of ivermectin for COVID-19 was implemented in Itajai, a Southern city in Brazil in the state of Santa Catarina. The objective of this analysis is to evaluate the effects of the use of ivermectin for prevention of COVID-19 infection, risk of dying and mortality, compared to non-users. This is a retrospective analysis of registry data from the medical based citywide COVID-19 prevention with ivermectin program, between July 2020 to December of 2020. The whole population of Itajaí was invited for a medical visit to compile demographic and medical parameters. In the absence of contraindications, ivermectin was offered as an optional treatment for 2 days every 15 days at a dose of 0.2mg/kg/day. Patients’ preferences and medical autonomy were preserved. Ivermectin users were compared with the comorbidity-matched population of non-users for COVID-19 by age, sex, COVID-19 infection rate, and COVID-19 mortality rate. Results in terms of mortality were adjusted for all relevant variables and Propensity Score Matching (PSM) was calculated. A total of 220,517 subjects were included in the analysis; 133,051 (60.3%) ivermectin users and 87,466 (39.7%) non-users. COVID-19 infection occurred in 4,311 (3.2%) treated subjects, and 3,034 (3.5%) non-treated subjects. This evidence showed a 7% reduction in COVID-19 infection rate with use of ivermectin: COVID-19 infection rate ratio. A total of 62 deaths (1.4% mortality rate) occurred among users and 79 deaths (2.6% mortality rate) among non-users, showing a 48% reduction in mortality rate. Risk of dying from COVID-19 among ivermectin users was 45% lower than non-users. Prophylactic use of ivermectin showed significantly reduced COVID-19 infection rate, mortality rate and chance of dying from COVID-19 on a calculated population-level analysis, which controlled for all relevant confounding variables.”

Keywords: ivermectin, prophylaxis, prevention

Journal of Chiropractic Medicine

An exploratory review of Potential Adjunct Therapies for the Treatment of Coronavirus Infections

Authors: Brett, R, Martin, DC, Richardson, J

“The purpose of this exploratory review c, including vitamin D, zinc, vitamin A, elderberry (S nigra), garlic (A sativum), licorice (G glabra), stinging nettle (U dioica), N-acetylcysteine, quercetin and selenium as potential adjunct therapies for the treatment of coronavirus infections. A search of PubMed was performed for articles published from 2005 to 2021. Key words searched were zinc, vitamin A, vitamin D, Sambucus nigra, Allium sativum, Glycyrrhiza glabra, Urtica dioica, N-Acetylcysteine, quercetin, selenium and coronavirus.There were 47 articles selected for this review. Findings included that vitamin D, zinc, vitamin A, S nigra, A sativum, G glabra, U dioica, N-acetylcysteine, quercetin and selenium have been shown to produce anti-inflammatory, immunostimulatory or antiviral effects that may enhance the actions of standard therapeutics for the treatment of CoV infections. We found only research articles related to the effects of vitamin D, zinc, G glabra, quercetin and selenium against COVID-19. We identified non-pharmaceutical supplements (Vitamin D, zinc, vitamin A, S nigra, A sativum, G glabra and U dioica) which may have potential to provide support for those with coronavirus infections. However, rigorous clinical studies need to be performed before any clinical recommendations can be made at this time.”

Keywords: Vitamin D, Quercetin, Selen, Zinc, Vitamin A, Elderberry, Garlic, Licorice, Stinging nettle

Revista Española de Quimioterapia

Preprint

Pharmacological treatment of COVID-19: an opinion paper

Authors: García-Lledó, A., Gómez-Pavón, J., González Del Castillo, J., et al.

“The precocity and efficacy of the vaccines developed so far against COVID-19 has been the most significant and saving advance against the pandemic. The development of vaccines has not prevented, during the whole period of the pandemic, the constant search for therapeutic medicines, both among existing drugs with different indications and in the development of new drugs. The Scientific Committee of the COVID-19 of the Illustrious College of Physicians of Madrid wanted to offer an early, simplified and critical approach to these new drugs, to new developments in immunotherapy and to what has been learned from the immune response modulators already known and which have proven effective against the virus, in order to help understand the current situation.”

Keywords: AZD7442, Adalimumab, Anakinra, Azithromycin, BRII-196, BRII-198, Banlanivimab, Baricitinib, COVID-19, Canakinumab, Casirivimab, Certolizumab, Ciganilmab, Colchicine, Dexamethasone, Etanercept, Etesevimab, Evusheld, Favipiravir, Fluvoxamine, Golimumab, Hydroxychloroquine, Imdevinab, Infliximab, Itolizumab, Ivermectin, Lemilumab, Lopinavir/Ritonavir, Metformin, Molnupiravir, PF-07321332, Paxlovid, Ravulizumab, Remdesivir, Ruxolitinib, SARS-CoV-2, Sarilumab, Sotrovimab, Tixagevimab, Tocilizumab, Tofacitinib, Vitamin D, convalescent plasma, treatment

Journal of Clinical Endocrinology & Metabolism

Prognostic and therapeutic role of vitamin D in COVID-19: systematic review and meta-analysis

Authors: Dissanayake, HA, de Silva, NL, Sumanatilleke, M, et al.

“Vitamin D deficiency/insufficiency may increase the susceptibility to COVID-19. We aimed to determine the association between vitamin D deficiency/insufficiency and susceptibility to COVID-19, its severity, mortality and role of vitamin D in its treatment. We searched CINHAL, Cochrane library, EMBASE, PubMED, Scopus, and Web of Science up to 30.05.2021 for observational studies on association between vitamin D deficiency/insufficiency and susceptibility to COVID-19, severe disease and death among adults, and, randomized controlled trials (RCTs) comparing vitamin D treatment against standard care or placebo, in improving severity or mortality among adults with COVID-19. Risk of bias was assessed using Newcastle-Ottawa scale for observational studies and AUB-KQ1 Cochrane tool for RCTs. Study-level data were analyzed using RevMan 5.3 and R (v4∙1∙0). Heterogeneity was determined by I 2 and sources were explored through pre-specified sensitivity analyses, subgroup analyses and meta-regressions. Of 1877 search results, 76 studies satisfying eligibility criteria were included. Seventy-two observational studies were included in the meta-analysis (n=1976099). Vitamin D deficiency/insufficiency increased the odds of developing COVID-19, severe disease, and death. 25-hydroxy vitamin D (25(OH)D) concentration were lower in individuals with COVID-19 compared to controls, in patients with severe COVID-19 compared to controls with non-severe COVID19 and in non-survivors compared to survivors. The association between vitamin D deficiency/insufficiency and death was insignificant when studies with high risk of bias or studies reporting unadjusted effect estimates were excluded. Risk of bias and heterogeneity were high across all analyses. Discrepancies in timing of vitamin D testing, definitions of severe COVID-19 and vitamin D deficiency/insufficiency partly explained the heterogeneity. Four RCTs were widely heterogeneous precluding meta-analysis. Multiple observational studies involving nearly two million adults suggest vitamin D deficiency/insufficiency increases susceptibility to COVID-19 and severe COVID-19, although with a high risk of bias and heterogeneity. Association with mortality was less robust. Heterogeneity in RCTs precluded their meta-analysis.”

Keywords: vitamin D

Journal of the Egyptian Public Health Association

The protective role of vitamin C in the management of COVID-19: A Review

Authors: Uddin, MS, Millat, MS, Baral, PK, et al.

“The outbreak of coronavirus infectious disease-2019 (COVID-19) is globally deemed a significant threat to human life. Researchers are searching for prevention strategies, mitigation interventions, and potential therapeutics that may reduce the infection’s severity. One such means that is highly being talked in online and in social media is vitamin C. Vitamin C is a robust antioxidant that boosts the immune system of the human body. It helps in normal neutrophil function, scavenging of oxidative species, regeneration of vitamin E, modulation of signaling pathways, activation of pro-inflammatory transcription factors, activation of the signaling cascade, regulation of inflammatory mediators, and phagocytosis and increases neutrophil motility to the site of infection. All of these immunological functions are required for the prevention of COVID-19 infection. Considering the role of vitamin C, it would be imperative to administrate vitamin C for the management of severe COVID-19. However, there is no specific clinical data available to confirm the use of vitamin C in the current pandemic.”

Keywords: Vitamin C, Pathogenesis of COVID-19, Immunity

BMJ Investigation

Covid-19: Researcher blows the whistle on data integrity issues in Pfizer’s vaccine trial

Authors: Paul D Thacker

“Revelations of poor practices at a contract research company helping to carry out Pfizer’s pivotal covid-19 vaccine trial raise questions about data integrity and regulatory oversight.”

medRxiv

Preprint

Reduced neutralisation of SARS-COV-2 Omicron-B.1.1.529 variant by post-immunisation serum

Authors: Dejnirattisai, W, Shaw, RH, Supasa, P., et al.

“In this report, we present live neutralisation titres against SARS-CoV-2 Omicron variant, compared with neutralisation against Victoria, Beta and Delta variants. Sera from day-28 post second-dose were obtained from participants in the Com-COV2 study who had received a two-dose COVID-19 vaccination schedule with either AstraZeneca (AZD1222) or Pfizer (BNT162b2) vaccines. There was a substantial fall in neutralisation titres in recipients of both AZD1222 and BNT16b2 primary courses, with evidence of some recipients failing to neutralise at all. This will likely lead to increased breakthrough infections in previously infected or double vaccinated individuals, which could drive a further wave of infection, although there is currently no evidence of increased potential to cause severe disease, hospitalization or death.”

Nutrients

Vitamin D Dosing: Basic Principles and a Brief Algorithm (2021 Update)

Authors: Bleizgys, A

“Nowadays, in modern societies, many people can be at high risk to have low vitamin D levels. Therefore, testing of serum 25-hydroxy-vitamin D (25OH-D) levels should be performed before prescribing them vitamin D supplementation. However, in some cases the 25OH-D level assessment is not available at the right moment, e.g., due to mandatory quarantine of COVID-19 outpatients. Therefore, such patients could be advised to start taking moderate vitamin D doses (e.g., 4000 IU/day for adults), and their 25-OH-D levels could be checked later. The proposed algorithm also comprises vitamin D dosing principles when baseline 25OH-D levels are known. ”

Keywords: vitamin D, calcidiol, supplementation

European Review for Medical and Pharmacological Sciences

Proposal of a food supplement for the management of post-COVID syndrome

Authors: Naureen, Z, Dautaj, A, Nodari, S, et al.

“A vast majority of COVID-19 patients experience fatigue, extreme tiredness and symptoms that persist beyond the active phase of the disease. This condition is called post-COVID syndrome. The mechanisms by which the virus causes prolonged illness are still unclear. The aim of this review is to gather information regarding post-COVID syndrome so as to highlight its etiological basis and the nutritional regimes and supplements that can mitigate, alleviate or relieve the associated chronic fatigue, gastrointestinal disorders and continuing inflammatory reactions. Naturally-occurring food supplements, such as acetyl L-carnitine, hydroxytyrosol and vitamins B, C and D hold significant promise in the management of post-COVID syndrome. In this pilot observational study, we evaluated the effect of a food supplement containing hydroxytyrosol, acetyl L-carnitine and vitamins B, C and D in improving perceived fatigue in patients who recovered from COVID-19 but had post-COVID syndrome characterized by chronic fatigue. The results suggest that the food supplement could proceed to clinical trials of its efficacy in aiding the recovery of patients with long COVID.”

Keywords: post-COVID, food supplement, vitamins

European Journal of Medical & Health Sciences

Vitamin D Levels among Hospitalized and Non-Hospitalized COVID-19 Patients in Dr. M. Djamil General Hospital Padang

Authors: Putra, H, Elfrida, Yaswir, R

“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. Vitamin D deficiency affected hospitalized group more than the non-hospitalized group, but not statistically significant (71% vs. 64.5%). 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.”

Keywords: cytokine storm, inflammation, vitamin D deficiency

Critical Reviews in Food Science and Nutrition

Association between vitamin D status and risk of covid-19 in-hospital mortality: A systematic review and meta-analysis of observational studies

Authors: Ebrahimzadeh, A, Mohseni, S, Narimani, B, et al.

“Some earlier studies reported higher risk of COVID-19 mortality in patients with vitamin D deficiency, while some others failed to find such as association. Due to inconsistences between earlier meta-analyses and needs for an updated study, we conducted current systematic review and meta-analysis on the association between vitamin D status and risk of COVID-19 in-hospital mortality among observational studies. We searched PubMed, Scopus and Web of Science up to 27 July 2021. We conduct our systematic review and meta-analysis in according to PRISM statement. Two authors independently screened studies and extracted data from the relevant ones. All types of observational studies about the association between vitamin D status and in hospital COVID-19 mortality were included. Data was pooled using a random-effect model. We identified 13 observational studies. Pooling 9 studies which categorized vitamin D level, a significant positive relationship was found between vitamin D deficiency and risk of COVID-19 in-hospital mortality. All subgroup analyses also showed significant relationship between vitamin D deficiency and risk of COVID-19 in-hospital mortality. In the other analysis, pooling data from 5 studies in which vitamin D level was entered as a continues variable, we found an inverse significant association between each unit increment in serum vitamin D concentrations and risk of COVID-19 in-hospital mortality. We found a significant direct association between vitamin D deficiency and elevated risk of COVID-19 in-hospital mortality. Moreover, each unit increment in serum vitamin D levels was associated to significant reduction in risk of COVID-19 mortality. Further prospective studies are needed to confirm our findings.”

Keywords: meta-analysis, mortality, vitamin D

Postgraduate Medicine

Vitamin D and COVID-19: where are we now?

Authors: Contreras-Bolívar, V, García-Fontana, B, García-Fontana, C, et al.

“The pandemic caused by the SARS-CoV-2 virus has triggered great interest in the search for the pathophysiological mechanisms of COVID-19 and its associated hyperinflammatory state. The presence of prognostic factors such as diabetes, cardiovascular disease, hypertension, obesity, and age influence the expression of the disease’s clinical severity. Other elements, such as 25-hydroxyvitamin D (25(OH)D3) concentrations, are currently being studied. Various studies, mostly observational, have sought to demonstrate whether there is truly a relationship between 25(OH)D3 levels and the acquisition and/or severity of the disease. The objective of this study was to carry out a review of the current data that associate vitamin D status with the acquisition, evolution, and/or severity of infection by the SARS-CoV-2 virus and to assess whether prevention through vitamin D supplementation can prevent infection and/or improve the evolution once acquired. Vitamin D system has an immunomodulatory function and plays a significant role in various bacterial and viral infections. The immune function of vitamin D is explained in part by the presence of its receptor (VDR) and its activating enzyme 25-hydroxyvitamin D-1alpha-hydroxylase (CYP27B1) in immune cells. The vitamin D, VDR, and Retinoid X Receptor complex allows the transcription of genes with antimicrobial activities, such as cathelicidins and defensins. COVID-19 characteristically presents a marked hyperimmune state, with the release of proinflammatory cytokines such as IL-6, TNF-α, and IL-1β. Thus, there are biological factors linking vitamin D to the cytokine storm, which can herald some of the most severe consequences of COVID-19, such as acute respiratory distress syndrome. Hypovitaminosis D is widespread worldwide, so the prevention of COVID-19 through vitamin D supplementation is being considered as a possible therapeutic strategy easy to implement. However, more-quality studies and well-designed randomized clinical trials are needed to address this relevant question.”

Keywords: Vitamin D, 25-hydroxyvitamin D, vitamin D receptor (VDR), 25-hydroxyvitamin D-1alpha-hydroxylase (CYP27B1)

New England Journal of Medicine

Waning Immune Humoral Response to BNT162b2 Covid-19 Vaccine over 6 Months

Authors: Levin, EG, Lustig, Y, Cohen, C, et al.

“Despite high vaccine coverage and effectiveness, the incidence of symptomatic infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been increasing in Israel. Whether the increasing incidence of infection is due to waning immunity after the receipt of two doses of the BNT162b2 vaccine is unclear. We conducted a 6-month longitudinal prospective study involving vaccinated health care workers who were tested monthly for the presence of anti-spike IgG and neutralizing antibodies. Linear mixed models were used to assess the dynamics of antibody levels and to determine predictors of antibody levels at 6 months. The study included 4868 participants, with 3808 being included in the linear mixed-model analyses. The level of IgG antibodies decreased at a consistent rate, whereas the neutralizing antibody level decreased rapidly for the first 3 months with a relatively slow decrease thereafter. Although IgG antibody levels were highly correlated with neutralizing antibody titers, the regression relationship between the IgG and neutralizing antibody levels depended on the time since receipt of the second vaccine dose. Six months after receipt of the second dose, neutralizing antibody titers were substantially lower among men than among women, lower among persons 65 years of age or older than among those 18 to less than 45 years of age, and lower among participants with immunosuppression than among those without immunosuppression. Six months after receipt of the second dose of the BNT162b2 vaccine, humoral response was substantially decreased, especially among men, among persons 65 years of age or older, and among persons with immunosuppression.”

Keywords: anti-spike IgG, neutralizing antibodies, antibody titers

Journal of Neuroimmunology

New diagnosis of multiple sclerosis in the setting of mRNA COVID-19 vaccine exposure

Authors: Karlo Toljan, Moein Amin, Amy Kunchok, Daniel Ontaneda

“Background: Multiple sclerosis (MS) with onset in the setting of acute SARS-CoV-2 virus infection has been reported, and reactivation of MS following non-mRNA COVID-19 vaccination has been noted, but there have only been three reports of newly diagnosed MS following exposure to mRNA COVID-19 vaccine. The association cannot be determined to be causal, as latent central nervous system demyelinating disease may unmask itself in the setting of an infection or a systemic inflammatory response. We report a series of 5 cases of newly diagnosed MS following recent exposure to mRNA COVID-19 vaccines. Latency from vaccination to initial presentation varied. Neurological manifestations and clinical course appeared to be typical for MS including response to high dose steroids in 4 cases and additional need for plasmapheresis in one case. Conclusion: Acute neurological deficits in the setting of recent mRNA COVID-19 vaccine administration may represent new onset multiple sclerosis.”

Keywords: COVID-19 vaccines, Diagnosis, Multiple sclerosis, SARS-CoV-2Vaccination

Drug Resist Updat

An update on drugs with therapeutic potential for SARS-CoV-2 (COVID-19) treatment

Authors: Drożdżal, S, Rosik, J, Lechowicz, K, et al.

“The COVID-19 pandemic is one of the greatest threats to human health in the 21st century with more than 257 million cases and over 5.17 million deaths reported worldwide (as of November 23, 2021. Various agents were initially proclaimed to be effective against SARS-CoV-2, the etiological agent of COVID-19. Hydroxychloroquine, lopinavir/ritonavir, and ribavirin are all examples of therapeutic agents, whose efficacy against COVID-19 was later disproved. Meanwhile, concentrated efforts of researchers and clinicians worldwide have led to the identification of novel therapeutic options to control the disease including PAXLOVID™ (PF-07321332). Although COVID-19 cases are currently treated using a comprehensive approach of anticoagulants, oxygen, and antibiotics, the novel Pfizer agent PAXLOVID™ (PF-07321332), an investigational COVID-19 oral antiviral candidate, significantly reduced hospitalization time and death rates, based on an interim analysis of the phase 2/3 EPIC-HR (Evaluation of Protease Inhibition for COVID-19 in High-Risk Patients) randomized, double-blind study of non-hospitalized adult patients with COVID-19, who are at high risk of progressing to severe illness. The scheduled interim analysis demonstrated an 89 % reduction in risk of COVID-19-related hospitalization or death from any cause compared to placebo in patients treated within three days of symptom onset (primary endpoint). However, there still exists a great need for the development of additional treatments, as the recommended therapeutic options are insufficient in many cases. Thus far, mRNA and vector vaccines appear to be the most effective modalities to control the pandemic. In the current review, we provide an update on the progress that has been made since April 2020 in clinical trials concerning the effectiveness of therapies available to combat COVID-19. We focus on currently recommended therapeutic agents, including steroids, various monoclonal antibodies, remdesivir, baricitinib, anticoagulants and PAXLOVID™ summarizing the latest original studies and meta-analyses. Moreover, we aim to discuss other currently and previously studied agents targeting COVID-19 that either show no or only limited therapeutic activity. The results of recent studies report that hydroxychloroquine and convalescent plasma demonstrate no efficacy against SARS-CoV-2 infection. Lastly, we summarize the studies on various drugs with incoherent or insufficient data concerning their effectiveness, such as amantadine, ivermectin, or niclosamide. ”

Keywords: Baricitinib, Casirivimab, Dexamethasone, Imdevimab, Remdesivir, Sotrovimab, Tocilizumab, Paxlovid, Omicron

Drug Resistance Update

An update on drugs with therapeutic potential for SARS-CoV-2 (COVID-19) treatment

Authors: Drożdżal, S, Rosik, J, Lechowicz, K, et al.

“The COVID-19 pandemic is one of the greatest threats to human health in the 21st century with more than 257 million cases and over 5.17 million deaths reported worldwide (as of November 23, 2021. Various agents were initially proclaimed to be effective against SARS-CoV-2, the etiological agent of COVID-19. Hydroxychloroquine, lopinavir/ritonavir, and ribavirin are all examples of therapeutic agents, whose efficacy against COVID-19 was later disproved. Meanwhile, concentrated efforts of researchers and clinicians worldwide have led to the identification of novel therapeutic options to control the disease including PAXLOVID™ (PF-07321332). Although COVID-19 cases are currently treated using a comprehensive approach of anticoagulants, oxygen, and antibiotics, the novel Pfizer agent PAXLOVID™ (PF-07321332), an investigational COVID-19 oral antiviral candidate, significantly reduced hospitalization time and death rates, based on an interim analysis of the phase 2/3 EPIC-HR (Evaluation of Protease Inhibition for COVID-19 in High-Risk Patients) randomized, double-blind study of non-hospitalized adult patients with COVID-19, who are at high risk of progressing to severe illness. The scheduled interim analysis demonstrated an 89 % reduction in risk of COVID-19-related hospitalization or death from any cause compared to placebo in patients treated within three days of symptom onset (primary endpoint). However, there still exists a great need for the development of additional treatments, as the recommended therapeutic options are insufficient in many cases. Thus far, mRNA and vector vaccines appear to be the most effective modalities to control the pandemic. In the current review, we provide an update on the progress that has been made since April 2020 in clinical trials concerning the effectiveness of therapies available to combat COVID-19. We focus on currently recommended therapeutic agents, including steroids, various monoclonal antibodies, remdesivir, baricitinib, anticoagulants and PAXLOVID™ summarizing the latest original studies and meta-analyses. Moreover, we aim to discuss other currently and previously studied agents targeting COVID-19 that either show no or only limited therapeutic activity. The results of recent studies report that hydroxychloroquine and convalescent plasma demonstrate no efficacy against SARS-CoV-2 infection. Lastly, we summarize the studies on various drugs with incoherent or insufficient data concerning their effectiveness, such as amantadine, ivermectin, or niclosamide. ”

Keywords: Baricitinib, Casirivimab, Dexamethasone, Imdevimab, Omicron, Paxlovid, Remdesivir, Sotrovimab, Tocilizumab

Researchgate

Preprint

COVID vaccination and age-stratified all-cause mortality risk

Authors: Pantazatos, SP, Seligmann, H

“Accurate estimates of COVID vaccine-induced severe adverse event and death rates are critical for risk-benefit ratio analyses of vaccination and boosters against SARS-CoV-2 coronavirus in different age groups. However, existing surveillance studies are not designed to reliably estimate life-threatening event or vaccine-induced fatality rates (VFR). Here, regional variation in vaccination rates was used to predict all-cause mortality and non-COVID deaths in subsequent time periods using two independent, publicly available datasets from the US and Europe (monthand week-level resolutions, respectively). Vaccination correlated negatively with mortality 6-20 weeks post-injection, while vaccination predicted all-cause mortality 0-5 weeks post-injection in almost all age groups and with an age-related temporal pattern consistent with the US vaccine rollout. Results from fitted regression slopes (p<0.05 FDR corrected) suggest a US national average VFR of 0.04% and higher VFR with age (VFR=0.004% in ages 0-17 increasing to 0.06% in ages >75 years), and 146K to 187K vaccine-associated US deaths between February and August, 2021. Notably, adult vaccination increased ulterior mortality of unvaccinated young (<18, US; <15, Europe). Comparing our estimate with the CDC-reported VFR (0.002%) suggests VAERS deaths are underreported by a factor of 20, consistent with known VAERS underascertainment bias. Comparing our age-stratified VFRs with published age-stratified coronavirus infection fatality rates (IFR) suggests the risks of COVID vaccines and boosters outweigh the benefits in children, young adults, and older adults with low occupational risk or previous coronavirus exposure. Our findings raise important questions about current COVID mass vaccination strategies and warrant further investigation and review.”

Keywords: Public health, medical ethics, risk-benefit ratio, epidemiology, vaccine adverse events

Nutrients

Nordic Walking Rather Than High Intensity Interval Training Reduced Myostatin Concentration More Effectively in Elderly Subjects and the Range of This Drop Was Modified by Metabolites of Vitamin D

Authors: Micielska, K, Flis, M, Kortas, JA, et al.

“The COVID-19 pandemic and subsequent self-isolation exacerbated the problem of insufficient amounts of physical activity and its consequences. At the same time, this revealed the advantage of vitamin D. Thus, there was a need to verify the effects of those forms of training that can be performed independently. In this study, we examined the effects of Nordic walking (NW) and high intensity interval training (HIIT) with regard to the impact of the metabolite vitamin D. We assigned 32 overweight adults (age = 61 ± 12 years) to one of two training groups: NW = 18 and HIIT = 14. Body composition assessment and blood sample collection were conducted before starting the training programs and a day after their completion. NW training induced a significant decrease in myostatin concentration; however, the range was dependent on the baseline concentrations of vitamin D metabolites. This drop was accompanied by a significant negative correlation with the decorin concentration. Unexpectedly, NW caused a decrement in both forms of osteocalcin: undercarboxylated (Glu-OC) and carboxylated-type (Gla-OC). The scope of Glu-OC changes was dependent on a baseline concentration of 25(OH)D2. In contrast, the HIIT protocol did not induce any changes. Overall results revealed that NW diminished the myostatin concentration and that this effect is more pronounced among adults with a sufficient concentration of vitamin D metabolites.”

Keywords: decorin, aging, myokines, osteokines, 25(OH)D3, 24.25(OH)2D3, 3-epi-25(OH)D3

The Journal of Physical Chemistry Letters

Mechanisms of SARS-CoV-2 Evolution Revealing Vaccine-Resistant Mutations in Europe and America

Authors: Wang, R, Chen, J, Wei, GW

“The importance of understanding SARS-CoV-2 evolution cannot be overlooked. Recent studies confirm that natural selection is the dominating mechanism of SARS-CoV-2 evolution, which favors mutations that strengthen viral infectivity. Here, we demonstrate that vaccine-breakthrough or antibody-resistant mutations provide a new mechanism of viral evolution. Specifically, vaccine-resistant mutation Y449S in the spike (S) protein receptor-binding domain, which occurred in co-mutations Y449S and N501Y, has reduced infectivity compared to that of the original SARS-CoV-2 but can disrupt existing antibodies that neutralize the virus. By tracking the evolutionary trajectories of vaccine-resistant mutations in more than 2.2 million SARS-CoV-2 genomes, we reveal that the occurrence and frequency of vaccine-resistant mutations correlate strongly with the vaccination rates in Europe and America. We anticipate that as a complementary transmission pathway, vaccine-breakthrough or antibody-resistant mutations, like those in Omicron, will become a dominating mechanism of SARS-CoV-2 evolution when most of the world’s population is either vaccinated or infected. Our study sheds light on SARS-CoV-2 evolution and transmission and enables the design of the next-generation mutation-proof vaccines and antibody drugs”

Future Virology

Myocarditis and COVID-19 mRNA vaccines: a mechanistic hypothesis involving dsRNA

Authors: Milano, G, Gal, J, Creisson, A, et al.

“While tolerance to COVID-19 vaccination is considered satisfactory, a phenomenon of myocarditis, although rare, is becoming a safety concern in mRNA COVID-19 vaccination. The presence of low residual levels of double-strand RNA (dsRNA) has been reported in mRNA COVID-19 vaccine preparations. dsRNA is a known inducer of immune-inflammatory reactions. dsRNA present in vaccine nanoparticles may be suspected to be at the origin of the still unexplained cases of myocarditis.”

Keywords: dsRNA, mRNA COVID-19 vaccines, myocarditis

Circulation

Clinically Suspected Myocarditis Temporally Related to COVID-19 Vaccination in Adolescents and Young Adults

Authors: Dongngan, TT, Dionne, A, Muniz, JC, et al.

“Background: Understanding the clinical course and short-term outcomes of suspected myocarditis following COVID-19 vaccination has important public health implications in the decision to vaccinate youth. Results: We report on 139 adolescents and young adults with 140 episodes of suspected myocarditis (49 confirmed, 91 probable) at 26 centers. Most patients were male (N=126, 90.6%) and White (N=92, 66.2%); 29 (20.9%) were Hispanic; and median age was 15.8 years (range 12.1-20.3, IQR 14.5-17.0). Suspected myocarditis occurred in 136 patients (97.8%) following mRNA vaccine, with 131 (94.2%) following the Pfizer-BioNTech vaccine; 128 (91.4%) occurred after the 2nd dose. Symptoms started a median of 2 days (range 0-22, IQR 1-3) after vaccination. The most common symptom was chest pain (99.3%). Patients were treated with nonsteroidal anti-inflammatory drugs (81.3%), intravenous immunoglobulin (21.6%), glucocorticoids (21.6%), colchicine (7.9%) or no anti-inflammatory therapies (8.6%). Twenty-six patients (18.7%) were in the ICU, two were treated with inotropic/vasoactive support, and none required ECMO or died. Median hospital stay was 2 days (range 0-10, IQR 2-3). All patients had elevated troponin I (N=111, 8.12 ng/mL, IQR 3.50-15.90) or T (N=28, 0.61 ng/mL, IQR 0.25-1.30); 69.8% had abnormal electrocardiograms and/or arrythmias (7 with non-sustained ventricular tachycardia); and 18.7% had left ventricular ejection fraction (LVEF) <55% on echocardiogram. Of 97 patients who underwent cMRI at median 5 days (range 0-88, IQR 3-17) from symptom onset, 75 (77.3%) had abnormal findings: 74 (76.3%) had late gadolinium enhancement, 54 (55.7%) had myocardial edema, and 49 (50.5%) met Lake Louise criteria. Among 26 patients with LVEF <55% on echocardiogram, all with follow-up had normalized function (N=25). Conclusions: Most cases of suspected COVID-19 vaccine myocarditis occurring in persons <21 years have a mild clinical course with rapid resolution of symptoms. Abnormal findings on cMRI were frequent. Future studies should evaluate risk factors, mechanisms, and long-term outcomes.”

Keywords: p

OSF Preprints

Preprint

Delay in assessing vitamin D supplements and live vaccines for tuberculosis, polio, and measles to protect people from Covid-19

Authors: Gisselquist, D

“In March 2020, less than three months after China reported a cluster of pneumonia cases in Wuhan, the United States (US) government budgeted money to support development of Covid-19 vaccines. By mid-December 2020, two had been developed, tested, and received the US government’s experimental use authorization. Given evidence that vitamin D supplements and live vaccines for tuberculosis, polio, and measles reduce risks for acute respiratory infection, many experts hypothesized they might reduce risks for Covid-19 infection. Expedited randomized controlled trials, as done for Covid-19 vaccines, could have assessed their protection against C19 no later than end-July 2020. On 21 April 2021, I searched trial registries maintained by the US National Institutes of Medicine and the World Health Organization for trials with ≥400 participants to assess vitamin D or live vaccines to prevent Covid-19 infections (all or symptomatic). On 10-13 November 2021, I searched PubMed and medRxiv for results reported from these trials. In April 2021, I found 32 trials (9 for vitamin D and 23 for live vaccines) proposing to assess the impact of these interventions on rates of new Covid-19 infections (all or symptomatic). Only 10 trials proposed to begin by June 2020, and only one to end in 2020. My search on 10-13 November 2021, almost 11 months after the US approved the first two Covid-19 vaccines, found results reported from only one of the 32 trials (live measles vaccine significantly reduced new symptomatic infections). If health experts had demonstrated similar urgency in assessing vitamin D supplements and live vaccines for tuberculosis, polio, and measles as in developing Covid-19 vaccines, trials could have reported by end-July 2020. Depending on what trials reported, these interventions could have prevented a large percentage of more than 600,000 Covid-19 deaths reported in the US from August 2020 through November 2021. Delay in assessing vitamin D has racial implications as well, since vitamin D deficiency and Covid-19 deaths in the US have been far more common among Blacks and Hispanics compared to Whites. Going forward, depending on what trials report, these interventions could help people live with Covid-19 as an endemic virus.”

Keywords: vitamin D, supplements, vaccines, tuberculosis, polio, measles

medRxiv

Preprint

Epidemiology of myocarditis and pericarditis following mRNA vaccines in Ontario, Canada: by vaccine product, schedule and interval

Authors: Buchan, SA, Seo, CY, Johnson, C., et al.

“Importance: Increased rates of myocarditis/pericarditis following COVID-19 mRNA vaccines have been observed. However, little data are available related to product-specific differences, which have important programmatic impacts. Results: There were 19,740,741 doses of mRNA vaccines administered and 297 reports of myocarditis/pericarditis meeting our inclusion criteria. Among these, 69.7% occurred following the second dose of COVID-19 mRNA vaccine and 76.8% occurred in males. The median age of individuals with a reported event was 24 years. The highest reporting rate of myocarditis/pericarditis was observed in males aged 18-24 years following mRNA-1273 as the second dose; the rate in this age group was 5.1 (95% CI 1.9-15.5) times higher than the rate following BNT162b2 as the second dose. Overall reporting rates were higher when the inter-dose interval was shorter (i.e., ≤30 days) for both vaccine products.Among individuals who received mRNA-1273 for the second dose, rates were higher for those who had a heterologous as opposed to homologous vaccine schedule.”

Archives of Razi Institute

Preprint

Effects of Vitamin D on Risks and Severity of COVID-19 Infection

Authors: Abdul Ridha Al-Awade, H, Shakir Abed Almjalawi, B

“In the last two decades, many studies were carried out to find correlations between vitamin D and the efficiency of lungs and respiratory system. The aim of current study was to find the relationship between taking vitamin D and the risks of the severity of infection with COVID-19 and the risk of infection on chronic diseases patients. The total of 100 patients of COVID-19 (61 males and 39 females) that were divided into never take vitamin D and patients take dose 50 and 1000 IU; The effect of the sex (male or female), and chronic diseases (Hypertension and Diabetes) and required intensive care unit, were evaluated. Results showed that females were at lower risks of infection with COVID-19 than males and taking 50IU of vitamin D can lower the severe cases 33%, also patients with chronic disease are more sensitive to COVID_19 and take 50 units of vitamin D in this patients decreased the need of ICU from 49% to 9%. Given that vitamin D enhances the immune system and respiratory function, research has shown that vitamin D reduces the risk of COVID-19, but it cannot prevent it.”

Keywords: vitamin D, chronic diseases, ICU, Iraq

Life

The Effects of Vitamin C on the Multiple Pathophysiological Stages of COVID-19

Authors: Miranda-Massari, JR, Toro, AP, Loh, D, et al.

“Currently available anti-viral drugs may be useful in reducing the viral load but are not providing the necessary physiological effects to reduce the SARS-CoV-2 complications efficiently. Treatments that provide better clinical outcomes are urgently needed. Vitamin C (ascorbic acid, AA) is an essential nutrient with many biological roles that have been proven to play an important part in immune function; it serves as an antioxidant, an anti-viral, and exerts anti-thrombotic effects among many other physiological benefits. Research has proven that AA at pharmacological doses can be beneficial to patients with acute respiratory distress syndrome (ARDS) and other respiratory illnesses, including sepsis. In addition, High-Dose Intravenous Vitamin C (HDIVC) has proven to be effective in patients with different viral diseases, such as influenza, chikungunya, Zika, and dengue. Moreover, HDIVC has been demonstrated to be very safe. Regarding COVID-19, vitamin C can suppress the cytokine storm, reduce thrombotic complications, and diminish alveolar and vascular damage, among other benefits. Due to these reasons, the use of HDIVC should be seriously considered in complicated COVID-19 patients. In this article, we will emphasize vitamin C’s multiple roles in the most prominent pathophysiological processes presented by the COVID-19 disease.”

Keywords: ascorbic acid, intravenous vitamin C, pathophysiology of COVID-19

Cancers

A Narrative Review of the Safety of Anti-COVID-19 Nutraceuticals for Patients with Cancer

Authors: Bader-Larsen, KS, Larson, EA, Dalamaga, M, et al.

“Interest in dietary supplements and their efficacy in treating and preventing disease has increased greatly since the outbreak of the COVID-19 pandemic. Due to the risk of severe COVID-19 in patients with cancer, we conducted a narrative review aiming to better understand the data on the safety of the most efficacious 'anti-COVID-19' nutraceuticals for patients with cancer. We conducted a PubMed database search aimed at identifying the most effective nutrients for use against COVID-19. For the identified nutraceuticals, we searched PubMed again regarding their safety for patients with cancer. Fifty-four total records (52 independent studies) were retrieved, pertaining to vitamin D, vitamin C, selenium, omega-3 fatty acids, and zinc. Vitamin D results from 23 articles indicated safe use, but two articles indicated potential harm. All 14 articles for vitamin C and five out of six articles for selenium indicated the safety of use (one study for selenium suggested harm with high-dose supplementation). Results for omega-3 fatty acids (seven articles) and zinc (one article), however, were rather mixed regarding safety. We conclude that vitamin D, vitamin C, and selenium supplements are likely safe or even beneficial at typically recommended doses; however, caution is urged with omega-3 fatty acid supplements, and zinc supplements should likely be avoided. More experimental research is needed, and nutraceutical use by patients with cancer should always be under the supervision of a healthcare team.”

Keywords: cancer, nutraceuticals, supplements

Evidence-Based Complementary and Alternative Medicine

A Comprehensive Review of the Potential Use of Green Tea Polyphenols in the Management of COVID-19

Authors: Tallei, TE, Fatimawali, Niode, NJ, et al.

“Green tea is produced from Camellia sinensis (L.) buds and leaves that have not gone through the oxidation and withering processes used to produce black and oolong teas. It was originated in China, but its cultivation and production have expanded to other Eastern Asian countries. Several polyphenolic compounds, including flavandiols, flavonols, flavonoids, and phenolic acids, are found in green tea and may constitute greater than 30% of the dry weight. Flavonols, especially catechins, represent the majority of green tea polyphenols. Green tea polyphenolic compounds have been reported to confer several health benefits. This review describes the potential use of green tea polyphenols in the management of coronavirus disease 2019 (COVID-19). The immunomodulatory, antibacterial, antioxidant, and anti-inflammatory effects of green tea polyphenols have also been considered in this review. In addition to describing the bioactivities associated with green tea polyphenols, this review discusses the potential delivery of these biomolecules using a nanoparticle drug delivery system. Moreover, the bioavailability and toxicity of green tea polyphenols are also evaluated.”

Keywords: polyphenolic compounds, flavandiols, flavonols, flavonoids, phenolic acids, antioxidants

The American Journal of Clinical Nutrition

Associations between predicted vitamin D status, vitamin D intake, and risk of SARS-CoV-2 infection and Coronavirus Disease 2019 severity

Authors: Ma, W, Nguyen, LH, Yue, Y, et al.

“Vitamin D may have a role in immune responses to viral infections. However, data on the association between vitamin D and SARS-CoV-2 infection and Coronavirus Disease 2019 (COVID-19) severity have been limited and inconsistent. Design: We examined the associations of predicted vitamin D status and intake with risk of SARS-CoV-2 infection and COVID-19 severity. We used data from periodic surveys (May 2020 to March 2021) within the Nurses’ Health Study II. Among 39,315 participants, 1,768 reported a positive test for SARS-CoV-2 infection. Usual vitamin D intake from foods and supplements were measured using a semi-quantitative, pre-pandemic food frequency questionnaire in 2015. Predicted 25-hydroxyvitamin D [25(OH)D] levels were calculated based on a previously validated model including dietary and supplementary vitamin D intake, ultraviolet-B (UVB), and other behavioral predictors of vitamin D status. Results: Higher predicted 25(OH)D levels, but not vitamin D intake, were associated with a lower risk of SARS-CoV-2 infection. Comparing participants in the highest quintile of predicted 25(OH)D levels to the lowest. Participants in the highest quartile of UVB and UVA also had lower risk of SARS-CoV-2 infection compared to the lowest. High intake of vitamin D from supplements (≥400 IU/d) was associated with a lower risk of hospitalization. Conclusions: Our study provides suggestive evidence on the association between higher predicted circulating 25(OH)D levels and a lower risk of SARS-CoV-2 infection. Greater intake of vitamin D supplements was associated with a lower risk of hospitalization. Our data also support an association between exposure to UVB or UVA, independent of vitamin D, and SARS-CoV-2 infection, so results for predicted 25(OH)D need to be interpreted cautiously.”

Keywords: vitamin D, diet, supplement, infection, severity, solar UV-B, UV-A, Robertson-Berger meter

Scientific Reports

Real world evidence of calcifediol or vitamin D prescription and mortality rate of COVID-19 in a retrospective cohort of hospitalized Andalusian patients

Authors: Loucera, C, Peña-Chilet, M, Esteban-Medina, M, et al.

“COVID-19 is a major worldwide health problem because of acute respiratory distress syndrome, and mortality. Several lines of evidence have suggested a relationship between the vitamin D endocrine system and severity of COVID-19. We present a survival study on a retrospective cohort of 15,968 patients, comprising all COVID-19 patients hospitalized in Andalusia between January and November 2020. Based on a central registry of electronic health records (the Andalusian Population Health Database, BPS), prescription of vitamin D or its metabolites within 15–30 days before hospitalization were recorded. The effect of prescription of vitamin D (metabolites) for other indication previous to the hospitalization was studied with respect to patient survival. Kaplan–Meier survival curves and hazard ratios support an association between prescription of these metabolites and patient survival. Such association was stronger for calcifediol than for cholecalciferol, when prescribed 15 days prior hospitalization. Although the relation is maintained, there is a general decrease of this effect when a longer period of 30 days prior hospitalization is considered, suggesting that association was stronger when the prescription was closer to the hospitalization.”

Keywords: vitamin D, hospitalized patients

Medicina

The Immunomodulatory Function of Vitamin D, with Particular Reference to SARS-CoV-2

Authors: Alberto, C-G, Noriega, DC, Bello, HJ, et al.

“Vaccines are the only way to reduce the morbidity associated to SARS-CoV-2 infection. The appearance of new mutations urges us to increase the effectiveness of vaccines as a complementary alternative. In this context, the use of adjuvant strategies has improved the effectiveness of different vaccines against virus infections such as dengue, influenza, and common cold. Recent reports on patients infected by COVID-19 reveal that low levels of circulating vitamin D correlate with a severe respiratory insufficiency. The immunomodulatory activity of this micronutrient attenuates the synthesis of pro-inflammatory cytokines and at the same time, increases antibody production. Therefore, the present review proposes the use of vitamin D as adjuvant micronutrient to increase the efficacy of vaccines against SARS-CoV-2 infection.”

Keywords: immunomodulation, vaccination, vitamin D

The Lancet

Safety and immunogenicity of seven COVID-19 vaccines as a third dose (booster) following two doses of ChAdOx1 nCov-19 or BNT162b2 in the UK (COV-BOOST): a blinded, multicentre, randomised, controlled, phase 2 trial

Authors: Munro, APS, Janani, L, Cornelius, V, et al

“Few data exist on the comparative safety and immunogenicity of different COVID-19 vaccines given as a third (booster) dose. To generate data to optimise selection of booster vaccines, we investigated the reactogenicity and immunogenicity of seven different COVID-19 vaccines as a third dose after two doses of ChAdOx1 nCov-19 (Oxford–AstraZeneca; hereafter referred to as ChAd) or BNT162b2 (Pfizer–BioNtech, hearafter referred to as BNT). Between June 1 and June 30, 2021, 3498 people were screened. 2878 participants met eligibility criteria and received COVID-19 vaccine or control. The median ages of ChAd/ChAd-primed participants were 53 years (IQR 44–61) in the younger age group and 76 years (73–78) in the older age group. In the BNT/BNT-primed participants, the median ages were 51 years (41–59) in the younger age group and 78 years (75–82) in the older age group. In the ChAd/ChAD-primed group, 676 (46·7%) participants were female and 1380 (95·4%) were White, and in the BNT/BNT-primed group 770 (53·6%) participants were female and 1321 (91·9%) were White. Three vaccines showed overall increased reactogenicity: m1273 after ChAd/ChAd or BNT/BNT; and ChAd and Ad26 after BNT/BNT. For ChAd/ChAd-primed individuals, spike IgG geometric mean ratios (GMRs) between study vaccines and controls ranged from 1·8 (99% CI 1·5–2·3) in the half VLA group to 32·3 (24·8–42·0) in the m1273 group. GMRs for wild-type cellular responses compared with controls ranged from 1·1 (95% CI 0·7–1·6) for ChAd to 3·6 (2·4–5·5) for m1273. For BNT/BNT-primed individuals, spike IgG GMRs ranged from 1·3 (99% CI 1·0–1·5) in the half VLA group to 11·5 (9·4–14·1) in the m1273 group. GMRs for wild-type cellular responses compared with controls ranged from 1·0 (95% CI 0·7–1·6) for half VLA to 4·7 (3·1–7·1) for m1273. The results were similar between those aged 30–69 years and those aged 70 years and older. Fatigue and pain were the most common solicited local and systemic adverse events, experienced more in people aged 30–69 years than those aged 70 years or older. Serious adverse events were uncommon, similar in active vaccine and control groups. In total, there were 24 serious adverse events: five in the control group (two in control group A, three in control group B, and zero in control group C), two in Ad26, five in VLA, one in VLA-half, one in BNT, two in BNT-half, two in ChAd, one in CVn, two in NVX, two in NVX-half, and one in m1273.”

Medicinal Chemistry Research

A review of natural products, their effects on SARS-CoV-2 and their utility as lead compounds in the discovery of drugs for the treatment of COVID-19

Authors: Chapman, RL, Andurkar, SV

“During the COVID-19 pandemic lasting now for well more than a year, nearly 247 million cases have been diagnosed and over 5 million deaths have been recorded worldwide as of November 2021. The devastating effects of the SARS-CoV-2 virus on the immune system lead to the activation of signaling pathways involved in inflammation and the production of inflammatory cytokines. SARS-CoV-2 displays a great deal of homology with other coronaviruses, especially SARS-CoV and MERS-CoV which all display similar components which may serve as targets, namely the Spike (S) protein, the main protease (MPro) which is a chymotrypsin-like protease (CLPro) and RNA-directed RNA polymerase (RdRp). Natural constituents found in traditional herbal medicines, dietary supplements and foods demonstrate activity against SARS-CoV-2 by affecting the production of cytokines, modulating cell signaling pathways related to inflammation and even by direct interaction with targets found in the virus. This has been demonstrated by the application of fluorescence resonance energy transfer (FRET) experiments, assays of cytopathic effect (CPE) and in silico molecular docking studies that estimate binding strength. Glycyrrhizin, flavonoids such as quercetin, kaempferol and baicalein, and other polyphenols are the most common constituents found in Traditional Chinese Medicines that modulate inflammation and cell signaling pathways, and bind viral targets demonstrating valuable effects against SARS-CoV-2. However, the bioavailability of these natural products and their dependence on each other in extracts make it difficult to assess their actual utility in the treatment of COVID-19. Therefore, more can be learned through rational drug design based on natural products and from well-designed clinical trials employing specific doses of standardized combinations.”

Keywords: Traditional Chinese medicine, TCM, Glycyrrhizin, Flavonoids, Polyphenolics, Cannabis

Physiological Mini Reviews

A rational approach between vitamin D, immunomodulation and the renin-angiotensin system linked to prevention and treatment of severe acute respiratory syndrome by Covid-19

Authors: Giménez, M, Margarita, V, Carmona, M, et al.

“A distinctive feature of COVID-19 is its low mortality rate, where the leading cause of decease is related to the development of severe acute respiratory syndrome (SARS). This syndrome involves an exacerbated inflammatory reaction, frequently known as cytokine storm, mainly in the lungs and concomitant over activation of the renin-angiotensin-aldosterone system (RAAS). Consequently, this 'explosive cocktail' can lead to death or permanent respiratory sequelae in patients infected with SARSCoV-2. In this sense, multiple therapeutic strategies have been proposed. Among them, vitamin D stands out as it exerts numerous immunomodulatory effects by acting on various types of immune and epithelial cells, in addition to being able to stimulate the protective arm [(ACE2/Ang-(1-7)] and inhibit the damaging arm (ACE/Ang-II) of the RAAS. Therefore, in the present mini-review, some of the main mechanisms underlying these effects mediated by vitamin D and its receptors are analyzed. Knowledge and translational projection of these mechanisms would positively influence the prevention and treatment of SARS. Thus, current evidence on vitamin D and COVID-19 adds arguments to rational therapy regarding reducing or avoiding disease progression and improving prognosis. ”

Keywords: vitamin D, severe acute respiratory syndrome

Indian Journal of Natural Sciences

Glutathione and Vitamin D to Prevent COVID-19: A Review

Authors: Majumder, S, Dhabal, D, Choudhuri, SK

“The alarming pandemic situation of corona virus disease (COVID-19) outbreak arises due to rapid spread of Novel Corona Virus (SARSCoV-2). Impaired redox homeostasis in association with oxidative stress is found to be important biological processes that may account for increased individual susceptibility to COVID-19 infection. Glutathione (GSH) is one of the main nonprotein antioxidants in the cell which, together with its related enzymes constitute the glutathione-system. The glutathione system plays an important role in the maintenance of good health and prevention of various diseases. Several approaches have been used to enhance cellular GSH availability. Restricted diet, drug administration and nutritional supplementation shows moderate success. Regular exercise has also evolved as a new approach. Some evidences suggest that GSH and vitamin D supplementation can reduce the risk of COVID-19 infections and deaths. Present review discusses the possible roles of Glutathione and Vitamin D in preventing and reducing the risk of COVID-19 associated acute infections and severity. ”

Keywords: glutathione, vitamin D

Aging and Disease

The Effect of COVID-19-related Lockdowns on Diet and Physical Activity in Older Adults: A Systematic Review

Authors: Elisabeth, AL, Karlen, SB, Magkos, F

“The lockdown restrictions imposed globally to curb the COVID-19 pandemic have altered many aspects of daily life, including diet and physical activity. The aim of this systematic review was to evaluate evidence for changes in the diet and physical activity habits of older adults due to COVID-19-related lockdowns. We included analytic observational studies that reported on changes in diet, physical activity, or both, among older individuals (≥50 years old). We searched PubMed and EBSCO LISTA to identify original research articles published between 01/2020-03/2021. We identified 27 studies, 5 of which reported on changes in diet, 17 on changes in physical activity, and 5 on changes in both. The sample sizes ranged from 17 to 3110 subjects. Six of 10 papers on diet reported no significant changes in quantity or quality of food consumption; of those who did find changes in diet, these were generally unfavorable. Thirteen of 22 studies on physical activity reported a decrease in physical activity or an increase in sedentary time; the rest reported no major changes. Pre-lockdown habits were a predictor of change in some studies. The safer-at-home measures have not greatly impacted the diet of older adults but have led to a significant decrease in their physical activity, putting them at higher risk for non-communicable diseases, which may further increase their susceptibility to COVID-19. Ultimately, these findings may help guide clinical practice, by promoting additional health screenings by general practitioners for the elderly and by emphasizing the need for lifestyle interventions like at-home exercise initiatives, to help mitigate the negative impact of the pandemic on this especially vulnerable age group.”

Keywords: lockdown, diet, physical activity, older adults

The Science of the Total Environment

CD147-spike protein interaction in COVID-19: Get the ball rolling with a novel receptor and therapeutic target

Authors: Behl, T, Kaur, I, Aleya, L, et al.

“The combat against the Corona virus disease of 2019 (COVID-19), has created a chaos among the healthcare institutions and researchers, in turn accelerating the dire need to curtail the infection spread. The already established entry mechanism, via ACE2 has not yet successfully aided in the development of a suitable and reliable therapy. Taking in account the constant progression and deterioration of the cases worldwide, a different perspective and mechanistic approach is required, which has thrown light onto the cluster of differentiation 147 (CD147) transmembrane protein, as a novel route for SARS-CoV-2 entry. Despite lesser affinity towards COVID-19 virus, as compared to ACE2, this receptor provides a suitable justification behind elevated blood glucose levels in infected patients, retarded COVID-19 risk in women, enhanced susceptibility in geriatrics, greater infection susceptibility of T cells, infection prevalence in non-susceptible human cardiac pericytes and so on. The manuscript invokes the title role and distribution of CD147 in COVID-19 as an entry receptor and mediator of endocytosis-promoted entry of the virus, along with the 'catch and clump' hypothesis, thereby presenting its Fundamental significance as a therapeutic target for potential candidates, such as Azithromycin, melatonin, statins, beta adrenergic blockers, ivermectin, Meplazumab etc. Thus, the authors provide a comprehensive review of a different perspective in COVID-19 infection, aiming to aid the researchers and virologists in considering all aspects of viral entry, in order to develop a sustainable and potential cure for the 2019 COVID-19 disease.”

Keywords: ACE2, CD147, Catch and clump, Melatonin, Receptor

Physiology & Behavior

Physical activity and COVID-19. The basis for an efficient intervention in times of COVID-19 pandemic

Authors: Clemente-Suárez, VJ, Beltrán-Velasco, AI, Ramos-Campo, DJ, et al.

“The Coronavirus Disease 2019 (COVID-19) pandemic has shocked world health authorities generating a global health crisis. The present study aimed to analyze the different factors associated with physical activity that could have an impact in the COVID-19, providing a practical recommendation based on actual scientific knowledge. We conducted a consensus critical review using primary sources, scientific articles, and secondary bibliographic indexes, databases, and web pages. The method was a narrative literature review of the available literature regarding physical activity and physical activity related factors during the COVID-19 pandemic. The main online database used in the present research were PubMed, SciELO, and Google Scholar. COVID-19 has negatively influenced motor behavior, levels of regular exercise practice, eating and nutritional patterns, and the psychological status of citizens. These factors feed into each other, worsening COVID-19 symptoms, the risk of death from SARS-CoV-2, and the symptoms and effectiveness of the vaccine. The characteristics and symptoms related with the actual COVID-19 pandemic made the physical activity interventions a valuable prevention and treatment factor. Physical activity improves body composition, the cardiorespiratory, metabolic, and mental health of patients and enhancing antibody responses in vaccination.”

Keywords: Cardiorespiratory fitness, Inactivity, Mental health, Metabolic health, Mitochondrial fitness

Clinical Nutrition ESPEN

The association between Vitamin D and severity in Covid-19 patient: systematic review

Authors: Law, NK, Sutanto, M, Samudra, P, et al.

“Currently, COVID-19 is declared as a pandemic around the world. Therefore, there is a need for therapy to reduce the symptoms and severity from COVID-19. One of the new hypotheses is through vitamin D serum, for which patients with deficient vitamin D claimed to have increased severity in COVID-19 infected patients. Since vitamin D may play an important role to suppress cytokines storm in COVID-19, such as interleukin-1 (IL-1) and interleukin-6 (IL-6). Though the relationship between Vitamin-D and COVID-19 is still not well understood. Therefore the purpose of this systematic review is to find association between vitamin D and severity in COVID-19 patient. This research was conducted on 16 – 24 April 2021. Two Independent researchers will systematically extract data from several databases, such as PubMed Central (PMC), PUBMED, Science direct and Google Scholar using mesh term such as Vitamin D Deficiency'[Mesh] AND 'Severity of Illness Index'[Mesh]) AND 'COVID-19'[Mesh]) AND 'SARS-CoV-2'[Mesh]. Studies that are extracted will be analyzed and selected according to our inclusion criteria such as cohort and cross-sectional studies in the last 10 years. We excluded systematic reviews, meta-analysis, case series, case reports, and studies on animals. Then, the quality of the journal is rated with Newcastle-Ottawa (NOS). Through several inclusion criteria selection, six journals are suitable for data extraction, with. 5 out of 6 journals found a positive association of decreased vitamin D and increased severity of COVID-19 patients, and mean vitamin D in patients with severe severity was below ideal standards. However 1 of 6 journals shows negative association. The severe and moderate COVID-19 patient has a different sample portion, which may explain the research shows negative association. In conclusion, Vitamin D is an essential factor in the severity and outcome of COVID-19 patients. Patients with vitamin D deficiency have a poor disease course and severe degree of severity. Clinical symptoms differentiate drastically between mild and severe symptoms. Further RCT studies need to be done to confirm the Results.”

Keywords: vitamin D, degree of severity, outcome

Cogent Medicine

Consequences of the COVID-19 pandemic on adolescents’ health and health behaviour

Authors: Dzielska, AM, Nałȩcz, H, Kleszczewska, D, et al.

“The COVID-19 pandemic disrupted the lives of children and adolescents by invading their families, peer groups and school, worsening their prospects and causing anxiety about the future. Due to the threat of COVDI-19, restrictions were imposed worldwide, forcing changes in daily life, social interactions, education and work. There is no doubt that these strict restrictions have contributed immensely to reducing the risk of SARS-CoV-2 virus spread, but at the same time had significantly affected the health of young people in all its dimensions. The main aim of this study is to present changes in health and health behaviours between 2018 and 2021. Data from the Youth and COVID-19 survey conducted in the first quarter of 2021 by the Institute of Mother and Child in Warsaw among adolescents aged 11-17 years (n=1571) as well as data from the Health Behaviour in School-aged Children (HBSC) according to the 2018 survey conducted in the same age groups (n=7701) were analysed. So were analysed indicators of physical development, mental health, subjective complaints and health behaviour. The prevalence of the aforementioned indicators was compared between 2018 and 2021, overall, by gender and age using chi2 test. A significant increase was observed in the percentage of overweight and obese adolescents (according to WHO criteria) evident in the older age groups (15 and 17 years) and the percentage of underweight boys;an increase in the percentage of adolescents negatively assessing their health and well-being (according to the WHO5 scale-score indicating depressive symptoms) in each age group and both genders;frequently experiencing physical and mental health problems-in both genders such as headache, stomach ache, backache, feeling depressed, nervousness, difficulty in falling asleep and dizziness;only in girls-tiredness;in older adolescents-headache, stomach ache, backache, feeling depressed, irritability, nervousness, difficulty in falling asleep and dizziness;in each age group-feeling depressed;only in the youngest-tiredness. There was a significant decrease in the percentage of adolescents undertaking moderate-to-intensive physical activity at the recommended level of 60 minutes per day in both genders and each age group. However, there were positive changes in dietary behaviour an increase in the percentage of adolescents eating daily with family in each age group, eating vegetables daily in both sexes and each age group, and a decrease in the percentage of adolescents frequently drinking sugary drinks in both sexes and each age group. Furthermore, no change was observed in the rate of frequent consumption of fruit and vegetables. The adverse effects of the pandemic on health and well-being are progressing rapidly, so urgent action is needed to help mitigate the severe effects of the pandemic and safeguard the future of young people.”

Keywords: health behaviours, mental health, health complaints, adolescents

Clinical Nutrition Espen

Vitamin D status of critically ill patients with Covid-19

Authors: Airey, S, Harman, D

“Vitamin D may enhance the immune response against respiratory viruses. Vitamin D treatment might decrease the incidence of viral respiratory tract infections in patients with vitamin D deficiency(1). NICE guidance(2) concluded further research is required to confirm the impact of vitamin D on COVID-19 and studies are currently in progress. It is not common practice to test vitamin D status on admission to intensive care units (ICU). We sought to determine the vitamin D status of acutely severe respiratory failure patients presenting with COVID-19 in a large tertiary ICU in the UK. We reviewed 99 consecutive patients with COVID-19 admitted to ICU between November 2020 and April 2021. All required mechanical ventilator support. Serum concentration of 25 hydroxyvitamin D was measured using a tandem mass spectrometer. Deficiency was considered if serum concentration was <25nmol/litre. Vitamin D supplementation was administered to all patients with recognised deficiency. This retrospective review was conducted with institutional approval and no patient consent was required. Results: 44 % (44/99) of patients had vitamin D levels tested. 48 % (21/44) of those tested were classed as deficient. Mean age: deficient 48 years (SD ±9 years), non-deficient 51 years (SD ±11 years). Mean Body Mass Index (BMI): deficient 29.6 kg/m2 (SD ±7.4), non-deficient 28.7 kg/m2 (SD ±8.1). Incomplete data for ethnicity of patients so unable to compare between groups. Average time from admission to blood test result = 14 days (range 1-57 days). Vitamin D deficiency was common (48 %) in a population of adult patients with severe respiratory failure due to COVID-19. Testing vitamin D status is simple and relatively low cost (£ 16.45/test). Treating vitamin D deficiency in these patients might be of value. We conclude that routine testing of vitamin D status of COVID-19 critical care patients may be of benefit.”

Keywords: vitamin d, vitamin d deficiency

Acute and Critical Care

Association of vitamin D deficiency with COVID-19 severity and mortality in Iranian people: a prospective observational study

Authors: Fatemi, A, Ardehali, SH, Eslamian, G, et al.

“As the coronavirus disease 2019 (COVID-19) pandemic continues to escalate, it is important to identify the prognostic factors related to increased mortality and disease severity. To assess the possible associations of vitamin D level with disease severity and survival, we studied 248 hospitalized COVID-19 patients in a single center in a prospective observational study from October 2020 to May 2021 in Tehran, Iran. Patients who had a record of their 25-hydroxyvitamin D level measured in the previous year before testing positive with COVID-19 were included. Serum 25-hydroxyvitamin D level was measured upon admission in COVID-19 patients. The associations between clinical outcomes of patients and 25-hydroxyvitamin D level were assessed by adjusting for potential confounders and estimating a multivariate logistic regression model. The median (interquartile range) age of patients was 60 years (44–74 years), and 53% were male. The median serum 25-hydroxyvitamin D level prior to admission decreased with increasing COVID-19 severity. Similar findings were obtained when comparing median serum 25-hydroxyvitamin D on admission between moderate and severe patients. A univariate logistic regression model showed that vitamin D deficiency prior to COVID-19 was associated with a significant increase in the odds of mortality. The multivariate Cox model showed that vitamin D deficiency on admission was associated with a significant increase in risk for mortality. Based on our results, it is likely that deficient vitamin D status is associated with increased mortality in COVID-19 patients. Thus, evaluating vitamin D level in COVID-19 patients is warranted.”

Keywords: 25-hydroxyvitamin D, critical care outcomes

Nutrients

Recent Progress in Applicability of Exercise Immunology and Inflammation Research to Sports Nutrition

Authors: Suzuki, K

“This article focuses on how nutrition may help prevent and/or assist with recovery from the harmful effects of strenuous acute exercise and physical training (decreased immunity, organ injury, inflammation, oxidative stress, and fatigue), with a focus on nutritional supplements. First, the effects of ketogenic diets on metabolism and inflammation are considered. Second, the effects of various supplements on immune function are discussed, including antioxidant defense modulators (vitamin C, sulforaphane, taheebo), and inflammation reducers (colostrum and hyperimmunized milk). Third, how 3-hydroxy-3-methyl butyrate monohydrate (HMB) may offset muscle damage is reviewed. Fourth and finally, the relationship between exercise, nutrition and COVID-19 infection is briefly mentioned. While additional verification of the safety and efficacy of these supplements is still necessary, current evidence suggests that these supplements have potential applications for health promotion and disease prevention among athletes and more diverse populations.”

Keywords: anti-inflammatory substances, antioxidant, exercise, functional foods, immunity, inflammation, metabolism, muscle damage, oxidative stress, training

Clinical Infectious Diseases

Epidemiology of Acute Myocarditis/Pericarditis in Hong Kong Adolescents Following Comirnaty Vaccination

Authors: Chua, GT, Kwan, MYW, Chui, CSL, et al.

“Background: Age-specific incidence of acute myocarditis/pericarditis in adolescents following Comirnaty vaccination in Asia is lacking. This study aimed to study the clinical characteristics and incidence of acute myocarditis/pericarditis among Hong Kong adolescents following Comirnaty vaccination. Methods: This is a population cohort study in Hong Kong that monitored adverse events following immunization through a pharmacovigilance system for COVID-19 vaccines. All adolescents aged between 12 and 17 years following Comirnaty vaccination were monitored under the COVID-19 vaccine Adverse Event Response and Evaluation Programme. The clinical characteristics and overall incidence of acute myocarditis/pericarditis in adolescents following Comirnaty vaccination were analysed.Results Between 14 June 2021 and 4 September 2021, 33 Chinese adolescents who developed acute myocarditis/pericarditis following Comirnaty vaccination were identified. 29 (87.88%) were males and 4 (12.12%) were females, with a median age of 15.25 years. 27 (81.82%) and 6 (18.18%) cases developed acute myocarditis/pericarditis after receiving the second and first dose, respectively. All cases are mild and required only conservative management.The overall incidence of acute myocarditis/pericarditis was 18.52 (95% Confidence Interval [CI], 11.67-29.01) per 100,000 persons vaccinated. The incidence after the first and second doses were 3.37 (95%CI 1.12-9.51) and 21.22 (95%CI 13.78-32.28 per 100,000 persons vaccinated, respectively. Among male adolescents, the incidence after the first and second doses were 5.57 (95% CI 2.38-12.53) and 37.32 (95% CI 26.98-51.25) per 100,000 persons vaccinated. Conclusions There is a significant increase in the risk of acute myocarditis/pericarditis following Comirnaty vaccination among Chinese male adolescents, especially after the second dose.”

Keywords: Myocarditis, Pericarditis, adolescents, Comirnaty, Hong Kong

Interdisciplinary Neurosurgery

Vitamin D and its’ role in Parkinson’s disease patients with SARS-CoV-2 infection. A review article

Authors: Azzam, AY, Ghozy, S, Azab, MA

“A novel coronavirus reportedly called 2019-nCoV started to spread around the world at the end of 2019. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was later renamed after links with SARS were observed. Multiple studies have reported possible connections between the COVID-19 virus and neurodegenerative diseases, including Parkinson’s disease. Theories support that vitamin D deficiency plays a part in the pathogenicity of Parkinson’s disease or the credibility of the associated dopamine system. Administration of vitamin D3 was shown to significantly enhance the motor and non-motor manifestations of Parkinson’s disease and enhance the quality of life. Also, multiple recent reviews have shown specific ways in which vitamin D reduces the risk of pathogenic infections. Recent studies supported the potential role of vitamin D in reducing the risk of COVID-19 infections and mortality. On the immunological level, immune response regulation remains one of the well-recognized actions of vitamin D. Vitamin D deficiency has been linked to complications in patients with SARS-CoV-2 infection and Parkinson’s disease. Whereas more studies are required, Vitamin D supplementation with a moderate and well-calculated dosage of vitamin D3 in patients with Parkinson’s disease can help minimize the risk and burden of COVID-19 complications.”

Keywords: Parkinson’s disease, Vitamin D

Cureus

Comparison of Dementia Patients Admission Rates and Dementia Characteristics Before and During the COVID-19 Pandemic

Authors: Morkavuk, G, Demirkol, A, Berber, GE, et al.

“The coronavirus disease 2019 (COVID-19) epidemic was recognized as a pandemic by the World Health Organization on March 2020. There have been significant changes in our lives due to the measures used to prevent the spread of the COVID-19 pandemic. Dementia patients are one of the most vulnerable groups who have difficulties in adapting to this situation. Our study aimed to compare the admission rate to the hospital and dementia characteristics of dementia patients in the COVID-19 pandemic and pre-pandemic periods. Dementia patients admitted to the neurology outpatient clinic during the pandemic and pre-pandemic periods were included in the study. In these two periods, age, gender, dementia type, stage, age of onset, mini-mental state examination, reason for admission, vitamin B12, vitamin D, folic acid levels, brain imaging, electroencephalogram results were analysed retrospectively. Dementia characteristics and vitamin levels were compared. Two hundred and two dementia patients were included in the study. When the reasons for admission to the hospital were examined, the number of applications with the complaint of forgetfulness was highest in the pre-COVID period (53.1%); this rate was 37.8% in the COVID period. Also, 9.5% of patients were admitted for a drug prescription or medication report during the COVID period, while this rate was 1.6% in the pre-COVID period. Brain imaging was performed on 91 patients in the pre-COVID period, while 42 patients underwent imaging in the COVID period. Although this study was performed with a limited population, it indicates that the COVID-19 pandemic indirectly affects the clinical conditions of people living with dementia.”

Keywords: dementia, vitamins

Current Nutrition Reports

The Nutrition-COVID-19 Interplay: a Review

Authors: Antwi, J, Appiah, B, Oluwakuse, B, et al.

“Nutritional status is affected by the COVID-19 pandemic, directly or indirectly. Even with the recent rollout of the coronavirus disease 2019 (COVID-19) vaccines and availability of medicines such as remdesivir, and monoclonal antibodies, host nutritional status is pivotal in the fight against the acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and outcomes. The purpose of this review is to discuss the effects of COVID-19-related lockdown on lifestyle behaviors, and the nutritional consequences, and the direct sequelae of the infection on nutrition including potential nutritional interventions. The COVID-19-related lockdown imposed radical changes in lifestyle behaviors with considerable short-term and long-term health and nutritional consequences including weight gain and obesity and increased cardiometabolic risk, consistently linked to worsened prognosis. The extent of the impact was dependent on food insecurity, overall stress and disordered eating, physical inactivity, and exposure to COVID-19-related nutrition information sources. COVID-19 could directly induce inflammatory responses and poor nutrient intake and absorption leading to undernutrition with micronutrient deficiencies, which impairs immune system function with subsequent amplified risk of infection and disease severity. Nutrition interventions through nutrition support, dietary supplementation, and home remedies such as use of zinc, selenium, vitamin D, and omega-3 fatty acids showed the most significant promise to mitigate the course of COVID-19 infection and improve survival rates. The nutrition-COVID-19 relationship and related dietary changes mimic a vicious cycle of the double burden of malnutrition, both obesity and undernutrition with micronutrient deficiencies, which promote infection, disease progression, and potential death.”

Keywords: Nutrition, Immune system, Double burden of malnutrition, Nutrition behavior, Weight changes, Food insecurity, Ageusia, Dysgeusia, Lockdown

Biological Trace Element Research

Beneficial Effects of Vitamins, Minerals, and Bioactive Peptides on Strengthening the Immune System Against COVID-19 and the Role of Cow’s Milk in the Supply of These Nutrients

Authors: Ahvanooei, MRR, Norouzian, MA, Vahmani, P

“The COVID-19 pandemic, which causes severe respiratory tract infections in humans, has become a global health concern and is spreading rapidly. At present, the most important issue associated with COVID-19 is the immune system and the factors that affect it. It is well known that cow’s milk is highly rich in micronutrients that increase and strengthen the immune system. Research shows that the administration of these nutrients is very effective in fighting COVID-19, and a deficiency in any of them can be a weakness in the fight against the virus. On the other hand, cow’s milk is accessible to the whole population, and drinking colostrum, raw, and micro-filtered milk from cows vaccinated against SARS-CoV-2 could provide individuals with short-term protection against the SARS-CoV-2 infection until vaccines become commercially available. This review aimed to discuss the effects of milk vitamins, minerals, and bioactive peptides on general health in humans to combat viral diseases, especially COVID-19, and to what extent cow’s milk consumption plays a role in providing these metabolites. Cow’s milk contains many bioactive compounds that include vitamins, minerals, biogenic amines, nucleotides, oligosaccharides, organic acids, and immunoglobulins. Humans can meet a significant portion of their requirements for vitamins and minerals through the consumption of cow’s milk. Recent studies have shown that micronutrients such as vitamins D, E, B, C, and A as well as minerals Zn, Cu, Mg, I, and Se and bioactive peptides, each can have positive and significant effects on strengthening the immune system and general health in humans.”

Keywords: Cow milk, Immune system, Mineral, Vitamin

Clinics

Effect of a Single High-Dose Vitamin D3 on the Length of Hospital Stay of Severely 25-Hydroxyvitamin D-Deficient Patients with COVID-19

Authors: Murai, IH, Fernandes, AL, Antonangelo, L, et al.

“In this ancillary analysis of a multicenter, double-blinded, randomized, placebo-controlled trial, we investigated the effect of a single high dose of vitamin D3 on the length of hospital stay of patients with severe 25-hydroxyvitamin D deficiency and COVID-19. The primary outcome was length of hospital stay, defined as the total number of days that patients remained hospitalized from the date of randomization until the date of hospital discharge. Secondary outcomes included serum levels of 25-hydroxyvitamin D, mortality during hospitalization, number of patients admitted to the intensive care unit, and number of patients who required mechanical ventilation. Thirty-two patients were included in the study. The mean (SD) age was 58.5 (15.6) years, body mass index was 30.8 (8.6) kg/m2, and 25-hydroxyvitamin D level was 7.8 (1.6) ng/mL. No significant difference was observed in the median interquartile range of length of hospital stay between the vitamin D3 group (6.0 days) versus placebo (9.5 days). Vitamin D3 significantly increased serum 25-hydroxyvitamin D levels in the vitamin D3 group compared with that in the placebo group. A dose of 200.000 IU of vitamin D3 did not significantly reduce the length of hospital stay of patients with severe 25-hydroxyvitamin D deficiency and COVID-19.”

Keywords: Immune System, Pneumonia, Acute Respiratory Disease

Cureus

Therapies to Prevent Progression of COVID-19, Including Hydroxychloroquine, Azithromycin, Zinc, and Vitamin D3 With or Without Intravenous Vitamin C: An International, Multicenter, Randomized Trial

Authors: Ried K, BinJemain T, Sali A

“COVID-19 is a global pandemic. Treatment with hydroxychloroquine (HCQ), zinc, and azithromycin (AZM), also known as the Zelenko protocol, and treatment with intravenous (IV) vitamin C (IVC) have shown encouraging results in a large number of trials worldwide. In addition, vitamin D levels are an important indicator of the severity of symptoms in patients with COVID-19. Our multicenter, randomized, open-label study aimed to assess the effectiveness of HCQ, AZM, and zinc with or without IVC in hospitalized patients with COVID-19 in reducing symptom severity and duration and preventing death. Hospitalized patients with COVID-19 in seven participating hospitals in Turkey were screened for eligibility and randomly allocated to receive either HCQ, AZM, and zinc (group 1) or HCQ, AZM, zinc plus IV vitamin C treatment (group 2) for 14 days. The patients also received nontherapeutic levels of vitamin D3. A total of 237 hospitalized patients with COVID-19 aged 22-99 years (mean: 63.3 ± 15.7 years) were enrolled in the study. Almost all patients were vitamin D deficient (97%), 55% were severely vitamin D deficient (<25 nmol/L) and 42% were vitamin D deficient (<50 nmol/L); 3% had insufficient vitamin D levels (<75 nmol/L), and none had optimal vitamin D levels. Of the patients, 73% had comorbidities, including diabetes (35%), heart disease (36%), and lung disease (34%). All but one patient (99.6%; n = 236/237) treated with HCQ, AZM, and zinc with or without high-dose IV vitamin C (IVC) fully recovered. Additional IVC therapy contributed significantly to a quicker recovery (15 days versus 45 days until discharge). Side effects such as diarrhea, nausea, and vomiting, reported by 15%-27% of the patients, were mild to moderate and transient. No cardiac side effects were observed. Low vitamin D levels were significantly correlated with a higher probability of admission to the intensive care unit (ICU) and longer hospital stay. Sadly, one 70-year-old female patient with heart and lung disease died after 17 days in ICU and 22 days in the hospital. Her vitamin D level was 6 nmol/L on admission (i.e., severely deficient). Our study suggests that the treatment protocol of HCQ, AZM, and zinc with or without vitamin C is safe and effective in the treatment of COVID-19, with high dose IV vitamin C leading to a significantly quicker recovery. Importantly, our study confirms vitamin D deficiency to be a high-risk factor of severe COVID-19 disease and hospitalization, with 97% of our study’s patient cohort being vitamin D deficient, 55% of these being severely vitamin D deficient, and none had optimal levels. Future trials are warranted to evaluate the treatment with a combination of high-dose vitamin D3 in addition to HCQ, AZM, and zinc and high-dose intravenous vitamin C.”

Keywords: hydroxychloroquine, zinc, azithromycin, vitamins, vitamin C, vitamin D

The Lancet

The emergence of powerful oral anti-COVID-19 drugs in the post-vaccine era

Authors: Fan, H, Lou, F, Fan, J, et al.

“Abstract: The quest for effective drugs to treat COVID-19 has been a priority since the outbreak of the disease. The clinical application of remdesivir has been greatly restricted by the need for intravenous administration, as well as unstable concentrations in plasma and variable antiviral activity in different organelles. Four neutralising antibodies (bamlanivimab, etesevimab, casirivimab, and imdevimab) have been approved by the United States Food and Drug Administration; however, their high cost and need for intravenous administration render them inaccessible to the public. Therefore, effective and economical oral drugs are the priority for the prevention and control of COVID-19, because they can be used after exposure to SARS-CoV-2 or at the first sign of COVID-19. Molnupiravir is an oral antiviral drug with β-d-N4 -hydroxycytidine (NHC) as the active ingredient, and has been jointly developed by Merck (Kenilworth, NJ, USA) and Ridgeback (Miami, FL, USA). NHC monophosphate can pair with adenine or guanine and induce lethal mutations during subsequent RNA synthesis; however, NHC does not terminate strand synthesis and is therefore resistant to the proofreading function of SARS-CoV-2 nsp14. Data from the phase 3 MOVe-OUT trial showed that treatment with molnupiravir reduced hospitalisation or mortality by approximately 50% compared with placebo in patients with mild or moderate COVID-19—a very promising finding given that more than 4·7 million deaths worldwide have been attributed to COVID-19 to date. Molnupiravir showed a stronger antiviral effect than remdesivir (50% inhibitory concentration [IC50]: 0·3 μmol/L vs 0·77 μmol/L) and ideal toxicity (50% cytotoxic concentration [CC50]>10 μmol/L) in vitro. The phase 2 clinical trial also showed a promising result: no live virus could be isolated from patients who received 400 mg (n=42) or 800 mg (n=53) molnupiravir for 5 days, whereas live virus was isolated from 11·1% of patients in the placebo group (n=54). Moreover, molnupiravir has a favourable safety and tolerability profil.”

Keywords: oral anti-COVID-19 drugs, Bamlanivimab, Etesevimab, Casirivimab, Imdevimab

Clinical Nutrition ESPEN

COVID-19 mortality is associated with low Vitamin D levels in patients with risk factors and/or advanced age

Authors: Jenei, T, Jenei, S, Tamás, LT, et al.

“Although conclusive evodence is yet lacking, it has been suggested that vitamin D deficiency (VD) may be associated with a more severe course of SARS-CoV-2 Infection (COVID-19). In this retrospective study we assessed the association of VD deficiency with mortality in a group of COVID-19 patients treated in a tertiary referral center. Data of 257 Covid-19 patients hospitalized between 30th September 2020 and 2nd March 2021 have been collected retrospectively. The following parameters were collected: age, gender, serum level of 25-OH-Vitamin D3, outcome (survival/death) comorbidities (cancer, diabetes mellitus and chronic obstructive pulmonary disease). Serum VD measurement was done within 3 days of admission. VD levels were significantly lower in patients who did not survive, however, in this patients’ group the average age was significantly higher than among those, who survived. After age-matching, in a subgroup of patients with risk factors and/or 60 years of age or older who survived had significantly higher VD level in their serum than those who deceased. Serum C-reactive protein, lactate-dehydrogenase and creatinin-kinase were significantly higher in the group in which the patients died, however these laboratory parameters did not correlate with the VD levels. We found that in COVID-19 infection, when old age as risk factor (60 years of age or older) was pooled with risk factors (cancer, diabetes and/or COPD), the VD levels were significantly lower in the patient group, in which the patients did not survive. We suggest further, prospective studies in similar subgroups to explore a possible causal relationship.”

Keywords: Vitamin D, Risk factors, Elderly

Clinical Research in Cardiology

Letter to the Editors: Trends in ambulatory cardiology consultations for suspected myocarditis after COVID-19 vaccination

Authors: Eggebrecht, H, Breitbart, P, Koch, A, et al.

“In Germany, vaccination against coronavirus disease 2019 (COVID-19) was approved on December 21st 2020 and the first patient treated on December 26th. On May 7th 2021, the European Medicines Agency (EMA) announced an official investigation of case reports of myopericarditis in temporal relation to COVID-19 vaccination [1,2,3], which was updated on June 11th [4]. Since then, we noted increasing requests from General Practitioners for urgent cardiologic consultation of patients with suspected myocarditis after COVID-19 vaccination. All patients were scheduled within the 2 following business days and underwent standardized cardiologic assessment including electrocardiography (ECG), echocardiography, and determination of NT-proBNP and high-sensitive troponin T. Cardiac magnetic resonance (CMR) was performed at the discretion of the treating cardiologist. Statistical analysis was performed using IBM SPSS Statistics 27.0. Continuous variables are presented as mean and 95% confidence interval [CI], and categorical variables are represented as frequencies and percentages. Comparisons were performed with Student’s t test and with the Chi-square test for categorical variables. A two-sided p value of ≤ 0.05 was considered statistically significant.”

Keywords: COVID-19, SARS-CoV-2, Myocarditis

Nutrients

Editorial: A Review of Micronutrients and the Immune System—Working in Harmony to Reduce the Risk of Infection

Authors: Marcos, A

“The emergence of the SARS-CoV virus in December 2019 saw the beginning of an unprecedented pandemic that represents the most significant public health problem in recent memory. Initial public health strategies were mainly reactive, including social distancing and hygienic practices, therapeutic drugs to improve patient outcomes, and vaccine development and distribution, all aimed at preventing the spread of the highly-infective virus. However, there is a need for additional strategies to prevent severe COVID-19-related complications, and to ensure a proper immune response following vaccination. One outcome of the pandemic has been the increasing public awareness of the role of the immune system as the first line of defense against external pathogens, as well as the importance of adequate nutrition in maintaining strong immune defenses. This is why nutrition should be the most important prevention factor to count on. Indeed, a high-quality diet has recently been shown to reduce both the risk and severity of COVID-19, particularly in areas with higher socioeconomic deprivation. This ensures that nutritional support is a safe and cost-effective strategy that could be implemented to promote optimal immune function. ”

Keywords: vitamins, vitamin A, vitamin D, vitamin C, vitamin E, vitamin B6, vitamin B12, folate, iron, copper, zinc, selenium, nutrition, immune system

Turkish Journal of Geriatrics

The effect of the vitamin d level on the clinical, laboratory, and outcome in patients over 65 years of age with covid-19: Comprehensive tertiary center experience

Authors: Gökbulut Bektaş, Ş, İzdeş, S

“This study aimed to examine the relationship between vitamin D levels and the disease course, laboratory results, and clinical outcomes in patients aged > 65 years with coronavirus disease 2019 (COVID-19). The laboratory and clinical results of patients aged > 65 years who were admitted to a tertiary intensive care unit due to COVID-19 between April 2020 and May 2021 were retrospectively examined. A total of 299 patients aged >65 years (median 76 years [interquartile range 70–83]) diagnosed with COVID-19 were admitted in the ICU. The regression analysis performed between vitamin D level ≥30 ng/mL and <30 ng/mL and the inflammatory markers revealed the significant correlation of vitamin D <30 ng/mL with a low lymphocyte count and fibrinogen level. When the relationship between mortality, inflammatory markers, and clinical parameters was examined, lymphocyte count, D-dimer level, fibrinogen level, chest tomography stage 3, and vitamin D deficiency were also effective factors for predicting mortality. In COVID-19 patients, the vitamin D cut-off value for mortality was found to be 18.5 ng/mL. We observed a high rate of patients with low vitamin D levels in patients aged > 65 years who were admitted to the intensive care unit due to COVID-19. The rates of inflammation and mortality were higher in patients with vitamin D deficiency.”

Keywords: aged, inflammation intensive care unit, mortality, vitamin D

Frontiers in Medicine

Rapid Progression of Angioimmunoblastic T Cell Lymphoma Following BNT162b2 mRNA Vaccine Booster Shot: A Case Report

Authors: Goldman, S, Bron, D, Tousseyn, T, et al.

“Since nucleoside-modified mRNA vaccines strongly activate T follicular helper cells, it is important to explore the possible impact of approved SARS-CoV-2 mRNA vaccines on neoplasms affecting this cell type. Herein, we report and discuss unexpected rapid progression of lymphomatous lesions after administration of a BNT162b2 mRNA vaccine booster in a man recently diagnosed with AITL”

Research, Society and Development

Nutritional importance of vitamin D in the prevention of COVID-19: a systematic review

Authors: da Silva Neto, JG, da Silva, BP, de Oliveira, LEA, et al.

“To verify the nutritional importance of vitamin D in the prevention of Covid-19. Methodology: A systematic review was carried out which followed the PRISMA criteria – Main Items for Reporting Systematic Reviews and Meta-analysis. The search for articles was performed in the PubMed, Scielo, Lilacs and Virtual Health Library databases, using the descriptors in Portuguese and English: COVID-19', 'Prevention' and 'Vitamin D'. Access to the databases was carried out from February to March 2021. 250 articles were found and after applying the inclusion criteria, 13 articles remained. Vitamin D was found to play an important role in decreasing the risks and severity of COVID-19. The possible explanation for the mechanism of action of this vitamin in infectious diseases such as COVID-19 is its regulatory role in acquired immunity and innate immunity. Vitamin D may play a role in preventing COVID-19, particularly for people with levels below recommended levels. It is linked to anti-inflammatory, antiviral, antithrombotic, antioxidant and immune system modulating actions as being of great value in decreasing the risk of infection and disease progression.”

Keywords: Prevention, D vitamin

Indian Journal of Clinical Practice

Correlation of Vitamin D Levels with COVID-19 Severity and Outcome

Authors: Kaur, G, Sharma, G, Sharma, J, et al.

“Low vitamin D levels have been associated with an increase in inflammatory cytokines and a significantly increased risk of pneumonia and viral upper respiratory tract infections. Vitamin D deficiency is associated with an increase in thrombotic episodes, which are frequently observed in coronavirus disease 2019 (COVID-19). These conditions are reported to carry a higher mortality in COVID-19. So, we conducted a study to prove the correlation of vitamin D levels with COVID-19 infection and severity. The present study was conducted at RNT Medical College, Udaipur, Rajasthan. This study was done over a period of 2 months after getting approval from Institutional Ethics Committee. Written and informed consent was obtained from patients. In this study, 81 patients admitted in COVID wards and ICU, with COVID reverse transcriptase-polymerase chain reaction (RT-PCR) positive reports were included. Out of a total 81 patients, 37 (45.7%) were in the 41-60 years age group, 29 (35.8%) were more than 60 years of age and 15 (18.5%) were less than 40 years of age. Seventeen patients had severe vitamin D deficiency, 27 patients had moderate vitamin D deficiency, 20 patients had mild vitamin D deficiency and 17 patients had normal vitamin D level. Out of 17 patients who had severe vitamin D deficiency, 11 (64.7%) patients required invasive mechanical ventilation and out of these 17 patients, 13 (76.47%) patients died. Out of 17 patients who had normal level of vitamin D, 16 (94.1%) maintained SpO2 at room air and only 1 patient required invasive mechanical ventilation. As the level of vitamin D increased from severely low to normal level, requirement of high oxygen support decreased and SpO2 at room air increased. Mean of vitamin D among the patients who died was 10.4963 while mean of vitamin D level among patients who survived and were discharged was 27.2362. All 17 patients who had normal level of vitamin D were discharged from the hospital. Mean of serum ferritin and mean of interleukin (IL)-6 was high in patients who died and low in patients who were discharged. Vitamin D level plays an important role in COVID-19 disease. Vitamin D have significant role in protection from severe form of disease.”

Keywords: vitamin D, T regulatory lymphocytes, acute respiratory distress syndrome, IL-6, serum ferritin

The Lancet

The emergence of powerful oral anti-COVID-19 drugs in the post-vaccine era

Authors: Fan, H, Lou, F, Fan, J, et al.

“Abstract: The quest for effective drugs to treat COVID-19 has been a priority since the outbreak of the disease.