The association between vitamin D intake with inflammatory and biochemical indices and mortality in critically ill patients with COVID-19: A case-control study.

BACKGROUND: The coronavirus disease-2019 (COVID-19) has become a worldwide health issue with widespread hospitalization and dependence on the intensive care unit (ICU). Vitamin D has a key role in modulating immune cells and modulating the inflammatory responses. This study aimed to investigate the association of vitamin D supplementation with inflammatory, biochemical, and mortality indices in critically ill patients with COVID-19. METHODS: This case-control study was conducted on critically ill COVID-19 patients hospitalized in the ICU including the survived >30 day patients as the case group and dead patients as the control group. The status of vitamin D supplementation and inflammatory and biochemical indices of the patients were retrieved from the medical records. Logistic regression method was used to assess the association between 30 days survival and vitamin D supplement intake. RESULTS: Compared to the group of COVID-19 patients who died in <30 day, the survived patients had a lower eosinophile level (2.2 ± 0.5 vs. 6 ± 0.0, p < .001) and higher vitamin D supplementation duration (9 ± 4.4 vs. 3.3 ± 1.9 day, p = .001). Vitamin D supplementation had a positive association with survival in COVID-19 patients (OR: 1.98, 95% CI: 1.15-3.40, p < .05). The association remained significant after adjustments fot age, sex, underlying diseases, and smoking. CONCLUSION: Vitamin D supplementation in critically ill patients with COVID-19 has the potential to increase survivability within the first 30 days of hospitalization.

The Efficacy of an Oral Formulation of Glycyrrhiza glabra, Viola odorata, and Operculina turpethum as an Add-on Therapy for Mild-to-moderate Childhood Asthma: A Randomized Placebo-Controlled Clinical Trial.

Objective: We aimed to evaluate the efficacy of an oral combined tablet of Glycyrrhiza glabra, Viola odorata, and Operculina turpethum (Anti-Asthma®) as an add-on therapy for the relief of the severity of symptoms in mild-to-moderate childhood asthma. Methods: This randomized placebo-controlled clinical trial was performed on 60 children and adolescents with chronic mild-to-moderate childhood asthma. Patients were randomly divided into cases who received Anti-Asthma® oral combined tablets 2 tablets twice dailt for 1 month and controls, received placebo tablets identically the same to Anti-Asthma® (2 tablets, twice daily, for 1 month) as add-ons to their standard therapy according to the guideline. The severity and frequency of cough attacks and shortness of breath, respiratory test indices (based on spirometry), and the extent of disease control and treatment adherence were measured clinically by validated questionnaires at the beginning and after the study. Findings: Respiratory test indices improved and the severity of activity restriction decreased significantly in the cases compared to the controls However, the mean difference before and after the study was significantly different between the cases and controls only for the number and severity of coughs and the severity of activity restriction. In the scores of the Asthma Control Questionnaire, the cases group had a significant improvement compared to the controls. Conclusion: Anti-Asthma® oral formulation may be effective as an adjunct add-on treatment in the maintenance therapy of mild-to-moderate childhood asthma.

The Effect of Vitamin C on Pathological Parameters and Survival Duration of Critically Ill Coronavirus Disease 2019 Patients: A Randomized Clinical Trial.

Introduction: Vitamin C has been reported to have beneficial effects on patients with coronavirus disease 2019 (COVID-19). This study aimed to investigate the effect of vitamin C supplementation on pathological parameters and survival duration of critically ill patients with COVID-19. Methods: This clinical trial was conducted on 120 hospitalized critically ill patients infected with COVID-19. The intervention group (n = 31) received one capsule of 500 mg of vitamin C daily for 14 days. The control group (n = 69) received the same nutrition except for vitamin C supplements. Measurement of pathological and biochemical parameters was performed at baseline and after 2 weeks of the intervention. Results: Following 2 weeks of vitamin C supplementation, the level of serum K was significantly lower in the patients compared with the control group (3.93 vs. 4.21 mEq/L, p < 0.01). Vitamin C supplementation resulted in a higher mean survival duration compared with that of the control group (8 vs. 4 days, p < 0.01). There was a linear association between the number of days of vitamin C intake and survival duration (B = 1.66, p < 0.001). The vitamin C supplementation had no effect on blood glucose, mean arterial pressure, arterial blood gas (ABG) parameters, Glasgow Coma Scale (GCS), kidney function, cell blood count (CBC), hemoglobin (Hb), platelet (Plt), partial thromboplastin time (PTT), albumin, hematocrit (Hct), and other serum electrolytes including sodium (Na), calcium, and phosphorus (P). Conclusion: The present study demonstrated the potential of vitamin C supplementation in enhancing the survival duration of critically ill patients with COVID-19. Clinical Trial Registration: https://www.irct.ir/trial/55074, identifier IRCT20151226025699N5.