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1.
Mo Med ; 118(1): 68-73, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33551489

RESUMEN

Magnesium and vitamin D each have the possibility of affecting the immune system and consequently the cytokine storm and coagulation cascade in COVID-19 infections. Vitamin D is important for reducing the risk of upper respiratory tract infections and plays a role in pulmonary epithelial health. While the importance of vitamin D for a healthy immune system has been known for decades, the benefits of magnesium has only recently been elucidated. Indeed, magnesium is important for activating vitamin D and has a protective role against oxidative stress. Magnesium deficiency increases endothelial cell susceptibility to oxidative stress, promotes endothelial dysfunction, reduces fibrinolysis and increases coagulation. Furthermore, magnesium deficient animals and humans have depressed immune responses, which, when supplemented with magnesium, a partial or near full reversal of the immunodeficiency occurs. Moreover, intracellular free magnesium levels in natural killer cells and CD8 killer T cells regulates their cytotoxicity. Considering that magnesium and vitamin D are important for immune function and cellular resilience, a deficiency in either may contribute to cytokine storm in the novel coronavirus 2019 (COVID-19) infection.


Asunto(s)
/complicaciones , Síndrome de Liberación de Citoquinas/etiología , Coagulación Intravascular Diseminada/etiología , Enfermedades del Sistema Inmune/etiología , Deficiencia de Magnesio/complicaciones , Deficiencia de Vitamina D/complicaciones , Animales , Linfocitos T CD8-positivos/efectos de los fármacos , /tratamiento farmacológico , Humanos , Células Asesinas Naturales/efectos de los fármacos , Magnesio/administración & dosificación , Magnesio/farmacología , Magnesio/uso terapéutico , Estrés Oxidativo/efectos de los fármacos , /genética , Vitamina D/administración & dosificación , Vitamina D/farmacología , Vitamina D/uso terapéutico , Vitaminas/administración & dosificación , Vitaminas/farmacología , Vitaminas/uso terapéutico
2.
Artículo en Ruso | MEDLINE | ID: mdl-33591652

RESUMEN

The overview of scientific information concerning actual characteristics of population's supply with vitamin D and its role in case of risk of development of infectious diseases and COVID-19 is presented. The analysis established that vitamin D deficiency contributes both to higher risk of susceptibility to infectious agent and to negative impact to course and outcome of disease. The significant role of vitamin D in prevention and treatment of viral diseases is established. The international research studies confirm that at infectious diseases and early stages of COVID-19 protective immune response is responsible for elimination of the virus. Therefore, using vitamin D in treatment of COVID-19 is the strategy of immune protection. The authors consider that in case of infectious risks, preventive application of vitamin D is necessary. In case of initial manifestations of COVID-19, it is appropriate to promptly achieve levels of optimal status of micro-nutrient supply.


Asunto(s)
Vitamina D , Vitaminas , /tratamiento farmacológico , Humanos , Pandemias/prevención & control , Vitamina D/uso terapéutico , Vitaminas/uso terapéutico
3.
Nutrients ; 13(1)2021 Jan 12.
Artículo en Inglés | MEDLINE | ID: mdl-33445474

RESUMEN

Human skin is continually changing. The condition of the skin largely depends on the individual's overall state of health. A balanced diet plays an important role in the proper functioning of the human body, including the skin. The present study draws attention to bioactive substances, i.e., vitamins, minerals, fatty acids, polyphenols, and carotenoids, with a particular focus on their effects on the condition of the skin. The aim of the study was to review the literature on the effects of bioactive substances on skin parameters such as elasticity, firmness, wrinkles, senile dryness, hydration and color, and to define their role in the process of skin ageing.


Asunto(s)
Antioxidantes/uso terapéutico , Carotenoides/uso terapéutico , Minerales/uso terapéutico , Envejecimiento de la Piel/efectos de los fármacos , Piel/metabolismo , Vitaminas/uso terapéutico , Humanos
4.
Nutrients ; 13(1)2021 Jan 14.
Artículo en Inglés | MEDLINE | ID: mdl-33466642

RESUMEN

Little information is available on the beneficial effects of cholecalciferol treatment in comorbid patients hospitalized for COVID-19. The aim of this study was to retrospectively examine the clinical outcome of patients receiving in-hospital high-dose bolus cholecalciferol. Patients with a positive diagnosis of SARS-CoV-2 and overt COVID-19, hospitalized from 15 March to 20 April 2020, were considered. Based on clinical characteristics, they were supplemented (or not) with 400,000 IU bolus oral cholecalciferol (200,000 IU administered in two consecutive days) and the composite outcome (transfer to intensive care unit; ICU and/or death) was recorded. Ninety-one patients (aged 74 ± 13 years) with COVID-19 were included in this retrospective study. Fifty (54.9%) patients presented with two or more comorbid diseases. Based on the decision of the referring physician, 36 (39.6%) patients were treated with vitamin D. Receiver operating characteristic curve analysis revealed a significant predictive power of the four variables: (a) low (<50 nmol/L) 25(OH) vitamin D levels, (b) current cigarette smoking, (c) elevated D-dimer levels (d) and the presence of comorbid diseases, to explain the decision to administer vitamin D (area under the curve = 0.77, 95% CI: 0.67-0.87, p < 0.0001). Over the follow-up period (14 ± 10 days), 27 (29.7%) patients were transferred to the ICU and 22 (24.2%) died (16 prior to ICU and six in ICU). Overall, 43 (47.3%) patients experienced the combined endpoint of transfer to ICU and/or death. Logistic regression analyses revealed that the comorbidity burden significantly modified the effect of vitamin D treatment on the study outcome, both in crude (p = 0.033) and propensity score-adjusted analyses (p = 0.039), so the positive effect of high-dose cholecalciferol on the combined endpoint was significantly amplified with increasing comorbidity burden. This hypothesis-generating study warrants the formal evaluation (i.e., clinical trial) of the potential benefit that cholecalciferol can offer in these comorbid COVID-19 patients.


Asunto(s)
/tratamiento farmacológico , Colecalciferol/uso terapéutico , Vitaminas/uso terapéutico , Adulto , Anciano , Anciano de 80 o más Años , /mortalidad , Colecalciferol/administración & dosificación , Femenino , Hospitalización , Humanos , Inyecciones Intravenosas , Masculino , Persona de Mediana Edad , Curva ROC , Estudios Retrospectivos , Resultado del Tratamiento , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/tratamiento farmacológico , Vitaminas/administración & dosificación
5.
Int J Med Sci ; 18(2): 314-324, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33390800

RESUMEN

The coronavirus disease 2019 (COVID-19) pandemic is the largest health crisis ever faced worldwide. It has resulted in great health and economic costs because no effective treatment is currently available. Since infected persons vary in presentation from healthy asymptomatic mild symptoms to those who need intensive care support and eventually succumb to the disease, this illness is considered to depend primarily on individual immunity. Demographic distribution and disease severity in several regions of the world vary; therefore, it is believed that natural inherent immunity provided through dietary sources and traditional medicines could play an important role in infection prevention and disease progression. People can boost their immunity to prevent them from infection after COVID-19 exposure and can reduce their inflammatory reactions to protect their organ deterioration in case suffering from the disease. Some drugs with in-situ immunomodulatory and anti-inflammatory activity are also identified as adjunctive therapy in the COVID-19 era. This review discusses the importance of COVID-19 interactions with immune cells and inflammatory cells; and further emphasizes the possible pathways related with traditional herbs, medications and nutritional products. We believe that such pathophysiological pathway approach treatment is rational and important for future development of new therapeutic agents for prevention or cure of COVID-19 infection.


Asunto(s)
/tratamiento farmacológico , Interacciones Huésped-Patógeno , Medicina Tradicional , /prevención & control , Quimioterapia Combinada , Humanos , Inmunomodulación , Terapia Molecular Dirigida , Fitoterapia , Extractos Vegetales/uso terapéutico , Vitaminas/uso terapéutico , Zinc/uso terapéutico
6.
Maturitas ; 143: 1-9, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33308613

RESUMEN

The world is currently in the grips of the coronavirus disease (COVID-19) pandemic, caused by the SARS-CoV-2 virus, which has mutated to allow human-to-human spread. Infection can cause fever, dry cough, fatigue, severe pneumonia, respiratory distress syndrome and in some instances death. COVID-19 affects the immune system by producing a systemic inflammatory response, or cytokine release syndrome. Patients with COVID-19 have shown a high level of pro-inflammatory cytokines and chemokines. There are currently no effective anti-SARS-CoV-2 viral drugs or vaccines. COVID-19 disproportionately affects the elderly, both directly, and through a number of significant age-related comorbidities. Undoubtedly, nutrition is a key determinant of maintaining good health. Key dietary components such as vitamins C, D, E, zinc, selenium and the omega 3 fatty acids have well-established immunomodulatory effects, with benefits in infectious disease. Some of these nutrients have also been shown to have a potential role in the management of COVID-19. In this paper, evidence surrounding the role of these dietary components in immunity as well as their specific effect in COVID-19 patients are discussed. In addition, how supplementation of these nutrients may be used as therapeutic modalities potentially to decrease the morbidity and mortality rates of patients with COVID-19 is discussed.


Asunto(s)
/tratamiento farmacológico , Vitaminas/uso terapéutico , Ácido Ascórbico/inmunología , Ácido Ascórbico/uso terapéutico , Suplementos Dietéticos , Ácidos Grasos Omega-3/inmunología , Ácidos Grasos Omega-3/uso terapéutico , Humanos , Sistema Inmunológico/efectos de los fármacos , Selenio/inmunología , Selenio/uso terapéutico , Vitamina D/inmunología , Vitamina D/uso terapéutico , Vitamina E/inmunología , Vitamina E/uso terapéutico , Vitaminas/inmunología , Zinc/inmunología , Zinc/uso terapéutico
7.
Maturitas ; 143: 184-189, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33308627

RESUMEN

OBJECTIVE: To prevent osteoporotic fractures in nursing home residents a combination of bisphosphonates, calcium and vitamin D is recommended. This study assessed the prevalence of pharmacological osteoporosis prevention in nursing home residents from eight countries, and assessed its association with patient characteristics. DESIGN: Cross-sectional analyses of the SHELTER study data. We assessed the overall prevalence of osteoporosis medication (OM) use (vitamin D, calcium and bisphosphonates) in residents stratified for falls and fractures over last 30 days, health instability with high mortality risk, cognitive impairment, and dependence in walking. SETTING AND PARTICIPANTS: Nursing home residents in the Czech Republic, England, Finland, France, Germany, Italy, The Netherlands and Israel. RESULTS: Of 3832 eligible residents, vitamin D, calcium and bisphosphonates were used by 16.2%, 10.4%, and 4.5% respectively. All 3 classes of OM together were used by 1.5% of all residents. Of residents with a recent fracture, 9.5% used a bisphosphonate (2.7% all 3 OMs). In patients with recent falls, 20.8% used vitamin D and 15.3% calcium. In residents with severe cognitive impairment, 15.5% used vitamin D and 9.3% used calcium. Of the bisphosphonate users, 33.7% also used both vitamin D and calcium, 25.8% used only calcium in addition and 17.4% only vitamin D in addition. The use of any OM varied widely across countries, from 66.8% in Finland to 3.0% in Israel. CONCLUSIONS AND IMPLICATIONS: We found substantial pharmacological under-treatment of prevention of osteoporosis in residents with recent falls, fractures and dependence in walking. Only two-thirds of bisphosphonate users also took a vitamin D-calcium combination, despite guideline recommendations. On the other hand, possible over-treatment was found in residents with high mortality risk in whom preventive pharmacotherapy might not have still been appropriate. The prevalence of pharmacological prevention of osteoporosis differed substantially between countries. Efforts are needed to improve pharmacotherapy in residents.


Asunto(s)
Casas de Salud/estadística & datos numéricos , Osteoporosis/tratamiento farmacológico , Accidentes por Caídas , Anciano , Anciano de 80 o más Años , Calcio en la Dieta/uso terapéutico , Difosfonatos/uso terapéutico , Utilización de Medicamentos/estadística & datos numéricos , Europa (Continente) , Femenino , Humanos , Israel , Masculino , Osteoporosis/prevención & control , Fracturas Osteoporóticas/prevención & control , Vitamina D/uso terapéutico , Vitaminas/uso terapéutico
8.
BMJ Case Rep ; 13(12)2020 Dec 15.
Artículo en Inglés | MEDLINE | ID: mdl-33323421

RESUMEN

Long QT syndrome with Torsades de Pointes (TdP) is a life-threatening polymorphic ventricular arrhythmia. The corrected QT (QTc) prolongation >500 milliseconds (ms) has been associated with TdP. Hypocalcaemia due to severe vitamin D deficiency is an uncommon cause of acquired long QT. We hereby present a case of a 40-year-old woman with sensorineural deafness and having symptoms of palpitations and presyncope. She had a QTc interval of 556 ms (reference range, QTc 451-470 ms in adult healthy woman) on 24-hour Holter analysis. Genetic analysis for congenital long QT syndrome was negative. She was diagnosed with severe hypocalcaemia secondary to severe vitamin D deficiency. After treatment with intravenous calcium gluconate, followed by oral vitamin D and calcium supplementation, the QTc became normalised and no further episode of palpitations or presyncope occurred. The causes of vitamin D deficiency was due to inadequate exposure to sunlight and a strict vegan diet.


Asunto(s)
Síndrome de QT Prolongado/diagnóstico , Síndrome de QT Prolongado/etiología , Deficiencia de Vitamina D/complicaciones , Deficiencia de Vitamina D/diagnóstico , Antagonistas de Receptores Adrenérgicos beta 1/uso terapéutico , Adulto , Calcio/uso terapéutico , Gluconato de Calcio/uso terapéutico , Electrocardiografía Ambulatoria/métodos , Femenino , Humanos , Hipocalcemia/diagnóstico , Hipocalcemia/tratamiento farmacológico , Hipocalcemia/etiología , Síndrome de QT Prolongado/tratamiento farmacológico , Metoprolol/uso terapéutico , Vitamina D/uso terapéutico , Deficiencia de Vitamina D/tratamiento farmacológico , Vitaminas/uso terapéutico
9.
JAMA ; 324(18): 1855-1868, 2020 11 10.
Artículo en Inglés | MEDLINE | ID: mdl-33170239

RESUMEN

Importance: The benefits of vitamin D, omega-3 fatty acids, and exercise in disease prevention remain unclear. Objective: To test whether vitamin D, omega-3s, and a strength-training exercise program, alone or in combination, improved 6 health outcomes among older adults. Design, Setting, and Participants: Double-blind, placebo-controlled, 2 × 2 × 2 factorial randomized clinical trial among 2157 adults aged 70 years or older who had no major health events in the 5 years prior to enrollment and had sufficient mobility and good cognitive status. Patients were recruited between December 2012 and November 2014, and final follow-up was in November 2017. Interventions: Participants were randomized to 3 years of intervention in 1 of the following 8 groups: 2000 IU/d of vitamin D3, 1 g/d of omega-3s, and a strength-training exercise program (n = 264); vitamin D3 and omega-3s (n = 265); vitamin D3 and exercise (n = 275); vitamin D3 alone (n = 272); omega-3s and exercise (n = 275); omega-3s alone (n = 269); exercise alone (n = 267); or placebo (n = 270). Main Outcomes and Measures: The 6 primary outcomes were change in systolic and diastolic blood pressure (BP), Short Physical Performance Battery (SPPB), Montreal Cognitive Assessment (MoCA), and incidence rates (IRs) of nonvertebral fractures and infections over 3 years. Based on multiple comparisons of 6 primary end points, 99% confidence intervals are presented and P < .01 was required for statistical significance. Results: Among 2157 randomized participants (mean age, 74.9 years; 61.7% women), 1900 (88%) completed the study. Median follow-up was 2.99 years. Overall, there were no statistically significant benefits of any intervention individually or in combination for the 6 end points at 3 years. For instance, the differences in mean change in systolic BP with vitamin D vs no vitamin D and with omega-3s vs no omega-3s were both -0.8 (99% CI, -2.1 to 0.5) mm Hg, with P < .13 and P < .11, respectively; the difference in mean change in diastolic BP with omega-3s vs no omega-3s was -0.5 (99% CI, -1.2 to 0.2) mm Hg; P = .06); and the difference in mean change in IR of infections with omega-3s vs no omega-3s was -0.13 (99% CI, -0.23 to -0.03), with an IR ratio of 0.89 (99% CI, 0.78-1.01; P = .02). No effects were found on the outcomes of SPPB, MoCA, and incidence of nonvertebral fractures). A total of 25 deaths were reported, with similar numbers in all treatment groups. Conclusions and Relevance: Among adults without major comorbidities aged 70 years or older, treatment with vitamin D3, omega-3s, or a strength-training exercise program did not result in statistically significant differences in improvement in systolic or diastolic blood pressure, nonvertebral fractures, physical performance, infection rates, or cognitive function. These findings do not support the effectiveness of these 3 interventions for these clinical outcomes. Trial Registration: ClinicalTrials.gov Identifier: NCT01745263.


Asunto(s)
Colecalciferol/uso terapéutico , Suplementos Dietéticos , Ácidos Grasos Omega-3/uso terapéutico , Estado de Salud , Entrenamiento de Resistencia , Vitaminas/uso terapéutico , Anciano , Anciano de 80 o más Años , Trastornos del Conocimiento/prevención & control , Método Doble Ciego , Femenino , Estudios de Seguimiento , Fracturas Óseas/prevención & control , Humanos , Hipertensión/terapia , Inmunidad , Masculino , Aptitud Física , Resultado del Tratamiento
10.
Int Immunopharmacol ; 88: 106995, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33182059

RESUMEN

There is recent evidence that interleukin-6 (IL-6) levels are elevated in cases of complicated COVID-19, but it is also possible that this cytokine may have a far more important role in the pathogenesis of viral infection. IL-6 is known to be modulated by Vitamin D, and there is preliminary evidence that deficiency of this vitamin is linked to poorer outcomes. To identify whether IL-6 levels prior to infection might predict outcome, early data on COVID-19 mortality from Italy and the UK were compared with previously published results of mean IL-6 levels from these countries as well as from the USA. There was a highly significant correlation (r = 0.9883; p = 0.00025) between age-stratified mortality rates and IL-6 levels from previously published data on healthy individuals. To determine whether Vitamin D may be beneficial at lowering IL-6 levels in patients, a limited analysis of trials examining the relationship between these entities published since 2015 was undertaken. Eight out of 11 studies described a significant lowering effect of Vitamin D on IL-6. Given that IL-6 likely facilitates viral cell entry and replication, levels prior to infection may predict mortality. This provides a rationale for prophylactic and therapeutic measures directed at lowering IL-6, including Vitamin D prescription.


Asunto(s)
Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/mortalidad , Interleucina-6/sangre , Neumonía Viral/sangre , Neumonía Viral/mortalidad , Vitamina D/uso terapéutico , Vitaminas/uso terapéutico , Adulto , Anciano , Anciano de 80 o más Años , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/epidemiología , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/epidemiología , Reino Unido/epidemiología , Adulto Joven
11.
Nutrients ; 12(11)2020 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-33142828

RESUMEN

Vitamin D deficiency co-exists in patients with COVID-19. At this time, dark skin color, increased age, the presence of pre-existing illnesses and vitamin D deficiency are features of severe COVID disease. Of these, only vitamin D deficiency is modifiable. Through its interactions with a multitude of cells, vitamin D may have several ways to reduce the risk of acute respiratory tract infections and COVID-19: reducing the survival and replication of viruses, reducing risk of inflammatory cytokine production, increasing angiotensin-converting enzyme 2 concentrations, and maintaining endothelial integrity. Fourteen observational studies offer evidence that serum 25-hydroxyvitamin D concentrations are inversely correlated with the incidence or severity of COVID-19. The evidence to date generally satisfies Hill's criteria for causality in a biological system, namely, strength of association, consistency, temporality, biological gradient, plausibility (e.g., mechanisms), and coherence, although experimental verification is lacking. Thus, the evidence seems strong enough that people and physicians can use or recommend vitamin D supplements to prevent or treat COVID-19 in light of their safety and wide therapeutic window. In view of public health policy, however, results of large-scale vitamin D randomized controlled trials are required and are currently in progress.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/sangre , Neumonía Viral/sangre , Índice de Severidad de la Enfermedad , Deficiencia de Vitamina D/virología , Vitamina D/análogos & derivados , Infecciones por Coronavirus/mortalidad , Infecciones por Coronavirus/virología , Suplementos Dietéticos , Femenino , Humanos , Masculino , Estudios Observacionales como Asunto , Pandemias , Neumonía Viral/mortalidad , Neumonía Viral/virología , Vitamina D/sangre , Vitamina D/uso terapéutico , Vitaminas/uso terapéutico
12.
Nutrients ; 12(11)2020 Nov 14.
Artículo en Inglés | MEDLINE | ID: mdl-33202670

RESUMEN

Severe acute respiratory syndrome coronavirus type (SARS-CoV2, also known as COVID-19), which is the latest pandemic infectious disease, constitutes a serious risk to human health. SARS-CoV2 infection causes immune activation and systemic hyperinflammation which can lead to respiratory distress syndrome (ARDS). ARDS victims are characterized by a significant increase in IL-6 and IL-1. Macrophage activation, associated with the "cytokine storm", promotes the dysregulation of the innate immunity. So far, without vaccines or specific therapy, all efforts to design drugs or clinical trials are worthwhile. Vitamin D and its receptor vitamin D receptor (VDR) exert a critical role in infections due to their remarkable impact on both innate and adaptive immune responses and on the suppression of the inflammatory process. The protective properties of vitamin D supplementation have been supported by numerous observational studies and by meta-analysis of clinical trials for prevention of viral acute respiratory infection. In this review, we compare the mechanisms of the host immune response to SARS-CoV2 infection and the immunomodulatory actions that vitamin D exerts in order to consider the preventive effect of vitamin D supplementation on SARS-CoV2 viral infection.


Asunto(s)
Betacoronavirus/inmunología , Colecalciferol/uso terapéutico , Infecciones por Coronavirus/prevención & control , Inmunidad Innata/efectos de los fármacos , Pandemias/prevención & control , Neumonía Viral/prevención & control , Vitaminas/uso terapéutico , Infecciones por Coronavirus/inmunología , Citocinas/inmunología , Suplementos Dietéticos , Humanos , Neumonía Viral/inmunología
13.
Nutrients ; 12(11)2020 Nov 02.
Artículo en Inglés | MEDLINE | ID: mdl-33147894

RESUMEN

BACKGROUND: The objective of this quasi-experimental study was to determine whether bolus vitamin D supplementation taken either regularly over the preceding year or after the diagnosis of COVID-19 was effective in improving survival among hospitalized frail elderly COVID-19 patients. METHODS: Seventy-seven patients consecutively hospitalized for COVID-19 in a geriatric unit were included. Intervention groups were participants regularly supplemented with vitamin D over the preceding year (Group 1), and those supplemented with vitamin D after COVID-19 diagnosis (Group 2). The comparator group involved participants having received no vitamin D supplements (Group 3). Outcomes were 14-day mortality and highest (worst) score on the ordinal scale for clinical improvement (OSCI) measured during COVID-19 acute phase. Potential confounders were age, gender, functional abilities, undernutrition, cancer, hypertension, cardiomyopathy, glycated hemoglobin, number of acute health issues at admission, hospital use of antibiotics, corticosteroids, and pharmacological treatments of respiratory disorders. RESULTS: The three groups (n = 77; mean ± SD, 88 ± 5years; 49% women) were similar at baseline (except for woman proportion, p = 0.02), as were the treatments used for COVID-19. In Group 1 (n = 29), 93.1% of COVID-19 participants survived at day 14, compared to 81.2% survivors in Group 2 (n = 16) (p = 0.33) and 68.7% survivors in Group 3 (n = 32) (p = 0.02). While considering Group 3 as reference (hazard ratio (HR) = 1), the fully-adjusted HR for 14-day mortality was HR = 0.07 (p = 0.017) for Group 1 and HR = 0.37 (p = 0.28) for Group 2. Group 1 had longer survival time than Group 3 (log-rank p = 0.015), although there was no difference between Groups 2 and 3 (log-rank p = 0.32). Group 1, but not Group 2 (p = 0.40), was associated with lower risk of OSCI score ≥5 compared to Group 3 (odds ratio = 0.08, p= 0.03). CONCLUSIONS: Regular bolus vitamin D supplementation was associated with less severe COVID-19 and better survival in frail elderly.


Asunto(s)
Infecciones por Coronavirus/mortalidad , Suplementos Dietéticos , Fragilidad/mortalidad , Neumonía Viral/mortalidad , Vitamina D/uso terapéutico , Vitaminas/uso terapéutico , Anciano de 80 o más Años , Betacoronavirus , Infecciones por Coronavirus/sangre , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/terapia , Femenino , Anciano Frágil/estadística & datos numéricos , Fragilidad/sangre , Fragilidad/virología , Hospitalización , Humanos , Masculino , Ensayos Clínicos Controlados no Aleatorios como Asunto , Pandemias , Neumonía Viral/sangre , Neumonía Viral/terapia , Tasa de Supervivencia
14.
Nutrients ; 12(10)2020 Oct 20.
Artículo en Inglés | MEDLINE | ID: mdl-33092041

RESUMEN

Viral infections are a leading cause of morbidity and mortality worldwide, and the importance of public health practices including handwashing and vaccinations in reducing their spread is well established. Furthermore, it is well known that proper nutrition can help support optimal immune function, reducing the impact of infections. Several vitamins and trace elements play an important role in supporting the cells of the immune system, thus increasing the resistance to infections. Other nutrients, such as omega-3 fatty acids, help sustain optimal function of the immune system. The main aim of this manuscript is to discuss of the potential role of micronutrients supplementation in supporting immunity, particularly against respiratory virus infections. Literature analysis showed that in vitro and observational studies, and clinical trials, highlight the important role of vitamins A, C, and D, omega-3 fatty acids, and zinc in modulating the immune response. Supplementation with vitamins, omega 3 fatty acids and zinc appears to be a safe and low-cost way to support optimal function of the immune system, with the potential to reduce the risk and consequences of infection, including viral respiratory infections. Supplementation should be in addition to a healthy diet and fall within recommended upper safety limits set by scientific expert bodies. Therefore, implementing an optimal nutrition, with micronutrients and omega-3 fatty acids supplementation, might be a cost-effective, underestimated strategy to help reduce the burden of infectious diseases worldwide, including coronavirus disease 2019 (COVID-19).


Asunto(s)
Infecciones por Coronavirus/tratamiento farmacológico , Suplementos Dietéticos , Ácidos Grasos Omega-3/uso terapéutico , Neumonía Viral/tratamiento farmacológico , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Oligoelementos/uso terapéutico , Virosis/tratamiento farmacológico , Vitaminas/uso terapéutico , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/inmunología , Infecciones por Coronavirus/virología , Ácidos Grasos Omega-3/farmacología , Humanos , Inmunidad/efectos de los fármacos , Micronutrientes/uso terapéutico , Estado Nutricional , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/inmunología , Neumonía Viral/virología , Infecciones del Sistema Respiratorio/inmunología , Infecciones del Sistema Respiratorio/virología , Oligoelementos/farmacología , Virosis/inmunología , Virosis/virología , Vitaminas/farmacología , Zinc/farmacología , Zinc/uso terapéutico
15.
Nutrients ; 12(11)2020 Oct 27.
Artículo en Inglés | MEDLINE | ID: mdl-33121019

RESUMEN

Investigation into the role of vitamin C in the prevention and treatment of pneumonia and sepsis has been underway for many decades. This research has laid a strong foundation for translation of these findings into patients with severe coronavirus disease (COVID-19). Research has indicated that patients with pneumonia and sepsis have low vitamin C status and elevated oxidative stress. Administration of vitamin C to patients with pneumonia can decrease the severity and duration of the disease. Critically ill patients with sepsis require intravenous administration of gram amounts of the vitamin to normalize plasma levels, an intervention that some studies suggest reduces mortality. The vitamin has pleiotropic physiological functions, many of which are relevant to COVID-19. These include its antioxidant, anti-inflammatory, antithrombotic and immuno-modulatory functions. Preliminary observational studies indicate low vitamin C status in critically ill patients with COVID-19. There are currently a number of randomized controlled trials (RCTs) registered globally that are assessing intravenous vitamin C monotherapy in patients with COVID-19. Since hypovitaminosis C and deficiency are common in low-middle-income settings, and many of the risk factors for vitamin C deficiency overlap with COVID-19 risk factors, it is possible that trials carried out in populations with chronic hypovitaminosis C may show greater efficacy. This is particularly relevant for the global research effort since COVID-19 is disproportionately affecting low-middle-income countries and low-income groups globally. One small trial from China has finished early and the findings are currently under peer review. There was significantly decreased mortality in the more severely ill patients who received vitamin C intervention. The upcoming findings from the larger RCTs currently underway will provide more definitive evidence. Optimization of the intervention protocols in future trials, e.g., earlier and sustained administration, is warranted to potentially improve its efficacy. Due to the excellent safety profile, low cost, and potential for rapid upscaling of production, administration of vitamin C to patients with hypovitaminosis C and severe respiratory infections, e.g., COVID-19, appears warranted.


Asunto(s)
Ácido Ascórbico/uso terapéutico , Infecciones por Coronavirus/tratamiento farmacológico , Neumonía Viral/tratamiento farmacológico , Vitaminas/uso terapéutico , Antiinflamatorios/farmacología , Antiinflamatorios/uso terapéutico , Antioxidantes/farmacología , Antioxidantes/uso terapéutico , Ácido Ascórbico/farmacología , Deficiencia de Ácido Ascórbico/complicaciones , Deficiencia de Ácido Ascórbico/tratamiento farmacológico , Betacoronavirus , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Enfermedad Crítica , Humanos , Estado Nutricional , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/virología , Síndrome Respiratorio Agudo Grave/tratamiento farmacológico , Síndrome Respiratorio Agudo Grave/virología , Vitaminas/farmacología
16.
Maturitas ; 141: 63-70, 2020 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-33036705

RESUMEN

During the last decade, a cascade of evidence has questioned the anti-fracture efficacy of vitamin D supplementation. In general, vitamin D status, reflected by serum 25-hydroxy-vitamin D [25(OH)D] concentrations, seems to predict fracture risk and bone mineral density (BMD). Despite the well-documented detrimental effect of vitamin D deficiency on bones, vitamin D monotherapy does not seem to reduce the risk of fractures. On the other hand, high vitamin D doses, either at monthly (60,000-100,000 IU) or daily intervals (>4000 IU), appear to be harmful with regard to falls, fracture risk and BMD, especially for people without vitamin D deficiency and at low fracture risk. Therefore, a U-shaped effect of vitamin D on the musculoskeletal system may be supported by the current evidence. Vitamin D supplementation could be of value, at daily doses of at least 800 IU, co-supplemented with calcium (1000-1200  mg/day), in elderly populations, especially those with severe vitamin D deficiency [25(OH)D <25-30  nmol/L (<10-12  ng/mL)], although its anti-fracture and anti-fall efficacy is modest. Good compliance and at least 3-5 years of therapy are required.


Asunto(s)
Densidad Ósea/efectos de los fármacos , Fracturas Óseas/prevención & control , Vitamina D/administración & dosificación , Accidentes por Caídas , Anciano , Huesos/efectos de los fármacos , Calcio en la Dieta/administración & dosificación , Suplementos Dietéticos , Fracturas Óseas/etiología , Humanos , Vitamina D/efectos adversos , Vitamina D/análogos & derivados , Deficiencia de Vitamina D/complicaciones , Vitaminas/uso terapéutico
17.
Arch Osteoporos ; 15(1): 154, 2020 10 03.
Artículo en Inglés | MEDLINE | ID: mdl-33009959

RESUMEN

The purpose was to determine if increasing serum 25(OH)D and calcium in postmenopausal women increased skeletal muscle size, strength, balance, and functional task performance while decreasing muscle fatigue. PCSA of the vastus lateralis increased and ascent of stairs time decreased after 6 months of increased serum 25(OH)D. PURPOSE: The Institute of Medicine recommends ≥ 20 ng/ml of serum 25-hydroxyvitamin D [25(OH)D] for bone and overall health. Serum 25(OH)D levels have been associated with physical performance, postural sway, and falls. The purpose of this study was to determine if increasing postmenopausal women's serum 25(OH)D levels from 20-30 ng/ml to 40-50 ng/ml improved skeletal muscle size, strength, balance, and functional performance while decreasing skeletal muscle fatigue. METHODS: Twenty-six post-menopausal women (60-85 years old) with baseline serum 25(OH)D levels between 20 and 30 ng/ml were recruited. Oral over-the-counter (OTC) vitamin D3 and calcium citrate were prescribed to increase subjects' serum 25(OH)D to levels between 40 and 50 ng/ml, serum calcium levels above 9.2 mg/dl, and PTH levels below 60 pg/ml, which were confirmed at 6 and 12 weeks. Outcome measures assessed at baseline and 6 months included muscle physiological cross-sectional area (PCSA), muscle strength, postural balance, time to perform functional tasks, and muscle fatigue. Repeated measures comparisons between baseline and follow-up were performed. RESULTS: Nineteen subjects completed the study. One individual could not afford the time commitment for the repeated measures. Three individuals did not take their vitamin D as recommended. Two subjects were lost to follow-up (lack of interest), and one did not achieve targeted serum 25(OH)D. Vastus lateralis PCSA increased (p = 0.007) and ascent of stair time decreased (p = 0.042) after 6 months of increasing serum 25(OH)D levels from 20-30 ng/ml to 40-50 ng/ml. Isometric strength was unchanged. Anterior-posterior center of pressure (COP) excursion and COP path length decreased (p < 0.1) albeit non-significantly, suggesting balance may improve from increased serum 25(OH)D and calcium citrate levels. CONCLUSIONS: Several measures of muscle structure and function were sensitive to elevated serum 25(OH)D and calcium levels indicating that further investigation of this phenomenon in post-menopausal women is warranted.


Asunto(s)
Citrato de Calcio/administración & dosificación , Calcio/sangre , Colecalciferol/administración & dosificación , Fatiga Muscular/efectos de los fármacos , Fuerza Muscular/efectos de los fármacos , Posmenopausia/sangre , Deficiencia de Vitamina D/prevención & control , Vitamina D/análogos & derivados , Absorciometría de Fotón/métodos , Anciano , Anciano de 80 o más Años , Conservadores de la Densidad Ósea/administración & dosificación , Conservadores de la Densidad Ósea/uso terapéutico , Citrato de Calcio/uso terapéutico , Colecalciferol/uso terapéutico , Relación Dosis-Respuesta a Droga , Femenino , Humanos , Persona de Mediana Edad , Actividad Motora/efectos de los fármacos , Proyectos Piloto , Análisis y Desempeño de Tareas , Resultado del Tratamiento , Vitamina D/sangre , Deficiencia de Vitamina D/sangre , Deficiencia de Vitamina D/tratamiento farmacológico , Vitaminas/administración & dosificación , Vitaminas/uso terapéutico
18.
Medicine (Baltimore) ; 99(40): e22583, 2020 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-33019474

RESUMEN

INTRODUCTION: Henoch-Schönlein purpura (HSP) is an extremely rare condition in patients with pulmonary tuberculosis, with only a few reported cases. Compared to patients with typical clinical symptoms, it is difficult to make a definitive diagnosis when HSP presents as an initial manifestation in pulmonary tuberculosis patients. Herein, a case of pulmonary tuberculosis that showed HSP at first was reported, and the related literatures were reviewed. PATIENT CONCERNS: A 24-year-old man presented with palpable purpura on the extremities, accompanied by abdominal pain, bloody stools, and knee pain. DIAGNOSES: The patient was diagnosed with pulmonary tuberculosis based on the results of interferon gamma release assays, purified protein derivative test, and computed tomography. INTERVENTIONS: The patient was treated with vitamin C and chlorpheniramine for 2 weeks, and the above-mentioned symptoms were relieved. However, 3 weeks later, the purpura recurred with high-grade fever and chest pain during the inspiratory phase. The patient was then treated with anti-tuberculosis drugs, and the purpura as well as the high fever disappeared. OUTCOMES: The patient recovered well and remained free of symptoms during the follow-up examination. CONCLUSION: Pulmonary tuberculosis presenting with HSP as an initial manifestation is not common. Therefore, it is difficult to clinically diagnose and treat this disease. When an adult patient shows HSP, it is important to consider the possibility of tuberculosis to avoid misdiagnosis and delayed treatment.


Asunto(s)
Antituberculosos/uso terapéutico , Púrpura de Schoenlein-Henoch/etiología , Tuberculosis Pulmonar/complicaciones , Tuberculosis Pulmonar/tratamiento farmacológico , Dolor Abdominal/diagnóstico , Dolor Abdominal/etiología , Cuidados Posteriores , Ácido Ascórbico/uso terapéutico , Clorfeniramina/uso terapéutico , Diagnóstico Diferencial , Fiebre/diagnóstico , Fiebre/etiología , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/etiología , Antagonistas de los Receptores Histamínicos H1/uso terapéutico , Humanos , Ensayos de Liberación de Interferón gamma/métodos , Masculino , Púrpura de Schoenlein-Henoch/tratamiento farmacológico , Resultado del Tratamiento , Tuberculina , Tuberculosis Pulmonar/sangre , Tuberculosis Pulmonar/diagnóstico por imagen , Vitaminas/uso terapéutico , Adulto Joven
19.
Nutrients ; 12(10)2020 Sep 29.
Artículo en Inglés | MEDLINE | ID: mdl-33003648

RESUMEN

The third coronavirus outbreak in the last two decades has caused significant damage to the world's economy and community health. The highly contagious COVID-19 infection has affected millions of people to date and has led to hundreds of thousands of deaths worldwide. Aside from the highly infectious nature of SARS-CoV-2, the lack of a treatment or vaccine has been the main reason for its spread. Thus, it has become necessary to find alternative methods for controlling SARS-CoV-2. For the present review, we conducted an online search for different available nutrition-based therapies for previously known coronavirus infections and RNA-based virus infections as well as general antiviral therapies. These treatments have promise for combating COVID-19, as various nutrients and minerals play direct and indirect roles in the control and prevention of this newly emerged viral infection. The patients' nutritional status with COVID-19 must be analyzed before administering any treatment, and nutritional supplements should be given to the affected individuals along with routine treatment. We suggest a potential interventional role of nutrients to strengthen the immune system against the emerging infection caused by COVID-19.


Asunto(s)
Infecciones por Coronavirus/inmunología , Sistema Inmunológico/efectos de los fármacos , Minerales/farmacología , Neumonía Viral/inmunología , Oligoelementos/farmacología , Vitaminas/farmacología , Betacoronavirus , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/virología , Suplementos Dietéticos , Humanos , Sistema Inmunológico/fisiología , Micronutrientes , Minerales/uso terapéutico , Estado Nutricional , Pandemias , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/virología , Síndrome Respiratorio Agudo Grave , Oligoelementos/uso terapéutico , Vitaminas/uso terapéutico
20.
Eur Rev Med Pharmacol Sci ; 24(18): 9721-9738, 2020 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-33015818

RESUMEN

OBJECTIVE: In 2019, an infection provoked by SARS-CoV-2 virus arose in Wuhan, China. Currently, there is still no definite and efficacious therapy for SARS-CoV-2 infection. Moreover, our understanding of the physiopathology of the infection, and risk elements for severity and mortality, is incomplete. PATIENTS AND METHODS: One largely neglected element that could affect prognosis of SARS-CoV-2 infection is the vitamin status of population. The purpose of this review is to evaluate whether a vitamin insufficiency could provoke an augmented risk of SARS-CoV-2 infection or the appearance of major complications. In particular, we evaluated the presence of studies related to the state and effects of vitamin D, C, B, and A in subjects with SARS-CoV-2 disease. RESULTS: Although, actually, the interest in a possible use for vitamin supplementation in SARS-CoV-2 patients is essentially based on indirect data, we tried to examine the evidence about a favorable effect of vitamin supplementation in the therapy of the infection and its complications. CONCLUSIONS: Supplements with vitamin A, B, C, D, and E could represent an inexpensive and sufficiently safe approach, and a useful therapeutic complement. However, solid clinical research data are expected to support such claim.


Asunto(s)
Avitaminosis/complicaciones , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/tratamiento farmacológico , Neumonía Viral/complicaciones , Neumonía Viral/tratamiento farmacológico , Vitaminas/uso terapéutico , Betacoronavirus , Infecciones por Coronavirus/diagnóstico , Humanos , Pandemias , Neumonía Viral/diagnóstico , Pronóstico , Factores de Riesgo
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