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M Hassen B, Rashedy SH, Mostafa A, Mahrous N, Nafie MS, Elebeedy D, Abdel Azeiz AZ. Identification of potential antiviral compounds from Egyptian marine algae against influenza A virus. Nat Prod Res 2024; 38:4411-4418. [PMID: 37990847 DOI: 10.1080/14786419.2023.2284865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 11/01/2023] [Accepted: 11/12/2023] [Indexed: 11/23/2023]
Abstract
Influenza is a contagious viral infection of the respiratory tract, affecting nearly 10% of the world's population, each year. The aim of this study was to extract and identify antiviral compounds against the influenza-A virus (H1N1) from different species of Egyptian marine algae. Three samples of marine macroalgae species were extracted and the antiviral activity of the extracts were tested on Madin Darby Canine Kidney cells. The bioactive compounds present in the most active fractions were identified using gas chromatography-mass spectrometry (GC-MS), then the binding potentials of the identified compounds were examined towards neuraminidase (NA) of the influenza-A virus using molecular docking. The methanolic extract of Sargassum aquifolium showed promising in-vitro antiviral activity with a selectivity index (SI) value of 101. The GC-MS analysis showed twelve compounds and the molecular docking analysis found that tetradecanoic acid showed the strongest binding affinities towards the NA enzyme.
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Affiliation(s)
- Bassel M Hassen
- College of Biotechnology, Misr University for Science and Technology (MUST), 6th of October, Egypt
| | - Sarah H Rashedy
- National Institute of Oceanography and Fisheries (NIOF), Cairo, Egypt
| | - Ahmed Mostafa
- Center of Scientific Excellence for Influenza Viruses, National Research Centre, Giza, Egypt
| | - Noura Mahrous
- Center of Scientific Excellence for Influenza Viruses, National Research Centre, Giza, Egypt
| | - Mohamed S Nafie
- Chemistry Department, Faculty of Science, Suez Canal University, Ismailia, Egypt
| | - Dalia Elebeedy
- College of Biotechnology, Misr University for Science and Technology (MUST), 6th of October, Egypt
| | - A Z Abdel Azeiz
- College of Biotechnology, Misr University for Science and Technology (MUST), 6th of October, Egypt
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Engin MMN, Özdemir Ö. Role of vitamin D in COVID-19 and other viral infections. World J Virol 2024; 13:95349. [PMID: 39323448 PMCID: PMC11401007 DOI: 10.5501/wjv.v13.i3.95349] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 06/14/2024] [Accepted: 07/19/2024] [Indexed: 08/29/2024] Open
Abstract
Vitamin D is a steroid hormone that is naturally produced in the body or obtained through dietary sources, primarily under the influence of UVB radiation. This essential nutrient has a vital role in numerous physiological processes, encompassing immune function, cell growth, differentiation, insulin regulation, and cardiovascular well-being, along with its pivotal role in sustaining the delicate equilibrium of calcium and phosphate concentrations in the body. Moreover, vitamin D reinforces mucosal defense and bolsters the immune system through immunomodulation, making it a critical component of overall health. Numerous studies have unveiled the profound connection between vitamin D and the predisposition to respiratory tract infections, including well-known viruses such as influenza and the novel severe acute respiratory syndrome coronavirus 2. Vitamin D deficiency has been consistently linked to increased severity of coronavirus disease 2019 (COVID-19) and a heightened risk of mortality among afflicted individuals. Retrospective observational studies have further substantiated these findings, indicating that levels of vitamin D are linked with both the occurrence and severity of COVID-19 cases. Vitamin D has its influence on viral infections through a multitude of mechanisms, such as promoting the release of antimicrobial peptides and fine-tuning the responses of the immune system. Additionally, vitamin D is intertwined with the intricate network of the renin-angiotensin system, suggesting a potential impact on the development of complications related to COVID-19. While further clinical trials and extensive research are warranted, the existing body of evidence strongly hints at the possible use of vitamin D as a valuable tool in the prophylaxis and management of COVID-19 and other viral infectious diseases.
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Affiliation(s)
| | - Öner Özdemir
- Division of Allergy and Immunology, Department of Pediatrics, Sakarya Research and Training Hospital, Sakarya University, Faculty of Medicine, Sakarya 54100, Türkiye
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Al-Hadithy BE, Salih BO, Anber ZNH, Al-Hadad NS. Evaluation of normal range of serum 25 hydroxyvitamin d in iraqi healthy adults: demographic and socioeconomic effects. POLSKI MERKURIUSZ LEKARSKI : ORGAN POLSKIEGO TOWARZYSTWA LEKARSKIEGO 2024; 52:208-215. [PMID: 38642357 DOI: 10.36740/merkur202402110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/22/2024]
Abstract
OBJECTIVE Aim: To determine the normal range of serum levels of total 25(OH)VD in Iraqi healthy adult subjects and to relate its level with demographic profile and socioeconomic status.. PATIENTS AND METHODS Materials and Methods: This cross sectional study was carried out at Iraq and the samples were collected during the period from August 2019 to January 2020. It included 649 adult subjects apparently healthy, from three governorates (Baghdad, Al-Anbar and Al-Basrah), Investigations included serum measurement of total 25(OH)D in all included individuals by using ELISA technique. Age, gender, marital state, blood pressure, smoking, sunshine exposure (%), hours of exposure/day, percentage of body surface area exposed, body mass index (BMI) subgroups, waist circumference (WC) subgroups, diet type, sport type and time, geographic factor (governorate) were measured and / or calculated and the levels of 25(OH)D were studied according to each of these factors. RESULTS Results: The mean ± SD level of 25(OH)D in total (n=649) studied Iraqi subjects was (16.29 ± 8.22 ng/ml), with women were significantly deficient than men (15.76 ± 6.89 ng/ml, 17.14 ± 6.85 ng/ml; p < 0.01 respectively). However, there was no significant differences in mean values of serum 25(OH)D levels among studied governorates, subgroups of BMI, WC, marital status, smokers and nonsmoker and subgroups of age. The mean value of serum 25(OH)D was found to be decreased in January, October and November as well as according to diet and sport types. There was significant positive correlation between total 25(OH)D and sun exposed surface area, sun exposure duration and with sun exposure area. CONCLUSION Conclusions: The mean (±SD) value of serum total 25(OH)D in Iraqi healthy subjects was 16.29 ng/ml (±8.22) reflecting the actual body status of this vitamin with lower concentration in women than in men. Type and time of sport and diet type were the major vitamin D dependent factors.
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Murari A, Gelfusa M, Craciunescu T, Gelfusa C, Gaudio P, Bovesecchi G, Rossi R. Effects of environmental conditions on COVID-19 morbidity as an example of multicausality: a multi-city case study in Italy. Front Public Health 2023; 11:1222389. [PMID: 37965519 PMCID: PMC10642182 DOI: 10.3389/fpubh.2023.1222389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 10/06/2023] [Indexed: 11/16/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), broke out in December 2019 in Wuhan city, in the Hubei province of China. Since then, it has spread practically all over the world, disrupting many human activities. In temperate climates overwhelming evidence indicates that its incidence increases significantly during the cold season. Italy was one of the first nations, in which COVID-19 reached epidemic proportions, already at the beginning of 2020. There is therefore enough data to perform a systematic investigation of the correlation between the spread of the virus and the environmental conditions. The objective of this study is the investigation of the relationship between the virus diffusion and the weather, including temperature, wind, humidity and air quality, before the rollout of any vaccine and including rapid variation of the pollutants (not only their long term effects as reported in the literature). Regarding them methodology, given the complexity of the problem and the sparse data, robust statistical tools based on ranking (Spearman and Kendall correlation coefficients) and innovative dynamical system analysis techniques (recurrence plots) have been deployed to disentangle the different influences. In terms of results, the evidence indicates that, even if temperature plays a fundamental role, the morbidity of COVID-19 depends also on other factors. At the aggregate level of major cities, air pollution and the environmental quantities affecting it, particularly the wind intensity, have no negligible effect. This evidence should motivate a rethinking of the public policies related to the containment of this type of airborne infectious diseases, particularly information gathering and traffic management.
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Affiliation(s)
- Andrea Murari
- Consorzio RFX (CNR, ENEA, INFN, Università di Padova, Acciaierie Venete SpA), Padua, Italy
- Istituto per la Scienza e la Tecnologia dei Plasmi, CNR, Padua, Italy
| | - Michela Gelfusa
- Department of Industrial Engineering, University of Rome “Tor Vergata”, Rome, Italy
| | - Teddy Craciunescu
- National Institute for Laser, Plasma and Radiation Physics, Măgurele, Romania
| | - Claudio Gelfusa
- Department of Industrial Engineering, University of Rome “Tor Vergata”, Rome, Italy
| | - Pasquale Gaudio
- Department of Industrial Engineering, University of Rome “Tor Vergata”, Rome, Italy
| | - Gianluigi Bovesecchi
- Department of Enterprise Engineering, University of Rome “Tor Vergata”, Rome, Italy
| | - Riccardo Rossi
- Department of Industrial Engineering, University of Rome “Tor Vergata”, Rome, Italy
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Zhu Z, Yang X, Huang C, Liu L. The Interferon-Induced Protein with Tetratricopeptide Repeats Repress Influenza Virus Infection by Inhibiting Viral RNA Synthesis. Viruses 2023; 15:1412. [PMID: 37515100 PMCID: PMC10384122 DOI: 10.3390/v15071412] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/14/2023] [Accepted: 06/16/2023] [Indexed: 07/30/2023] Open
Abstract
Influenza A virus (IAV) is an eight-segment negative-sense RNA virus and is subjected to gene recombination between strains to form novel strains, which may lead to influenza pandemics. Seasonal influenza occurs annually and causes great losses in public healthcare. In this study, we examined the role of interferon-induced protein with tetratricopeptide repeats 1 and 2 (IFIT1 and IFIT2) in influenza virus infection. Knockdown of IFIT1 or IFIT2 using a lentiviral shRNA increased viral nucleoprotein (NP) and nonstructural protein 1 (NS1) protein levels, as well as progeny virus production in A/Puerto Rico/8/34 H1N1 (PR/8)-infected lung epithelial A549 cells. Overexpression of IFIT1 or IFIT2 reduced viral NP and NS1 RNA and protein levels in PR/8-infected HEK293 cells. Overexpression of IFIT1 or IFIT2 also inhibited influenza virus infection of various H1N1 strains, including PR/8, A/WSN/1933, A/California/07/2009 and A/Oklahoma/3052/2009, as determined by a viral reporter luciferase assay. Furthermore, knockdown of IFIT1 or IFIT2 increased while overexpression of IFIT1 or IFIT2 decreased viral RNA, complementary RNA, and mRNA levels of NP and NS1, as well as viral polymerase activities. Taken together, our results support that both IFIT1 and -2 have anti-influenza virus activities by inhibiting viral RNA synthesis.
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Affiliation(s)
- Zhengyu Zhu
- The Lundberg-Kienlen Lung Biology and Toxicology Laboratory, Department of Physiological Sciences, Oklahoma State University, Stillwater, OK 74078, USA; (Z.Z.); (X.Y.); (C.H.)
- Oklahoma Center for Respiratory and Infectious Diseases, Oklahoma State University, Stillwater, OK 74078, USA
| | - Xiaoyun Yang
- The Lundberg-Kienlen Lung Biology and Toxicology Laboratory, Department of Physiological Sciences, Oklahoma State University, Stillwater, OK 74078, USA; (Z.Z.); (X.Y.); (C.H.)
- Oklahoma Center for Respiratory and Infectious Diseases, Oklahoma State University, Stillwater, OK 74078, USA
| | - Chaoqun Huang
- The Lundberg-Kienlen Lung Biology and Toxicology Laboratory, Department of Physiological Sciences, Oklahoma State University, Stillwater, OK 74078, USA; (Z.Z.); (X.Y.); (C.H.)
- Oklahoma Center for Respiratory and Infectious Diseases, Oklahoma State University, Stillwater, OK 74078, USA
| | - Lin Liu
- The Lundberg-Kienlen Lung Biology and Toxicology Laboratory, Department of Physiological Sciences, Oklahoma State University, Stillwater, OK 74078, USA; (Z.Z.); (X.Y.); (C.H.)
- Oklahoma Center for Respiratory and Infectious Diseases, Oklahoma State University, Stillwater, OK 74078, USA
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Zhang R, Li Y, Bi P, Wu S, Peng Z, Meng Y, Wang Y, Wang S, Huang Y, Liang J, Wu J. Seasonal associations between air pollutants and influenza in 10 cities of southern China. Int J Hyg Environ Health 2023; 252:114200. [PMID: 37329817 DOI: 10.1016/j.ijheh.2023.114200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 05/20/2023] [Accepted: 06/05/2023] [Indexed: 06/19/2023]
Abstract
Few studies have explored the associations between air pollutants and influenza across seasons, especially at large scales. This study aimed to evaluate seasons' modifying effects on associations between air pollutants and influenza from 10 cities of southern China. Through scientific evidence, it provides mitigation and adaptation strategies with practical guidelines to local health authorities and environmental protection agencies. Daily influenza incidence, meteorological, and air pollutants data from 2016 to 2019 were collected. Quasi-Poisson regression with a distributed lag nonlinear model was used to evaluate city-specific air pollutants and influenza associations. Meta-analysis was used to pool site-specific estimates. Attributable fractions (AFs) of influenza incidence due to pollutants were calculated. Stratified analyses were conducted by season, sex, and age. Overall, the cumulative relative risk (CRR) of influenza incidence for a 10-unit increase in PM2.5, PM10, SO2, NO2, and CO was 1.45 (95% CI: 1.25, 1.68), 1.53 (95% CI: 1.29, 1.81), 1.87 (95% CI: 1.40, 2.48), 1.74 (95% CI: 1.49, 2.03), and 1.19 (95% CI: 1.04, 1.36), respectively. Children aged 0-17 were more sensitive to air pollutants in spring and winter. PM10 had greater effect on influenza than PM2.5 in autumn, winter, and overall, lesser in spring. The overall AF due to PM2.5, PM10, SO2, NO2, and CO was 4.46% (95% eCI: 2.43%, 6.43%), 5.03% (95% eCI: 2.33%, 7.56%), 5.36% (95% eCI: 3.12%, 7.58%), 24.88% (95% eCI: 18.02%, 31.67%), and 23.22% (95% eCI: 17.56%, 28.61%), respectively. AF due to O3 was 10.00% (95% eCI: 4.76%, 14.95%) and 3.65% (95% eCI: 0.50%, 6.59%) in spring and summer, respectively. The seasonal variations in the associations between air pollutants and influenza in southern China would provide evidence to service providers for tailored intervention, especially for vulnerable populations.
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Affiliation(s)
- Rui Zhang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China; Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yonghong Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peng Bi
- School of Public Health, The University of Adelaide, South Australia, Australia
| | - Siyuan Wu
- Sprott School of Business, Carleton University, Ottawa Ontario, Canada
| | - Zhibin Peng
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yujie Meng
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yu Wang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Songwang Wang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yushu Huang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Juan Liang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jing Wu
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China; Chinese Center for Disease Control and Prevention, Beijing, China.
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Zheleznichenko T, Voronkova M, Asbaganov S, Kukushkina T, Filippova E, Protsenko M, Mazurkova N, Novikova T. Impact of different Agrobacterium rhizogenes strains on secondary metabolites accumulation in Nitraria schoberi L. hairy roots and antiviral activity of their extracts against influenza virus of subtypes A (H5N1) and A (H3N2). IN VITRO CELLULAR & DEVELOPMENTAL BIOLOGY. PLANT : JOURNAL OF THE TISSUE CULTURE ASSOCIATION 2023; 59:1-15. [PMID: 37363438 PMCID: PMC10101541 DOI: 10.1007/s11627-023-10343-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Accepted: 03/20/2023] [Indexed: 06/28/2023]
Abstract
To optimize protocol for obtaining hairy roots of Nitraria schoberi L. with high antiviral activities, factors such as four strain types of Agrobacterium rhizogenes (A4, ATCC15834, R-1601, 8196), two explant types, namely cotyledonous and primary leaves of seedlings, and different cultivation durations (30 and 90 d) were studied. The formation of hairy roots was observed after 2 to 4 wk of incubation, depending on the type of explant and the strain of A. rhizogenes used. The maximum transformation frequency (85.7%) was observed in the cotyledons genetically modified with the strain ATCC15834. The transgenic nature of hairy roots was revealed by PCR with primers to the Agrobacterium oncogenes rolB and rolC. The absence of contamination of the culture by A. rhizogenes was confirmed by primers to the virC and virD1 genes. Phytochemical analysis showed that accumulation of individual metabolites in the line samples exceeded their levels in the native Nitraria roots. Catechin content in the cultures of long-term cultivation (90 d) was found 1.4 to 2.2 times higher than the same samples of short cultivation (30 d) and 4.8 to 10.8 times higher in comparison with the native roots. The most productive in terms of catechin level were hairy roots of long-term cultivation obtained during the transformation of primary leaves of N. schoberi seedlings with ATCC15834 strain. These data were consistent with the highest antiviral activities against influenza viruses of A (H5N1) and A (H3N2) subtypes with neutralization indexes 6.5 to 6.75 log10, and selectivity index values were in the range 15.4 to 16.4.
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Affiliation(s)
- Tatiana Zheleznichenko
- Central Siberian Botanical Garden of the Siberian Branch of the Russian Academy of Sciences, Zolotodolinskaya, 101, 630090 Novosibirsk, Russian Federation
- Novosibirsk State University, Pirogova 2, 630090 Novosibirsk, Russian Federation
| | - Mariya Voronkova
- Central Siberian Botanical Garden of the Siberian Branch of the Russian Academy of Sciences, Zolotodolinskaya, 101, 630090 Novosibirsk, Russian Federation
| | - Sergey Asbaganov
- Central Siberian Botanical Garden of the Siberian Branch of the Russian Academy of Sciences, Zolotodolinskaya, 101, 630090 Novosibirsk, Russian Federation
| | - Tatyana Kukushkina
- Central Siberian Botanical Garden of the Siberian Branch of the Russian Academy of Sciences, Zolotodolinskaya, 101, 630090 Novosibirsk, Russian Federation
| | - Ekaterina Filippova
- State Research Center of Virology and Biotechnology “VECTOR” 630559, Koltsovo, Novosibirsk Region, Russian Federation
| | - Mariya Protsenko
- State Research Center of Virology and Biotechnology “VECTOR” 630559, Koltsovo, Novosibirsk Region, Russian Federation
| | - Natalya Mazurkova
- State Research Center of Virology and Biotechnology “VECTOR” 630559, Koltsovo, Novosibirsk Region, Russian Federation
| | - Tatyana Novikova
- Central Siberian Botanical Garden of the Siberian Branch of the Russian Academy of Sciences, Zolotodolinskaya, 101, 630090 Novosibirsk, Russian Federation
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Lagathu G, Grolhier C, Besombes J, Maillard A, Comacle P, Pronier C, Thibault V. Using Discarded Facial Tissues to Monitor and Diagnose Viral Respiratory Infections. Emerg Infect Dis 2023; 29:511-518. [PMID: 36787721 PMCID: PMC9973701 DOI: 10.3201/eid2903.221416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
Molecular biology amplification enables sensitive detection of most respiratory viruses through nasopharyngeal swabbing. We developed an innovative approach to detect viral genomes on used facial tissues. In 2 communities of children, used tissues were collected once weekly for 1 year. Pooled analysis of tissues enabled detection of successive virus circulation in 4 age groups over time and forecasted by several weeks the circulation of influenza in the general population. At the individual level, in a proof-of-concept study of 30 volunteers with influenza-like signs/symptoms, we identified common respiratory viruses. The signals for SARS-CoV-2 obtained in parallel from 15 facial tissues and swab samples were similar and often higher for the tissues (11/15). Individual analysis of tissues offers a noninvasive, sensitive, and affordable alternative to self-sampling without a medical care requirement. Pooled analyses may be used to detect virus spread in specific communities, predict seasonal epidemics, and alert the population to viral infections.
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Du M, Zhu H, Yin X, Ke T, Gu Y, Li S, Li Y, Zheng G. Exploration of influenza incidence prediction model based on meteorological factors in Lanzhou, China, 2014-2017. PLoS One 2022; 17:e0277045. [PMID: 36520836 PMCID: PMC9754291 DOI: 10.1371/journal.pone.0277045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 10/19/2022] [Indexed: 12/23/2022] Open
Abstract
Humans are susceptible to influenza. The influenza virus spreads quickly and behave seasonally. The seasonality and spread of influenza are often associated with meteorological factors and have spatio-temporal differences. Based on the influenza cases and daily average meteorological factors in Lanzhou from 2014 to 2017, this study firstly aimed to analyze the characteristics of influenza incidence in Lanzhou and the impact of meteorological factors on influenza activities. Then, SARIMA(X) models for the prediction were established. The influenza cases in Lanzhou from 2014 to 2017 was more male than female, and the younger the age, the higher the susceptibility; the epidemic characteristics showed that there is a peak in winter, a secondary peak in spring, and a trough in summer and autumn. The influenza cases in Lanzhou increased with increasing daily pressure, decreasing precipitation, average relative humidity, hours of sunshine, average daily temperature and average daily wind speed. Low temperature was a significant driving factor for the increase of transmission intensity of seasonal influenza. The SARIMAX (1,0,0)(1,0,1)[12] multivariable model with average temperature has better prediction performance than the university model. This model is helpful to establish an early warning system, and provide important evidence for the development of influenza control policies and public health interventions.
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Affiliation(s)
- Meixia Du
- School of Public Health, Gansu University of Chinese Medicine, Gansu Lanzhou, China
- Gansu Provincial Cancer Hospital, Gansu Lanzhou, China
| | - Hai Zhu
- School of Public Health, Gansu University of Chinese Medicine, Gansu Lanzhou, China
| | - Xiaochun Yin
- School of Public Health, Gansu University of Chinese Medicine, Gansu Lanzhou, China
- The Collaborative Innovation Center for Prevention and Control by Chinese Medicine on Disease Related Northwestern Environment and Nutrition, Gansu Lanzhou, China
- * E-mail: (XY); (SL)
| | - Ting Ke
- School of Public Health, Gansu University of Chinese Medicine, Gansu Lanzhou, China
| | - Yonge Gu
- School of Public Health, Gansu University of Chinese Medicine, Gansu Lanzhou, China
- The Collaborative Innovation Center for Prevention and Control by Chinese Medicine on Disease Related Northwestern Environment and Nutrition, Gansu Lanzhou, China
| | - Sheng Li
- First People’s Hospital of Lanzhou City, Gansu Lanzhou, China
- * E-mail: (XY); (SL)
| | - Yongjun Li
- Gansu Provincial Center for Disease Control and Prevention, Gansu Lanzhou, China
| | - Guisen Zheng
- School of Public Health, Gansu University of Chinese Medicine, Gansu Lanzhou, China
- The Collaborative Innovation Center for Prevention and Control by Chinese Medicine on Disease Related Northwestern Environment and Nutrition, Gansu Lanzhou, China
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10
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Mishra P, Parveen R, Bajpai R, Agarwal N. Vitamin D Deficiency and Comorbidities as Risk Factors of COVID-19 Infection: A Systematic Review and Meta-analysis. J Prev Med Public Health 2022; 55:321-333. [PMID: 35940187 PMCID: PMC9371781 DOI: 10.3961/jpmph.21.640] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 05/09/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES Extensive evidence links low vitamin D status and comorbidities with coronavirus disease 2019 (COVID-19) outcomes, but the results of published studies are contradictory. Therefore, we investigated the association of lower levels of vitamin D and comorbidities with the risk of COVID-19 infection. METHODS We searched MEDLINE (via PubMed), Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov for articles published until August 20, 2021. Sixteen eligible studies were identified (386 631 patients, of whom 181 114 were male). We included observational cohort and case-control studies that evaluated serum levels of vitamin D in COVID-19-positive and COVID-19-negative patients. Mean differences (MDs) with 95% confidence intervals (CIs) were calculated. RESULTS Significantly lower vitamin D levels were found in COVID-19-positive patients (MD, -1.70; 95% CI, -2.74 to -0.66; p=0.001), but with variation by study design (case-control: -4.04; 95% CI, -5.98 to -2.10; p<0.001; cohort: -0.39; 95% CI, -1.62 to 0.84; p=0.538). This relationship was more prominent in female patients (MD, -2.18; 95% CI, -4.08 to -0.28; p=0.024) than in male patients (MD, -1.74; 95% CI, -3.79 to 0.31; p=0.096). Male patients showed higher odds of having low vitamin D levels (odds ratio [OR], 2.09; 95% CI, 1.38 to 3.17; p<0.001) than female patients (OR, 1.17; 95% CI, 0.74 to 1.86; p=0.477). Comorbidities showed inconsistent, but generally non-significant, associations with COVID-19 infection. CONCLUSIONS Low serum vitamin-D levels were significantly associated with the risk of COVID-19 infection. This relationship was stronger in female than in male COVID-19 patients. Limited evidence was found for the relationships between comorbidities and COVID-19 infection, warranting large population-based studies to clarify these associations.
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Affiliation(s)
- Pinki Mishra
- Centre for Translational and Clinical Research, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi,
India
| | - Rizwana Parveen
- Centre for Translational and Clinical Research, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi,
India
| | - Ram Bajpai
- School of Medicine, Keele University, Staffordshire,
UK
| | - Nidhi Agarwal
- Centre for Translational and Clinical Research, School of Chemical and Life Sciences, Jamia Hamdard, New Delhi,
India
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Abstract
PURPOSE OF REVIEW To review the mechanisms by which vitamin D and its metabolites regulate the immune system to facilitate the ability of the body to prevent and/or treat SARS-CoV2 and other respiratory infections and encourage further research into the role that vitamin D supplementation plays in preventing/treating such infections. RECENT FINDINGS Vitamin D deficiency is associated with an increased risk of SARS-CoV2 and other respiratory infections. Clinical trials in general demonstrate that correction of vitamin D deficiency reduces the risk of hospitalization, ICU admission, and death from SARS-CoV2 infection. The airway epithelium and alveolar macrophages express the enzyme, CYP27B1, that produces the active metabolite of vitamin D, 1,25(OH)2D, and the vitamin D receptor, VDR. Vitamin D and its metabolites promote the innate immune response, which provides the first line of defense against viral and bacterial infections while restricting the adaptive immune response, which if unchecked promotes the inflammatory response leading to the acute respiratory distress syndrome and death. The rationale for treating vitamin D deficiency to reduce the risk of SARS-CoV2 infection and supplementing patients with vitamin D early in the course of SARS-CoV2 infection rests primarily on the ability of vitamin D metabolites to promote an effective immune response to the infection.
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Affiliation(s)
- Daniel D Bikle
- Veterans Affairs Medical Center, University of California San Francisco, 1700 Owens St, San Francisco, CA, 94158, USA.
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12
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Cross-reactive immunity potentially drives global oscillation and opposed alternation patterns of seasonal influenza A viruses. Sci Rep 2022; 12:8883. [PMID: 35614123 PMCID: PMC9131982 DOI: 10.1038/s41598-022-08233-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 03/02/2022] [Indexed: 11/08/2022] Open
Abstract
Several human pathogens exhibit distinct patterns of seasonality and circulate as pairs. For instance, influenza A virus subtypes oscillate and peak during winter seasons of the world’s temperate climate zones. Alternation of dominant strains in successive influenza seasons makes epidemic forecasting a major challenge. From the start of the 2009 influenza pandemic we enrolled influenza A virus infected patients (n = 2980) in a global prospective clinical study. Complete hemagglutinin sequences were obtained from 1078 A/H1N1 and 1033 A/H3N2 viruses. We used phylodynamics to construct high resolution spatio-temporal phylogenetic hemagglutinin trees and estimated global influenza A effective reproductive numbers (R) over time (2009–2013). We demonstrate that R oscillates around R = 1 with a clear opposed alternation pattern between phases of the A/H1N1 and A/H3N2 subtypes. Moreover, we find a similar alternation pattern for the number of global viral spread between the sampled geographical locations. Both observations suggest a between-strain competition for susceptible hosts on a global level. Extrinsic factors that affect person-to-person transmission are a major driver of influenza seasonality. The data presented here indicate that cross-reactive host immunity is also a key intrinsic driver of influenza seasonality, which determines the influenza A virus strain at the onset of each epidemic season.
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13
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Rethinking Outdoor Courtyard Spaces on University Campuses to Enhance Health and Wellbeing: The Anti-Virus Built Environment. SUSTAINABILITY 2022. [DOI: 10.3390/su14095602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Responding to the events surrounding the COVID-19 pandemic, this study explores how to improve health and wellbeing and reduce infections in outdoor open spaces on university campuses to maximize their potential as a response to future crises. The study identifies the relationship between human behavior (social) and the various physical and environmental elements of these spaces. A case study and mixed-methods approach were undertaken, comprising four modes of inspection: user analysis layer using questionnaires and observations to survey students’ needs and behavior; context analysis layer using space syntax and CFD to examine the space’s physical and environmental conditions; design solutions reflecting an understanding of virus transmission; and a performance analysis layer to test the performance of ‘anti-virus’ courtyards. The findings demonstrated that students are willing to use the open spaces that they used before the pandemic, at the same frequency. This indicates a need to redesign the current spaces to prevent the spread of viruses. The study highlights the social, physical, and environmental implications to be considered in designs for outdoor anti-virus spaces. It provides a comprehensive process for transforming outdoor spaces on university campuses into anti-virus spaces that meet users’ needs. These findings have implications for the designing and retrofitting of open spaces to reduce infection.
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14
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Abstract
Covid-19 has to date infected a confirmed 275 million people with 5.4 million, now dead, with the count rising every day. Although the virus, SARS-CoV2, causing Covid-19 infects many cells in the body, its infection of the upper and lower respiratory tract (upper airway epithelia and pulmonary alveolar pneumocytes and macrophages) causing what is now called a cytokine storm in the lungs is the major cause of morbidity and mortality. This results from a dysregulation of the innate immune system with an outpouring of proinflammatory cytokines and chemokines leading to abnormal activation of the adaptive immune pathway. Airway epithelia constitutively expresses CYP27B1, the enzyme producing the active vitamin D metabolite, 1,25(OH)2D, and the vitamin D receptor (VDR) for which 1,25(OH)2D is the ligand. Pulmonary alveolar macrophages, on the other hand, are induced to express both CYP27B1 and VDR by various pathogens including viruses and cytokines released from infected epithelia and other immune cells. Although not demonstrated for corona viruses like SARS-CoV2, for other viruses and other respiratory pathogens activation of innate immunity leading to increased local 1,25(OH)2D production has been shown to enhance viral neutralization and clearance while modulating the subsequent proinflammatory response. Whether such will be the case for SARS-CoV2 remains to be seen, but is currently being proposed and investigated. This mini review will discuss some of the mechanisms by which vitamin D may help reduce morbidity and mortality in this devastating pandemic.
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Affiliation(s)
- Daniel D Bikle
- Veterans Affairs Medical Center and University of California San Francisco, 4150 Clement Street (111N), San Francisco, CA, 94121, USA.
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15
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Singh S, Singh CM, Ranjan A, Kumar S, Singh DK. Evidences suggesting a possible role of Vitamin D in COVID 19: The missing link. Indian J Pharmacol 2021; 53:394-402. [PMID: 34854410 PMCID: PMC8641745 DOI: 10.4103/ijp.ijp_654_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 is spreading like wildfire with no specific recommended treatment in sight. While some risk factors such as the presence of comorbidities, old age, and ethnicity have been recognized, not a lot is known about who the virus will strike first or impact more. In this hopeless scenario, exploration of time-tested facts about viral infections, in general, seems to be a sound basis to prop further research upon. The fact that immunity and its various determinants (e.g., micronutrients, sleep, and hygiene) have a crucial role to play in the defense against invading organisms, may be a good starting point for commencing research into these as yet undisclosed territories. Herein, the excellent immunomodulatory, antiviral, and anti-inflammatory roles of Vitamin D necessitate thorough investigation, particularly in COVID-19 perspective. This article reviews mechanisms and evidence suggesting the role Vitamin D plays in people infected by the newly identified COVID-19 virus. For this review, we searched the databases of Medline, PubMed, and Embase. We studied several meta-analyses and randomized controlled trials evaluating the role of Vitamin D in influenza and other contagious viral infections. We also reviewed the circumstantial and anecdotal evidence connecting Vitamin D with COVID-19 emerging recently. Consequently, it seems logical to conclude that the immune-enhancing, antiviral, anti-inflammatory, and lung-protective role of Vitamin D can be potentially lifesaving. Hence, Vitamin D deserves exhaustive exploration through rigorously designed and controlled scientific trials. Using Vitamin D as prophylaxis and/or chemotherapeutic treatment of COVID-19 infection is an approach worth considering. In this regard, mass assessment and subsequent supplementation can be tried, especially considering the mechanistic evidence in respiratory infections, low potential for toxicity, and widespread prevalence of the deficiency of Vitamin D affecting many people worldwide.
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Affiliation(s)
- Shruti Singh
- Department of Pharmacology, All India Institute of Medical Sciences, Patna, Bihar, India
| | - C M Singh
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Alok Ranjan
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Sanjeev Kumar
- Department of CTVS, All India Institute of Medical Sciences, Patna, Bihar, India
| | - Dheeraj Kumar Singh
- Department of Pharmacology, All India Institute of Medical Sciences, Patna, Bihar, India
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16
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Maganeva IS, Gorbacheva AM, Bibik EE, Aboisheva EA, Eremkina AK, Mokrysheva NG. Mineral metabolism and COVID-19: is there a connection? TERAPEVT ARKH 2021; 93:1227-1233. [DOI: 10.26442/00403660.2021.10.201114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 11/05/2021] [Indexed: 11/22/2022]
Abstract
Due to global spread of COVID-19, the search for new factors that could influence its clinical course becomes highly important. This review summarize the relevant publications on the association between immune system and the main regulators of mineral homeostasis including. In addition, we have highlighted the various aspects of phosphorus-calcium metabolism related to the acute respiratory diseases and in particular to COVID-19. The data about the calcium-phosphorus metabolism in SARS-CoV-2 infection is required to understand the possible clinical implications and to develop new therapeutic and preventive interventions.
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17
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Fiorino S, Tateo F, Biase DD, Gallo CG, Orlandi PE, Corazza I, Budriesi R, Micucci M, Visani M, Loggi E, Hong W, Pica R, Lari F, Zippi M. SARS-CoV-2: lessons from both the history of medicine and from the biological behavior of other well-known viruses. Future Microbiol 2021; 16:1105-1133. [PMID: 34468163 PMCID: PMC8412036 DOI: 10.2217/fmb-2021-0064] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 07/22/2021] [Indexed: 02/07/2023] Open
Abstract
SARS-CoV-2 is the etiological agent of the current pandemic worldwide and its associated disease COVID-19. In this review, we have analyzed SARS-CoV-2 characteristics and those ones of other well-known RNA viruses viz. HIV, HCV and Influenza viruses, collecting their historical data, clinical manifestations and pathogenetic mechanisms. The aim of the work is obtaining useful insights and lessons for a better understanding of SARS-CoV-2. These pathogens present a distinct mode of transmission, as SARS-CoV-2 and Influenza viruses are airborne, whereas HIV and HCV are bloodborne. However, these viruses exhibit some potential similar clinical manifestations and pathogenetic mechanisms and their understanding may contribute to establishing preventive measures and new therapies against SARS-CoV-2.
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Affiliation(s)
- Sirio Fiorino
- Internal Medicine Unit, Budrio Hospital, Budrio (Bologna), Azienda USL, Bologna, 40054, Italy
| | - Fabio Tateo
- Institute of Geosciences & Earth Resources, CNR, c/o Department of Geosciences, Padova University, 35127, Italy
| | - Dario De Biase
- Department of Pharmacy & Biotechnology, University of Bologna, Bologna, 40126, Italy
| | - Claudio G Gallo
- Fisiolaserterapico Emiliano, Castel San Pietro Terme, Bologna, 40024, Italy
| | | | - Ivan Corazza
- Department of Experimental, Diagnostic & Specialty Medicine, University of Bologna, Bologna, 40126, Italy
| | - Roberta Budriesi
- Department of Pharmacy & Biotechnology, Alma Mater Studiorum-University of Bologna, Bologna, 40126, Italy
| | - Matteo Micucci
- Department of Pharmacy & Biotechnology, Alma Mater Studiorum-University of Bologna, Bologna, 40126, Italy
| | - Michela Visani
- Department of Pharmacy & Biotechnology, University of Bologna, Bologna, 40126, Italy
| | - Elisabetta Loggi
- Hepatology Unit, Department of Medical & Surgical Sciences, University of Bologna, Bologna, 40126, Italy
| | - Wandong Hong
- Department of Gastroenterology & Hepatology, First Affiliated Hospital of Wenzhou Medical University, Wenzhou City, Zhejiang, 325035, PR China
| | - Roberta Pica
- Unit of Gastroenterology & Digestive Endoscopy, Sandro Pertini Hospital, Rome, 00157, Italy
| | - Federico Lari
- Internal Medicine Unit, Budrio Hospital, Budrio (Bologna), Azienda USL, Bologna, 40054, Italy
| | - Maddalena Zippi
- Unit of Gastroenterology & Digestive Endoscopy, Sandro Pertini Hospital, Rome, 00157, Italy
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18
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Taha R, Abureesh S, Alghamdi S, Hassan RY, Cheikh MM, Bagabir RA, Almoallim H, Abdulkhaliq A. The Relationship Between Vitamin D and Infections Including COVID-19: Any Hopes? Int J Gen Med 2021; 14:3849-3870. [PMID: 34335050 PMCID: PMC8318784 DOI: 10.2147/ijgm.s317421] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 06/22/2021] [Indexed: 12/17/2022] Open
Abstract
Vitamin D is proposed to have a potential role in the pathogenicity, clinical presentation, prognosis, complications, and treatment of several diseases. In addition to its well-known role in calcium metabolism, vitamin D regulates both innate and adaptive immunity, and subsequently modulates the antiviral and antibacterial inflammatory immune responses. In view of the emerging coronavirus disease 2019 (COVID-19) pandemic, searching for potential therapeutic and protective strategies is of urgent interest, and vitamin D is one of the promising agents in this field. In this review, we present data from literature that supports the promising role of vitamin D in treatment and/or prevention of several infections including severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This review summarizes vitamin D metabolism and its role in inflammation, thrombosis and immune regulation. It also reviews, in short, the role of vitamin D and the impact of its deficiency in several infections namely tuberculosis, influenza, human immunodeficiency virus (HIV), and SARS-CoV-2. Considering the roles of vitamin D on immune modulation, controlling of thrombosis, and attacking several microorganisms, the current review will elaborate on the association between these salient roles of vitamin D and the pathogenicity of various infectious agents including COVID-19. Consequently, the comprehensive finding of the current review shows a possible significant impact of vitamin D supplement as a hope in preventing, treating, and/or improving the progression of certain infections, specifically during the worldwide attempts to fight against the COVID-19 pandemic and minimize the severity of health complications encountered accordingly. In addition, avoiding a status of vitamin D deficiency to obtain its positive effects on the immune system and its protective mechanism during infections will be a general benefit overall.
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Affiliation(s)
- Rbab Taha
- Department of Transplant Infectious Disease, University Health Network, Toronto, Ontario, Canada
| | - Shahd Abureesh
- Department of Medicine, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Shuruq Alghamdi
- Department of Medicine, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Rola Y Hassan
- Department of Internal Medicine, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Mohamed M Cheikh
- Department of Internal Medicine, Doctor Soliman Fakeeh Hospital, Jeddah, Saudi Arabia
- Department of Medicine, Fakeeh College for Medical Sciences, Jeddah, Saudi Arabia
| | - Rania A Bagabir
- Department of Immunology and Hematology, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Hani Almoallim
- Department of Medicine, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
- Alzaidi Chair of Research in Rheumatic Diseases, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Altaf Abdulkhaliq
- Department of Clinical Biochemistry, Faculty of Medicine, Umm Al-Qura University, Makkah, Saudi Arabia
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19
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Ebrahimzadeh-Attari V, Panahi G, Hebert JR, Ostadrahimi A, Saghafi-Asl M, Lotfi-Yaghin N, Baradaran B. Nutritional approach for increasing public health during pandemic of COVID-19: A comprehensive review of antiviral nutrients and nutraceuticals. Health Promot Perspect 2021; 11:119-136. [PMID: 34195036 PMCID: PMC8233676 DOI: 10.34172/hpp.2021.17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 02/03/2021] [Indexed: 12/15/2022] Open
Abstract
Background: The novel coronavirus (COVID-19) is considered as the most life-threatening pandemic disease during the last decade. The individual nutritional status, though usually ignored in the management of COVID-19, plays a critical role in the immune function and pathogenesis of infection. Accordingly, the present review article aimed to report the effects of nutrients and nutraceuticals on respiratory viral infections including COVID-19, with a focus on their mechanisms of action. Methods: Studies were identified via systematic searches of the databases including PubMed/ MEDLINE, ScienceDirect, Scopus, and Google Scholar from 2000 until April 2020, using keywords. All relevant clinical and experimental studies published in English were included. Results: Protein-energy malnutrition (PEM) is common in severe respiratory infections and should be considered in the management of COVID-19 patients. On the other hand, obesity can be accompanied by decreasing the host immunity. Therefore, increasing physical activity at home and a slight caloric restriction with adequate intake of micronutrients and nutraceuticals are simple aids to boost host immunity and decrease the clinical manifestations of COVID-19. Conclusion: The most important nutrients which can be considered for COVID-19 management are vitamin D, vitamin C, vitamin A, folate, zinc, and probiotics. Their adequacy should be provided through dietary intake or appropriate supplementation. Moreover, adequate intake of some other dietary agents including vitamin E, magnesium, selenium, alpha linolenic acid and phytochemicals are required to maintain the host immunity.
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Affiliation(s)
| | - Ghodratollah Panahi
- Department of Clinical Biochemistry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - James R. Hebert
- Department of Epidemiology & Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
- Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Alireza Ostadrahimi
- Nutrition Research Center, Department of Clinical Nutrition, Faculty of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Saghafi-Asl
- Nutrition Research Center, Department of Clinical Nutrition, Faculty of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Neda Lotfi-Yaghin
- Student Research Committee, Department of Clinical Nutrition, Faculty of Nutrition & Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Behzad Baradaran
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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20
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McCullough PJ, McCullough WP, Lehrer D, Travers JB, Repas SJ. Oral and Topical Vitamin D, Sunshine, and UVB Phototherapy Safely Control Psoriasis in Patients with Normal Pretreatment Serum 25-Hydroxyvitamin D Concentrations: A Literature Review and Discussion of Health Implications. Nutrients 2021; 13:1511. [PMID: 33947070 PMCID: PMC8146035 DOI: 10.3390/nu13051511] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 04/21/2021] [Accepted: 04/27/2021] [Indexed: 12/15/2022] Open
Abstract
Vitamin D, sunshine and UVB phototherapy were first reported in the early 1900s to control psoriasis, cure rickets and cure tuberculosis (TB). Vitamin D also controlled asthma and rheumatoid arthritis with intakes ranging from 60,000 to 600,000 International Units (IU)/day. In the 1980s, interest in treating psoriasis with vitamin D rekindled. Since 1985 four different oral forms of vitamin D (D2, D3, 1-hydroxyvitaminD3 (1(OH)D3) and 1,25-dihydroxyvitaminD3 (calcitriol)) and several topical formulations have been reported safe and effective treatments for psoriasis-as has UVB phototherapy and sunshine. In this review we show that many pre-treatment serum 25(OH)D concentrations fall within the current range of normal, while many post-treatment concentrations fall outside the upper limit of this normal (100 ng/mL). Yet, psoriasis patients showed significant clinical improvement without complications using these treatments. Current estimates of vitamin D sufficiency appear to underestimate serum 25(OH)D concentrations required for optimal health in psoriasis patients, while concentrations associated with adverse events appear to be much higher than current estimates of safe serum 25(OH)D concentrations. Based on these observations, the therapeutic index for vitamin D needs to be reexamined in the treatment of psoriasis and other diseases strongly linked to vitamin D deficiency, including COVID-19 infections, which may also improve safely with sufficient vitamin D intake or UVB exposure.
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Affiliation(s)
- Patrick J. McCullough
- Medical Services Department, Summit Behavioral Healthcare, Ohio Department of Mental Health and Addiction Services, 1101 Summit Rd, Cincinnati, OH 45237, USA
- Department of Psychiatry, Wright State University Boonshoft School of Medicine, 3640 Colonel Glenn Hwy, Dayton, OH 45435, USA;
| | | | - Douglas Lehrer
- Department of Psychiatry, Wright State University Boonshoft School of Medicine, 3640 Colonel Glenn Hwy, Dayton, OH 45435, USA;
| | - Jeffrey B. Travers
- Department of Pharmacology & Toxicology, Wright State University Boonshoft School of Medicine, 3640 Colonel Glenn Hwy, Dayton, OH 45435, USA;
| | - Steven J. Repas
- Wright State University Boonshoft School of Medicine, 3640 Colonel Glenn Hwy, Dayton, OH 45435, USA;
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21
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Javanian M, Barary M, Ghebrehewet S, Koppolu V, Vasigala V, Ebrahimpour S. A brief review of influenza virus infection. J Med Virol 2021; 93:4638-4646. [PMID: 33792930 DOI: 10.1002/jmv.26990] [Citation(s) in RCA: 192] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 03/27/2021] [Accepted: 03/30/2021] [Indexed: 12/13/2022]
Abstract
Influenza is an acute viral respiratory infection that affects all age groups and is associated with high mortality during pandemics, epidemics, and sporadic outbreaks. Nearly 10% of the world's population is affected by influenza annually, with about half a million deaths each year. Influenza vaccination is the most effective method for preventing influenza infection and its complications. The influenza vaccine's efficacy varies each season based on the circulating influenza strains and vaccine uptake rates. Currently, three antiviral drugs targeting the influenza virus surface glycoprotein neuraminidase are available for treatment and prophylaxis of disease. Given the significant burden of influenza infection globally, this review is focused on the latest findings in the etiology, epidemiology, transmission, clinical manifestation, diagnosis, prevention, and treatment of influenza.
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Affiliation(s)
- Mostafa Javanian
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Barary
- Student Research Committee, Babol University of Medical Sciences, Babol, Iran
| | - Sam Ghebrehewet
- Cheshire and Merseyside Health Protection Team, Public Health England North West, Liverpool, UK
| | - Veerendra Koppolu
- Scientist, Department of Analytical Biotechnology, MedImmune/AstraZeneca, Gaithersburg, Maryland, 20878, USA
| | - VeneelaKrishnaRekha Vasigala
- Department of General Medicine, Rangaraya Medical College, NTR University of Health Sciences, Vijayawada, Andhra Pradesh, India
| | - Soheil Ebrahimpour
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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22
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Wojtys EM. Boosting Performance. Sports Health 2021; 13:109-110. [PMID: 33622110 DOI: 10.1177/1941738121991495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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23
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Infante M, Buoso A, Pieri M, Lupisella S, Nuccetelli M, Bernardini S, Fabbri A, Iannetta M, Andreoni M, Colizzi V, Morello M. Low Vitamin D Status at Admission as a Risk Factor for Poor Survival in Hospitalized Patients With COVID-19: An Italian Retrospective Study. J Am Coll Nutr 2021; 41:250-265. [PMID: 33600292 PMCID: PMC7899172 DOI: 10.1080/07315724.2021.1877580] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Preliminary findings suggest a relationship between lower serum 25-hydroxyvitamin D [25(OH)D] levels and incidence and severity of COVID-19. The aim of this study was to evaluate the relationship between vitamin D status at admission and different markers of inflammation, coagulation, and sepsis in hospitalized patients with COVID-19. METHOD We conducted a retrospective study on 137 consecutive patients with SARS-CoV-2 infection and available data on serum 25(OH)D levels, who were admitted to our Institution between March 1 and April 30, 2020. Patients were divided into two groups: survivors (n = 78; 57%) and non-survivors (n = 59; 43%). RESULTS At admission, all patients showed hypovitaminosis D. Median total serum 25(OH)D levels at admission were significantly higher in survivors than non-survivors (12 ng/mL vs 8 ng/mL; p < 0.01). Non-survivors exhibited significantly higher median levels of white blood cell (WBC) count, neutrophil-to-lymphocyte count ratio (NLR), high-sensitivity C-reactive protein (hsCRP), ferritin, interleukin 6 (IL-6), D-dimer, fibrinogen, and procalcitonin (PCT) compared to survivors at three different time points during hospitalization. In a multivariate analysis performed by a logistic regression model, serum 25(OH)D levels were significantly inversely associated with risk of COVID-19-related in-hospital mortality (odds ratio, 0.91; 95% confidence interval, 0.85-0.98; p = 0.01). According to receiver operating characteristic curve analysis, hsCRP, NLR, ferritin, and D-dimer were the best predictive biomarkers for poor prognosis of COVID-19, whereas IL-6, PCT, fibrinogen, 25(OH)D, WBC count, and tumor necrosis factor alpha (TNF-α) may serve as supportive biomarkers for worse clinical course of the disease. CONCLUSIONS We found a markedly high prevalence (100%) of hypovitaminosis D in patients admitted to hospital with COVID-19, suggesting a possible role of low vitamin D status in increasing the risk of SARS-CoV-2 infection and subsequent hospitalization. The inverse association between serum 25(OH)D levels and risk of in-hospital mortality observed in our cohort suggests that a lower vitamin D status upon admission may represent a modifiable and independent risk factor for poor prognosis in COVID-19.
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Affiliation(s)
- Marco Infante
- Department of Systems Medicine, Diabetes Research Institute Federation (DRIF), CTO Hospital ASL Roma 2, University of Rome Tor Vergata, Rome, Italy.,UniCamillus, Saint Camillus International University of Health Sciences, Rome, Italy.,Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Rome, Italy
| | - Andrea Buoso
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Infectious Disease Clinic, Tor Vergata University Hospital (PTV), Rome, Italy
| | - Massimo Pieri
- Clinical Biochemistry and Molecular Biology, Department of Experimental Medicine, Faculty of Medicine, University of Rome Tor Vergata, Rome, Italy.,Clinical Biochemistry Department, Tor Vergata University Hospital (PTV), Rome, Italy
| | - Santina Lupisella
- Clinical Biochemistry and Molecular Biology, Department of Experimental Medicine, Faculty of Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Marzia Nuccetelli
- Clinical Biochemistry and Molecular Biology, Department of Experimental Medicine, Faculty of Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Sergio Bernardini
- Clinical Biochemistry and Molecular Biology, Department of Experimental Medicine, Faculty of Medicine, University of Rome Tor Vergata, Rome, Italy.,Clinical Biochemistry Department, Tor Vergata University Hospital (PTV), Rome, Italy
| | - Andrea Fabbri
- Department of Systems Medicine, Diabetes Research Institute Federation (DRIF), CTO Hospital ASL Roma 2, University of Rome Tor Vergata, Rome, Italy
| | - Marco Iannetta
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Infectious Disease Clinic, Tor Vergata University Hospital (PTV), Rome, Italy
| | - Massimo Andreoni
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.,Infectious Disease Clinic, Tor Vergata University Hospital (PTV), Rome, Italy
| | - Vittorio Colizzi
- UNESCO Chair of Biotechnology & Bioethics, University of Rome Tor Vergata, Rome, Italy
| | - Maria Morello
- Clinical Biochemistry and Molecular Biology, Department of Experimental Medicine, Faculty of Medicine, University of Rome Tor Vergata, Rome, Italy.,Clinical Biochemistry Department, Tor Vergata University Hospital (PTV), Rome, Italy
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Burra P, Soto-Díaz K, Chalen I, Gonzalez-Ricon RJ, Istanto D, Caetano-Anollés G. Temperature and Latitude Correlate with SARS-CoV-2 Epidemiological Variables but not with Genomic Change Worldwide. Evol Bioinform Online 2021; 17:1176934321989695. [PMID: 33551640 PMCID: PMC7841253 DOI: 10.1177/1176934321989695] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 12/30/2020] [Indexed: 12/17/2022] Open
Abstract
The SARS-CoV-2 virus that causes the COVID-19 disease has spread quickly and massively around the entire globe, causing millions of confirmed cases and deaths worldwide. The disease poses a serious ongoing threat to public health. This study aims to understand the disease potential of the virus in different regions by studying how average spring temperature and its strong predictor, latitude, affect epidemiological variables such as disease incidence, mortality, recovery cases, active cases, testing rate, and hospitalization. We also seek to understand the association of temperature and geographic coordinates with viral genomics. Epidemiological data along with temperature, latitude, longitude, and preparedness index were collected for different countries and US states during the early stages of the pandemic. Our worldwide epidemiological analysis showed a significant correlation between temperature and incidence, mortality, recovery cases and active cases. The same tendency was found with latitude, but not with longitude. In the US, we observed no correlation between temperature or latitude and epidemiological variables. Interestingly, longitude was correlated with incidence, mortality, active cases, and hospitalization. An analysis of mutational change and mutational change per time in 55 453 aligned SARS-CoV-2 genome sequences revealed these parameters were uncorrelated with temperature and geographic coordinates. The epidemiological trends we observed worldwide suggest a seasonal effect for the disease that is not directly controlled by the genomic makeup of the virus. Future studies will need to determine if correlations are more likely the result of effects associated with the environment or the innate immunity of the host.
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Affiliation(s)
- Prakruthi Burra
- Department of Computer Science, University of Illinois at Urbana-Champaign, USA
| | - Katiria Soto-Díaz
- Neuroscience Program, University of Illinois at Urbana-Champaign, USA
| | - Izan Chalen
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, USA
| | | | - Dave Istanto
- Department of Crop Sciences, University of Illinois at Urbana-Champaign, USA
| | - Gustavo Caetano-Anollés
- Department of Crop Sciences, University of Illinois at Urbana-Champaign, USA
- C.R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, USA
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25
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Tanner A, Tiwari D, Allen S. Covid-19 Susceptibility and Severity Might be Modified by Vitamin D Status: Theoretical and Practical Considerations. CURRENT RESPIRATORY MEDICINE REVIEWS 2021. [DOI: 10.2174/1568009620999200924155221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background:
The recently identified SARS-CoV-2 coronavirus has resulted in the
Covid-19 pandemic with severe morbidity and high mortality, particularly in certain sections of the
population. The co-morbidity patterns associated with adverse outcomes are multiple and complex
and there is emerging epidemiological, nutritional and molecular biological evidence that an inadequate
vitamin D status is a contributing factor.
Objective:
The aim was to review the role of vitamin D in immune function with particular reference
to the mechanisms whereby it supports immune efficiency, host protection and immune modulation.
The evidence for the possible benefit of vitamin D supplementation to ameliorate the severity
of respiratory infection by SARS-CoV-2 and other pathogens was also reviewed with a view to
making a recommendation.
Methods:
PubMed, MEDLINE and Google Scholar were searched using the terms: Covid-19, coronavirus,
SARS-CoV-2, vitamin D, calcitriol, deficiency, adaptive immunity, innate immunity, ventilation,
critical care, intensive care, acute respiratory distress syndrome, cytokine storm, respiratory
viruses, respiratory tract infection, respiratory syncytial virus, influenza, supplementation. Papers
for inclusion were selected on the basis of relevance and quality.
Findings:
Vitamin D insufficiency is widespread in many parts of the world. Vitamin D is needed
for normal protective and surveillance immune function and there is evidence that deficiency increases
the risk of some respiratory infections, probably including Covid-19. By binding with dedicated
receptors on immune cells vitamin D influences several strands of immune function, including
the production of anti-microbial peptides and several cytokines that promote an appropriate immune
response. Vitamin D supplementation probably reduces the risk of respiratory infection, with
persuasive biological, epidemiological and observational evidence for possible benefit against
Covid-19.
Conclusion:
Despite the lack of direct evidence specific to Covid-19 a cogent theoretical case can
be made for giving adults from selected groups, and arguably all adults, routine supplementation
with vitamin D to improve immune efficiency and reduce the incidence and severity of respiratory
infections. This could be particularly important in sections of the population with a high prevalence
of vitamin D insufficiency. Targeted research is required to provide firm evidence to guide practice.
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Affiliation(s)
- Alex Tanner
- The Royal Bournemouth Hospital, Dorset, United Kingdom
| | - Divya Tiwari
- The Royal Bournemouth Hospital, Dorset, United Kingdom
| | - Stephen Allen
- The Royal Bournemouth Hospital, Dorset, United Kingdom
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Moozhipurath RK, Kraft L, Skiera B. Evidence of protective role of Ultraviolet-B (UVB) radiation in reducing COVID-19 deaths. Sci Rep 2020; 10:17705. [PMID: 33077792 PMCID: PMC7572372 DOI: 10.1038/s41598-020-74825-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 10/06/2020] [Indexed: 01/10/2023] Open
Abstract
Prior studies indicate the protective role of Ultraviolet-B (UVB) radiation in human health, mediated by vitamin D synthesis. In this observational study, we empirically outline a negative association of UVB radiation as measured by ultraviolet index (UVI) with the number of COVID-19 deaths. We apply a fixed-effect log-linear regression model to a panel dataset of 152 countries over 108 days (n = 6524). We use the cumulative number of COVID-19 deaths and case-fatality rate (CFR) as the main dependent variables and isolate the UVI effect from potential confounding factors. After controlling for time-constant and time-varying factors, we find that a permanent unit increase in UVI is associated with a 1.2 percentage points decline in daily growth rates of cumulative COVID-19 deaths [p < 0.01] and a 1.0 percentage points decline in the CFR daily growth rate [p < 0.05]. These results represent a significant percentage reduction in terms of daily growth rates of cumulative COVID-19 deaths (− 12%) and CFR (− 38%). We find a significant negative association between UVI and COVID-19 deaths, indicating evidence of the protective role of UVB in mitigating COVID-19 deaths. If confirmed via clinical studies, then the possibility of mitigating COVID-19 deaths via sensible sunlight exposure or vitamin D intervention would be very attractive.
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Affiliation(s)
| | - Lennart Kraft
- Faculty of Economics and Business, Goethe University Frankfurt, Theodor-W.-Adorno-Platz 4, 60629, Frankfurt, Germany
| | - Bernd Skiera
- Faculty of Economics and Business, Goethe University Frankfurt, Theodor-W.-Adorno-Platz 4, 60629, Frankfurt, Germany
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27
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O'Connor S, Huseyin OR, Whyte EF, Lacey P. A 2-year prospective study of injuries and illness in an elite national junior tennis program. PHYSICIAN SPORTSMED 2020; 48:342-348. [PMID: 31928289 DOI: 10.1080/00913847.2020.1714512] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: Injury and illness in elite national tennis programs can limit players' current and future performance. This study aimed to prospectively examine injuries and illnesses in an Irish elite national junior tennis program over 2 years. Methods: All injuries and illnesses that led to missed tennis training and match play in the Irish national junior tennis program (n = 82) over 2 years were collected in a prospective cohort study. Injury and illness prevalence and rates were calculated and reported with respect to gender and age group. Descriptive statistics were calculated for the type of illness and the region, location, type, nature, mechanism, and severity of injury. Results: Over the course of the study, 54% of players became injured, with 9.0% receiving more than one injury. Injuries were most frequent in the under-16 age group (12.93 injuries per 1,000 athletic exposures), compared to younger age groups (4.13 [U10], 3.43 [U12], 4.63 [U14] injuries per 1,000 athletic exposures) and seniors (1.98 injuries per 1,000 athletic exposures). Lower (49.5%) and upper limb (35.9%) injuries were frequent and mostly occurred due to overextension (35.9%). No significant differences in males and females injury rates were noted. However, females received a greater proportion of shoulder injuries (23.5% vs 10.9%), with more knee injuries in males (29.1% vs 7.8%). 0.52 illnesses per 1,000 athletic exposures were reported, with respiratory/cardiorespiratory (43.5%) most frequent. Injuries lead to greater average sessions lost (6.77 ± 11.56) than illness (1.83 ± 1.11). Conclusion: These findings can inform injury and illness preventative strategies to minimize absence from tennis play and should be prioritized in the under-16 group. Due to the different injury profiles between males and females, tailored preventative programs should be developed for males and females individually.
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Affiliation(s)
- Siobhán O'Connor
- School of Health and Human Performance, Dublin City University , Dublin, Ireland
| | - Oktay R Huseyin
- National Tennis Centre, Tennis Ireland, Dublin City University , Dublin, Ireland
| | - Enda F Whyte
- School of Health and Human Performance, Dublin City University , Dublin, Ireland
| | - Peter Lacey
- School of Health and Human Performance, Dublin City University , Dublin, Ireland
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Hayashi H, Okamatsu M, Ogasawara H, Tsugawa N, Isoda N, Matsuno K, Sakoda Y. Oral Supplementation of the Vitamin D Metabolite 25(OH)D 3 Against Influenza Virus Infection in Mice. Nutrients 2020; 12:E2000. [PMID: 32635656 PMCID: PMC7400405 DOI: 10.3390/nu12072000] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 06/22/2020] [Accepted: 07/02/2020] [Indexed: 12/17/2022] Open
Abstract
Vitamin D is a fat-soluble vitamin that is metabolized by the liver into 25-hydroxyvitamin D [25(OH)D] and then by the kidney into 1,25-dihydroxyvitamin D [1,25(OH)2D], which activates the vitamin D receptor expressed in various cells, including immune cells, for an overall immunostimulatory effect. Here, to investigate whether oral supplementation of 25-hydroxyvitamin D3 [25(OH)D3], a major form of vitamin D metabolite 25(OH)D, has a prophylactic effect on influenza A virus infection, mice were fed a diet containing a high dose of 25(OH)D3 and were challenged with the influenza virus. In the lungs of 25(OH)D3-fed mice, the viral titers were significantly lower than in the lungs of standardly fed mice. Additionally, the proinflammatory cytokines IL-5 and IFN-γ were significantly downregulated after viral infection in 25(OH)D3-fed mice, while anti-inflammatory cytokines were not significantly upregulated. These results indicate that 25(OH)D3 suppresses the production of inflammatory cytokines and reduces virus replication and clinical manifestations of influenza virus infection in a mouse model.
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Affiliation(s)
- Hirotaka Hayashi
- Laboratory of Microbiology, Faculty of Veterinary Medicine, Hokkaido University, Kita 18 Nishi 9, Kita-ku, Sapporo 060-0818, Japan; (H.H.); (M.O.); (K.M.)
| | - Masatoshi Okamatsu
- Laboratory of Microbiology, Faculty of Veterinary Medicine, Hokkaido University, Kita 18 Nishi 9, Kita-ku, Sapporo 060-0818, Japan; (H.H.); (M.O.); (K.M.)
| | - Honami Ogasawara
- Department of Health and Nutrition, Faculty of Health and Nutrition, Osaka Shoin Woman’s University, Hishiyanishi 4-2-26, Higashiosaka 577-8550, Japan; (H.O.); (N.T.)
| | - Naoko Tsugawa
- Department of Health and Nutrition, Faculty of Health and Nutrition, Osaka Shoin Woman’s University, Hishiyanishi 4-2-26, Higashiosaka 577-8550, Japan; (H.O.); (N.T.)
| | - Norikazu Isoda
- Unit of Risk Analysis and Management, Research Center for Zoonosis Control, Hokkaido University, Kita 20 Nishi 10, Kita-ku, Sapporo 001-0020, Japan;
- Global Station of Zoonosis Control, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo 001-0020, Japan
| | - Keita Matsuno
- Laboratory of Microbiology, Faculty of Veterinary Medicine, Hokkaido University, Kita 18 Nishi 9, Kita-ku, Sapporo 060-0818, Japan; (H.H.); (M.O.); (K.M.)
- Global Station of Zoonosis Control, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo 001-0020, Japan
| | - Yoshihiro Sakoda
- Laboratory of Microbiology, Faculty of Veterinary Medicine, Hokkaido University, Kita 18 Nishi 9, Kita-ku, Sapporo 060-0818, Japan; (H.H.); (M.O.); (K.M.)
- Global Station of Zoonosis Control, Global Institution for Collaborative Research and Education (GI-CoRE), Hokkaido University, Sapporo 001-0020, Japan
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29
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Grant WB, Lahore H, McDonnell SL, Baggerly CA, French CB, Aliano JL, Bhattoa HP. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients 2020; 12:nu12040988. [PMID: 32252338 PMCID: PMC7231123 DOI: 10.3390/nu12040988] [Citation(s) in RCA: 1080] [Impact Index Per Article: 216.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 03/30/2020] [Accepted: 03/31/2020] [Indexed: 02/06/2023] Open
Abstract
The world is in the grip of the COVID-19 pandemic. Public health measures that can reduce the risk of infection and death in addition to quarantines are desperately needed. This article reviews the roles of vitamin D in reducing the risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19, and how vitamin D supplementation might be a useful measure to reduce risk. Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increasing concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced the risk of influenza, whereas others did not. Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D (25(OH)D) concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome; and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce the risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40-60 ng/mL (100-150 nmol/L). For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.
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Affiliation(s)
- William B. Grant
- Sunlight, Nutrition, and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA
- Correspondence: ; Tel.: +1-415-409-1980
| | - Henry Lahore
- 2289 Highland Loop, Port Townsend, WA 98368, USA;
| | - Sharon L. McDonnell
- GrassrootsHealth, Encinitas, CA 92024, USA; (S.L.M.); (C.A.B.); (C.B.F.); (J.L.A.)
| | - Carole A. Baggerly
- GrassrootsHealth, Encinitas, CA 92024, USA; (S.L.M.); (C.A.B.); (C.B.F.); (J.L.A.)
| | - Christine B. French
- GrassrootsHealth, Encinitas, CA 92024, USA; (S.L.M.); (C.A.B.); (C.B.F.); (J.L.A.)
| | - Jennifer L. Aliano
- GrassrootsHealth, Encinitas, CA 92024, USA; (S.L.M.); (C.A.B.); (C.B.F.); (J.L.A.)
| | - Harjit P. Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei Blvd 98, H-4032 Debrecen, Hungary;
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30
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Grant WB, Lahore H, McDonnell SL, Baggerly CA, French CB, Aliano JL, Bhattoa HP. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients 2020. [PMID: 32252338 DOI: 10.20944/preprints202003.0235.v2] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The world is in the grip of the COVID-19 pandemic. Public health measures that can reduce the risk of infection and death in addition to quarantines are desperately needed. This article reviews the roles of vitamin D in reducing the risk of respiratory tract infections, knowledge about the epidemiology of influenza and COVID-19, and how vitamin D supplementation might be a useful measure to reduce risk. Through several mechanisms, vitamin D can reduce risk of infections. Those mechanisms include inducing cathelicidins and defensins that can lower viral replication rates and reducing concentrations of pro-inflammatory cytokines that produce the inflammation that injures the lining of the lungs, leading to pneumonia, as well as increasing concentrations of anti-inflammatory cytokines. Several observational studies and clinical trials reported that vitamin D supplementation reduced the risk of influenza, whereas others did not. Evidence supporting the role of vitamin D in reducing risk of COVID-19 includes that the outbreak occurred in winter, a time when 25-hydroxyvitamin D (25(OH)D) concentrations are lowest; that the number of cases in the Southern Hemisphere near the end of summer are low; that vitamin D deficiency has been found to contribute to acute respiratory distress syndrome; and that case-fatality rates increase with age and with chronic disease comorbidity, both of which are associated with lower 25(OH)D concentration. To reduce the risk of infection, it is recommended that people at risk of influenza and/or COVID-19 consider taking 10,000 IU/d of vitamin D3 for a few weeks to rapidly raise 25(OH)D concentrations, followed by 5000 IU/d. The goal should be to raise 25(OH)D concentrations above 40-60 ng/mL (100-150 nmol/L). For treatment of people who become infected with COVID-19, higher vitamin D3 doses might be useful. Randomized controlled trials and large population studies should be conducted to evaluate these recommendations.
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Affiliation(s)
- William B Grant
- Sunlight, Nutrition, and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA
| | - Henry Lahore
- 2289 Highland Loop, Port Townsend, WA 98368, USA
| | | | | | | | | | - Harjit P Bhattoa
- Department of Laboratory Medicine, Faculty of Medicine, University of Debrecen, Nagyerdei Blvd 98, H-4032 Debrecen, Hungary
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Khan ZA, Yumnamcha T, Mondal G, Devi SD, Rajiv C, Labala RK, Sanjita Devi H, Chattoraj A. Artificial Light at Night (ALAN): A Potential Anthropogenic Component for the COVID-19 and HCoVs Outbreak. Front Endocrinol (Lausanne) 2020; 11:622. [PMID: 33013700 PMCID: PMC7511708 DOI: 10.3389/fendo.2020.00622] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Accepted: 07/30/2020] [Indexed: 12/18/2022] Open
Abstract
The origin of the coronavirus disease 2019 (COVID-19) pandemic is zoonotic. The circadian day-night is the rhythmic clue to organisms for their synchronized body functions. The "development for mankind" escalated the use of artificial light at night (ALAN). In this article, we tried to focus on the possible influence of this anthropogenic factor in human coronavirus (HCoV) outbreak. The relationship between the occurrences of coronavirus and the ascending curve of the night-light has also been delivered. The ALAN influences the physiology and behavior of bat, a known nocturnal natural reservoir of many Coronaviridae. The "threatened" and "endangered" status of the majority of bat species is mainly because of the destruction of their proper habit and habitat predominantly through artificial illumination. The stress exerted by ALAN leads to the impaired body functions, especially endocrine, immune, genomic integration, and overall rhythm features of different physiological variables and behaviors in nocturnal animals. Night-light disturbs "virus-host" synchronization and may lead to mutation in the genomic part of the virus and excessive virus shedding. We also proposed some future strategies to mitigate the repercussions of ALAN and for the protection of the living system in the earth as well.
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Affiliation(s)
- Zeeshan Ahmad Khan
- Biological Rhythm Laboratory, Animal Resources Programme, Institute of Bioresources and Sustainable Development, Department of Biotechnology, Government of India, Imphal, India
| | - Thangal Yumnamcha
- Biological Rhythm Laboratory, Animal Resources Programme, Institute of Bioresources and Sustainable Development, Department of Biotechnology, Government of India, Imphal, India
| | - Gopinath Mondal
- Biological Rhythm Laboratory, Animal Resources Programme, Institute of Bioresources and Sustainable Development, Department of Biotechnology, Government of India, Imphal, India
| | - Sijagurumayum Dharmajyoti Devi
- Biological Rhythm Laboratory, Animal Resources Programme, Institute of Bioresources and Sustainable Development, Department of Biotechnology, Government of India, Imphal, India
| | - Chongtham Rajiv
- Biological Rhythm Laboratory, Animal Resources Programme, Institute of Bioresources and Sustainable Development, Department of Biotechnology, Government of India, Imphal, India
| | - Rajendra Kumar Labala
- Distributed Information Sub-centre, Institute of Bioresources and Sustainable Development, Department of Biotechnology, Government of India, Imphal, India
- Biological Rhythm Laboratory, Department of Animal Science, Kazi Nazrul University, Asansol, India
| | - Haobijam Sanjita Devi
- Biological Rhythm Laboratory, Animal Resources Programme, Institute of Bioresources and Sustainable Development, Department of Biotechnology, Government of India, Imphal, India
| | - Asamanja Chattoraj
- Biological Rhythm Laboratory, Department of Animal Science, Kazi Nazrul University, Asansol, India
- *Correspondence: Asamanja Chattoraj ;
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32
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Agrawal AA, Kolte AP, Kolte RA, Chari S, Gupta M, Pakhmode R. Evaluation and comparison of serum vitamin D and calcium levels in periodontally healthy, chronic gingivitis and chronic periodontitis in patients with and without diabetes mellitus - a cross-sectional study. Acta Odontol Scand 2019; 77:592-599. [PMID: 31198072 DOI: 10.1080/00016357.2019.1623910] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Objective: Limited data are available with respect to the relation of vitamin D and calcium with periodontal infections and type-2 diabetes mellitus (T2DM). The aim of this cross-sectional study was to evaluate the levels of vitamin D and calcium in serum of periodontally healthy, chronic gingivitis and chronic periodontitis patients with and without T2DM. Material and methods: The study evaluated 100 patients equally divided into five groups (Group I to Group V) according to the inclusion criteria. Clinical parameters and serum 25-hydroxyvitamin D level were assessed. Other laboratory investigations comprised of random blood sugar, glycated haemoglobin and serum calcium. Results: The probing pocket depth and clinical attachment loss were found to be greater in chronic periodontitis and chronic periodontitis with diabetes mellitus, while the vitamin D and calcium levels were found to be least in these groups. When vitamin D and calcium levels were compared between periodontal disease with diabetes to that of non-diabetics, statistically significant difference were found between the two with p-value of .001 indicating decrease in levels of vitamin D and calcium with increase in RBS and HbA1c values. Conclusion: Vitamin D and calcium levels are inversely correlated with random blood sugar and glycated haemoglobin and also probing pocket depth and clinical attachment loss, thus contributing towards increase in periodontal disease severity.
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Affiliation(s)
- Anshuka A. Agrawal
- Department of Periodontics & Implantology, VSPM Dental College and Research Centre, Nagpur, India
| | - Abhay P. Kolte
- Department of Periodontics & Implantology, VSPM Dental College and Research Centre, Nagpur, India
| | - Rajashri A. Kolte
- Department of Periodontics & Implantology, VSPM Dental College and Research Centre, Nagpur, India
| | - Suresh Chari
- Department of Biochemistry, NKP Salve Institute of Medical Sciences, Nagpur, India
| | - Madhur Gupta
- Department of Biochemistry, NKP Salve Institute of Medical Sciences, Nagpur, India
| | - Resham Pakhmode
- Department of Periodontics & Implantology, VSPM Dental College and Research Centre, Nagpur, India
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33
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Markowitz S, Nesson E, Robinson JJ. The effects of employment on influenza rates. ECONOMICS AND HUMAN BIOLOGY 2019; 34:286-295. [PMID: 31097347 DOI: 10.1016/j.ehb.2019.04.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 04/05/2019] [Accepted: 04/11/2019] [Indexed: 05/25/2023]
Abstract
The seasonal influenza virus afflicts millions of people in the U.S. population each year, imposing significant costs on those who fall ill, their families, employers, and the health care system. The flu is transmitted via droplet spread or close contact, and certain environments, such as schools or offices, promote transmission. In this paper, we examine whether increases in employment are associated with increased incidence of the flu. We use state-level data on the prevalence of the flu from the Centers for Disease Control and Prevention. In our preferred specification, we find that a one percentage point increase in the employment rate increases the number of influenza related outpatient health care visits by 19%, and these effects are highly pronounced in the retail sector and healthcare sector, the sectors with the highest levels of interpersonal contact.
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Affiliation(s)
- Sara Markowitz
- Department of Economics, Emory University, Atlanta, GA, USA; NBER, USA.
| | - Erik Nesson
- Department of Economics, Miller College of Business, Ball State University, Muncie, IN, USA; NBER, USA.
| | - Joshua J Robinson
- Department of Marketing, Industrial Distribution, and Economics, Collat School of Business, University of Alabama at Birmingham, Birmingham, AL, USA.
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34
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Abhimanyu, Coussens AK. The role of UV radiation and vitamin D in the seasonality and outcomes of infectious disease. Photochem Photobiol Sci 2018; 16:314-338. [PMID: 28078341 DOI: 10.1039/c6pp00355a] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The seasonality of infectious disease outbreaks suggests that environmental conditions have a significant effect on disease risk. One of the major environmental factors that can affect this is solar radiation, primarily acting through ultraviolet radiation (UVR), and its subsequent control of vitamin D production. Here we show how UVR and vitamin D, which are modified by latitude and season, can affect host and pathogen fitness and relate them to the outcomes of bacterial, viral and vector-borne infections. We conducted a thorough comparison of the molecular and cellular mechanisms of action of UVR and vitamin D on pathogen fitness and host immunity and related these to the effects observed in animal models and clinical trials to understand their independent and complementary effects on infectious disease outcome. UVR and vitamin D share common pathways of innate immune activation primarily via antimicrobial peptide production, and adaptive immune suppression. Whilst UVR can induce vitamin D-independent effects in the skin, such as the generation of photoproducts activating interferon signaling, vitamin D has a larger systemic effect due to its autocrine and paracrine modulation of cellular responses in a range of tissues. However, the seasonal patterns in infectious disease prevalence are not solely driven by variation in UVR and vitamin D levels across latitudes. Vector-borne pathogens show a strong seasonality of infection correlated to climatic conditions favoring their replication. Conversely, pathogens, such as influenza A virus, Mycobacterium tuberculosis and human immunodeficiency virus type 1, have strong evidence to support their interaction with vitamin D. Thus, UVR has both vitamin D-dependent and independent effects on infectious diseases; these effects vary depending on the pathogen of interest and the effects can be complementary or antagonistic.
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Affiliation(s)
- Abhimanyu
- Clinical Infectious Diseases Research Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Anzio Rd, Observatory, 7925, Western Cape, South Africa.
| | - Anna K Coussens
- Clinical Infectious Diseases Research Initiative, Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Anzio Rd, Observatory, 7925, Western Cape, South Africa. and Division of Medical Microbiology, Department of Pathology, University of Cape Town, Anzio Rd, Observatory, 7925, Western Cape, South Africa
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Lee RU, Won SH, Hansen C, Crum-Cianflone NF. 25-hydroxyvitamin D, influenza vaccine response and healthcare encounters among a young adult population. PLoS One 2018; 13:e0192479. [PMID: 29425250 PMCID: PMC5806853 DOI: 10.1371/journal.pone.0192479] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 01/24/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Influenza causes significant morbidity and mortality; the pandemic in 2009-2010 was a reminder of the potential for novel strains and antigenic changes. Studies have shown that vitamin D deficiency may be associated with poor vaccine immunogenicity, therefore we sought to determine if there was a correlation between 25-hydroxyvitamin D [25(OH)D] and influenza vaccine response. METHODS A retrospective observational study was conducted among young, healthy military members to evaluate the association between total 25(OH)D levels with post influenza vaccination antibody titers and healthcare encounters during the 2009-10 influenza season. Univariate analyses were performed to evaluate whether 25(OH)D levels are associated with baseline characteristics and post-vaccination antibody responses. Multivariable logistic regression models were utilized to determine the associations between antibody responses and 25(OH)D levels adjusting for possible confounders. RESULTS A total of 437 subjects were studied. Most participants were young adults (91% were 18-39 years of age), 50% were male, and 56% resided in the southern U.S. Overall, 152 (34.8%) were vitamin D deficient, 167 (38.2%) insufficient, and 118 (27.0%) with normal 25(OH)D levels. There were no demographic differences by 25(OH)D category. Only 224 (51.3%) demonstrated a seroprotective anti-influenza post-vaccination titer, which did not vary by categorical 25(OH)D levels [vitamin D deficient vs. normal: OR 1.10 (0.68-1.78) and insufficient vs. normal: OR 1.25 (0.78-2.01)] or continuous vitamin D levels [OR 0.98 (0.84-1.15)]. There were also no associations with increased influenza like illnesses, respiratory diagnoses and healthcare encounters between the vitamin D groups. CONCLUSION Vitamin D insufficiency and deficiency were highly prevalent despite evaluating a young, healthy adult population. There were no significant associations between 25(OH)D levels and post-vaccination antibody titers to influenza vaccine. Further studies are required to discover strategies to improve vaccine efficacy as well as to determine the role of 25(OH)D in vaccine immunity.
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Affiliation(s)
- Rachel U. Lee
- Division of Allergy and Immunology, Department of Internal Medicine, Naval Medical Center San Diego, San Diego, CA
- * E-mail:
| | - Seung Hyun Won
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Bethesda, MD
| | - Christian Hansen
- Operational Infectious Disease Department, Naval Health Research Center, San Diego, CA
| | - Nancy F. Crum-Cianflone
- Division of Infectious Disease, Department of Internal Medicine, Scripps Mercy Hospital, San Diego, CA
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Moradi MT, Karimi A, Lorigooini Z. Alkaloids as the natural anti-influenza virus agents: a systematic review. TOXIN REV 2017. [DOI: 10.1080/15569543.2017.1323338] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Mohammad-Taghi Moradi
- Students Research Committee, Shahrekord University of Medical Sciences, Shahrekord, Iran and
| | - Ali Karimi
- Medical Plants Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Zahra Lorigooini
- Medical Plants Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran
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In vitro and in vivo effects of Peganum harmala L. seeds extract against influenza A virus. AVICENNA JOURNAL OF PHYTOMEDICINE 2017; 7:519-530. [PMID: 29299435 PMCID: PMC5745536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Influenza A virus infections are still a major health problem and the choices available for the control and treatment of the disease are limited. This research evaluated in vitro and in vivo antiviral effects of Peganum harmala L. seeds (PHS) extract against influenza A virus. MATERIALS AND METHODS In this research, in vitro anti-influenza A virus activity of the extract was assessed in Madin-Darby canine kidney (MDCK) cells. In order to evaluate anti-influenza activity of PHS extract in vivo, BALB/c mice were infected with 5LD50 of mouse-adapted influenza virus (H1N1; PR8) and received 200 mg/kg/day of PHS extract or 20 mg/kg/day oseltamivir. Lungs of seven mice per group were removed on day 3 post-infection and lung virus titers were determined by qRT-PCR. Mice survival, body weights and general conditions were observed for up to 14 days post-infection. RESULTS The results demonstrated that, the ethanolic extract of PHS possesses high activity against influenza virus with IC50 value of 15.7 (CI95%:11.7-21) μg/ml in MDCK cells. Our results also showed that, oral administration of PHS extract (200 mg/kg/day) or oseltamivir (20 mg/kg/day) to infected mice, increased the survival rate, reduced body weight loss, and decreased lung virus titer. CONCLUSION Based on our findings, P. harmala seeds extract can inhibit influenza A virus replication in vitro and in vivo. Therefore, isolation and characterization of the plant's active compounds and investigation of the underlying mechanisms of its antiviral action are highly suggested.
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Zdrenghea MT, Makrinioti H, Bagacean C, Bush A, Johnston SL, Stanciu LA. Vitamin D modulation of innate immune responses to respiratory viral infections. Rev Med Virol 2016; 27. [PMID: 27714929 DOI: 10.1002/rmv.1909] [Citation(s) in RCA: 130] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 08/28/2016] [Accepted: 08/30/2016] [Indexed: 12/23/2022]
Abstract
Vitamin D, in addition to its classical functions in bone homeostasis, has a modulatory and regulatory role in multiple processes, including host defense, inflammation, immunity, and epithelial repair. Patients with respiratory disease are frequently deficient in vitamin D, implying that supplementation might provide significant benefit to these patients. Respiratory viral infections are common and are the main trigger of acute exacerbations and hospitalization in children and adults with asthma and other airways diseases. Respiratory monocytes/macrophages and epithelial cells constitutively express the vitamin D receptor. Vitamin D, acting through this receptor, may be important in protection against respiratory infections. Whether the in vitro findings can be translated into a substantial in vivo benefit still remains uncertain. Here we review the in vitro data on the role of vitamin D in antiviral innate immunity, the data concerning the deficient levels of vitamin D in lung diseases, and the in vivo role of supplementation as protection against respiratory viral infections in healthy individuals and in patients with chronic respiratory diseases. Finally, we suggest ways of improving the effectiveness of vitamin D as an adjuvant in the prevention and treatment of acute respiratory infections.
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Affiliation(s)
- Mihnea T Zdrenghea
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy Cluj and Ion Chiricuta Oncology Institute, Cluj-Napoca, Romania
| | - Heidi Makrinioti
- Airways Disease Infection Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - Cristina Bagacean
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy Cluj and Ion Chiricuta Oncology Institute, Cluj-Napoca, Romania.,Laboratory of Immunology and Immunotherapy, University Hospital Brest, France
| | - Andy Bush
- Department of Paediatric Respiratory Medicine, Royal Brompton Hospital and Imperial College London, London, UK
| | - Sebastian L Johnston
- Airways Disease Infection Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - Luminita A Stanciu
- Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy Cluj and Ion Chiricuta Oncology Institute, Cluj-Napoca, Romania.,Airways Disease Infection Section, National Heart and Lung Institute, Imperial College London, London, UK
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Haque F, Sturm-Ramirez K, Homaira N, Gurley ES, Hossain MJ, Hasan SMM, Chowdhury S, Sarkar S, Khan AKMD, Rahman M, Rahman M, Luby SP. Influenza B virus outbreak at a religious residential school for boys in Northern Bangladesh, 2011. Influenza Other Respir Viruses 2016; 11:165-169. [PMID: 27603154 PMCID: PMC5304566 DOI: 10.1111/irv.12430] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2016] [Indexed: 12/01/2022] Open
Abstract
Background National media reported a febrile illness among dormitory residents of a boys' religious school. We investigated the outbreak to identify cause. Methods Individuals with fever (>100°F) and cough or sore throat between 1 and 13 August 2011 were influenza‐like‐illness (ILI) case‐patients. We collected histories and specimens from hospitalized case‐patients and visited campus to explore environmental context. Results All 28 case‐patients were dormitory residents including 27 hospitalizations. Accommodation space per resident was <0.8 square metres. Nasal and oropharyngeal swabs from 22 case‐patients were positive for influenza B virus using real‐time reverse transcription polymerase chain reaction (rRT‐PCR). Conclusions Overcrowding likely facilitated transmission leading to this dormitory outbreak.
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Affiliation(s)
- Farhana Haque
- Programme on Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, Dhaka, Bangladesh.,Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh
| | - Katharine Sturm-Ramirez
- Programme on Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, Dhaka, Bangladesh.,Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
| | - Nusrat Homaira
- Programme on Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, Dhaka, Bangladesh
| | - Emily Suzane Gurley
- Programme on Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, Dhaka, Bangladesh
| | - Md Jahangir Hossain
- Programme on Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, Dhaka, Bangladesh
| | - S M Murshid Hasan
- Programme on Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, Dhaka, Bangladesh
| | - Sukanta Chowdhury
- Programme on Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, Dhaka, Bangladesh
| | - Shamim Sarkar
- Programme on Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, Dhaka, Bangladesh
| | | | - Mustafizur Rahman
- Programme on Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, Dhaka, Bangladesh
| | - Mahmudur Rahman
- Institute of Epidemiology, Disease Control and Research (IEDCR), Dhaka, Bangladesh
| | - Stephen P Luby
- Programme on Emerging Infections (PEI), Infectious Diseases Division (IDD), icddr,b, Dhaka, Bangladesh.,Centers for Disease Control and Prevention (CDC), Atlanta, Georgia, USA
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Abstract
Background: Vitamin D plays an important role in several systems of the human body. Various studies have linked vitamin D deficiency to stress and insufficiency fractures, muscle recovery and function, and athletic performance. The prevalence of vitamin D deficiency in the elite athletic population has not been extensively studied, and very few reports exist among professional athletes. Hypothesis: There is a high prevalence of vitamin D deficiency or insufficiency among players attending the National Basketball Association (NBA) Combine. Study Design: Cross-sectional study; Level of evidence, 3. Methods: This is a retrospective review of data previously collected as part of the routine medical evaluation of players in the NBA Combines from 2009 through 2013. Player parameters evaluated were height, weight, body mass index (BMI), and vitamin D level. Statistical analysis using t tests and analysis of variance was used to detect any correlation between the player parameters and vitamin D level. Vitamin D levels were categorized as deficient (<20 ng/mL), insufficient (20-32 ng/mL), and sufficient (>32 ng/mL). Results: After institutional review board approval was submitted to the NBA, the NBA released deidentified data on 279 players who participated in the combines from 2009 through 2013. There were 90 players (32.3%) who were deficient, 131 players (47.0%) who were insufficient, and 58 players (20.8%) who were sufficient. A total of 221 players (79.3%) were either vitamin D deficient or insufficient. Among all players included, the average vitamin D level was 25.6 ± 10.2 ng/mL. Among the players who were deficient, insufficient, and sufficient, the average vitamin D levels were 16.1 ± 2.1 ng/mL, 25.0 ± 3.4 ng/mL, and 41.6 ± 8.6 ng/mL, respectively. Player height and weight were significantly increased in vitamin D–sufficient players compared with players who were not sufficient (P = .0008 and .009, respectively). Player age and BMI did not significantly differ depending on vitamin D status (P = .15 and .77, respectively). Conclusion: There is a high prevalence of vitamin D deficiency or insufficiency among participants in the NBA Combines. As a result, there should be a high suspicion for this metabolic abnormality among elite basketball players. Clinical Relevance: Vitamin D level has been linked to bone health, muscle recovery and function, and athletic performance. Because of the high prevalence of vitamin D deficiency in the NBA Combines, clinicians should maintain a high suspicion for vitamin D abnormalities among elite basketball players.
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Spiga R, Batton-Hubert M, Sarazin M. Predicting Fluctuating Rates of Hospitalizations in Relation to Influenza Epidemics and Meteorological Factors. PLoS One 2016; 11:e0157492. [PMID: 27310145 PMCID: PMC4911150 DOI: 10.1371/journal.pone.0157492] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 05/30/2016] [Indexed: 11/18/2022] Open
Abstract
Introduction In France, rates of hospital admissions increase at the peaks of influenza epidemics. Predicting influenza-associated hospitalizations could help to anticipate increased hospital activity. The purpose of this study is to identify predictors of influenza epidemics through the analysis of meteorological data, and medical data provided by general practitioners. Methods Historical data were collected from Meteo France, the Sentinelles network and hospitals’ information systems for a period of 8 years (2007–2015). First, connections between meteorological and medical data were estimated with the Pearson correlation coefficient, Principal component analysis and classification methods (Ward and k-means). Epidemic states of tested weeks were then predicted for each week during a one-year period using linear discriminant analysis. Finally, transition probabilities between epidemic states were calculated with the Markov Chain method. Results High correlations were found between influenza-associated hospitalizations and the variables: Sentinelles and emergency department admissions, and anti-correlations were found between hospitalizations and each of meteorological factors applying a time lag of: -13, -12 and -32 days respectively for temperature, absolute humidity and solar radiation. Epidemic weeks were predicted accurately with the linear discriminant analysis method; however there were many misclassifications about intermediate and non-epidemic weeks. Transition probability to an epidemic state was 100% when meteorological variables were below: 2°C, 4 g/m3 and 32 W/m2, respectively for temperature, absolute humidity and solar radiation. This probability was 0% when meteorological variables were above: 6°C, 5.8g/m3 and 74W/m2. Conclusion These results confirm a good correlation between influenza-associated hospitalizations, meteorological factors and general practitioner’s activity, the latter being the strongest predictor of hospital activity.
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Affiliation(s)
- Radia Spiga
- Service de Santé publique et d’information médicale, Centre Hospitalo-Universitaire, Saint-Etienne, France
- * E-mail:
| | - Mireille Batton-Hubert
- Ecole Nationale Supérieure des Mines, Unité Mixte de Recherche 6158, Institut Fayol, Saint-Etienne, France
| | - Marianne Sarazin
- Institut National de la Santé et de la Recherche Médicale, Unité Mixte de Recherche en Santé 1136, Paris, France
- Sorbonne Universités, Université Pierre et Marie Curie Paris 06, Paris, France
- Centre Ingénierie et Santé, Ecole Nationale Supérieure des Mines, Saint Etienne, France
- Département d’Information Médicale, Centre Hospitalier, Firminy, France
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1α,25(OH)2 Vitamin D3 Modulates Avian T Lymphocyte Functions without Inducing CTL Unresponsiveness. PLoS One 2016; 11:e0150134. [PMID: 26910045 PMCID: PMC4765962 DOI: 10.1371/journal.pone.0150134] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 02/09/2016] [Indexed: 12/24/2022] Open
Abstract
1,25-Dihydroxyvitamin D3 (Vitamin D) is a naturally synthesized fat soluble vitamin shown to have immunomodulatory, anti-inflammatory and cancer prevention properties in human and murine models. Here, we studied the effects of Vitamin D on the functional abilities of avian T lymphocytes using chicken Interferon (IFN)-γ ELISPOT assay, BrdU proliferation assay, Annexin V apoptosis assay and PhosFlow for detecting phosphorylated signalling molecules. The results demonstrate that Vitamin D significantly inhibited the abilities of T lymphocytes to produce IFN-γ and proliferate in vitro (P≤0.05), but retained their ability to undergo degranulation, which is a maker for cytotoxicity of these cells. Similarly, Vitamin D did not inhibit Extracellular signal-Regulated Kinase (ERK) 1/2 phosphorylation, a key mediator in T cell signalling, in the stimulated T lymphocytes population, while reduced ERK1/2 phosphorylation levels in the unstimulated cells. Our data provide evidence that Vitamin D has immuno-modulatory properties on chicken T lymphocytes without inducing unresponsiveness and by limiting immuno-pathology can promote protective immunity against infectious diseases of poultry.
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The environmental deposition of influenza virus from patients infected with influenza A(H1N1)pdm09: Implications for infection prevention and control. J Infect Public Health 2015; 9:278-88. [PMID: 26653976 DOI: 10.1016/j.jiph.2015.10.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2015] [Revised: 08/13/2015] [Accepted: 10/07/2015] [Indexed: 01/11/2023] Open
Abstract
In a multi-center, prospective, observational study over two influenza seasons, we sought to quantify and correlate the amount of virus recovered from the nares of infected subjects with that recovered from their immediate environment in community and hospital settings. We recorded the symptoms of adults and children with A(H1N1)pdm09 infection, took nasal swabs, and sampled touched surfaces and room air. Forty-two infected subjects were followed up. The mean duration of virus shedding was 6.2 days by PCR (Polymerase Chain Reaction) and 4.2 days by culture. Surface swabs were collected from 39 settings; 16 (41%) subject locations were contaminated with virus. Overall, 33 of the 671 (4.9%) surface swabs were PCR positive for influenza, of which two (0.3%) yielded viable virus. On illness Day 3, subjects yielding positive surface samples had significantly higher nasal viral loads (geometric mean ratio 25.7; 95% CI 1.75, 376.0, p=0.021) and a positive correlation (r=0.47, p=0.006) was observed between subject nasal viral loads and viral loads recovered from the surfaces around them. Room air was sampled in the vicinity of 12 subjects, and PCR positive samples were obtained for five (42%) samples. Influenza virus shed by infected subjects did not detectably contaminate the vast majority of surfaces sampled. We question the relative importance of the indirect contact transmission of influenza via surfaces, though our data support the existence of super-spreaders via this route. The air sampling results add to the accumulating evidence that supports the potential for droplet nuclei (aerosol) transmission of influenza.
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Saber A, Fotuhi F, Rostami Z, Einollahi B, Nemati E. Vitamin D Levels After Kidney Transplantation and the Risk of Cytomegalovirus Infection. Nephrourol Mon 2015; 7:e29677. [PMID: 26866004 PMCID: PMC4744636 DOI: 10.5812/numonthly.29677] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Revised: 05/26/2015] [Accepted: 06/03/2015] [Indexed: 12/31/2022] Open
Abstract
Background: Some studies reported an association between low levels of vitamin D and the risk of infections, especially viral infections. Kidney transplant patients are at risk of opportunistic infections; however, no study has been conducted on the association between vitamin D levels and the risk of CMV infection. Objectives: The aim of this study was to compare the level of vitamin D in two groups of patients with and without CMV infection within four months after the transplantation. Moreover, we aimed to find a relation between vitamin D level, before and after transplantation in each group. Patients and Methods: This prospective cohort study was conducted in Baqiyatallah hospital in Tehran in 2013. A total of 82 kidney transplant patients were enrolled and vitamin D levels were measured in them before transplantation. The kidney transplant patients had been followed up for four months and monitored for the presence of cytomegalovirus antigen (CMV Ag) in their blood. In patients with positive CMV Ag, vitamin D level was measured again when they became positive but in other patients it was measured at the end of follow-up; at the end, characteristics of patients and vitamin D levels were compared between the two groups. Results: Of all, 40 patients were CMV Ag positive and 42 patients were negative. In most patients transplanted organs were taken from cadaver (66%) and the most common type of dialysis was hemodialysis (92%). Most participants did not undergo antithymocyte globulin therapy (69%) and pulse corticosteroid therapy (83%). Vitamin D level before transplantation was 17.2 ± 11.6 ng/mL. In patients with positive results or at the end of follow-up in patients without CMV Ag, vitamin D level was 16.3 ± 11.4 ng/mL. Only 11% of kidney transplant patients, within four months after transplantation, had a normal level of vitamin D (> 30 ng/mL). There was no significant difference between the two groups for patients’ characteristics (P > 0.05). Vitamin D levels, before transplantation and at the time of detecting CMV Ag or at the end of follow-up period in patients without CMV, were not significantly different between the two groups (P > 0.05). However, vitamin D levels decreased in patients with CMV, while it increased in CMV Ag negative patients, which was statistically significant (P = 0.037). Conclusions: Only 11% of kidney transplant patients, even with a successful transplantation of the kidney and with an acceptable performance of the transplanted kidney, had an adequate level of vitamin D. Although, we did not find any significant association between vitamin D levels and CMV infection during a 4-month follow-up after kidney transplantation. It was observed that, compared with the time before transplantation, vitamin D levels decreased in patients with CMV, while it increased in CMV negative patients.
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Affiliation(s)
- Azadeh Saber
- Department of Nephrology, Kerman University of Medical Sciences, Kerman, IR Iran
| | - Farzaneh Fotuhi
- Department of Nephrology, Rajaei Cardiovascular, Medical & Research Center, Tehran, IR Iran
| | - Zohre Rostami
- Department of Nephrology, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Zohre Rostami, Department of Nephrology, Baqiyatallah University of Medical Sciences, Tehran, IR Iran. Tel: +98-218126, E-mail:
| | - Behzad Einollahi
- Department of Nephrology, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
| | - Eghlim Nemati
- Department of Nephrology, Baqiyatallah University of Medical Sciences, Tehran, IR Iran
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Sadarangani SP, Whitaker JA, Poland GA. "Let there be light": the role of vitamin D in the immune response to vaccines. Expert Rev Vaccines 2015; 14:1427-40. [PMID: 26325349 DOI: 10.1586/14760584.2015.1082426] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Vitamin D's non-skeletal actions, including immunomodulatory role, have been increasingly recognized. Of significance, many immune cells are able to synthesize a biologically active form of vitamin D from circulating 25-hydroxyvitamin D with subsequent intracrine actions, and the vitamin D receptor is broadly distributed. In this review, we discuss vitamin D's potent role in innate and adaptive immune responses and published studies evaluating the impact of serum vitamin D, vitamin D gene pathway polymorphisms or empiric vitamin D supplementation on vaccine immunogenicity. We highlight existing knowledge gaps and propose the steps needed to advance the science and answer the question of whether vitamin D may prove valuable as a vaccine adjuvant for certain vaccines against infectious diseases.
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Affiliation(s)
- Sapna P Sadarangani
- a 1 Mayo Vaccine Research Group, Rochester, MN, USA.,b 2 Division of Infectious Diseases, Mayo Clinic, Rochester, MN, USA
| | | | - Gregory A Poland
- a 1 Mayo Vaccine Research Group, Rochester, MN, USA.,c 3 Mayo Clinic Division of General Internal Medicine, Rochester, MN, USA
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Does the weather play a role in the spread of pandemic influenza? A study of H1N1pdm09 infections in France during 2009-2010. Epidemiol Infect 2015; 143:3384-93. [PMID: 26112598 DOI: 10.1017/s0950268815000941] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Understanding patterns of influenza spread and persistence is crucial for pandemic preparedness. The H1N1pdm09 virus caused the first influenza pandemic of the 21st century which resulted in at least 18500 deaths. Based on laboratory-confirmed primary-care case reports we investigated the role of weather conditions and socio-demographic variables in its initial spread and subsequent presence in France. Our findings suggest that low relative humidity and high population density were determinants in shaping the early spread of the virus at the national level. Those conditions also favoured the persistence of viral presence throughout the first 33 weeks of the pandemic. Additionally this persistence was significantly favoured by low insolation. These results confirm the increasingly recognized role of humidity in influenza dynamics and underlie the concomitant effect of insolation. Therefore climatic factors should be taken into account when designing influenza control and prevention measures.
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Abstract
The inference of key infectious disease epidemiological parameters is critical for characterizing disease spread and devising prevention and containment measures. The recent emergence of surveillance records mined from big data such as health-related online queries and social media, as well as model inference methods, permits the development of new methodologies for more comprehensive estimation of these parameters. We use such data in conjunction with Bayesian inference methods to study the transmission dynamics of influenza. We simultaneously estimate key epidemiological parameters, including population susceptibility, the basic reproductive number, attack rate, and infectious period, for 115 cities during the 2003-2004 through 2012-2013 seasons, including the 2009 pandemic. These estimates discriminate key differences in the epidemiological characteristics of these outbreaks across 10 y, as well as spatial variations of influenza transmission dynamics among subpopulations in the United States. In addition, the inference methods appear to compensate for observational biases and underreporting inherent in the surveillance data.
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Susilarini NK, Sitorus M, Praptaningsih CY, Sampurno OD, Bratasena A, Mulyadi E, Rusli R, Fandil A, Mangiri A, Apsari H, Hariyanto E, Samaan G. Application of WHO's guideline for the selection of sentinel sites for hospital-based influenza surveillance in Indonesia. BMC Health Serv Res 2014; 14:424. [PMID: 25248619 PMCID: PMC4179842 DOI: 10.1186/1472-6963-14-424] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 09/15/2014] [Indexed: 11/10/2022] Open
Abstract
Background A sentinel hospital-based severe acute respiratory infection (SARI) surveillance system was established in Indonesia in 2013. Deciding on the number, geographic location and hospitals to be selected as sentinel sites was a challenge. Based on the recently published WHO guideline for influenza surveillance (2012), this study presents the process for hospital sentinel site selection. Methods From the 2,165 hospitals in Indonesia, the first step was to shortlist to hospitals that had previously participated in respiratory disease surveillance systems and had acceptable surveillance performance history. The second step involved categorizing the shortlist according to five regions in Indonesia to maximize geographic representativeness. A checklist was developed based on the WHO recommended attributes for sentinel site selection including stability, feasibility, representativeness and the availability of data to enable disease burden estimation. Eight hospitals, a maximum of two per geographic region, were visited for checklist administration. Checklist findings from the eight hospitals were analyzed and sentinel sites selected in the third step. Results Six hospitals could be selected based on resources available to ensure system stability over a three-year period. For feasibility, all eight hospitals visited had mechanisms for specimen shipment and the capacity to report surveillance data, but two had limited motivation for system participation. For representativeness, the eight hospitals were geographically dispersed around Indonesia, and all could capture cases in all age and socio-economic groups. All eight hospitals had prerequisite population data to enable disease burden estimation. The two hospitals with low motivation were excluded and the remaining six were selected as sentinel sites. Conclusions The multi-step process enabled sentinel site selection based on the WHO recommended attributes that emphasize right-sizing the surveillance system to ensure its stability and maximizing its geographic representativeness. This experience may guide other countries interested in adopting WHO’s influenza surveillance standards for sentinel site selection.
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Affiliation(s)
- Ni Ketut Susilarini
- National Institute of Health Research and Development, Ministry of Health, Jakarta, Indonesia.
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Rech MA, Hunsaker T, Rodriguez J. Deficiency in 25-hydroxyvitamin D and 30-day mortality in patients with severe sepsis and septic shock. Am J Crit Care 2014; 23:e72-9. [PMID: 25179041 DOI: 10.4037/ajcc2014723] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Vitamin D has immunomodulating properties. OBJECTIVE To determine if vitamin D deficiency within 30 days of admission to the intensive care unit in patients with sepsis might be associated with increased all-cause 30-day mortality. METHODS In a retrospective cohort study at a large, tertiary, urban, academic medical center, records of patients who had 25-hydroxyvitamin D levels measured within 30 days of admission for severe sepsis or septic shock from June 2006 to April 2011 were examined. Patients were considered deficient in vitamin D if its serum concentration was 15 ng/mL or less. The primary outcome of interest was 30-day mortality. RESULTS Among the 121 patients in the sample, 65 (54%) were vitamin D deficient. Baseline demographics were similar between vitamin D deficient and nondeficient groups, except that the vitamin D deficient group had more African Americans (P = .01). All-cause 30-day mortality was significantly higher in patients deficient in vitamin D (37% vs 20%; P = .04) and remained higher at 90 days (51% vs 25%, P = .005). In multivariate analysis, age (odds ratio, 1.04; 95% CI 1.01-1.07; P = .01) and vitamin D deficiency (odds ratio, 2.7; 95% CI, 1.39-18.8; P = .02) were independently associated with increased 30-day mortality. CONCLUSION Patients deficient in vitamin D within 30 days of hospital admission for severe sepsis or septic shock may be at increased risk for all-cause 30-day mortality.
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Affiliation(s)
- Megan A. Rech
- Megan A. Rech, Todd Hunsaker, and Jennifer Rodriguez are clinical pharmacists, critical care, Department of Pharmacy Services, Henry Ford Hospital, Detroit, Michigan
| | - Todd Hunsaker
- Megan A. Rech, Todd Hunsaker, and Jennifer Rodriguez are clinical pharmacists, critical care, Department of Pharmacy Services, Henry Ford Hospital, Detroit, Michigan
| | - Jennifer Rodriguez
- Megan A. Rech, Todd Hunsaker, and Jennifer Rodriguez are clinical pharmacists, critical care, Department of Pharmacy Services, Henry Ford Hospital, Detroit, Michigan
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