-
Winter Vitamin D Update
Vitamin D
Essential role in immunomodulation
Innate and adaptive immune systems
Enhances innate immunity, immune peptides, anti-viral effects, disrupt viral envelopes
Suppressing the excessive expression of proinflammatory cytokines
Regulating the expression of ACE2 receptors
Epidemiological and clinical evidence, incidence, severity and mortality
Low levels
Hypertension, diabetes, cancer, cardiovascular diseases
Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot randomized clinical study
https://covid19.tabipacademy.com/2020/09/08/vitamin-d-reduces-risk-of-icu-admission-97/
https://www.sciencedirect.com/science/article/pii/S0960076020302764?via%3Dihub
50 patients treated with calcifediol
One required admission to the ICU (2%)
No deaths
All discharged, without complications
26 untreated patients
13 required ICU (50 %)
2 died
Calcifediol clinical trial, 1,000 patients, 15 hospitals
https://sevilla.abc.es/andalucia/cordoba/sevi-coronavirus-cordoba-calcifediol-ensayo-clinico-1000-pacientes-15-hospitales-probara-eficacia-farmaco-contra-covid-202010091322_noticia.html?ref=https:%2F%2Fwww.youtube.com
Vitamin D Status in Hospitalized Patients With SARS-CoV-2 Infection
The Journal of Clinical Endocrinology & Metabolism (Accepted, 27th October 2020)
https://academic.oup.com/jcem/advance-article/doi/10.1210/clinem/dgaa733/5934827
To assess serum 25-hydroxyvitamin D (25OHD) levels in hospitalized patients with COVID-19
Analyze the possible influence of vitamin D status on disease severity
Retrospective
Case-control
216 COVID-19 patients
197 population-based controls
Results
Vitamin D deficiency was defined as serum 25OHD levels less than 20 ng/ml (50 nmol/L)
COVID patients group
Mean levels 13.8 ng/ml. (34.5 nmol/L)
82.2% vitamin D deficient
Community control group
Mean levels 20.9 ng/ml (52.25 nmol/L) (p less than 0.0001)
47.2% vitamin D deficient
Blood levels lower in men than in women
Evidence of protective role of Ultraviolet-B (UVB) radiation in reducing COVID-19 deaths (Nature scientific reports, 19th October 2020)
https://www.nature.com/articles/s41598-020-74825-z
Ultraviolet-B (UVB) radiation, mediated by vitamin D synthesis
Dataset of 152 countries over 108 days (n = 6,524)
A permanent unit increase in UVI is associated with a 1.2 percentage points decline in daily growth rates of cumulative COVID-19 deaths
and a 1.0 percentage points decline in the CFR daily growth rate
Globally
Minus 12% of cumulative COVID-19 deaths
Minus 38% on CFR
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
Vitamin D sufficiency, a serum 25-hydroxyvitamin D at least 30 ng/mL reduced risk for adverse clinical outcomes in patients with COVID-19 infection
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0239799
Association between serum 25-hydroxyvitamin D levels and its effect on adverse clinical outcomes
n = 235
Results
Based on CDC criteria, among our study patients, 74% had severe COVID-19 infection and 32.8% were vitamin D sufficient.
Vitamin D sufficiency
25(OH)D less than 30 ng/ml. (75 nmol/L)
Reduction in clinical severity
Inpatient mortality
Serum levels of C-reactive protein (CRP)
Increase in lymphocyte percentage
Vitamin D insufficiency in southern Arizona (American Journal of Clinical Nutrition)
https://academic.oup.com/ajcn/article/87/3/608/4633323
Population 26.1 ng/ml (65.25 nmol/L)
Below 20 ng/ml (50 nmol/L)
Blacks 55%
Hispanics 37.6%
Whites 22.7%
Also more obesity in first two groups
Adult Health Status Among Native American Families Participating in the Growing Resilience Home Garden Study (CDC August 22, 2019)
https://www.cdc.gov/pcd/issues/2019/19_0021.htm
Northern Arapaho and Eastern Shoshone tribes sharing the Wind River Indian Reservation (WRIR) in Wyoming reportedly die 30 years earlier than whites in the state
Nearly 80% of adults had deficient vitamin D levels ( less than 20 ng/mL; n = 167) (50 nmol/L)
Obesity
Waist circumference, associated with higher risk of obesity-related disease
Women 95%
Men 80%
Hypertension
Diabetes
EVMS CRITICAL CARE COVID-19 MANAGEMENT PROTOCOL
https://www.evms.edu/media/evms_public/departments/internal_medicine/EVMS_Critical_Care_COVID-19_Protocol.pdf
If you would like to donate to John's educational projects, please use the following link, thank you, https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=78GGHGLK5ZXAE -
Winter Vitamin D Update
Vitamin D
Essential role in immunomodulation
Innate and adaptive immune systems
Enhances innate immunity, immune peptides, anti-viral effects, disrupt viral envelopes
Suppressing the excessive expression of proinflammatory cytokines
Regulating the expression of ACE2 receptors
Epidemiological and clinical evidence, incidence, severity and mortality
Low levels
Hypertension, diabetes, cancer, cardiovascular diseases
Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot randomized clinical study
https://covid19.tabipacademy.com/2020/09/08/vitamin-d-reduces-risk-of-icu-admission-97/
https://www.sciencedirect.com/science/article/pii/S0960076020302764?via%3Dihub
50 patients treated with calcifediol
One required admission to the ICU (2%)
No deaths
All discharged, without complications
26 untreated patients
13 required ICU (50 %)
2 died
Calcifediol clinical trial, 1,000 patients, 15 hospitals
https://sevilla.abc.es/andalucia/cordoba/sevi-coronavirus-cordoba-calcifediol-ensayo-clinico-1000-pacientes-15-hospitales-probara-eficacia-farmaco-contra-covid-202010091322_noticia.html?ref=https:%2F%2Fwww.youtube.com
Vitamin D Status in Hospitalized Patients With SARS-CoV-2 Infection
The Journal of Clinical Endocrinology & Metabolism (Accepted, 27th October 2020)
https://academic.oup.com/jcem/advance-article/doi/10.1210/clinem/dgaa733/5934827
To assess serum 25-hydroxyvitamin D (25OHD) levels in hospitalized patients with COVID-19
Analyze the possible influence of vitamin D status on disease severity
Retrospective
Case-control
216 COVID-19 patients
197 population-based controls
Results
Vitamin D deficiency was defined as serum 25OHD levels less than 20 ng/ml (50 nmol/L)
COVID patients group
Mean levels 13.8 ng/ml. (34.5 nmol/L)
82.2% vitamin D deficient
Community control group
Mean levels 20.9 ng/ml (52.25 nmol/L) (p less than 0.0001)
47.2% vitamin D deficient
Blood levels lower in men than in women
Evidence of protective role of Ultraviolet-B (UVB) radiation in reducing COVID-19 deaths (Nature scientific reports, 19th October 2020)
https://www.nature.com/articles/s41598-020-74825-z
Ultraviolet-B (UVB) radiation, mediated by vitamin D synthesis
Dataset of 152 countries over 108 days (n = 6,524)
A permanent unit increase in UVI is associated with a 1.2 percentage points decline in daily growth rates of cumulative COVID-19 deaths
and a 1.0 percentage points decline in the CFR daily growth rate
Globally
Minus 12% of cumulative COVID-19 deaths
Minus 38% on CFR
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
Vitamin D sufficiency, a serum 25-hydroxyvitamin D at least 30 ng/mL reduced risk for adverse clinical outcomes in patients with COVID-19 infection
https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0239799
Association between serum 25-hydroxyvitamin D levels and its effect on adverse clinical outcomes
n = 235
Results
Based on CDC criteria, among our study patients, 74% had severe COVID-19 infection and 32.8% were vitamin D sufficient.
Vitamin D sufficiency
25(OH)D less than 30 ng/ml. (75 nmol/L)
Reduction in clinical severity
Inpatient mortality
Serum levels of C-reactive protein (CRP)
Increase in lymphocyte percentage
Vitamin D insufficiency in southern Arizona (American Journal of Clinical Nutrition)
https://academic.oup.com/ajcn/article/87/3/608/4633323
Population 26.1 ng/ml (65.25 nmol/L)
Below 20 ng/ml (50 nmol/L)
Blacks 55%
Hispanics 37.6%
Whites 22.7%
Also more obesity in first two groups
Adult Health Status Among Native American Families Participating in the Growing Resilience Home Garden Study (CDC August 22, 2019)
https://www.cdc.gov/pcd/issues/2019/19_0021.htm
Northern Arapaho and Eastern Shoshone tribes sharing the Wind River Indian Reservation (WRIR) in Wyoming reportedly die 30 years earlier than whites in the state
Nearly 80% of adults had deficient vitamin D levels ( less than 20 ng/mL; n = 167) (50 nmol/L)
Obesity
Waist circumference, associated with higher risk of obesity-related disease
Women 95%
Men 80%
Hypertension
Diabetes
EVMS CRITICAL CARE COVID-19 MANAGEMENT PROTOCOL
https://www.evms.edu/media/evms_public/departments/internal_medicine/EVMS_Critical_Care_COVID-19_Protocol.pdf
If you would like to donate to John's educational projects, please use the following link, thank you, https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=78GGHGLK5ZXAE -
Vitamin D studies confirm correlations
Download my two educational text books for free using this link: http://159.69.48.3
Hard copy of the Physiology Notes text book on ebay, http://ebay.us/DcmyYV?cmpnId=5338273189
Hard copy of the Pathophysiology text book, https://www.ebay.co.uk/itm/154260052745
Vitamin D
UK biobank
https://www.ukbiobank.ac.uk
Habitual use of vitamin D supplements and risk of coronavirus disease 2019 (COVID-19) infection: a prospective study in UK Biobank (29th January, 2021)
https://academic.oup.com/ajcn/advance-article/doi/10.1093/ajcn/nqaa381/6123965
The American Journal of Clinical Nutrition
Background
Vitamin D supplementation, lower risk of acute respiratory tract infection
Emerging evidence, vitamin D insufficiency is related to a higher risk of coronavirus infection and disease
Objectives
To investigate the prospective association between habitual use of vitamin D supplements and risk of COVID- 19 infection
Associations according to levels of circulating and genetically predicted vitamin D
Methods
N = 8,297 adults
Records of COVID-19 test results from UK Biobank
16 March 2020 to 29 June 2020
Results
Of the 8,297 adults, 1,374 (16.6%) tested positive
Vit D users, n = 363
Non-vit D users, n = 7,934
Unadjusted model
OR 0.78 (p = 0.105)
Adjustment for covariates
Age, sex, race, origin (outpatient or inpatient), blood-type, years of education, TDI, smoking, moderate drinking, physical activity, healthy diet score, use of any other supplements
Inverse association emerged
Between habitual use of vitamin D supplements and risk of COVID-19 infection
OR, 0.66, (P = 0.038)
Habitual use of vitamin D supplements was significantly associated with a 34% lower risk of COVID-19 infection
No association with baseline blood vitamin D levels and risk of COVID-19 infection
Associations between the risk of COVID-19 infection and habitual use of other individual supplements
Vitamin A, vitamin B, vitamin C, vitamin E, folic acid, a
multivitamin,
Calcium, zinc, iron, selenium, glucosamine, fish
Oil
Vitamin D Deficiency and Outcome of COVID-19 Patients
Medical University Hospital Heidelberg, (September 2020)
https://www.mdpi.com/2072-6643/12/9/2757
Identification of modifiable prognostic factors may help to improve outcomes
N = 185, diagnosed and treated in Heidelberg
Median Vitamin D level was 16.6 ng/ml
Associations of vitamin D status with disease severity and survival
Vitamin D status assessed at first presentation
Deficient
25-hydroxyvitamin D (Calcifediol)
level less than 12 ng/mL ( less than 30 nM)
N = 41 (22%)
Median IL-6 levels at hospitalization were significantly higher
70.5 versus 29.7 pg/mL
Insufficiency
Less than 20 ng/mL (less than 50 nM)
N = 118 (64%)
Higher levels
N = 26
Median Vitamin D level was significantly lower in the inpatient versus the outpatient subgroup
Results
Median observation period of 66 days
93 (50%) patients required hospitalization
28 patients required ventilation
Including 16 deaths
Adjusting for age, sex, comorbidities
Deficiency was associated with higher risk of ventilation and death
Mechanical ventilation
HR 6.12
p less than 0.001
Death
HR 14.73
p less than 0.001
Other hazard ratios
Male, 1.69 2.5
Over 60, 3.2 7.7
Comorbidity, 2.7 5.3
Need for interventional studies
Cholecalciferol
Calcifediol
Active form of vitamin D3, 1, 25-dihydroxyvitamin D3 (1,25D3), calcitriol, is
pluripotent hormone and important modulator of both innate and adaptive immunity -
Vaccineren | Zondag met Lubach (S13)
We gaan een spannende tijd tegemoet, maar gelukkig zijn we begonnen met vaccineren.
Dit is het dertiende seizoen van Zondag met Lubach. Serie rond de Tweede Kamerverkiezingen 2021. Zeven dagen nieuws in 30 minuten, satirisch geremixt door Arjen Lubach. Vanachter een desk. In een pak. Op een stoel. Laatste seizoen. Zo goed als nieuws. #ZondagMetLubach zie je iedere week om 21.15 uur op #NPO3 en YouTube. #ZML
Deze video komt uit uitzending 1 van seizoen 13 van Zondag met Lubach. Kijk hier de hele aflevering: https://www.npo3.nl/zondag-met-lubach/07-02-2021/VPWON_1328961
https://www.vpro.nl/zml -
Waarom zouden ouderen vaker moeten hardlopen? Prof. Dr. Erik Scherder (3/5)
Waarom zouden ouderen vaker moeten hardlopen? Bewegen is goed voor je motoriek en je geheugen. Volgens professor Scherder zouden ouderen dan ook meer moeten worden gestimuleerd om te bewegen.
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Live college bijwonen? ► https://universiteitvannederland.nl/#bijwonen
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Deze week in Universiteit van Nederland:
Neuropsycholoog Erik Scherder!
Professor Erik Scherder (1951) is als hoogleraar Klinische Neuropsychologie verbonden aan de Vrije Universiteit. Hij won meerdere keren de VU Onderwijsprijs. De jury schreef onder meer: "Erik is een van de weinige docenten waarbij studenten zo goed als alle colleges hebben gevolgd. Hoe leuk de vorige avond ook was, hoe laat het ook is geworden, de colleges van Scherder sla je niet over."
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Over de Universiteit van Nederland:
De beste hoogleraren van Nederland geven gratis college op internet. Elke werkdag komt er een nieuw college online, en elke week een nieuwe hoogleraar.
Een opname bijwonen? Dat kan!
Vier avonden per maand nemen we colleges op in Club AIR, Amsterdam, en jij kunt daarbij zijn. Tijdens zo’n avond nemen we vijf colleges van een kwartier op, gevolgd door Q&A en meet and greet (want tegen die tijd is de hoogleraar een rockster). Een echte aanrader!
Voor tickets en meer info ► https://universiteitvannederland.nl/#bijwonen
Check onze website! ► http://www.universiteitvannederland.nl/
Twitter ► https://twitter.com/UniversiteitNL
Facebook ► https://www.facebook.com/UniversiteitVanNederland -
Fast-food stall from Roman era uncovered in Pompeii, Italy
A thermopolium, the Roman-era equivalent of a fast-food stall, which has just uncovered by Italian archeologists in Pompeii after being covered with ash since nearby Mount Vesuvius erupted about 2,000 years ago.
Subscribe to RT! https://www.youtube.com/channel/UCpwvZwUam-URkxB7g4USKpg?sub_confirmation=1
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#RT (Russia Today) is a global #news network broadcasting from Moscow, London, Paris and Washington studios to over 100 countries. RT is the first news channel to break the 1 billion YouTube views benchmark. -
Second Vitamin D clinical trial, positive results
Download my two educational text books for free using this link: http://159.69.48.3US Influenza
Short term, high-dose vitamin D supplementation for COVID-19 disease: a randomised, placebo-controlled, study (SHADE study)
https://pmj.bmj.com/content/early/2020/11/12/postgradmedj-2020-139065.full
It has been observed that vitamin D-deficient individuals
have increased COVID-19 risk and mortality
Pharmacologic treatments for coronavirus disease 2019 (COVID-19): a review. JAMA 2020;323:1824–36. doi: 10.1001/jama.2020.6019
The role of vitamin D in the prevention of coronavirus disease infection and mortality.
Aging Clin Exp Res 2020;32:1195–8. doi: 10.1007/s40520-020-01570-8
Association of vitamin D status and other clinical characteristics with COVID-19 test results.
JAMA Netw Open 2020;3:e2019722. (Published 3 Sep 2020).doi: 10.1001/jamanetworkopen.2020.19722
Immunomodulatory role and protective effect of vitamin D against other viral infections
Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ 2017;15:356:i6583. doi: 10.1136/bmj.i6583
An intervention study with calcifediol noticed a reduction in requirement for intensive care among hospitalised patients for COVID19
Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: a pilot randomized clinical study.
J Steroid Biochem Mol Biol 2020;203:105751. doi: 10.1016/j.jsbmb.2020.105751
50 patients treated with calcifediol, one required admission to the ICU (2%), no deaths
26 untreated patients, 13 required admission (50 %) to the ICU, 2 deaths
Immune-modulatory effect of vitamin D is likely to be observed at 25(OH)D levels, which are considered higher than that required for its skeletal effects
Vitamin D to prevent COVID-19: recommendations for the design of clinical trials. Febs J2020;287:3689–92. doi: 10.1111/febs.15534
Positive correlation between circulating cathelicidin antimicrobial peptide (hCAP18/LL-37) and 25-hydroxyvitamin D levels in healthy adults.
BMC Res Notes 2012;5:575. doi: 10.1186/1756-0500-5-575
Vitamin D sufficiency, a serum 25-hydroxyvitamin D at least 30 ng/mL reduced risk for adverse clinical outcomes in patients with COVID-19 infection.
PLoS One 2020;15:e0239799.doi: 10.1371/journal.pone.0239799
Aim
https://pmj.bmj.com/content/early/2020/11/12/postgradmedj-2020-139065.full
Effect of high dose, oral cholecalciferol supplementation on SARS-CoV-2 viral clearance
First cholecalciferol intervention study for asymptomatic and mildly symptomatic SARS-CoV-2 positive individuals
Design
Randomised, placebo-controlled.
Participants
Asymptomatic or mildly symptomatic SARS-CoV-2
RNA positive vitamin D deficient (25(OH) D less than 20 ng/ml)
Calcifediol, calcidiol, 25-hydroxycholecalciferol, or 25-hydroxyvitamin D3
Pre intervention baseline serum 25(OH) D
Intervention group, 8.6 ng/ml
Control group, 9.54 ng/ml (p=0.730)
10 out of 16 patients could achieve 25(OH)D more than 50 ng/ml by
day-7
Another two by day-14
Outcome measure
Proportion of patients with SARS-CoV-2 RNA negative before day-21
Change in inflammatory markers
Intervention group (n=16)
60 000 IU of cholecalciferol (oral nano-liquid droplets) for 7 days
Therapeutic target 25(OH)D more than 50 ng/ml
Cholecalciferol supplementation was continued for those with 25(OH)D less than 50 ng/ml
Fibrinogen levels significantly decreased with cholecalciferol supplementation
10 (62.5%) participants became SARS-CoV-2 RNA negative
Control group (n=24)
Placebo
5 (20.8%) participants became SARS-CoV-2 RNA negative (p less than 0.018)
Both groups
Patients requiring invasive ventilation or with significant comorbidities were excluded
25(OH)D levels were assessed at day 7
Regular measurements of: SARS-CoV-2 RNA, fibrinogen, D-dimer, procalcitonin, CRP, ferritin
Improvements
Calcifediol would have been better
Little and often for prevention -
Second Vitamin D clinical trial, positive results
Download my two educational text books for free using this link: http://159.69.48.3US Influenza
Short term, high-dose vitamin D supplementation for COVID-19 disease: a randomised, placebo-controlled, study (SHADE study)
https://pmj.bmj.com/content/early/2020/11/12/postgradmedj-2020-139065.full
It has been observed that vitamin D-deficient individuals
have increased COVID-19 risk and mortality
Pharmacologic treatments for coronavirus disease 2019 (COVID-19): a review. JAMA 2020;323:1824–36. doi: 10.1001/jama.2020.6019
The role of vitamin D in the prevention of coronavirus disease infection and mortality.
Aging Clin Exp Res 2020;32:1195–8. doi: 10.1007/s40520-020-01570-8
Association of vitamin D status and other clinical characteristics with COVID-19 test results.
JAMA Netw Open 2020;3:e2019722. (Published 3 Sep 2020).doi: 10.1001/jamanetworkopen.2020.19722
Immunomodulatory role and protective effect of vitamin D against other viral infections
Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ 2017;15:356:i6583. doi: 10.1136/bmj.i6583
An intervention study with calcifediol noticed a reduction in requirement for intensive care among hospitalised patients for COVID19
Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: a pilot randomized clinical study.
J Steroid Biochem Mol Biol 2020;203:105751. doi: 10.1016/j.jsbmb.2020.105751
50 patients treated with calcifediol, one required admission to the ICU (2%), no deaths
26 untreated patients, 13 required admission (50 %) to the ICU, 2 deaths
Immune-modulatory effect of vitamin D is likely to be observed at 25(OH)D levels, which are considered higher than that required for its skeletal effects
Vitamin D to prevent COVID-19: recommendations for the design of clinical trials. Febs J2020;287:3689–92. doi: 10.1111/febs.15534
Positive correlation between circulating cathelicidin antimicrobial peptide (hCAP18/LL-37) and 25-hydroxyvitamin D levels in healthy adults.
BMC Res Notes 2012;5:575. doi: 10.1186/1756-0500-5-575
Vitamin D sufficiency, a serum 25-hydroxyvitamin D at least 30 ng/mL reduced risk for adverse clinical outcomes in patients with COVID-19 infection.
PLoS One 2020;15:e0239799.doi: 10.1371/journal.pone.0239799
Aim
https://pmj.bmj.com/content/early/2020/11/12/postgradmedj-2020-139065.full
Effect of high dose, oral cholecalciferol supplementation on SARS-CoV-2 viral clearance
First cholecalciferol intervention study for asymptomatic and mildly symptomatic SARS-CoV-2 positive individuals
Design
Randomised, placebo-controlled.
Participants
Asymptomatic or mildly symptomatic SARS-CoV-2
RNA positive vitamin D deficient (25(OH) D less than 20 ng/ml)
Calcifediol, calcidiol, 25-hydroxycholecalciferol, or 25-hydroxyvitamin D3
Pre intervention baseline serum 25(OH) D
Intervention group, 8.6 ng/ml
Control group, 9.54 ng/ml (p=0.730)
10 out of 16 patients could achieve 25(OH)D more than 50 ng/ml by
day-7
Another two by day-14
Outcome measure
Proportion of patients with SARS-CoV-2 RNA negative before day-21
Change in inflammatory markers
Intervention group (n=16)
60 000 IU of cholecalciferol (oral nano-liquid droplets) for 7 days
Therapeutic target 25(OH)D more than 50 ng/ml
Cholecalciferol supplementation was continued for those with 25(OH)D less than 50 ng/ml
Fibrinogen levels significantly decreased with cholecalciferol supplementation
10 (62.5%) participants became SARS-CoV-2 RNA negative
Control group (n=24)
Placebo
5 (20.8%) participants became SARS-CoV-2 RNA negative (p less than 0.018)
Both groups
Patients requiring invasive ventilation or with significant comorbidities were excluded
25(OH)D levels were assessed at day 7
Regular measurements of: SARS-CoV-2 RNA, fibrinogen, D-dimer, procalcitonin, CRP, ferritin
Improvements
Calcifediol would have been better
Little and often for prevention -
COVID-19 and Zinc
President Trump taking zinc (WSJ)
https://www.wsj.com/articles/trump-takes-zinc-maybe-you-should-too-11601916665
Low zinc levels at clinical admission associates with poor outcomes in COVID-19, (11th October)
https://www.medrxiv.org/content/10.1101/2020.10.07.20208645v1
Zinc balances immune responses and also has a proven direct antiviral action against some viruses.
Zinc deficiency (ZD) is a common condition in elderly and individuals with chronic diseases
Increased intracellular zinc concentrations efficiently impair replication
Resulting in a lower number of viruses
Retrospective analysis
Patients admitted in Barcelona
15th March to 30th April 2020
Clinical severity of COVID-19 and PMH assessed
Fasting plasma zinc levels measured routinely at admission
N = 611
Mean age, 63 years
Male 332, (55%)
Total mortality was 87 patients (14%) during study time
But
249 of 611 patients studied
Of the 249, 21 (8%) died
Baseline zinc levels
Died, (21 people) mean plasma zinc = 43 μg/dl
Survived, (228 people) mean plasma zinc = 63.1 μg/dl
Higher zinc levels, associated with lower maximum levels of interleukin-6 during the period of active infection
Zinc level lower than 50 μg/dl at admission, 2.3 times increased risk of in-hospital death
Compared with those of 50 μg/dl or higher
Lower zinc levels at admission correlate with higher inflammation in the course of infection and poorer outcome
Low plasma zinc levels at admission are associated with mortality in COVID-19 in our study
Further studies are needed to assess the therapeutic impact of this association
COVID-19: Poor outcomes in patients with zinc deficiency (International Journal of Infectious Diseases, November 2020)
Chennai, India
Prospective study of fasting zinc levels in COVID-19 patients at the time of hospitalization
Healthy controls median 105.8 μg/dl
https://www.sciencedirect.com/science/article/pii/S120197122030730X
Zinc is a trace element with potent immunoregulatory and antiviral properties
Is utilized in the treatment of coronavirus disease 2019 (COVID-19)
Patients with serious COVID-19 had significantly low zinc levels in comparison to healthy controls
Zinc deficient COVID patients developed more complications
Zinc deficient patients 70.4% developed complications
Non zinc deficient patients, 30.0% developed complications, (p = 0.009)
Acute respiratory distress syndrome
More need of steroids
Increased mortality
Zinc deficient COVID patients had a prolonged hospital stay
Zinc deficient patients, 7.9 days
Non zinc deficient patients, 5.7 days, (p = 0.048)
In vitro studies
Reduced zinc levels increase SARS-CoV-2 virus receptor interactions
Increased zinc levels inhibit ACE2 expression
https://ods.od.nih.gov/factsheets/Zinc-HealthProfessional/
What zinc does
Catalytic activity of approximately 100 enzymes
Plays a role in immune function
Protein synthesis
Wound healing
DNA synthesis
Cell division
Normal growth and development, pregnancy, childhood, adolescence
Required for sense of taste and smell
Zinc and immunity
Severe zinc deficiency depresses immune function
Even mild to moderate degrees of zinc deficiency can impair macrophage and neutrophil functions, natural killer cell activity, and complement activity
Body requires zinc to develop and activate T-lymphocytes
Low zinc levels have shown reduced lymphocyte proliferation
…. that can be corrected by zinc supplementation
Low zinc status has been associated with increased susceptibility to pneumonia and other infections in children in developing countries and the elderly
Foods
Oysters
Sea food
Beef
Pork
Baked beans
Fortified cereals
Pumpkin seeds
Yogurt
Cashew nuts
Chickpeas
Oats
Almonds
Vitamin D and zinc can be made in bulk for essentially nothing -
How To Make Perfect Scrambled Eggs - 3 ways | Jamie Oliver
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Scrambled eggs can be hard to get right so Jamie's done a little video to give you a helping hand. There's three variations on this simple dish - English, French and American. All different. All tasty. Which one is your favourite?
What's your best tips for making scrambled eggs Food Tubers? Is there is a method from your own country you'd love to share? Let us know in the comments box below.
Thanks to our fine friends at www.clarencecourt.co.uk for the fabulous eggs in this video.
Did you find the hidden Easter egg link in this video? Turn on your annotations and take a closer look...
Links from the video:
Jamie Oliver - How to Make Perfect Porridge | http://goo.gl/HFiz3l
French Cooking Guy - 15 Amazing Facts about Eggs | http://goo.gl/FjyIxo
Music | Brightlight City | Charm Offensive, Escape
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Vegetarian and Vegan NPD (product development) examples at TOP b.v. Wageningen, Netherlands (c) 2020
Some illustrations of NPD projects that run at TOP b.v. We are specialised in practical food innovations in the domain vegetarian and vegan products. Thus plant-based proteins.
Primary the NPD of products liked by the new flexitarian consumers (we call this 'real meat applications') that could be stored 'chilled' is part of our skill-set at TOP b.v.
Take a look at : www.top-bv.nl
Wouter de Heij
www.wouterdeheij.nl
www.wouterdeheij.com -
Braadworst TOP bv
See also
Www.top-bv.nl
Www.boxnv.nl