Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19
The association between hypovitaminosis D, airways inflammation and increased risk of respiratory infections started before the COVID-19 era when a large body of studies evaluated the efficacy of vitamin D supplementation as adjunctive treatment in patients with respiratory diseases.
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the results of our study show a high prevalence of hypovitaminosis D in COVID-19 patients treated in a RICU. Higher risk of mortality was found in patients with severe vitamin D deficiency. Further studies need to be conducted on a larger population, to demonstrate whether adjunctive treatment with vitamin D might be effective in improving disease outcomes and in reducing mortality risk.
Vitamin D for prevention of respiratory tract infections
Respiratory tract infections are conditions that affect the air passages. These include acute infections that affect the lower respiratory tract and lungs, such as pneumonia and influenza, which are among the leading causes of death in children worldwide. In 2015, 16% of all deaths in children under five years of age were attributed to pneumonia. These conditions may also have an impact on quality of life. Therefore, it is important to find interventions that could prevent respiratory conditions.
Vitamin D is a fat-soluble-vitamin, different from others in that a major source derives from UV light-induced conversion of its precursor under the skin. Dietary sources include fortified foods and supplements. Studies have indicated that there is a high prevalence of vitamin D deficiency worldwide. Vitamin D deficiency may affect the immune system as vitamin D plays an immunomodulation role, enhancing innate immunity by up-regulating the expression and secretion of antimicrobial peptides, which boosts mucosal defences. Furthermore, recent meta-analyses have reported a protective effect of vitamin D supplementation on respiratory tract infections. Therefore, in this commentary we reviewed the applicability of such intervention and implementation in settings with limited resources based on these four systematic reviews and meta-analyses.
The effects of vitamin D on acute viral respiratory infections: A rapid review
Current evidence suggests vitamin D replacement may reduce risk for acute respiratory tract infections (ARTI) in people with deficiency or insufficiency, although the effects of supplementation on incidence and severity of ARTI in the general population remain unknown. Oral vitamin D supplemzentation taken at routine doses appears to be generally safe and well tolerated.
Vitamin B12 Pharmaconutrition for Covid-19
Mortality from Covid-19 disease is much greater in the elderly, many of whom succumb to acute respiratory distress syndrome (ARDS) triggered by the viral infection. High dose parenteral vitamin B12 offers a promising novel therapy for those Covid-19 patients with ARDS from sepsis/septic shock. The anti- inflammatory and antioxidant properties of vitamin B12 and transcobalamins can modulate the systemic inflammation contributing to the cytokine cascade that leads to ARDS. Clinical studies are now required to establish an appropriate regimen for administering vitamin B12 as pharmaconutrient for critically ill Covid-19 patients.
Vitamin B12 Supplementation and NT-proBNP Levels in COPD Patients: A Secondary Analysis of a Randomized and Controlled Study in Rehabilitation
We conclude that vitamin B12 supplementation could modulate NT-proBNP secretion. Moreover, possibly, the slower the initial V’O2 adjustments toward a steady-state during rest-to-exercise transitions, the more severe the ventricular chamber volume/pressure stress recruitment, expressed through higher NT-proBNP secretion in subjects with larger V’O2 time constants, despite unchanged final acute exercise-induced neurohormone secretion.
Addition of vitamin B12 to exercise training improves cycle ergometer endurance in advanced COPD patients: A randomized and controlled study
Micronutrients are essential for life and many elderly people are at risk of presenting deficiency of several components, including vitamin B12 (cobalamin). Chronic disease increases this risk. COPD patients, whose mortality will reach among the highest levels in 2020, have lower micronutrient and vitamin B12 levels than healthy controls. The presence of absolute or relative deficiency of vitamin B12 is associated with hyperhomocysteinemia and COPD patients have higher homocysteine levels compared to aged matched controls, which is in turn related to a decline in lung function in this population. Whether or not an epiphenomenon, there is evidence of a relationship between hyperhomocysteinemia, low blood levels of vitamin B12 and endothelial dysfunction [7], [8], mitochondrial dysfunction and muscular weakness and altered physical and neuromuscular performance.