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      COVID-19 Disease Severity and Death in Relation to Vitamin D Status among SARS-CoV-2-Positive UAE Residents

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          Abstract

          Insufficient blood levels of the neurohormone vitamin D are associated with increased risk of COVID-19 severity and mortality. Despite the global rollout of vaccinations and promising preliminary results, the focus remains on additional preventive measures to manage COVID-19. Results conflict on vitamin D’s plausible role in preventing and treating COVID-19. We examined the relation between vitamin D status and COVID-19 severity and mortality among the multiethnic population of the United Arab Emirates. Our observational study used data for 522 participants who tested positive for SARS-CoV-2 at one of the main hospitals in Abu Dhabi and Dubai. Only 464 of those patients were included for data analysis. Demographic and clinical data were retrospectively analyzed. Serum samples immediately drawn at the first hospital visit were used to measure serum 25-hydroxyvitamin D [25(OH)D] concentrations through automated electrochemiluminescence. Levels < 12 ng/mL were significantly associated with higher risk of severe COVID-19 infection and of death. Age was the only other independent risk factor, whereas comorbidities and smoking did not contribute to the outcomes upon adjustment. Sex of patients was not an important predictor for severity or death. Our study is the first conducted in the UAE to measure 25(OH)D levels in SARS-CoV-2-positive patients and confirm the association of levels < 12 ng/mL with COVID-19 severity and mortality.

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          COVID-19 and Racial/Ethnic Disparities

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            High prevalence of obesity in severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) requiring invasive mechanical ventilation

            Abstract Objective The Covid‐19 pandemic is rapidly spreading worldwide, notably in Europe and North America, where obesity is highly prevalent. The relation between obesity and severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) has not been fully documented. Methods In this retrospective cohort study we analyzed the relationship between clinical characteristics, including body mass index (BMI), and the requirement for invasive mechanical ventilation (IMV) in 124 consecutive patients admitted in intensive care for SARS‐CoV‐2, in a single French center. Results Obesity (BMI >30 kg/m2) and severe obesity (BMI >35 kg/m2) were present in 47.6% and 28.2% of cases, respectively. Overall, 85 patients (68.6%) required IMV. The proportion of patients who required IMV increased with BMI categories (p 35 kg/m2 (85.7%). In multivariate logistic regression, the need for IMV was significantly associated with male sex (p 35 kg/m2 vs patients with BMI <25 kg/m2 was 7.36 (1.63‐33.14; p=0.02) Conclusion The present study showed a high frequency of obesity among patients admitted in intensive care for SARS‐CoV‐2. Disease severity increased with BMI. Obesity is a risk factor for SARS‐CoV‐2 severity requiring increased attention to preventive measures in susceptible individuals.
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              Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths

              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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                Author and article information

                Contributors
                Role: Academic Editor
                Journal
                Nutrients
                Nutrients
                nutrients
                Nutrients
                MDPI
                2072-6643
                19 May 2021
                May 2021
                : 13
                : 5
                : 1714
                Affiliations
                [1 ]Center for Biotechnology, Khalifa University of Science and Technology, Abu Dhabi 127788, United Arab Emirates; habiba.alsafar@ 123456ku.ac.ae (H.A.); guan.tay@ 123456uwa.edu.au (G.T.)
                [2 ]Department of Biomedical Engineering, College of Engineering, Khalifa University of Science and Technology, Abu Dhabi 127788, United Arab Emirates
                [3 ]Department of Genetics and Molecular Biology, College of Medicine and Health Sciences, Khalifa University of Science and Technology, Abu Dhabi 127788, United Arab Emirates
                [4 ]Sunlight, Nutrition and Health Research Center, P.O. Box 641603, San Francisco, CA 94164-1603, USA; williamgrant08@ 123456comcast.net
                [5 ]Department of Mathematics and Statistics, College of Natural and Health Sciences, Zayed University, Abu Dhabi 144534, United Arab Emirates; Rafiq.Hijazi@ 123456zu.ac.ae
                [6 ]Department of Pediatric Infectious Disease, Sheikh Khalifa Medical City, Abu Dhabi 51900, United Arab Emirates; muddin@ 123456seha.ae (M.U.); nalkaabi@ 123456seha.ae (N.A.)
                [7 ]Division of Psychiatry, Faculty of Health and Medical Sciences, University of Western Australia, Crawley, Western Australia, Australia
                [8 ]School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
                [9 ]Dubai Health Authority, Rashid Hospital, Dubai, United Arab Emirates; drbassam_mahboub@ 123456yahoo.com
                [10 ]Department of Health Sciences, College of Natural and Health Sciences, Zayed University, Abu Dhabi 144534, United Arab Emirates
                Author notes
                [* ]Correspondence: Fatme.AlAnouti@ 123456zu.ac.ae
                [†]

                These authors contributed equally to this work.

                Author information
                https://orcid.org/0000-0001-7141-1438
                https://orcid.org/0000-0002-1439-3285
                https://orcid.org/0000-0002-6895-9280
                https://orcid.org/0000-0002-1175-4145
                https://orcid.org/0000-0001-6639-3298
                https://orcid.org/0000-0003-4665-6024
                https://orcid.org/0000-0002-1993-6656
                Article
                nutrients-13-01714
                10.3390/nu13051714
                8159141
                34069412
                ae5616d2-a99e-46f9-be0d-db4a8aed10d2
                © 2021 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( https://creativecommons.org/licenses/by/4.0/).

                History
                : 05 May 2021
                : 17 May 2021
                Categories
                Article

                Nutrition & Dietetics
                vitamin d,covid-19,sars-cov-2,severity,mortality,united arab emirates
                Nutrition & Dietetics
                vitamin d, covid-19, sars-cov-2, severity, mortality, united arab emirates

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