scholarly journals Association of Vitamin D Status and COVID-19-Related Hospitalization and Mortality

2022 ◽  
Author(s):  
Karen H. Seal ◽  
Daniel Bertenthal ◽  
Evan Carey ◽  
Carl Grunfeld ◽  
Daniel D. Bikle ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Dose Response ◽  
Health Care Facilities ◽  
Primary Study ◽  
Vitamin D Status ◽  
Response Relationship ◽  
Dose Response Relationship ◽  
Race Ethnicity ◽  
The Impact

Abstract Background The relationship between vitamin D status and COVID-19-related clinical outcomes is controversial. Prior studies have been conducted in smaller, single-site, or homogeneous populations limiting adjustments for social determinants of health (race/ethnicity and poverty) common to both vitamin D deficiency and COVID-19 outcomes. Objective To evaluate the dose-response relationship between continuous 25(OH)D and risk for COVID-19-related hospitalization and mortality after adjusting for covariates associated with both vitamin D deficiency and COVID-19 outcomes. Design Retrospective cohort study. Patients Veteran patients receiving care in US Department of Veteran Affairs (VA) health care facilities with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) test and a blood 25(OH)D test between February 20, 2020, and November 8, 2020, followed for up to 60 days. Main Measures Exposure was blood 25(OH)D concentration ascertained closest to and within 15 to 90 days preceding an index positive SARS-CoV-2 test. Co-primary study outcomes were COVID-19-related inpatient hospitalization requiring airborne, droplet, contact, or other isolation and mortality ascertained within 60 days of an index positive SARS-CoV-2 test. Key Results Of 4,599 veterans with a positive SARS-CoV-2 test, vitamin D deficiency (< 20 ng/mL) was identified in 665 (14.5%); 964 (21.0%) were hospitalized; and 340 (7.4%) died. After adjusting for all covariates, including race/ethnicity and poverty, there was a significant independent inverse dose-response relationship between increasing continuous 25(OH)D concentrations (from 15 to 60 ng/mL) and decreasing probability of COVID-19-related hospitalization (from 24.1 to 18.7%, p=0.009) and mortality (from 10.4 to 5.7%, p=0.001). In modeling 25(OH)D as a log-transformed continuous variable, the greatest risk for hospitalization and death was observed at lower 25(OH)D concentrations. Conclusions Continuous blood 25(OH)D concentrations are independently associated with COVID-19-related hospitalization and mortality in an inverse dose-response relationship in this large racially and ethnically diverse cohort of VA patients. Randomized controlled trials are needed to evaluate the impact of vitamin D supplementation on COVID-19-related outcomes.

scholarly journals Dose-Response Relationship of EAE Clinical Severity in a MOG35-55 Mouse Model: A Pilot Study

2018 ◽  
Vol 1 (1) ◽  
pp. 123-132
Author(s):  
Gerlinde AS Metz ◽  
Bettenson D ◽  
Babatunde S ◽  
Gustafson C ◽  
Chan R
Keyword(s):  
Pilot Study ◽  
Pertussis Toxin ◽  
Dose Response ◽  
Clinical Symptoms ◽  
Clinical Severity ◽  
Response Relationship ◽  
Motor Impairments ◽  
Dose Response Relationship ◽  
Nociceptive Sensitivity ◽  
The Impact

Experimental autoimmune encephalomyelitis (EAE) is a common animal model of multiple sclerosis (MS) which mimics the autoimmune, demyelinating, and inflammatory hallmarks of this human disorder. To better understand the severity of the symptoms in relation to the antigen in EAE, we explored the dose-symptom relationship between the quantity of MOG35-55 and clinical symptoms in a C57/BL6 mouse pilot study. To isolate the impact of MOG35-55 we developed an EAE model that does not require the additional application of pertussis toxin. Mice were treated with either 50µg, 100µg, or 150µg of MOG35-55 emulsified in complete Freund’s adjuvant. Following induction, the mice were assessed for clinical symptoms daily, and tested weekly for gross and fine motor impairments, mechanical allodynia, and anxiety-like behaviours. The time course of sensorimotor function loss was characterized by multiphasic disease progression. Findings also suggested an inverted U-shape dose-response relationship with a medium dosage of 100 µl MOG35-55 dosage aggravating symptom severity in induced animals. Outcomes measured by a clinical score correlated with performance on motor and nociceptive sensitivity tasks. As the disease progressed, fine and gross motor impairments and nociceptive sensitivity diminished and impairments persisted beyond 8 weeks. This study indicates that mild to moderate EAE can be induced in the absence of use of pertussis toxin. The progression suggests a spontaneously multiphasic disease course, which may have attractive implications for clinically relevant animal models.

scholarly journals The impact of 1-year vitamin D supplementation on vitamin D status in athletes: a dose–response study

2016 ◽  
Vol 70 (9) ◽  
pp. 1009-1014 ◽  
Author(s):  
E M P Backx ◽  
M Tieland ◽  
K Maase ◽  
A K Kies ◽  
M Mensink ◽  
...  
Keyword(s):  
Vitamin D ◽  
Dose Response ◽  
Vitamin D Supplementation ◽  
Vitamin D Status ◽  
Dose Response Study ◽  
The Impact

scholarly journals Setting-Specific and Symptom-Specific Association between Secondhand Smoke Exposure and Depressive Symptoms

2019 ◽  
Vol 16 (7) ◽  
pp. 1249
Author(s):  
Xiaohua Ye ◽  
Jingya Huang ◽  
Liang Xia ◽  
Xiaojun Xu ◽  
Xiao Gong ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Dose Response ◽  
Secondhand Smoke ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Response Relationship ◽  
Dose Response Relationship ◽  
Cross Sectional ◽  
Shs Exposure ◽  
The Impact

Few studies have focused on the potential relationship between secondhand smoke (SHS) exposure and depressive symptoms. This study aimed to explore the potential association between SHS exposure and depressive symptoms and differentiate this association in setting-specific exposure and symptom-specific outcomes. A cross-sectional study was conducted in Guangdong province of China from September to December 2010 using a multistage sampling method to randomly sample adults aged 18 years and older. SHS exposure was defined as inhalation by non-smokers of the smoke exhaled from smokers for at least 1 day a week in the past 30 days. Depressive symptoms were measured using the nine-item Patient Health Questionnaire. The zero-inflate negative binomial regression models were used to explore the associations between SHS exposure and depressive symptoms. A total of 2771 non-smokers were included in this study, with mean age of 49.6 ± 14.0 years and 70.3% of females. The prevalence of depressive symptoms was significantly higher in participants with SHS exposure than in those without exposure (incidence rate ratio (IRR) = 1.32, 95% confidence interval (CI) 1.16–1.51), and there were similar positive associations for SHS exposure in medical facilities (IRR = 1.37, 95% CI 1.17–1.61) and in schools (IRR = 1.46, 95% CI 1.20–1.77). Notably, there was a monotonically increasing dose-response relationship between frequency of SHS exposure and depressive symptoms. When differentiating this relationship by the dimensions of depressive symptoms, there were similar dose-response relationships for cognitive-affective and somatic symptoms. When differentiating this relationship by sex, only females showed a significant dose-response relationship. Our findings suggest dose-response relationships between SHS exposure and depressive symptoms in sex-specific and symptom-specific manners. Future longitudinal studies are needed to establish the biological mechanisms of the impact of SHS exposure.

scholarly journals Vitamin D Status in Children with Leukemia

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 3973-3973 ◽  
Author(s):  
Natalja Jackmann ◽  
Arja H Harila-Saari ◽  
Outi Mäkitie ◽  
Jan Gustafsson ◽  
Dzeneta Nezirevich Dernroth ◽  
...  
Keyword(s):  
Vitamin D ◽  
Overall Survival ◽  
Myeloid Leukaemia ◽  
Vitamin D Deficiency ◽  
Conflicts Of Interest ◽  
Significant Negative Correlation ◽  
Vitamin D Status ◽  
Cross Sectional ◽  
Pediatric Cancer Patients ◽  
The Impact

Abstract Children and adolescents with leukemia are potentially at a high risk of developing vitamin D deficiency, due to limited physical activity and sunlight exposure, poor nutrition, chemotherapy, and its complications. The prevalence of vitamin D inadequacy in European pediatric cancer patients has been reported to be high. It is not known how many patients already have vitamin D deficiency at the time of diagnosis and whether vitamin D status at the time of diagnosis influences clinical outcome. We aimed to investigate vitamin D status in children with leukemia at the time of diagnosis and explore possible factors (age, type of leukemia, gender, year and season of sampling) contributing to a low level of 25-hydroxyvitamin D (25-OHD). Furthermore, we aimed to investigate if vitamin D status at the time of diagnosis influences overall survival. We carried out a cross-sectional study including all 295 children (169 boys, 57.3%) aged <18 years who were diagnosed with leukemia in our institution between 1991 and 2016 and had a stored serum sample available from the time of diagnosis. All samples had been stored at -80C. We analysed serum 25-OHD and PTH with reagents from the same batch in January 2018; 25-OHD levels <25 nmol/L were considered deficient, 25-50 nmol/L insufficient, 50-75 nmol/L sufficient, and ≥75nmol/L optimal. Clinical data (sex, age, diagnosis, date of the diagnosis, overall survival) were collected from the Swedish Childhood Cancer Registry. Altogether 295 children were included: 232 of them had acute lymphoblastic leukaemia (ALL), 52 acute myeloid leukaemia (AML), and 11 other types of leukemia (8 chronic myeloid leukaemia and 3 juvenile myelomonocytic leukaemia). Mean 25-OHD concentration was 60.7 nmol/L (SD 23.3). One third of the children (33.2%) had a subnormal 25-OHD level (6.4% had deficiency and 26.8% insufficiency), 39.7% were sufficient and 27.1% had an optimal level. There was a significant negative correlation between serum 25-OHD and PTH (p<0.001). Season affected serum 25-OHD: it was lowest in the spring (55.2 nmol/L, SD 21.7) and highest in the summer (68.4 nmol/L, SD 19.6). Multiple linear regression with unadjusted and adjusted analyses to explore the impact of age, diagnosis, gender, season, and time of sampling (calendar year) on 25-OHD level indicated that significant predictors of lower 25-OHD level were older age (p<0.001), sampling in the spring (p<0.001), sampling in more recent calendar year (p=0.001) and sampling in the winter (p=0.001). When exploring the impact of 25-OHD on survival, we used Cox proportional hazard regression. In the whole cohort only the diagnosis and the age at diagnosis were significant. However, when the younger patients (≤ 6 year of age) were analysed separately, 25-OHD level <50 nmol/L at the time of diagnosis was associated with inferior overall survival independently of other factors (HR 3.05, p=0.03) as compared with those with 25-OHD ≥50 nmol/L. This patient group included 163 patients with 16 events. Conclusion: Subnormal 25-OHD levels are common in pediatric patients with leukemia already at the time of diagnosis. In younger children with leukemia 25-OHD level <50 nmol/L is associated with inferior survival. Disclosures No relevant conflicts of interest to declare.

scholarly journals Factors Associated with Hospitalization and Disease Severity in a Racially and Ethnically Diverse Population of COVID-19 Patients

2020 ◽  
Author(s):  
Angelico Mendy ◽  
Senu Apewokin ◽  
Anjanette A. Wells ◽  
Ardythe L. Morrow
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Disease Severity ◽  
Severe Disease ◽  
Ethnically Diverse ◽  
Chronic Obstructive ◽  
Factors Associated ◽  
Race Ethnicity ◽  
The Impact ◽  
Hispanic White

ABSTRACTBackgroundThe coronavirus disease (COVID-19) first identified in Wuhan in December 2019 became a pandemic within a few months of its discovery. The impact of COVID-19 is due to both its rapid spread and its severity, but the determinants of severity have not been fully delineated.ObjectiveIdentify factors associated with hospitalization and disease severity in a racially and ethnically diverse cohort of COVID-19 patients.MethodsWe analyzed data from COVID-19 patients diagnosed at the University of Cincinnati health system from March 13, 2020 to May 31, 2020. Severe COVID-19 was defined as admission to intensive care unit or death. Logistic regression modeling adjusted for covariates was used to identify the factors associated with hospitalization and severe COVID-19.ResultsAmong the 689 COVID-19 patients included in our study, 29.2% were non-Hispanic White, 25.5% were non-Hispanic Black, 32.5% were Hispanic, and 12.8% were of ‘Other’ race/ethnicity. About 31.3% of patients were hospitalized and 13.2% had severe disease. In adjusted analyses, the sociodemographic factors associated with hospitalization and/or disease severity included older age, non-Hispanic Black or Hispanic race/ethnicity (compared non-Hispanic White), and smoking. The following comorbidities: diabetes, hypercholesterolemia, asthma, chronic obstructive pulmonary disease (COPD), chronic kidney disease, cardiovascular diseases, osteoarthritis, and vitamin D deficiency, were associated with hospitalization and/or disease severity. Hematological disorders such as anemia, coagulation disorders, and thrombocytopenia were associated with higher odds of both hospitalization and disease severity.ConclusionThis study confirms race and ethnicity as predictors of severe COVID-19 and identifies clinical risk factors not previously reported such a vitamin D deficiency, hypercholesterolemia, osteoarthritis, and anemia.

scholarly journals Childhood maltreatment disrupts HPA-axis activity under basal and stress conditions in a dose–response relationship in children and adolescents

2021 ◽  
pp. 1-14
Author(s):  
Laia Marques-Feixa ◽  
Helena Palma-Gudiel ◽  
Soledad Romero ◽  
Jorge Moya-Higueras ◽  
Marta Rapado-Castro ◽  
...  
Keyword(s):  
Hpa Axis ◽  
Dose Response ◽  
Childhood Maltreatment ◽  
Trier Social Stress Test ◽  
Cortisol Response ◽  
Response Relationship ◽  
Dose Response Relationship ◽  
Diurnal Cortisol ◽  
Hpa Axis Functioning ◽  
The Impact

Abstract Background This study investigates the impact of childhood maltreatment (CM) on hypothalamic–pituitary–adrenal (HPA)-axis functioning and on anxiety perception. Moreover, the influence of CM severity and frequency was also explored. Methods In total, 187 participants aged 7–17 were assessed for CM history using validated questionnaires and ad hoc interviews to be classified according to the criteria of the Tool for Assessing the Severity of Situations in which Children are Vulnerable (TASSCV). Psychopathology was ascertained using the K-SADS-PL5. To assess HPA-axis functioning, salivary cortisol samples were collected throughout a normal day and during an acute psychosocial stressor, the Trier Social Stress Test for children (TSST-C). Subjective anxiety was evaluated using STAI/-C. Results Youth with a CM history had higher overall diurnal cortisol levels (p = 0.001), blunted cortisol response to acute psychosocial stress (p = 0.002) and greater perceived anxiety (p = 0.003), than those without CM. Specifically, participants exposed to moderate/severe or often/frequent CM showed the greater diurnal cortisol output (pseverity = 0.002; pfrequency = 0.003), and blunted cortisol response during the TSST-C (pseverity = 0.006; pfrequency = 0.008). Meanwhile, youth with low CM severity/frequency exhibited a similar cortisol response to those without CM. However, perceived anxiety was higher in those exposed to CM (p < 0.001), regardless of its severity/frequency. Conclusions Disturbances in HPA-axis functioning are already evident early after CM exposure, while psychological and physiological responses to an acute stressor are dissociated in youth exposed to CM. The dose–response relationship described in this paper highlights the need to comprehensively evaluate CM so that vulnerable children can be identified and assigned to proper interventions.

What is the Dose-Response Relationship between Vitamin D and Cancer Risk?

2007 ◽  
Vol 65 (8) ◽  
pp. 91-95 ◽  
Author(s):  
Cedric F. Garland ◽  
William B. Grant ◽  
Sharif B. Mohr ◽  
Edward D. Gorham ◽  
Frank C. Garland
Keyword(s):  
Vitamin D ◽  
Cancer Risk ◽  
Dose Response ◽  
Response Relationship ◽  
Dose Response Relationship

scholarly journals Correlation of Vitamin D levels with feto-maternal outcome

2017 ◽  
Vol 7 (1) ◽  
pp. 137
Author(s):  
Nidhi Chauhan ◽  
Nikita Pahuja ◽  
Vinita Kalra
Keyword(s):  
Vitamin D ◽  
Birth Weight ◽  
Vitamin D Deficiency ◽  
Hypovitaminosis D ◽  
Vitamin D Status ◽  
Vitamin D Levels ◽  
Increase Risk ◽  
Sufficient Vitamin ◽  
Tract Infections ◽  
The Impact

Background: Vitamin D deficiency in adult females may increase risk of pre-eclampsia, gestational diabetes, bacterial vaginosis. Various malpresentation, cephalo-pelvic disproportion and difficult deliveries increases the risk of caesarean section. It may also increase the risk of fetal hypovitaminosis D, neonatal rickets and tetany, lower respiratory tract infections, low birth weight, the largest cause of infant mortality in India. This study was under taken to study the impact of vitamin D deficiency on feto-maternal outcome.Methods: The study was conducted in the Department of Obstetrics and Gynaecology, Himalayan Institute of Medical Sciences (HIMS), Swami Ram Nagar, Dehradun, over a period of 12 months. Sample size was 100 pregnant females attending antenatal clinic.Results: Out of 100 subjects, pre-eclampsia was seen in 15, among which 5 (23.80%) had deficient, 9 (13.04%) had insufficient and 1 (10%) had sufficient vitamin D levels. Eclampsia was seen in 3 subjects, out of which 1 (4.76%) had deficient, 2 (2.89%) had insufficient vitamin D status. IUGR was seen in 8 subjects, out of which 4 (19.04%) had deficient vitamin D levels, 4 (5.79%) had insufficient vitamin D status. Neither of the two had sufficient vitamin D status. Deficient vitamin D status with birth weight ≤2.5 kg was seen in 9 (42.85%) subjects and 12 (57.14%) subjects with >2.5 kg Insufficient Vitamin D status was seen in 22 (31.88%) subjects with birth weight ≤2.5 kg and 48 (69.56%) with birth weight >2.5 kg.Conclusions: Prevalence of vitamin D deficiency and insufficiency was noted in this region and its association with pre-eclampsia (23.80%, 13.04% and 10% in deficient, insufficient and sufficient group respectively) was seen. Higher incidence of LSCS was also present among the deficient and the insufficient group.

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