Background: Several studies have suggested the positive impact of vitamin D on patients infected with SARS-CoV-2. This systematic review aims to evaluate the effects of vitamin D supplementation on clinical outcomes and mortality rate of COVID-19 patients. Methods: A comprehensive search was conducted through the databases of PubMed, Scopus, Web of Knowledge, Embase, Ovid, and The Cochrane Library without time and language limitation, until December 16, 2020. The results were screened, and the outcomes of interest were extracted. Using the Joanna Briggs Institute (JBI) Critical Appraisal Tools, the remaining results were appraised critically. Statistical analysis was performed using the Comprehensive Meta-Analysis (CMA) software version 2.0. Results: Of the 2311 results, four studies and 259 patients were enrolled, including 139 patients in vitamin D intervention groups. The pooled analysis of three studies, reporting the patients’ survival and mortality rate, showed a significantly lower mortality rate among the intervention groups compared with the control groups (OR=0.264, 95% CI=0.099–0.708, p-value=0.008). Two of the studies reported the clinical outcomes based on the World Health Organization’s Ordinal Scale for Clinical Improvement (OSCI) score for COVID-19, where both of them showed a significant decrease in OSCI score in the vitamin D intervention groups. One study reported a lower rate of intensive care unit (ICU) admission, and one study reported a significant decrease in serum levels of Fibrinogen. Conclusion: Prescribing vitamin D supplementation to patients with COVID-19 infection seems to decrease the mortality rate, the severity of the disease, and serum levels of the inflammatory markers. Further studies are needed to determine the ideal type, dosage, and duration of supplementation.
BackgroundSeveral studies have suggested the positive impact of vitamin D on patients infected with SARS-CoV-2. This systematic review aims to evaluate the effects of vitamin D supplementation on clinical outcomes and mortality rate of COVID-19 patients.MethodsA comprehensive search was conducted through the databases of PubMed, Scopus, Web of Knowledge, Embase, Ovid, and The Cochrane Library with no limitation in time and language, until December 16, 2020. The results were screened based on their accordance with the subject. Two independent reviewers selected the eligible studies and the outcomes of interest were extracted. Using the Joanna Briggs Institute (JBI) Critical Appraisal Tools for Randomized Controlled Trials (RCTs) and Quasi-Experimental Studies, the remaining results were appraised critically. Statistical analysis was performed using the Comprehensive Meta-Analysis (CMA) software version 2.0.ResultsOf the 2311 results, 1305 duplicated results were removed. After screening the titles, abstracts, and the full-text articles of the remaining records, four studies and 259 patients were enrolled, including 139 patients in vitamin D intervention groups. In three of the studies, the patients’ survival and mortality rate were evaluated. The pooled analysis of these studies showed a significantly lower mortality rate among the intervention groups (10.56%) compared with the control groups (23.88%) (OR = 0.264, 95% CI = 0.099–0.708, p-value = 0.008). Two of the studies reported the clinical outcomes based on the World Health Organization’s Ordinal Scale for Clinical Improvement (OSCI) score for COVID-19, where both of them showed a significant decrease in OSCI score in the vitamin D intervention groups. Additionally, One study reported a lower rate of intensive care unit (ICU) admission, and one study reported a significant decrease in serum levels of Fibrinogen.ConclusionPrescribing vitamin D supplementation to patients with COVID-19 infection seems to decrease the mortality rate, the severity of the disease, and serum levels of the inflammatory markers. Further studies are needed to determine the ideal type, dosage and duration of supplementation.
Stroke is a serious health condition that is responsible for more than 5% of total deaths. Near 20% of patients experiencing stroke die every year, resulting in the stroke being at the top of the list of preventable causes of death. Once an acute stroke is suspected, a golden hour of less than an hour is available to prevent the undesirable consequences. Since neuroimaging is mandatory in the diagnosis of stroke, the proper use of neuroimaging could help saving time and planning the right treatment for the patient. Some of the available imaging methods help us with rapid results, while others benefit us from a more accurate diagnosis. Hereby, we aim to provide a clinical review of the advantages and disadvantages of different available neuroimaging methods in approaching acute stroke to help clinicians choose the best method according to the settings.
To the Editor-Outbreaks impose massive burdens on healthcare systems. For example, >510 deaths were reported among the healthcare workers (HCWs) during the last Ebola outbreak, and by February 24, 2020, >3,300 HCWs had been infected with SARS-Cov-2 in China alone. 1,2 This issue represents the essence of outbreaks-a mass of patients who require prompt medical care. Under these conditions, the classical healthcare system cannot manage the large number of COVID-19 patients immediately and effectively. 3 Telehealth provides vital services through the application of information and communication technologies for each stage of managing diseases, research, and continuing education. 4 With telecommunication, visits are more economical and preserve government, community, and family resources, which are already limited during global outbreaks. It can be used to provide rapid diagnosis, and it enables caregivers to act quickly. 5 With the appropriate utilization of telecommunication, it is possible bring access to medicine and concurrent therapy in hard-to-reach regions and communities, facilitating direct-to-patient or specialty consultation services from a distance, which is cost-effective and improves the efficacy of follow-up. 6 The benefits of implementing telehealth in outbreaks comprise 8 main areas of focus:1. The available admission capacity and the number of HCWs are limited, and the hospital infrastructure may not be adequate to serve all patients. Figure 1 presents an optimum model of telemedicine that could aid medical and social management during an outbreak. 2. The more patients referred to healthcare facilities, the more HCWs are at risk of being infected. Also, most referrals are unnecessary and merely increase the load on the healthcare system. Furthermore, people referred to hospitals are at an incredibly higher risk of infection. More than 40% of the infections are assumed to be hospital related, though they should be quite simple to prevent (Fig. 1). 73. In affected regions, most healthcare facilities are dedicated to the management of COVID-19 patients. Therefore, noncritical patients (like patients with chronic and metabolic disorders such as hypertension, diabetes, and hyperlipidemia) have a lower priority. As a result of self-isolating, these people, mostly the older adults, cannot attend the healthcare units. A remote follow up and visit of these patients could prevent the consequences of poorly controlling the diseases. 4. During a worldwide health emergency, some people with less mobility (ie, disabled patients) may not even be able to access the nearest local care center. Telehealth can facilitate assistance in their location while simultaneously providing clinicians instant access to their medical records. 5. In many countries, medical schools and universities are among the closed establishments. The duration of this shutdown is unknown, and medical education should be continued through the online and virtual classes. Medical conferences and gatherings could be scheduled likewise. 6. Proper us...
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.