Different studies have shown the regulatory effects of vitamin D(3) on the immune system and bone metabolism. Regarding the effects of vitamin D on immune cells and the importance of cytokines on bone metabolism, we assessed the association between serum levels of interleukin (IL)-6, IL-10, IL-12, IL-17 and IFN-γ cytokines and bone metabolism markers (Ca, P, PTH, ALP) in female students with vitamin D deficiency compared with control group. A total of 100 subjects with 25-hydroxy vitamin D(3) (25-(OH) D(3)) deficiency were selected as case and 100 subjects with sufficient 25-hydroxy vitamin D(3) (25-(OH) D(3)) were selected as the control group. The serum levels of IL-6, IL-10, IL-12, IL-17 and IFN-γ were measured by ELISA method. Ionized Ca, PTH, P, ALP levels were also determined in all participants. The results showed a statistically significant positive correlation between the levels of ALP with IFN-γ, PTH with IL-17 and a significant negative correlation between P with IL-10 in vitamin D deficient group. The results suggest that IL-17, IFN-γ and IL-10 are important mediators of bone metabolism and vitamin D affect bone metabolism, at least in part, through immune system. In addition, not only vitamin D affect bone metabolism but also modulates immune responses.
Introduction: Central nervous system involvement by SARS-CoV-19 appears to be very rare in neonates. We report a case of viral meningitis in a neonate admitted to Kerman Afzalipour Hospital in Southeastern Iran. Case Presentation: The patient was a 15-day-old neonate who presented with lethargy, fever, and poor feeding the day before admission. After the initial evaluation and experimental treatment, viral meningitis was diagnosed with SARS- CoV-19 by polymerase chain reaction (PCR) analysis of cerebrospinal fluid. Empirical treatment was done with antibiotics and supportive care. After viral meningitis was confirmed, the antibiotics were discontinued. In a follow-up two weeks later, the neonate had a good condition with no particular problem. Conclusions: This report is a case of SARS-CoV-2 meningitis in a neonate. Therefore, if there is epidemiological evidence, the central nervous system involvement due to this virus should also be considered in neonates.
Background
Despite the relative prevalence of small bowel and proximal colon perforation in the neonatal period, recto-sigmoid perforation is extremely rare. Full-term neonates experience intestinal perforation less frequently than premature infants. Here we report a neonate with sigmoid perforation and simultaneous Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection.
Case presentation
A 2550 g female neonate born at 38-weeks’ gestation from a coronavirus disease-2019 (COVID-19) infected mother by cesarean section. Despite a good Apgar score in the first and fifth minutes, she was admitted to the neonatal intensive care unit with grunting and mild respiratory distress. She underwent antibiotics and oxygen by head box resulting in an Oxygen Saturation rate of 94%. The patients’ respiratory distress decreased during the second day, resulting once breastfeeding without tolerance. While she passed meconium in the first 2 days, she developed abdominal distention on day 3. The nasopharyngeal SARS-CoV-2 real-time polymerase chain reaction (RT-PCR) was performed with positive results. Surgical consultation was requested and a thoraco-abdominal X-Ray was performed at this stage, which suspected to be a gastrointestinal perforation.
Due to clinical deterioration and persistent abdominal distention, a contrast study was performed with water-soluble contrast, which confirmed intestinal perforation. However, the surgical exploration revealed perforation of the sigmoid colon at the posterior segment. The patient underwent antibiotic therapy, abdominal lavage, and colostomy, immediately. She was discharged in good condition approximately 14-days later.
Conclusion
To our knowledge, this is the first report of sigmoid colon perforation in a term neonate following COVID-19.
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