More positive news regarding remdesivir. And again, as with HCQ, it appears that treatment earlier in the course of infection is more effective. The US market opened ~2% higher on the news.
https://finance.yahoo.com/news/gilead-says-remdesivir-shows-improvement-130650230.html
I've mentioned this before and likely a certain public official has discredited it with some bizarre thinking, but Vitamin D levels which are increased by UV exposure (on the skin NOT inside the body). It is also available in gelcap form for those afraid of solar overexposure.
https://hospitalhealthcare.com/covi...t-biomarker-for-symptom-severity-in-covid-19/ Vitamin D has been shown to not only reduce the production of these pro-inflammatory cytokines but to increase the expression of anti-inflammatory cytokines by macrophages. This may be of value given the proinflammatory cytokine milieu observed in those infected with COVID-194 and how this “cytokine storm” leads to acute respiratory distress syndrome.
In light of the possible immune-enhancing effects, a recent retrospective analysis was undertaken of vitamin D status in patients with confirmed COVID-19 infection.3 Using a database from three hospitals in Southern Asian countries, the author categorised 212 cases of COVID-19 infections as mild, ordinary, severe and critical and matched these to 25(OH)D status. Normal was defined as 25(OH)D > 30ng/ml, insufficient, 21–29ng/ml and deficient as <20ng/ml. The
analysis revealed that for those with mild infection, mean 25(OH)D levels were 31.2ng/ml, ordinary, 27.4 ng/ml, severe, 21.2ng/ml and critical the lowest at 17.1ng/ml. These differences were found to be statistically significant and hint at the possibly that patients with higher levels of 25(OH)D have less severe symptoms
In summary, while vitamin D is known to have immune-enhancing properties, in the absence of clinical studies, the value of either supplementing or maintaining adequate vitamin D levels to reduce the symptom burden in those with COVID-19 infection remain unclear. Nevertheless, based on the latest analysis,3 it would seem eminently sensible for clinicians to ensure that those infected with COVID-19 have adequate vitamin D levels because this may lessen the effects of the virus and possibly save more lives.
- McCartney DM, Byrne DG. Optimisation of Vitamin D status for enhanced immune-protection against Covid-19. Ir Med J 2020;113(4):58.
- Alipio M. Vitamin D supplementation could possibly improve clinical outcomes of patients infected with Coronavirus-2019 (COVID-19) (April 8, 2020). https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3571484 (accessed April 2020).
- Huang C et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395(10223):497–506.
- Xu Z, Shi L, Wang Y et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Resp Med 2020;8(4):420–22.
https://www.nutraingredients.com/Ar...-and-severity-of-coronavirus-says-researchers
Clear link between vitamin D deficiency and severity of coronavirus, says researchers
By Nikki Hancocks
28-Apr-2020 - Last updated on 29-Apr-2020 at 08:21 GMT
Getty | AntonioGuillem Getty | AntonioGuillem
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Vitamin D deficiency may play an important role in the severity of COVID-19 infections so supplementation should be strongly advised at this time, according to researchers after studying the mortality rates across the globe.
Researchers from Trinity College in Dublin, Ireland, studied the high prevalence of Vitamin D deficiency in Northern Hemisphere countries and the possible role of vitamin D in suppressing the severe inflammatory responses seen in very ill COVID-19 patients and in COVID-19 deaths.
The work was undertaken by Dr Eamon Laird, from the School of Medicine at Trinity College Dublin, and Professor Rose Anne Kenny, Principal Investigator and founder of the Irish Longitudinal Study on Ageing (TILDA), in collaboration with Professor Jon Rhodes and Dr Sree Subramanian at the University of Liverpool.
Published as an editorial in the Journal of Alimentary Pharmacology and Therapeutics, the authors point out that it is becoming clear that countries in the Southern Hemisphere such as Australia are seeing relatively low mortality due to COVID-19, which can no longer feasibly be related to the later appearance and spread of the virus.
The study states that all countries that lie below a latitude of 35 degrees North have relatively low mortality from COVID-19, whereas people in countries that lie thirty-five degrees North and above receive insufficient sunlight for adequate vitamin D levels in winter and spring. These include Italy and Spain, which have low population levels of vitamin D.
Mortality rates from COVID-19 are higher at these latitudes, with the exception of Nordic countries, where vitamin D supplementation is widespread and deficiency much less common.
Vitamin D is important in regulation and suppression of the inflammatory cytokine response, which plays a role in the severe consequences of COVID-19 and ‘acute respiratory distress syndrome’ associated with ventilation and mortality in COVID-19.
The report argues that further research is 'urgently needed' to assess whether there may be a correlation between vitamin D status and severity of COVID-19 but says that, in the meantime, governments should be advocating supplementation of the vitamin.
It states: "A substantial proportion of the population in the Northern Hemisphere will currently be vitamin D deficient, and supplements eg. 1000 units per day are very safe. It is time for governments to strengthen recommendations for vitamin D intake and supplementation, particularly when under lock-down Vitamin D deficiency correlates with poor sunlight exposure, age, hypertension, diabetes, obesity and ethnicity—all features associated with increased risk of severe COVID-19."
Public Health England, and the Scottish and Welsh governments have issued recommendations for supplements for all adults from October to March, and supplementation all year round for adults living in care homes or nursing homes, required to wear clothes that cover most of the skin when outdoors, or with dark skin.
The National Health Service has also recommended everyone consider taking 10 micrograms of vitamin D a day during lockdown as they may not be getting enough vitamin D from sunlight if they’re indoors most of the day.
Professor Kenny says: “Similar public health recommendations are called for in Ireland. This advice is of importance given high mortality rates for SARS-CoV-2 infection in our nursing home sector. We are recommending that all nursing home residents take vitamin D.”
Dr Laird adds that whilst vitamin D can be consumed through the diet, supplementation can help ensure sufficient levels in the bloodstream.
He says: “In addition to metabolism in the skin, which is due to sun exposure, Vitamin D is present in foods such as oily fish (salmon, tuna, sardines), cheese, egg yolks and beef liver. However, supplementation is the best means of ensuring sufficient Vitamin D blood levels. As the effects of coronavirus continue, many of us are limited in the time we can spend outdoors, so extra care is required to keep vitamin D levels healthy.”
Source: Alimentary Pharmacology and Therapeutics
Rhodes. J. M. et al
"Editorial: low population mortality from COVID‐19 in countries south of latitude 35 degrees North – supports vitamin D as a factor determining severity"
I would suspect that Vitamin D supplementation would blow Remsedevir out of the water. Probably an exaggeration, but certainly easier than intravenous infusion (and cheaper.) They could be used together. Final comment, the references may not be conclusive but if I was a physician dealing with Covid cases, I would check Vitamin D levels and supplement as needed to bring it up to normal levels.
