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Alqutub ST, Alzahrani FA, Hassan AS, Alirbidi AH, Alraddadi OA, AlSadah OA, Yamani MB, Tobaiqy M. Exogenous Melatonin Use in University Students: A Cross-Sectional Survey. Pharmacy (Basel) 2024; 12:41. [PMID: 38525721 PMCID: PMC10961763 DOI: 10.3390/pharmacy12020041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/14/2024] [Accepted: 02/21/2024] [Indexed: 03/26/2024] Open
Abstract
To assess the prevalence of melatonin use and its perceived benefits among university students in different specialties in Saudi Arabia, a cross-sectional survey was conducted between March and June 2023. Data about demographics, time of melatonin use, perceived reasons for exogenous melatonin use, melatonin use in relation to exam periods, perceived safety, and adverse effects was gathered. Of 380 students, ~52% reported using exogenous melatonin for sleep disorders. Most participants reported using melatonin during and after exam periods. Additionally, several (n = 157; 75.4%) believed that its use was safe. The predominant use patterns were daily and as needed, and this study observed a higher rate of use compared with previous studies in Saudi Arabia. The most frequently reported adverse effect was headache (n = 36; 37.5%). A significant number of undergraduate male students in health specialties used melatonin. A high rate of melatonin use was noted during exam periods, which was attributed to sleep deprivation. Additionally, a significant number of students from private universities reported using exogenous melatonin. Melatonin use is common among university students. Future research should use a reliable psychometric measure to test its effect on university students' sleep quality and quantity.
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Affiliation(s)
- Sulafa T. Alqutub
- Department of Family and Community Medicine, College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia
| | - Faris A. Alzahrani
- College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia; (F.A.A.); (A.S.H.); (A.H.A.); (O.A.A.); (O.A.A.); (M.B.Y.)
| | - Abdulrahman S. Hassan
- College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia; (F.A.A.); (A.S.H.); (A.H.A.); (O.A.A.); (O.A.A.); (M.B.Y.)
| | - Abdullah H. Alirbidi
- College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia; (F.A.A.); (A.S.H.); (A.H.A.); (O.A.A.); (O.A.A.); (M.B.Y.)
| | - Osama A. Alraddadi
- College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia; (F.A.A.); (A.S.H.); (A.H.A.); (O.A.A.); (O.A.A.); (M.B.Y.)
| | - Omar A. AlSadah
- College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia; (F.A.A.); (A.S.H.); (A.H.A.); (O.A.A.); (O.A.A.); (M.B.Y.)
| | - Mohammad B. Yamani
- College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia; (F.A.A.); (A.S.H.); (A.H.A.); (O.A.A.); (O.A.A.); (M.B.Y.)
| | - Mansour Tobaiqy
- Department of Pharmacology, College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia;
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Xue M, Lin Z, Zhang T, Cheng ZJ, Lin R, Guo B, Zeng Y, Hu F, Li F, Zheng P, Huang H, Li N, Zhao Q, Sun B, Tang X. ERC-BiP Functional Protein Pathway for Assessing Endoplasmic Reticulum Stress Induced by SARS-CoV-2 Replication after Cell Invasion. Can J Infect Dis Med Microbiol 2023; 2023:7253779. [PMID: 37849973 PMCID: PMC10578982 DOI: 10.1155/2023/7253779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 06/24/2023] [Accepted: 09/15/2023] [Indexed: 10/19/2023]
Abstract
Background SARS-CoV-2 induces apoptosis and amplifies the immune response by continuously stressing the endoplasmic reticulum (ER) after invading cells. This study aimed to establish a protein-metabolic pathway associated with ER dysfunction based on the invasion mechanism of SARS-CoV-2. Methods This study included 17 healthy people and 46 COVID-19 patients, including 38 mild patients and 8 severe patients. Proteomics and metabolomics were measured in the patient plasma collected at admission and one week after admission. The patients were further divided into the aggravation and remission groups based on disease progression within one week of admission. Results Cross-sectional comparison showed that endoplasmic reticulum molecular chaperone-binding immunoglobulin protein (ERC-BiP), angiotensinogen (AGT), ceramide acid (Cer), and C-reactive protein (CRP) levels were significantly increased in COVID-19 patients, while the sphingomyelin (SM) level was significantly decreased (P < 0.05). In addition, longitudinal comparative analysis found that the temporal fold changes of ERC-BiP, AGT, Cer, CRP, and SM were significantly different between the patients in the aggravation and remission groups (P < 0.05). ERC-BiP, AGT, and Cer levels were significantly increased in aggravation patients, while SM was significantly decreased (P < 0.05). Meanwhile, ERC-BiP was significantly correlated with AGT (r = 0.439; P < 0.001). Conclusions ERC-BiP can be used as a core index to reflect the degree of ER stress in COVID-19 patients, which is of great value for evaluating the functional state of cells. A functional pathway for AGT/ERC-BiP/glycolysis can directly assess the activation of unfolded protein reactions. The ERC-BiP pathway is closer to the intracellular replication pathway of SARS-CoV-2 and may help in the development of predictive protocols for COVID-19 exacerbation.
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Affiliation(s)
- Mingshan Xue
- Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou 510060, China
- Guangzhou Laboratory, XingDaoHuanBei Road, Guangzhou International Bio-Island, Guangzhou 510005, Guangdong Province, China
- National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Zhiwei Lin
- National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Teng Zhang
- Cancer Centre, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macau, China
- MoE Frontiers Science Center for Precision Oncology, University of Macau, Taipa, Macau, China
| | - Zhangkai J. Cheng
- National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Runpei Lin
- National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Baojun Guo
- National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
- School of Medicine, Henan University, Kaifeng 475000, Henan, China
| | - Yifeng Zeng
- National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Fengyu Hu
- Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou 510060, China
| | - Feng Li
- Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou 510060, China
| | - Peiyan Zheng
- National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Huimin Huang
- National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Ning Li
- National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Qi Zhao
- Cancer Centre, Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Taipa, Macau, China
- MoE Frontiers Science Center for Precision Oncology, University of Macau, Taipa, Macau, China
| | - Baoqing Sun
- National Center for Respiratory Medicine, The First Affiliated Hospital of Guangzhou Medical University, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, Guangzhou 510120, China
| | - Xiaoping Tang
- Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou 510060, China
- Guangzhou Laboratory, XingDaoHuanBei Road, Guangzhou International Bio-Island, Guangzhou 510005, Guangdong Province, China
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Georgieva E, Ananiev J, Yovchev Y, Arabadzhiev G, Abrashev H, Abrasheva D, Atanasov V, Kostandieva R, Mitev M, Petkova-Parlapanska K, Karamalakova Y, Koleva-Korkelia I, Tsoneva V, Nikolova G. COVID-19 Complications: Oxidative Stress, Inflammation, and Mitochondrial and Endothelial Dysfunction. Int J Mol Sci 2023; 24:14876. [PMID: 37834324 PMCID: PMC10573237 DOI: 10.3390/ijms241914876] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 09/28/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
SARS-CoV-2 infection, discovered and isolated in Wuhan City, Hubei Province, China, causes acute atypical respiratory symptoms and has led to profound changes in our lives. COVID-19 is characterized by a wide range of complications, which include pulmonary embolism, thromboembolism and arterial clot formation, arrhythmias, cardiomyopathy, multiorgan failure, and more. The disease has caused a worldwide pandemic, and despite various measures such as social distancing, various preventive strategies, and therapeutic approaches, and the creation of vaccines, the novel coronavirus infection (COVID-19) still hides many mysteries for the scientific community. Oxidative stress has been suggested to play an essential role in the pathogenesis of COVID-19, and determining free radical levels in patients with coronavirus infection may provide an insight into disease severity. The generation of abnormal levels of oxidants under a COVID-19-induced cytokine storm causes the irreversible oxidation of a wide range of macromolecules and subsequent damage to cells, tissues, and organs. Clinical studies have shown that oxidative stress initiates endothelial damage, which increases the risk of complications in COVID-19 and post-COVID-19 or long-COVID-19 cases. This review describes the role of oxidative stress and free radicals in the mediation of COVID-19-induced mitochondrial and endothelial dysfunction.
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Affiliation(s)
- Ekaterina Georgieva
- Department of General and Clinical Pathology, Forensic Medicine, Deontology and Dermatovenerology, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria;
| | - Julian Ananiev
- Department of General and Clinical Pathology, Forensic Medicine, Deontology and Dermatovenerology, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria;
| | - Yovcho Yovchev
- Department of Surgery and Anesthesiology, University Hospital “Prof. Dr. St. Kirkovich”, 6000 Stara Zagora, Bulgaria; (Y.Y.); (G.A.)
| | - Georgi Arabadzhiev
- Department of Surgery and Anesthesiology, University Hospital “Prof. Dr. St. Kirkovich”, 6000 Stara Zagora, Bulgaria; (Y.Y.); (G.A.)
| | - Hristo Abrashev
- Department of Vascular Surgery, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria;
| | - Despina Abrasheva
- II Department of Internal Medicine Therapy: Cardiology, Rheumatology, Hematology and Gastroenterology, Medical Faculty, Trakia University, 6000 Stara Zagora, Bulgaria;
| | - Vasil Atanasov
- Forensic Toxicology Laboratory, Military Medical Academy, 3 G. Sofiiski, 1606 Sofia, Bulgaria; (V.A.); (R.K.)
| | - Rositsa Kostandieva
- Forensic Toxicology Laboratory, Military Medical Academy, 3 G. Sofiiski, 1606 Sofia, Bulgaria; (V.A.); (R.K.)
| | - Mitko Mitev
- Department of Diagnostic Imaging, University Hospital “Prof. Dr. St. Kirkovich”, 6000 Stara Zagora, Bulgaria;
| | - Kamelia Petkova-Parlapanska
- Department of Medical Chemistry and Biochemistry, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria; (K.P.-P.); (Y.K.)
| | - Yanka Karamalakova
- Department of Medical Chemistry and Biochemistry, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria; (K.P.-P.); (Y.K.)
| | - Iliana Koleva-Korkelia
- Department of Obstetrics and Gynaecology Clinic, University Hospital “Prof. St. Kirkovich”, 6000 Stara Zagora, Bulgaria;
| | - Vanya Tsoneva
- Department of Propaedeutics of Internal Medicine and Clinical Laboratory, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria;
| | - Galina Nikolova
- Department of Medical Chemistry and Biochemistry, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria; (K.P.-P.); (Y.K.)
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Tobaiqy M, AlZahrani FA, Hassan AS, Alirbidi AH, Alraddadi OA, AlSadah OA, Yamani MB, Alqutub ST. Community Pharmacists' Knowledge, Attitudes and the Perceived Safety and Effectiveness of Melatonin Supplements: A Cross-Sectional Survey. Pharmacy (Basel) 2023; 11:147. [PMID: 37736919 PMCID: PMC10514787 DOI: 10.3390/pharmacy11050147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/02/2023] [Accepted: 09/14/2023] [Indexed: 09/23/2023] Open
Abstract
Melatonin, which is classified as a dietary supplement by the Saudi Food and Drug Authority, is used to manage sleep disorders. In this study, community pharmacists' knowledge and attitudes about dispensing melatonin supplements and the perceived safety and effectiveness of melatonin were assessed. A cross-sectional survey of community pharmacists in Jeddah, Saudi Arabia was conducted from March-June 2023. Community pharmacists' knowledge and attitudes towards prescribing and dispensing melatonin supplements, the methods of dispensing melatonin supplements (prescription, over the counter, self-administered), indications, ages of users, dosage forms, and adverse drug reactions related to melatonin use among consumers were surveyed using a questionnaire. Potential participants were approached face to face, a questionnaire was administered to those agreeing to participate in the study, and responses were recorded electronically. The response rate of the 300 community pharmacists who participated in this study was 83.5%. The mean age of participants was 33.6 years, and 89.3% (n = 268) of community pharmacists reported dispensing melatonin supplements. Self-medication and over the counter (n = 213; 71.2%) were the most common dispensing and prescribing patterns (p = 0.001). Awareness rates about melatonin supplement pharmacokinetics and pharmacodynamics among community pharmacists were 38% and 37%, respectively. Despite its popularity, community pharmacists reported relatively low rates of awareness of melatonin supplement pharmacokinetics and pharmacodynamics. Further attention to this issue is needed.
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Affiliation(s)
- Mansour Tobaiqy
- Department of Pharmacology, College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia
| | - Faris A. AlZahrani
- College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia; (F.A.A.); (M.B.Y.)
| | - Abdulrahman S. Hassan
- College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia; (F.A.A.); (M.B.Y.)
| | - Abdullah H. Alirbidi
- College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia; (F.A.A.); (M.B.Y.)
| | - Osama A. Alraddadi
- College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia; (F.A.A.); (M.B.Y.)
| | - Omar A. AlSadah
- College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia; (F.A.A.); (M.B.Y.)
| | - Mohammad B. Yamani
- College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia; (F.A.A.); (M.B.Y.)
| | - Sulafa T. Alqutub
- Department of Family and Community Medicine, College of Medicine, University of Jeddah, Jeddah P.O. Box 45311, Saudi Arabia;
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Bocek J, Prasko J, Genzor S, Hodny F, Vanek J, Pobeha P, Belohradova K, Ociskova M. Sleep Disturbance and Immunological Consequences of COVID-19. Patient Prefer Adherence 2023; 17:667-677. [PMID: 36941925 PMCID: PMC10024468 DOI: 10.2147/ppa.s398188] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/18/2023] [Indexed: 03/14/2023] Open
Abstract
The overarching importance of sleep was further emphasized during the pandemic of COVID-19. The subjects infected by COVID-19 frequently experience sleep disturbances; some are long-lasting problems and decrease the quality of life. Insomnia is the most studied sleep disorder associated with COVID-19. Insomnia affects patients who have experienced an infection and the general population. Good sleep is important in maintaining mental and physical health, including immune system functions. The interconnections between insomnia, the immune system, and COVID-19 are complex. Insomnia triggers numerous immune system dysregulations and makes individuals more vulnerable to respiratory infections. This narrative review overviews the influence of the COVID-19 pandemic on the immune system through sleep disorders.
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Affiliation(s)
- Jonas Bocek
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, The Czech Republic
| | - Jan Prasko
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, The Czech Republic
- Department of Psychology Sciences, Faculty of Social Science and Health Care, Constantine the Philosopher University in Nitra, Nitra, The Slovak Republic
- Department of Psychotherapy, Institute for Postgraduate Training in Health Care, Prague, The Czech Republic
- Rehabilitation Hospital Beroun, Jessenia Inc, Akeso Holding, Beroun, The Czech Republic
- Correspondence: Jan Prasko, Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital, I. P. Pavlova 6, Olomouc, 77520, The Czech Republic, Tel +420 603 414 930, Email
| | - Samuel Genzor
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, University Palacky Olomouc and University Hospital, Olomouc, The Czech Republic
| | - Frantisek Hodny
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, The Czech Republic
| | - Jakub Vanek
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, The Czech Republic
| | - Pavol Pobeha
- Department of Respiratory Diseases and Tuberculosis University Hospital and Faculty of Medicine and Dentistry Pavol Jozef Safarik University, Kosice, The Slovak Republic
| | - Kamila Belohradova
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, The Czech Republic
| | - Marie Ociskova
- Department of Psychiatry, Faculty of Medicine and Dentistry, University Palacky Olomouc, University Hospital, Olomouc, The Czech Republic
- Rehabilitation Hospital Beroun, Jessenia Inc, Akeso Holding, Beroun, The Czech Republic
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Chen W, Liang B, Wu X, Li L, Wang C, Xing D. Advances And Challenges In Using Nirmatrelvir And Its Derivatives Against Sars-Cov-2 Infection. J Pharm Anal 2022; 13:255-261. [PMID: 36345404 PMCID: PMC9628234 DOI: 10.1016/j.jpha.2022.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/27/2022] [Accepted: 10/29/2022] [Indexed: 11/06/2022] Open
Abstract
On 22 December 2021, the United States Food and Drug Administration (FDA) approved the first Mpro inhibitor, i.e., oral antiviral nirmatrelvir (PF-07321332)/ritonavir (Paxlovid), for the treatment of early severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Nirmatrelvir inhibits SARS-CoV-2 infection, but high doses or long-term treatment may cause embryonic developmental toxicity and changes in host gene expression. The chiral structure of nirmatrelvir plays a key role in its antiviral activity. Ritonavir boosts the efficacy of nirmatrelvir by inactivating cytochrome P450 3A4 (CYP3A4) expression and occupying the plasma protein binding sites. Multidrug resistance protein 1 (MDR1) inhibitors may increase the efficacy of nirmatrelvir. However, paxlovid has many contraindications. Some patients treated with paxlovid experience a second round of coronavirus disease 2019 (COVID-19) symptoms soon after recovery. Interestingly, the antiviral activity of nirmatrelvir metabolites, such as compounds 12−18, is similar to or higher than that of nirmatrelvir. Herein, we review the advances and challenges in using nirmatrelvir and its derivatives with the aim of providing knowledge to drug developers and physicians in the fight against COVID-19.
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Affiliation(s)
- Wujun Chen
- Department of Orthopedics, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong, 266071, China
| | - Bing Liang
- Department of Orthopedics, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong, 266071, China
| | - Xiaolin Wu
- Department of Orthopedics, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong, 266071, China
| | - Ling Li
- Department of Pharmacy, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai, Guangdong, 519000, China
| | - Chao Wang
- Department of Orthopedics, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong, 266071, China,Corresponding author
| | - Dongming Xing
- Department of Orthopedics, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong, 266071, China,School of Life Sciences, Tsinghua University, Beijing, 100084, China,Corresponding author. Department of Orthopedics, The Affiliated Hospital of Qingdao University, Qingdao University, Qingdao Cancer Institute, Qingdao, Shandong, 266071, China
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Olczak-Pruc M, Swieczkowski D, Ladny JR, Pruc M, Juarez-Vela R, Rafique Z, Peacock FW, Szarpak L. Vitamin C Supplementation for the Treatment of COVID-19: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14194217. [PMID: 36235869 PMCID: PMC9570769 DOI: 10.3390/nu14194217] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/06/2022] [Accepted: 10/08/2022] [Indexed: 11/23/2022] Open
Abstract
Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, caused by the severe respiratory syndrome coronavirus 2 (SARS-CoV-2), millions of people have died, and the medical system has faced significant difficulties. Our purpose was to perform a meta-analysis to estimate the effect of vitamin C on in-hospital mortality and the ICU or hospital length of stay for patients diagnosed with COVID-19. We conducted a systematic review with meta-analysis in the following databases: PubMed, Web of Science, Scopus and Cochrane Central Register of Controlled Trials. We included studies that evaluated the effect of vitamin C supplementation, compared with standard treatment in COVID-19 patients who are ≥18 y of age. Nineteen trials were included in the meta-analysis. In-hospital mortality with and without vitamin C supplementation was 24.1% vs. 33.9% (OR = 0.59; 95%CI: 0.37 to 0.95; p = 0.03), respectively. Sub-analysis showed that, in randomized clinical trials, in-hospital mortality varied and amounted to 23.9% vs. 35.8% (OR = 0.44; 95%CI: 0.25 to 0.76; p = 0.003), respectively. In the non-randomized trials, in-hospital mortality was 24.2% vs. 33.5% (OR = 0.72; 95%CI: 0.38 to 1.39; p = 0.33), respectively. The ICU length of stay was longer in patients treated with vitamin C vs. standard therapy, 11.1 (7.3) vs. 8.3 (4.7) days (MD = 1.91; 95%CI: 0.89 to 2.93; p < 0.001), respectively. Acute kidney injury in patients treated with and without vitamin C varied and amounted to 27.8% vs. 45.0% (OR = 0.56; 95%CI: 0.40 to 0.78; p < 0.001), respectively. There were no differences in the frequency of other adverse events among patients’ treatment with and without vitamin C (all p > 0.05). The use of vitamin C reduces hospital mortality. The length of stay in the ICU is longer among patients treated with vitamin C. In terms of patient safety, vitamin C has an acceptable profile. Low doses of vitamin C are effective and safe. Despite some evidence of the usefulness of vitamin C in modifying the course of COVID-19, it is too early to modify guidelines and recommendations. Further studies, in particular randomized clinical trials, are necessary.
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Affiliation(s)
| | - Damian Swieczkowski
- Department of Toxicology, Faculty of Pharmacy, Medical University of Gdansk, 80-210 Gdańsk, Poland
| | - Jerzy R. Ladny
- Department of Emergency Medicine, Medical University of Bialystok, 15-089 Bialystok, Poland
- Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland
| | - Michal Pruc
- Research Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, Poland
| | - Raul Juarez-Vela
- Faculty of Health Science, University of La Rioja, Logroño, 26006 La Rioja, Spain
| | - Zubaid Rafique
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Frank W. Peacock
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Lukasz Szarpak
- Henry JN Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX 77030, USA
- Institute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, 00-136 Warsaw, Poland
- Correspondence: or ; Tel.: +48-50-0186-225
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Dhawan M, Emran TB, Priyanaka, Choudhary OP. Immunomodulatory effects of zinc and its impact on COVID-19 severity. Ann Med Surg (Lond) 2022; 77:103638. [PMID: 35464610 PMCID: PMC9012669 DOI: 10.1016/j.amsu.2022.103638] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 04/13/2022] [Accepted: 04/13/2022] [Indexed: 12/19/2022] Open
Abstract
The COVID-19 pandemic has led to severe financial, clinical, and societal repercussions and imposed more pressure on the healthcare system of many nations. COVID-19 impacts the immune system by causing a systemic inflammatory reaction, often known as cytokine release syndrome (CRS). COVID-19 patients had elevated levels of pro-inflammatory cytokines and chemokines. In this context, many dietary interventions have been utilized to mitigate the adverse effects of COVID-19 by regulating the excessive secretion of cytokines and chemokines. Zinc, an anti-inflammatory and antioxidant mineral in food with a well-established role in immunity, is now being employed in several clinical studies against COVID-19. Zn deficiency has been correlated with the increased production of pro-inflammatory cytokines. As a result, we will summarise zinc's immunomodulatory effects in this article. We will investigate how zinc deficiency might contribute to a poor prognosis of COVID-19 disease by altering the release of particular cytokines.
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Affiliation(s)
- Manish Dhawan
- Department of Microbiology, Punjab Agricultural University, Ludhiana-141004, India.,Trafford College, Altrincham, Manchester, WA14 5PQ, UK
| | - Talha Bin Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, 4381, Bangladesh
| | - Priyanaka
- Independent Researcher, 07, Type Iv Quarter, College of Veterinary Sciences and Animal Husbandry, Central Agricultural University (I), Selesih, Aizawl, India
| | - Om Prakash Choudhary
- Department of Veterinary Anatomy and Histology, College of Veterinary Sciences and Animal Husbandry, Central Agricultural University (I), Selesih, Aizawl, India
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Imran M, Fatima W, Alzahrani AK, Suhail N, Alshammari MK, Alghitran AA, Alshammari FN, Ghoneim MM, Alshehri S, Shakeel F. Development of Therapeutic and Prophylactic Zinc Compositions for Use against COVID-19: A Glimpse of the Trends, Inventions, and Patents. Nutrients 2022; 14:nu14061227. [PMID: 35334884 PMCID: PMC8955262 DOI: 10.3390/nu14061227] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 02/06/2023] Open
Abstract
Zinc is an essential nutrient for human health; it is involved in the catalytic, structural, and regulatory functions of the human cellular system. Different compositions of zinc, as well as its pharmaceutically acceptable salts, are available on the market. Recent studies have demonstrated the role of zinc in combating COVID-19. It has been determined that zinc prevents the entry of SARS-CoV-2 into cells by lowering the expression of ACE-2 receptors and inhibiting the RNA-dependent RNA polymerase of SARS-CoV-2. Zinc also prevents the cytokine storm that takes place after the entry of SARS-CoV-2 into the cell, via its anti-inflammatory activity. The authors believe that no study has yet been published that has reviewed the trends, inventions, and patent literature of zinc compositions to treat/prevent COVID-19. Accordingly, this review has been written in order to fill this gap in the literature. The information about the clinical studies and the published patents/patent applications was retrieved from different databases. This review covers patent literature on zinc compositions up to 31 January 2022. Many important patents/patent applications for zinc-based compositions filed by innovative universities and industries were identified. The patent literature revealed zinc compositions in combination with zinc ionophores, antioxidants, antivirals, antibiotics, hydroxychloroquine, heparin, ivermectin, and copper. Most of these studies were supported by clinical trials. The patent literature supports the potential of zinc and its pharmaceutical compositions as possible treatments for COVID-19. The authors believe that countless zinc-based compositions are still unexplored, and there is an immense opportunity to evaluate a considerable number of the zinc-based compositions for use against COVID-19.
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Affiliation(s)
- Mohd Imran
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Northern Border University, Rafha 91911, Saudi Arabia
- Correspondence: (M.I.); (F.S.)
| | - Waseem Fatima
- Department of Clinical Nutrition, Faculty of Applied Medical Sciences, Northern Border University, Arar 91431, Saudi Arabia;
| | - A. Khuzaim Alzahrani
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Northern Border University, Arar 91431, Saudi Arabia; (A.K.A.); (N.S.)
| | - Nida Suhail
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Northern Border University, Arar 91431, Saudi Arabia; (A.K.A.); (N.S.)
| | | | - Abdulrahman A. Alghitran
- Department of Clinical Pharmacy, General Administration of Pharmaceutical Care, Ministry of Health, Riyadh 11176, Saudi Arabia;
| | - Fayez Nafea Alshammari
- Community Pharmacist, Al-Dawaa Pharmacies, Kingdom of Saudi Arabia, Hafer Albatin 39911, Saudi Arabia;
| | - Mohammed M. Ghoneim
- Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, Ad Diriyah 13713, Saudi Arabia;
| | - Sultan Alshehri
- Department of Pharmaceutics, College of Pharmacy, Riyadh 11451, Saudi Arabia;
| | - Faiyaz Shakeel
- Department of Pharmaceutics, College of Pharmacy, Riyadh 11451, Saudi Arabia;
- Correspondence: (M.I.); (F.S.)
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