Connect with us

Community

Vitamin D & Covid-19

Published

on

Thursday, May 7, 2020

MUSC World-Class Vitamin D Research Team to Study Connection to COVID-19 Prevention and Treatment

Medical University of South Carolina (MUSC) College of Medicine scientists and clinicians, led by world-renowned vitamin D research experts Bruce Hollis, Ph.D., professor emeritus in the Department of Pediatrics, and Carol Wagner, M.D., a professor in the Department of Pediatrics and neonatologist, are planning a focused research effort to determine if individuals with sufficient baseline levels of vitamin D have more protection against severe COVID-19 infection.

Recent reports in the medical literature point toward a potential link between vitamin D deficiency and the pathogenesis of COVID-19 in certain patients. This information aligns with what Hollis, Wagner and other national experts have established in their own vitamin D research in at-risk populations – unrelated to COVID-19 – that vitamin D deficiency is more prevalent among African Americans and individuals with more melanin in their skin as well as in some elderly nursing home residents who have very low exposure to sunlight. In addition, effective vitamin D repletion can be accomplished safely and with minimal expense.

“Our team has the ability to determine vitamin D levels for COVID-19-positive patients and track that information to begin this work. This area of study is worthy of their expertise and efforts,” said David J. Cole, M.D., FACS, MUSC president. “This is a great opportunity to raise awareness that this due diligence is needed so we can potentially help particularly vulnerable populations in our community.”

To be clear, neither these studies nor MUSC are suggesting that vitamin D cures or prevents COVID-19 infection. However, the body of prior and emerging scientific evidence would suggest that individuals with low vitamin D levels who contract COVID-19, including African Americans and elderly nursing home residents, might experience worse clinical outcomes than other groups with normal vitamin D levels.

“It is important to study this topic to determine if recommending vitamin D supplementation for vulnerable populations can make a difference in COVID-19 outcomes. If valid,” Cole explained, “we would have an inexpensive, readily available strategy not only to help these groups of individuals but also the general population of South Carolina and beyond.”

MUSC scientists point out that recent COVID-19 and vitamin D studies suggest that at-risk individuals with historically low levels of vitamin D also had increased severity of COVID-19 infection and worse clinical outcomes, especially if the viral infection reached the lower respiratory tract. Certain cells located there are known primary targets of the virus, and if affected, it becomes harder for the lungs to initiate tissue repair and rebound from an infection, thus causing acute respiratory distress and the hospitalization of patients nationwide.

Hollis, Wagner and their team are rapidly pursuing clinical studies to validate or refute the clinical assumption that when patients have sufficient vitamin D levels, their immune responses to the virus’ primary targets are enabled, stronger and more capable of fighting off the most acute form of COVID-19.

“If we know that certain groups of the population are already at high risk for deficiency, and recent, valid studies suggest that increasing vitamin D levels might help prevent or lessen the severity of the disease, it would seem irresponsible to us as health care providers and scientists not to pursue this for our statewide and national community,” Wagner said. “We know vitamin D has a critical role in many functions of our overall health, so we have a responsibility to our families, neighbors, coworkers, friends and community to help answer this question.”

Essentially, the team seeks to replicate recent findings related to COVID-19 and vitamin D deficiency and explore the idea that patients might need to reach sufficient vitamin D levels through the appropriate clinical standard dosing of IV or oral supplements or, in some cases, simply get more exposure to sunlight. As the research effort matures, Hollis and Wagner plan to offer guidance on whether supplementation in certain individuals improves their clinical outcomes following a positive COVID-19 test. In addition, they hope to offer insight into whether vitamin D supplementation for all South Carolinians could improve their vitamin D statuses and mitigate the severity of COVID19 should they become infected.

“Our previous work has demonstrated that African Americans and other vulnerable populations can achieve vitamin D sufficiency through clinically validated supplements, which is a relatively inexpensive therapy that has a large safety profile when given in doses between 4,000 to 6,000 international units a day to adults,” Hollis said. “Some individuals with low levels of melanin in their skin can achieve better vitamin D sufficiency just by standing or sitting for 15 to 20 minutes in the direct sunlight each day that its possible, which is another easy way to address low vitamin D levels.”

Scientists know that vitamin D is present in very few foods, and typically at lower levels than what is needed for sufficiency, but it can be produced by the body when human skin is exposed to ultraviolet rays from sunlight, which triggers vitamin D synthesis. It promotes calcium absorption by the gut and helps strengthen bones. Additionally, vitamin D has been shown to play an important role in a number of other bodily processes like modulation of cell growth and differentiation and enabling proper innate and adaptive immune functions to fight off pathogens. It’s also thought to protect against some chronic conditions, including cardiovascular disease, diabetes and some cancers.

Hollis and Wagner have more than 60 years of combined vitamin D research experience, with a collective body of work referenced and replicated across the spectrum by institutions such as Harvard University and the National Institutes of Health. They have accrued thousands of citations and have been published in numerous peer-reviewed journals on various subtopics around vitamin D deficiency and sufficiency.

Advertisements
Continue Reading
Advertisement

Community

Congresswoman Beatty Gets Pepper Sprayed During George Floyd Protest

Published

on

Nationwide — Democratic Rep. Joyce Beatty, a congresswoman from Ohio, was reportedly pepper-sprayed while trying to mediate between police officers and protesters in Columbus. The protest was one of many across the nation after the killing of George Floyd in Minneapolis.

“I was there because I wanted the young protesters to know that in solidarity, that I stand with them,” Beatty told NBC 4. “You know, I’m a grandmother, I’m an elected official, but I’m a Black woman first and I felt the pain.”

Columbus City Council President Shannon Hardin confirmed in a post on Twitter that he and the congresswoman were “sprayed with mace or pepper spray” but are now fine.

Beatty said she came to the protest to “support them.” In a video posted on Hardin’s Twitter page, she said, “It was just something in my heart thinking about George Floyd, thinking about all of the injustices, that I needed to be out there, thinking I was protecting them and it probably was not safe.”

Beatty was apparently trying to come between a police officer and a protester before an altercation between both groups happened and she was sprayed.

“One young black female took a step off (the curb) and the cop kind of took that, I guess, ‘sideways.’ Instantly, a white man kind of came to her defense and then was instantly body-slammed to the ground. The congresswoman runs out into the street to hold back the cop and the protesters. Another cop comes up with his bike and pushes the congresswoman out of the way … and then it’s naturally getting heated … that one cop pulls, I don’t know why he does it, he pulls out his Mace and does what he does,” Dominic Manecke, a spokesman for Beatty, told CNN about the incident.

Moreover, Beatty condemned how the police are handling the escalating tension during protests. In the Twitter video, she said that “too much force is not the answer to this.”

Even though she said she is proud of the protesters, she said it is important for them to remain calm. She added, “We must continue to protest, but it must be peaceful and that does not mean we aren’t standing up for justice.”

Advertisements
Continue Reading

Community

Beyond Unacceptable

Published

on

Another Dead Black Man Too Many: The Family of George Floyd Speak Out.

From the Today Show – Delivered by Black Video News

Advertisements
Continue Reading

Community

Black People & PTSD

Published

on

Black People, Post-Traumatic Stress Disorder (PTSD) and the Risk of Death From Coronavirus (COVID-19)

Nationwide —Here are some facts: Black people have been found to be more likely to die from COVID-19 infection than white people, both in the United Kingdom and the United States of America. Black people also have a higher rate of PTSD diagnosis than white people. PTSD can result in suppression of the immune system. Immunosuppression is associated with a higher risk of death from COVID-19. It is thus not unreasonable to question whether PTSD-induced immunosuppression is contributing to the elevated risk of dying from COVID-19 amongst black people.

Data reveals that Black people are more than four times more likely to die from COVID-19 than white people in England and Wales and that even after adjusting for age, socioeconomic conditions and prior health, the figures show that Black people remain twice as likely to die from COVID-19 than white people in England and Wales, according to the Office for National Statistics.1 Some suggest sickle cell disease is the explanation, however this is unlikely, being already in a shielded group they are likely to have little or no ongoing expo-sure to COVID-19. Other contributary factors which have been highlighted are obesity, over-crowding and frontline working, however these are likely to be already adjusted for within socioeconomic status.

This article proposes that PTSD-induced immunosuppression contributes to raised mortality from COVID-19. PTSD is a condition which occurs after a traumatic experience where symptoms persist of reliving the distressing event and there is hypervigilance, numbing, mood changes including negativity about the self, the world and the future. There is avoidance of people and situations that act as reminders of the event and sleep and concentration disturbance. Physical symptoms including Neurological, Respiratory and Cardiovascular symptoms also occur in PTSD.2

What is the evidence that Black people have higher rates of PTSD?

The Adult Psychiatric Morbidity Survey: Survey of Mental Health and Wellbeing, England, 2014 found doubling of the rate of PTSD amongst black adults at 8.3 per compared to white adults at 4.2 though assumed that the differences could not be relied on because of the small sizes involved.3

One study found that when PTSD affects US race/ethnic minorities, it is usually untreated and likely to become chronic and persistent and suggested that the large disparities in treatment indicate a need for investment in accessible and culturally sensitive treatment options.4 A separate two year follow up study found that African Americans with PTSD experience high number of traumas and most do not receive treatment.5

Findings from large-scale national studies suggest African Americans have a 9.1% prevalence rate for PTSD.6 This suggests that almost one in ten Black people becomes traumatized. This is an underestimate due to known under-diagnosis of PTSD in black people.7 Studies of racial discrimination and race-related stress have shown that when an individual reports psychological distress from racism, trauma was often not considered.8

Why would Black people be at increased risk of PTSD?

In addition to traumatic experiences that a person of any race or ethnicity might face, race-specific traumas include micro-aggressions and the erosion of a fundamental requirement for human beings – a sense of belonging. A striking example of that undermining of belonging was witnessed by the Windrush generation in the UK. Black people face challenges to a sense of belonging to desirable social, housing, occupational groups and on a wider scale there are challenges to the black person’s right to belong in a country such as the UK, a crude example being the ‘go back to where you came from’ statement. A sense of belonging is an intrinsic human need. The psychologist Maslow’s hierarchy of human needs defined self-actualization and self-esteem as requiring the secure foundations created by a sense of belonging.

Another often overlooked contributory factor to the large prevalence of traumas affecting Black people is Intergenerational transmission of trauma. Parent-child attachment patterns are known to replicate through generations within families. Going back to slavery and post-slavery eras, forced black familial disruption was part of the mechanism that enabled forced labour and enrichment of slave owners and others and this involved brutal disregard for the integrity of the black family unit by white oppressors. Yet another overlooked factor is vicarious trauma and witnessing shootings of unarmed black people can give rise to a sense of threat to the black viewer’s sense of their own safety.

What is the evidence that PTSD suppresses the immune system?

A study of 1,550 male workers with a previous history of PTSD concluded that PTSD produces immunosuppression and has long-term implications for health.9 This finding is now widely accepted amongst mental health professionals and a questionnaire commonly used as a tool to diagnose PTSD is the IES-r.10 A cut-off point of 37 and above in the IES-r is commonly accepted by mental health workers as associated with immunosuppression.

Treatment of PTSD

PTSD in Black people is treatable with a growing number of psychotherapies including prolonged exposure therapy, EMDR, cognitive processing therapy, somatic experiencing, if delivered by psychotherapists with training and knowledge of diversity matters. Medication is sometimes but not always required.

Conclusion

There now exists evidence for higher death rates of Black people from COVID-19 compared to White people as well as evidence that Black people have a higher rate of PTSD diagnosis than White people and furthermore that PTSD is associated with immunosuppression and we know that immunosuppression is associated with a higher risk of death from COVID-19. The proposed association described here between PTSD-induced immunosuppression and increased risk of death from COVID-19 needs to be explored further and in addition, high PTSD rates in black people need to be recognised and treated as both a mental and physical health priority.

References

1. Office of National Statistics. Release date: 7 May 2020. Coronavirus (COVID-19) related deaths by ethnic group, England and Wales: 2 March 2020 to 10 April 2020 obtained on 12 May 2020

2. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Publishing

3. Adult Psychiatric Morbidity Survey. (2014) retrieved on 11 May 2020 from https://www.ethnicity-facts-figures.service.gov.uk/health/mental-health/adults-with-post-traumatic-stress-disorder-ptsd-in-the-month-prior-to-survey/latest

4. Roberts, A.L., Gilman, S.E., Breslau, J.N., Breslau, N., & Koenen, K.C. (2011). Race/ethnic differences in exposure to traumatic events, development of post-traumatic stress disorder, and treatment-seeking for post-traumatic stress disorder in the United States. Psychol Med.

5. Pérez Benítez, C., Sibrava, N., Kohn-Wood, L., Bjornsson, A., Zlotnick, C., Weisberg, R. & Keller, M. (2014). Posttraumatic stress disorder in African Americans: A two year follow-up study. Psychiatry Research-neuroimaging Volume: 220, Issue: 1, pp 376-383

6. Himle, J.A., Baser, R.E., Taylor, R.J., Campbell, R. D. & Jackson J.S. (2009). Anxiety disorders among African Americans, blacks of Caribbean descent, and non-Hispanic whites in the United States, Journal of Anxiety Disorders, 23(5): 578-590.

7. Williams M., Malcoun E. & Bahojb Nouri L. (2015) Assessment of Posttraumatic Stress Disorder with African Americans. In: Benuto L., Leany B. (eds) Guide to Psychological Assessment with African Americans. Springer, New York, NY

8. Carter, R. (2007). Racism and Psychological and Emotional Injury: Recognizing and Assessing Race-Based Traumatic Stress. The counselling psychologist Volume: 35 issue: 1, page(s): 13-105

9. Noriyuki Kawamura, Yoshiharu Kim & Nozomu Asukai (2001) Suppression of Cellular Immunity in Men with a past history of Posttraumatic stress disorder. Retrieved on 11 May 2020 from https://ajp.psychiatryonline.org/doi/full/10.1176/appi.ajp.158.3.484

10. Weiss, D.S., & Marmar, C.R. (1997). The Impact of Event Scale-Revised. In J.P. Wilson, & T.M. Keane (Eds.), Assessing Psychological Trauma and PTSD: A Practitioner’s Handbook (pp. 399-411). New York: Guilford Press

Source: Anne Coker

Advertisements
Continue Reading

Hot Topics