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Article: Prognostic Nutritional Index and Oxygen Therapy Requirement Associated With Longer Hospital Length of Stay in Patients With Moderate to Severe COVID-19: Multicenter Prospective Cohort Analyses.

Fernandes, Alan L / Reis, Bruna Z / Murai, Igor H / Pereira, Rosa M R

2022 Volume 9, Page(s) 802562

Abstract: Purpose: To evaluate whether the prognostic nutritional index (PNI) is related to the oxygen therapy requirement at hospital admission and to ascertain the prognostic effect of the PNI and the oxygen therapy requirement as predictors of hospital length ... ...

Abstract	Purpose: To evaluate whether the prognostic nutritional index (PNI) is related to the oxygen therapy requirement at hospital admission and to ascertain the prognostic effect of the PNI and the oxygen therapy requirement as predictors of hospital length of stay in patients with moderate to severe coronavirus disease 2019 (COVID-19). Methods: This is a Results: According to PNI, malnutrition was more prevalent in the high-flow therapy group (94.9%; Conclusion: In addition to oxygen therapy requirement, low PNI was associated with longer hospital length of stay. Our findings suggest that PNI could be useful in the assessment of nutritional status related to the prognosis of patients with moderate to severe COVID-19.
Language	English
Publishing date	2022-04-05
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2776676-7
ISSN	2296-861X
ISSN	2296-861X
DOI	10.3389/fnut.2022.802562
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Article ; Online: Assessment of Bone Microarchitecture in Patients with Systemic Mastocytosis and its Association with Clinical and Biochemical Parameters of the Disease.

Franco, Andre S / Murai, Igor H / Takayama, Liliam / Caparbo, Valeria F / Marchi, Luan L / Velloso, Elvira D R P / Pereira, Rosa M R

Calcified tissue international

2023 Volume 113, Issue 3, Page(s) 276–285

Abstract: Patients with systemic mastocytosis (SM) are at high risk of bone deterioration. However, the evaluation of bone microarchitecture in this disease remains unclear. We aimed to assess bone microarchitecture in patients with SM. This was a cross-sectional ... ...

Abstract	Patients with systemic mastocytosis (SM) are at high risk of bone deterioration. However, the evaluation of bone microarchitecture in this disease remains unclear. We aimed to assess bone microarchitecture in patients with SM. This was a cross-sectional study of 21 adult patients with SM conducted in a quaternary referral hospital in Sao Paulo, Brazil. A healthy, age-, weight-, and sex-matched cohort of 63 participants was used to provide reference values for bone microarchitecture, assessed by high resolution peripheral quantitative computed tomography (HR-pQCT). Total volumetric bone mineral density (vBMD), cortical vBMD, and cortical thickness at the radius were significantly lower in the control group compared with the SM group (all P < 0.001). Patients with aggressive SM had significantly lower trabecular number (Tb.N) (P = 0.035) and estimated failure load (F.load) (P = 0.032) at the tibia compared with those with indolent SM. Handgrip strength was significantly higher in patients who had more Tb.N at the radius (ρ, 0.46; P = 0.036) and tibia (ρ, 0.49; P = 0.002), and lower who had more trabecular separation at the radius (ρ, -0.46; P = 0.035) and tibia (ρ, -0.52; P = 0.016). Strong and positive associations between F.load (ρ, 0.75; P < 0.001) and stiffness (ρ, 0.70; P < 0.001) at the radius, and between F.load at the tibia (ρ, 0.45; P = 0.038) were observed with handgrip strength. In this cross-sectional study, aggressive SM was more susceptible to bone deterioration compared with indolent SM. In addition, the findings demonstrated that handgrip strength was associated with bone microarchitecture and bone strength.
MeSH term(s)	Adult ; Humans ; Cross-Sectional Studies ; Mastocytosis, Systemic ; Hand Strength ; Brazil ; Bone and Bones ; Bone Density ; Radius/diagnostic imaging ; Tibia ; Absorptiometry, Photon
Language	English
Publishing date	2023-06-09
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	304266-2
ISSN	1432-0827 ; 0944-0747 ; 0008-0594 ; 0171-967X
ISSN (online)	1432-0827
ISSN	0944-0747 ; 0008-0594 ; 0171-967X
DOI	10.1007/s00223-023-01107-x
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Article: Persistent or new symptoms 1 year after a single high dose of vitamin D

Fernandes, Alan L / Sales, Lucas P / Santos, Mayara D / Caparbo, Valeria F / Murai, Igor H / Pereira, Rosa M R

Frontiers in nutrition

2022 Volume 9, Page(s) 979667

Abstract: Purpose: The aim of this study was to investigate the reported persistent or new symptoms 1 year after a single dose of 200,000 IU of vitamin D: Methods: This is a : Results: Between 2 June and 27 August 2020, we randomized 240 patients of which ... ...

Abstract	Purpose: The aim of this study was to investigate the reported persistent or new symptoms 1 year after a single dose of 200,000 IU of vitamin D Methods: This is a Results: Between 2 June and 27 August 2020, we randomized 240 patients of which 144 were included in this study [the vitamin D Conclusion: The findings do not support the use of 200,000 IU of vitamin D
Language	English
Publishing date	2022-09-13
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2776676-7
ISSN	2296-861X
ISSN	2296-861X
DOI	10.3389/fnut.2022.979667
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Article ; Online: Effect of a Single High-Dose Vitamin D3 on the Length of Hospital Stay of Severely 25-Hydroxyvitamin D-Deficient Patients with COVID-19.

Murai, Igor H / Fernandes, Alan L / Antonangelo, Leila / Gualano, Bruno / Pereira, Rosa Maria Rodrigues

Clinics (Sao Paulo, Brazil)

2021 Volume 76, Page(s) e3549

Abstract: Objectives: In this ancillary analysis of a multicenter, double-blinded, randomized, placebo-controlled trial, we investigated the effect of a single high dose of vitamin D3 on the length of hospital stay of patients with severe 25-hydroxyvitamin D ... ...

Abstract	Objectives: In this ancillary analysis of a multicenter, double-blinded, randomized, placebo-controlled trial, we investigated the effect of a single high dose of vitamin D3 on the length of hospital stay of patients with severe 25-hydroxyvitamin D deficiency and COVID-19. Methods: The primary outcome was length of hospital stay, defined as the total number of days that patients remained hospitalized from the date of randomization until the date of hospital discharge. Secondary outcomes included serum levels of 25-hydroxyvitamin D, mortality during hospitalization, number of patients admitted to the intensive care unit, and number of patients who required mechanical ventilation. ClinicalTrials.gov: NCT04449718. Results: Thirty-two patients were included in the study. The mean (SD) age was 58.5 (15.6) years, body mass index was 30.8 (8.6) kg/m2, and 25-hydroxyvitamin D level was 7.8 (1.6) ng/mL. No significant difference was observed in the median interquartile range of length of hospital stay between the vitamin D3 group (6.0 [4.0-18.0] days) versus placebo (9.5 [6.3-15.5] days) (log-rank p=0.74; hazard ratio, 1.13 [95% confidence interval (CI), 0.53-2.40]; p=0.76). Vitamin D3 significantly increased serum 25-hydroxyvitamin D levels in the vitamin D3 group compared with that in the placebo group (between-group difference, 23.9 ng/mL [95% CI, 17.7-30.1]; p<0.001). Conclusions: A dose of 200.000 IU of vitamin D3 did not significantly reduce the length of hospital stay of patients with severe 25-hydroxyvitamin D deficiency and COVID-19.
MeSH term(s)	COVID-19 ; Cholecalciferol ; Double-Blind Method ; Humans ; Length of Stay ; Middle Aged ; SARS-CoV-2 ; Vitamin D/analogs & derivatives ; Vitamin D Deficiency/drug therapy
Chemical Substances	Vitamin D (1406-16-2) ; Cholecalciferol (1C6V77QF41) ; 25-hydroxyvitamin D (A288AR3C9H)
Language	English
Publishing date	2021-11-26
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial
ZDB-ID	2182801-5
ISSN	1980-5322 ; 1807-5932
ISSN (online)	1980-5322
ISSN	1807-5932
DOI	10.6061/clinics/2021/e3549
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Article ; Online: Effect of a Single High-Dose Vitamin D3 on the Length of Hospital Stay of Severely 25-Hydroxyvitamin D-Deficient Patients with COVID-19

Igor H. Murai / Alan L. Fernandes / Leila Antonangelo / Bruno Gualano / Rosa Maria Rodrigues Pereira

Clinics, Vol

2021 Volume 76

Abstract: OBJECTIVES: In this ancillary analysis of a multicenter, double-blinded, randomized, placebo-controlled trial, we investigated the effect of a single high dose of vitamin D3 on the length of hospital stay of patients with severe 25-hydroxyvitamin D ... ...

Abstract	OBJECTIVES: In this ancillary analysis of a multicenter, double-blinded, randomized, placebo-controlled trial, we investigated the effect of a single high dose of vitamin D3 on the length of hospital stay of patients with severe 25-hydroxyvitamin D deficiency and COVID-19. METHODS: The primary outcome was length of hospital stay, defined as the total number of days that patients remained hospitalized from the date of randomization until the date of hospital discharge. Secondary outcomes included serum levels of 25-hydroxyvitamin D, mortality during hospitalization, number of patients admitted to the intensive care unit, and number of patients who required mechanical ventilation. ClinicalTrials.gov: NCT04449718. RESULTS: Thirty-two patients were included in the study. The mean (SD) age was 58.5 (15.6) years, body mass index was 30.8 (8.6) kg/m2, and 25-hydroxyvitamin D level was 7.8 (1.6) ng/mL. No significant difference was observed in the median interquartile range of length of hospital stay between the vitamin D3 group (6.0 [4.0-18.0] days) versus placebo (9.5 [6.3-15.5] days) (log-rank p=0.74; hazard ratio, 1.13 [95% confidence interval (CI), 0.53-2.40]; p=0.76). Vitamin D3 significantly increased serum 25-hydroxyvitamin D levels in the vitamin D3 group compared with that in the placebo group (between-group difference, 23.9 ng/mL [95% CI, 17.7-30.1]; p<0.001). CONCLUSIONS: A dose of 200.000 IU of vitamin D3 did not significantly reduce the length of hospital stay of patients with severe 25-hydroxyvitamin D deficiency and COVID-19.
Keywords	SARS-CoV-2 ; Immune System ; Pneumonia ; Acute Respiratory Disease ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	Elsevier España
Document type	Article ; Online
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Article ; Online: Response to Letter to the Editor: "Exercise Mitigates Bone Loss in Women With Severe Obesity After Roux-en-Y Gastric Bypass: A Randomized Controlled Trial".

Murai, Igor Hisashi / Roschel, Hamilton / Gualano, Bruno

The Journal of clinical endocrinology and metabolism

2019 Volume 105, Issue 3

Language	English
Publishing date	2019-10-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	3029-6
ISSN	1945-7197 ; 0021-972X
ISSN (online)	1945-7197
ISSN	0021-972X
DOI	10.1210/clinem/dgz109
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Article ; Online: Effects of population mobility on the COVID-19 spread in Brazil.

Chagas, Eduarda T C / Barros, Pedro H / Cardoso-Pereira, Isadora / Ponte, Igor V / Ximenes, Pablo / Figueiredo, Flávio / Murai, Fabricio / Couto da Silva, Ana Paula / Almeida, Jussara M / Loureiro, Antonio A F / Ramos, Heitor S

PloS one

2021 Volume 16, Issue 12, Page(s) e0260610

Abstract: This article proposes a study of the SARS-CoV-2 virus spread and the efficacy of public policies in Brazil. Using both aggregated (from large Internet companies) and fine-grained (from Departments of Motor Vehicles) mobility data sources, our work sheds ... ...

Abstract	This article proposes a study of the SARS-CoV-2 virus spread and the efficacy of public policies in Brazil. Using both aggregated (from large Internet companies) and fine-grained (from Departments of Motor Vehicles) mobility data sources, our work sheds light on the effect of mobility on the pandemic situation in the Brazilian territory. Our main contribution is to show how mobility data, particularly fine-grained ones, can offer valuable insights into virus propagation. For this, we propose a modification in the SENUR model to add mobility information, evaluating different data availability scenarios (different information granularities), and finally, we carry out simulations to evaluate possible public policies. In particular, we conduct a case study that shows, through simulations of hypothetical scenarios, that the contagion curve in several Brazilian cities could have been milder if the government had imposed mobility restrictions soon after reporting the first case. Our results also show that if the government had not taken any action and the only safety measure taken was the population's voluntary isolation (out of fear), the time until the contagion peak for the first wave would have been postponed, but its value would more than double.
MeSH term(s)	Brazil/epidemiology ; COVID-19/epidemiology ; COVID-19/pathology ; COVID-19/transmission ; COVID-19/virology ; Databases, Factual ; Humans ; Models, Theoretical ; Movement ; Pandemics ; Public Policy ; Quarantine ; SARS-CoV-2/isolation & purification
Language	English
Publishing date	2021-12-07
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2267670-3
ISSN	1932-6203 ; 1932-6203
ISSN (online)	1932-6203
ISSN	1932-6203
DOI	10.1371/journal.pone.0260610
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Article ; Online: No independent associations between physical activity and clinical outcomes among hospitalized patients with moderate to severe COVID-19.

Pinto, Ana J / Goessler, Karla F / Fernandes, Alan L / Murai, Igor H / Sales, Lucas P / Reis, Bruna Z / Santos, Mayara Diniz / Roschel, Hamilton / Pereira, Rosa M R / Gualano, Bruno

Journal of sport and health science

2021 Volume 10, Issue 6, Page(s) 690–696

Abstract: Background: Regular physical activity (PA) has been postulated to improve, or at least maintain, immunity across the life span. However, the link between physical (in)activity and coronavirus disease 2019 (COVID-19) remains to be established. This small- ...

Abstract	Background: Regular physical activity (PA) has been postulated to improve, or at least maintain, immunity across the life span. However, the link between physical (in)activity and coronavirus disease 2019 (COVID-19) remains to be established. This small-scale prospective cohort study is nested within a randomized controlled trial aimed to investigate the possible associations between PA levels and clinical outcomes among hospitalized patients with moderate to severe COVID-19. Methods: Hospitalized patients with COVID-19 (mean age: 54.9 years) were recruited from the Clinical Hospital of the School of Medicine of the University of Sao Paulo (a quaternary referral teaching hospital) and from Ibirapuera Field Hospital, both located in Sao Paulo, Brazil. PA level was assessed using the Baecke Questionnaire of Habitual Physical Activity. The primary outcome was hospital length of stay. The secondary outcomes were mortality, admission to the intensive care unit (ICU), and mechanical ventilation requirement. Results: The median hospital length of stay was 7.0 ± 4.0 days, median ± IQR; 3.3% of patients died, 13.8% were admitted to the ICU, and 8.6% required mechanical ventilation. Adjusted linear regression models showed that PA indices were not associated with hospital length of stay (work index: β = -0.57 (95% confidence interval (95%CI): -1.80 to 0.65), p = 0.355; sport index: β = 0.43 (95%CI: -0.94 to 1.80), p = 0.536; leisure-time index: β = 1.18 (95%CI: -0.22 to 2.59), p = 0.099; and total activity index: β = 0.20 (95%CI: -0.48 to 0.87), p = 0.563). None of the PA indices were associated with mortality, admission to the ICU, or mechanical ventilation requirement (all p > 0.050). Conclusion: Among hospitalized patients with COVID-19, PA did not independently associate with hospital length of stay or any other clinically relevant outcomes. These findings should be interpreted as meaning that, among already hospitalized patients with more severe forms of COVID-19, being active is a potential protective factor likely outweighed by a cluster of comorbidities (e.g., type 2 diabetes, hypertension, weight excess) and older age, suggesting that the benefit of PA against the worsening of COVID-19 may vary across stages of the disease.
MeSH term(s)	Aged ; Brazil/epidemiology ; COVID-19/epidemiology ; COVID-19/therapy ; Exercise ; Hospitalization ; Humans ; Middle Aged ; Patient Acuity ; Prospective Studies ; Treatment Outcome
Language	English
Publishing date	2021-08-12
Publishing country	China
Document type	Journal Article ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	2673028-5
ISSN	2213-2961 ; 2095-2546
ISSN (online)	2213-2961
ISSN	2095-2546
DOI	10.1016/j.jshs.2021.08.001
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Article ; Online: Erratum. Exercise-Induced Increases in Insulin Sensitivity After Bariatric Surgery Are Mediated By Muscle Extracellular Matrix Remodeling. Diabetes 2020;69:1675-1691.

Diabetes

2021 Volume 70, Issue 6, Page(s) 1415

Language	English
Publishing date	2021-05-11
Publishing country	United States
Document type	Journal Article ; Published Erratum
ZDB-ID	80085-5
ISSN	1939-327X ; 0012-1797
ISSN (online)	1939-327X
ISSN	0012-1797
DOI	10.2337/db21-er06b
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Article ; Online: Effect of a single high dose of vitamin D3 on cytokines, chemokines, and growth factor in patients with moderate to severe COVID-19.

Fernandes, Alan L / Murai, Igor H / Reis, Bruna Z / Sales, Lucas P / Santos, Mayara D / Pinto, Ana J / Goessler, Karla F / Duran, Camila S C / Silva, Carla B R / Franco, André S / Macedo, Marina B / Dalmolin, Henrique H H / Baggio, Janaina / Balbi, Guilherme G M / Antonangelo, Leila / Caparbo, Valeria F / Gualano, Bruno / Pereira, Rosa M R

The American journal of clinical nutrition

2022 Volume 115, Issue 3, Page(s) 790–798

Abstract: Background: The modulating effect of vitamin D on cytokine concentrations in severe coronavirus disease 2019 (COVID-19) remains unknown.: Objectives: We aimed to investigate the effect of a single high dose of vitamin D3 on cytokines, chemokines, and ...

Abstract	Background: The modulating effect of vitamin D on cytokine concentrations in severe coronavirus disease 2019 (COVID-19) remains unknown. Objectives: We aimed to investigate the effect of a single high dose of vitamin D3 on cytokines, chemokines, and growth factor in hospitalized patients with moderate to severe COVID-19. Methods: This is a post hoc, ancillary, and exploratory analysis from a multicenter, double-blind, placebo-controlled, randomized clinical trial. Patients with moderate to severe COVID-19 were recruited from 2 hospitals in São Paulo, Brazil. Of 240 randomly assigned patients, 200 were assessed in this study and randomly assigned to receive a single oral dose of 200,000 IU vitamin D3 (n = 101) or placebo (n = 99). The primary outcome was hospital length of stay, which has been published in our previous study. The prespecified secondary outcomes were serum concentrations of IL-1β, IL-6, IL-10, TNF-α, and 25-hydroxyvitamin D. The post hoc exploratory secondary outcomes were IL-4, IL-12p70, IL-17A, IFN-γ, granulocyte-macrophage colony-stimulating factor (GM-CSF), IL-8, IFN-inducible protein-10 (IP-10), macrophage inflammatory protein-1β (MIP-1β), monocyte chemoattractant protein-1 (MCP-1), vascular endothelial growth factor (VEGF), and leukocyte count. Generalized estimating equations for repeated measures, with Bonferroni's adjustment, were used for testing all outcomes. Results: The study included 200 patients with a mean ± SD age of 55.5 ± 14.3 y and BMI of 32.2 ± 7.1 kg/m2, of which 109 (54.5%) were male. GM-CSF concentrations showed a significant group-by-time interaction effect (P = 0.04), although the between-group difference at postintervention after Bonferroni's adjustment was not significant. No significant effects were observed for the other outcomes. Conclusions: The findings do not support the use of a single dose of 200,000 IU vitamin D3, compared with placebo, for the improvement of cytokines, chemokines, and growth factor in hospitalized patients with moderate to severe COVID-19.This trial was registered at clinicaltrials.gov as NCT04449718.
MeSH term(s)	Adult ; Aged ; Brazil ; COVID-19/immunology ; Chemokines/drug effects ; Cholecalciferol/administration & dosage ; Cytokines/drug effects ; Double-Blind Method ; Female ; Granulocyte-Macrophage Colony-Stimulating Factor/drug effects ; Humans ; Intercellular Signaling Peptides and Proteins/blood ; Male ; Middle Aged ; SARS-CoV-2/immunology ; Vascular Endothelial Growth Factor A/drug effects ; Vitamins/administration & dosage ; COVID-19 Drug Treatment
Chemical Substances	Chemokines ; Cytokines ; Intercellular Signaling Peptides and Proteins ; Vascular Endothelial Growth Factor A ; Vitamins ; Cholecalciferol (1C6V77QF41) ; Granulocyte-Macrophage Colony-Stimulating Factor (83869-56-1)
Language	English
Publishing date	2022-01-12
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
ZDB-ID	280048-2
ISSN	1938-3207 ; 0002-9165
ISSN (online)	1938-3207
ISSN	0002-9165
DOI	10.1093/ajcn/nqab426
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