Vitamin D and Long COVID - A Case Report (Coronavirus Update 146)

#meds #longcovid #symptoms

Patient Background

• Age and Health: 11-year-old female with no known comorbidities.
• Symptoms: Persistent abdominal pain for three months post SARS-CoV-2 infection, characterized as crampy and burning, exacerbated by eating or defecating. The pain intensity ranged between 5 to 7 out of 10.
• Location: Resides in New York, a detail noted due to potential implications for Vitamin D levels given the city's high latitude.

Medical Examinations and Findings

• Initial Response: Treated with a proton pump inhibitor initially, a common treatment for gastroesophageal reflux disease.
• Blood and Stool Tests:
  • Complete Blood Count and Metabolic Panel: Normal results, ruling out issues related to white blood cell count, hemoglobin, platelets, electrolytes, and liver enzymes.
  • Inflammatory Markers (ESR and CRP): Normal, indicating no non-specific causes of inflammation.
  • Gluten Allergy and H. pylori Tests: Negative, ruling out gluten allergies and bacterial infections often linked to stomach issues.
• Vitamin D and Calprotectin Levels:
  • Vitamin D: Low levels found — 14 nanograms per milliliter, whereas the normal range starts at 30.
  • Calprotectin: Elevated levels — 358 micrograms per gram of stool, significantly higher than the normal range (<100 micrograms).

Endoscopic Procedures and Biopsy

• Upper Endoscopy: Normal, with no issues detected in the esophagus, stomach, and a portion of the small bowel.
• Colonoscopy:
  • Observations: Found friable (easily damaged) and inflamed tissue in the colon.
  • Biopsy Results: Showed chronic inflammation with many lymphocytes in the lamina propria, and the presence of SARS-CoV-2 nucleocapsid proteins, confirming a persistent SARS-CoV-2 infection in the gastrointestinal tract.

Discussion on Vitamin D and Long COVID

• Vitamin D Deficiency: The patient's deficiency raised questions regarding the role of vitamin D in Long COVID symptoms, and whether supplementation could potentially alleviate symptoms.
• Sunlight Exposure: The discussion extended to the potential broader health benefits of sunlight, beyond vitamin D synthesis, as explored in other videos by the MedCram team.

Conclusions and Future Directions

• Unique Case: The case stands out due to the patient’s young age and lack of comorbidities, which generally complicates the diagnosis.
• Therapeutic Interventions: The authors suggested potential therapies including Monoclonal Antibody therapy and corticosteroid therapy, though emphasized the need for further research.
• Post-Vaccination Improvement: The report noted anecdotal evidence of symptom improvement in some Long COVID patients following vaccination.
• Call for Further Research: The authors called for more studies to understand the persistence of gastrointestinal SARS-CoV-2 infections and their correlation with the severity of the disease.

Summary:
The case report brings attention to the patient's vitamin D deficiency, suggesting a potential link between low vitamin D levels and persistent symptoms of COVID-19, or "long COVID." The report suggests that future studies should explore whether vitamin D supplementation could be a beneficial intervention for individuals experiencing long COVID symptoms. Moreover, the discussion hints at a broader perspective where vitamin D levels might be a marker for adequate sunlight exposure, which could have additional health benefits, potentially including mitigation of long COVID symptoms. This perspective is based on a broader understanding of the health benefits of sunlight, which encompasses more than just vitamin D synthesis. It is a call to explore this avenue more in future research to potentially find therapeutic interventions for long COVID.