Keen
Well-Known Member
Ha! I should ask him that. He would drive himself nuts at the thought of 5-15% false rate.
The Covid-19 Thread: News, Preparation Tips, Etc
- Thread starter Black Ambrosia
- Start date
shelli4018
Well-Known Member
Grocery shopping is keeping me on my toes. Definitely seeing meat shortages in most of the stores I’ve checked. Also haven’t been able to find flour for a couple of weeks. I understand there’s a shortage. There’s definitely major issues with our food supply. I’m no longer in denial about that. So I decided to start planting a few herbs and veggies. Wouldn’t you know there’s a shortage of gardening supplies. Lol! I’m just gonna plow forward. I’ll just start some veggies from scrap. Now I understand why folk had Victory Gardens in WWII.
vevster
Well-Known Member
I noticed Trader Joe's had no flour. Happy I'm mostly gluten free.
werenumber2
Well-Known Member
This virus has bugs coming in my house that should NOT be here. If this is an example of the Earth ~healing itself~, I’m gonna need Mother Nature to go back to feeling sick. 
I have an exterminator coming tomorrow
I have an exterminator coming tomorrow
Layluh
Well-Known Member
Lol wait what kind of bugs?This virus has bugs coming in my house that should NOT be here. If this is an example of the Earth ~healing itself~, I’m gonna need Mother Nature to go back to feeling sick.
I have an exterminator coming tomorrow
werenumber2
Well-Known Member
Waterbugs!
We’ve had 3 since the beginning of April. I’m about to set this apartment on fire. I’m seeing a lot of local posts about an increase of pests and rodents so I’m guessing the fact that there are less people outside are driving them to seek out food inside of people’s houses. I can’t y’all
shelli4018
Well-Known Member
I was hoping to bake more since our meat consumption has decreased. I’m not too upset. Clearly Rona is telling me gluten is off the menu. Lol! We were probably too reliant on wheat and animal protein in our diet anyway. Boy! The learning curve is a little steep when you’re trying to change habits as quickly as this pandemic requires.
Nevertheless, I managed to pot my tomato plant and started some seedlings on my window sill. I’m a little late but last Fall and winter were unseasonably warm. I think I’ll be ok. My little garden will be established by the time the 2nd wave of infections begin.
May plant some medicinal plants too.
Ms. Tarabotti
Well-Known Member
This virus has bugs coming in my house that should NOT be here. If this is an example of the Earth ~healing itself~, I’m gonna need Mother Nature to go back to feeling sick.
I have an exterminator coming tomorrow
Waterbugs!
I’m seeing a lot of local posts about an increase of pests and rodents so I’m guessing the fact that there are less people outside are driving them to seek out food inside of people’s houses. I can’t y’all
Aw, they just want some place to quarantine. Don't you have any extra room?
I guess since most restaurants and other shops are closed, there are slim pickings for all the vermin out there. Less food trash on the street means that they are seeking food elsewhere.
Black Ambrosia
Well-Known Member
I bought seeds and a few trays of seedlings yesterday. I have no experience with growing vegetables. I’m hoping for the best but my expectations are low.
Ms. Tarabotti
Well-Known Member
So I can attend a convention in DC this August!
People are crazy- is it that important to be walking around a crowded park because it is sunny and warm when there is a pandemic going on? No one has said that white people are immune yet these people act like it can't happen to them.
This 'black people" disease is going to run rampant among these foolish white people.
werenumber2
Well-Known Member
Aw, they just want some place to quarantine. Don't you have any extra room?
I hate everything about this timeline!
Transformer
Well-Known Member
An IBM survey released on Friday found that 54 percent of the 25,000 adults polled would like to be able to primarily work from home and 75 percent would like the option to do it occasionally. Once businesses can reopen, 40 percent of people responded that they feel strongly their employer should offer opt-in remote work options.
Transformer
Well-Known Member
Do tell what was in the other order. One of the reasons they were unconcerned is that they can’t take the order back. Once in your possession it must be destroyed even if you take it back to the store.
Transformer
Well-Known Member
https://www.washingtonpost.com/nati...us-update-us/#link-EYQLJNNYKNFEDEFLFF7BZ66QYA
Ohio’s Department of Job and Family Services launched a Web page and sent emails to employers on Friday encouraging them to report employees who don’t return to work so that their unemployment benefits eligibility can be reassessed, the Plain Dealer reported.
The state told employers in an email that it’s against the law for people to receive unemployment benefits if they refuse offers of “suitable” work or quit their jobs without a good reason, the news outlet reported. The state wants to know about those people so that they can determine their unemployment eligibility.
Turning down work could result in an administrative review process where the employee and the employer state their positions before the state, which will ultimately decide eligibility, the Plain Dealer reported.
Kimberly Hall, director of the Department of Job and Family Services, told the outlet that the review process existed before the pandemic, but that she recognized that there could be differences of opinion on how a business is taking care of health and safety standards. Employees would have to demonstrate a strong reason for denying work and why a “reasonable person” would quit their job under similar conditions, which could be a very arduous process full of documentation, the news outlet reported.
More than a million Ohioans have filed for unemployment benefits in the past six weeks, the Plain Dealer reported. The state has more than 19,000 confirmed cases of coronavirus with a death toll that’s inching close to 1,000.
Ohio Gov. Mike DeWine’s phase-in reopen order allowed employees in construction, distribution and manufacturing to return to work Monday along with employees at office spaces as long as certain conditions were met, Fox 8 reported.
Ohio’s Department of Job and Family Services launched a Web page and sent emails to employers on Friday encouraging them to report employees who don’t return to work so that their unemployment benefits eligibility can be reassessed, the Plain Dealer reported.
The state told employers in an email that it’s against the law for people to receive unemployment benefits if they refuse offers of “suitable” work or quit their jobs without a good reason, the news outlet reported. The state wants to know about those people so that they can determine their unemployment eligibility.
Turning down work could result in an administrative review process where the employee and the employer state their positions before the state, which will ultimately decide eligibility, the Plain Dealer reported.
Kimberly Hall, director of the Department of Job and Family Services, told the outlet that the review process existed before the pandemic, but that she recognized that there could be differences of opinion on how a business is taking care of health and safety standards. Employees would have to demonstrate a strong reason for denying work and why a “reasonable person” would quit their job under similar conditions, which could be a very arduous process full of documentation, the news outlet reported.
More than a million Ohioans have filed for unemployment benefits in the past six weeks, the Plain Dealer reported. The state has more than 19,000 confirmed cases of coronavirus with a death toll that’s inching close to 1,000.
Ohio Gov. Mike DeWine’s phase-in reopen order allowed employees in construction, distribution and manufacturing to return to work Monday along with employees at office spaces as long as certain conditions were met, Fox 8 reported.
It was a lot of ground beef, fresh fruit and fifty-eleven Kroger store brand vanilla yogurts.
Everything Zen
Well-Known Member
Saw this one coming a mile away.
Transformer
Well-Known Member
OhTall1
Well-Known Member
Me and my peers are being asked to do a write up on what we want work/life balance to look like for us and our direct reports once stay at home orders and social distancing go away. Our management was notorious for blocking telework particularly on Mondays and Fridays because they saw it as staff trying to extend their weekends. And just a few weeks ago, we had to document what our staff was working on to justify that we were actually doing our jobs.
Chromia
Well-Known Member
They made sure (tried at least) that they had their favorite yogurt! Hopefully there was enough left in the store for if & when they got their order.
Here's a ground beef recipe from my YouTube favorites if you're interested.
-Julio's Seasoning
-Chili Powder
-1 packet of Taco Seasoning
-1 lb Extra Lean Ground Beef
-Onions Chopped
-2 Cans of diced tomatoes
-1 Can of Kidney Beans
-1 Can of Pinto Beans
-1 Can of Garbanzo Beans
-1 Can of Corn white and yellow
-Cilantro
-Salsa with Cilantro
-Avocado
-Shredded Cheese
-Baked Chips
-Sour Cream Light
This recipe starts at 8:10.
Last edited:
Everything Zen
Well-Known Member
Me and my peers are being asked to do a write up on what we want work/life balance to look like for us and our direct reports once stay at home orders and social distancing go away. Our management was notorious for blocking telework particularly on Mondays and Fridays because they saw it as staff trying to extend their weekends. And just a few weeks ago, we had to document what our staff was working on to justify that we were actually doing our jobs.
It’s such an easy (free) thing to give employees. Especially when you can’t pay folks. Heaven forbid someone try to extend a weekend and ease in or out of the work week.
The ability to telecommute is clutch especially in Chicagoland traffic. I been doing these insane commutes for more than a decade and it was messing with my health. This past year of 100% remote work unless I had to fly somewhere has been a Godsend and I even have a office I can go to if I just want to get out of the house. My former employer straight took my flextime away from me after two years (Even though I barely used it) when I was working in a location managing myself calling themselves trying to dictate my hours. The job was cool until that moment and then the quality of work took a nosedive. Another former employer is trying to get me back as well with a minimum 50k increase in pay with the title but they are notoriously anti-remote working. I don’t know if it’s worth making that terrible commute again bc I used to just be in tears on the road. I’ll make that type of money (and more) eventually.
lavaflow99
In search of the next vacation
https://www.roche.com/media/releases/med-cor-2020-05-03.htm
This looks promising!!
Roche’s COVID-19 antibody test receives FDA Emergency Use Authorization and is available in markets accepting the CE mark
“Thanks to the enormous efforts of our dedicated colleagues we are now able to deliver a high-quality antibody test in high quantities, so we can support healthcare systems around the world with an important tool to better manage the COVID-19 health crisis,” said Severin Schwan, CEO Roche Group. ”I am in particular pleased about the high specificity and sensitivity of our test, which is crucial to support health care systems around the world with a reliable tool to better manage the COVID-19 health crisis.”
“Our best scientists have worked 24/7 over the last few weeks and months to develop a highly reliable antibody test to help fight this pandemic,” said Thomas Schinecker, CEO Roche Diagnostics. “Roche is committed to helping laboratories deliver fast, accurate, and reliable results to healthcare professionals and their patients.”
Roche’s SARS-CoV2 antibody test, which has a specificity greater than 99.8% and 100% sensitivity3 (14 Days post-PCR confirmation), can help assess patients’ immune response to the virus. As more is understood about immunity to SARS-CoV-2, the test may help to assess who has built up immunity to the virus.
With extensive global manufacturing capabilities, Roche will be able to deliver high double-digit millions of tests per month. Hospitals and reference laboratories can run the test on Roche’s cobas e analysers, which are widely available around the world.
For countries with specific regulatory requirements, local approval timelines apply. In addition there may be other country-specific regulations, such as import requirements, which will determine when the test becomes available locally. Roche will work closely with the respective regional representatives to ensure we appropriately support local registration efforts.
About antibody testing
An antibody test, also called a serology test, is used to determine whether a person might have gained immunity against a pathogen or not. The human body makes antibodies in response to many illnesses. In the current situation of the COVID-19 pandemic, antibody tests need to be able to specifically detect antibodies against SARS-CoV-2 with no cross-reactivity to other similar coronaviruses, which could generate a false positive result and thus wrongly indicate potential immunity. A false positive result happens when a person receives a positive test result, when they should have received a negative result. False positives are particularly critical when we do not know how many people in a given population have had COVID-19. As of 24 April 2020, no study has evaluated whether the presence of antibodies to SARS-CoV-2 confers immunity to subsequent infection by this virus in humans4.
About Elecsys Anti-SARS-CoV-2 serology test
Elecsys® Anti-SARS-CoV-2 is an immunoassay for the in-vitro qualitative detection of antibodies (including IgG) to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in human serum and plasma. Through a blood sample, the test, which is based on an in-solution double-antigen sandwich format, can detect antibodies to the new coronavirus causing COVID-19, which could signal whether a person has already been infected and potentially developed immunity to the virus. Based on the measurement of a total of 5272 samples, the Elecsys® Anti-SARS-CoV-2 assay has 99.81% specificity and shows no cross-reactivity to the four human coronaviruses causing common cold. This means it can lower the chance of false positives due to the detection of similar antibodies that may be present in an individual, but are specific for coronaviruses other than SARS-CoV-2. Elecsys® Anti-SARS-CoV-2 detected antibodies with 100% sensitivity in samples taken 14 days after a PCR-confirmed infection. The importance of specificity and sensitivity of a particular test will be dependent on its purpose and disease prevalence within a given population.
Hospitals and reference laboratories can run the test on Roche’s cobas e analysers, which are widely available around the world. These fully automated systems can provide SARS-CoV-2 test results in approximately 18 minutes for one single test, with a test throughput of up to 300 tests/hour, depending on the analyser.
About Roche
Roche is a global pioneer in pharmaceuticals and diagnostics focused on advancing science to improve people’s lives. The combined strengths of pharmaceuticals and diagnostics under one roof have made Roche the leader in personalised healthcare – a strategy that aims to fit the right treatment to each patient in the best way possible.
Roche is the world’s largest biotech company, with truly differentiated medicines in oncology, immunology, infectious diseases, ophthalmology and diseases of the central nervous system. Roche is also the world leader in in vitro diagnostics and tissue-based cancer diagnostics, and a frontrunner in diabetes management.
Founded in 1896, Roche continues to search for better ways to prevent, diagnose and treat diseases and make a sustainable contribution to society. The company also aims to improve patient access to medical innovations by working with all relevant stakeholders. More than thirty medicines developed by Roche are included in the World Health Organization Model Lists of Essential Medicines, among them life-saving antibiotics, antimalarials and cancer medicines. Moreover, for the eleventh consecutive year, Roche has been recognised as one of the most sustainable companies in the Pharmaceuticals Industry by the Dow Jones Sustainability Indices (DJSI).
The Roche Group, headquartered in Basel, Switzerland, is active in over 100 countries and in 2019 employed about 98,000 people worldwide. In 2019, Roche invested CHF 11.7 billion in R&D and posted sales of CHF 61.5 billion. Genentech, in the United States, is a wholly owned member of the Roche Group. Roche is the majority shareholder in Chugai Pharmaceutical, Japan. For more information, please visit www.roche.com.
All trademarks used or mentioned in this release are protected by law.
References
[1] The Emergency Use Authorisation (EUA) authority allows FDA to help strengthen the nation’s public health protections against CBRN threats by facilitating the availability and use of medical countermeasures needed during public health emergencies https://www.fda.gov/home
[2] CE-IVD marking is granted through completion of a comprehensive technical validation and self declaration under the European Directive for In Vitro Diagnostic Medical Devices.
[3] Full specifications of Roche’s Elecsys® Anti-SARS-CoV-2 antibody test and immunoassay systems, including throughput, can be found on our diagnostics.roche website
[4] https://www.who.int/news-room/commentaries/detail/immunity-passports-in-the-context-of-covid-19
This looks promising!!
Roche’s COVID-19 antibody test receives FDA Emergency Use Authorization and is available in markets accepting the CE mark
- The serology test has a specificity greater than 99.8% and sensitivity of 100% (14 Days post-PCR confirmation)
- The high specificity of the test is crucial to determine reliably if a person has been exposed to the virus and if the patient has developed antibodies
- Roche will provide high double-digit millions of tests already in May for countries accepting the CE mark and in the U.S. under Emergency Use Authorization, further ramping up capacities thereafter
- The test is available on Roche’s cobas e analysers which are widely available around the world
“Thanks to the enormous efforts of our dedicated colleagues we are now able to deliver a high-quality antibody test in high quantities, so we can support healthcare systems around the world with an important tool to better manage the COVID-19 health crisis,” said Severin Schwan, CEO Roche Group. ”I am in particular pleased about the high specificity and sensitivity of our test, which is crucial to support health care systems around the world with a reliable tool to better manage the COVID-19 health crisis.”
“Our best scientists have worked 24/7 over the last few weeks and months to develop a highly reliable antibody test to help fight this pandemic,” said Thomas Schinecker, CEO Roche Diagnostics. “Roche is committed to helping laboratories deliver fast, accurate, and reliable results to healthcare professionals and their patients.”
Roche’s SARS-CoV2 antibody test, which has a specificity greater than 99.8% and 100% sensitivity3 (14 Days post-PCR confirmation), can help assess patients’ immune response to the virus. As more is understood about immunity to SARS-CoV-2, the test may help to assess who has built up immunity to the virus.
With extensive global manufacturing capabilities, Roche will be able to deliver high double-digit millions of tests per month. Hospitals and reference laboratories can run the test on Roche’s cobas e analysers, which are widely available around the world.
For countries with specific regulatory requirements, local approval timelines apply. In addition there may be other country-specific regulations, such as import requirements, which will determine when the test becomes available locally. Roche will work closely with the respective regional representatives to ensure we appropriately support local registration efforts.
About antibody testing
An antibody test, also called a serology test, is used to determine whether a person might have gained immunity against a pathogen or not. The human body makes antibodies in response to many illnesses. In the current situation of the COVID-19 pandemic, antibody tests need to be able to specifically detect antibodies against SARS-CoV-2 with no cross-reactivity to other similar coronaviruses, which could generate a false positive result and thus wrongly indicate potential immunity. A false positive result happens when a person receives a positive test result, when they should have received a negative result. False positives are particularly critical when we do not know how many people in a given population have had COVID-19. As of 24 April 2020, no study has evaluated whether the presence of antibodies to SARS-CoV-2 confers immunity to subsequent infection by this virus in humans4.
About Elecsys Anti-SARS-CoV-2 serology test
Elecsys® Anti-SARS-CoV-2 is an immunoassay for the in-vitro qualitative detection of antibodies (including IgG) to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) in human serum and plasma. Through a blood sample, the test, which is based on an in-solution double-antigen sandwich format, can detect antibodies to the new coronavirus causing COVID-19, which could signal whether a person has already been infected and potentially developed immunity to the virus. Based on the measurement of a total of 5272 samples, the Elecsys® Anti-SARS-CoV-2 assay has 99.81% specificity and shows no cross-reactivity to the four human coronaviruses causing common cold. This means it can lower the chance of false positives due to the detection of similar antibodies that may be present in an individual, but are specific for coronaviruses other than SARS-CoV-2. Elecsys® Anti-SARS-CoV-2 detected antibodies with 100% sensitivity in samples taken 14 days after a PCR-confirmed infection. The importance of specificity and sensitivity of a particular test will be dependent on its purpose and disease prevalence within a given population.
Hospitals and reference laboratories can run the test on Roche’s cobas e analysers, which are widely available around the world. These fully automated systems can provide SARS-CoV-2 test results in approximately 18 minutes for one single test, with a test throughput of up to 300 tests/hour, depending on the analyser.
About Roche
Roche is a global pioneer in pharmaceuticals and diagnostics focused on advancing science to improve people’s lives. The combined strengths of pharmaceuticals and diagnostics under one roof have made Roche the leader in personalised healthcare – a strategy that aims to fit the right treatment to each patient in the best way possible.
Roche is the world’s largest biotech company, with truly differentiated medicines in oncology, immunology, infectious diseases, ophthalmology and diseases of the central nervous system. Roche is also the world leader in in vitro diagnostics and tissue-based cancer diagnostics, and a frontrunner in diabetes management.
Founded in 1896, Roche continues to search for better ways to prevent, diagnose and treat diseases and make a sustainable contribution to society. The company also aims to improve patient access to medical innovations by working with all relevant stakeholders. More than thirty medicines developed by Roche are included in the World Health Organization Model Lists of Essential Medicines, among them life-saving antibiotics, antimalarials and cancer medicines. Moreover, for the eleventh consecutive year, Roche has been recognised as one of the most sustainable companies in the Pharmaceuticals Industry by the Dow Jones Sustainability Indices (DJSI).
The Roche Group, headquartered in Basel, Switzerland, is active in over 100 countries and in 2019 employed about 98,000 people worldwide. In 2019, Roche invested CHF 11.7 billion in R&D and posted sales of CHF 61.5 billion. Genentech, in the United States, is a wholly owned member of the Roche Group. Roche is the majority shareholder in Chugai Pharmaceutical, Japan. For more information, please visit www.roche.com.
All trademarks used or mentioned in this release are protected by law.
References
[1] The Emergency Use Authorisation (EUA) authority allows FDA to help strengthen the nation’s public health protections against CBRN threats by facilitating the availability and use of medical countermeasures needed during public health emergencies https://www.fda.gov/home
[2] CE-IVD marking is granted through completion of a comprehensive technical validation and self declaration under the European Directive for In Vitro Diagnostic Medical Devices.
[3] Full specifications of Roche’s Elecsys® Anti-SARS-CoV-2 antibody test and immunoassay systems, including throughput, can be found on our diagnostics.roche website
[4] https://www.who.int/news-room/commentaries/detail/immunity-passports-in-the-context-of-covid-19
TrulyBlessed
Well-Known Member
Last edited:
ThirdEyeBeauty
Well-Known Member
Interesting study that may or may not be worth the read.
Note: the table did not come out correct but you can find the article via the link.
Note: the table did not come out correct but you can find the article via the link.
Patterns of COVID-19 Mortality and Vitamin D: An Indonesian Study
Prabowo Raharusuna*, Sadiah Priambada, Cahni Budiarti, Erdie
Agung, Cipta Budi
*Correspondence:
[email protected]
RSUD Kabupaten Sukamara
Kec. Sukamara, Kabupaten Sukamara,
Kalimantan Tengah 74171, Indonesia
April 26, 2020
Data Availability:
The data that support the findings of this study are available
from the corresponding author upon reasonable request.
Statement of Conflict of Interest:
The authors declare no conflict of interest.
Source of Funding:
The study was not funded by external sources.
This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=3585561
Disclaimer: This is a preliminary study for early dissemination of results. Data are subject to changes.
KEY FINDINGS:
• Majority of the COVID-19 cases with insufficient and
deficient Vitamin D status died.
• The odds of death was higher in older and male cases with
pre-existing condition and below normal Vitamin D levels.
• When controlling for age, sex, and comorbidity, Vitamin D
status is strongly associated with COVID-19 mortality.
• Randomized controlled trials are warranted to investigate
the role of vitamin D supplementation on COVID-19 outcomes
and to establish the underlying mechanisms.
ABSTRACT
This is a retrospective cohort study which included two cohorts (active and expired) of 780 cases with laboratory-confirmed infection of SARS-CoV-2 in Indonesia. Age, sex, co-morbidity, Vitamin D status, and disease outcome (mortality) were extracted from electronic medical records. The aim was to determine patterns of mortality and associated factors, with a special focus on Vitamin D status. Results revealed that majority of the death cases were male and older and had pre-existing condition and below normal Vitamin D serum level. Univariate analysis revealed that older and male cases with pre-existing condition and below normal Vitamin D levels were associated with increasing odds of death. When controlling for age, sex, and comorbidity, Vitamin D status is strongly associated with COVID-19 mortality outcome of cases.
INTRODUCTION
The Coronavirus-2019 (COVID-19) pandemic remains a pressing
problem in the world and will continually surface as more than
30 different mutations of the disease strain, severe acute
respiratory syndrome-coronavirus (SARS-CoV-2), were detected
from the latest study in China.1 With the increasing number of
novel strains, researchers across the world are driven to conduct
clinical trials for potential anti-viral treatments. However,
the likelihood of potential vaccines for the disease went down,
due to more evidence debuting previous claims on the efficacy
of the tested drugs. Scientists continue to search for effective
treatments, with efforts focused on several existing drugs.
Vitamin D has been proven to enhance expression of anti
oxidation-related genes, modulates adaptive immunity, and
improves cellular immunity.2,3,4,5With the remarkable potential of
Vitamin D, several researchers proposed Vitamin D
supplementation could possibly treat COVID-19 or reduce severity,
at least.6,7,8,9,10,11,12
In a previous report, a significant association between vitamin
D status and severity of COVID-19 disease has been documented
in Southeast Asia.11 The report suggests that serum 25(OH)D level
was lowest in critical cases, but highest in mild cases which
thereby increase the odds of having a mild clinical outcome
rather than a critical outcome by approximately 19.61 times. The
result further fortified initial hypotheses of Vitamin D
proponents that a decrease in serum 25(OH)D level in the body
could worsen clinical outcomes of COVID-19 patients while an
increase in serum 25(OH)D level in the body could either mitigate
worst outcome or improve clinical outcomes.
Existing literature provides evidence that pre-hospitalization
serum 25(OH)D is linked to outcomes of respiratory diseases.
Using cross-sectional data from 6789 participants in the
nationwide 1958 British birth cohort who had measurements of
25(OH)D, Berry et al.13 reported that vitamin D status had a
linear relationship with respiratory infections and lung
function. Pre-admission 25(OH)D deficiency was also predictive
for short-term and long-term mortality.14,15
This study has focused on identifying patterns of mortality among
patients infected with Covid-19 and the possible association
between serum 25(OH)D level and mortality outcomes. In this study,
age, sex, and co-morbidity were added as factors and an outcome
variable, mortality, was analyzed to further provide strong
evidence of Vitamin D potency for SARS-CoV-2.
METHODS
Study Design and Participants
This is a retrospective cohort study which included two cohorts
(active and expired) of 780 cases with laboratory-confirmed
infection of SARS-CoV-2. Data between March 2, 2020 (start of
outbreak in Indonesia) and April 24, 2020 were obtained from
medical records of Indonesia government hospitals. The
requirement for informed consent was waived by the Ethics
Commission. To ensure anonymity, all names were preserved
throughout the analysis.
Data Collection
Age, sex, co-morbidity, Vitamin D status, and disease outcome
(mortality) were extracted from electronic medical records. Co
morbidity status was classified as with or without pre-existing
condition.
For Vitamin D status, cases were classified based on their serum
25(OH)D levels: (1) normal - serum 25(OH)D of > 30 ng/ml, (2)
insufficient - serum 25(OH)D of 21-29 ng/ml, and (3) deficient
- serum 25(OH)D of < 20 ng/ml. This classification was based on
existing literature.16 The pre-admission serum 25(OH)D levels
were considered for the analysis. Serum 25(OH)D level was checked
by two physicians based on the available clinical data of the
patients.
Statistical Analysis
Analysis was carried out using SPSS 21.0 statistical software.
Mean was used for continuous variable (age), while frequency and
percentage were employed for categorical variables. To compare
differences in the outcomes, Mann-Whitney U and χ² tests were
used. Meanwhile, univariate logistics regression was used to
determine the association between each predictor variable and
mortality outcome. The odds ratio (OR) associated with the effect
of a one standard deviation increase in the predictor was used
in the interpretation of data. To determine the association of
Vitamin D status and mortality outcome, all ORs were adjusted
for age, sex, and comorbidity using a generalized linear model.
A p-value less than 0.05 was considered statistically
significant.
RESULTS AND DISCUSSION
Descriptive Statistics
The demographic and clinical characteristics of two cohorts
(active and expired) are presented (Table 1). Mean overall age
was 54.5 years, mean age for expired cases was 65.2 years, higher
compared to active cases (46.3 years). Of the 780 sample,
majority (58.8%) aged below 50 years, most of the them (83.0%)
are still admitted in the hospital. Of the 321 samples aged 50
years and above, majority (66.6%) died due to the disease.
Females (51.3%) outnumbered males (48.7%); however, there were
more male cases who died (66.6%) than female (33.4%). Patients
with existing condition (84.9%) comprised majority of the death
cases. Interestingly, majority of the cases had normal Vitamin
D status (49.7%), most of them (93.0%) are still hospitalized.
Of the 213 cases with insufficient Vitamin D status, majority
(49.1%) died. The same distribution was observed in Vitamin D
deficient cases where majority (46.7%) died due to the disease.
Univariate Analysis
Each predictor was separately analyzed using univariate logistic
regression (Table 2). Older cases (50 years and above) were
approximately 10.45 times more likely to die than younger cases
(at most 50 years) (OR=10.45; p<0.001). Male cases were
approximately 5.73 times more likely to die from the disease
than female cases (OR=5.73; p<0.001). Meanwhile, cases with pre
existing condition had increased odds of mortality compared to
cases without (OR=11.24; p<0.001). With reference to normal
cases, Vitamin D insufficient cases were approximately 12.55
times more likely to die (OR=12.55; p<0.001) while Vitamin D
deficient cases were approximately 19.12 times more likely to
die from the disease (OR=19.12; p<0.001).
Generalized Linear Model
To control for possible confounding of age, sex, and comorbidity
on the association of Vitamin D status and mortality outcome, a
generalized linear model was employed (Table 3). After
accounting for these variables in the model, a significant
association has been obtained between Vitamin D status and
mortality. In particular, the odds of death was higher in cases
with insufficient Vitamin D status (OR=7.63; p<0.001). When
compared to cases with normal Vitamin D status, death was
approximately 10.12 times more likely for Vitamin D deficient
cases (OR=10.12; p<0.001).
Table 1. Demographic and clinical characteristics of sample
Variables Total Expired Active p-value
(N=780) (N=380) (N=400)
Age, mean 54.5 65.2 46.3
< 50 years 459 (58.8%) 127 (33.4%) 332 (83.0%) <0.001
≥ 50 years 321 (41.2%) 253 (66.6%) 68 (17.0%)
Sex
Female 400 (51.3%) 128 (33.4%) 332 (83.0%) <0.001
Male 380 (48.7%) 252 (66.6%) 68 (17.0%)
Comorbidity
Yes 383 (49.1%) 323 (84.9%) 60 (15.0%) <0.001
No 397 (50.9%) 57 (15.1%) 340 (85.0%)
Vitamin D Status
Normal 388 (49.7%) 16 (4.2%) 372 (93.0%) <0.001
Insufficient 213 (27.3%) 187 (49.1%) 26 (6.5%)
Deficient 179 (23.0%) 177 (46.7%) 2 (0.5%)
Table 2. Univariate analysis for factors associated with
mortality
Table 3. Association between Vitamin D status and mortality
(adjusted for age, sex, and comorbidity)
Variables OR p-value
Age, mean
< 50 years -
≥ 50 years 10.45 <0.001
Sex
Female -
Male 5.73 <0.001
Comorbidity
Yes 11.24 <0.001
No -
Vitamin D Status
Normal -
Insufficient 12.55 <0.001
Deficient 19.12 <0.001
Variable OR p-value
Vitamin D Status
Normal -
Insufficient 7.63 <0.001
Deficient 10.12 <0.001
CONCLUSION
To the best of the researchers’ knowledge, this is the first
retrospective study which determines the association of Vitamin
D status and COVID-19 mortality outcome. Older and male cases
with pre-existing condition and below normal Vitamin D levels
were associated with increasing odds of death. When controlling
for age, sex, and comorbidity, Vitamin D status is strongly
associated with COVID-19 mortality outcome of cases. Randomized
controlled trials are warranted to investigate the role of
vitamin D supplementation on COVID-19 outcomes and to establish
the underlying mechanisms.
REFERENCES
1 Hangping Yao, Xiangyun Lu, Qiong Chen, Kaijin Xu, Yu Chen, Linfang Cheng, Fumin Liu, Zhigang Wu, Haibo Wu, Changzhong Jin, Min Zheng, Nanping Wu, Chao Jiang, Lanjuan Li. Patient-derived mutations impact pathogenicity of SARS-CoV-2. doi: 10.1101/2020.04.14.20060160
2 Rondanelli, M., Miccono, A., Lamburghini, S., Avanzato, I., Riva, A., Allegrini, P., ... & Perna, S. (2018). Self-care for common colds: the pivotal role of vitamin D, vitamin C, zinc, and Echinacea in three main immune interactive clusters (physical barriers, innate and adaptive immunity) involved during an episode of common colds—Practical advice on dosages and on the time to take these nutrients/botanicals in order to prevent or treat common colds. Evidence-Based Complementary and Alternative Medicine, 2018.
3 Cantorna, M. T. (2010). Mechanisms underlying the effect of vitamin D on the immune system. Proceedings of the Nutrition Society, 69(3), 286-289.
4 Sharifi, A., Vahedi, H., Nedjat, S., Rafiei, H., & Hosseinzadeh‐Attar, M. J. (2019). Effect of single‐dose injection of vitamin D on immune cytokines in ulcerative colitis patients: a randomized placebocontrolled trial. Apmis, 127(10), 681-687.
5 Lei, G. S., Zhang, C., Cheng, B. H., & Lee, C. H. (2017). Mechanisms
This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=3585561
Disclaimer: This is a preliminary study for early dissemination of results. Data are subject to changes.
of action of vitamin D as supplemental therapy for Pneumocystis pneumonia. Antimicrobial agents and chemotherapy, 61(10), e01226-17.
6 Wimalawansa, S. J. (2020). Global epidemic of coronavirus--COVID-19: What we can do to minimize risks. European Journal of Biomedical, 7(3), 432-438.
7 Grant, W. B., Lahore, H., McDonnell, S. L., Baggerly, C. A., French, C. B., Aliano, J. L., & Bhattoa, H. P. (2020). Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients, 12(4), 988.
8 Brown RA, Sarkar A (2020). Vitamin D deficiency: a factor in COVID19, progression, severity and mortality? – An urgent call for research. MitoFit Preprint Arch doi: 10.26124/mitofit:200001
9 Ilie, P., Stefanescu, S., Smith, L. (2020). The role of Vitamin D in the prevention of Coronavirus Disease 2019 infection and mortality. Square Research. doi:10.21203/rs.3.rs-21211/v1.
10 Grant, W. (2020). Re: Preventing a covid-19 pandemic: Can vitamin D supplementation reduce the spread of COVID-19? Try first with health care workers and first responders. doi: 10.1136/bmj.m810 https://www.bmj.com/content/368/bmj.m810/rr-42
11 Alipio, M. (2020). Vitamin D Supplementation Could Possibly Improve Clinical Outcomes of Patients Infected with Coronavirus-2019 (COVID2019). Available at SSRN: https://ssrn.com/abstract=3571484 or http://dx.doi.org/10.2139/ssrn.3571484
12 Rhodes, J.M., Subramanian, S., Laird, E. and Anne Kenny, R. (2020), Editorial: low population mortality from COVID‐19 in countries south of latitude 35 degrees North – supports vitamin D as a factor determining severity. Aliment Pharmacol Ther. Accepted Author Manuscript. doi:10.1111/apt.15777
13 Berry, D. J., Hesketh, K., Power, C., & Hyppönen, E. (2011). Vitamin D status has a linear association with seasonal infections and lung function in British adults. British Journal of Nutrition, 106(9), 14331440.
14 Braun, A., Chang, D., Mahadevappa, K., Gibbons, F. K., Liu, Y., Giovannucci, E., & Christopher, K. B. (2011). Association of low serum 25-hydroxyvitamin D levels and mortality in the critically ill. Critical care medicine, 39(4), 671.
15 Watkins, R. R., Lemonovich, T. L., & Salata, R. A. (2015). An update
This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=3585561
Disclaimer: This is a preliminary study for early dissemination of results. Data are subject to changes.
on the association of vitamin D deficiency with common infectious diseases. Canadian journal of physiology and pharmacology, 93(5), 363368.
16 Holick, M. F. (2009). Vitamin D status: measurement, interpretation, and clinical application. Annals of epidemiology, 19(2), 73-78.
This
Prabowo Raharusuna*, Sadiah Priambada, Cahni Budiarti, Erdie
Agung, Cipta Budi
*Correspondence:
[email protected]
RSUD Kabupaten Sukamara
Kec. Sukamara, Kabupaten Sukamara,
Kalimantan Tengah 74171, Indonesia
April 26, 2020
Data Availability:
The data that support the findings of this study are available
from the corresponding author upon reasonable request.
Statement of Conflict of Interest:
The authors declare no conflict of interest.
Source of Funding:
The study was not funded by external sources.
This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=3585561
Disclaimer: This is a preliminary study for early dissemination of results. Data are subject to changes.
KEY FINDINGS:
• Majority of the COVID-19 cases with insufficient and
deficient Vitamin D status died.
• The odds of death was higher in older and male cases with
pre-existing condition and below normal Vitamin D levels.
• When controlling for age, sex, and comorbidity, Vitamin D
status is strongly associated with COVID-19 mortality.
• Randomized controlled trials are warranted to investigate
the role of vitamin D supplementation on COVID-19 outcomes
and to establish the underlying mechanisms.
ABSTRACT
This is a retrospective cohort study which included two cohorts (active and expired) of 780 cases with laboratory-confirmed infection of SARS-CoV-2 in Indonesia. Age, sex, co-morbidity, Vitamin D status, and disease outcome (mortality) were extracted from electronic medical records. The aim was to determine patterns of mortality and associated factors, with a special focus on Vitamin D status. Results revealed that majority of the death cases were male and older and had pre-existing condition and below normal Vitamin D serum level. Univariate analysis revealed that older and male cases with pre-existing condition and below normal Vitamin D levels were associated with increasing odds of death. When controlling for age, sex, and comorbidity, Vitamin D status is strongly associated with COVID-19 mortality outcome of cases.
INTRODUCTION
The Coronavirus-2019 (COVID-19) pandemic remains a pressing
problem in the world and will continually surface as more than
30 different mutations of the disease strain, severe acute
respiratory syndrome-coronavirus (SARS-CoV-2), were detected
from the latest study in China.1 With the increasing number of
novel strains, researchers across the world are driven to conduct
clinical trials for potential anti-viral treatments. However,
the likelihood of potential vaccines for the disease went down,
due to more evidence debuting previous claims on the efficacy
of the tested drugs. Scientists continue to search for effective
treatments, with efforts focused on several existing drugs.
Vitamin D has been proven to enhance expression of anti
oxidation-related genes, modulates adaptive immunity, and
improves cellular immunity.2,3,4,5With the remarkable potential of
Vitamin D, several researchers proposed Vitamin D
supplementation could possibly treat COVID-19 or reduce severity,
at least.6,7,8,9,10,11,12
In a previous report, a significant association between vitamin
D status and severity of COVID-19 disease has been documented
in Southeast Asia.11 The report suggests that serum 25(OH)D level
was lowest in critical cases, but highest in mild cases which
thereby increase the odds of having a mild clinical outcome
rather than a critical outcome by approximately 19.61 times. The
result further fortified initial hypotheses of Vitamin D
proponents that a decrease in serum 25(OH)D level in the body
could worsen clinical outcomes of COVID-19 patients while an
increase in serum 25(OH)D level in the body could either mitigate
worst outcome or improve clinical outcomes.
Existing literature provides evidence that pre-hospitalization
serum 25(OH)D is linked to outcomes of respiratory diseases.
Using cross-sectional data from 6789 participants in the
nationwide 1958 British birth cohort who had measurements of
25(OH)D, Berry et al.13 reported that vitamin D status had a
linear relationship with respiratory infections and lung
function. Pre-admission 25(OH)D deficiency was also predictive
for short-term and long-term mortality.14,15
This study has focused on identifying patterns of mortality among
patients infected with Covid-19 and the possible association
between serum 25(OH)D level and mortality outcomes. In this study,
age, sex, and co-morbidity were added as factors and an outcome
variable, mortality, was analyzed to further provide strong
evidence of Vitamin D potency for SARS-CoV-2.
METHODS
Study Design and Participants
This is a retrospective cohort study which included two cohorts
(active and expired) of 780 cases with laboratory-confirmed
infection of SARS-CoV-2. Data between March 2, 2020 (start of
outbreak in Indonesia) and April 24, 2020 were obtained from
medical records of Indonesia government hospitals. The
requirement for informed consent was waived by the Ethics
Commission. To ensure anonymity, all names were preserved
throughout the analysis.
Data Collection
Age, sex, co-morbidity, Vitamin D status, and disease outcome
(mortality) were extracted from electronic medical records. Co
morbidity status was classified as with or without pre-existing
condition.
For Vitamin D status, cases were classified based on their serum
25(OH)D levels: (1) normal - serum 25(OH)D of > 30 ng/ml, (2)
insufficient - serum 25(OH)D of 21-29 ng/ml, and (3) deficient
- serum 25(OH)D of < 20 ng/ml. This classification was based on
existing literature.16 The pre-admission serum 25(OH)D levels
were considered for the analysis. Serum 25(OH)D level was checked
by two physicians based on the available clinical data of the
patients.
Statistical Analysis
Analysis was carried out using SPSS 21.0 statistical software.
Mean was used for continuous variable (age), while frequency and
percentage were employed for categorical variables. To compare
differences in the outcomes, Mann-Whitney U and χ² tests were
used. Meanwhile, univariate logistics regression was used to
determine the association between each predictor variable and
mortality outcome. The odds ratio (OR) associated with the effect
of a one standard deviation increase in the predictor was used
in the interpretation of data. To determine the association of
Vitamin D status and mortality outcome, all ORs were adjusted
for age, sex, and comorbidity using a generalized linear model.
A p-value less than 0.05 was considered statistically
significant.
RESULTS AND DISCUSSION
Descriptive Statistics
The demographic and clinical characteristics of two cohorts
(active and expired) are presented (Table 1). Mean overall age
was 54.5 years, mean age for expired cases was 65.2 years, higher
compared to active cases (46.3 years). Of the 780 sample,
majority (58.8%) aged below 50 years, most of the them (83.0%)
are still admitted in the hospital. Of the 321 samples aged 50
years and above, majority (66.6%) died due to the disease.
Females (51.3%) outnumbered males (48.7%); however, there were
more male cases who died (66.6%) than female (33.4%). Patients
with existing condition (84.9%) comprised majority of the death
cases. Interestingly, majority of the cases had normal Vitamin
D status (49.7%), most of them (93.0%) are still hospitalized.
Of the 213 cases with insufficient Vitamin D status, majority
(49.1%) died. The same distribution was observed in Vitamin D
deficient cases where majority (46.7%) died due to the disease.
Univariate Analysis
Each predictor was separately analyzed using univariate logistic
regression (Table 2). Older cases (50 years and above) were
approximately 10.45 times more likely to die than younger cases
(at most 50 years) (OR=10.45; p<0.001). Male cases were
approximately 5.73 times more likely to die from the disease
than female cases (OR=5.73; p<0.001). Meanwhile, cases with pre
existing condition had increased odds of mortality compared to
cases without (OR=11.24; p<0.001). With reference to normal
cases, Vitamin D insufficient cases were approximately 12.55
times more likely to die (OR=12.55; p<0.001) while Vitamin D
deficient cases were approximately 19.12 times more likely to
die from the disease (OR=19.12; p<0.001).
Generalized Linear Model
To control for possible confounding of age, sex, and comorbidity
on the association of Vitamin D status and mortality outcome, a
generalized linear model was employed (Table 3). After
accounting for these variables in the model, a significant
association has been obtained between Vitamin D status and
mortality. In particular, the odds of death was higher in cases
with insufficient Vitamin D status (OR=7.63; p<0.001). When
compared to cases with normal Vitamin D status, death was
approximately 10.12 times more likely for Vitamin D deficient
cases (OR=10.12; p<0.001).
Table 1. Demographic and clinical characteristics of sample
Variables Total Expired Active p-value
(N=780) (N=380) (N=400)
Age, mean 54.5 65.2 46.3
< 50 years 459 (58.8%) 127 (33.4%) 332 (83.0%) <0.001
≥ 50 years 321 (41.2%) 253 (66.6%) 68 (17.0%)
Sex
Female 400 (51.3%) 128 (33.4%) 332 (83.0%) <0.001
Male 380 (48.7%) 252 (66.6%) 68 (17.0%)
Comorbidity
Yes 383 (49.1%) 323 (84.9%) 60 (15.0%) <0.001
No 397 (50.9%) 57 (15.1%) 340 (85.0%)
Vitamin D Status
Normal 388 (49.7%) 16 (4.2%) 372 (93.0%) <0.001
Insufficient 213 (27.3%) 187 (49.1%) 26 (6.5%)
Deficient 179 (23.0%) 177 (46.7%) 2 (0.5%)
Table 2. Univariate analysis for factors associated with
mortality
Table 3. Association between Vitamin D status and mortality
(adjusted for age, sex, and comorbidity)
Variables OR p-value
Age, mean
< 50 years -
≥ 50 years 10.45 <0.001
Sex
Female -
Male 5.73 <0.001
Comorbidity
Yes 11.24 <0.001
No -
Vitamin D Status
Normal -
Insufficient 12.55 <0.001
Deficient 19.12 <0.001
Variable OR p-value
Vitamin D Status
Normal -
Insufficient 7.63 <0.001
Deficient 10.12 <0.001
CONCLUSION
To the best of the researchers’ knowledge, this is the first
retrospective study which determines the association of Vitamin
D status and COVID-19 mortality outcome. Older and male cases
with pre-existing condition and below normal Vitamin D levels
were associated with increasing odds of death. When controlling
for age, sex, and comorbidity, Vitamin D status is strongly
associated with COVID-19 mortality outcome of cases. Randomized
controlled trials are warranted to investigate the role of
vitamin D supplementation on COVID-19 outcomes and to establish
the underlying mechanisms.
REFERENCES
1 Hangping Yao, Xiangyun Lu, Qiong Chen, Kaijin Xu, Yu Chen, Linfang Cheng, Fumin Liu, Zhigang Wu, Haibo Wu, Changzhong Jin, Min Zheng, Nanping Wu, Chao Jiang, Lanjuan Li. Patient-derived mutations impact pathogenicity of SARS-CoV-2. doi: 10.1101/2020.04.14.20060160
2 Rondanelli, M., Miccono, A., Lamburghini, S., Avanzato, I., Riva, A., Allegrini, P., ... & Perna, S. (2018). Self-care for common colds: the pivotal role of vitamin D, vitamin C, zinc, and Echinacea in three main immune interactive clusters (physical barriers, innate and adaptive immunity) involved during an episode of common colds—Practical advice on dosages and on the time to take these nutrients/botanicals in order to prevent or treat common colds. Evidence-Based Complementary and Alternative Medicine, 2018.
3 Cantorna, M. T. (2010). Mechanisms underlying the effect of vitamin D on the immune system. Proceedings of the Nutrition Society, 69(3), 286-289.
4 Sharifi, A., Vahedi, H., Nedjat, S., Rafiei, H., & Hosseinzadeh‐Attar, M. J. (2019). Effect of single‐dose injection of vitamin D on immune cytokines in ulcerative colitis patients: a randomized placebocontrolled trial. Apmis, 127(10), 681-687.
5 Lei, G. S., Zhang, C., Cheng, B. H., & Lee, C. H. (2017). Mechanisms
This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=3585561
Disclaimer: This is a preliminary study for early dissemination of results. Data are subject to changes.
of action of vitamin D as supplemental therapy for Pneumocystis pneumonia. Antimicrobial agents and chemotherapy, 61(10), e01226-17.
6 Wimalawansa, S. J. (2020). Global epidemic of coronavirus--COVID-19: What we can do to minimize risks. European Journal of Biomedical, 7(3), 432-438.
7 Grant, W. B., Lahore, H., McDonnell, S. L., Baggerly, C. A., French, C. B., Aliano, J. L., & Bhattoa, H. P. (2020). Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients, 12(4), 988.
8 Brown RA, Sarkar A (2020). Vitamin D deficiency: a factor in COVID19, progression, severity and mortality? – An urgent call for research. MitoFit Preprint Arch doi: 10.26124/mitofit:200001
9 Ilie, P., Stefanescu, S., Smith, L. (2020). The role of Vitamin D in the prevention of Coronavirus Disease 2019 infection and mortality. Square Research. doi:10.21203/rs.3.rs-21211/v1.
10 Grant, W. (2020). Re: Preventing a covid-19 pandemic: Can vitamin D supplementation reduce the spread of COVID-19? Try first with health care workers and first responders. doi: 10.1136/bmj.m810 https://www.bmj.com/content/368/bmj.m810/rr-42
11 Alipio, M. (2020). Vitamin D Supplementation Could Possibly Improve Clinical Outcomes of Patients Infected with Coronavirus-2019 (COVID2019). Available at SSRN: https://ssrn.com/abstract=3571484 or http://dx.doi.org/10.2139/ssrn.3571484
12 Rhodes, J.M., Subramanian, S., Laird, E. and Anne Kenny, R. (2020), Editorial: low population mortality from COVID‐19 in countries south of latitude 35 degrees North – supports vitamin D as a factor determining severity. Aliment Pharmacol Ther. Accepted Author Manuscript. doi:10.1111/apt.15777
13 Berry, D. J., Hesketh, K., Power, C., & Hyppönen, E. (2011). Vitamin D status has a linear association with seasonal infections and lung function in British adults. British Journal of Nutrition, 106(9), 14331440.
14 Braun, A., Chang, D., Mahadevappa, K., Gibbons, F. K., Liu, Y., Giovannucci, E., & Christopher, K. B. (2011). Association of low serum 25-hydroxyvitamin D levels and mortality in the critically ill. Critical care medicine, 39(4), 671.
15 Watkins, R. R., Lemonovich, T. L., & Salata, R. A. (2015). An update
This preprint research paper has not been peer reviewed. Electronic copy available at: https://ssrn.com/abstract=3585561
Disclaimer: This is a preliminary study for early dissemination of results. Data are subject to changes.
on the association of vitamin D deficiency with common infectious diseases. Canadian journal of physiology and pharmacology, 93(5), 363368.
16 Holick, M. F. (2009). Vitamin D status: measurement, interpretation, and clinical application. Annals of epidemiology, 19(2), 73-78.
This
vevster
Well-Known Member
I bought a basil plant over the weekend.
Black Ambrosia
Well-Known Member
I had a basil plant before. Love, love, love the smell of fresh basil.
Black Ambrosia
Well-Known Member
vevster
Well-Known Member
I use it in my tuna salad
Transformer
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