COVID-19 Update: Low Vitamin D, Heart Damage After 'Recovery'

Laura Stokowski, RN, MS

July 29, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's  Coronavirus Resource Center.

Here are the coronavirus stories Medscape's editors around the globe think you need to know about today:

Low Vitamin D, Higher Risk?

Low plasma vitamin D levels emerged as an independent risk factor for COVID-19 infection and hospitalization in a large, population-based study. The study population included 14,000 patients who had been tested for COVID-19 and also had a previous blood test for plasma 25(OH)D level.

Participants who tested positive for COVID-19 were 50% more likely to have low vs normal 25(OH)D levels in a multivariate analysis that controlled for other confounders.

The study makes a compelling case for screening vitamin D levels for judging an individual's risk of COVID-19 infection and hospitalization, and exposes the need for a large randomized vitamin D supplement study to see whether vitamin D has a role in infection prevention.

Heart Damage After "Recovery"

Clinicians have observed that COVID-19 negatively affects the heart, but the "why" has largely been speculative. Does SARS-CoV-2 directly attack the heart? 

Two new reports published July 27 in JAMA Cardiology shed light on how the virus can infect the myocardium without causing myocarditis. Furthermore, some recovered COVID-19 patients are faced with persisting myocardial injury and inflammation that potentially could later manifest as heart failure.

A prospective cohort study of patients who recovered from a recent bout of COVID-19 showed evidence of ventricular dysfunction, greater ventricular mass, and signs of myocardial inflammation on cardiac imaging. Another study, a postmortem analysis of 39 hearts of COVID-19 patients, revealed a significant SARS-CoV-2 presence and signs that the virus vigorously replicated in the myocardium. More research is needed to understand the long-term cardiac consequences of COVID-19.

Hair Loss

For some patients recovering from COVID-19, there is an unexpected and very unwelcome long-term effect: hair loss.

Starting weeks or even months after the acute infection, the type of hair loss being reported is telogen effluvium, a temporary form of hair loss caused by a physical or emotional stress, high fever, illness, or weight loss — all of which have been reported in COVID-19. The stress event can cause up to 50% of a person's hair to begin shedding. No one knows yet why hair loss occurs in some, but not all, COVID-19 survivors.

"One Big Wave"

A coronavirus surge in Florida, California, and other hard-hit states could be peaking while other parts of the country may be on the cusp of growing outbreaks, said Anthony Fauci, MD, director of the US National Institute of Allergy and Infectious Diseases.

States with a rise in the percentage of positive coronavirus tests need to act quickly now to prevent a surge, Fauci urged. The number of people dying from COVID-19 has now topped 150,000 in the United States.

Earlier hopes that SARS-CoV-2 would die out with the warmer weather have been dashed. The World Health Organization now describes the COVID-19 pandemic as "one big wave" and warned against complacency during the summer, because the virus does not share influenza's tendency to follow seasons.

As case numbers continue to rise in the United States throughout the summer, citizens are again urged to practice vigilance, wear masks, and avoid large gatherings.

$5 Million Prize for New Rapid Test

A new $5 million, 6-month competition aims to develop faster, cheaper, and easier-to-use testing methods for the virus that causes COVID-19. The competition, sponsored by the XPRIZE Foundation, aims to eliminate frequent testing shortages and uncertain viral results.

"There is near infinite need and demand for COVID-19 tests, and we need screening testing capabilities 100-times greater than our current status to return our economy and society to normal function," said Jeff Huber, president and cofounder of OpenCovidScreen.

In Memoriam

As frontline healthcare workers care for patients with COVID-19, they commit themselves to difficult, draining work and also put themselves at risk for infection. Thousands throughout the world have died. 

Medscape has published a memorial list to commemorate them. We will continue updating this list as, sadly, needed. Please help us ensure this list is complete by submitting names with an age, profession or specialty, and location through this form

If you would like to share any other experiences, stories, or concerns related to the pandemic, please join the conversation here.

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