4. Discussion
infection, diarrhea
SARS-COV-2 INFECTION, INFLAMMATION, DISEASE, PATHOPHYSIOLOGY, INFECTION, INFLAMMATORY RESPONSE
As was expected, higher mortality was found in men, older patients and those with severe radiological involvement. Moreover, taking Gasteel PlusIn our study, diarrhea was the most common digestive symptom (23%). The prevalence of digestive symptoms was slightly higher (37%) than in a recent study by Leal et al. [A growing body of evidence supports these findings, as the intestinal microbiota can slow the entry of viruses both via the digestive and upper respiratory tracts by strengthening the lung microbiota and thereby preventing or limiting infection [The cytokine storm is an offensive inflammatory response induced by COVID-19, which leads to severe disease in some patients [SARS-CoV-2 uses the angiotensin-converting enzyme 2 (ACE2) receptor in human cells as a gateway to penetrate the cell and to replicate. This receptor is expressed in endothelial cells, including intestinal cells, so we should be aware of its possible involvement in the pathophysiology of the disease. Altered activity of this receptor causes impaired expression of antimicrobial peptides in intestinal Paneth cells, which leads to a change in the intestinal microbiota [In patients with non-severe radiological involvement at admission, the mean length of stay was significantly shorter in the intervention group despite a higher prevalence of risk factors, dependence, and comorbidities (In line with this finding, a study conducted in July 2020 by d’Ettorre et al. [Despite multiple treatments having been proposed for SARS-CoV-2 infection, the most robust evidence has been found with dexamethasone both in reducing mortality and in the need for mechanical ventilation. Concerning moderate–severe disease, studies with anti-IL-6 receptor monoclonal antibodies (more robust evidence with tocilizumab and baricitinib), remdesivir and anakinra have also described a reduction in mortality and time to clinical recovery. Evidence has recently emerged on treatment in patients with asymptomatic or mild disease with high risk of progression using sotrovimab, remdesivir or nirmatrelvir/ritonavir [Vitamin D is known to play an important role in immune function and inflammation, but evidence supporting the efficacy of vitamin D supplementation for the prevention or treatment of COVID-19 is inconclusive [As a limitation of the study, because of the situation of overburdened healthcare resources during the COVID-19 emergency, the control group was not given a placebo. To guarantee identical follow-up in both groups, a medical history was taken using the same questionnaire for both groups. Baseline levels of vitamin D, selenium and zinc were also not determined.