Serum vitamin D levels and inflammatory status in COVID-19 patients
Desislava Arabadzhiyska, Tanya Deneva
Bratislava Medical Journal, doi:10.4149/bll_2023_069
OBJECTIVES: The coronavirus 2019 disease (COVID-19) is characterized by a heterogeneous clinical presentation, a complex pathophysiology and a wide range of laboratory fi ndings, depending on disease severity. BACKGROUND: We studied some laboratory parameters in correlation with vitamin D status representing the infl ammatory state in hospitalized COVID-19 patients on admission. METHODS: The study included 100 COVID-19 patients with moderate (n=55) and severe (n=45) form of the disease. Complete blood count and differential blood count, routine biochemical parameters, C-reactive protein and serum procalcitonin, ferritin, human IL-6 and serum vitamin D (measured as 25-OH vitamin D) concentrations, were performed. RESULTS: According to the severity of the disease, patients with severe form had signifi cantly lower serum vitamin D (16.54±6.51 ng/ml vs 20.37±5.63 ng/ml, p=0.0012), higher serum interleukin-6 (41.24±28.46 pg/ml vs. 24.75±16.28 pg/ml, p=0.0003), C-reactive p rotein (101.49± 57.15 mg/l vs 74.43±42.99 mg/l, p=0.0044), ferritin (969.89±338.37 ng/ml vs 845.96±359.91 ng/ml, p=0.0423) and LDH (1050.53±369.11 U/l vs 905.31±335.57 U/l, p=0.0222) compared to those with moderate form of the disease. CONCLUSION: The presented data provide a relationship between increased infl ammatory laboratory markers, low vitamin D levels and disease severity in Fig. 3, Ref. 32).
References
Ali, Role of vitamin D in preventing of COVID-19 infection, progression and severity, J Infect Public Health
Alvarez-Rodriguez, Lopez-Hoyos, Garcia-Unzueta, Cacho, Martinez-Taboada, Age and low levels of circulating vitamin D are associated with impaired innate immune function, J Leukoc Biol
Balzanelli, Distratis, Lazzaro, The Vitamin D, IL-6 and the eGFR markers a possible way to elucidate the lung-heart-kidney cross-talk in COVID-19 disease: A foregone conclusion, Microorganisms
Borissova, Shinkov, Vlahov, Dynamic of the seasonal levels of 25(OH)D in Bulgaria according to sex, age and winter status of vitamin D, Nutrition and Aging
Charoenngam, Holick, Immunologic effects of vitamin D on human health and disease, Nutrients
Dancer, Parekh, Lax, Vitamin D defi ciency contributes directly to the acute respiratory distress syndrome (ARDS), Thorax
Daneshkhah, Agrawal, Eshein, Subramanian, Roy et al., Evidence for possible association of vitamin D status with cytokine storm and unregulated infl ammation in COVID-19 patients, Aging Clin Exp Res
Darling, Ahmadi, Ward, Vitamin D concentration, body mass index, ethnicity and SARS-CoV-2/COVID-19: initial analysis of the fi rst-reported UK Biobank Cohort positive cases (n 1474) compared with negative controls (n 4643), Proc Nutr Soc
Del Giudice, Gangestad, Rethinking IL-6 and CRP: Why they are more than infl ammatory biomarkers, and why it matters, Brain Behav Immun
Dror, Morozov, Daoud, Pre-infection 25-hydroxyvitamin D3 levels and association with severity of COVID-19 illness, medRxiv,
doi:10.1101/2021.06.04.21258358Gois, Ferreira, Olenski, Seguro, Vitamin D and infectious diseases: simple bystander or contributing factor?, Nutrients
Grant, Lahore, Mcdonnell, Evidence that vitamin D supplementation could reduce risk of infl uenza and COVID-19 infections and deaths, Nutrients
Guan, Ni, Hu, Clinical characteristics of coronavirus disease 2019 in China, N Engl J Med
Hastie, Mackay, Ho, Vitamin D concentrations and CO-VID-19 infection in UK Biobank, Diabetes Metab Syndr
Holick, The vitamin D defi ciency pandemic: approaches for diagnosis, treatment and prevention, Rev Endocr Metab Disord
Hwang, Hsu, Lim, Increased vitamin D is associated with decline of naïve, but accumulation of effector, CD8T cells during early aging, Adv Aging Res
Jain, Chaurasia, Sengar, Singh, Mahor et al., Analysis of vitamin D level among asymptomatic and critically ill CO-VID-19 patients and its correlation with infl ammatory markers, Sci Rep
Mamani, Muceli, Basir, Vasheghani, Poorolajal, Association between serum concentration of 25-hydroxyvitamin D and community acquired pneumonia: a case-control study, Int J Gen Med
Mansur, Tajer, Mariani, Inserra, Ferder et al., Vitamin D high doses supplementation could represent a promising alternative to prevent or treat COVID-19 infection, Clin Investig Arterioscler
Martineau, Jolliffe, Greenberg, Vitamin D supplementation to prevent acute respiratory infections: individual participant data meta-analysis, Health Technol Assess
Mcgonagle, Sharif, 'regan, Bridgewood, The role of cytokines including interleukin-6 in COVID-19 induced pneumonia and macrophage activation syndrome-like disease, Autoimmun Rev
Mcgregor, Chauss, Freiwald, An autocrine Vitamin Ddriven Th1 shutdown program can be exploited for COVID-19, bioRxiv,
doi:10.1101/2020.07.18.210161Okazaki, Ozono, Fukumoto, Assessment criteria for vitamin D defi ciency/insuffi ciency in Japan: proposal by an expert panel supported by the Research Program of Intractable Diseases, Ministry of Health, Labour and Welfare, Japan, the Japanese Society for Bone and Mineral Research and the Japan Endocrine Society (Opinion), J Bone Miner Metab
Palacios, The role of nutrients in bone health, from A to Z, Crit Rev Food Sci Nutr
Pender, CD8+ T-Cell defi ciency, Epstein-Barr virus infection, vitamin D defi ciency, and steps to autoimmunity: a unifying hypothesis, Autoimmune Dis
Rabenberg, Scheidt-Nave, Busch, Rieckmann, Hintzpeter et al., Vitamin D status among adults in Germany -results from the German Health Interview and Examination Survey for Adults (DEGS1), BMC Public Health
Shi, Liu, Yao, Chronic vitamin D defi ciency induces lung fi brosis through activation of the renin-angiotensin system, Sci Rep
Smet, Smet, Herroelen, Gryspeerdt, Martens, Serum 25(OH)D level on hospital admission associated with COVID-19 stage and mortality, Am J Clin Pathol
Wang, Wang, Xu, Vitamin D improves immune function in immunosuppressant mice induced by glucocorticoid, Biomed Rep
Watkins, Lemonovich, Salata, An update on the association of vitamin D defi ciency with common infectious diseases, Can J Physiol Pharmacol
Zhang, Leung, Richers, Vitamin D inhibits monocyte/ macrophage proinfl ammatory cytokine production by targeting MAPK phosphatase-1, J Immunol
