Association between Vitamin D Status and Secondary Infections in Patients with Severe COVID-19 Admitted in the Intensive Care Unit of a Tertiary-Level Hospital in Turkey

{ 'indexed': { 'date-parts': [[2022, 12, 28]], 'date-time': '2022-12-28T05:36:29Z', 'timestamp': 1672205789893}, 'reference-count': 38, 'publisher': 'MDPI AG', 'issue': '1', 'license': [ { 'start': { 'date-parts': [[2022, 12, 26]], 'date-time': '2022-12-26T00:00:00Z', 'timestamp': 1672012800000}, 'content-version': 'vor', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0/'}], 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'abstract': '<jats:p>There are several studies showing that the vitamin D status can determine risk of ' 'COVID-19 infections, severity and mortality from coronavirus disease 2019 (COVID-19). ' 'However, the association between vitamin D (25(OH)D) and secondary infections in the ' 'prognosis of COVID-19 patients has not been reported yet. The aim was to investigate whether ' 'the vitamin D status affects the rates of secondary infections in patients with severe ' 'COVID-19 hospitalized in the intensive care unit (ICU) of a tertiary-level hospital in ' 'Turkey. The data of 194 patients with diagnosis of severe COVID-19 who were admitted to the ' 'ICU from March 2020 to June 2021 and older than 18 years were evaluated in this retrospective ' 'study. The patients were divided into two groups according to total serum 25(OH)D level as ' 'normal group (≥20 ng/mL) and low group (&lt;20 ng/mL). The 25(OH)D level was low in 118 ' '(60.8%) and normal in 76 (39.2%) patients. The mean age of the low group was significantly ' 'higher than that of the normal group (67.02 ± 14.47 vs. 61.70 ± 14.38; p = 0.013). The ' 'systolic and diastolic blood pressure as well as the Glasgow coma scale score of the low ' 'group were significantly lower than that of the normal group (p = 0.004, 0.002 and 0.001, ' 'respectively). The intubation rate and APACHE (Acute Physiology and Chronic Health ' 'Evaluation) score of the low group was significantly higher than that of the normal group (p ' '= 0.001). The platelets number and blood pH decreased, and the neutrophil/lymphocyte ratio, ' 'procalcitonin, lactate, urea, creatinine and lactate dehydrogenase concentrations increased ' 'significantly in the low group (p &lt; 0.05). The mortality rate was 79.7% in the low group ' 'and 22.4% in the normal group (p &lt; 0.001). Microbiological growth was observed in 68.6% of ' 'the normal group and 52.6% of the normal group (p = 0.025). The number of cultures with ' 'resistant bacteria was significantly higher in the low group (25.9%) than that in the normal ' 'group (17.5%) (p = 0.035). The severe COVID-19 patients hospitalized with vitamin D ' 'deficiency may have increased risks of poor prognosis and mortality due to secondary ' 'infections in the ICU.</jats:p>', 'DOI': '10.3390/diagnostics13010059', 'type': 'journal-article', 'created': { 'date-parts': [[2022, 12, 27]], 'date-time': '2022-12-27T12:02:12Z', 'timestamp': 1672142532000}, 'page': '59', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Association between Vitamin D Status and Secondary Infections in Patients with Severe COVID-19 ' 'Admitted in the Intensive Care Unit of a Tertiary-Level Hospital in Turkey', 'prefix': '10.3390', 'volume': '13', 'author': [ { 'ORCID': 'http://orcid.org/0000-0002-4803-9137', 'authenticated-orcid': False, 'given': 'Lutfiye Karcioglu', 'family': 'Batur', 'sequence': 'first', 'affiliation': []}, {'given': 'Suna', 'family': 'Koç', 'sequence': 'additional', 'affiliation': []}], 'member': '1968', 'published-online': {'date-parts': [[2022, 12, 26]]}, 'reference': [ { 'key': 'ref_1', 'doi-asserted-by': 'crossref', 'first-page': '1373', 'DOI': '10.1016/j.jiph.2020.06.021', 'article-title': 'Role of vitamin D in preventing of COVID-19 infection, progression and ' 'severity', 'volume': '13', 'author': 'Ali', 'year': '2020', 'journal-title': 'J. Infect. Public Health'}, { 'key': 'ref_2', 'doi-asserted-by': 'crossref', 'first-page': '1308', 'DOI': '10.1080/10408398.2020.1841090', 'article-title': 'Vitamin D deficiency aggravates COVID-19: Systematic review and ' 'meta-analysis', 'volume': '62', 'author': 'Pereira', 'year': '2022', 'journal-title': 'Crit. Rev. Food Sci. Nutr.'}, { 'key': 'ref_3', 'doi-asserted-by': 'crossref', 'first-page': '31', 'DOI': '10.2147/RMHP.S291584', 'article-title': 'Effects of Vitamin D on COVID-19 Infection and Prognosis: A Systematic ' 'Review', 'volume': '14', 'author': 'Yisak', 'year': '2021', 'journal-title': 'Risk Manag. Healthc. Policy'}, { 'key': 'ref_4', 'doi-asserted-by': 'crossref', 'first-page': '1207', 'DOI': '10.1007/s40520-020-01607-y', 'article-title': 'Association between low vitamin D and COVID-19: Don’t forget the ' 'vitamin D binding protein', 'volume': '32', 'author': 'Speeckaert', 'year': '2020', 'journal-title': 'Aging Clin. Exp. Res.'}, { 'key': 'ref_5', 'doi-asserted-by': 'crossref', 'first-page': '281', 'DOI': '10.1111/cen.14540', 'article-title': 'Association of vitamin D deficiency with COVID-19 infection severity: ' 'Systematic review and meta-analysis', 'volume': '96', 'author': 'Wang', 'year': '2021', 'journal-title': 'Clin. Endocrinol.'}, { 'key': 'ref_6', 'doi-asserted-by': 'crossref', 'first-page': '630956', 'DOI': '10.3389/fphys.2021.630956', 'article-title': 'Can Vitamin D Deficiency Increase the Susceptibility to COVID-19?', 'volume': '12', 'author': 'Maha', 'year': '2021', 'journal-title': 'Front. Physiol.'}, { 'key': 'ref_7', 'first-page': '84', 'article-title': 'Vitamin D deficiency and ARDS after SARS-CoV-2 infection', 'volume': '113', 'author': 'Faul', 'year': '2020', 'journal-title': 'Ir. Med. J.'}, { 'key': 'ref_8', 'doi-asserted-by': 'crossref', 'unstructured': 'Grant, W.B., Lahore, H., McDonnell, S.L., Baggerly, C.A., French, C.B., ' 'Aliano, J.L., and Bhattoa, H.P. (2020). Evidence that Vitamin D ' 'Supplementation Could Reduce Risk of Influenza and COVID-19 Infections ' 'and Deaths. Nutrients, 12.', 'DOI': '10.20944/preprints202003.0235.v2'}, { 'key': 'ref_9', 'first-page': '4', 'article-title': 'A rapid advice guideline for the diagnosis and treatment of 2019 novel ' 'coronavirus (2019-nCoV) infected pneumonia (standard version)', 'volume': '7', 'author': 'Jin', 'year': '2020', 'journal-title': 'Mil. Med. Res.'}, { 'key': 'ref_10', 'doi-asserted-by': 'crossref', 'first-page': '495', 'DOI': '10.1007/s11154-020-09569-2', 'article-title': 'Endocrine and metabolic aspects of the COVID-19 pandemic', 'volume': '21', 'author': 'Marazuela', 'year': '2020', 'journal-title': 'Rev. Endocr. Metab. Disord.'}, { 'key': 'ref_11', 'doi-asserted-by': 'crossref', 'first-page': '1117', 'DOI': '10.1038/s41430-020-0634-3', 'article-title': 'Nutrition amid the COVID-19 pandemic: A multi-level framework for ' 'action', 'volume': '74', 'author': 'Naja', 'year': '2020', 'journal-title': 'Eur. J. Clin. Nutr.'}, { 'key': 'ref_12', 'doi-asserted-by': 'crossref', 'unstructured': 'Alipio, M. (2020). Vitamin D supplementation could possibly improve ' 'clinical outcomes of patients infected with coronavirus-2019 ' '(COVID-2019). SSRN Electron. J.', 'DOI': '10.2139/ssrn.3571484'}, { 'key': 'ref_13', 'doi-asserted-by': 'crossref', 'first-page': '66', 'DOI': '10.1080/07435800.2020.1867162', 'article-title': 'Vitamin D Status and COVID-19 Clinical Outcomes in Hospitalized ' 'Patients', 'volume': '46', 'author': 'Szeto', 'year': '2020', 'journal-title': 'Endocr. Res.'}, { 'key': 'ref_14', 'doi-asserted-by': 'crossref', 'unstructured': 'Lin, L.-Y., Mulick, A., Mathur, R., Smeeth, L., Warren-Gash, C., and ' 'Langan, S.M. (2022). The association between vitamin D status and ' 'COVID-19 in England: A cohort study using UK Biobank. PLoS ONE, 17.', 'DOI': '10.1371/journal.pone.0269064'}, { 'key': 'ref_15', 'unstructured': 'COVID-19 Treatment Guidelines Panel (2022, July 29). Coronavirus Disease ' '2019 (COVID-19) Treatment Guidelines. National Institutes of Health, ' 'Available online: https://www.covid19treatmentguidelines.nih.gov/.'}, { 'key': 'ref_16', 'doi-asserted-by': 'crossref', 'unstructured': 'Batur, L.K., Özaydın, A., Maviş, M.E., Gürsu, G.G., Harbige, L., and ' 'Hekim, N. (2021). Vitamin-D Binding Protein Gene Polymorphisms and Serum ' '25-Hydroxyvitamin-D in a Turkish Population. Metabolites, 11.', 'DOI': '10.3390/metabo11100696'}, { 'key': 'ref_17', 'doi-asserted-by': 'crossref', 'first-page': '58', 'DOI': '10.1016/j.ijid.2020.12.077', 'article-title': 'Low vitamin D status is associated with coronavirus disease 2019 ' 'outcomes: A systematic review and meta-analysis', 'volume': '104', 'author': 'Liu', 'year': '2021', 'journal-title': 'Int. J. Infect. Dis.'}, { 'key': 'ref_18', 'doi-asserted-by': 'crossref', 'unstructured': 'Mercola, J., Grant, W.B., and Wagner, C.L. (2020). Evidence Regarding ' 'Vitamin D and Risk of COVID-19 and Its Severity. Nutrients, 12.', 'DOI': '10.3390/nu12113361'}, { 'key': 'ref_19', 'doi-asserted-by': 'crossref', 'first-page': '2211', 'DOI': '10.3389/fimmu.2019.02211', 'article-title': 'Vitamin D Signaling in the Context of Innate Immunity: Focus on Human ' 'Monocytes', 'volume': '10', 'author': 'Carlberg', 'year': '2019', 'journal-title': 'Front. Immunol.'}, { 'key': 'ref_20', 'doi-asserted-by': 'crossref', 'first-page': '69', 'DOI': '10.2147/JIR.S63898', 'article-title': 'Vitamin D and inflammatory diseases', 'volume': '7', 'author': 'Agrawal', 'year': '2014', 'journal-title': 'J. Inflamm. Res.'}, { 'key': 'ref_21', 'doi-asserted-by': 'crossref', 'first-page': '27', 'DOI': '10.1007/s40618-020-01327-0', 'article-title': 'Possible role of vitamin D in COVID-19 infection in pediatric ' 'population', 'volume': '44', 'author': 'Panfili', 'year': '2020', 'journal-title': 'J. Endocrinol. Investig.'}, { 'key': 'ref_22', 'doi-asserted-by': 'crossref', 'first-page': '246', 'DOI': '10.1016/j.jsbmb.2015.09.016', 'article-title': 'Species-specific regulation of innate immunity by vitamin D signaling', 'volume': '164', 'author': 'Dimitrov', 'year': '2016', 'journal-title': 'J. Steroid Biochem. Mol. Biol.'}, { 'key': 'ref_23', 'doi-asserted-by': 'crossref', 'first-page': '915', 'DOI': '10.1016/B978-0-12-809963-6.00103-6', 'article-title': 'Vitamin D and Tuberculosis', 'volume': '2', 'author': 'Martineau', 'year': '2018', 'journal-title': 'Vitam. D'}, { 'key': 'ref_24', 'doi-asserted-by': 'crossref', 'first-page': '1129', 'DOI': '10.1017/S0950268806007175', 'article-title': 'Epidemic influenza and vitamin D', 'volume': '134', 'author': 'Cannell', 'year': '2006', 'journal-title': 'Epidemiol. Infect.'}, { 'key': 'ref_25', 'doi-asserted-by': 'crossref', 'first-page': '736', 'DOI': '10.1017/S0007114520001749', 'article-title': '‘Scientific Strabismus’ or two related pandemics: Coronavirus disease ' 'and vitamin D deficiency', 'volume': '124', 'author': 'Kara', 'year': '2020', 'journal-title': 'Br. J. Nutr.'}, { 'key': 'ref_26', 'doi-asserted-by': 'crossref', 'first-page': '745', 'DOI': '10.1001/jamacardio.2020.1282', 'article-title': 'Coronavirus Disease 2019 (COVID-19) Infection and Renin Angiotensin ' 'System Blockers', 'volume': '5', 'author': 'Bavishi', 'year': '2020', 'journal-title': 'JAMA Cardiol.'}, { 'key': 'ref_27', 'doi-asserted-by': 'crossref', 'first-page': '7432', 'DOI': '10.3892/mmr.2017.7546', 'article-title': 'Vitamin D alleviates lipopolysaccharide-induced acute lung injury via ' 'regulation of the renin-angiotensin system', 'volume': '16', 'author': 'Xu', 'year': '2017', 'journal-title': 'Mol. Med. Rep.'}, { 'key': 'ref_28', 'first-page': 'e2119', 'article-title': 'A brief review of interplay between vitamin D and ' 'angiotensin-converting enzyme 2: Implications for a potential treatment ' 'for COVID-19', 'volume': '30', 'author': 'Mahdavi', 'year': '2020', 'journal-title': 'Rev. Med. Virol.'}, { 'key': 'ref_29', 'doi-asserted-by': 'crossref', 'first-page': '88', 'DOI': '10.1136/annrheumdis-2020-218323', 'article-title': 'Preliminary predictive criteria for COVID-19 cytokine storm', 'volume': '80', 'author': 'Caricchio', 'year': '2021', 'journal-title': 'Ann. Rheum. Dis.'}, { 'key': 'ref_30', 'doi-asserted-by': 'crossref', 'first-page': '363', 'DOI': '10.1038/s41577-020-0311-8', 'article-title': 'The trinity of COVID-19: Immunity, inflammation and intervention', 'volume': '20', 'author': 'Tay', 'year': '2020', 'journal-title': 'Nat. Rev. Immunol.'}, { 'key': 'ref_31', 'doi-asserted-by': 'crossref', 'first-page': '105719', 'DOI': '10.1016/j.jsbmb.2020.105719', 'article-title': 'Vitamin d receptor stimulation to reduce acute respiratory distress ' 'syndrome (ards) in patients with Coronavirus SARS-CoV-2 infections: ' 'Revised ms sbmb 2020_166', 'volume': '202', 'author': 'Castillo', 'year': '2020', 'journal-title': 'J. Steroid Biochem. Mol. Biol.'}, { 'key': 'ref_32', 'doi-asserted-by': 'crossref', 'first-page': '480', 'DOI': '10.1097/MCC.0000000000000862', 'article-title': 'Is there a role for immune-enhancing therapies for acutely ill patients ' 'with coronavirus disease 2019?', 'volume': '27', 'author': 'Wittebole', 'year': '2021', 'journal-title': 'Curr. Opin. Crit. Care'}, { 'key': 'ref_33', 'doi-asserted-by': 'crossref', 'first-page': 'ofab001', 'DOI': '10.1093/ofid/ofab001', 'article-title': 'Matched Cohort Study of Convalescent COVID-19 Plasma Treatment in ' 'severely or life threateningly ill COVID-19 patients', 'volume': '8', 'author': 'Klapholz', 'year': '2021', 'journal-title': 'Open Forum. Infect. Dis.'}, { 'key': 'ref_34', 'doi-asserted-by': 'crossref', 'first-page': '619', 'DOI': '10.1056/NEJMoa2031304', 'article-title': 'A Randomized Trial of Convalescent Plasma in COVID-19 Severe Pneumonia', 'volume': '384', 'author': 'Simonovich', 'year': '2021', 'journal-title': 'N. Engl. J. Med.'}, { 'key': 'ref_35', 'doi-asserted-by': 'crossref', 'unstructured': 'RECOVERY Collaborative Group (2021). Convalescent plasma in patients ' 'admitted to hospital with COVID-19 (RECOVERY): A randomised controlled, ' 'open-label, platform trial. Lancet, 397, 2049–2059.', 'DOI': '10.1101/2021.03.09.21252736'}, { 'key': 'ref_36', 'doi-asserted-by': 'crossref', 'first-page': '1700', 'DOI': '10.1056/NEJMoa2119657', 'article-title': 'Early Outpatient Treatment for COVID-19 with Convalescent Plasma', 'volume': '386', 'author': 'Sullivan', 'year': '2022', 'journal-title': 'N. Engl. J. Med.'}, { 'key': 'ref_37', 'doi-asserted-by': 'crossref', 'first-page': '93', 'DOI': '10.1097/MNH.0000000000000658', 'article-title': 'Building a hemodiafiltration system from readily available components ' 'for continuous renal replacement therapy under disasters and pandemics: ' 'Preparing for an acute kidney injury surge during COVID-19', 'volume': '30', 'author': 'Hanna', 'year': '2020', 'journal-title': 'Curr. Opin. Nephrol. Hypertens.'}, { 'key': 'ref_38', 'doi-asserted-by': 'crossref', 'first-page': '976', 'DOI': '10.1159/000512199', 'article-title': 'COVID-19: Hyperinflammatory Syndrome and Hemoadsorption with CytoSorb', 'volume': '50', 'author': 'Masmouei', 'year': '2021', 'journal-title': 'Blood Purif.'}], 'container-title': 'Diagnostics', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://www.mdpi.com/2075-4418/13/1/59/pdf', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2022, 12, 27]], 'date-time': '2022-12-27T12:54:52Z', 'timestamp': 1672145692000}, 'score': 1, 'resource': {'primary': {'URL': 'https://www.mdpi.com/2075-4418/13/1/59'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2022, 12, 26]]}, 'references-count': 38, 'journal-issue': {'issue': '1', 'published-online': {'date-parts': [[2023, 1]]}}, 'alternative-id': ['diagnostics13010059'], 'URL': 'http://dx.doi.org/10.3390/diagnostics13010059', 'relation': {}, 'ISSN': ['2075-4418'], 'subject': ['Clinical Biochemistry'], 'container-title-short': 'Diagnostics', 'published': {'date-parts': [[2022, 12, 26]]}}