Vitamin D levels associate with blood glucose and BMI in COVID-19 patients predicting disease severity

DOI record: { "DOI": "10.1210/clinem/dgab599", "ISSN": [ "0021-972X", "1945-7197" ], "URL": "http://dx.doi.org/10.1210/clinem/dgab599", "abstract": "<jats:title>Abstract</jats:title>\n <jats:sec>\n <jats:title>Context</jats:title>\n <jats:p>A high prevalence of vitamin D (VD) deficiency in COVID-19 patients has been reported and hypothesized to increase COVID-19 severity likely because of its negative impact on immune and inflammatory responses. Furthermore, clear associations between hypovitaminosis D and fat body mass excess and diabetes, factors associated with COVID-19 severity, have been widely recognized.</jats:p>\n </jats:sec>\n <jats:sec>\n <jats:title>Objective</jats:title>\n <jats:p>The aim of this study was to evaluate in COVID-19 patients the relationship between VD levels and inflammatory response, body mass index (BMI), blood glucose (GLU), and disease severity.</jats:p>\n </jats:sec>\n <jats:sec>\n <jats:title>Methods</jats:title>\n <jats:p>Patients admitted to San Raffaele-Hospital for COVID-19 were enrolled in this study, excluding those with comorbidities and therapies influencing VD metabolism. 25-Hydroxyvitamin D levels, plasma GLU levels, BMI, and inflammatory parameters were evaluated at admission.</jats:p>\n </jats:sec>\n <jats:sec>\n <jats:title>Results</jats:title>\n <jats:p>A total of 88 patients were included. Median VD level was 16.3 ng/mL and VD deficiency was found in 68.2% of patients. VD deficiency was found more frequently in male patients and in those affected by severe COVID-19. Regression analyses showed a positive correlation between VD and PaO2/FiO2 ratio, and negative correlations between VD and plasma GLU, BMI, neutrophil/lymphocyte ratio, C-reactive protein, and interleukin 6. Patients with both hypovitaminosis D and diabetes mellitus, as well those with hypovitaminosis D and overweight, were more frequently affected by a severe disease with worse inflammatory response and respiratory parameters, compared to those without or just one of these conditions.</jats:p>\n </jats:sec>\n <jats:sec>\n <jats:title>Conclusion</jats:title>\n <jats:p>We showed, for the first-time, a strict association of VD levels with blood GLU and BMI in COVID-19 patients. VD deficiency might be a novel common pathophysiological mechanism involved in the detrimental effect of hyperglycemia and adiposity on disease severity.</jats:p>\n </jats:sec>", "author": [ { "affiliation": [ { "name": "Institute of Endocrine and Metabolic Sciences, Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital, Milan, Italy" } ], "family": "di Filippo", "given": "Luigi", "sequence": "first" }, { "affiliation": [ { "name": "Institute of Endocrine and Metabolic Sciences, Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital, Milan, Italy" } ], "family": "Allora", "given": "Agnese", "sequence": "additional" }, { "affiliation": [ { "name": "Institute of Endocrine and Metabolic Sciences, Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital, Milan, Italy" } ], "family": "Doga", "given": "Mauro", "sequence": "additional" }, { "affiliation": [ { "name": "Institute of Endocrine and Metabolic Sciences, Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital, Milan, Italy" } ], "family": "Formenti", "given": "Anna Maria", "sequence": "additional" }, { "affiliation": [ { "name": "Laboratory Medicine Service, IRCCS San Raffaele Hospital, Milan, Italy" } ], "family": "Locatelli", "given": "Massimo", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0003-2615-3649", "affiliation": [ { "name": "Vita-Salute San Raffaele University and Division of Transplantation, Immunology and Infectious Diseases, IRCCS San Raffaele Hospital, Milan, Italy" } ], "authenticated-orcid": false, "family": "Rovere Querini", "given": "Patrizia", "sequence": "additional" }, { "affiliation": [ { "name": "Institute of Endocrine and Metabolic Sciences, Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital, Milan, Italy" } ], "family": "Frara", "given": "Stefano", "sequence": "additional" }, { "ORCID": "http://orcid.org/0000-0001-6783-3398", "affiliation": [ { "name": "Institute of Endocrine and Metabolic Sciences, Vita-Salute San Raffaele University, IRCCS San Raffaele Hospital, Milan, Italy" } ], "authenticated-orcid": false, "family": "Giustina", "given": "Andrea", "sequence": "additional" } ], "container-title": "The Journal of Clinical Endocrinology &amp; Metabolism", "content-domain": { "crossmark-restriction": false, "domain": [] }, "created": { "date-parts": [ [ 2021, 8, 12 ] ], "date-time": "2021-08-12T16:34:17Z", "timestamp": 1628786057000 }, "deposited": { "date-parts": [ [ 2021, 12, 18 ] ], "date-time": "2021-12-18T23:15:30Z", "timestamp": 1639869330000 }, "indexed": { "date-parts": [ [ 2024, 3, 7 ] ], "date-time": "2024-03-07T20:59:41Z", "timestamp": 1709845181473 }, "is-referenced-by-count": 30, "issue": "1", "issued": { "date-parts": [ [ 2021, 8, 12 ] ] }, "journal-issue": { "issue": "1", "published-online": { "date-parts": [ [ 2021, 8, 12 ] ] }, "published-print": { "date-parts": [ [ 2022, 1, 1 ] ] } }, "language": "en", "license": [ { "URL": "https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model", "content-version": "vor", "delay-in-days": 0, "start": { "date-parts": [ [ 2021, 8, 12 ] ], "date-time": "2021-08-12T00:00:00Z", "timestamp": 1628726400000 } } ], "link": [ { "URL": "http://academic.oup.com/jcem/advance-article-pdf/doi/10.1210/clinem/dgab599/40302452/dgab599.pdf", "content-type": "application/pdf", "content-version": "am", "intended-application": "syndication" }, { "URL": "https://academic.oup.com/jcem/article-pdf/107/1/e348/41819314/dgab599.pdf", "content-type": "application/pdf", "content-version": "vor", "intended-application": "syndication" }, { "URL": "https://academic.oup.com/jcem/article-pdf/107/1/e348/41819314/dgab599.pdf", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "80", "original-title": [], "page": "e348-e360", "prefix": "10.1210", "published": { "date-parts": [ [ 2021, 8, 12 ] ] }, "published-online": { "date-parts": [ [ 2021, 8, 12 ] ] }, "published-other": { "date-parts": [ [ 2022, 1, 1 ] ] }, "published-print": { "date-parts": [ [ 2022, 1, 1 ] ] }, "publisher": "The Endocrine Society", "reference": [ { "DOI": "10.1056/NEJMoa2001316", "article-title": "Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia", "author": "Li", "doi-asserted-by": "crossref", "first-page": "1199", "issue": "13", "journal-title": "N Engl J Med.", "key": "2021121823131290400_CIT0001", "volume": "382", "year": "2020" }, { "DOI": "10.1001/jama.2020.1585", "article-title": "Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China [published correction appears in JAMA. 2021;325(11):1113]", "author": "Wang", "doi-asserted-by": "crossref", "first-page": "1061", "issue": "11", "journal-title": "JAMA", "key": "2021121823131290400_CIT0002", "volume": "323", "year": "2020" }, { "DOI": "10.1038/s41591-020-0968-3", "article-title": "Extrapulmonary manifestations of COVID-19", "author": "Gupta", "doi-asserted-by": "crossref", "first-page": "1017", "issue": "7", "journal-title": "Nat Med.", "key": "2021121823131290400_CIT0003", "volume": "26", "year": "2020" }, { "DOI": "10.1007/s11154-020-09569-2", "article-title": "Endocrine and metabolic aspects of the COVID-19 pandemic [published correction appears in Rev Endocr Metab Disord. 2021;22(1):145]", "author": "Marazuela", "doi-asserted-by": "crossref", "first-page": "495", "issue": "4", "journal-title": "Rev Endocr Metab Disord", "key": "2021121823131290400_CIT0004", "volume": "21", "year": "2020" }, { "DOI": "10.1007/s12020-020-02294-5", "article-title": "COVID-19 and endocrine diseases. 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