Vitamin D Levels Are Reduced at the Time of Hospital Admission in Sicilian SARS-CoV-2-Positive Patients
Agostino Gaudio, Andrea Ruben Murabito, Antonella Agodi, Arturo Montineri, Pietro Castellino
International Journal of Environmental Research and Public Health, doi:10.3390/ijerph18073491
The coronavirus disease 2019 (COVID-19) pandemic poses a worldwide healthcare challenge that needs an efficient response. Unfortunately, to date there is no highly effective treatment, so a deep understanding of COVID-19 risk factors could be an important step in treating the disease. Vitamin D affects the immune system in many different ways, and other authors already found that COVID-19 patients have low levels of vitamin D. In our retrospective study, we evaluated the vitamin D status at the time of hospital admission in 50 COVID-19 patients in Sicily, which is the southernmost region of Italy, and compared them with 100 control subjects matched for age and sex. Our data showed markedly low levels of vitamin D in patients with a positive polymerase chain reaction (PCR) for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but no association was found with inflammation markers or clinical severity. Vitamin D levels were reduced at the time of hospital admission in Sicilian SARS-CoV-2-positive patients, but it is not clear whether this condition has an impact on the clinical course of COVID-19.
Author Contributions: Conceptualization, A.G. and A.R.M.; methodology, A.A.; formal analysis, A.A.; investigation, A.R.M. and A.M.; resources, P.C.; data curation, A.M.; writing-original draft preparation, A.G. and A.R.M.; writing-review and editing, A.G. and P.C.; funding acquisition, P.C. All authors have read and agreed to the published version of the manuscript. Funding: This study was partially funded by the 2020/2022 Research Plan 'Piaceri' of the University of Catania -line 2.
Institutional Review Board Statement: The study was conducted according to the guidelines of the Declaration of Helsinki, and approved by the Ethics Committee of Azienda Ospedaliero-Universitaria Policlinico "G. Rodolico-San Marco" Catania (approval number 283 of 23 December, 2020).
Informed
Conflicts of Interest: The authors declare no conflict of interest.
References
Annweiler, Corvaisier, Gautier, Dubée, Legrand et al., Vitamin D Supplementation Associated to Better Survival in Hospitalized Frail Elderly COVID-19 Patients: The GERIA-COVID Quasi-Experimental Study, Nutrients,
doi:10.3390/nu12113377
Arboleda, Urcuqui-Inchima, Vitamin, Supplementation: A Potential Approach for Coronavirus/COVID-19 Therapeutics? Front, Immunol,
doi:10.3389/fimmu.2020.01523
Bergman, Lindh, Björkhem-Bergman, Lindh, Vitamin D and Respiratory Tract Infections: A Systematic Review and Meta-Analysis of Randomized Controlled Trials, PLoS ONE,
doi:10.1371/journal.pone.0065835
Bilezikian, Bikle, Hewison, Lazaretti-Castro, Formenti et al., Mechanisms in endocrinology: Vitamin D and COVID-19, Eur. J. Endocrinol,
doi:10.1530/EJE-20-0665
Bishop, Ismailova, Dimeloe, Hewison, White, Vitamin D and Immune Regulation: Antibacterial, Antiviral, Anti-Inflammatory, JBMR Plus,
doi:10.1002/jbm4.10405
Carpagnano, Di Lecce, Quaranta, Zito, Buonamico et al., Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19, J. Endocrinol. Investig,
doi:10.1007/s40618-020-01370-x
Cascella, Rajnik, Cuomo, Dulebohn, Di Napoli et al., Evaluation, and Treatment of Coronavirus
Castillo, Entrenas Costa, Vaquero Barrios, Díaz, Miranda et al., Effect of calcifediol treatment and best available therapy versus best available therapy on intensive care unit admission and mortality among patients hospitalized for COVID-19: A pilot randomized clinical study, J Steroid Biochem. Mol. Biol
D'avolio, Avataneo, Manca, Cusato, De Nicolò et al., 25-Hydroxyvitamin D Concentrations Are Lower in Patients with Positive PCR for SARS-CoV-2, Nutrients,
doi:10.3390/nu12051359
Falchetti, Sferrazza, Cepollaro, Gozzini, Del Monte et al., FokI Polymorphism of the Vitamin D Receptor Gene Correlates with Parameters of Bone Mass and Turnover in a Female Population of the Italian Island of Lampedusa, Calcif. Tissue Int,
doi:10.1007/s00223-005-0295-1
Gavioli, Miyashita, Hassaneen, Siau, An Evaluation of Serum 25-Hydroxy Vitamin D Levels in Patients with COVID-19 in New York City, J. Am. Coll. Nutr,
doi:10.1080/07315724.2020.1869626
Guevara, Lu, Moore, Chambers, Eastman et al., Vitamin D and Streptococci: The Interface of Nutrition, Host Immune Response, and Antimicrobial Activity in Response to Infection, ACS Infect. Dis,
doi:10.1021/acsinfecdis.0c00666
Hastie, Mackay, Ho, Celis-Morales, Jani et al., Vitamin D concentrations and COVID-19 infection in UK Biobank [published correction appears in, Diabetes Metab Syndr
Hribar, Cobbold, Church, Potential Role of Vitamin D in the Elderly to Resist COVID-19 and to Slow Progression of Parkinson's Disease, Brain Sci,
doi:10.3390/brainsci10050284
Ilie, Stefanescu, Smith, The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality, Aging Clin. Exp. Res,
doi:10.1007/s40520-020-01570-8
Infante, Buoso, Pieri, Lupisella, Nuccetelli et al., Low Vitamin D Status at Admission as a Risk Factor for Poor Survival in Hospitalized Patients With COVID-19: An Italian Retrospective Study, J. Am. Coll. Nutr,
doi:10.1080/07315724.2021.1877580
Jan, Faisal, Khan, Khan, Usman et al., COVID-19: Review of Epidemiology and Potential Treatments Against 2019 Novel Coronavirus, Discoveries,
doi:10.15190/d.2020.5
Malek Mahdavi, A brief review of interplay between vitamin D and angiotensin-converting enzyme 2: Implications for a potential treatment for COVID-19, Rev. Med. Virol,
doi:10.1002/rmv.2119
Martineau, Jolliffe, Hooper, Greenberg, Aloia et al., Vitamin D supplementation to prevent acute respiratory tract infections: Systematic review and meta-analysis of individual participant data, BMJ,
doi:10.1136/bmj.i6583
Meltzer, Best, Zhang, Vokes, Arora et al., Association of Vitamin D Deficiency and Treatment with COVID-19 Incidence, medRxiv
Mendy, Apewokin, Wells, Morrow, Factors Associated with Hospitalization and Disease Severity in a Racially and Ethnically Diverse Population of COVID-19 Patients, medRxiv
Merzon, Tworowski, Gorohovski, Vinker, Cohen et al., Low plasma 25(OH) vitamin D level is associated with increased risk of COVID-19 infection: An Israeli population-based study, FEBS J,
doi:10.1111/febs.15495
Munshi, Hussein, Toraih, Elshazli, Jardak et al., Vitamin D insufficiency as a potential culprit in critical COVID-19 patients, J. Med Virol,
doi:10.1002/jmv.26360
Napoli, Strollo, Sprini, Maddaloni, Rini et al., Serum 25-OH Vitamin D in relation to Bone Mineral Density and Bone Turnover, Int. J. Endocrinol,
doi:10.1155/2014/487463
Panagiotou, Tee, Ihsan, Athar, Marchitelli et al., Low serum 25-hydroxyvitamin D (25[OH]D) levels in patients hospitalized with COVID-19 are associated with greater disease severity, Clin. Endocrinol,
doi:10.1111/cen.14276
Rhodes, Subramanian, Laird, Griffin, Kenny, Perspective: Vitamin D deficiency and COVID-19 severityplausibly linked by latitude, ethnicity, impacts on cytokines, ACE2 and thrombosis, J. Intern. Med,
doi:10.1111/joim.13149
Rhodes, Subramanian, Laird, Kenny, Editorial: Low population mortality from COVID-19 in countries south of latitude 35 degrees North supports vitamin D as a factor determining severity, Aliment. Pharmacol. Ther
Robertsen, Grimnes, Melbye, Association between serum 25-hydroxyvitamin D concentration and symptoms of respiratory tract infection in a Norwegian population: The Tromsø Study, Public Health Nutr,
doi:10.1017/S1368980013001134
Siddiqui, Manansala, Abdulrahman, Nasrallah, Smatti et al., Immune Modulatory Effects of Vitamin D on Viral Infections, Nutrients,
doi:10.3390/nu12092879
Slominski, Stefan, Athar, Holick, Jetten et al., COVID-19 and Vitamin D: A lesson from the skin, Exp. Dermatol,
doi:10.1111/exd.14170
Teymoori-Rad, Shokri, Salimi, Marashi, The interplay between vitamin D and viral infections, Rev. Med Virol,
doi:10.1002/rmv.2032
Ungogo, Mohammed, Umar, Bala, Khalid, Review of pharmacologic and immunologic agents in the management of COVID-19, Biosaf. Health,
doi:10.1016/j.bsheal.2021.01.001
Zadshir, Tareen, Pan, Norris, Martins, The prevalence of hypovitaminosis D among US adults: Data from the NHANES III, Ethn. Dis
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