Relationship of anti-SARS-CoV-2 IgG antibodies with Vitamin D and inflammatory markers in COVID-19 patients
Latifi-Pupovci et al.,
Relationship of anti-SARS-CoV-2 IgG antibodies with Vitamin D and inflammatory markers in COVID-19 patients,
Scientific Reports, doi:10.1038/s41598-022-09785-7
Prospective study of 69 COVID+ patients in Kosovo, showing lower vitamin D levels associated with COVID-19 severity.
Latifi-Pupovci et al., 5 Apr 2022, prospective, Kosovo, peer-reviewed, 9 authors.
Abstract: www.nature.com/scientificreports
OPEN
Relationship of anti‑SARS‑CoV‑2
IgG antibodies with Vitamin
D and inflammatory markers
in COVID‑19 patients
Hatixhe Latifi‑Pupovci1,2, Sadie Namani1,2*, Artina Pajaziti1, Blerina Ahmetaj‑Shala3,
Lindita Ajazaj2, Afrim Kotori4, Valdete Haxhibeqiri2, Valentin Gegaj2 & Gramoz Bunjaku2
Several studies have found an association of COVID-19 disease severity with Vitamin D deficiency
and higher levels of anti-SARS-CoV-2 IgGs. The aim of this study was to determine whether levels
of Vitamin D and “inflammatory state” influence the magnitude of anti-SARS-CoV-2 IgGs levels in
COVID-19 patients. For this purpose, in 67 patients levels of anti-SARS-CoV-2 IgG were measured
in week 4 whereas in 52 patients levels of Vitamin D were measured in week 1 after symptom onset.
We found that low Vitamin D levels were significantly associated with age and disease severity
whereas there was a trend without significance, towards negative correlation of Vitamin D with antiSARS-CoV-2 IgG. Anti-SARS-CoV-2 IgG were significantly higher in older ages, patients with severe
disease, diabetes and those who received corticosteroid and antibiotic therapy. There was a positive
correlation of anti-SARS-CoV-2 IgG with IL-6, CRP, LDH, ESR and with percentages of granulocytes.
In conclusion, Vitamin D and anti-SARS-CoV-2 IgG share common parameters associated with
inflammatory state. However, even though Vitamin D protects against severe forms of COVID-19 it
could not directly affect anti-SARS-CoV-2 IgG production.
The coronavirus disease 2019 (COVID‑19) is caused by a new coronavirus which in addition to acute respira‑
tory failure is associated with systemic disorders such as hyperinflammation, hypercoagulation and vasculitis1.
Although many people exhibit mild ‘flu-like’ symptoms, in severe responses systemic changes have been attrib‑
uted to the cytokine storm accompanying severe inflammatory s yndrome2–4. Severe forms of COVID-19 have
been linked with low levels of circulating 25-hydroxy Vitamin D (25[OH]D) as an expression of Vitamin D
(Vit. D)5–10. Vit. D has immunomodulatory activity in response to invasion of bacterial and viral pathogens11,12
interacting with its receptor (VDR) in immune c ells13–15. In several studies it was shown that severe inflammatory
syndrome was accompanied with changes in hematological markers and increased several inflammatory markers
such as CRP, LDH, ESR, ferritin etc.2,16–18. A recent study has shown that in the presence of Vit. D, IL-6 induces
higher production of IL-10, a known anti-inflammatory cytokine which is expected to lead to the reduction of
inflammatory markers such as C
RP19. Several studies have shown inverse association between Vit. D and CRP
levels20–22. Additionally, high levels of CRP were associated with lowering levels of Vit. D
23 indicating that Vit.
D is a negative acute phase reactant. Thus, Vit. D insufficiency could be the cause and effect of high CRP levels
in COVID-19 patients.
Humoral and cellular immune responses, two wings of adaptive immunity, are crucial in clearing a variety of
viral infections24, and have been implicated in recovered COVID-19 patients25,26. In several studies disease sever‑
ity of COVID-19 was associated with higher levels of antibodies27–29 whereas asymptomatic patients minimally
produced anti-SARS-CoV-2 IgGs which were poorly m
aintained28,30. Taking into account that Vit. D affects
adaptive immune response, it may have an impact on..
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