Micronutrient status (vitamins A and D) and its effect on the severity of the course of COVID-19 in children

{ 'indexed': {'date-parts': [[2024, 4, 9]], 'date-time': '2024-04-09T00:34:00Z', 'timestamp': 1712622840392}, 'reference-count': 0, 'publisher': 'Higher State Educational Establishment of Ukraine Bukovinian State Medical University', 'issue': '1(51)', 'license': [ { 'start': { 'date-parts': [[2024, 4, 5]], 'date-time': '2024-04-05T00:00:00Z', 'timestamp': 1712275200000}, 'content-version': 'unspecified', 'delay-in-days': 0, 'URL': 'http://creativecommons.org/licenses/by/4.0'}], 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'abstract': '<jats:p>A strong immune response is important during recovery from COVID-19, and its status ' 'is infl uenced by several micronutrients. Vitamin D is important in regulating the immune ' 'response and protecting against respiratory infections. Vitamin A also has immunomodulatory ' 'eff ects, inhibiting viral replication and enhancing immune responses, thereby reducing ' 'morbidity and mortality from COVID-19. The aim of research was to study the levels of ' 'vitamins A, D, and retinol- binding protein 4 in children with COVID-19, and their ' 'associations with the severity of the disease.Material and Methods. 112 children aged 1 month ' 'to 18 years with COVID-19 confi rmed by polymerase chain reaction (PCR)in nasal swabs or by a ' 'positive serologic test (IgM and IgG or IgM). In all children, vitamin D levels were ' 'determined by thecolorimetric enzyme- linked immunosorbent assay (ELISA) using the Monobind ' 'test system. Vitamin A and retinol binding protein 4 (RBP4) levels were determined by the ' 'colorimetric enzyme- linked immunosorbent assay (ELISA) using the Elabscience test system. ' 'Statistical analysis was performed using Stat Plus (its 95 % confi dence interval (95 % CI) ' 'was calculated for the mean values, and the Kruskal- Wallis test (H-test) was used as the ' 'reliability criterion for checking the equality of the medians of several samples). The level ' 'of statistical signifi cance was set at P&lt;0.05). The study was conducted in accordance ' 'with the rules of patient safety and ethical principles of scientifi c medical research ' 'involving human subjects (2000). The permission to conduct this study was granted by the ' 'Bioethics Commission (Protocol No. 73, dated April 3, 2023). The parents (legal ' 'representatives) of the patients gave their written consent to the conduct of this study. ' 'This study is a fragment of research work «Optimizing the diagnosis of clinical and ' 'pathogenetic characteristics of the COVID-19 coronavirus infection in children with comorbid ' 'pathology and treatment features» (state registration No. 0123U100064, 2023-2025).Results. ' 'The mean age of the children was (7.04±5.75) years (95 % CI 5.96-8.12). According to the ' 'severity of the disease,57 children (50.89 %) had a mild course, 43 children (38.39 %) had a ' 'moderate course, and 12 children (10.72 %) had a severe course. The concentration of vitamin ' 'D in children with mild course of COVID-19 was 30.91 ng/ml, in children with moderate course ' '– 29.10 ng/ml, in children with severe course – 22.42 ng/ml (Р&lt;0.05). The level of vitamin ' 'A also varied in children with diff erent severity of the disease: in mild COVID-19 it was ' '456.10 ng/ml, in moderate – 347.30 ng/ml, and in severe – 242.90 ng/ ml (Р &lt;0.001). At the ' 'same time, the level of retinol binding protein 4 was 30.66 ng/ml in mild disease, 33.07 ' 'ng/ml in moderate disease and 23.28 ng/ml in severe disease.Conclusions. Children with ' 'moderate and severe COVID-19 have signifi cantly lower levels of vitamins A, D, and ' 'RBP4compared to uninfected individuals. Vitamin A and RBP4 levels were age-dependent, and ' 'vitamin D levels did not show agerelated patterns. Lower levels of vitamins A and D are ' 'associated with higher levels of pro-infl ammatory markers – CRP,leukocytes and ESR.</jats:p>', 'DOI': '10.24061/2413-4260.xiv.1.51.2024.6', 'type': 'journal-article', 'created': {'date-parts': [[2024, 4, 8]], 'date-time': '2024-04-08T14:48:14Z', 'timestamp': 1712587694000}, 'page': '41-47', 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'MICRONUTRIENT STATUS (VITAMINS A AND D) AND ITS EFFECT ON THE SEVERITY OF THE COURSE OF COVID-19 ' 'IN CHILDREN', 'prefix': '10.24061', 'volume': '14', 'author': [ {'given': 'H.', 'family': 'Pavlyshyn', 'sequence': 'first', 'affiliation': []}, {'given': 'O.', 'family': 'Labivka', 'sequence': 'additional', 'affiliation': []}, {'given': 'K.', 'family': 'Kozak', 'sequence': 'additional', 'affiliation': []}], 'member': '10153', 'published-online': {'date-parts': [[2024, 4, 5]]}, 'container-title': 'Neonatology, Surgery and Perinatal Medicine', 'original-title': [], 'link': [ { 'URL': 'http://neonatology.bsmu.edu.ua/article/download/301276/293438', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'http://neonatology.bsmu.edu.ua/article/download/301276/293587', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'http://neonatology.bsmu.edu.ua/article/download/301276/293438', 'content-type': 'unspecified', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2024, 4, 8]], 'date-time': '2024-04-08T14:48:52Z', 'timestamp': 1712587732000}, 'score': 1, 'resource': {'primary': {'URL': 'http://neonatology.bsmu.edu.ua/article/view/301276'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2024, 4, 5]]}, 'references-count': 0, 'journal-issue': {'issue': '1(51)', 'published-online': {'date-parts': [[2024, 4, 8]]}}, 'URL': 'http://dx.doi.org/10.24061/2413-4260.XIV.1.51.2024.6', 'relation': {}, 'ISSN': ['2413-4260', '2226-1230'], 'subject': [ 'Surgery', 'Pediatrics, Perinatology and Child Health', 'Obstetrics and Gynecology', 'Genetics (clinical)'], 'container-title-short': 'Neonatol. hìr. perinat. med.', 'published': {'date-parts': [[2024, 4, 5]]}}