Vitamin D status in patients with COVID-19 – sex differences associated with severity of the disease

Pop-Kostova et al., Medical Journal MEDICUS, 28:1, May 2023

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Retrospective 115 COVID-19 patients in North Macedonia, showing lower vitamin D levels associated with hospitalization.

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Pop-Kostova et al., 12 May 2023, retrospective, North Macedonia, peer-reviewed, 2 authors, study period September 2020 - December 2020.

Original scientific paper ЛИПИДНИОТ МАРКЕР АПОЛИПОПРОТЕИН Б КАКО ПРЕДИКТОР ЗА КОРОНАРНАТА АРТЕРИСКА БОЛЕСТ КАЈ ДИЈАБЕТЕС МЕЛИТУС ТИП 2 ПАЦИЕНТИ СО И БЕЗ ДИЈАБЕТИЧНА НЕФРОПАТИЈА

Вера Пеншовска Николова, Христијан Николов, Оливер С Георгиевски, Сефедин Биљали, Светлана Цековска, Жаклина Трајковска- Анчевска, Никола Оровчанец, PhD, Wels, Austria Atilla Rexhepi, Valon Asani, Fisnik Demiri, Vlora Ibrahimi, Amela Dobjani, Majlinda Ademi Profesional, Angjela Debreshlioska, Irfan Ismaili, Irina Angelovska, Venco Vuinov, Marija Karakostova, Ibadete Bucalija, Isjanovski Igor, Valza Ismajli, Veron Ismajli, Lidija Ristovska, Zora Jachova, Ilber Besimi, MD Bekim Ismaili, Rron Elezi, Katarina Vidoevska, Nagip Rufati, Besim Zeqiri, Valentina Simonovska, Lenče Miloševa, Ajla Shabani, Viktorija Jovanovska, Aleksandra Boshku, Nezhla Sh, Nikola Islami, Orovchanec, MD, Macedonia Ankica Pop-Kostova, Tatjana Ruskovska, Rozeta Shahinaj, Белакапоска Српанова, Арјета Рауфи, Крстевска Марина, Авди Константинова, Муртезани, Љиндита Џемаили Јакупи, Николовска Мимоза, Aртон Котевска, Нусрет Јакупи, Башким Исуфи, Османи, Ѓошевска Даштевска, Gazmend Mehmeti, Vesna Cheleva, Jana Nivicka Kjaeva, Hristian Duma, Наим Скендери, Бети Зафирова-Ивановскa, Арта Хисени Скендери, Марта Тунџева, Катарина Ставриќ, Кондова Ирена, Катерина Топузовска, Беким Ковачевиќ, Исмаили, Гициќ Азра, Ковачевиќ Катарина, Ангелеска Ружица, Сашка Јаневска, Danilo Nonkulovski, Ljelja Muaremoska-Kanzoska, Teodora Spasovska, Ilija Kirovski, Natasha Damjanovska, Ljubica Proeska Stojanovski, Katerina Grabuloska, Shkelqim Muharremi, Arlind Sejdini, Selami Zhaku, Jetmir Ziba, Gjulsen Selim, Teuta Dalipi, Rezeart Dalipi, Danica Popovska, MD Rexhep Selmani, Vladimir Joksimovic, Fesih Shehu, Fatjona Mislimi, Arian Selmani, Jovanovska Stojovska, Stojkovski A Medicus, Valza Ismajli, Veron Ismajli, MD Omer Dzemaili, PhD, Zurich, Switzerland Florin Ramadani, PhD, Tetovo, Macedonia Lul Raka, PhD, Prishtina, Kosova Nevzat Elezi, Nobel Laureate, MD Ferid Murad, PhD, Houston, USA Rifat Latifi, PhD, Arizona, USA Alex Leventa, Edirne, Turkiye Israel Sedat Ustundağ, MD Avdyl Krasniqi, PhD, Prishtina, Kosova Kirk Milhoan, PhD, Texas, USA Minir Hasani, PhD, Germany Alfred Priftanji, PhD, Tirana Albania Naser Ramadani, PhD, Prishtina, Kosova Yovcho Yovchev, PhD Stara Zagora, MD Bulgaria Skender Saiti, PhD, Skopje, Macedonia Milka Zdravkovska, PhD, Skopje, Macedonia Gentian Vyshka, PhD, Tirana Albania Gani Karamanaga, MD, Ulcinj, Montenegro Ramush Bejiqi, PhD, Prishtina, Kosova Meral Rexhepi, PhD, Tetovo, Macedonia Irfan Ahmeti, MD Shpetim Telegrafi, PhD New York, USA Gezim Bocari, PhD, Tirana, Albania Donco Donev, PhD, Skopje, Macedonia Isuf Dedushaj, PhD, Prishtina, Kosova Ramadan Jashari, PhD, Belgjum Holger Tietzt, PhD, Germany Vjollca Meka-Sahatciu, MD, PhD Milena Petrovska, PhD, Skopje, Macedonia Sonja Bojadzieva, PhD, Skopje, Macedonia Ylbert Ademi, MD, Gostivar, Macedonia Naser Durmishi, PhD Macedonia Sead Zeynel, MD, Macedonia Rihan Saiti

Background: Patients with COVID-19 can develop abnormal inflammatory response, which can progress to multiorgan failure and death, with a higher prevalence observed in men. Besides, recent research suggests a complex interaction between viral infections and vitamin D. Aims: This study evaluates sex differences of vitamin D status, circulating enzymes and biomarkers of inflammatory response at the time of diagnosis of COVID-19, depending on severity of disease the patients develop. Methods: This retrospective observational study was conducted from September to December 2020. Patients (n = 115) were divided in two groups: Group A-asymptomatic or mild cases (36 men and 19 women; mean age 53.3 ± 1.4 y.) and Group B-patients who develop moderate or severe COVID-19 requiring hospitalization (38 men and 22 women; mean age 56.1 ± 1.3 y.). Results: Patients of Group B had almost two-fold lower circulating 25(OH)D concentrations than patients of Group A (Group A: 61.6 ± 1.9 nmol/L; Group B: 32.2 ± 1.4 nmol/L; p < 0.001). Within Group A, the only parameter with a statistically significant sex difference was ferritin (p < 0.01). Within Group B, in addition to ferritin (p < 0.05), we observed a pronounced and statistically highly significant sex difference in circulating 25(OH)D concentrations (men: 35.8 ± 1.7 nmol/L; women: 26.0 ± 1.7; p < 0.001). Conclusions: Our results demonstrate that inadequate vitamin D status is associated with the development of moderate or severe COVID-19 and indicate that circulating 25(OH)D might be associated to sex differences in disease outcome.

VITAMIN D STATUS IN PATIENTS WITH COVID-19 -SEX DIFFERENCES ASSOCIATED WITH SEVERITY OF THE DISEASE. Conflict of interest The authors declare that they have no conflict of interest.

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