Is There a Crucial Link Between Vitamin D Status and Inflammatory Response in Patients With COVID-19?

DOI record: { "DOI": "10.3389/fimmu.2021.745713", "ISSN": [ "1664-3224" ], "URL": "http://dx.doi.org/10.3389/fimmu.2021.745713", "abstract": "<jats:sec><jats:title>Background</jats:title><jats:p>Hypovitaminosis D has been suggested to play a possible role in coronavirus disease 2019 (COVID-19) infection.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>The aim of this study is to analyze the relationship between vitamin D status and a biochemical panel of inflammatory markers in a cohort of patients with COVID-19. A secondary endpoint was to evaluate the correlation between 25OHD levels and the severity of the disease. Ninety-three consecutive patients with COVID-19-related pneumonia were evaluated from March to May 2020 in two hospital units in Pisa, in whom biochemical inflammatory markers, 25OHD levels, P/F ratio at nadir during hospitalization, and complete clinical data were available.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Sixty-five percent of patients presented hypovitaminosis D (25OHD ≤ 20 ng/ml) and showed significantly higher IL-6 [20.8 (10.9–45.6) vs. 12.9 (8.7–21.1) pg/ml, <jats:italic>p</jats:italic> = 0.02], CRP [10.7 (4.2–19.2) vs. 5.9 (1.6–8.1) mg/dl, <jats:italic>p</jats:italic> = 0.003], TNF-α [8.9 (6.0–14.8) vs. 4.4 (1.5–10.6) pg/ml, <jats:italic>p</jats:italic> = 0.01], D-dimer [0.53 (0.25–0.72) vs. 0.22 (0.17–0.35) mg/l, <jats:italic>p</jats:italic> = 0.002], and IL-10 [3.7 (1.8–6.9) vs. 2.3 (0.5–5.8) pg/ml, <jats:italic>p</jats:italic> = 0.03]. A significant inverse correlation was found between 25OHD and all these markers, even adjusted for age and sex. Hypovitaminosis D was prevalent in patients with severe ARDS, compared with the other groups (75% vs. 68% vs. 55%, <jats:italic>p</jats:italic> &amp;lt; 0.001), and 25OHD levels were lower in non-survivor patients.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The relationship between 25OHD levels and inflammatory markers suggests that vitamin D status needs to be taken into account in the management of these patients. If vitamin D is a marker of poor prognosis or a possible risk factor with beneficial effects from supplementation, this still needs to be elucidated.</jats:p></jats:sec>", "alternative-id": [ "10.3389/fimmu.2021.745713" ], "author": [ { "affiliation": [], "family": "Saponaro", "given": "Federica", "sequence": "first" }, { "affiliation": [], "family": "Franzini", "given": "Maria", "sequence": "additional" }, { "affiliation": [], "family": "Okoye", "given": "Chukwuma", "sequence": "additional" }, { "affiliation": [], "family": "Antognoli", "given": "Rachele", "sequence": "additional" }, { "affiliation": [], "family": "Campi", "given": "Beatrice", "sequence": "additional" }, { "affiliation": [], "family": "Scalese", "given": "Marco", "sequence": "additional" }, { "affiliation": [], "family": "Neri", "given": "Tommaso", "sequence": "additional" }, { "affiliation": [], "family": "Carrozzi", "given": "Laura", "sequence": "additional" }, { "affiliation": [], "family": "Monzani", "given": 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