Is There a Crucial Link Between Vitamin D Status and Inflammatory Response in Patients With COVID-19?
Federica Saponaro, Maria Franzini, Chukwuma Okoye, Rachele Antognoli, Beatrice Campi, Marco Scalese, Tommaso Neri, Laura Carrozzi, Fabio Monzani, Riccardo Zucchi, Alessandro Celi, Aldo Paolicchi, Alessandro Saba
Frontiers in Immunology, doi:10.3389/fimmu.2021.745713
Background: Hypovitaminosis D has been suggested to play a possible role in coronavirus disease 2019 (COVID-19) infection.
Methods: 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. Results: Sixty-five percent of patients presented hypovitaminosis D (25OHD ≤ 20 ng/ml) and showed significantly higher IL
Conflict of Interest: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Publisher's Note: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.
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'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> &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>',
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