The Role of Free Vitamin D and Vitamin D Binding Protein in SARS-Cov-2 Infection in Children
Mahmut Caner Us, Aslı Devrim Lanpir, Şükran Özdatlı Kurtuluş, Mesut Yağcı, Özlem Akarsu, Kamil Şahin, Gülşen Akkoç
doi:10.21203/rs.3.rs-2718581/v1
Purpose: Many studies have discussed the effects of serum vitamin D de ciency in SARS-CoV-2 patients. This study aimed to investigate the relationship between SARS-CoV-2 infection severity and free vitamin D (FVD) and bioavailable vitamin D (BAVD) levels in children. Methods: A prospective case-control study design was used. Participants were divided into three groups based on the World Health Organization (WHO) COVID-19 Clinical Progression Scale. Serum 25-hydroxyvitamin D (25OH vitamin D; ng/mL), albumin (g/L), and vitamin D binding protein (ng/mL) levels were evaluated to investigate the relationship between disease severity and FVD and BAVD levels. Results: In total, 82 participants were included in the study. Of those, 24.4 % were uninfected (n = 20), 50% had a mild case of SARSS-CoV-2 (n = 41), and 25.6% had a moderate case (n = 21). There was a statistically signi cant difference in FVD and BAVD levels between the groups (p = 0.026). Median FVD (p = 0.007, Cohen's d = 0.84) and BAVD (p = 0.007, Cohen's d = 0.86) levels were signi cantly higher in the mild group compared to the moderate group. FVD and BAVD metabolites were moderately positively correlated with lymphocyte counts (FVD: r = 0.437, p < 0.001; BAVD: r = 0.439, p < 0.001). Conclusion: This is the rst study to demonstrate a relationship between SARS-CoV-2 symptom severity and FVD and BAVD levels. The relationship between FVD and BAVD levels and lymphocyte counts could play an important role in symptom severity and should be evaluated in further studies. The study was registered with Clinical Trials (NCT05598957, 10/06/2022).
Declarations Acknowledgement: Authors thanks to all patients and their families Competing Interests: The authors have no relevant nancial or non-nancial interests to disclose. Author Contributions: All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Mahmut Caner Us, Gülşen Akkoç, Şükran Özdatli Kurtuluş, Mesut Yagci, Aslı Devrim Lanpir, Özlem Akarsu. The rst draft of the manuscript was written by Mahmut Caner Us, Gülşen Akkoç, Kamil Şahin and all authors commented on previous versions of the manuscript. All authors read and approved the nal manuscript. Ethics approval: This study was performed in line with the principles of the Declaration of Helsinki. Approval was granted by the TC Health Sciences University Hamidiye Clinical Ethics Committee with protocol decision numbered 2022/10/17 and registered with Clinical Trials (NCT05598957, 10/06/2022). Consent to participate: Written informed consent was obtained from the parents. Consent to publish: participants con rmed and signed the informed consent form to the publication of the study. Congresses: This paper was presented as oral presentation at the Social Pediatric Society of Turkey's in the selected abstracts of the 3th International Eurasian Social Pediatric congress organized in İzmir (Turkey) between November 16th-20th 2022. "SS-006"
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