tetano
Editor, Senior Moderator
BMC Infect Dis
. 2021 Jun 14;21(1):566.
doi: 10.1186/s12879-021-06281-7.
Vitamin D and COVID-19 severity and related mortality: a prospective study in Italy
Irene Campi[SUP] #[/SUP][SUP] 1 2 [/SUP], Luigi Gennari[SUP] #[/SUP][SUP] 3 [/SUP], Daniela Merlotti[SUP] 3 [/SUP], Christian Mingiano[SUP] 3 [/SUP], Alessandro Frosali[SUP] 3 [/SUP], Luca Giovanelli[SUP] 1 4 [/SUP], Camilla Torlasco[SUP] 5 6 [/SUP], Martino F Pengo[SUP] 5 6 [/SUP], Francesca Heilbron[SUP] 5 6 [/SUP], Davide Soranna[SUP] 7 [/SUP], Antonella Zambon[SUP] 7 8 [/SUP], Marta Di Stefano[SUP] 1 4 [/SUP], Carmen Aresta[SUP] 1 4 [/SUP], Marco Bonomi[SUP] 1 4 [/SUP], Biagio Cangiano[SUP] 1 4 [/SUP], Vittoria Favero[SUP] 1 4 [/SUP], Letizia Fatti[SUP] 1 4 [/SUP], Giovanni Battista Perego[SUP] 5 [/SUP], Iacopo Chiodini[SUP] 9 10 [/SUP], Gianfranco Parati[SUP] #[/SUP][SUP] 5 6 [/SUP], Luca Persani[SUP] #[/SUP][SUP] 1 4 [/SUP]
Affiliations
Abstract
Background: Vitamin D deficiency has been suggested to favor a poorer outcome of Coronavirus disease-19 (COVID-19). We aimed to assess if 25-hydroxyvitamin-D (25OHD) levels are associated with interleukin 6 (IL-6) levels and with disease severity and mortality in COVID-19.
Methods: We prospectively studied 103 in-patients admitted to a Northern-Italian hospital (age 66.1 ± 14.1 years, 70 males) for severely-symptomatic COVID-19. Fifty-two subjects with SARS-CoV-2 infection but mild COVID-19 symptoms (mildly-symptomatic COVID-19 patients) and 206 subjects without SARS-CoV-2 infection were controls. We measured 25OHD and IL-6 levels at admission and focused on respiratory outcome during hospitalization.
Results: Severely-symptomatic COVID-19 patients had lower 25OHD levels (18.2 ± 11.4 ng/mL) than mildly-symptomatic COVID-19 patients and non-SARS-CoV-2-infected controls (30.3 ± 8.5 ng/mL and 25.4 ± 9.4 ng/mL, respectively, p < 0.0001 for both comparisons). 25OHD and IL-6 levels were respectively lower and higher in severely-symptomatic COVID-19 patients admitted to intensive care Unit [(ICU), 14.4 ± 8.6 ng/mL and 43.0 (19.0-56.0) pg/mL, respectively], than in those not requiring ICU admission [22.4 ± 1.4 ng/mL, p = 0.0001 and 16.0 (8.0-32.0) pg/mL, p = 0.0002, respectively]. Similar differences were found when comparing COVID-19 patients who died in hospital [13.2 ± 6.4 ng/mL and 45.0 (28.0-99.0) pg/mL] with survivors [19.3 ± 12.0 ng/mL, p = 0.035 and 21.0 (10.5-45.9) pg/mL, p = 0.018, respectively). 25OHD levels inversely correlated with: i) IL-6 levels (ρ - 0.284, p = 0.004); ii) the subsequent need of the ICU admission [relative risk, RR 0.99, 95% confidence interval (95%CI) 0.98-1.00, p = 0.011] regardless of age, gender, presence of at least 1 comorbidity among obesity, diabetes, arterial hypertension, creatinine, IL-6 and lactate dehydrogenase levels, neutrophil cells, lymphocytes and platelets count; iii) mortality (RR 0.97, 95%CI, 0.95-0.99, p = 0.011) regardless of age, gender, presence of diabetes, IL-6 and C-reactive protein and lactate dehydrogenase levels, neutrophil cells, lymphocytes and platelets count.
Conclusion: In our COVID-19 patients, low 25OHD levels were inversely correlated with high IL-6 levels and were independent predictors of COVID-19 severity and mortality.
Keywords: COVID-19; Interleukin-6; Mortality; Vitamin D.
. 2021 Jun 14;21(1):566.
doi: 10.1186/s12879-021-06281-7.
Vitamin D and COVID-19 severity and related mortality: a prospective study in Italy
Irene Campi[SUP] #[/SUP][SUP] 1 2 [/SUP], Luigi Gennari[SUP] #[/SUP][SUP] 3 [/SUP], Daniela Merlotti[SUP] 3 [/SUP], Christian Mingiano[SUP] 3 [/SUP], Alessandro Frosali[SUP] 3 [/SUP], Luca Giovanelli[SUP] 1 4 [/SUP], Camilla Torlasco[SUP] 5 6 [/SUP], Martino F Pengo[SUP] 5 6 [/SUP], Francesca Heilbron[SUP] 5 6 [/SUP], Davide Soranna[SUP] 7 [/SUP], Antonella Zambon[SUP] 7 8 [/SUP], Marta Di Stefano[SUP] 1 4 [/SUP], Carmen Aresta[SUP] 1 4 [/SUP], Marco Bonomi[SUP] 1 4 [/SUP], Biagio Cangiano[SUP] 1 4 [/SUP], Vittoria Favero[SUP] 1 4 [/SUP], Letizia Fatti[SUP] 1 4 [/SUP], Giovanni Battista Perego[SUP] 5 [/SUP], Iacopo Chiodini[SUP] 9 10 [/SUP], Gianfranco Parati[SUP] #[/SUP][SUP] 5 6 [/SUP], Luca Persani[SUP] #[/SUP][SUP] 1 4 [/SUP]
Affiliations
- PMID: 34126960
- DOI: 10.1186/s12879-021-06281-7
Abstract
Background: Vitamin D deficiency has been suggested to favor a poorer outcome of Coronavirus disease-19 (COVID-19). We aimed to assess if 25-hydroxyvitamin-D (25OHD) levels are associated with interleukin 6 (IL-6) levels and with disease severity and mortality in COVID-19.
Methods: We prospectively studied 103 in-patients admitted to a Northern-Italian hospital (age 66.1 ± 14.1 years, 70 males) for severely-symptomatic COVID-19. Fifty-two subjects with SARS-CoV-2 infection but mild COVID-19 symptoms (mildly-symptomatic COVID-19 patients) and 206 subjects without SARS-CoV-2 infection were controls. We measured 25OHD and IL-6 levels at admission and focused on respiratory outcome during hospitalization.
Results: Severely-symptomatic COVID-19 patients had lower 25OHD levels (18.2 ± 11.4 ng/mL) than mildly-symptomatic COVID-19 patients and non-SARS-CoV-2-infected controls (30.3 ± 8.5 ng/mL and 25.4 ± 9.4 ng/mL, respectively, p < 0.0001 for both comparisons). 25OHD and IL-6 levels were respectively lower and higher in severely-symptomatic COVID-19 patients admitted to intensive care Unit [(ICU), 14.4 ± 8.6 ng/mL and 43.0 (19.0-56.0) pg/mL, respectively], than in those not requiring ICU admission [22.4 ± 1.4 ng/mL, p = 0.0001 and 16.0 (8.0-32.0) pg/mL, p = 0.0002, respectively]. Similar differences were found when comparing COVID-19 patients who died in hospital [13.2 ± 6.4 ng/mL and 45.0 (28.0-99.0) pg/mL] with survivors [19.3 ± 12.0 ng/mL, p = 0.035 and 21.0 (10.5-45.9) pg/mL, p = 0.018, respectively). 25OHD levels inversely correlated with: i) IL-6 levels (ρ - 0.284, p = 0.004); ii) the subsequent need of the ICU admission [relative risk, RR 0.99, 95% confidence interval (95%CI) 0.98-1.00, p = 0.011] regardless of age, gender, presence of at least 1 comorbidity among obesity, diabetes, arterial hypertension, creatinine, IL-6 and lactate dehydrogenase levels, neutrophil cells, lymphocytes and platelets count; iii) mortality (RR 0.97, 95%CI, 0.95-0.99, p = 0.011) regardless of age, gender, presence of diabetes, IL-6 and C-reactive protein and lactate dehydrogenase levels, neutrophil cells, lymphocytes and platelets count.
Conclusion: In our COVID-19 patients, low 25OHD levels were inversely correlated with high IL-6 levels and were independent predictors of COVID-19 severity and mortality.
Keywords: COVID-19; Interleukin-6; Mortality; Vitamin D.