tetano
Editor, Senior Moderator
Front Immunol
. 2022 Jan 24;12:745713.
doi: 10.3389/fimmu.2021.745713. eCollection 2021.
Is There a Crucial Link Between Vitamin D Status and Inflammatory Response in Patients With COVID-19?
Federica Saponaro[SUP] 1 [/SUP], Maria Franzini[SUP] 2 [/SUP], Chukwuma Okoye[SUP] 3 [/SUP], Rachele Antognoli[SUP] 3 [/SUP], Beatrice Campi[SUP] 1 [/SUP], Marco Scalese[SUP] 4 [/SUP], Tommaso Neri[SUP] 1 [/SUP], Laura Carrozzi[SUP] 1 [/SUP], Fabio Monzani[SUP] 3 [/SUP], Riccardo Zucchi[SUP] 1 [/SUP], Alessandro Celi[SUP] 1 [/SUP], Aldo Paolicchi[SUP] 2 [/SUP], Alessandro Saba[SUP] 1 [/SUP]
Affiliations
Abstract
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-6 [20.8 (10.9-45.6) vs. 12.9 (8.7-21.1) pg/ml, p = 0.02], CRP [10.7 (4.2-19.2) vs. 5.9 (1.6-8.1) mg/dl, p = 0.003], TNF-α [8.9 (6.0-14.8) vs. 4.4 (1.5-10.6) pg/ml, p = 0.01], D-dimer [0.53 (0.25-0.72) vs. 0.22 (0.17-0.35) mg/l, p = 0.002], and IL-10 [3.7 (1.8-6.9) vs. 2.3 (0.5-5.8) pg/ml, p = 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%, p < 0.001), and 25OHD levels were lower in non-survivor patients.
Conclusions: 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.
Keywords: COVID-19; SARS-CoV-2; cytokine storm; hypovitaminosis D; vitamin D.
. 2022 Jan 24;12:745713.
doi: 10.3389/fimmu.2021.745713. eCollection 2021.
Is There a Crucial Link Between Vitamin D Status and Inflammatory Response in Patients With COVID-19?
Federica Saponaro[SUP] 1 [/SUP], Maria Franzini[SUP] 2 [/SUP], Chukwuma Okoye[SUP] 3 [/SUP], Rachele Antognoli[SUP] 3 [/SUP], Beatrice Campi[SUP] 1 [/SUP], Marco Scalese[SUP] 4 [/SUP], Tommaso Neri[SUP] 1 [/SUP], Laura Carrozzi[SUP] 1 [/SUP], Fabio Monzani[SUP] 3 [/SUP], Riccardo Zucchi[SUP] 1 [/SUP], Alessandro Celi[SUP] 1 [/SUP], Aldo Paolicchi[SUP] 2 [/SUP], Alessandro Saba[SUP] 1 [/SUP]
Affiliations
- PMID: 35140702
- PMCID: PMC8818986
- DOI: 10.3389/fimmu.2021.745713
Abstract
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-6 [20.8 (10.9-45.6) vs. 12.9 (8.7-21.1) pg/ml, p = 0.02], CRP [10.7 (4.2-19.2) vs. 5.9 (1.6-8.1) mg/dl, p = 0.003], TNF-α [8.9 (6.0-14.8) vs. 4.4 (1.5-10.6) pg/ml, p = 0.01], D-dimer [0.53 (0.25-0.72) vs. 0.22 (0.17-0.35) mg/l, p = 0.002], and IL-10 [3.7 (1.8-6.9) vs. 2.3 (0.5-5.8) pg/ml, p = 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%, p < 0.001), and 25OHD levels were lower in non-survivor patients.
Conclusions: 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.
Keywords: COVID-19; SARS-CoV-2; cytokine storm; hypovitaminosis D; vitamin D.