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COVID-19 Pozitif Semptomatik Çocukların D Vitamini Düzeyleri

Year 2021, Volume: 19 Issue: 1, 9 - 14, 09.04.2021

Abstract

Giriş: D vitamini bir vitamin olarak bilinmesine rağmen aynı zamanda bir prohormon görevi görür ve birçok işlevi vardır. Çalışmamızda COVID-19 enfeksiyonu tanısı ile izlenen pediyatrik hastalarda D vitamini düzeylerinin değerlendirilmesi amaçlandı.

Gereç ve Yöntem: Çalışmamız Mart-Nisan 2020 tarihlerinde İstanbul’da bir 3. basamak eğitim ve araştırma hastanesinde gerçekleştirildi. Semptomatik COVID-19 enfeksiyonu tanısı alan çocuklar çalışmaya dahil edildi. Demografik, klinik ve laboratuvar bulgular retrospektif olarak hasta dosyalarından kaydedildi.
Tüm hastaların D vitamini seviyeleri değerlendirildi. Kontrol grubu aynı mevsimde pediyatri polikliniğine rutin kontrol için başvuran sağlıklı çocuklardan oluşturuldu. Otuz COVID (+) ve 82 sağlıklı çocuk 25-OH vitamin D düzeyleri açısından karşılaştırıldı.

Bulgular: COVID-19 pozitif hastaların ortanca yaşı 11,8 (1,8-17,6), kontrol grubunun ortanca yaşı 12,7 (1-16,4) idi. Enfekte grupta 15 (%50) kız, 15 (%50) erkek, kontrol grubunda 39 (%47,5) kız, 43 (%52,5) erkek vardı. Yaş ve cinsiyet gruplar arasında farklılık göstermiyordu. COVID-19 pozitif grupta medyan D vitamini seviyesi 8,9 ng/ml (3-42 ng / ml), kontrol grubunda 18,5 ng/ml (9- 40,7 ng/ml) idi. COVID19 (+) grupta kontrol grubuna göre istatistiksel olarak anlamlı daha düşük D vitamini düzeyleri saptandı (p<0.001). COVID-19 pozitif grupta 19 hastaya BT yapıldı ve 19 hastanın 12’sinde (%63) viral pnömoni tespit edildi. Pnömoni (+) grupta 17,4 yaşında kız hasta ve 13,1 yaşında erkek hastada yaşa göre düşük fosfor seviyeleri (2,2 ve 2,4 mg/dl) bulundu. Her ikisinin de yüksek akımlı oksijen tedavisine ihtiyacı oldu, diğer vakaların hiçbiri oksijen tedavisine ihtiyaç duymadı.

Sonuç: Çalışmamız, Türkiye’de çocuklarda COVID-19 enfeksiyonu ile yatırılarak tedavi edilen olguların D vitamini düzeylerinin araştırıldığı ilk çalışmadır. Yatırılarak tedavi edilen COVID-19 (+) çocuklarda daha düşük D vitamini değerleri tespit ettik.

References

  • 1. Monto AS. Medical reviews. Coronaviruses. Yale J Biol Med. 1974;47(4):234-51.
  • 2. Commission WMH Report of clustering pneumonia of unknown etiology in Wuhan City (2019-2020).
  • 3. https://www.who.int/docs/default source/coronaviruse/situationreports/ 20200311-sitrep-51 covid-19.pdf?sfvrsn=1ba62e57_10.
  • 4. Jiehao Cai, Jing Xu, Daojiong Lin et al. A Case Series of children with 2019 novel coronavirus infection: clinical and epidemiological features, Clinical Infectious Diseases,, ciaa198, https://doi.org/10.1093/cid/ciaa198.
  • 5. Liu W, Zhang Q, Chen J, et al Detection of Covid-19 in Children in Early January 2020 in Wuhan, China. N Engl J Med 2020; 382:1370.
  • 6. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395:1054.
  • 7. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-42. doi:10.1001/jama.2020.2648.
  • 8. CDC COVID-19 Response Team. Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019 — United States, February 12-March 28, 2020. MMWR Morb Mortal Wkly Rep 2020.
  • 9. Dong Y, Mo X, Hu Y, et al. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. Pediatrics 2020; doi: 10.1542/peds.2020-0702. 10. Arihiro S, Nakashima A, Matsuoka M, et al. Randomized Trial of Vitamin D Supplementation to Prevent Seasonal Influenza and Upper Respiratory Infection in Patients With Inflammatory Bowel Disease. Inflamm Bowel Dis. 2019;25(6):1088-1095. doi:10.1093/ibd/izy346.
  • 11. Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr. 2004;80(6 Suppl) :1678S-88S. doi:10.1093/ ajcn/80.6.1678S.
  • 12. Zhou YF, Luo BA, Qin LL. The association between vitamin D deficiency and community-acquired pneumonia: A metaanalysis of observational studies. Medicine 2019 (Baltimore) 98(38):e17252. doi:10.1097/MD.0000000000017252.
  • 13. Takishita Y, Yasuda H, Shimizu M, et al. Formation of neutrophil extracellular traps in mitochondrial DNA-deficient cells. J Clin Biochem Nutr. 2020;66(1):15-23. doi:10.3164/jcbn.19-77.
  • 14. Urashima M, Segawa T, Okazaki M et al. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr 2019; 91(5):1255-60.
  • 15. Hong M, Xiong T, Huang J.et al. Association of vitamin D supplementation with respiratory tract infection in infants. Matern Child Nutr 2020; (September 2019):1-10.
  • 16. Kuba K, Imai Y, Penninger JM. Angiotensin-converting enzyme 2 in lung diseases. Curr Opin Pharmacol. 2006;6(3):271-276. doi:10.1016/j.coph.2006.03.001.
  • 17. Cui C, Xu P, Li G, et al. Vitamin D receptor activation regulates microglia polarization and oxidative stress in spontaneously hypertensive rats and angiotensin II-exposed microglial cells: Role of renin-angiotensin system. Redox Biol. 2019;26:101295. doi:10.1016/j.redox.2019.101295.
  • 18. Ishii K, Takeuchi H, Fukunaga K. et al. Attenuation of lipopolysaccharide-induced acute lung injury after (pro)renin receptor blockade. Exp Lung Res 2015; 41:199-207. doi: 10.3109/01902148.2014.993444.
  • 19. Molloy EJ., Murphy N. Vitamin D, Covid-19 and Children. Ir Med J 2020; 3;113(4):64.
  • 20. Ilie PC, Stefanescu S, Smith L. The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality [published online ahead of print, 2020 May 6]. Aging Clin Exp Res. 2020;1-4. doi:10.1007/s40520-020-01570-8.
  • 21. Munns CF, Shaw N, Kiely M. et al. Global consensus recommendations on prevention and management of nutritional rickets. Horm Res Paediatr 2016; 85(2):83-106.
  • 22. Chowdhury R, Taneja S, Bhandari N. et al. Vitamin-D deficiency predicts infections in young north Indian children: A secondary data analysis. PLoS One 2017; 8;12(3):e0170509. doi: 10.1371/journal.pone.0170509. eCollection 2017.
  • 23. Banajeh SM. Nutritional rickets and vitamin D deficiency- -association with the outcomes of childhood very severe pneumonia: a prospective cohort study. Pediatr Pulmonol 2009;44(12):1207-15. doi: 10.1002/ppul.21121
  • 24. Yao J, Liu L, Chen G. et al. Two severe cases of H7N9 pneumonia patients with immunoneuroendocrine axis dysfunction and vitamin D insufficiency. BMC Infect Dis. 2014; 28;14:44. doi: 10.1186/1471-2334-14-44.
  • 25. Urashima M, Segawa T, Okazaki M. et al. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr 2010; 91(5):1255-60. doi: 10.3945/ajcn.2009.29094.
  • 26. Camargo CA Jr, Ganmaa D, Frazier AL. et al. Randomized trial of vitamin D supplementation and risk of acute respiratory infection in Mongolia. Pediatrics 2012; 130(3):e561-7. doi:10.1542/peds.2011-3029.
  • 27. Ozhan B, Evrengul H, Yılmaz AS et al. Vitamin D status of children in a university hospital in west turkey. HK J Pediatry 2016;21:251-6.
  • 28. Akman AO, Tumer L, Hasanoğlu A et al. The frequency of vitamin D insufficiency in healthy children between 1 and 16 years of age in Turkey. Pediatr Int 2011;53:968-73.
  • 29. Silva MC, Furlanetto TW. Does serum 25-hydroxyvitamin D decrease during acute-phase response? A systematic review. Nutr Res 2015; 35(2):91-6. doi:10.1016/j.nutres.2014.12.008.
  • 30. Ebadi M, Montano-Loza AJ. Perspective: improving vitamin D status in the management of COVID-19. Eur J Clin Nutr 2020;12. doi: 10.1038/s41430-020-0661-0.

Vitamin D Levels of COVID-19 Positive Sypmtomatic Pediatric Cases

Year 2021, Volume: 19 Issue: 1, 9 - 14, 09.04.2021

Abstract

Introduction:Vitamin D is known as a vitamin but also it acts as a prohormone and has many functions. The aim of this study is to investigate the vitamin D levels
in pediatric patients with COVID-19.

Materials and Methods: A retrospective study was performed in a tertiary education and research hospital in Istanbul, Turkey during the period of March to April 2020. Children diagnosed with symptomatic COVID-19 infection were included in the study. Demographic, clinical and laboratory findings were recorded from patient charts retrospectively. All patients investigated for vitamin D levels. Control group consists of healthy children admitted to pediatric outpatient units for routine check-up in the same season.Thirty children with COVID-19 and 82 healthy children included in this study were compared due to 25-OH vitamin D levels.

Results: The median age of COVID-19 positive patients was 11.8 (1.8-17.6) years and the median age of control group was 12.7 (1-16.4) years old. There were 15
(50%) females and 15 (50%) males in infected group and there were 39 (47.5%) females and 43 (52.5%) males control group. Age and gender did not differ among
the groups. Median vitamin D level in COVID-19 positive group was 8.9 ng/ml (3-42 ng/ml) and 18.5 ng/ml (9-40.7 ng/ml) in control group. We detected significantly
lower vitamin D values in COVID19(+) group when compared with control group (p<0.001). CT was performed 19 patients in COVID-19 positive group and viral
pneumonia was detected in 12(63%) of 19. pneumonia (+) group a 17.4-years-old female patient and a 13.1-years-old male patient had low phosphorus levels by age
(2.2 and 2.4 mg/dl). Both of them needed high flow oxygen therapy. None of the other cases needed oxygen therapy.

Conclusions: This is the first study to date has measured vitamin D levels in children with COVID-19 in Turkey. We detected significantly lower vitamin D
values in COVID-19(+) hospitalized children.

References

  • 1. Monto AS. Medical reviews. Coronaviruses. Yale J Biol Med. 1974;47(4):234-51.
  • 2. Commission WMH Report of clustering pneumonia of unknown etiology in Wuhan City (2019-2020).
  • 3. https://www.who.int/docs/default source/coronaviruse/situationreports/ 20200311-sitrep-51 covid-19.pdf?sfvrsn=1ba62e57_10.
  • 4. Jiehao Cai, Jing Xu, Daojiong Lin et al. A Case Series of children with 2019 novel coronavirus infection: clinical and epidemiological features, Clinical Infectious Diseases,, ciaa198, https://doi.org/10.1093/cid/ciaa198.
  • 5. Liu W, Zhang Q, Chen J, et al Detection of Covid-19 in Children in Early January 2020 in Wuhan, China. N Engl J Med 2020; 382:1370.
  • 6. Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet 2020;395:1054.
  • 7. Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention. JAMA. 2020;323(13):1239-42. doi:10.1001/jama.2020.2648.
  • 8. CDC COVID-19 Response Team. Preliminary Estimates of the Prevalence of Selected Underlying Health Conditions Among Patients with Coronavirus Disease 2019 — United States, February 12-March 28, 2020. MMWR Morb Mortal Wkly Rep 2020.
  • 9. Dong Y, Mo X, Hu Y, et al. Epidemiological characteristics of 2143 pediatric patients with 2019 coronavirus disease in China. Pediatrics 2020; doi: 10.1542/peds.2020-0702. 10. Arihiro S, Nakashima A, Matsuoka M, et al. Randomized Trial of Vitamin D Supplementation to Prevent Seasonal Influenza and Upper Respiratory Infection in Patients With Inflammatory Bowel Disease. Inflamm Bowel Dis. 2019;25(6):1088-1095. doi:10.1093/ibd/izy346.
  • 11. Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr. 2004;80(6 Suppl) :1678S-88S. doi:10.1093/ ajcn/80.6.1678S.
  • 12. Zhou YF, Luo BA, Qin LL. The association between vitamin D deficiency and community-acquired pneumonia: A metaanalysis of observational studies. Medicine 2019 (Baltimore) 98(38):e17252. doi:10.1097/MD.0000000000017252.
  • 13. Takishita Y, Yasuda H, Shimizu M, et al. Formation of neutrophil extracellular traps in mitochondrial DNA-deficient cells. J Clin Biochem Nutr. 2020;66(1):15-23. doi:10.3164/jcbn.19-77.
  • 14. Urashima M, Segawa T, Okazaki M et al. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr 2019; 91(5):1255-60.
  • 15. Hong M, Xiong T, Huang J.et al. Association of vitamin D supplementation with respiratory tract infection in infants. Matern Child Nutr 2020; (September 2019):1-10.
  • 16. Kuba K, Imai Y, Penninger JM. Angiotensin-converting enzyme 2 in lung diseases. Curr Opin Pharmacol. 2006;6(3):271-276. doi:10.1016/j.coph.2006.03.001.
  • 17. Cui C, Xu P, Li G, et al. Vitamin D receptor activation regulates microglia polarization and oxidative stress in spontaneously hypertensive rats and angiotensin II-exposed microglial cells: Role of renin-angiotensin system. Redox Biol. 2019;26:101295. doi:10.1016/j.redox.2019.101295.
  • 18. Ishii K, Takeuchi H, Fukunaga K. et al. Attenuation of lipopolysaccharide-induced acute lung injury after (pro)renin receptor blockade. Exp Lung Res 2015; 41:199-207. doi: 10.3109/01902148.2014.993444.
  • 19. Molloy EJ., Murphy N. Vitamin D, Covid-19 and Children. Ir Med J 2020; 3;113(4):64.
  • 20. Ilie PC, Stefanescu S, Smith L. The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality [published online ahead of print, 2020 May 6]. Aging Clin Exp Res. 2020;1-4. doi:10.1007/s40520-020-01570-8.
  • 21. Munns CF, Shaw N, Kiely M. et al. Global consensus recommendations on prevention and management of nutritional rickets. Horm Res Paediatr 2016; 85(2):83-106.
  • 22. Chowdhury R, Taneja S, Bhandari N. et al. Vitamin-D deficiency predicts infections in young north Indian children: A secondary data analysis. PLoS One 2017; 8;12(3):e0170509. doi: 10.1371/journal.pone.0170509. eCollection 2017.
  • 23. Banajeh SM. Nutritional rickets and vitamin D deficiency- -association with the outcomes of childhood very severe pneumonia: a prospective cohort study. Pediatr Pulmonol 2009;44(12):1207-15. doi: 10.1002/ppul.21121
  • 24. Yao J, Liu L, Chen G. et al. Two severe cases of H7N9 pneumonia patients with immunoneuroendocrine axis dysfunction and vitamin D insufficiency. BMC Infect Dis. 2014; 28;14:44. doi: 10.1186/1471-2334-14-44.
  • 25. Urashima M, Segawa T, Okazaki M. et al. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr 2010; 91(5):1255-60. doi: 10.3945/ajcn.2009.29094.
  • 26. Camargo CA Jr, Ganmaa D, Frazier AL. et al. Randomized trial of vitamin D supplementation and risk of acute respiratory infection in Mongolia. Pediatrics 2012; 130(3):e561-7. doi:10.1542/peds.2011-3029.
  • 27. Ozhan B, Evrengul H, Yılmaz AS et al. Vitamin D status of children in a university hospital in west turkey. HK J Pediatry 2016;21:251-6.
  • 28. Akman AO, Tumer L, Hasanoğlu A et al. The frequency of vitamin D insufficiency in healthy children between 1 and 16 years of age in Turkey. Pediatr Int 2011;53:968-73.
  • 29. Silva MC, Furlanetto TW. Does serum 25-hydroxyvitamin D decrease during acute-phase response? A systematic review. Nutr Res 2015; 35(2):91-6. doi:10.1016/j.nutres.2014.12.008.
  • 30. Ebadi M, Montano-Loza AJ. Perspective: improving vitamin D status in the management of COVID-19. Eur J Clin Nutr 2020;12. doi: 10.1038/s41430-020-0661-0.
There are 29 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Research Article
Authors

Elif Söbü

Ayşe Karaaslan This is me

Ceren Çetin This is me

Yasemin Akın This is me

Publication Date April 9, 2021
Published in Issue Year 2021 Volume: 19 Issue: 1

Cite

APA Söbü, E., Karaaslan, A., Çetin, C., Akın, Y. (n.d.). Vitamin D Levels of COVID-19 Positive Sypmtomatic Pediatric Cases. Güncel Pediatri, 19(1), 9-14.
AMA Söbü E, Karaaslan A, Çetin C, Akın Y. Vitamin D Levels of COVID-19 Positive Sypmtomatic Pediatric Cases. Güncel Pediatri. 19(1):9-14.
Chicago Söbü, Elif, Ayşe Karaaslan, Ceren Çetin, and Yasemin Akın. “Vitamin D Levels of COVID-19 Positive Sypmtomatic Pediatric Cases”. Güncel Pediatri 19, no. 1 n.d.: 9-14.
EndNote Söbü E, Karaaslan A, Çetin C, Akın Y Vitamin D Levels of COVID-19 Positive Sypmtomatic Pediatric Cases. Güncel Pediatri 19 1 9–14.
IEEE E. Söbü, A. Karaaslan, C. Çetin, and Y. Akın, “Vitamin D Levels of COVID-19 Positive Sypmtomatic Pediatric Cases”, Güncel Pediatri, vol. 19, no. 1, pp. 9–14.
ISNAD Söbü, Elif et al. “Vitamin D Levels of COVID-19 Positive Sypmtomatic Pediatric Cases”. Güncel Pediatri 19/1 (n.d.), 9-14.
JAMA Söbü E, Karaaslan A, Çetin C, Akın Y. Vitamin D Levels of COVID-19 Positive Sypmtomatic Pediatric Cases. Güncel Pediatri.;19:9–14.
MLA Söbü, Elif et al. “Vitamin D Levels of COVID-19 Positive Sypmtomatic Pediatric Cases”. Güncel Pediatri, vol. 19, no. 1, pp. 9-14.
Vancouver Söbü E, Karaaslan A, Çetin C, Akın Y. Vitamin D Levels of COVID-19 Positive Sypmtomatic Pediatric Cases. Güncel Pediatri. 19(1):9-14.