COVID-19 hastalarında D vitamini düzeyinin klinik durumla olan ilişkisi

Year 2023, Volume: 15 Issue: 1, 130 - 135, 15.03.2023

Fatih DAVRAN Ceyhan HACIOĞLU Eda KAYABAŞI Banu Hümeyra KESKİN Pelin DURAN Elif Nisa UNLU Elif EŞCAN Şengül CANGÜR Cihadiye Elif ÖZTÜRK

https://doi.org/10.18521/ktd.1134319

Abstract

Amaç: Vitamin D, mukozal bariyerlerin bütünlüğünün korunmasında, doğal ve kazanılmış bağışıklıkta önemli rol oynar. COVID-19 pandemisinde, virüsün varyantları olsa veya aşılanmış olsanız bile, hastalığın ağırlaşmasında veya hafifletilmesinde kişisel bağışıklığın gücü çok önemlidir.
Gereç ve Yöntem: Bu çalışmada hastanemize COVID-19 nedeniyle başvuran ayaktan ve yatarak tedavi gören hastaların klinik seyri ile D vitamini düzeyleri arasındaki ilişkiyi araştırdık. 47 ayaktan ve 47 yatan hasta olmak üzere toplam 94 hasta çalışmaya dahil edildi.
Bulgular: Her iki grubun ortalama yaş ve cinsiyet dağılımları benzerdi. Hastanemizde COVID-19 nedeniyle takip edilen 94 hastanın sadece 7'sinde D vitamini seviyeleri normal bulundu. D vitamini düzeyi ≥30 olan hastalar, "<10" ve "10-29.9" olanlardan anlamlı derecede düşüktü (her biri için p<0.01). D vitamini düzeyi <10 olan hastanede yatan hastalar (%71), D vitamini düzeyi ≥30 olanlardan (%0) anlamlı olarak daha yüksekti. Ek olarak, D vitamini düzeyi <10 olan ayaktan hastalar (%29), D vitamini düzeyi ≥30 olanlardan (%100) anlamlı olarak daha düşüktü.
Sonuç: D vitamini eksikliğinin komorbiditesi olmayan hastalarda bile COVID-19'un şiddetli klinik seyri ile ilişkili olabileceğini ve ayrıca COVID-19'da ölümle sonuçlanan predispozan faktörlerden biri olabileceğini gösterdik. Veriler, COVID-19 salgını sırasında D vitamini takviyelerine devam etmenin çok önemli olduğunu gösteriyor.

Keywords

D vitamini, COVID-19, klinik seyir, yatan hastalar, ayaktan hastalar

The Effect of Vitamin D Level on the Clinical Situation in COVID-19 Patients

Abstract

Objective: Vitamin D plays an important role in maintaining the integrity of mucosal barriers and in natural and acquired immunity. In the COVID-19 pandemic, the strength of personal immunity is very important in the severe or lightening of the disease, even if there are variants of the virus or if you are vaccinated.
Methods: In this study, we investigated the relationship between the clinical course and vitamin D levels of outpatient and inpatient follow-up patients admitted to our hospital due to COVID-19. A total of 94 patients, 47 outpatients and 47 inpatients, were included in the study.
Result: The mean age and gender distributions of both groups were similar. Vitamin D levels were found to be normal in only 7 of 94 patients who were followed up in our hospital due to COVID-19. Patients with vitamin D levels ≥30 were significantly lower than those with "<10" and "10-29.9" (p<0.01 for each). Hospitalized patients (71%) with vitamin D levels <10 were significantly higher than those (0%) with vitamin D levels ≥30. Additionally, the outpatients (29%) with vitamin D levels <10 were significantly lower than those (100%) with vitamin D levels ≥30.
Conclusion: We showed that vitamin D deficiency may be associated with the severe clinical course of COVID-19, even in patients without comorbidities, and may also be one of the predisposing factors resulting in death in COVID-19. The data suggest that it is crucial to continue vitamin D supplements during the COVID-19 pandemic.

Keywords

Vitamin D, COVID-19, clinical course, inpatients, outpatients

References

• World Health Organization. Director-General’s remarks at the media briefing on 2019-nCoV on 11 February 2020. http://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020. Accessed 12 Feb 2020
• Yu P, Zhu J, Zhang Z, Han Y. A Familial Cluster of Infection Associated with the 2019 Novel Coronavirus Indicating Possible Person-to-Person Transmission During the Incubation Period. J Infect Dis. 2020;221(11):1757-61.
• Wacker M, Holick MF. Sunlight and Vitamin D: A global perspective for health. Dermatoendocrinol. 2013;5(1):51-108.
• Christakos S, Ajibade DV, Dhawan P, Fechner AJ, Mady LJ. Vitamin D: metabolism. Endocrinol Metab Clin North Am. 2010;39(2):243-53.
• Alshishtawy MM. Vitamin D Deficiency: This clandestine endemic disease is veiled no more. Sultan Qaboos Univ Med J. 2012;12(2):140-52.
• Hewison M. Vitamin D and innate and adaptive immunity. Vitam Horm. 2011;86:23-62.
• Beard JA, Bearden A, Striker R. Vitamin D and the anti-viral state. J Clin Virol. 2011;50(3):194-200.
• Munshi R, Hussein MH, Toraih EA, Elshazli RM, Jardak C, Sultana N, et al. Vitamin D insufficiency as a potential culprit in critical COVID-19 patients. J Med Virol. 2021;93(2):733-40.
• Merzon E, Tworowski D, Gorohovski A, Vinker S, Golan Cohen A, Green I, et al. Low plasma 25(OH) vitamin D level is associated with increased risk of COVID-19 infection: an Israeli population-based study. FEBS J. 2020;287(17):3693-702.
• Kumar R, Rathi H, Haq A, Wimalawansa SJ, Sharma A. Putative roles of vitamin D in modulating immune response and immunopathology associated with COVID-19. Virus Res. 2021;292:198235.
• Simpson S, Kay FU, Abbara S, Bhalla S, Chung JH, Chung M, et al. Radiological Society of North America Expert Consensus Document on Reporting Chest CT Findings Related to COVID-19: Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA. Radiol Cardiothorac Imaging. 2020;2(2):e200152.
• Smith DL, Grenier JP, Batte C, Spieler B. A Characteristic Chest Radiographic Pattern in the Setting of the COVID-19 Pandemic. Radiol Cardiothorac Imaging. 2020;2(5):e200280.
• Schmid A, Walther B. Natural vitamin D content in animal products. Adv Nutr. 2013;4(4):453-62.
• Rondanelli M, Miccono A, Lamburghini S, Avanzato I, Riva A, Allegrini P, et al. Self-Care for Common Colds: The Pivotal Role of Vitamin D, Vitamin C, Zinc, and Echinacea in Three Main Immune Interactive Clusters (Physical Barriers, Innate and Adaptive Immunity) Involved during an Episode of Common Colds-Practical Advice on Dosages and on the Time to Take These Nutrients/Botanicals in order to Prevent or Treat Common Colds. Evid Based Complement Alternat Med. 2018;2018:5813095.
• Grant WB, Lahore H, McDonnell SL, Baggerly CA, French CB, Aliano JL, et al. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients. 2020;12(4):988.
• Schwalfenberg GK. A review of the critical role of vitamin D in the functioning of the immune system and the clinical implications of vitamin D deficiency. Mol Nutr Food Res. 2011;55(1):96-108.
• Ali N. Role of vitamin D in preventing of COVID-19 infection, progression and severity. J Infect Public Health. 2020;13(10):1373-1380.
• Kim JS, Lee JY, Yang JW, Lee KH, Effenberger M, Szpirt W, et al. Immunopathogenesis and treatment of cytokine storm in COVID-19. Theranostics. 2021;11(1):316-329.