Does the plasma vitamin D level affect the severity of infection in COVID-19 patients of different age groups?

Abstract

Purpose: SARS-CoV-2 has caused an on-going global pandemic of COVID-19 disease. Vitamin-D has an immunomodulatory effect on the disease by suppressing the adaptive immune system which can lead to a cytokine storm, and boosting the innate immune system. This study evaluated the relationship between both the clinical characteristics of COVID-19 patients and the severity of their infections, and their serum Vitamin D levels. Material and Methods: Forty COVID-19 patients from the period April to July, 2020, and 46 healthy subjects from a similar period in 2019, were included. Serum Vitamin-D level, Clinical findings, comorbidities, chest computed tomography findings, hematological and serum biochemistry analyzes of the patients were evaluated. Results: COVID-19 patients had a significantly lower mean serum 25(OH) Vitamin-D level (12·86 ± 6·27 ng/mL) than healthy subjects (25·4 ± 12·7 ng/mL) (p<<0·001). The prevalence of Vitamin D deficiency in COVID-19 patients was high, not only in the elderly, but also in middle age and young patients. Ground-glass opacification and paving stone sign were the most frequent patterns observed in chest-computed tomography (CT) images. There was a significant negative relationship between Vitamin-D deficiency and C-reactive protein (CRP) level (p=0·0243). In addition, a high CRP level was associated with abnormal CT findings (p=0·001). Conclusion: The authors conclude that determining the Vitamin-D level in COVID-19 patients and administering it at the appropriate dosage can reduce the severity and progression of COVID-19 disease by contributing to the regulation of the cytokine storm and pulmonary inflammatory response.

Keywords

• Computed Tomography
• Covid-19
• Vit D
• Laboratory findings.

Plazma D vitamini düzeyi farklı yaş gruplarındaki COVID-19 hastalarında enfeksiyonun şiddetini etkiler mi?

Öz

Amaç: SARS-CoV-2, devam eden küresel COVID-19 pandemisine sebep olmuştur. D vitamini, sitokin fırtınasına yol açabilen adaptif immun yanıtı baskılayarak ve doğuştan gelen immun yanıtı güçlendirerek immunmodulatör etki oluşturur. Bu çalışmada, COVID-19 hastalarının klinik özellikleri, enfeksiyonlarının şiddeti ve serum D vitamini düzeyleri arasındaki ilişki değerlendiridi. Gereç ve Yöntem: Nisan-Temmuz 2020 döneminde 40 COVID-19 hastası ve 2019'daki aynı döneme ait 46 sağlıklı denek çalışmaya dahil edildi. Hastaların serum D vitamini düzeyi, klinik bulgular, komorbiditeler, akciğere ait bilgisayarlı tomografi bulguları, hematolojik ve serum biyokimya analizleri değerlendirildi. Bulgular: COVID-19 hastalarının ortalama serum 25(OH) D Vitamini düzeyi (12.86 ± 6.27 ng/mL) sağlıklı deneklere (25.4 ± 12.7 ng/mL) göre anlamlı derecede düşük belirlenmiştir (p<<0.001). COVID-19 hastalarında D vitamini eksikliği prevalansı sadece yaşlılarda değil orta yaş ve genç hastalarda da yüksek bulunmuştur. Göğüs bilgisayarlı tomografi (BT) görüntülerinde en sık gözlenen paternler buzlu cam opaklaşması ve kaldırım taşı görüntüsü olmuştur. Vitamin D eksikliği ile C-reaktif protein (CRP) düzeyi arasında negatif ilişki belirlenmiştir (p=0.0243). Ayrıca yüksek CRP düzeyinin anormal BT bulguları ile ilişkili olduğu saptanmıştır (p=0.001). Sonuç: COVID-19 hastalarında D vitamini seviyesinin belirlenmesi ve uygun dozda uygulanmasının sitokin fırtınasının ve pulmoner inflamatuar yanıtın düzenlenmesine katkıda bulunarak COVID-19 hastalığının şiddetini ve ilerlemesini azaltabileceği sonucuna varılmıştır.

Anahtar Kelimeler

• Bilgisayarlı tomografi
• Covid-19
• Vit D
• Laboratuvar bulguları

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