Athanassiou, L.; Kostoglou-Athanassiou, I.; Nikolakopoulou, S.; Konstantinou, A.; Mascha, O.; Siarkos, E.; Samaras, C.; Athanassiou, P.; Shoenfeld, Y. Vitamin D Levels as a Marker of Severe SARS-CoV-2 Infection. Life 2024, 14, 210, doi:10.3390/life14020210.
Athanassiou, L.; Kostoglou-Athanassiou, I.; Nikolakopoulou, S.; Konstantinou, A.; Mascha, O.; Siarkos, E.; Samaras, C.; Athanassiou, P.; Shoenfeld, Y. Vitamin D Levels as a Marker of Severe SARS-CoV-2 Infection. Life 2024, 14, 210, doi:10.3390/life14020210.
Athanassiou, L.; Kostoglou-Athanassiou, I.; Nikolakopoulou, S.; Konstantinou, A.; Mascha, O.; Siarkos, E.; Samaras, C.; Athanassiou, P.; Shoenfeld, Y. Vitamin D Levels as a Marker of Severe SARS-CoV-2 Infection. Life 2024, 14, 210, doi:10.3390/life14020210.
Athanassiou, L.; Kostoglou-Athanassiou, I.; Nikolakopoulou, S.; Konstantinou, A.; Mascha, O.; Siarkos, E.; Samaras, C.; Athanassiou, P.; Shoenfeld, Y. Vitamin D Levels as a Marker of Severe SARS-CoV-2 Infection. Life 2024, 14, 210, doi:10.3390/life14020210.
Abstract
Severe infection from the SARS-CoV-2 virus is associated with various clinical findings, including hematological manifestations. Thrombotic events or a tendency to develop thrombotic events also characterize severe COVID-19 disease and may lead to death. Vitamin D is known to have immunomodulating properties and to enhance the body defense system against invading pathogens and to have immunostimulatory properties as far as the innate immune response is concerned. The aim was to measure 25(OH)D3 levels in patients hospitalized for severe COVID-19 infection, to explore the relationship between 25(OH)D3 and outcome and to investigate the relationship between 25(OH)D3 levels, CRP, ferritin, d-dimers and fibrinogen levels in this cohort. In a cohort of 88 patients hospitalized for severe infection from the SARS-CoV-2 virus and a control group matched for age and sex the levels of 25(OH)D3 were measured. In the same cohort CRP, ferritin, d-dimer and fibrinogen levels were also analyzed. Levels of 25(OH)D3 were 17.36±8.80 ng/ml (mean±SD) as compared with 24.34±10.34 ng/ml, in patients with severe SARS-CoV-2 infection and the control group, respectively, p<0.001 (Student’s t test). The levels of 25(OH)D3 were found to be significantly related to outcome, i.e. survival as opposed to non-survival, as more patients with 25(OH)D3 deficiency (0-10 ng/ml) and insufficiency (10-20 ng/ml) had a fatal outcome as compared with those with vitamin D sufficiency, p<0.001, chi-square test, p<0.001, Fischer’s exact test. Levels of 25(OH)D3 were inversely related to CRP, ferritin, d-dimer and fibrinogen levels, p<0.001, linear regression analysis, beta coefficient of variation, -0.176, -0,160, -0.178, -0.158, respectively. Vitamin D deficiency observed in severe SARS-CoV-2 infection was related to the disease outcome. Increased ferritin levels, and increased thrombotic markers, namely d-dimer and fibrinogen levels were observed in the patients and their concentration was also inversely related to vitamin D. We showed that vitamin D levels were low in hospitalized patients with severe SARS-CoV-2 infection and also inversely related to CRP, ferritin, d-dimer and fibrinogen concentration. It is proposed that vitamin D levels may be an index of severity in the context of SARS-CoV-2 infection.
Medicine and Pharmacology, Endocrinology and Metabolism
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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