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新型冠状病毒肺炎患者循环维生素 D 水平状况与临床预后指标。

Circulating Vitamin D levels status and clinical prognostic indices in COVID-19 patients.

机构信息

Respiratory Unit, Sant'Andrea Hospital, Sapienza University of Rome, Via di grottarossa, 1035, Rome, Italy.

Sant'Andrea Hospital, Rome, Italy.

出版信息

Respir Res. 2021 Mar 3;22(1):76. doi: 10.1186/s12931-021-01666-3.

Abstract

BACKGROUND

Several immune mechanisms activate in COVID-19 pathogenesis. Usually, coronavirus infection is characterized by dysregulated host immune responses, interleukine-6 increase, hyper-activation of cytotoxic CD8 T lymphocytes. Interestingly, Vitamin D deficiency has been often associated with altered immune responses and infections. In the present study, we evaluated Vitamin D plasma levels in patients affected with different lung involvement during COVID-19 infection.

METHODS

Lymphocyte phenotypes were assessed by flow cytometry. Thoracic CT scan involvement was obtained by an image analysis program.

RESULTS

Vitamin D levels were deficient in (80%) of patients, insufficient in (6.5%) and normal in (13.5%). Patients with very low Vitamin D plasma levels had more elevated D-Dimer values, a more elevated B lymphocyte cell count, a reduction of CD8 + T lymphocytes with a low CD4/CD8 ratio, more compromised clinical findings (measured by LIPI and SOFA scores) and thoracic CT scan involvement.

CONCLUSIONS

Vitamin D deficiency is associated with compromised inflammatory responses and higher pulmonary involvement in COVID-19 affected patients. Vitamin D assessment, during COVID-19 infection, could be a useful analysis for possible therapeutic interventions.

TRIAL REGISTRATION

'retrospectively registered'.

摘要

背景

COVID-19 发病机制中存在几种免疫机制。通常,冠状病毒感染的特征是宿主免疫反应失调、白细胞介素 6 增加、细胞毒性 CD8 T 淋巴细胞过度激活。有趣的是,维生素 D 缺乏常与免疫反应改变和感染有关。在本研究中,我们评估了 COVID-19 感染期间不同肺部受累患者的血浆维生素 D 水平。

方法

通过流式细胞术评估淋巴细胞表型。通过图像分析程序获得胸部 CT 扫描受累情况。

结果

80%的患者存在维生素 D 水平不足,6.5%的患者存在维生素 D 水平不足,13.5%的患者存在维生素 D 水平正常。血浆维生素 D 水平极低的患者 D-二聚体值更高,B 淋巴细胞计数更高,CD8+T 淋巴细胞减少,CD4/CD8 比值降低,临床症状更严重(通过 LIPI 和 SOFA 评分测量),胸部 CT 扫描受累更严重。

结论

维生素 D 缺乏与 COVID-19 感染患者炎症反应受损和更高的肺部受累有关。在 COVID-19 感染期间评估维生素 D 水平可能是一种有用的分析方法,用于可能的治疗干预。

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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a9b/7931550/85e89b1bec5a/12931_2021_1666_Fig1_HTML.jpg

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