Peruzzu Daniela, Pagano Maria Teresa, Pierdominici Marina, Ruggieri Anna, Antinori Andrea, D'Offizi Gianpiero, Petrosillo Nicola, Palmieri Fabrizio, Piselli Pierluca, Boumis Evangelo, Notari Stefania, Nicastri Emanuele, Agrati Chiara, Ippolito Giuseppe, Gagliardi Maria Cristina, Capobianchi Maria Rosaria, Ortona Elena
Center for Gender Specific Medicine, Istituto Superiore di Sanità, Rome, Italy.
National Institute for Infectious Diseases, Lazzaro Spallanzani, IRCCS, Rome, Italy.
Front Pharmacol. 2021 May 13;12:683529. doi: 10.3389/fphar.2021.683529. eCollection 2021.
The outcome of COVID-19 appears to be influenced by vitamin D status of population. Although epidemiological data indicate that COVID-19 produces more severe symptoms and higher mortality in elderly in comparison to young patients and in men in comparison to women to date sex and age differences in vitamin D status in infected patients have not been evaluated yet. In this study we evaluated the levels of circulating 25(OH)D in patients hospitalized for COVID-19 divided accordingly to their sex and age. We also correlated 25(OH)D levels with patient's respiratory status (i.e., PaO2/FiO2 ratio) and with sex hormones plasma levels to analyze the potential relationship of these parameters. We found no significant differences in plasma levels of 25(OH)D between pre- and post-menopausal female patients and age matched male patients. Interestingly, the 25(OH)D plasma levels positively correlated to PaO2/FiO2 ratio only in young patients, regardless of their sex. We also found a significantly positive correlation between 17β-estradiol and 25(OH)D in elderly women and between testosterone and 25(OH)D in elderly men, supporting the role of sex hormones in maintaining 25(OH)D levels. In conclusion, we suggest that a synergy between vitamin D and sex hormones could contribute to the age-related outcome of COVID-19.
新型冠状病毒肺炎（COVID-19）的病情转归似乎受人群维生素D水平的影响。尽管流行病学数据表明，与年轻患者相比，COVID-19在老年患者中会产生更严重的症状和更高的死亡率，并且与女性相比，男性的死亡率更高，但迄今为止，尚未评估感染患者维生素D水平的性别和年龄差异。在本研究中，我们评估了因COVID-19住院患者的循环25(OH)D水平，并根据其性别和年龄进行了分组。我们还将25(OH)D水平与患者的呼吸状态（即PaO2/FiO2比值）以及性激素血浆水平进行关联分析，以探讨这些参数之间的潜在关系。我们发现，绝经前和绝经后女性患者与年龄匹配的男性患者之间，25(OH)D的血浆水平无显著差异。有趣的是，仅在年轻患者中，无论性别如何，25(OH)D血浆水平与PaO2/FiO2比值呈正相关。我们还发现，老年女性中17β-雌二醇与25(OH)D之间以及老年男性中睾酮与25(OH)D之间存在显著正相关，这支持了性激素在维持25(OH)D水平中的作用。总之，我们认为维生素D与性激素之间的协同作用可能有助于COVID-19的年龄相关病情转归。
