Department of Obstetrics and Gynecology, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Health Sciences University, Emek Mahallesi, Namık Kemal Caddesi, No: 54, Sancaktepe, 34785, Istanbul, Turkey.
Eur J Nutr. 2022 Mar;61(2):1035-1041. doi: 10.1007/s00394-021-02709-7. Epub 2021 Oct 28.
To investigate the association between vitamin D status and the clinical severity of COVID-19 in pregnant women.
This prospective case-control study included 147 pregnant women with COVID-19 and 300 matched controls. Serum 25-hydroxyvitamin (25(OH)D) concentrations were measured on admission. Patients with mild-to-moderate disease (n = 114, 77.6%) and severe-to-critical disease (n = 33, 22.4%) were classified as symptomatic patients who did not require oxygen support and those who received oxygen support, respectively. SARS-CoV-2 positivity rates, clinical severity of COVID-19, and pulmonary involvement were compared according to vitamin D status.
Serum 25(OH)D concentrations were found to be 36.6 ± 26.8 and 31.3 ± 20.7 nmol/L in pregnant women infected with SARS-CoV-2 and healthy controls, respectively (p = 0.001). The clinical severity of pregnant women with COVID-19 did not differ concerning vitamin D deficiency (RR = 0.568, 95% CI [0.311-1.036]; p = 0.065), even after excluding patients on vitamin supplementation (RR = 0.625, 95% CI [0.275-1.419]; p = 0.261). Testing positive for SARS-CoV-2 was not related to vitamin D status in the overall cohort of pregnant women (RR = 0.767, 95% CI [0.570-1.030]; p = 0.078). Pulmonary involvement of COVID-19 was found to be similar between patients with vitamin D deficiency and adequate vitamin D levels (RR = 0.954; 95% CI [0.863-1.055]; p = 0.357).
The clinical severity and pulmonary involvement of COVID-19 may not be associated with vitamin D status in pregnant women. Vitamin D deficiency/adequacy rates were comparable in pregnant women infected with SARS-CoV-2 and healthy pregnant women.
探讨维生素 D 状态与 COVID-19 孕妇临床严重程度的关系。
这项前瞻性病例对照研究纳入了 147 例 COVID-19 孕妇和 300 例匹配对照。入院时测量血清 25-羟维生素（25（OH）D）浓度。将疾病轻-中度（n=114，77.6%）和重-危（n=33，22.4%）患者分别归类为无需氧支持的有症状患者和接受氧支持的有症状患者。根据维生素 D 状态比较 SARS-CoV-2 阳性率、COVID-19 临床严重程度和肺部受累情况。
感染 SARS-CoV-2 的孕妇血清 25（OH）D 浓度为 36.6±26.8 nmol/L，健康对照者为 31.3±20.7 nmol/L（p=0.001）。COVID-19 孕妇的临床严重程度与维生素 D 缺乏无关（RR=0.568，95%CI[0.311-1.036]；p=0.065），甚至在排除接受维生素补充的患者后（RR=0.625，95%CI[0.275-1.419]；p=0.261）。在孕妇总体队列中，SARS-CoV-2 检测阳性与维生素 D 状态无关（RR=0.767，95%CI[0.570-1.030]；p=0.078）。COVID-19 的肺部受累在维生素 D 缺乏和充足的维生素 D 水平的患者之间相似（RR=0.954；95%CI[0.863-1.055]；p=0.357）。
COVID-19 的临床严重程度和肺部受累可能与孕妇的维生素 D 状态无关。感染 SARS-CoV-2 的孕妇和健康孕妇的维生素 D 缺乏/充足率相当。
