Susianti Hani, Wahono Cesarius Singgih, Rahman Perdana Aditya, Pratama Mirza Zaka, Wulanda Indah Adhita, Hartanti Khoirunisah Dwi, Dewi Elvira Sari, Handono Kusworini
University of Brawijaya, Faculty of Medicine, Department of Clinical Pathology, Malang, Indonesia.
University of Brawijaya, Faculty of Medicine, Department of Internal Medicine, Rheumatology and Immunology Division, Malang, Indonesia.
J Med Biochem. 2021 Sep 3;40(4):341-350. doi: 10.5937/jomb0-30228.
This study was aimed to explore the association of vitamin D in the risk of coagulopathy in coronavirus disease-19 (COVID-19).
Clinical and laboratory findings were obtained from 50 confirmed COVID-19 patients hospitalized in Saiful Anwar General Hospital, Malang, Indonesia, from September to November 2020. Thrombotic events during hospitalization were recorded, and the ISTH disseminated intravascular coagulation (DIC) score was used to classify overt DIC. Hypovitaminosis D was defined by serum vitamin D level <49.92 nmol/L.
Among 50 patients, 42 (84%) had hypovitaminosis D, and 6 (12%) developed thrombotic events. Vitamin D levels were lower in patients with thrombotic events (p=0.015), D-dimer >2 mg/L (p=0.006), ISTH DIC score 5 (p=0.020), admitted on ICU (p=0.002), and non-survivor groups (p=0.007). Multivariate analysis for the risk in increased D-dimer levels showed low vitamin D as the only significant risk factor with OR 1.8 (1.2-4.4), p=0.034. Low vitamin D also increased the risk for developing overt DIC with OR. 5.4 (1.0-30.2), p=0.039. Vitamin D level had negative correlations with ferritin (R=-0.316, p=0.044) and CRP (R=-0.530, p=0.000).
In conclusion, a low level of vitamin D was found in most hospitalized COVID-19 patients and might be associated with the development of coagulopathy.
本研究旨在探讨维生素D与新型冠状病毒肺炎（COVID-19）凝血功能障碍风险之间的关联。
收集了2020年9月至11月在印度尼西亚玛琅赛富安瓦尔综合医院住院的50例确诊COVID-19患者的临床和实验室检查结果。记录住院期间的血栓形成事件，并使用国际血栓与止血学会（ISTH）弥散性血管内凝血（DIC）评分对显性DIC进行分类。维生素D缺乏症定义为血清维生素D水平<49.92 nmol/L。
50例患者中，42例（84%）存在维生素D缺乏症，6例（12%）发生血栓形成事件。发生血栓形成事件的患者、D-二聚体>2 mg/L的患者、ISTH DIC评分为5分的患者、入住重症监护病房（ICU）的患者以及非存活组患者的维生素D水平较低（p分别为0.015、0.006、0.020、0.002和0.007）。对D-二聚体水平升高风险的多因素分析显示，低维生素D是唯一的显著风险因素，比值比（OR）为1.8（1.2 - 4.4），p = 0.034。低维生素D还增加了发生显性DIC的风险，OR为5.4（1.0 - 30.2），p = 0.039。维生素D水平与铁蛋白（R = -0.316，p = 0.044）和C反应蛋白（CRP）（R = -0.530，p = 0.000）呈负相关。
总之，大多数住院COVID-19患者存在低水平维生素D，这可能与凝血功能障碍的发生有关。
