Department of Pediatrics, Faculty of Medicine, Cairo University, Giza, Egypt.
Department of Pediatrics, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.
Pediatr Res. 2023 Apr;93(5):1383-1390. doi: 10.1038/s41390-022-02275-6. Epub 2022 Sep 9.
Given the sparse data on vitamin D status in pediatric COVID-19, we investigated whether vitamin D deficiency could be a risk factor for susceptibility to COVID-19 in Egyptian children and adolescents. We also investigated whether vitamin D receptor (VDR) FokI polymorphism could be a genetic marker for COVID-19 susceptibility.
One hundred and eighty patients diagnosed to have COVID-19 and 200 matched control children and adolescents were recruited. Patients were laboratory confirmed as SARS-CoV-2 positive by real-time RT-PCR. All participants were genotyped for VDR Fok1 polymorphism by RT-PCR. Vitamin D status was defined as sufficient for serum 25(OH) D at least 30 ng/mL, insufficient at 21-29 ng/mL, deficient at <20 ng/mL.
Ninety-four patients (52%) had low vitamin D levels with 74 (41%) being deficient and 20 (11%) had vitamin D insufficiency. Vitamin D deficiency was associated with 2.6-fold increased risk for COVID-19 (OR = 2.6; [95% CI 1.96-4.9]; P = 0.002. The FokI FF genotype was significantly more represented in patients compared to control group (OR = 4.05; [95% CI: 1.95-8.55]; P < 0.001).
Vitamin D deficiency and VDR Fok I polymorphism may constitute independent risk factors for susceptibility to COVID-19 in Egyptian children and adolescents.
Vitamin D deficiency could be a modifiable risk factor for COVID-19 in children and adolescents because of its immune-modulatory action. To our knowledge, ours is the first such study to investigate the VDR Fok I polymorphism in Caucasian children and adolescents with COVID-19. Vitamin D deficiency and the VDR Fok I polymorphism may constitute independent risk factors for susceptibility to COVID-19 in Egyptian children and adolescents. Clinical trials should be urgently conducted to test for causality and to evaluate the efficacy of vitamin D supplementation for prophylaxis and treatment of COVID-19 taking into account the VDR polymorphisms.
鉴于儿科 COVID-19 患者维生素 D 状态的数据稀少，我们研究了维生素 D 缺乏是否是埃及儿童和青少年易感染 COVID-19 的危险因素。我们还研究了维生素 D 受体 (VDR) FokI 多态性是否是 COVID-19 易感性的遗传标志物。
招募了 180 名确诊为 COVID-19 的患者和 200 名匹配的对照儿童和青少年。通过实时 RT-PCR 对所有患者进行 SARS-CoV-2 检测。通过 RT-PCR 对所有参与者的 VDR Fok1 多态性进行基因分型。维生素 D 状态定义为血清 25(OH)D 至少 30ng/mL 为充足，21-29ng/mL 为不足，<20ng/mL 为缺乏。
94 名患者（52%）维生素 D 水平较低，其中 74 名（41%）患者维生素 D 缺乏，20 名（11%）患者维生素 D 不足。维生素 D 缺乏使 COVID-19 的风险增加 2.6 倍（OR=2.6；95%CI 1.96-4.9；P=0.002）。与对照组相比，FokI FF 基因型在患者中更为常见（OR=4.05；95%CI：1.95-8.55；P<0.001）。
维生素 D 缺乏和 VDR FokI 多态性可能是埃及儿童和青少年易感染 COVID-19 的独立危险因素。
由于维生素 D 具有免疫调节作用，因此维生素 D 缺乏可能是儿童和青少年 COVID-19 的可改变危险因素。据我们所知，这是第一项研究维生素 D 受体 FokI 多态性在白种人儿童和青少年 COVID-19 中的作用的研究。维生素 D 缺乏和 VDR FokI 多态性可能是埃及儿童和青少年易感染 COVID-19 的独立危险因素。应紧急进行临床试验，以检验因果关系，并评估维生素 D 补充剂预防和治疗 COVID-19 的疗效，同时考虑到 VDR 多态性。
