Department of Environmental Radiological Health Science, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA.
Medical Center of the Rockies, University of Colorado Health, Loveland, CO 80538, USA.
Nutrients. 2022 Dec 7;14(24):5204. doi: 10.3390/nu14245204.
Vitamin D deficiency is common in the United States and leads to altered immune function, including T cell and macrophage activity that may impact responses to SARS-CoV-2 infection. This study investigated 131 adults with a history of a positive SARS-CoV-2 nasopharyngeal PCR and 18 adults with no COVID-19 diagnosis that were recruited from the community or hospital into the Northern Colorado Coronavirus Biorepository (NoCo-COBIO). Participants consented to enrollment for a period of 6 months and provided biospecimens at multiple visits for longitudinal analysis. Plasma 25-hydroxyvitamin D levels were quantified by LC-MS/MS at the initial visit (n = 149) and after 4 months (n = 89). Adults were classified as deficient (<30 nM or <12 ng/mL), insufficient (<30−50 nM or 12−20 ng/mL), or optimal (50−75 nM or >20 ng/mL) for 25-hydroxyvitamin D status. Fisher’s exact test demonstrated an association between disease severity, gender, and body mass index (BMI) at baseline. Mixed model analyses with Tukey-Kramer were used for longitudinal analysis according to BMI. Sixty-nine percent (n = 103) of the entire cohort had optimal levels of total 25(OH)D, 22% (n = 32) had insufficient levels, and 9% (n = 14) had deficent levels. Participants with severe disease (n = 37) had significantly lower 25-hydroxyvitamin D (total 25(OH)D) when compared to adults with mild disease (p = 0.006) or no COVID-19 diagnosis (p = 0.007). There was 44% of the cohort with post-acute sequalae of COVID-19 (PASC) as defined by experiencing at least one of the following symptoms after 60 days’ post-infection: fatigue, dyspnea, joint pain, chest pain, forgetfulness or absent-mindedness, confusion, or difficulty breathing. While significant differences were detected in 25-hydroxyvitamin D status by sex and BMI, there were no correlations between 25-hydroxyvitamin D for those without and without PASC. This longitudinal study of COVID-19 survivors demonstrates an important association between sex, BMI, and disease severity for 25-hydroxyvitamin D deficiency during acute stages of infection, yet it is not clear whether supplementation efforts would influence long term outcomes such as developing PASC.
维生素 D 缺乏在美国很常见，会导致免疫功能改变，包括 T 细胞和巨噬细胞活性的改变，这可能会影响对 SARS-CoV-2 感染的反应。这项研究调查了 131 名曾有过 SARS-CoV-2 鼻咽 PCR 阳性史的成年人和 18 名无 COVID-19 诊断的成年人，他们是从社区或医院招募到科罗拉多北部冠状病毒生物库（NoCo-COBIO）的。参与者同意在 6 个月的时间内参与研究，并在多次就诊时提供生物样本进行纵向分析。在初次就诊时（n = 149）和 4 个月后（n = 89），通过 LC-MS/MS 定量测定血浆 25-羟维生素 D 水平。根据 25-羟维生素 D 状态，将成年人分为缺乏症（<30 nM 或 <12 ng/mL）、不足（<30-50 nM 或 12-20 ng/mL）或充足（50-75 nM 或 >20 ng/mL）。Fisher 确切检验表明，疾病严重程度、性别和基线时的体重指数（BMI）之间存在关联。根据 BMI，采用混合模型分析和 Tukey-Kramer 进行纵向分析。整个队列中 69%（n = 103）的人总 25（OH）D 水平最佳，22%（n = 32）的人不足，9%（n = 14）的人缺乏。与轻度疾病（p = 0.006）或无 COVID-19 诊断（p = 0.007）的成年人相比，患有严重疾病（n = 37）的成年人 25-羟维生素 D（总 25（OH）D）明显较低。在感染后 60 天出现至少以下一种症状的人群中，有 44%的患者定义为 COVID-19 的急性后遗症（PASC）：疲劳、呼吸困难、关节疼痛、胸痛、健忘或心不在焉、困惑或呼吸困难。尽管通过性别和 BMI 检测到 25-羟维生素 D 状态存在显著差异，但无 PASC 患者与有 PASC 患者之间的 25-羟维生素 D 无相关性。这项 COVID-19 幸存者的纵向研究表明，在感染急性期，性别、BMI 和疾病严重程度与 25-羟维生素 D 缺乏之间存在重要关联，但尚不清楚补充剂是否会影响长期结局，如发展为 PASC。
