Popovska Jovičić Biljana, Raković Ivana, Gavrilović Jagoda, Sekulić Marković Sofija, Petrović Sara, Marković Vladan, Pavković Aleksandar, Čanović Predrag, Radojević Marjanović Ružica, Irić-Čupić Violeta, Popović Dragonjić Lidija, Milosavljević Miloš Z
Department of Infectious Diseases, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia.
Clinic for Infectious Diseases, University Clinical Center Kragujevac, Zmaj Jovina 30, 34000 Kragujevac, Serbia.
J Clin Med. 2023 Apr 12;12(8):2825. doi: 10.3390/jcm12082825.
SARS-CoV-2 continues to pose a major challenge to scientists and clinicians. We examined the significance of the serum concentrations of vitamin D, albumin, and D-dimer for the severity of the clinical picture and mortality in COVID-19.
A total of 288 patients treated for COVID-19 infection participated in the research. The patients were treated in the period from May 2020 to January 2021. All patients were divided based on the need for oxygen therapy (Sat > 94%) into patients with mild or severe clinical pictures. The biochemical and radiographic parameters of the patients were analyzed. Appropriate statistical methods were used in the statistical analysis.
In patients with COVID-19 with confirmed severe clinical pictures, lower values of serum albumin ( < 0.0005) and vitamin D ( = 0.004) were recorded, as opposed to elevated values of D-dimer ( < 0.0005). Accordingly, the patients with fatal disease outcomes had lower levels of albumin ( < 0.0005) and vitamin D ( = 0.002), while their D-dimer ( < 0.0005) levels were elevated. An increase in the radiographic score, as a parameter for assessing the severity of the clinical picture, was accompanied by a decrease in serum albumin ( < 0.0005) and a simultaneous increase in D-dimer ( < 0.0005), without a change in the vitamin D concentration ( = 0.261). We also demonstrated the interrelations of the serum levels of vitamin D, albumin, and D-dimer in patients with COVID-19 as well as their significance as predictors of the outcome of the disease.
The significance of the predictive parameters in our study indicates the existence of an important combined role of vitamin D, albumin, and D-dimer in the early diagnosis of the most severe patients suffering from COVID-19. Reduced values of vitamin D and albumin, in combination with elevated values of D-dimer, can be timely indicators of the development of a severe clinical picture and death due to COVID-19.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）继续对科学家和临床医生构成重大挑战。我们研究了维生素D、白蛋白和D-二聚体的血清浓度对新型冠状病毒肺炎（COVID-19）临床表现严重程度和死亡率的意义。
共有288例接受COVID-19感染治疗的患者参与了本研究。这些患者在2020年5月至2021年1月期间接受治疗。所有患者根据是否需要氧疗（血氧饱和度>94%）分为临床表现为轻度或重度的患者。分析了患者的生化和影像学参数。在统计分析中使用了适当的统计方法。
在确诊为重度临床表现的COVID-19患者中，血清白蛋白（<0.0005）和维生素D（=0.004）的值较低，而D-二聚体的值升高（<0.0005）。因此，疾病结局为死亡的患者白蛋白（<0.0005）和维生素D（=0.002）水平较低，而其D-二聚体（<0.0005）水平升高。作为评估临床表现严重程度的参数，影像学评分增加伴随着血清白蛋白降低（<0.0005）和D-二聚体同时升高（<0.0005），而维生素D浓度无变化（=0.261）。我们还证明了COVID-19患者血清中维生素D、白蛋白和D-二聚体水平之间的相互关系以及它们作为疾病结局预测指标的意义。
我们研究中预测参数的意义表明，维生素D、白蛋白和D-二聚体在COVID-19最严重患者的早期诊断中存在重要的联合作用。维生素D和白蛋白值降低，同时D-二聚体值升高，可能是COVID-19严重临床表现发展和死亡的及时指标。
