Department of Respiratory and Critical Care Medicine, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.
Department of Respiratory and Critical Care Medicine, Changzhou Medical Center, Changzhou Third People's Hospital, Nanjing Medical University, Changzhou, China.
Virol J. 2023 Sep 13;20(1):212. doi: 10.1186/s12985-023-02165-1.
There are many studies on the relationship between vitamin D and coronavirus disease 2019 (COVID-19), while the results are matters of debate and the mechanisms remain unknown. The present study was performed to assess the impact of serum 25-hydroxyvitamin D [25(OH)D] levels on the severity of disease in hospitalized COVID-19 patients and identify potential mechanisms of 25(OH)D alterations.
A total of 399 hospitalized COVID-19 patients were recruited from three centers between December 19, 2022, and February 1, 2023. Medical history, laboratory examination, and radiologic data were retrospectively collected. The patients were divided into four groups based on disease severity. Serum 25(OH)D levels in the patients were determined by the electrochemiluminescence method and cytokines were detected by flow cytometry. The relationship between serum 25(OH)D status and the severity of COVID-19, and the correlation between 25(OH)D levels and cytokines in COVID-19 patients were assessed.
Levels of 25(OH)D were significantly lower in the deceased group than in the other three groups (P < 0.05), and lower in the critical group than in the general group (P < 0.05). There were no significant differences in the 25(OH)D levels between the general and severe groups (P > 0.05). The levels of 25(OH)D (odds ratio = 0.986, 95% confidence interval: 0.973-0.998, P = 0.024) and IL-5 (odds ratio = 1.239, 95% confidence interval: 1.104-1.391, P = 0.04) were independent risk factors for the severity of COVID-19 disease upon admission. Serum 25(OH)D levels were able to predict the mortality of patients with COVID-19, and the predictive value was even higher when combined with IL-5 levels and eosinophil (Eos) count. Circulating 25(OH)D status correlated negatively with the expression of IL-5 (r=-0.262, P < 0.001) and was positively linked with CD8 T cell counts (r=-0.121, P < 0.05) in patients with COVID-19.
This study found that the serum 25(OH)D status combined with IL-5 levels and Eos counts could be identified as a predictive factor for recognizing the risk of COVID-19 mortality. The serum 25(OH)D status in COVID-19 patients correlated negatively with the expression of IL-5. The potential mechanism for this relationship is worth further exploration.
有许多关于维生素 D 与 2019 年冠状病毒病（COVID-19）之间关系的研究，然而结果存在争议，其机制仍不清楚。本研究旨在评估血清 25-羟维生素 D [25(OH)D] 水平对住院 COVID-19 患者疾病严重程度的影响，并确定 25(OH)D 改变的潜在机制。
2022 年 12 月 19 日至 2023 年 2 月 1 日期间，我们从三个中心招募了 399 名住院 COVID-19 患者。回顾性收集病史、实验室检查和影像学数据。根据疾病严重程度将患者分为四组。采用电化学发光法测定患者血清 25(OH)D 水平，采用流式细胞术检测细胞因子。评估血清 25(OH)D 状态与 COVID-19 严重程度的关系，以及 COVID-19 患者 25(OH)D 水平与细胞因子的相关性。
死亡组的 25(OH)D 水平明显低于其他三组（P<0.05），危重组明显低于普通组（P<0.05）。普通组和严重组的 25(OH)D 水平无显著差异（P>0.05）。25(OH)D（比值比=0.986，95%置信区间：0.973-0.998，P=0.024）和 IL-5（比值比=1.239，95%置信区间：1.104-1.391，P=0.04）水平是 COVID-19 入院时疾病严重程度的独立危险因素。血清 25(OH)D 水平可预测 COVID-19 患者的死亡率，与 IL-5 水平和嗜酸性粒细胞（Eos）计数联合时预测价值更高。COVID-19 患者的循环 25(OH)D 状态与 IL-5 的表达呈负相关（r=-0.262，P<0.001），与 CD8 T 细胞计数呈正相关（r=-0.121，P<0.05）。
本研究发现，血清 25(OH)D 水平联合 IL-5 水平和 Eos 计数可作为识别 COVID-19 死亡风险的预测因素。COVID-19 患者的血清 25(OH)D 状态与 IL-5 的表达呈负相关。这种关系的潜在机制值得进一步探讨。
