Division of Hematology and Oncology, Department of Internal Medicine, Dr Cipto Mangunkusumo National Referral Hospital, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia.
Department of Clinical Pathology, YARSI University, Jakarta, Indonesia.
Medicine (Baltimore). 2024 Sep 13;103(37):e39252. doi: 10.1097/MD.0000000000039252.
The worldwide spread of coronavirus disease 2019 (COVID-19) has resulted in an unparalleled health emergency of global proportions. Around 31% of individuals with COVID-19 experience thrombosis associated with hypercoagulation. COVID-19 patients have shown an increase in platelet activation, but the mechanism has not been fully understood yet. One theory suggests that this could be related to the heparin-induced thrombocytopenia phenomenon, where platelet activation involves anti-PF4 antibodies that are associated with thrombosis. Vitamin D has been established to exert an influence on immunological responses and inflammation. The aim of this study is to analyze the correlation between serum 25-hydroxy-cholecalciferol [25(OH)D] levels and anti-PF4 antibodies among COVID-19 patients. A cross-sectional study was conducted among 160 COVID-19 patients at Cipto Mangunkusumo General Hospital and Wisma Atlit Hospital Jakarta from October 2021 to January 2022. The mean serum 25(OH)D level was 15.1 ng/mL. A significant negative correlation was found between serum 25(OH)D and anti-PF4 levels in mild COVID-19 patients (P = .035; R = -0.236). Remarkably, P-selectin levels were significantly higher in the moderate COVID-19 group compared to the severe group (P = .031). Serum 25(OH)D level had a significant negative correlation with anti-PF4 level in mild COVID-19 patients. Thus, it is highly recommended to ensure that serum 25(OH)D levels are maintained above 30 ng/mL. Remarkably, the P-selectin level was significantly higher in the moderate COVID-19 group compared to the severe group.
2019 年冠状病毒病（COVID-19）在全球范围内的传播导致了一场前所未有的全球卫生紧急情况。大约 31%的 COVID-19 患者会出现与高凝状态相关的血栓形成。COVID-19 患者表现出血小板活化增加，但机制尚未完全了解。一种理论认为，这可能与肝素诱导的血小板减少症现象有关，其中血小板活化涉及与血栓形成相关的抗 PF4 抗体。维生素 D 已被证明对免疫反应和炎症有影响。本研究旨在分析 COVID-19 患者血清 25-羟胆钙化醇[25(OH)D]水平与抗 PF4 抗体之间的相关性。2021 年 10 月至 2022 年 1 月，在雅加达 Cipto Mangunkusumo 综合医院和 Wisma Atlit 医院对 160 名 COVID-19 患者进行了横断面研究。平均血清 25(OH)D 水平为 15.1ng/ml。轻度 COVID-19 患者的血清 25(OH)D 与抗 PF4 水平呈显著负相关（P=0.035；R=-0.236）。值得注意的是，中度 COVID-19 组的 P-选择素水平明显高于重度 COVID-19 组（P=0.031）。轻度 COVID-19 患者的血清 25(OH)D 水平与抗 PF4 水平呈显著负相关。因此，强烈建议确保血清 25(OH)D 水平维持在 30ng/ml 以上。值得注意的是，中度 COVID-19 组的 P-选择素水平明显高于重度 COVID-19 组。
