Constantin Laura, Ungurianu Anca, Ţârcomnicu Isabela, Bălulescu Ema, Margină Denisa
Pharm, PhDc, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania, and National Institute for Infectious Diseases "Prof. Dr. Matei Balş", No. 1 Dr. Calistrat Grozovici street, Bucharest, 021105, Romania.
Pharm, Faculty of Pharmacy, Carol Davila University of Medicine and Pharmacy, No. 6 Traian Vuia street, Bucharest, 020956, Romania.
Germs. 2024 Sep 30;14(3):232-245. doi: 10.18683/germs.2024.1435. eCollection 2024 Sep.
The COVID-19 pandemic has promoted an intensive investigation into the pathophysiological mechanisms of SARS-CoV-2 infection, risk factors, and its impact on disease severity. Vitamin D has generated significant attention for its potential role in viral prevention and immune defense due to its pleiotropic functions, including immunomodulation and antimicrobial effects. This study aimed to assess serum 25(OH)D3 levels in patients with COVID-19 compared to those with other viral respiratory infections and to evaluate associations of vitamin D levels with symptomatology, clinical characteristics, presence of comorbidities and laboratory investigation.
The study included 78 patients admitted to a hospital with COVID-19 (52 patients) or other viral respiratory infections (26 patients). Routine blood biomarkers, markers of inflammation, markers of endothelial dysfunction, serum 25(OH)D3 were analyzed, and patients were classified according to vitamin D levels and presence of comorbidities.
Most patients had vitamin D levels <30 ng/mL and there was no significant difference in 25(OH)D3 levels between patients with and without COVID-19 (p=0.768). Aging and comorbidity prevalence were significantly increased in the COVID-19 than in the non-COVID-19 group (p<0.001; p=0.049). A significant positive correlation was determined between endocan level and serum ferritin concentration in patients with COVID-19 and vitamin D deficiency. A borderline significantly elevated NLR was observed in patients with COVID-19 who were also vitamin D deficient, compared with the similar non-COVID-19 subgroup (p=0.05). In patients with COVID-19 and insufficient vitamin D, levels of 25(OH)D negatively correlated with endocan. Interestingly, COVID-19 patients with diabetes exhibited significantly lower 25(OH)D3 levels compared to non-diabetic patients (p=0.003), along with higher ferritin levels, suggesting a potential association between vitamin D deficiency and diabetes in COVID-19.
These findings contribute to the understanding of the complex interplay between vitamin D status, comorbidities, and COVID-19 outcomes, emphasizing the need for further research to elucidate their underlying mechanisms and clinical implications.
新冠疫情促使人们对严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染的病理生理机制、危险因素及其对疾病严重程度的影响展开深入研究。维生素D因其多效功能，包括免疫调节和抗菌作用，在病毒预防和免疫防御中的潜在作用受到了广泛关注。本研究旨在评估新冠患者与其他病毒性呼吸道感染患者的血清25(OH)D3水平，并评估维生素D水平与症状、临床特征、合并症存在情况及实验室检查结果之间的关联。
该研究纳入了78名因新冠（52例）或其他病毒性呼吸道感染（26例）入院的患者。分析了常规血液生物标志物、炎症标志物、内皮功能障碍标志物及血清25(OH)D3，并根据维生素D水平和合并症情况对患者进行分类。
大多数患者的维生素D水平<30 ng/mL，新冠患者与非新冠患者的25(OH)D3水平无显著差异（p = 0.768）。与非新冠组相比，新冠组患者的年龄和合并症患病率显著升高（p<0.001；p = 0.049）。在新冠合并维生素D缺乏的患者中，内脂素水平与血清铁蛋白浓度之间存在显著正相关。与类似的非新冠亚组相比，新冠合并维生素D缺乏的患者中性粒细胞与淋巴细胞比值（NLR）略有显著升高（p = 0.05）。在新冠合并维生素D不足的患者中，25(OH)D水平与内脂素呈负相关。有趣的是，与非糖尿病患者相比，新冠合并糖尿病的患者25(OH)D3水平显著降低（p = 0.003），同时铁蛋白水平更高，这表明新冠患者中维生素D缺乏与糖尿病之间可能存在关联。
这些发现有助于理解维生素D状态、合并症与新冠结局之间的复杂相互作用，强调需要进一步研究以阐明其潜在机制和临床意义。
