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09 13, 2023;20 (1): 212.

Vitamin D status in hospitalized COVID‑19 patients is associated with disease severity and IL-5 production.

Yali Qiu, Wuping Bao, Xue Tian, Yingying Zhang, Yilin Pan, Guogang Xie, Aihua Bao, Dongning Yin, Min Zhang, Yan Zhou
Author Information
  1. Yali Qiu: Department of Respiratory and Critical Care Medicine, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.
  2. Wuping Bao: Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  3. Xue Tian: Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  4. Yingying Zhang: Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  5. Yilin Pan: Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  6. Guogang Xie: Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  7. Aihua Bao: Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  8. Dongning Yin: Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
  9. Min Zhang: Department of Respiratory and Critical Care Medicine, Shanghai General Hospital of Nanjing Medical University, Shanghai, China. maggie_zhangmin@163.com.
  10. Yan Zhou: Department of Respiratory and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. zhouyan790304@163.com.
PMID: 37705107 DOI: 10.1186/s12985-023-02165-1

Abstract

BACKGROUND: 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.
METHODS: 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.
RESULTS: 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.
CONCLUSIONS: 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.

Keywords

25-hydroxyvitamin D COVID-19 IL-5 SARS-CoV-2 infection Vitamin D

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MeSH Term

Humans
COVID-19
Cytokines
Interleukin-5
Patient Acuity
Retrospective Studies
Vitamin D

Chemicals

Cytokines
Interleukin-5
Vitamin D
IL5 protein, human
Journal Article Research Support, Non-U.S. Gov't
Article has an altmetric score of 28

Word Cloud

Created with Highcharts 10.0.0DOHCOVID-1925patientslevelsIL-5diseaseseveritystatusserumP < 005relationshiphospitalizedgroupsgroupmechanismsstudy25-hydroxyvitaminpotentialthree1Serumcytokineslowergeneralodds95%confidenceinterval:P = 0riskmortalitypredictivecombinedEoscorrelatednegativelyexpressionr=-0countsVitaminBACKGROUND:manystudiesvitamincoronavirus2019resultsmattersdebateremainunknownpresentperformedassessimpact[25D]identifyalterationsMETHODS:total399recruitedcentersDecember192022February2023MedicalhistorylaboratoryexaminationradiologicdataretrospectivelycollecteddividedfourbaseddeterminedelectrochemiluminescencemethoddetectedflowcytometrycorrelationassessedRESULTS:LevelssignificantlydeceasedcriticalsignificantdifferencessevereP > 0ratio = 09860973-0998024ratio = 1239104-139104independentfactorsuponadmissionablepredictvalueevenhighereosinophilcountCirculating262001positivelylinkedCD8Tcell121CONCLUSIONS:foundidentifiedfactorrecognizingmechanismworthexplorationCOVID‑19associatedproductionSARS-CoV-2infection

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