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COVID kids were more likely to have a poor VDR (4.3 X), than low Vitamin D (2.6 X) – Sept 2022

Vitamin D deficiency and vitamin D receptor FokI polymorphism as risk factors for COVID-19

Pediatr Res. 2022 Sep 9. doi: 10.1038/s41390-022-02275-6

Nancy M S Zeidan 1 , Hanan M Abd El Lateef 2 , Dalia M Selim 2 , Suzan A Razek 2 , Ghada A B Abd-Elrehim 3 , Mohamed Nashat 4 , Noha ElGyar 5 , Nevin M Waked 6 , Attia A Soliman 7 , Ahmed A Elhewala 7 , Mohamed M M Shehab 7 , Ahmed A A Ibraheem 7 , Hassan Shehata 7 , Yousif M Yousif 7 , Nagwa E Akeel 7 , Mustafa I A Hashem 7 , Amani A Ahmed 7 , Ahmed A Emam 8 , Mohamed M Abdelmohsen 9 , Mohamed F Ahmed 9 , Ahmed S E Saleh 10 , Heba H Eltrawy 11 , Gehan H Shahin 12 , Rehab M Nabil 13 , Thoraya A Hosny 13 , Mohamed R Abdelhamed 14 , Mona R Afify 15 , Mohanned T Alharbi 15 , Mohammed K Nagshabandi 15 , Muyassar K Tarabulsi 15 , Sherif F Osman 16 , Amal S M Abd-Elrazek 17 , Manal M Rashad 18 , Sonya A A El-Gaaly 19 , Said A B Gad 20 , Mohamed Y Mohamed 21 , Khalil Abdelkhalek 1 , Aly A Yousef 22

Background: Given the sparse data on vitamin D status in pediatric COVID-19, we investigated whether vitamin D deficiency could be a risk factor for susceptibility to COVID-19 in Egyptian children and adolescents. We also investigated whether vitamin D receptor (VDR) FokI polymorphism could be a genetic marker for COVID-19 susceptibility.

Methods: One hundred and eighty patients diagnosed to have COVID-19 and 200 matched control children and adolescents were recruited. Patients were laboratory confirmed as SARS-CoV-2 positive by real-time RT-PCR. All participants were genotyped for VDR Fok1 polymorphism by RT-PCR. Vitamin D status was defined as sufficient for serum 25(OH) D at least 30 ng/mL, insufficient at 21-29 ng/mL, deficient at <20 ng/mL.

Results: Ninety-four patients (52%) had low vitamin D levels with 74 (41%) being deficient and 20 (11%) had vitamin D insufficiency. Vitamin D deficiency was associated with 2.6-fold increased risk for COVID-19 (OR = 2.6; [95% CI 1.96-4.9]; P = 0.002. The FokI FF genotype was significantly more represented in patients compared to control group (OR = 4.05; [95% CI: 1.95-8.55]; P < 0.001).

Conclusions: Vitamin D deficiency and VDR Fok I polymorphism may constitute independent risk factors for susceptibility to COVID-19 in Egyptian children and adolescents.

Impact: Vitamin D deficiency could be a modifiable risk factor for COVID-19 in children and adolescents because of its immune-modulatory action. To our knowledge, ours is the first such study to investigate the VDR Fok I polymorphism in Caucasian children and adolescents with COVID-19. Vitamin D deficiency and the VDR Fok I polymorphism may constitute independent risk factors for susceptibility to COVID-19 in Egyptian children and adolescents. Clinical trials should be urgently conducted to test for causality and to evaluate the efficacy of vitamin D supplementation for prophylaxis and treatment of COVID-19 taking into account the VDR polymorphisms.

Case definition

One hundred and eighty patients aged <19 years who were diagnosed to have COVID-19 at the study hospitals were recruited. All patients were laboratory confirmed as SARS-CoV-2 positive by real-time reverse transcriptase polymerase chain reaction (RT-PCR) assay of nasopharyngeal swab specimens.
Patients' COVID-19 illness severity was categorized into moderate, severe, and critical subgroups according to the recently published classification by Chen et al.20
No asymptomatic or mild cases were seen among our cohort.

  • (I) Moderate: included (134) cases presented with pneumonia (lower respiratory symptoms plus fever >38 °C and age-specific tachypnea);
  • (II) Severe COVID-19: included (31) cases who rapidly develop dyspnea, hypoxia (arterial oxygen saturation <93%), dehydration with feeding difficulty, elevated liver enzymes, disturbed consciousness, coagulation dysfunction;
  • (III) Critically ill cases: included (15) patients who required intensive care unit (ICU) monitoring for acute respiratory failure (ARF), mechanical ventilation (partial arterial oxygen pressure/fraction of inspired oxygen PaO2/FiO2 ratio <300 despite oxygen therapy), septic shock, or organ failure.

Patients were admitted within 72 h from onset of fever and cough. Pulmonary high-resolution computed tomographic images were routinely performed for all patients and evaluated by two experienced radiologists (S.F.O. and A.S.M.) who were blinded to the patients' clinical data.

Control group

Two hundred healthy children and adolescents of matched age, sex, and season at enrollment who underwent pre-operative assessment for elective surgery at the study hospitals were enrolled as a control group (all tested negative for SARS-Cov2 by RT-PCR and had negative anti-N antibodies test for SARS-Cov2).
All patients and control subjects belong to the same ethnic group: African Caucasian.

Exclusion criteria

Patients with obesity, malnutrition, immunodeficiency, congenital heart disease, malignancy, metabolic diseases, autoimmune disorders, or any chronic debilitating disease were excluded. Those who received vitamin D, calcium, multi-vitamin, or mineral supplementation during the previous 6 months were also excluded.
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VitaminDWiki - 30 studies in both categories Virus and VDR

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VitaminDWiki – COVID-19 treated by Vitamin D - studies, reports, videos

As of Nov 25, 2022, the VitaminDWiki COVID page had:  19 trial results,   37 meta-analyses and reviews,   Mortality studies   see related:   Governments,   HealthProblems,   Hospitals,  Dark Skins,   26 risk factors are ALL associated with low Vit D,   Recent Virus pages   Fight COVID-19 with 50K Vit D weekly   Vaccines   Take lots of Vitamin D at first signs of COVID   116 COVID Clinical Trials using Vitamin D (08/2022)
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VitaminDWiki - Vitamin D Receptor activation can be increased in 14 ways

Resveratrol,  Omega-3,  MagnesiumZinc,   Quercetin,   non-daily Vit D,  Curcumin, intense exercise, Butyrate   Ginger,   Essential oils, etc  Note: The founder of VitaminDWiki uses 10 of the 14 known VDR activators

Diseases associated with a poor Vitamin D Receptor

Increased risk associated with a poor Vitamin D Receptor
   Note: Some diseases reduce VDR activation
those with a * are known to decrease activation

Health Problem
50Lyme Disease *
28Leprosy - another says 3X
15Chronic Heart Failure
15Temporary hair loss
14,7Childhood solid cancers
14Hand, Foot, and Mouth disease
11Metabolic Syndrome
9.6Chronic Periodontitis
   and smoke
8Juvenile Rheumatoid Arthritis
7.6Crohn's disease
7.5Respiratory Tract Infections
5.8Low back pain in athletes
5 Respiratory Distress in preemies
5Ulcerative Colitis
5Coronary Artery Disease
5Asthma Child see also 1.3, 2.0 and 3.6
4.6Breast Cancer * 16.9 X another study
4Polycystic ovary syndrome
3.6 Pneumonia - children
3.3 Pre-term birth
3.1 Colon Cancer survival
3 Multiple Sclerosis
3 Waist size
3 Ischemic Stroke
3Gestational Diabetes
2.9Hand, Foot, Mouth Disease
2.8Osteoporosis & COPD
2.7Gastric Cancer
2.6Lupus in children
2.5 Lumbar Disc Degeneration
2.4Lung Cancer
2.2Juvenile idiopathic arthritis
2.1Adolescent idiopathic scoliosis in Asians
2Diabetic Retinopathy
2 Wheezing/Asthma see also 5X
2 Melanoma   Non-melanoma Skin Cancers
1.9Uterine Fibroids
1.9Early tooth decay
1.8Diabetic nephropathy
1.8Sleep Apnea
1.6Diabetes - Type I
1.6Prostate Cancer while black
1.5 Diabetes -Type II
1.4Graves Disease
1.4 Rheumatoid arthritis
1.3Childhood asthma see also 5X
1.3Psoriasis in Caucasians
?? Rickets - Vitamin D resistant
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