Vitamin D Serum Levels in Subjects Tested for SARS-CoV-2: What Are the Differences among Acute, Healed, and Negative COVID-19 Patients? A Multicenter Real-Practice Study
Nutrients 2021, 13(11), 3932; https://doi.org/10.3390/nu13113932
by Luca Gallelli 1,‡ORCID,Gaia Chiara Mannino 2,‡ORCID,Filippo Luciani 3,Alessandro de Sire 4,*ORCID,Elettra Mancuso 2ORCID,Pietro Gangemi 5,Lucio Cosco 6,Giuseppe Monea 2ORCID,Carolina Averta 2,Pasquale Minchella 7,Manuela Colosimo 7,Lucia Muraca 8,Federico Longhini 9,Antonio Ammendolia 4ORCID,Francesco Andreozzi 2,*ORCID,Giovambattista De Sarro 1,G&P Working Group † andErika Cione 10ORCID
Vitamin D might play a role in counteracting COVID-19, albeit strong evidence is still lacking in the literature. The present multicenter real-practice study aimed to evaluate the differences of 25(OH)D3 serum levels in adults tested for SARS-CoV-2 (acute COVID-19 patients, subjects healed from COVID-19, and non-infected ones) recruited over a 6-month period (March–September 2021). In a sample of 117 subjects, a statistically significant difference was found, with
- acute COVID-19 patients demonstrating the lowest levels of serum 25(OH)D3 (9.63 ± 8.70 ng/mL),
- significantly lower than values reported by no-COVID-19 patients (15.96 ± 5.99 ng/mL, p = 0.0091) and
- healed COVID-19 patients (11.52 ± 4.90 ng/mL, p > 0.05).
Male gender across the three groups displayed unfluctuating 25(OH)D3 levels, hinting at an inability to ensure adequate levels of the active vitamin D3 form (1α,25(OH)2D3). As a secondary endpoint, we assessed the correlation between serum 25(OH)D3 levels and pro-inflammatory cytokine interleukin-6 (IL-6) in patients with extremely low serum 25(OH)D3 levels (<1 ng/mL) and in a subset supplemented with 1α,25(OH)2D3. Although patients with severe hypovitaminosis-D showed no significant increase in IL-6 levels, acute COVID-19 patients manifested high circulating IL-6 at admission (females = 127.64 ± 22.24 pg/mL, males = 139.28 ± 48.95 ng/mL) which dropped drastically after the administration of 1α,25(OH)2D3 (1.84 ± 0.77 pg/mL and 2.65 ± 0.92 ng/mL, respectively).
Taken together, these findings suggest that an administration of 1α,25(OH)2D3 might be helpful for treating male patients with an acute COVID-19 infection. Further studies on rapid correction of vitamin D deficiency with fast acting metabolites are warranted in COVID-19 patients.
Some patients had Vitamin D levels so extremely low as to be normally unmeasurable
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