ABSTRACT
Objectives: The immunomodulatory roles of Vitamin D and Vitamin D binding protein (VDBP) are in interest with incidence or outcome of coronavirus disease-2019 (COVID-19). This study aimed to investigate the association between the severity of COVID-19 with VDBP, total 25-hydroxy Vitamin D (25(OH)D), and its metabolites free Vitamin D (VDfree) and bioavailable Vitamin D (VDbio). Methods: Study group consisted of 68 COVID-19 patients and 20 healthy subjects. Patients were subgrouped as asymptotic, mild/moderately pneumonia, or severe pneumonia. Plasma total 25(OH)D was quantitated by liquid chromatography with mass spectrometry and serum VDBP by a polyclonal sandwich enzyme immunoassay. In addition, routinely used laboratory parameters in follow-up were recorded. VDfree and VDbio were calculated using total 25(OH)D, VDBP, and albumin levels. Results: Plasma total 25(OH)D (13.3±5.7 vs. 30.3±13.3 ng/dL), VDfree (2.18 [1.52–3.44] vs. 4.34 [3.74–6.48] pg/mL), and VDbio (1.86 [1.09–2.81] vs. 4.28 [3.45–6.34] nmol/L) levels were lower in COVID-19 patients (p<0.001). Despite the insignificance of 25(OH)D and metabolites between COVID-19 severity subgroups, serum VDBP was highest in mild/ moderately pneumonia (601.8±278.6 ng/mL) and lowest in severe pneumonia (427.9±147.2 ng/mL) (p<0.001). In addition, VDBP was positively correlated with lymphocyte counts (B:87.9, r2=0.068, p=0.031) and negatively correlated with D-Dimer levels (B:−0.024, r2=0.081, p=0.032). Conclusion: COVID-19 patients have lower plasma 25(OH)D levels and lower 25(OH)D metabolites VDfree, VDbio which are physiologically active. In addition, serum VDBP concentrations significantly decrease in critically ill patients which needs further studies to be associated in the etiopathogenesis of the disease severity. [ FROM AUTHOR] Copyright of International Journal of Medical Biochemistry is the property of KARE Publishing and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
BACKGROUND: Diabetes mellitus (DM) increases mortality and morbidity in patients with coronavirus disease (COVID-19). In this study, it was aimed to assess factors influencing on COVID-19 pneumonia in hospitalized patients with diabetes and association with oral anti-diabetic drugs. MATERIALS AND METHODS: This cross-sectional study included 432 patients with type 2 diabetes mellitus diagnosed with COVID-19. Data regarding clinical characteristics, demographic characteristics, intensive care unit (ICU) rate in patients admitted to ICU, laboratory results on day 1 and 7, thoracic computed tomography (CT) findings and oral anti-diabetic drugs used were extracted from medical records. In all patients, 75-days mortality was recorded. Data were assessed independently. RESULTS: There was pneumonia in 386 (89.4%) of 432 patients with diabetes. The risk for pneumonia was markedly higher in patients on DPP-4 inhibitors; however, there was no significant among other oral anti-diabetic groups and subgroups. In addition, elevated CRP was linked to the increased risk for pneumonia. Only patients in the pneumonia group had SGLT-2 inhibitor use. During follow-up, 91 patients died. In Cox regression analysis, low Glasgow Coma Scale score, and increased lactate dehydrogenase levels were identified as significant independent risk factors for mortality. CONCLUSION: The study indicated that DPP-4 inhibitor used and elevated CRP level were associated with pneumonia development. Only patients in the pneumonia group had SGLT-2 inhibitor use. No oral anti-diabetics was found to be associated with COVID-19 related death.