ABSTRACT
Background: The severe acute respiratory syndrome coronavirus 2 (SARS-COV2) viruses using angiotensin-converting enzyme 2 (ACE2) receptors, to enter human cells, these receptors are highly expressed in the lung alveolar cells, vascular endothelium, cardiac myocytes, and other cells. Inadequate vitamin D levels in the blood have been linked to a higher risk of COVID-19 severity. Objective: To determine the association between Vitamin D level and severity of COVID-19 infection. Materials and Method: A cross sectional study was conducted at Thumbay Hospital, Ajman, UAE. Enrolled 70 COVID-19 positive hospitalized patients with age group ≥ 18 years old of both genders. Patients taking vitamin D supplements were excluded from the study. The biochemical analysis for the collected blood samples was performed on the automated analyzer and assessed for significance analysis. Result: There is a statistically significant correlation between Vitamin D levels and disease severity (p < 0.05) as determined by Pearson's Chi-square test. Independent t-test shown that there is a statistically significant difference with regards to gender, age groups, and co morbidity (p < 0.05). Pearson's correlation revealed a moderate, positive correlation between Vitamin D levels and the severity of COVID-19 infection, which was statistically significant. Conclusion: Vitamin D levels affect COVID-19 severity, with more severe cases showing vitamin D levels lower than normal when compared to severe cases with sufficient vitamin D levels. Furthermore, blood vitamin D levels are linked to age groups in COVID-19 patients. Vitamin D insufficiency and deficiency, on the other hand, was not linked to a higher risk of death prognosis, and co morbidities. © Sabir SM, Ismail MK, Ibrahim EH, Khan ZA.
ABSTRACT
Background: The administration of modified immune cells (MIC) prior to kidney transplantation led to specific immunosuppression against the allogeneic donor and a significant increase in regulatory B lymphocytes (Breg) (Morath et al., J Clin Invest 2020). We now wanted to investigate how this approach affects the clinical course of treated patients. Method(s): Clinical results of ten patients from a phase I clinical trial who had received MIC infusions before kidney transplantation were compared to results of 15 matched standard-risk recipients. Follow-up was until year five after surgery. Result(s): The 10 MIC patients had an excellent clinical course with stable kidney graft function and showed no donor-specific human leukocyte antigen antibodies (DSA) or acute rejections during follow-up. In contrast, 1 of 15 controls died and 5 of 15 controls developed DSA (log rank P = 0.046) (Figure 1 A, B). While the number of patients with a non-opportunistic infection did not differ significantly between groups (P = 0.36), opportunistic infections were reported more frequently in controls (log rank P = 0.033) (Figure 1 C). Compared to controls, MIC patients were found to have a trend towards a higher COVID-19 anti-S1 IgG index after vaccination with a median of 53 vs. 2 (P = 0.16). Importantly, the four MIC patients who had received the highest MIC cell dose 7 days before surgery and were on low immunosuppression during follow-up, continued to show absent anti-donor T lymphocyte reactivity in vitro and high CD19+CD24hiCD38hi transitional Breg as well as CD19+CD24hiCD27+ memory Breg. Conclusion(s): MIC infusions together with reduced conventional immunosuppression were associated with lower de novo DSA development and lower rates of opportunistic infections. In the future, MIC infusions could contribute to graft protection while reducing the side effects of immunosuppressive therapy. (Figure Presented).