Review the Research<\/p>\n
Get summaries of key research on vitamin D and COVID-19<\/h5><\/div><\/div><\/div><\/div><\/div>\nThe association between vitamin D levels and the clinical severity and inflammation markers in pediatric COVID-19 patients: single-center experience from a pandemic hospital.<\/h1><\/div>Take Home Message<\/span><\/h2><\/div>In this retrospective cohort study of 103 COVID-19 positive pediatric patients aged 1-17 years in Istanbul, Turkey, a deficient serum vitamin D level [<12 ng\/mL (<30 nmol\/l)] was associated with clinical severity and elevated markers of inflammation.<\/p>\n<\/div><\/div><\/div><\/div><\/div>
Results<\/span><\/h2><\/div><\/div><\/div>\n- The prevalence of vitamin D deficiency in the asymptomatic, mild, and moderate-to-severe groups were 17.2%, 35.4%, and 70.6%, respectively.<\/li>\n
- A comparison of patients according to vitamin D levels revealed that 55.8% of the deficient group, 17.1% of the insufficient group, and 15.8% of the sufficient group had a moderate-to-severe clinical course.<\/li>\n
- The moderate-to-severe clinical group had significantly higher inflammation markers (CRP, procalcitonin, fibrinogen, D-dimer) and significantly lower 25 OH vitamin D levels compared to both the mild and asymptomatic groups.<\/li>\n
- The 25 OH vitamin D level was correlated positively with the lymphocyte count, and negatively with age, CRP and fibrinogen levels.<\/li>\n
- In a logistic regression analysis, vitamin D deficiency, D-dimer, and fibrinogen levels on admission were independent predictors of severe clinical course.<\/li>\n<\/ul>\n<\/div><\/div><\/div>
![](\"https:\/\/www.vitamindandme.org\/wp-content\/uploads\/2021\/08\/crop61_The-association-between_iStock-1254992796-300x300.jpg\" "\\"crop61_The")
<\/span><\/div><\/div><\/div><\/div><\/div>Who<\/span><\/h2><\/div>A total of 103 children (54 boys, 52.4%; 49 girls, 47.6%) with a positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction (RT-PCR) test who also had a measured serum vitamin D level (25 OH vit D) were included in this study. The mean age was 12.2\u00b14.92 years, ranging from 1\u201317 years. Patients with comorbidities (e.g., diabetes, asthma, tuberculosis, chronic renal failure), which may affect the clinical course of COVID-19, and those under 1 year of age were excluded from the study.<\/p>\n<\/div><\/div><\/div><\/div><\/div>
Things to Keep in Mind<\/span><\/h2><\/div>\n- This is a single-center study, and the findings may not be attributable to other populations.<\/li>\n
- Genetic variability of ACE2 or the vitamin D receptor may also affect the disease\u2019s course.<\/li>\n
- As the anthropometric measures of all patients were unavailable, the effect of obesity on the clinical course and inflammation markers were not evaluated.<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>
Author\u2019s Conclusions<\/span><\/h2><\/div><\/div><\/div>“<\/span><\/h2><\/div><\/div><\/div>Although the effects of vitamin D on the immune system are quite complex, the available data support that adequate 25 OH vit D levels facilitate the defense process against bacterial and viral infections and prevent hyperinflammation. In this study, it has been shown that the serum vitamin D level was associated with clinical severity and markers of inflammation in children and adolescents with COVID-19. Interestingly, these associations were observed especially when there was a deficiency<\/em> (i.e., 25 OH vit D <12 ng\/mL). Although it has been demonstrated that vitamin D insufficiency<\/em> has a role in bone metabolism, in the present study, vitamin D insufficiency<\/em> was not found to be associated with disease severity or inflammation markers in COVID-19. Lastly, we suggest that considering the ongoing lockdown measures, prophylactic vitamin D supplementation may be considered especially for the adolescent age group during the COVID-19 pandemic as a health policy.<\/p>\n<\/div><\/div><\/div>“<\/span><\/h2><\/div><\/div><\/div><\/div><\/div>Study Design<\/span><\/h2><\/div>\n- Included in this retrospective cohort study were 103 consecutive pediatric cases presenting at Haseki Training and Research Hospital Istanbul, Turkey between March and May 2020 with SARS-CoV-2 infection confirmed by RT-PCR and with measured serum 25 OH vitamin D levels.<\/li>\n
- Clinical data, laboratory, and imaging (chest X-ray and computed tomography) findings on admission were recorded retrospectively. COVID-19 cases were tested for a complete blood count: C-reactive protein (CRP), procalcitonin, fibrinogen, D-dimer, ferritin, calcium, phosphorus, and alkaline phosphatase (ALP).<\/li>\n
- According to the clinical findings, patients were divided into three groups: (1) asymptomatic group: patients who underwent a PCR test due to only contact history without any complaints; (2) mild group: patients with nonspecific symptoms such as cough, fever, malaise, and myalgia; and (3) moderate-to-severe group: patients whose pneumonia was confirmed by physical examination and imaging (chest X-ray and\/or computed tomography) with or without oxygen need. The moderate-to-severe group consisted of hospitalized patients. Asymptomatic and mild cases were followed by telephone or outpatient clinic visits, and none of them had a clinical deterioration.<\/li>\n
- Serum 25 OH vit D levels were measured in hospitalized patients and outpatients. Patients were grouped according to 25 OH vit D serum levels as sufficient [>20 ng\/mL (>50 nmol\/l)], insufficient [12\u201320 ng\/mL (30-50 nmol\/l)], and deficient [<12 ng\/mL (<30 nmol\/l)].<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>
Reference<\/span><\/h2><\/div>Bayramo\u011flu E, Akko\u00e7 G, A\u011fba\u015f A, Akg\u00fcn \u00d6, Yurdakul K, Sel\u00e7uk Duru HN, Elevli M. The association between vitamin D levels and the clinical severity and inflammation markers in pediatric COVID-19 patients: single-center experience from a pandemic hospital. Eur J Pediatr. 2021 Mar 31:1\u20137. doi: 10.1007\/s00431-021-04030-1. Epub ahead of print. PMID: 33788001; PMCID: PMC8009933.<\/p>\n<\/div><\/div><\/div>
The association between vitamin D levels and the clinical severity and inflammation markers in pediatric COVID-19 patients: single-center experience from a pandemic hospital.<\/h1><\/div>Take Home Message<\/span><\/h2><\/div>In this retrospective cohort study of 103 COVID-19 positive pediatric patients aged 1-17 years in Istanbul, Turkey, a deficient serum vitamin D level [<12 ng\/mL (<30 nmol\/l)] was associated with clinical severity and elevated markers of inflammation.<\/p>\n<\/div><\/div><\/div><\/div><\/div>
Results<\/span><\/h2><\/div><\/div><\/div>\n- The prevalence of vitamin D deficiency in the asymptomatic, mild, and moderate-to-severe groups were 17.2%, 35.4%, and 70.6%, respectively.<\/li>\n
- A comparison of patients according to vitamin D levels revealed that 55.8% of the deficient group, 17.1% of the insufficient group, and 15.8% of the sufficient group had a moderate-to-severe clinical course.<\/li>\n
- The moderate-to-severe clinical group had significantly higher inflammation markers (CRP, procalcitonin, fibrinogen, D-dimer) and significantly lower 25 OH vitamin D levels compared to both the mild and asymptomatic groups.<\/li>\n
- The 25 OH vitamin D level was correlated positively with the lymphocyte count, and negatively with age, CRP and fibrinogen levels.<\/li>\n
- In a logistic regression analysis, vitamin D deficiency, D-dimer, and fibrinogen levels on admission were independent predictors of severe clinical course.<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/span><\/div><\/div><\/div><\/div><\/div>
Who<\/span><\/h2><\/div>A total of 103 children (54 boys, 52.4%; 49 girls, 47.6%) with a positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction (RT-PCR) test who also had a measured serum vitamin D level (25 OH vit D) were included in this study. The mean age was 12.2\u00b14.92 years, ranging from 1\u201317 years. Patients with comorbidities (e.g., diabetes, asthma, tuberculosis, chronic renal failure), which may affect the clinical course of COVID-19, and those under 1 year of age were excluded from the study.<\/p>\n<\/div><\/div><\/div><\/div><\/div>
Things to Keep in Mind<\/span><\/h2><\/div>\n- This is a single-center study, and the findings may not be attributable to other populations.<\/li>\n
- Genetic variability of ACE2 or the vitamin D receptor may also affect the disease\u2019s course.<\/li>\n
- As the anthropometric measures of all patients were unavailable, the effect of obesity on the clinical course and inflammation markers were not evaluated.<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>
Author\u2019s Conclusions<\/span><\/h2><\/div><\/div><\/div>“<\/span><\/h2><\/div><\/div><\/div>Although the effects of vitamin D on the immune system are quite complex, the available data support that adequate 25 OH vit D levels facilitate the defense process against bacterial and viral infections and prevent hyperinflammation. In this study, it has been shown that the serum vitamin D level was associated with clinical severity and markers of inflammation in children and adolescents with COVID-19. Interestingly, these associations were observed especially when there was a deficiency<\/em> (i.e., 25 OH vit D <12 ng\/mL). Although it has been demonstrated that vitamin D insufficiency<\/em> has a role in bone metabolism, in the present study, vitamin D insufficiency<\/em> was not found to be associated with disease severity or inflammation markers in COVID-19. Lastly, we suggest that considering the ongoing lockdown measures, prophylactic vitamin D supplementation may be considered especially for the adolescent age group during the COVID-19 pandemic as a health policy.<\/p>\n<\/div><\/div><\/div>“<\/span><\/h2><\/div><\/div><\/div><\/div><\/div>Study Design<\/span><\/h2><\/div>\n- Included in this retrospective cohort study were 103 consecutive pediatric cases presenting at Haseki Training and Research Hospital Istanbul, Turkey between March and May 2020 with SARS-CoV-2 infection confirmed by RT-PCR and with measured serum 25 OH vitamin D levels.<\/li>\n
- Clinical data, laboratory, and imaging (chest X-ray and computed tomography) findings on admission were recorded retrospectively. COVID-19 cases were tested for a complete blood count: C-reactive protein (CRP), procalcitonin, fibrinogen, D-dimer, ferritin, calcium, phosphorus, and alkaline phosphatase (ALP).<\/li>\n
- According to the clinical findings, patients were divided into three groups: (1) asymptomatic group: patients who underwent a PCR test due to only contact history without any complaints; (2) mild group: patients with nonspecific symptoms such as cough, fever, malaise, and myalgia; and (3) moderate-to-severe group: patients whose pneumonia was confirmed by physical examination and imaging (chest X-ray and\/or computed tomography) with or without oxygen need. The moderate-to-severe group consisted of hospitalized patients. Asymptomatic and mild cases were followed by telephone or outpatient clinic visits, and none of them had a clinical deterioration.<\/li>\n
- Serum 25 OH vit D levels were measured in hospitalized patients and outpatients. Patients were grouped according to 25 OH vit D serum levels as sufficient [>20 ng\/mL (>50 nmol\/l)], insufficient [12\u201320 ng\/mL (30-50 nmol\/l)], and deficient [<12 ng\/mL (<30 nmol\/l)].<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>
Reference<\/span><\/h2><\/div>Bayramo\u011flu E, Akko\u00e7 G, A\u011fba\u015f A, Akg\u00fcn \u00d6, Yurdakul K, Sel\u00e7uk Duru HN, Elevli M. The association between vitamin D levels and the clinical severity and inflammation markers in pediatric COVID-19 patients: single-center experience from a pandemic hospital. Eur J Pediatr. 2021 Mar 31:1\u20137. doi: 10.1007\/s00431-021-04030-1. Epub ahead of print. PMID: 33788001; PMCID: PMC8009933.<\/p>\n<\/div><\/div><\/div>
Take Home Message<\/span><\/h2><\/div>In this retrospective cohort study of 103 COVID-19 positive pediatric patients aged 1-17 years in Istanbul, Turkey, a deficient serum vitamin D level [<12 ng\/mL (<30 nmol\/l)] was associated with clinical severity and elevated markers of inflammation.<\/p>\n<\/div><\/div><\/div><\/div><\/div>
Results<\/span><\/h2><\/div><\/div><\/div>\n- The prevalence of vitamin D deficiency in the asymptomatic, mild, and moderate-to-severe groups were 17.2%, 35.4%, and 70.6%, respectively.<\/li>\n
- A comparison of patients according to vitamin D levels revealed that 55.8% of the deficient group, 17.1% of the insufficient group, and 15.8% of the sufficient group had a moderate-to-severe clinical course.<\/li>\n
- The moderate-to-severe clinical group had significantly higher inflammation markers (CRP, procalcitonin, fibrinogen, D-dimer) and significantly lower 25 OH vitamin D levels compared to both the mild and asymptomatic groups.<\/li>\n
- The 25 OH vitamin D level was correlated positively with the lymphocyte count, and negatively with age, CRP and fibrinogen levels.<\/li>\n
- In a logistic regression analysis, vitamin D deficiency, D-dimer, and fibrinogen levels on admission were independent predictors of severe clinical course.<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/span><\/div><\/div><\/div><\/div><\/div>
Who<\/span><\/h2><\/div>A total of 103 children (54 boys, 52.4%; 49 girls, 47.6%) with a positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction (RT-PCR) test who also had a measured serum vitamin D level (25 OH vit D) were included in this study. The mean age was 12.2\u00b14.92 years, ranging from 1\u201317 years. Patients with comorbidities (e.g., diabetes, asthma, tuberculosis, chronic renal failure), which may affect the clinical course of COVID-19, and those under 1 year of age were excluded from the study.<\/p>\n<\/div><\/div><\/div><\/div><\/div>
Things to Keep in Mind<\/span><\/h2><\/div>\n- This is a single-center study, and the findings may not be attributable to other populations.<\/li>\n
- Genetic variability of ACE2 or the vitamin D receptor may also affect the disease\u2019s course.<\/li>\n
- As the anthropometric measures of all patients were unavailable, the effect of obesity on the clinical course and inflammation markers were not evaluated.<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>
Author\u2019s Conclusions<\/span><\/h2><\/div><\/div><\/div>“<\/span><\/h2><\/div><\/div><\/div>Although the effects of vitamin D on the immune system are quite complex, the available data support that adequate 25 OH vit D levels facilitate the defense process against bacterial and viral infections and prevent hyperinflammation. In this study, it has been shown that the serum vitamin D level was associated with clinical severity and markers of inflammation in children and adolescents with COVID-19. Interestingly, these associations were observed especially when there was a deficiency<\/em> (i.e., 25 OH vit D <12 ng\/mL). Although it has been demonstrated that vitamin D insufficiency<\/em> has a role in bone metabolism, in the present study, vitamin D insufficiency<\/em> was not found to be associated with disease severity or inflammation markers in COVID-19. Lastly, we suggest that considering the ongoing lockdown measures, prophylactic vitamin D supplementation may be considered especially for the adolescent age group during the COVID-19 pandemic as a health policy.<\/p>\n<\/div><\/div><\/div>“<\/span><\/h2><\/div><\/div><\/div><\/div><\/div>Study Design<\/span><\/h2><\/div>\n- Included in this retrospective cohort study were 103 consecutive pediatric cases presenting at Haseki Training and Research Hospital Istanbul, Turkey between March and May 2020 with SARS-CoV-2 infection confirmed by RT-PCR and with measured serum 25 OH vitamin D levels.<\/li>\n
- Clinical data, laboratory, and imaging (chest X-ray and computed tomography) findings on admission were recorded retrospectively. COVID-19 cases were tested for a complete blood count: C-reactive protein (CRP), procalcitonin, fibrinogen, D-dimer, ferritin, calcium, phosphorus, and alkaline phosphatase (ALP).<\/li>\n
- According to the clinical findings, patients were divided into three groups: (1) asymptomatic group: patients who underwent a PCR test due to only contact history without any complaints; (2) mild group: patients with nonspecific symptoms such as cough, fever, malaise, and myalgia; and (3) moderate-to-severe group: patients whose pneumonia was confirmed by physical examination and imaging (chest X-ray and\/or computed tomography) with or without oxygen need. The moderate-to-severe group consisted of hospitalized patients. Asymptomatic and mild cases were followed by telephone or outpatient clinic visits, and none of them had a clinical deterioration.<\/li>\n
- Serum 25 OH vit D levels were measured in hospitalized patients and outpatients. Patients were grouped according to 25 OH vit D serum levels as sufficient [>20 ng\/mL (>50 nmol\/l)], insufficient [12\u201320 ng\/mL (30-50 nmol\/l)], and deficient [<12 ng\/mL (<30 nmol\/l)].<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>
Reference<\/span><\/h2><\/div>Bayramo\u011flu E, Akko\u00e7 G, A\u011fba\u015f A, Akg\u00fcn \u00d6, Yurdakul K, Sel\u00e7uk Duru HN, Elevli M. The association between vitamin D levels and the clinical severity and inflammation markers in pediatric COVID-19 patients: single-center experience from a pandemic hospital. Eur J Pediatr. 2021 Mar 31:1\u20137. doi: 10.1007\/s00431-021-04030-1. Epub ahead of print. PMID: 33788001; PMCID: PMC8009933.<\/p>\n<\/div><\/div><\/div>
In this retrospective cohort study of 103 COVID-19 positive pediatric patients aged 1-17 years in Istanbul, Turkey, a deficient serum vitamin D level [<12 ng\/mL (<30 nmol\/l)] was associated with clinical severity and elevated markers of inflammation.<\/p>\n<\/div><\/div><\/div><\/div><\/div>
Results<\/span><\/h2><\/div><\/div><\/div>\n- The prevalence of vitamin D deficiency in the asymptomatic, mild, and moderate-to-severe groups were 17.2%, 35.4%, and 70.6%, respectively.<\/li>\n
- A comparison of patients according to vitamin D levels revealed that 55.8% of the deficient group, 17.1% of the insufficient group, and 15.8% of the sufficient group had a moderate-to-severe clinical course.<\/li>\n
- The moderate-to-severe clinical group had significantly higher inflammation markers (CRP, procalcitonin, fibrinogen, D-dimer) and significantly lower 25 OH vitamin D levels compared to both the mild and asymptomatic groups.<\/li>\n
- The 25 OH vitamin D level was correlated positively with the lymphocyte count, and negatively with age, CRP and fibrinogen levels.<\/li>\n
- In a logistic regression analysis, vitamin D deficiency, D-dimer, and fibrinogen levels on admission were independent predictors of severe clinical course.<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/span><\/div><\/div><\/div><\/div><\/div>
Who<\/span><\/h2><\/div>A total of 103 children (54 boys, 52.4%; 49 girls, 47.6%) with a positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction (RT-PCR) test who also had a measured serum vitamin D level (25 OH vit D) were included in this study. The mean age was 12.2\u00b14.92 years, ranging from 1\u201317 years. Patients with comorbidities (e.g., diabetes, asthma, tuberculosis, chronic renal failure), which may affect the clinical course of COVID-19, and those under 1 year of age were excluded from the study.<\/p>\n<\/div><\/div><\/div><\/div><\/div>
Things to Keep in Mind<\/span><\/h2><\/div>\n- This is a single-center study, and the findings may not be attributable to other populations.<\/li>\n
- Genetic variability of ACE2 or the vitamin D receptor may also affect the disease\u2019s course.<\/li>\n
- As the anthropometric measures of all patients were unavailable, the effect of obesity on the clinical course and inflammation markers were not evaluated.<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>
Author\u2019s Conclusions<\/span><\/h2><\/div><\/div><\/div>“<\/span><\/h2><\/div><\/div><\/div>Although the effects of vitamin D on the immune system are quite complex, the available data support that adequate 25 OH vit D levels facilitate the defense process against bacterial and viral infections and prevent hyperinflammation. In this study, it has been shown that the serum vitamin D level was associated with clinical severity and markers of inflammation in children and adolescents with COVID-19. Interestingly, these associations were observed especially when there was a deficiency<\/em> (i.e., 25 OH vit D <12 ng\/mL). Although it has been demonstrated that vitamin D insufficiency<\/em> has a role in bone metabolism, in the present study, vitamin D insufficiency<\/em> was not found to be associated with disease severity or inflammation markers in COVID-19. Lastly, we suggest that considering the ongoing lockdown measures, prophylactic vitamin D supplementation may be considered especially for the adolescent age group during the COVID-19 pandemic as a health policy.<\/p>\n<\/div><\/div><\/div>“<\/span><\/h2><\/div><\/div><\/div><\/div><\/div>Study Design<\/span><\/h2><\/div>\n- Included in this retrospective cohort study were 103 consecutive pediatric cases presenting at Haseki Training and Research Hospital Istanbul, Turkey between March and May 2020 with SARS-CoV-2 infection confirmed by RT-PCR and with measured serum 25 OH vitamin D levels.<\/li>\n
- Clinical data, laboratory, and imaging (chest X-ray and computed tomography) findings on admission were recorded retrospectively. COVID-19 cases were tested for a complete blood count: C-reactive protein (CRP), procalcitonin, fibrinogen, D-dimer, ferritin, calcium, phosphorus, and alkaline phosphatase (ALP).<\/li>\n
- According to the clinical findings, patients were divided into three groups: (1) asymptomatic group: patients who underwent a PCR test due to only contact history without any complaints; (2) mild group: patients with nonspecific symptoms such as cough, fever, malaise, and myalgia; and (3) moderate-to-severe group: patients whose pneumonia was confirmed by physical examination and imaging (chest X-ray and\/or computed tomography) with or without oxygen need. The moderate-to-severe group consisted of hospitalized patients. Asymptomatic and mild cases were followed by telephone or outpatient clinic visits, and none of them had a clinical deterioration.<\/li>\n
- Serum 25 OH vit D levels were measured in hospitalized patients and outpatients. Patients were grouped according to 25 OH vit D serum levels as sufficient [>20 ng\/mL (>50 nmol\/l)], insufficient [12\u201320 ng\/mL (30-50 nmol\/l)], and deficient [<12 ng\/mL (<30 nmol\/l)].<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>
Reference<\/span><\/h2><\/div>Bayramo\u011flu E, Akko\u00e7 G, A\u011fba\u015f A, Akg\u00fcn \u00d6, Yurdakul K, Sel\u00e7uk Duru HN, Elevli M. The association between vitamin D levels and the clinical severity and inflammation markers in pediatric COVID-19 patients: single-center experience from a pandemic hospital. Eur J Pediatr. 2021 Mar 31:1\u20137. doi: 10.1007\/s00431-021-04030-1. Epub ahead of print. PMID: 33788001; PMCID: PMC8009933.<\/p>\n<\/div><\/div><\/div>
- \n
- The prevalence of vitamin D deficiency in the asymptomatic, mild, and moderate-to-severe groups were 17.2%, 35.4%, and 70.6%, respectively.<\/li>\n
- A comparison of patients according to vitamin D levels revealed that 55.8% of the deficient group, 17.1% of the insufficient group, and 15.8% of the sufficient group had a moderate-to-severe clinical course.<\/li>\n
- The moderate-to-severe clinical group had significantly higher inflammation markers (CRP, procalcitonin, fibrinogen, D-dimer) and significantly lower 25 OH vitamin D levels compared to both the mild and asymptomatic groups.<\/li>\n
- The 25 OH vitamin D level was correlated positively with the lymphocyte count, and negatively with age, CRP and fibrinogen levels.<\/li>\n
- In a logistic regression analysis, vitamin D deficiency, D-dimer, and fibrinogen levels on admission were independent predictors of severe clinical course.<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/span><\/div><\/div><\/div><\/div><\/div>
Who<\/span><\/h2><\/div>
A total of 103 children (54 boys, 52.4%; 49 girls, 47.6%) with a positive SARS-CoV-2 reverse transcriptase-polymerase chain reaction (RT-PCR) test who also had a measured serum vitamin D level (25 OH vit D) were included in this study. The mean age was 12.2\u00b14.92 years, ranging from 1\u201317 years. Patients with comorbidities (e.g., diabetes, asthma, tuberculosis, chronic renal failure), which may affect the clinical course of COVID-19, and those under 1 year of age were excluded from the study.<\/p>\n<\/div><\/div><\/div><\/div><\/div>
Things to Keep in Mind<\/span><\/h2><\/div>
- \n
- This is a single-center study, and the findings may not be attributable to other populations.<\/li>\n
- Genetic variability of ACE2 or the vitamin D receptor may also affect the disease\u2019s course.<\/li>\n
- As the anthropometric measures of all patients were unavailable, the effect of obesity on the clinical course and inflammation markers were not evaluated.<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>
Author\u2019s Conclusions<\/span><\/h2><\/div><\/div><\/div>
“<\/span><\/h2><\/div><\/div><\/div>
Although the effects of vitamin D on the immune system are quite complex, the available data support that adequate 25 OH vit D levels facilitate the defense process against bacterial and viral infections and prevent hyperinflammation. In this study, it has been shown that the serum vitamin D level was associated with clinical severity and markers of inflammation in children and adolescents with COVID-19. Interestingly, these associations were observed especially when there was a deficiency<\/em> (i.e., 25 OH vit D <12 ng\/mL). Although it has been demonstrated that vitamin D insufficiency<\/em> has a role in bone metabolism, in the present study, vitamin D insufficiency<\/em> was not found to be associated with disease severity or inflammation markers in COVID-19. Lastly, we suggest that considering the ongoing lockdown measures, prophylactic vitamin D supplementation may be considered especially for the adolescent age group during the COVID-19 pandemic as a health policy.<\/p>\n<\/div><\/div><\/div>
“<\/span><\/h2><\/div><\/div><\/div><\/div><\/div>
Study Design<\/span><\/h2><\/div>
- \n
- Included in this retrospective cohort study were 103 consecutive pediatric cases presenting at Haseki Training and Research Hospital Istanbul, Turkey between March and May 2020 with SARS-CoV-2 infection confirmed by RT-PCR and with measured serum 25 OH vitamin D levels.<\/li>\n
- Clinical data, laboratory, and imaging (chest X-ray and computed tomography) findings on admission were recorded retrospectively. COVID-19 cases were tested for a complete blood count: C-reactive protein (CRP), procalcitonin, fibrinogen, D-dimer, ferritin, calcium, phosphorus, and alkaline phosphatase (ALP).<\/li>\n
- According to the clinical findings, patients were divided into three groups: (1) asymptomatic group: patients who underwent a PCR test due to only contact history without any complaints; (2) mild group: patients with nonspecific symptoms such as cough, fever, malaise, and myalgia; and (3) moderate-to-severe group: patients whose pneumonia was confirmed by physical examination and imaging (chest X-ray and\/or computed tomography) with or without oxygen need. The moderate-to-severe group consisted of hospitalized patients. Asymptomatic and mild cases were followed by telephone or outpatient clinic visits, and none of them had a clinical deterioration.<\/li>\n
- Serum 25 OH vit D levels were measured in hospitalized patients and outpatients. Patients were grouped according to 25 OH vit D serum levels as sufficient [>20 ng\/mL (>50 nmol\/l)], insufficient [12\u201320 ng\/mL (30-50 nmol\/l)], and deficient [<12 ng\/mL (<30 nmol\/l)].<\/li>\n<\/ul>\n<\/div><\/div><\/div><\/div><\/div>
Reference<\/span><\/h2><\/div>
Bayramo\u011flu E, Akko\u00e7 G, A\u011fba\u015f A, Akg\u00fcn \u00d6, Yurdakul K, Sel\u00e7uk Duru HN, Elevli M. The association between vitamin D levels and the clinical severity and inflammation markers in pediatric COVID-19 patients: single-center experience from a pandemic hospital. Eur J Pediatr. 2021 Mar 31:1\u20137. doi: 10.1007\/s00431-021-04030-1. Epub ahead of print. PMID: 33788001; PMCID: PMC8009933.<\/p>\n<\/div><\/div><\/div>