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Vitamin D status in hospitalized COVID‑19 patients is associated with disease severity and IL-5 production
Yali Qiu1,2, Wuping Bao3, Xue Tian3
1Department of Respiratory and Critical Care Medicine, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.
Insights
Low vitamin D levels are linked to severe COVID-19 outcomes. This study found that serum 25-hydroxyvitamin D [25(OH)D] levels, combined with IL-5 and eosinophil counts, can predict COVID-19 mortality risk.
Area of Science:
- Immunology
- Endocrinology
- Infectious Diseases
Background:
- Conflicting evidence exists regarding the association between vitamin D and COVID-19 severity.
- The underlying mechanisms linking vitamin D status to COVID-19 outcomes remain unclear.
Purpose of the Study:
- To investigate the impact of serum 25-hydroxyvitamin D [25(OH)D] levels on COVID-19 disease severity in hospitalized patients.
- To explore potential mechanisms contributing to alterations in 25(OH)D levels during COVID-19 infection.
Main Methods:
- Retrospective analysis of 399 hospitalized COVID-19 patients.
- Measurement of serum 25(OH)D levels and cytokine profiles (including IL-5).
- Correlation analysis between 25(OH)D, cytokines, and disease severity.
Main Results:
- Significantly lower 25(OH)D levels were observed in deceased and critical COVID-19 patients compared to milder cases.
- Serum 25(OH)D and IL-5 levels were identified as independent risk factors for COVID-19 severity.
- 25(OH)D levels negatively correlated with IL-5 expression and positively with CD8+ T cell counts.
Conclusions:
- Serum 25(OH)D status, IL-5 levels, and eosinophil counts can serve as predictive factors for COVID-19 mortality risk.
- A negative correlation between 25(OH)D and IL-5 suggests a potential mechanistic link requiring further investigation.
Background:
There are many studies on the relationship between vitamin D and coronavirus disease 2019 (COVID-19), while the results are matters of debate and the mechanisms remain unknown. The present study was performed to assess the impact of serum 25-hydroxyvitamin D [25(OH)D] levels on the severity of disease in hospitalized COVID-19 patients and identify potential mechanisms of 25(OH)D alterations.
Methods:
A total of 399 hospitalized COVID-19 patients were recruited from three centers between December 19, 2022, and February 1, 2023. Medical history, laboratory examination, and radiologic data were retrospectively collected. The patients were divided into four groups based on disease severity. Serum 25(OH)D levels in the patients were determined by the electrochemiluminescence method and cytokines were detected by flow cytometry. The relationship between serum 25(OH)D status and the severity of COVID-19, and the correlation between 25(OH)D levels and cytokines in COVID-19 patients were assessed.
Results:
Levels of 25(OH)D were significantly lower in the deceased group than in the other three groups (P < 0.05), and lower in the critical group than in the general group (P < 0.05). There were no significant differences in the 25(OH)D levels between the general and severe groups (P > 0.05). The levels of 25(OH)D (odds ratio = 0.986, 95% confidence interval: 0.973-0.998, P = 0.024) and IL-5 (odds ratio = 1.239, 95% confidence interval: 1.104-1.391, P = 0.04) were independent risk factors for the severity of COVID-19 disease upon admission. Serum 25(OH)D levels were able to predict the mortality of patients with COVID-19, and the predictive value was even higher when combined with IL-5 levels and eosinophil (Eos) count. Circulating 25(OH)D status correlated negatively with the expression of IL-5 (r=-0.262, P < 0.001) and was positively linked with CD8+ T cell counts (r=-0.121, P < 0.05) in patients with COVID-19.
Conclusions:
This study found that the serum 25(OH)D status combined with IL-5 levels and Eos counts could be identified as a predictive factor for recognizing the risk of COVID-19 mortality. The serum 25(OH)D status in COVID-19 patients correlated negatively with the expression of IL-5. The potential mechanism for this relationship is worth further exploration.
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