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Association of Serum Vitamin D and Hematological Parameters with SARS-CoV-2 PCR Positivity: A Combined Biomarker
Mehmet Almacioglu1, Ipek Kocer1, Demet Ari2
1Department of Pediatrics, Faculty of Medicine, Sanko University, 27060 Gaziantep, Turkey.
Insights
Lower vitamin D levels and altered blood counts are linked to SARS-CoV-2 positivity in asymptomatic children. A combined biomarker approach may aid early risk assessment for COVID-19 in kids.
Area of Science:
- Immunology
- Pediatrics
- Infectious Diseases
Background:
- Vitamin D plays a role in immune function and susceptibility to respiratory infections like COVID-19.
- Limited data exists on vitamin D and hematological parameters in asymptomatic children with COVID-19 exposure.
Purpose of the Study:
- To investigate the association between serum vitamin D levels and hematological parameters with SARS-CoV-2 PCR positivity in asymptomatic children.
- To evaluate the potential of these markers for early risk stratification in pediatric COVID-19 cases.
Main Methods:
- Retrospective study of 127 asymptomatic children (aged 2-18) with household COVID-19 exposure.
- Analysis of serum 25(OH)D3 levels and hematological parameters (WBC, platelets, neutrophils, basophils).
- Logistic regression and ROC curve analysis for predictor identification and model construction.
Main Results:
- PCR-positive children had significantly lower vitamin D levels (17 vs. 27 ng/mL) and higher frequency of deficiency (43% vs. 19%).
- Reduced white blood cell, platelet, and neutrophil counts, with higher basophil counts, were observed in PCR-positive children.
- Vitamin D, platelet, neutrophil, and basophil counts were independent predictors of SARS-CoV-2 positivity; a combined model showed improved discrimination (AUC: 0.80).
Conclusions:
- Lower vitamin D levels and specific hematological alterations are independently associated with SARS-CoV-2 positivity in asymptomatic children.
- A combined biomarker approach using vitamin D and hematological parameters shows promise for early risk stratification.
- Further prospective studies are warranted to confirm findings and explore vitamin D's role in preventive strategies.
Abstract:
Vitamin D has been implicated in immune modulation and susceptibility to respiratory infections, including COVID-19. However, data in asymptomatic pediatric populations, particularly those with household exposure, remain limited. This study aimed to investigate the association between serum vitamin D levels and hematological parameters with SARS-CoV-2 PCR positivity in asymptomatic children, and to evaluate their potential role in early risk stratification. This retrospective study included 127 asymptomatic children (aged 2-18 years) with confirmed household exposure to COVID-19. Participants were classified as PCR-positive (n = 74) or PCR-negative (n = 53). Serum 25(OH)D3 levels and hematological parameters were analyzed. Univariate and multivariable logistic regression analyses were performed to identify independent predictors. Receiver operating characteristic (ROC) curve analysis was used to assess discriminative performance, and a combined multimarker model was constructed. Serum vitamin D levels were significantly lower in PCR-positive children compared to PCR-negative children (17 ± 8 vs. 27 ± 11 ng/mL, p = 0.001). White blood cell (p = 0.002), platelet (p = 0.01), and neutrophil counts (p = 0.01) were significantly reduced, while basophil counts were higher in PCR-positive children (p = 0.02). In multivariable analysis, vitamin D (OR: 0.87, 95% CI: 0.82-0.93, p < 0.001), platelet (p = 0.02), neutrophil (p = 0.02), and basophil counts (p = 0.01) remained independent predictors. ROC analysis showed that vitamin D had moderate discriminative performance (AUC: 0.75, 95% CI: 0.67-0.83), while platelet (AUC: 0.64), neutrophil (AUC: 0.61), and basophil (AUC: 0.62) counts showed modest performance. The combined multimarker model demonstrated improved predictive ability (AUC: 0.80, 95% CI: 0.72-0.88), with sensitivity of 71.6% and specificity of 68.2%. Additionally, vitamin D deficiency was significantly more frequent in PCR-positive children (43% vs. 19%, p = 0.003). Conclusions: Lower vitamin D levels and associated hematological alterations are independently associated with SARS-CoV-2 PCR positivity in asymptomatic children. A combined biomarker approach may improve early risk stratification using simple and routinely available parameters. Further prospective studies are needed to validate these findings and clarify the role of vitamin D in preventive strategies.
