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Vol 6, No 3 (2021)
Review paper
Published online: 2021-08-09
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Relationship between serum 25-hydroxyvitamin D concentration and acute inflammatory markers in hospitalized patients with SARS-CoV-2 infection

Teodoro J. Oscanoa12, José Amado12, Rawia A. Ghashut3, Roman Romero-Ortuno45
DOI: 10.5603/DEMJ.a2021.0024
·
Disaster Emerg Med J 2021;6(3):144-153.
Affiliations
  1. Faculty of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru
  2. Faculty of Medicine, Universidad de San Martín de Porres, Drug Safety Research Centre, Hospital Almenara, ESSALUD, Lima, Peru
  3. Academic Unit of Anaesthesia, College of Medical, Veterinary and Life of Sciences, University of Glasgow, United Kingdom
  4. Discipline of Medical Gerontology, Mercer’s Institute for Successful Ageing, St James’s Hospital, Dublin, Ireland
  5. Global Brain Health Institute, Trinity College, Dublin, Ireland

open access

Vol 6, No 3 (2021)
ORIGINAL ARTICLES
Published online: 2021-08-09

Abstract

INTRODUCTION: There is experimental and clinical evidence that the serum concentration of 25-hydroxyvita­min D [25(OH)D)] may decrease in acute systemic inflammatory responses; in this context, low values may not necessarily indicate a pre-existing deficiency. This may also apply to low 25(OH)D levels found in the context of the systemic inflammatory response caused by SARS-CoV-2 infection. To conduct a systematic review of the relationship between serum 25(OH)D and the concentrations of C-re­active protein (CRP), interleukin 6 (IL-6) and tumour necrosis factor a (TNF-a) in acutely hospitalized patients with SARS-CoV-2 infection.  

MATERIAL AND METHODS: We searched PubMed, EMBASE, Google Scholar and the Cochrane Database of Systematic Reviews for studies published between January 2020 and February 2021. In each study, the au­thors compared levels of inflammatory markers between patients reported as having low levels of 25(OH) D and those above the study cut-off.

RESULTS: 18 studies were included (n = 3482, mean age 63.5 ± 9.3 years, 56.9% men). The cut-off for the definition of low 25(OH)D varied across studies. In all studies, mean values for inflammatory markers were higher in the low 25(OH)D groups. These differences were statistically significant (p < 0.05) in 6/15 studies with CRP, 4/8 with IL-6 and 0/1 with TNF-a.  

CONCLUSIONS: Markers of acute systemic inflammatory response were elevated in patients with SARS-CoV-2 infection and low concentrations of 25(OH)D. Therefore, the vitamin D status in those patients should be interpreted with caution, and studies should be designed to assess whether hypovitaminosis D could be an epiphenomenon.

Abstract

INTRODUCTION: There is experimental and clinical evidence that the serum concentration of 25-hydroxyvita­min D [25(OH)D)] may decrease in acute systemic inflammatory responses; in this context, low values may not necessarily indicate a pre-existing deficiency. This may also apply to low 25(OH)D levels found in the context of the systemic inflammatory response caused by SARS-CoV-2 infection. To conduct a systematic review of the relationship between serum 25(OH)D and the concentrations of C-re­active protein (CRP), interleukin 6 (IL-6) and tumour necrosis factor a (TNF-a) in acutely hospitalized patients with SARS-CoV-2 infection.  

MATERIAL AND METHODS: We searched PubMed, EMBASE, Google Scholar and the Cochrane Database of Systematic Reviews for studies published between January 2020 and February 2021. In each study, the au­thors compared levels of inflammatory markers between patients reported as having low levels of 25(OH) D and those above the study cut-off.

RESULTS: 18 studies were included (n = 3482, mean age 63.5 ± 9.3 years, 56.9% men). The cut-off for the definition of low 25(OH)D varied across studies. In all studies, mean values for inflammatory markers were higher in the low 25(OH)D groups. These differences were statistically significant (p < 0.05) in 6/15 studies with CRP, 4/8 with IL-6 and 0/1 with TNF-a.  

CONCLUSIONS: Markers of acute systemic inflammatory response were elevated in patients with SARS-CoV-2 infection and low concentrations of 25(OH)D. Therefore, the vitamin D status in those patients should be interpreted with caution, and studies should be designed to assess whether hypovitaminosis D could be an epiphenomenon.

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Keywords

SARS-CoV-2, COVID-19, interleukin 6, C-reactive protein, vitamin D, 25-hydroxyvitamin D

About this article
Title

Relationship between serum 25-hydroxyvitamin D concentration and acute inflammatory markers in hospitalized patients with SARS-CoV-2 infection

Journal

Disaster and Emergency Medicine Journal

Issue

Vol 6, No 3 (2021)

Article type

Review paper

Pages

144-153

Published online

2021-08-09

Page views

6715

Article views/downloads

506

DOI

10.5603/DEMJ.a2021.0024

Bibliographic record

Disaster Emerg Med J 2021;6(3):144-153.

Keywords

SARS-CoV-2
COVID-19
interleukin 6
C-reactive protein
vitamin D
25-hydroxyvitamin D

Authors

Teodoro J. Oscanoa
José Amado
Rawia A. Ghashut
Roman Romero-Ortuno

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