VITAMIN D LEVEL IN CHILDREN WITH THE SIGNS OF COVID-19

Authors

DOI:

https://doi.org/10.11603/24116-4944.2022.1.13255

Keywords:

children, COVID-19, vitamin D

Abstract

The aim of the study – to analyse vitamin D status in children with symptoms of COVID-19 and its relationship with the severity of the disease.

Materials and Methods. 73 children aged 6 to 18 were examined, among them 45 had clinical manifestations of laboratory-confirmed SARS-CoV-2 infection and 28 children had no signs of COVID-19. The clinical course of the disease and laboratory indicators (C-reactive protein, ESR, D-dimer) were evaluated. According to the severity of the course of the disease, 2 groups were formed: 17 children with a mild course of COVID-19 made up the first group, 28 patients with a medium-severe and severe course of the disease – the second group. Children without any manifestations of infectious diseases (28 people) made up the control group. The 25-OH vitamin D level was determined in all children (Accu Bind ELISA Microwells). The optimal level of vitamin D was considered at 30–100 ng/ml, vitamin D insufficiency at 20–30 ng/ml, vitamin D deficiency at a concentration of less than 20 ng/ml. Statistical analysis was carried out with the help of the program "Stat Plus" ( Shapiro-Wilk tests, mean±SD in the case of correct distribution of the trait, median, upper and lower quartiles in case of incorrect distribution, Chisquare2 test, Kruskal-Wallis test, correlation coefficient were calculated.

 Results and Discussion. Temperature increasing was observed in the most patients with COVID-19, subfebrile temperature was prevailed in children with a mild course, in children of the second group the temperature was higher than 38 0C. Subfebrile body temperature was noted in 88.2 % of children with a mild course of COVID-19 and in 3 .7 % of children of the second group (р<0.05, x2=32.2, statistically significant difference). At the same time, hyperthermia over 38 °C was observed in 92.6 % of patients with a moderate and severe course, while in the children of the first group – the body temperature did not rise above 38°C, (р<0.05, x2=35.4, statistically significant difference). The average duration of treatment was 1.5 times higher in the second group of children.

A decrease in the average values ​​of vitamin D in patients with COVID-19 compared to the control group was established, and a decrease in the concentration of vitamin D in the blood serum of patients was observed against the background of increasing severity of the course of the disease. Children with COVID-19 with optimal levels of vitamin D have lower ESR, CRP, and D-dimer than children with deficiency and deficiency of this vitamin. A medium-strength negative correlation was established between the level of vitamin D and indicators of ESR, CRP and D-dimer.

Conclusions. The more severe course of COVID-19 is characterized by a longer duration and severity of the hyperthermic syndrome, a longer duration of treatment, a higher level of CRP, ESR, D-dimer and a decrease of the vitamin D level.

Author Biographies

H. А. Pavllyshyn, I.Horbachevsky Ternopil National Medical University

MD, PhD, D.Sc., Professor; I.Horbachevsky Ternopil National Medical University, Head of the Department of Pediatrics No2, 1 Maidan Voli, Ternopil

O. I. Panchenko, I.Horbachevsky Ternopil National Medical University

PhD fellow, I.Horbachevsky Ternopil National Medical University, Department of Pediatrics

References

Karimian P., Tahami M., Sayyahfar S., Delaware M. (2022). Vitamin D and COVID-19 in children. Eur. J. Transl. Myol., 32 (2), 10453, DOI: 10.4081/ejtm.2022.10453

Bouillon R., Marcocci C., Carmeliet G. & Bilezikian J . (2019). Skeletal and extraskeletal actions of vitamin D: Current evidence and outstanding questions. Endocr. Rev., 40 (4). 1109-1151. DOI:10.1210/er.2018-00126

Wang T.Т., Nestel F.Р., Bourdeau V. & White J. (2004.) Cutting edge: 1,25-dihydroxyvitamin D3 is a direct inducer of antimicrobial peptide gene expression. J. Immunol., 173 (5), 2909-2912. DOI: 10.4049/jimmunol.173.5.2909

Barlow P.G., Svoboda P., Mackellar A. & Donis R. (2011). Antiviral activity and increased host defense against influenza infection elicited by the human Cathelicidin LL-37. PLoS ONE, 6 (10), e25333. DOI: 10.1371/journal.pone.0025333

Kaufman, H.W., Niles, J.K., Kroll, M.H., Bi, C., & Holick, M.F. (2020). SARS-CoV-2 positivity rates associated with circulating 25-hydroxyvitamin D levels. PLoS ONE, 15 (9), e0239252 . DOI: 10.1371/journal.pone.0239252

Kramarev, S.O., & Zakordonets, L.V. (2021). Modern views on the role of vitamin D in the child’s immune system. CHILD HEALTH, 16 (1), 89-98.

Mailhot, G., & Whitе, J.H. (2020). Vitamin D and immunity in infants and children. Nutrients, 12 (5), 1233. DOI: 10.3390/nu12051233.

Holick, M., Binkley, N, Bischoff-Ferrari, H., Gordon, C., Hanley, D. & Weaver C. (2011). Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society clinical practice guideline The Journal of Clinical Endocrinology & Metabolism, 96 (7), 1911-1930. DOI: 10.1210/jc.2011-0385

Saleem, H., Rahman, J., Aslam, N., & Khan, S. (2020). Coronavirus disease 2019 (COVID-19) in children: Vulnerable or spared? A systematic review. Cureus, 12 (5), e8207. DOI:10.7759/cureus.8207

Bayramoğlu, E., Akkoç, G., Ağbaş, A., Akgün, O., Yurdakul, K., Duru H., & Elevli M. (2021).. .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., 180 (8), 2699-2705. DOI: 10.1007/s00431-021-04030-1

Speeckaert, M., Speeckaert, R., & Delanghe, J. (2021). The biologic importance of the vitamin D binding protein polymorphism in pediatric COVID-19 patients. Eur J Pediatr., 180 (8), 2707-2708.. DOI: 10.1007/s00431-021-04.11.0-2

Speeckaert, M.M., & Delanghe, J.R. (2021). Contribution of vitamin D-binding protein polymorphism to susceptibility and outcome of COVID-19 patients. J. Nutr. 151 (8), 2498-2499. DOI: 10.1093/jn/nxab234

Speechaert, M., , J. (2021). Vitamin D binding protein and its polymorphisms may explain the link between vitamin D deficienc and COVID-19. Sciense Progress, 104 (4), 1-4. DOI: 10.1177/00368504211053510

Teama, M., Abdelhakam, D., Elmohamadi, M., Badr, F. (2021). Vitamin D deficiency as a predictor of severity in patients with COVID-19 infection. Science Progress, 104 (3), 1-14. DOI: 00368504211036854

Carpagnano, G., Lecce, V., Quarant, V., Zito, A., Buonamico, E., Gioia, G., Valerio, V., & Resta O. (2021). Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19. Journal of Endocrinological Investigation, 44, 765-771. DOI:10.1007/s40618-020-01370-x

Karahan, S., & Katkat, F. (2021). Impact of serum 25(OH) vitamin D level on mortality in patients with COVID-19 in Turkey. J. Nutr. Health Aging, 25 (2), 189-196. https://doi.org/10.1007/s12603-020-1479-0 17. Karonova, T., Andreeva, A., Golovatuk, K., Bykova, E. & Shlyakhto E. (2021). Low 25(OH)D level is associated with severe course and poor prognosis in COVID-19. Nutrients. 13 (9),3021. https://doi.org/10.3390/nu13093021

Reis, B., Fernandes, A., Sales, L. & Pereira R. (2021). Influence of vitamin D status on hospital length of stay and prognosis in hospitalized patients with moderate to severe COVID-19: a multicenter prospective cohort study. Am. J. Clin. Nutr., 114 (2), 598-604. DOI: 10.1093/ajcn/nqab151

Murai, I., Fernandes, A., Sales, L., Pinto A., Goessler, K. & Pereira R. (2021). Effect of a single high dose of vitamin D3 on hospital length of stay in patients with moderate to severe COVID-19: A Randomized Clinical Trial. JAMA, 325 (11), 1053-1060. DOI:10.1001/jama.2020.26848

Leaf, D., & Ginde A. (2021). Vitamin D3 to Treat COVID-19:Different Disease, Same Answer. JAMA. 325 (11), 1047-1048. DOI:10.1001/jama.2020.26850

Trovas, G., & Toumis, S. (2021). . Vitamin D and COVID-19. Hormones (Athens). 20 (1). 207-208. DOI: 10.1007/s42000-020-00231-9

Published

2022-10-19

How to Cite

Pavllyshyn H. А., & Panchenko, O. I. (2022). VITAMIN D LEVEL IN CHILDREN WITH THE SIGNS OF COVID-19. Actual Problems of Pediatrics, Obstetrics and Gynecology, (1), 75–81. https://doi.org/10.11603/24116-4944.2022.1.13255

Issue

Section

PEDIATRICS