tetano
Editor, Senior Moderator
Am J Clin Nutr
. 2022 Jan 10;nqab426.
doi: 10.1093/ajcn/nqab426. Online ahead of print.
Effect of a single high dose of Vitamin D3 on cytokines, chemokines and growth factor in patients with moderate to severe COVID-19
Alan L Fernandes[SUP] 1 [/SUP], Igor H Murai[SUP] 1 [/SUP], Bruna Z Reis[SUP] 1 [/SUP], Lucas P Sales[SUP] 1 [/SUP], Mayara D Santos[SUP] 1 [/SUP], Ana J Pinto[SUP] 2 [/SUP], Karla F Goessler[SUP] 2 [/SUP], Camila S C Duran[SUP] 1 [/SUP], Carla B R Silva[SUP] 1 [/SUP], André S Franco[SUP] 1 [/SUP], Marina B Macedo[SUP] 1 [/SUP], Henrique H H Dalmolin[SUP] 1 [/SUP], Janaina Baggio[SUP] 1 [/SUP], Guilherme G M Balbi[SUP] 1 [/SUP], Leila Antonangelo[SUP] 3 [/SUP], Valeria F Caparbo[SUP] 1 [/SUP], Bruno Gualano[SUP] 2 4 [/SUP], Rosa M R Pereira[SUP] 1 [/SUP]
Affiliations
Abstract
Background: The modulating effect of vitamin D on cytokine levels in severe coronavirus disease 2019 (COVID-19) remains unknown.
Objectives: To investigate the effect of a single high-dose of vitamin D3 on cytokines, chemokines, and growth factor in hospitalized patients with moderate to severe COVID-19.
Methods: This is a post-hoc, ancillary and exploratory analysis from a multicenter, double-blind, placebo-controlled, randomized clinical trial registered in ClinicalTrials.gov, NCT04449718. Patients with moderate to severe COVID-19 were recruited from two hospitals in Sao Paulo, Brazil. Of 240 randomized patients, 200 were assessed in this study and randomly assigned to receive a single oral dose of 200 000 IU of vitamin D3 (n = 101) or placebo (n = 99). The primary outcome was hospital length of stay, that has been published in our previous study. The prespecified secondary outcomes were serum levels of interleukin-1β, interleukin-6, interleukin-10, tumor necrosis factor alpha (TNF-α) and 25-hydroxyvitamin D. The post-hoc exploratory secondary outcomes were interleukin-4, interleukin-12p70, interleukin-17A, interferon gamma (IFN-γ), granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-8, interferon-inducible protein-10 (IP-10), macrophage inflammatory protein-1 beta (MIP-1β), monocyte chemoattractant protein-1 (MCP-1), growth factor vascular endothelial (VEGF), and leukocytes count. Generalized estimating equations (GEE) for repeated measures, with Bonferroni's adjustment, were used for testing all outcomes.
Results: The study included 200 patients with a mean (SD) age 55.5 (14.3) years and body mass index (BMI) 32.2 (7.1) kg/m2, of which 109 (54.5%) were male. GM-CSF levels showed a significant group by time interaction effect (P = 0.04), although between-group difference at post-intervention after Bonferroni's adjustment was not significant. No significant effects were observed for the other outcomes.
Conclusions: The findings do not support the use of a single dose of 200 000 IU of vitamin D3, compared to placebo, for the improvement of cytokines, chemokines, and growth factor in hospitalized patients with moderate to severe COVID-19. Clinical Trial Registration: ClinicalTrials.gov, NCT04449718.
Keywords: SARS-CoV-2; acute-phase reactants; immune response; inflammation; vitamin d.
. 2022 Jan 10;nqab426.
doi: 10.1093/ajcn/nqab426. Online ahead of print.
Effect of a single high dose of Vitamin D3 on cytokines, chemokines and growth factor in patients with moderate to severe COVID-19
Alan L Fernandes[SUP] 1 [/SUP], Igor H Murai[SUP] 1 [/SUP], Bruna Z Reis[SUP] 1 [/SUP], Lucas P Sales[SUP] 1 [/SUP], Mayara D Santos[SUP] 1 [/SUP], Ana J Pinto[SUP] 2 [/SUP], Karla F Goessler[SUP] 2 [/SUP], Camila S C Duran[SUP] 1 [/SUP], Carla B R Silva[SUP] 1 [/SUP], André S Franco[SUP] 1 [/SUP], Marina B Macedo[SUP] 1 [/SUP], Henrique H H Dalmolin[SUP] 1 [/SUP], Janaina Baggio[SUP] 1 [/SUP], Guilherme G M Balbi[SUP] 1 [/SUP], Leila Antonangelo[SUP] 3 [/SUP], Valeria F Caparbo[SUP] 1 [/SUP], Bruno Gualano[SUP] 2 4 [/SUP], Rosa M R Pereira[SUP] 1 [/SUP]
Affiliations
- PMID: 35020796
- DOI: 10.1093/ajcn/nqab426
Abstract
Background: The modulating effect of vitamin D on cytokine levels in severe coronavirus disease 2019 (COVID-19) remains unknown.
Objectives: To investigate the effect of a single high-dose of vitamin D3 on cytokines, chemokines, and growth factor in hospitalized patients with moderate to severe COVID-19.
Methods: This is a post-hoc, ancillary and exploratory analysis from a multicenter, double-blind, placebo-controlled, randomized clinical trial registered in ClinicalTrials.gov, NCT04449718. Patients with moderate to severe COVID-19 were recruited from two hospitals in Sao Paulo, Brazil. Of 240 randomized patients, 200 were assessed in this study and randomly assigned to receive a single oral dose of 200 000 IU of vitamin D3 (n = 101) or placebo (n = 99). The primary outcome was hospital length of stay, that has been published in our previous study. The prespecified secondary outcomes were serum levels of interleukin-1β, interleukin-6, interleukin-10, tumor necrosis factor alpha (TNF-α) and 25-hydroxyvitamin D. The post-hoc exploratory secondary outcomes were interleukin-4, interleukin-12p70, interleukin-17A, interferon gamma (IFN-γ), granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-8, interferon-inducible protein-10 (IP-10), macrophage inflammatory protein-1 beta (MIP-1β), monocyte chemoattractant protein-1 (MCP-1), growth factor vascular endothelial (VEGF), and leukocytes count. Generalized estimating equations (GEE) for repeated measures, with Bonferroni's adjustment, were used for testing all outcomes.
Results: The study included 200 patients with a mean (SD) age 55.5 (14.3) years and body mass index (BMI) 32.2 (7.1) kg/m2, of which 109 (54.5%) were male. GM-CSF levels showed a significant group by time interaction effect (P = 0.04), although between-group difference at post-intervention after Bonferroni's adjustment was not significant. No significant effects were observed for the other outcomes.
Conclusions: The findings do not support the use of a single dose of 200 000 IU of vitamin D3, compared to placebo, for the improvement of cytokines, chemokines, and growth factor in hospitalized patients with moderate to severe COVID-19. Clinical Trial Registration: ClinicalTrials.gov, NCT04449718.
Keywords: SARS-CoV-2; acute-phase reactants; immune response; inflammation; vitamin d.