Vitamin D for Recovery of COVID-19 in Patients With Chronic Kidney Disease

Clinical characteristics of patients with maintenance hemodialysis affected by COVID‑19: A single‑center retrospective study

The coronavirus disease 2019 (COVID-19) is spreading continuously worldwide. Maintenance hemodialysis (MHD) patients are a particular group at higher risk of contracting COVID-19. The aim of the present study was to investigate the various risk factors that contribute to the occurrence of co-infection with COVID-19 among patients with MHD. A retrospective analysis was conducted on 171 patients with MHD. The characteristics and outcomes were examined among patients with MHD who were infected with COVID-19 and those who were not. Moreover, risk factors associated with survival or mortality among the COVID-19-infected patients with MHD were analyzed. The results of the present study revealed that the mean level of 25-hydroxyvitamin D [25(OH)D] in patients with MHD was 22.3±11.28 ng/ml. However, there was no significant difference in the levels of 25(OH)D between patients with MHD with and without COVID-19. Logistic regression analysis revealed that decreased levels of intact parathyroid hormone (iPTH) and increased levels of serum ferritin were associated with an increased risk of COVID-19 in these patients. Additionally, the levels of 25(OH)D and albumin were decreased in the deceased patients. Similarly, logistic regression analysis was performed to identify risk factors for mortality in patients with MHD with COVID-19, which revealed that decreased levels of 25(OH)D were associated with an increased risk of mortality in these patients. The results of the present study indicated that iPTH and serum ferritin levels could potentially increase the risk of COVID-19 among patients with MHD. Additionally, 25(OH)D levels may influence the mortality rate among patients with MHD who have been infected with COVID-19.

Active vitamin D analog and SARS-CoV-2 IgG after BNT162b2 vaccination in patients with hemodialysis

INTRODUCTION

Vaccination is the effective strategy for coronavirus disease 2019 (COVID-19). However, few studies have investigated the association between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin (Ig)G and vitamin D.

METHODS

This study aimed to investigate the association between SARS-CoV-2 IgG and active vitamin D analogs in hemodialysis patients. Blood samples were collected four times: before vaccination and 30, 60, and 90 days after vaccination, BNT162b2 (Pfizer©).

RESULTS

A total of 418 patients were enrolled. The mean age was 71.1 ± 12 years. Almost two thirds of the patients were prescribed active vitamin D analogs. The distribution of SARS-CoV-2 IgG before vaccination was 235 (93-454) AU/mL. After multiple regression analyses, active vitamin D analog use was found to be associated with higher SARS-CoV-2 IgG levels from prevaccination to 90 days postvaccination.

CONCLUSION

This study demonstrated an association between higher SARS-CoV-2 IgG and active vitamin D analog use in hemodialysis patients.

CLINICAL TRIAL REGISTRATION

The study information was registered in the UMIN-CTR (UMIN 000046906).

Crosstalk between COVID-19 Infection and Kidney Diseases: A Review on the Metabolomic Approaches

The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes COVID-19, a respiratory disorder. Various organ injuries have been reported in response to this virus, including kidney injury and, in particular, kidney tubular injury. It has been discovered that infection with the virus does not only cause new kidney disease but also increases treatment difficulty and mortality rates in people with kidney diseases. In individuals hospitalized with COVID-19, urinary metabolites from several metabolic pathways are used to distinguish between patients with acute kidney injury (AKI) and those without. This review summarizes the pathogenesis, pathophysiology, treatment strategies, and role of metabolomics in relation to AKI in COVID-19 patients. Metabolomics is likely to play a greater role in predicting outcomes for patients with kidney disease and COVID-19 with varying levels of severity in the near future as data on metabolic profiles expand rapidly. Here, we also discuss the correlation between COVID-19 and kidney diseases and the available metabolomics approaches.

Clinical and Prognostic Significance of Baseline Serum Vitamin D Levels in Hospitalized Egyptian Covid-19 Patients

BACKGROUND AND AIM

Vitamin D is a hormone with essential roles in both cellular metabolism and immunity. It controls calcium homeostasis and modulates innate and adaptive immune system responses. Many studies suggested an association between vitamin D deficiency and clinical outcomes of covid-19 infection, while others failed to document such a relation. The present study aimed to evaluate the clinical and prognostic significance of baseline vitamin D levels in hospitalized Egyptian covid-19 patients.

PATIENTS AND METHODS

The present retrospective study included 300 hospitalized covid-19 patients. Patients were submitted to standard clinical, laboratory, and radiological assessment. According to vitamin D levels, patients were classified to have normal levels (≥30), insufficient levels (20-29) or deficient levels (<20).

RESULTS

According to their vitamin D levels, patients were classified into those with normal vitamin D (n=135), others with vitamin D insufficiency (n=114), and a third group with vitamin D deficiency (n=51). Patients with normal vitamin D levels and vitamin D insufficiency are significantly younger [median (IQR): 49.0 (39.0-57.0) versus 51.0 (40.0-61.0) and 55.0 (43.0-62.0) years, respectively, p=0.012] and had less frequency of severe disease (24.4% versus 40.4% and 51.0%, respectively) when compared with those with vitamin D deficiency. Moreover, they had significantly lower levels of D dimer [median (IQR): 1.5 (0.9-2.5) versus 1.8 (0.9-3.1) and 2.0 (1.0-3.2)], CRP [median (IQR): 58.0 (30.0-120.0) versus 76.0 (42.5-160.0) and 105.0 (74.0-208.0), respectively, p<0.001], ferritin [median (IQR): 458.0 (240.0-759.0) versus 606.0 (433.8-897.8) and 820.0 (552.0-1087.0), respectively, p<0.001], and procalcitonin [median (IQR): 290.0 (152.0-394.0) versus 372.5 (227.0-530.5) and 443.0 (272.0-575.0), respectively, p<0.001]. Only lower vitamin D levels were significant predictors of mortality in multivariate analysis [OR (95% CI): 0.88 (0.84-0.92), p<0.001].

CONCLUSION

Low vitamin D levels are related to exaggerated inflammatory response, disease severity, and poor clinical outcome in hospitalized covid-19 patients.