The association of vitamin d status with interleukin-6 (IL-6), d-dimer and severity of covid-19 disease in a sample of iraqi population

ABSTRACT

Background: Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a recently emerged, highly transmissible, and pathogenic coronavirus that has created global public health and economic crisis. Since December 2019, when Covid-19 emerged in Hunan seafood market in Wuhan, South China, and rapidly spread throughout the world, the virus outbreak has been declared a public health emergency of international concern by the World Health Organization (WHO). This research included several parameters (Vit-D, IL-6, and D-Dimer) to evaluate the association between these biomarkers and outcomes in COVID-19 hospitalized and non-hospitalized patients, to guide potential COVID-19 Diagnosis, Treatments, and Prevention of COVID-19 disease. Aim of the study 1. To determine if there is an association between the status of vitamin D level in blood and the severity of COVID19 disease. 2. To determine the association between vit-D level and (IL-6, and D-Dimer) levels in serum and their effect on these markers in the hospitalized COVID19 disease. 3. to evaluate the association between (IL-6, and D-Dimer) and the severity of COVID19 disease. Methods: A Cross-sectional study consisted of 40 patients with age range (18-90 years) that collected from ICU (hospitalized patients) in (West Irbil Governmental Hospital and Lalaf Governmental Hospital) in Erbil city/ Iraq, at admission to the hospital, and 40 patients with age range (18-90 year)there were non-hospitalized patients from the same place in Erbil city/ Iraq, from December 2020 to April 2021. Serum(Vit-D, and IL-6), and plasma D-Dimer concentrations were measured, firstly to comparing them with (age, gender, and the severity of SARS-CoV-2 virus infection) to demonstrate the association of them with the severity of COVID-19 disease, and secondly to compered them with vit-D and demonstrate the effect of this vitamin on these parameters. Results: In the present study, the data showed A significant decrease in Vit-D concentration in sera of patients with SARS-CoV-2 virus infection in both groups, which determines the strong correlation in (two-tailed) between vit-D concentration and the severity of SARS-CoV-2 virus infection P-value (0.00001), as while as, there is a statistical correlation between the severity of COVID-19 disease and D-Dimer in both groups P-value (6.2E-9). while statistically non-significant relation between the severity of COVID-19 disease in both groups and age P-value (0.79), also non-significant relation between vit-D and age p-value (0.08), and Non-significant correlation between gender and the severity of COVID-19 disease in both groups P-value (0.82). In both groups, there is a significant negative correlation between vitamin-D and D-dimer concentrations in H group correlation P-value (0.0001), in the non-H group P-value(0.025). Statistical analysis showed a significantly strong correlation between high IL-6 level and the severity of SARS-CoV-2 virus infection in both study groups non-H and H, P-value (0.00001).in comparison with severe deficiency of Vit-D that determines the strong correlation in (two-tailed) between vit-D concentration and IL-6 Conc. of SARS-CoV-2 virus infection. Conclusion: 1. The results of this study reveal that vitamin D deficiency presents an association with the severity of COVID-19, Anecdotal and observational data indicate that vitamin D deficiency may play a significant role in the progression of the COVID-19 disease state. In conclusion, the results confirm the high prevalence of vitamin D deficiency in people with COVID-19, we observed a positive association between vitamin D deficiency and the severity of the disease. 2. The current study revealed a significantly strong correlation between IL-6 and D-dimer with Vit-D levels, in hospitalized patients and non-hospitalized patients suggesting that Vit-D blood levels have an important effect on IL-6 and D-dimer levels that’s maybe a biomarker of disease severity and progression in patients with COVID-19. 3. According to the severity of COVID-19 disease, the present study showe a significant correlation between (vitamin-D, IL-6, and D-dimer) with the severity of COVID-19 disease suggesting that these parameters may be biomarkers of disease severity and progression in patients with COVID-19.