ارتباط فيتامين د 3 والكاثيليسيدين بخطورة مرض كوفيد 19 في عينة من المرضى العراقيين

The association of vitamin D3 and Cathelicidin with the severity of COVID 19 in a sample of Iraqi patients

Abstract

Background: Pneumonia is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has emerged in Wuhan City, Hubei Province, China in December 2019. By Feb. 11, 2020, the World Health Organization (WHO) officially named the disease resulting from infection with SARS-CoV-2 as coronavirus disease 2019 (COVID-19). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for COVID-19 infection. Vitamin D3 is a fat-soluble vitamin and has immune function, particularly in modulating the inflammatory response to viral infection. vitaminD3 modulates both the adaptive and innate immune at cellular level. Cathelicidin is Antimicrobial peptide and main components of innate immunity.

Aims: To find the association between vitamin D3 levels and the severity of COVID-19 in studied subjects. Study the mechanisms of Vitamin D3 action in patients with COVID-19 and discus how it will be used in reduction the severity of this disease and To study the association between Cathelicidin and vitamin D3 levels in order to support the use of vit D3 in treatment of Iraqi patients with COVID 19.

Materials and methods: This case–control study consisted of 90 samples, 60 of them have COVID-19. Patient divided into three group (20 mild, 20moderate, 20 sever cases of COVID-19). Classified into three severity levels depending on clinical manifestations: mild, moderate, and severe disease depended on pulmonary imaging, however, respiratory characteristics such as respiratory rate, oxygen saturation, and lesion development are employed as categorization criteria. Different organ dysfunctions, such as septic shock, heart failure, and disseminated intravascular coagulation, worsen severe cases (DIC).
Control individuals were 30 and age range of individuals (patient and control) was (20-70).
Detection of cathelicidin levels were carried out by Enzyme-Linked Immunosorbent Assay (ELISA). vitamin D3 levels were carried out by fully automated chemiluminescence immunoassay analyser. D-dimer was tested using Cobas e 411 fully automated analyzer and ferritin level was tested using
automated Mini-Vidas system. CBC measurements were done by XP 300™ Automated hematology analyzer device.

Results: Monitoring of the Vitamin D3, D-dimer and ferritin in the studied groups were shown a highly significant in severe patients and related to severity of COVID-19 in studied subjects(p-value <0.05).D-dimer and ferritin levels were significantly increased, while vitamin D3 was decreased in COVID-19 patient The present study showed negative correlation between Vitamin D3 and Cathelicidin in covid19 patients. Vitamin D3, cathelicidin and D-dimer showed high specificity and sensitivity in ROC analysis.

Conclusion; vitamin D3, and D-dimer are factors for severity of COVID-19 in studied subjects and Vitamin D3 deficiency is more susceptible to development of COVID-19 diseases by affecting on innate immunity. Therefor, this study may suggest recommended the monitoring of cathelicidin, vitamin D3 and D-dimer levels in COVID19 good biomarkers for prognosis and treatment.