Vitamin D deficiency and vitamin D receptor FokI polymorphism as risk factors for COVID-19
Ahmed Zeid, Hanan M. Abd El Lateef, Dalia Selim, Suzan A. Razek, Ghada A. B. Abd‐Elrehim, Mohamed Nashat, Noha El-Gyar, Nevin M Waked, Attia A. Soliman, Ahmed Elhewala, Mohamed M. Shehab, Ahmed A. A. Ibraheem, Hassan Shehata, Yousif M. Yousif, Nagwa E. Akeel, Mustafa Hashem, Amani A. Ahmed, Ahmed A. Emam, Mohamed Mostafa Abdelmohsen, Mohamed Farouk Ahmed, Ahmed Saleh, Heba H. Eltrawy, Gehan H. Shahin, Rehab M. Nabil, Thoraya Hosny, Mohamed R. Abdelhamed, Mona Afify, Mohanned Talal Alharbi, Mohammed K. Nagshabandi, Muyassar K. Tarabulsi, Sherif Osman, Amal S. M. Abd-Elrazek, Manal M. Rashad, Sonya Ahmed Ali El-Gaaly, Said Abdelbaky Gad, Mohamed Y. Mohamed, Khalil Abdelkhalek, A. A. Yousef
Abstract
BACKGROUND: Given the sparse data on vitamin D status in pediatric COVID-19, we investigated whether vitamin D deficiency could be a risk factor for susceptibility to COVID-19 in Egyptian children and adolescents. We also investigated whether vitamin D receptor (VDR) FokI polymorphism could be a genetic marker for COVID-19 susceptibility. METHODS: One hundred and eighty patients diagnosed to have COVID-19 and 200 matched control children and adolescents were recruited. Patients were laboratory confirmed as SARS-CoV-2 positive by real-time RT-PCR. All participants were genotyped for VDR Fok1 polymorphism by RT-PCR. Vitamin D status was defined as sufficient for serum 25(OH) D at least 30 ng/mL, insufficient at 21-29 ng/mL, deficient at <20 ng/mL. RESULTS: Ninety-four patients (52%) had low vitamin D levels with 74 (41%) being deficient and 20 (11%) had vitamin D insufficiency. Vitamin D deficiency was associated with 2.6-fold increased risk for COVID-19 (OR = 2.6; [95% CI 1.96-4.9]; P = 0.002. The FokI FF genotype was significantly more represented in patients compared to control group (OR = 4.05; [95% CI: 1.95-8.55]; P < 0.001). CONCLUSIONS: Vitamin D deficiency and VDR Fok I polymorphism may constitute independent risk factors for susceptibility to COVID-19 in Egyptian children and adolescents. IMPACT: Vitamin D deficiency could be a modifiable risk factor for COVID-19 in children and adolescents because of its immune-modulatory action. To our knowledge, ours is the first such study to investigate the VDR Fok I polymorphism in Caucasian children and adolescents with COVID-19. Vitamin D deficiency and the VDR Fok I polymorphism may constitute independent risk factors for susceptibility to COVID-19 in Egyptian children and adolescents. Clinical trials should be urgently conducted to test for causality and to evaluate the efficacy of vitamin D supplementation for prophylaxis and treatment of COVID-19 taking into account the VDR polymorphisms.