Purpose
Vitamin D deficiency has emerged as another potential risk factor for coronavirus disease (COVID‐19) due to the immunomodulatory effects of 25 hydroxyvitamin D [25 (OH)D]. Vitamin D receptor (VDR) gene polymorphisms such as Fok I, Bsm I, Apa I, and Taq I are also associated with different courses of viral infections. This study aimed to evaluate the association between the VDR gene polymorphism at Fok I, Taq I, Bsm I, and Apa I genotypes and the prognosis of COVID‐19 in respect to vitamin D deficiency.
Methods
Two‐hundred ninety‐seven patients with COVID‐19 were enrolled. Serum 25 (OH)D levels were measured. Four variant regions of the VDR gene, FokI, BsmI, ApaI, and TaqI were determined.
Results
Eighty‐three percent of subjects had vitamin D deficiency, and 40.7% of the whole group had severe deficiency. Median 25 (OH)D level was 11.97 ng/ml. Vitamin D levels were not related to inflammatory markers, disease severity, admission to intensive care unit (ICU), and mortality. While disease severity was related to Fok I Ff genotype, it was Taq TT genotype for ICU admission. Moreover, the ApaI aa genotype was common among the patients who were died. None of the deceased subjects had the Fok I FF genotype.
Conclusion
25 (OH)D levels were not related to the severity and mortality of COVID‐19. VDR gene polymorphisms are independently associated with the severity of COVID‐19 and the survival of patients.
Background
Coronavirus disease 2019 (COVID-19) quickly spread worldwide to become a pandemic. This study aimed to define the predictors of critical illness development within 28 days postadmission.
Methods
We conducted a prospective cohort study including 477 PCR-positive COVID-19 patients admitted to a tertiary care hospital in Istanbul from March 12 to May 12, 2020. The development of critical illness, e.g., invasive mechanical ventilation and/or death, was followed for a period of 28 days postadmission. Demographic characteristics, number of comorbidities, illness severity at admission defined by the WHO scale, vital signs, laboratory findings and period of admission to the hospital were independent variables. Cox proportional hazards analysis was performed, and the C-index was calculated.
Results
The median (IQR) age of the cohort was 55.0 (44.0-67.0) years, and 50.1% were male. The most common presenting symptoms were cough, dyspnea and fatigue. Overall, 65.2% of the patients had at least one comorbidity. Hydroxychloroquine was given to 99.2% of the patients. Critical illness developed in 45 (9.4%; 95% CI: 7.0%-12.4%) patients. In the multivariable analysis, age (HR: 1.05, p<0.001), number of comorbidities (HR: 1.33, p=0.02), procalcitonin ≥0.25 μg/L (HR: 2.12, p=0.03) and LDH ≥350 U/L (HR: 2.04, p=0.03) were independently associated with critical illness development. The WHO scale on admission was the strongest predictor of critical illness (HR: 4.15, p<0.001). Prognosis improved within the study period (p<0.05). The C-index of the model was 0.92.
Conclusions
Age, comorbidity number, WHO scale, LDH and procalcitonin were independently associated with critical illness development. Mortality from COVID-19 seems to be decreasing as the pandemic advances.
Objective: Electrocardiographic alterations were investigated following the second dosage of COVID-19 mRNA vaccination. Methods: A total of 260 individuals after two doses of COVID-19 vaccine with Pfizer-BioNTech were included in the study. The electrocardiographic parameters recorded at baseline and approximately one week later after two doses of Pfizer-BioNTech vaccine were compared for all patients. Results: PR interval was increased and QTc maximum interval was decreased significantly after second dose COVID-19 mRNA vaccination. Baseline and post-second dose vaccination states regarding P wave dispersion and QT dispersion/Tp-e interval which have been recognized to imply inhomogeneous atrial conduction and heterogeneity in ventricular repolarization were similar between groups. Conclusion: Our findings suggest that there should be no concern related to asymptomatic involvement of the myocardium subsequent the second dose of COVID-19 mRNA vaccination.
Although it is was not included in the ESC 2015 Modified Duke Criteria, "new valvular regurgitation (Worsening or changing or pre-existing murmur not sufficient)" was included as a major echocardiographic criterion in the original Modified Duke Criteria (3).
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