IntroductionAssociation of vitamin D, inflammation and endothelial dysfunction, beside the classic bone metabolism disorders, may explain the pathogenesis of numerous diseases associated with vitamin D deficiency. While large numbers of reports support the relationship of vitamin D with inflammation, several reports fail to confirm this relationship. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are novel and inexpensive markers of inflammation that can be studied in all centers. The goal of this study was to investigate the association between 25-hydroxy vitamin D (25(OH)D) and inflammation with the novel inflammatory markers NLR and PLR.Material and methodsThis study was performed retrospectively. Results of the simultaneously performed 25(OH)D, parathyroid hormone, albumin, calcium, phosphorus, alkaline phosphatase and creatinine level measurements and complete blood count were recorded. The data of 4120 patients were included in the study.ResultsBetween vitamin D deficient and non-deficient groups there were significant differences in PLR (p < 0.001) and NLR (p = 0.001). Vitamin D had a significant negative correlation with PLR (p < 0.001) and NLR (p < 0.001). Multiple regression analysis indicated that 25(OH)D was independently and negatively correlated with PLR (OR = 0.994, 95% CI 0.991–0.998, p = 0.02).ConclusionsPlatelet-to-lymphocyte ratio and NLR were significantly associated with 25(OH)D levels, and PLR was found to be an independent predictor of 25(OH)D levels. Our study revealed an inverse association of vitamin D levels and inflammation with these inexpensive and universally available markers.
Background
Many laboratory parameters have been associated with morbidity and mortality in SARS‐CoV‐2 (COVID‐19), which emerged in an animal market in Wuhan, China in December 2019 and has infected over 20 million people. This study investigated the relationship between serum interleukin (IL)‐18, IL‐1 receptor antagonist (IL‐1Ra), and alpha defensin levels and the clinical course and prognosis of COVID‐19.
Materials and Methods
This study included 100 patients who were admitted to the chest diseases department and intensive care unit of our hospital and diagnosed with COVID‐19 by real‐time polymerase chain reaction (PCR) of nasopharyngeal swab samples between March 24 and May 31, 2020. The control group consisted of 50 nonsymptomatic health workers with negative real‐time PCR results in routine COVID‐19 screening in our hospital.
Results
Serum alpha defensin, IL‐1Ra, and IL‐18 levels were significantly higher in patients who developed macrophage activation syndrome (MAS) and acute respiratory distress syndrome (ARDS) compared to patients who did not (
p
< .001 for all). Alpha defensin, IL‐1Ra, and IL‐18 levels were significantly higher in COVID‐19 patients with and without MAS or ARDS when compared to the control group (
p
< .001 for all). When the 9 patients who died were compared with the 91 surviving patients, IL‐1Ra and IL‐18 levels were found to be significantly higher in the nonsurvivors (
p
< .001).
Conclusion
Our findings of correlations between alpha defensin and levels of IL‐1Ra and IL‐18, which were previously shown to be useful in COVID‐19 treatment and follow‐up, indicates that it may also be promising in treatment.
In the light of our findings, we think that gallic acid may have played a protective role against cisplatin-induced ototoxicity in rats, as indicated by the distortion product otoacoustic emissions test results, biochemical findings and immunohistochemical analyses.
Coronavirus disease 2019 (COVID‐19) is one of the most pressing health problems of this century, but our knowledge of the disease is still limited. In this study, we aimed to examine serum‐soluble urokinase plasminogen activator receptor (suPAR) and kidney injury molecule 1 (KIM‐1) levels based on the clinical course of COVID‐19. Our study included 102 patients over the age of 18 who were diagnosed as having COVID‐19 between September 2020 and December 2020 and a control group of 50 health workers over the age of 18 whose severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) PCR results were negative. KIM‐1 was measured by ELISA and suPAR by suPARnostic™ assay. Analysis of previously identified variables of prognostic significance in COVID‐19 revealed high neutrophil to lymphocyte ratio, lactose dehydrogenase, prothrombin time, C‐reactive protein, PaO
2
/FiO
2
, D‐dimer, ferritin, and fibrinogen levels in patients with severe disease (
p
< 0.05 for all). KIM‐1 and suPAR levels were significantly higher in COVID‐19 patients compared to the control group (
p
= 0.001 for all). KIM‐1 level was higher in severe patients compared to moderate patients (
p
= 0.001), while suPAR level was lower (
p
= 0.001). KIM‐1, which is believed to play an important role in the endocytosis of SARS‐CoV‐2, was elevated in patients with severe COVID‐19 and may be a therapeutic target in the future. SuPAR may have a role in defense mechanism and fibrinolysis, and low levels in severe patients may be associated with poor prognosis in the early period.
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