Vitamin D deficiency and vitamin D receptor FokI polymorphism as risk factors for COVID-19

Ahmed Zeid ,Attia A Soliman,Ahmed A Emam,Ahmed A A Ibraheem,Yousif M Yousif,Muyassar K Tarabulsi,Mohamed Y Mohamed,Mohamed R Abdelhamed,Amal S M Abd-Elrazek,Nevin M Waked ,Mohamed M Shehab ,Mona Afify ,Suzan Abd El Razek ,Khalil Abdelkhalek,Mohamed O Ahmed ,Ahmed Saleh ,Mohamed Abdel‐Mohsen ,Said Abdelbaky Gad ,Sherif Osman ,Hanan Mohamed Abd El Lateef ,Mohamed Nashat,Sonya Ahmed El-Gaaly ,Noha Elgyar,Mohammed K Nagshabandi,Ahmed Elhewala ,A A Ahmed ,Nagwa E Akeel,Hassan Shehata,Manal M Rashad,Mustafa Hashem ,Rehab M Nabil,Dalia Selim ,Gehan H Shahin,Mohanned Talal Alharbi ,Ghada A B Abd-Elrehim,Heba H Eltrawy ,Thoraya Hosny ,A A Yousef

doi:10.1038/s41390-022-02275-6

Abstract

BackgroundGiven 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.MethodsOne 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.ResultsNinety-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).ConclusionsVitamin D deficiency and VDR Fok I polymorphism may constitute independent risk factors for susceptibility to COVID-19 in Egyptian children and adolescents.ImpactVitamin 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.

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