OBJECTIVE: To evaluate levels of Ang II and Ang-(1-7), cytokine profile, and gut microbiota status in patients hospitalized for mild COVID-19 with a history of cardiovascular disease and treated with daily doses of vitamin D3.
METHODS: We recruited 50 adult patients. We screened 50 adult patients and accessed pathophysiology study 22, randomized to daily oral doses of 10,000IU vitamin D3 (n=11) or placebo (n=11). Plasma levels of Ang II and Ang-(1-7) were determined by radioimmunoassay, TMA and TMAO were measured by liquid chromatography and interleukins (ILs) 6, 8, 10 and TNF-α by ELISA.
RESULTS: The Ang-(1-7)/Ang II ratio, as an indirect measure of ACE2 enzymatic activity, increased in the vitamin D3 group (24±5pg/mL vs. 4.66±2pg/mL, p<0.01). Also, in the vitamin D3-treated, there was a significant decline in inflammatory ILs and an increase in protective markers, such as a substantial reduction in TMAO (5±2μmoles/dL vs. 60±10μmoles/dL, p<0.01). In addition, treated patients experienced less severity of infection, required less intensive care, had fewer days of hospitalization, and a reduced mortality rate. Additionally, improvements in markers of cardiovascular function were seen in the vitamin D3 group, including a tendency for reductions in blood pressure in hypertensive patients.
CONCLUSIONS: Vitamin D3 supplementation in patients with COVID-19 and specific conditions is associated with a more favourable prognosis, suggesting therapeutic potential in patients with comorbidities such as cardiovascular disease and gut dysbiosis.
目的:评估AngII和Ang-(1-7)的水平,细胞因子谱,有心血管疾病史并接受每日剂量维生素D3治疗的轻度COVID-19住院患者的肠道菌群状况。
方法:我们招募了50名成年患者。我们筛选了50名成年患者,并进行了病理生理学研究22,随机接受每日口服剂量的10,000IU维生素D3(n=11)或安慰剂(n=11)。用放射免疫法测定血浆AngⅡ和Ang-(1-7)水平,通过液相色谱法测量TMA和TMAO,通过ELISA测量白介素(IL)6、8、10和TNF-α。
结果:Ang-(1-7)/AngII比率,作为ACE2酶活性的间接测量,维生素D3组增加(24±5pg/mL与4.66±2pg/mL,p<0.01)。此外,在维生素D3治疗中,炎性IL显著下降,保护性标志物增加,例如TMAO的大幅减少(5±2μmoles/dL与60±10μmoles/dL,p<0.01)。此外,接受治疗的患者感染严重程度较低,需要较少的重症监护,住院天数较少,和降低死亡率。此外,在维生素D3组中观察到心血管功能标志物的改善,包括高血压患者血压下降的趋势。
结论:COVID-19和特定疾病患者补充维生素D3与更有利的预后相关,提示心血管疾病和肠道菌群失调等合并症患者的治疗潜力。