Banca de DEFESA: LUCAS ALVES DE SOUSA GOMEZ

Role of Vitamin D and inflammatory markers in hospitalized patients in ICUs during different SARS-CoV-2 pandemic peaks

inflammation; covid-19; vitamin D

The prognosis of covid-19 relies on several factors, including patient's immune
response, metabolic and nutritional status and genetic characteristics of the virus. This
study investigated the inflammatory profile, oxidative stress and vitamin D levels in
patients admitted to intensive care units at Hospital do Coração (HC) and Hospital
Giselda Trigueiro (HGT), infected with the B.1.1.33 strain (2020) and P.2 or P.1
(Gamma) strains of SARS-CoV-2, respectively. Patients with positive RT-PCR were
organized into two groups: the first group had their blood collected from April to May
2020 (B.1.1.33). The second group had blood collected in January and February of

2021 (P.2/P.1). We determined global and differential leukocyte counts, neutrophil-
lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), systemic levels of C-reactive

protein (CRP), lactic dehydrogenase (LDH), creatinine, vitamin D, malondialdehyde
(MDA), cytokines and chemokines. Based on hematological characteristics and blood
marker levels, they were characterized by two different groups, observing that patients
with P.2/P.1 (group 2 – G2) had a higher number of leukocytes, mainly neutrophils,
with higher proportions of NLR and PLR when compared to patients B.1.1.33 (group 1
– G1). Furthermore, higher levels of LDH, CXCL8 and MDA and lower levels of vitamin
D, GM-CSF and IFN- were found in G2 patients. The neutrophilia observed together
with elevated levels of CXCL8 and LDH in G2 patients suggests greater susceptibility
to the occurrence of pyroptosis and NETosis, which may play an important role in the
severity of lung damage and systemic compromise during Covid-19 caused by the P.2
and P.1 lineages, in contrast to patients with a more ancestral lineage of the virus.