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The Vitamin D, IL-6 and the eGFR Markers a Possible Way to Elucidate the Lung–Heart–Kidney Cross-Talk in COVID-19 Disease: A Foregone Conclusion

Background: Based on recent findings, we speculated the existence of the lung, heart, and kidney axis as the main pathway for the COVID-19 disease progression. Methods: This paper reports on an observational study conducted by a team of researchers and doctors of the 118-Pre-Hospital and Emergency D...

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Autores principales: Balzanelli, Mario Giosuè, Distratis, Pietro, Lazzaro, Rita, Cefalo, Angelo, Catucci, Orazio, Aityan, Sergey Khachatur, Dipalma, Gianna, Vimercati, Luigi, Inchingolo, Alessio Danilo, Maggiore, Maria Elena, Mancini, Antonio, Santacroce, Luigi, Gesualdo, Loreto, Pham, Van Hung, Iacobone, Donatello, Contaldo, Maria, Serpico, Rosario, Scarano, Antonio, Lorusso, Felice, Toai, Tran Cong, Tafuri, Silvio, Migliore, Giovanni, Inchingolo, Angelo Michele, Nguyen, Kieu Cao Diem, Inchingolo, Francesco, Tomassone, Diego, Gargiulo Isacco, Ciro
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8464828/
https://www.ncbi.nlm.nih.gov/pubmed/34576798
http://dx.doi.org/10.3390/microorganisms9091903
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author Balzanelli, Mario Giosuè
Distratis, Pietro
Lazzaro, Rita
Cefalo, Angelo
Catucci, Orazio
Aityan, Sergey Khachatur
Dipalma, Gianna
Vimercati, Luigi
Inchingolo, Alessio Danilo
Maggiore, Maria Elena
Mancini, Antonio
Santacroce, Luigi
Gesualdo, Loreto
Pham, Van Hung
Iacobone, Donatello
Contaldo, Maria
Serpico, Rosario
Scarano, Antonio
Lorusso, Felice
Toai, Tran Cong
Tafuri, Silvio
Migliore, Giovanni
Inchingolo, Angelo Michele
Nguyen, Kieu Cao Diem
Inchingolo, Francesco
Tomassone, Diego
Gargiulo Isacco, Ciro
author_facet Balzanelli, Mario Giosuè
Distratis, Pietro
Lazzaro, Rita
Cefalo, Angelo
Catucci, Orazio
Aityan, Sergey Khachatur
Dipalma, Gianna
Vimercati, Luigi
Inchingolo, Alessio Danilo
Maggiore, Maria Elena
Mancini, Antonio
Santacroce, Luigi
Gesualdo, Loreto
Pham, Van Hung
Iacobone, Donatello
Contaldo, Maria
Serpico, Rosario
Scarano, Antonio
Lorusso, Felice
Toai, Tran Cong
Tafuri, Silvio
Migliore, Giovanni
Inchingolo, Angelo Michele
Nguyen, Kieu Cao Diem
Inchingolo, Francesco
Tomassone, Diego
Gargiulo Isacco, Ciro
author_sort Balzanelli, Mario Giosuè
collection PubMed
description Background: Based on recent findings, we speculated the existence of the lung, heart, and kidney axis as the main pathway for the COVID-19 disease progression. Methods: This paper reports on an observational study conducted by a team of researchers and doctors of the 118-Pre-Hospital and Emergency Department of SG Moscati of Taranto City in Italy. The study was conducted on a totality of 185 participants that were divided into three groups. The study group included COVID-19 affected patients (PP n = 80), the first control group included patients with different pathologies (non-COVID-19 NNp n = 62) of the SG Moscati Hospital, and the second control group included healthy individuals (NNh n = 43). The core of the current trial was focused on assessing the level of the vitamin D (serum 25(OH) D concentration), IL-6, and the renal glomerular filtrate (eGFR) in COVID-19 disease and non-COVID-19 patients in both groups. Results: It was observed that the majority of COVID-19-infected patients showed a progressive multi-organ involvement, especially in regard to the lung, kidney, and heart. The majority of the COVID-19 patients exhibited preexisting comorbidities which include cardiovascular, respiratory, and renal disorders accompanied by a severely low level of vitamin D, extremely high level of IL-6, and low glomerular filtration rate (eGFR). The significant overall damages exerted by the immune-mediated responses under the hyper-expression of proinflammatory cytokines and interleukins, such as IL-6, may be facilitated by either a decreased level of vitamin D or the ageing process. The reduced presence of vitamin D was often found together with a reduced functionality of renal activity, as revealed by the low eGFR, and both were seen to be concomitant with an increased mortality risk in patients with lung disorders and heart failure (HF), whether it is showed at baseline or it develops during manifestation of COVID-19. Therefore, the documentation of the modifiable risk factors related to SARS-CoV-2 and lung impairment in older patients with kidney and heart disease may help the clinician to better manage the situation. Conclusions: This paper addresses how a low level of vitamin D and older age may be indicative of systemic worsening in patients with COVID-19, with a goal of providing a broader context in which to view a better therapeutic approach.
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spelling pubmed-84648282021-09-27 The Vitamin D, IL-6 and the eGFR Markers a Possible Way to Elucidate the Lung–Heart–Kidney Cross-Talk in COVID-19 Disease: A Foregone Conclusion Balzanelli, Mario Giosuè Distratis, Pietro Lazzaro, Rita Cefalo, Angelo Catucci, Orazio Aityan, Sergey Khachatur Dipalma, Gianna Vimercati, Luigi Inchingolo, Alessio Danilo Maggiore, Maria Elena Mancini, Antonio Santacroce, Luigi Gesualdo, Loreto Pham, Van Hung Iacobone, Donatello Contaldo, Maria Serpico, Rosario Scarano, Antonio Lorusso, Felice Toai, Tran Cong Tafuri, Silvio Migliore, Giovanni Inchingolo, Angelo Michele Nguyen, Kieu Cao Diem Inchingolo, Francesco Tomassone, Diego Gargiulo Isacco, Ciro Microorganisms Article Background: Based on recent findings, we speculated the existence of the lung, heart, and kidney axis as the main pathway for the COVID-19 disease progression. Methods: This paper reports on an observational study conducted by a team of researchers and doctors of the 118-Pre-Hospital and Emergency Department of SG Moscati of Taranto City in Italy. The study was conducted on a totality of 185 participants that were divided into three groups. The study group included COVID-19 affected patients (PP n = 80), the first control group included patients with different pathologies (non-COVID-19 NNp n = 62) of the SG Moscati Hospital, and the second control group included healthy individuals (NNh n = 43). The core of the current trial was focused on assessing the level of the vitamin D (serum 25(OH) D concentration), IL-6, and the renal glomerular filtrate (eGFR) in COVID-19 disease and non-COVID-19 patients in both groups. Results: It was observed that the majority of COVID-19-infected patients showed a progressive multi-organ involvement, especially in regard to the lung, kidney, and heart. The majority of the COVID-19 patients exhibited preexisting comorbidities which include cardiovascular, respiratory, and renal disorders accompanied by a severely low level of vitamin D, extremely high level of IL-6, and low glomerular filtration rate (eGFR). The significant overall damages exerted by the immune-mediated responses under the hyper-expression of proinflammatory cytokines and interleukins, such as IL-6, may be facilitated by either a decreased level of vitamin D or the ageing process. The reduced presence of vitamin D was often found together with a reduced functionality of renal activity, as revealed by the low eGFR, and both were seen to be concomitant with an increased mortality risk in patients with lung disorders and heart failure (HF), whether it is showed at baseline or it develops during manifestation of COVID-19. Therefore, the documentation of the modifiable risk factors related to SARS-CoV-2 and lung impairment in older patients with kidney and heart disease may help the clinician to better manage the situation. Conclusions: This paper addresses how a low level of vitamin D and older age may be indicative of systemic worsening in patients with COVID-19, with a goal of providing a broader context in which to view a better therapeutic approach. MDPI 2021-09-07 /pmc/articles/PMC8464828/ /pubmed/34576798 http://dx.doi.org/10.3390/microorganisms9091903 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Balzanelli, Mario Giosuè
Distratis, Pietro
Lazzaro, Rita
Cefalo, Angelo
Catucci, Orazio
Aityan, Sergey Khachatur
Dipalma, Gianna
Vimercati, Luigi
Inchingolo, Alessio Danilo
Maggiore, Maria Elena
Mancini, Antonio
Santacroce, Luigi
Gesualdo, Loreto
Pham, Van Hung
Iacobone, Donatello
Contaldo, Maria
Serpico, Rosario
Scarano, Antonio
Lorusso, Felice
Toai, Tran Cong
Tafuri, Silvio
Migliore, Giovanni
Inchingolo, Angelo Michele
Nguyen, Kieu Cao Diem
Inchingolo, Francesco
Tomassone, Diego
Gargiulo Isacco, Ciro
The Vitamin D, IL-6 and the eGFR Markers a Possible Way to Elucidate the Lung–Heart–Kidney Cross-Talk in COVID-19 Disease: A Foregone Conclusion
title The Vitamin D, IL-6 and the eGFR Markers a Possible Way to Elucidate the Lung–Heart–Kidney Cross-Talk in COVID-19 Disease: A Foregone Conclusion
title_full The Vitamin D, IL-6 and the eGFR Markers a Possible Way to Elucidate the Lung–Heart–Kidney Cross-Talk in COVID-19 Disease: A Foregone Conclusion
title_fullStr The Vitamin D, IL-6 and the eGFR Markers a Possible Way to Elucidate the Lung–Heart–Kidney Cross-Talk in COVID-19 Disease: A Foregone Conclusion
title_full_unstemmed The Vitamin D, IL-6 and the eGFR Markers a Possible Way to Elucidate the Lung–Heart–Kidney Cross-Talk in COVID-19 Disease: A Foregone Conclusion
title_short The Vitamin D, IL-6 and the eGFR Markers a Possible Way to Elucidate the Lung–Heart–Kidney Cross-Talk in COVID-19 Disease: A Foregone Conclusion
title_sort vitamin d, il-6 and the egfr markers a possible way to elucidate the lung–heart–kidney cross-talk in covid-19 disease: a foregone conclusion
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8464828/
https://www.ncbi.nlm.nih.gov/pubmed/34576798
http://dx.doi.org/10.3390/microorganisms9091903
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