Vitamin D Supplementation Could Possibly Improve Clinical Outcomes of Patients Infected with Coronavirus-2019 (COVID-19)
9 Pages Posted: 9 Apr 2020 Last revised: 7 May 2020
Date Written: April 9, 2020
The rapid spread of COVID-19 in many areas of the world calls for preventive health measures. Although basic guidelines on infection control are suggested, treatment has remained the best choice to avert mortality. However, for the time being, there are no known vaccines for the disease. In this paper, a multinomial logistic regression was used to predict clinical outcomes of patients infected with COVID-19 based on 25-hydroxyvitamin D [25(OH)D] levels, the barometer for Vitamin D status. A retrospective multicentre study of 212 cases with laboratory-confirmed infection of SARS-CoV-2 was conducted. Data pertaining to clinical features and serum 25(OH)D levels were extracted from the medical records. For statistical analysis, Mann-Whitney U and χ² tests were used to compare differences in the clinical outcomes. Multinomial logistic regression was used to explore the association between serum 25(OH)D level and clinical outcomes of the cases. Frequency and percentage were used for categorical variables. Mean was used for continuous variables. A p-value below 0.01 was considered statistically significant. Of the 212 cases of COVID-19, majority had ordinary clinical outcome. Mean serum 25(OH)D level was 23.8 ng/ml. Serum 25(OH)D level was lowest in critical cases, but highest in mild cases. Serum 25(OH)D levels were statistically significant among clinical outcomes. Majority had insufficient Vitamin D status, most of them were not severe. Vitamin D status is significantly associated with clinical outcomes. A multinomial logistic regression analysis reported that for each standard deviation increase in serum 25(OH)D, the odds of having a mild clinical outcome rather than a severe outcome were approximately 7.94 times (OR=0.126, p<0.001) while interestingly, the odds of having a mild clinical outcome rather than a critical outcome were approximately 19.61 times (OR=0.051, p<0.001). The results suggest that an increase in serum 25(OH)D level in the body could either improve clinical outcomes or mitigate worst (severe to critical) outcomes, while a decrease in serum 25(OH)D level in the body could worsen clinical outcomes of COVID-2019 patients. In conclusion, this study provides substantial information to clinicians and health policy-makers. Vitamin D supplementation could possibly improve clinical outcomes of patients infected with COVID-19. Further research should conduct randomized controlled trials and large population studies to evaluate this recommendation.
Note: Funding: None. No funding to declare.
Conflict of Interest: The author declares no conflict of interest.
Ethical Approval: Ethics approval was considered exempt owing to the nature of the study and open-access data used.
Keywords: Coronavirus, COVID-19 Clinical outcome, Infectious disease, Public health, Vitamin D
JEL Classification: I1, I12, I18, I28
Suggested Citation: Suggested Citation