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Vitamin D Sufficiency Reduced Risk for Morbidity and Mortality in COVID-19 Patients

13 Pages Posted: 14 Jul 2020

See all articles by Zhila Maghbooli

Zhila Maghbooli

Tehran University of Medical Sciences

Mehdi Ebrahimi

Tehran University of Medical Sciences

Arash Shirvani

Boston University - Section of Endocrinology, Nutrition, Diabetes and Weight Management

Mehrad Nasiri

Tehran University of Medical Sciences

Marzieh Pazoki

Tehran University of Medical Sciences

Samira Kafan

Tehran University of Medical Sciences

Hedieh Moradi Tabriz

Tehran University of Medical Sciences

Azar Hadadi

Tehran University of Medical Sciences

Mahnaz Montazeri

Tehran University of Medical Sciences

Mohammad Ali Sahraian

Tehran University of Medical Sciences

Michael F. Holick

Boston University - Section of Endocrinology, Nutrition, Diabetes and Weight Management

More...

Abstract

The aim of the study was to investigate the association between serum 25-hydroxyvitamin D levels and its effect on adverse clinical outcomes, parameters of immune function and mortality due to a SARS-CoV-2 infection.

Method: Hospital medical records were analyzed from inpatient database of Sina Hospital COVID-19 Registry (SHCo-19R). The data include demographics, laboratory measurements and computerized tomography results. Vitamin D sufficiency was defined a serum 25-hydroxyvitamin D [25(OH)D] level of at least 30ng/mL.

Results: The hospital data of 235 patients infected with COVID-19 were analyzed. The mean age was 58·7 years ± 15·2 SD. Based on CDC criteria, among our study patients, 74% had severe COVID-19 infection and 32·8% were vitamin D sufficient [25(OH)D≥30 ng/mL]. After adjusting for confounding factors, there was a significant association between vitamin D sufficiency and reduction in clinical severity, inpatient mortality, serum levels of C-reactive protein (CRP)and an increase in lymphocyte percentage Only 9·7% of patients older than 40 years who were vitamin D sufficient succumbed to the infection compared to 20% who had a circulating level of 25(OH)D< 30 ng/mL.

Discussion: The significant reduction in serum CRP, an inflammatory marker, along with increased lymphocytes percentage suggest that vitamin D sufficiency also may help modulate the immune response possibly by reducing risk for cytokine storm in response to this viral infection. Therefore, it is recommended that improving vitamin D status in the general population and in particular hospitalized patients has a potential benefit in reducing the severity of morbidities and mortality associated with acquiring COVID-19.

Funding Statement: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors for trial design, data collection, or analysis.

Declaration of Interests: MFH former consultant for Quest Diagnostics, speakers Bureau for Abbott Inc., consultant Ontometrics Inc., all other authors declare that they have no conflict of interest.

Ethics Approval Statement: The current study was approved by the ethics review board at Tehran University of Medical Sciences (IR.TUMS.VCR.REC.1399.338).

Keywords: SARS-CoV-2; COVID-19; Vitamin D; 25-hydroxyvitamin D; immunomodulation; hypoxia; unconsciousness; lymphocyte; C-reactive protein; mortality; morbidity

Suggested Citation

Maghbooli, Zhila and Ebrahimi, Mehdi and Shirvani, Arash and Nasiri, Mehrad and Pazoki, Marzieh and Kafan, Samira and Tabriz, Hedieh Moradi and Hadadi, Azar and Montazeri, Mahnaz and Sahraian, Mohammad Ali and Holick, Michael F., Vitamin D Sufficiency Reduced Risk for Morbidity and Mortality in COVID-19 Patients (5/27/2020). Available at SSRN: https://ssrn.com/abstract=3616008 or http://dx.doi.org/10.2139/ssrn.3616008

Zhila Maghbooli

Tehran University of Medical Sciences

Number 21, Dameshg St.
Vali-e Asr Ave.
Tehran, 14195
Iran

Mehdi Ebrahimi

Tehran University of Medical Sciences

Number 21, Dameshg St.
Vali-e Asr Ave.
Tehran, 14195
Iran

Arash Shirvani

Boston University - Section of Endocrinology, Nutrition, Diabetes and Weight Management

MA
United States

Mehrad Nasiri

Tehran University of Medical Sciences

Number 21, Dameshg St.
Vali-e Asr Ave.
Tehran, 14195
Iran

Marzieh Pazoki

Tehran University of Medical Sciences

Number 21, Dameshg St.
Vali-e Asr Ave.
Tehran, 14195
Iran

Samira Kafan

Tehran University of Medical Sciences

Number 21, Dameshg St.
Vali-e Asr Ave.
Tehran, 14195
Iran

Hedieh Moradi Tabriz

Tehran University of Medical Sciences

Number 21, Dameshg St.
Vali-e Asr Ave.
Tehran, 14195
Iran

Azar Hadadi

Tehran University of Medical Sciences

Number 21, Dameshg St.
Vali-e Asr Ave.
Tehran, 14195
Iran

Mahnaz Montazeri

Tehran University of Medical Sciences

Number 21, Dameshg St.
Vali-e Asr Ave.
Tehran, 14195
Iran

Mohammad Ali Sahraian

Tehran University of Medical Sciences

Number 21, Dameshg St.
Vali-e Asr Ave.
Tehran, 14195
Iran

Michael F. Holick (Contact Author)

Boston University - Section of Endocrinology, Nutrition, Diabetes and Weight Management ( email )

MA
United States

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