Vitamin D Sufficiency Reduced Risk for Morbidity and Mortality in COVID-19 Patients
13 Pages Posted: 14 Jul 2020More...
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
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