Retrospective analysis of vitamin D status on ınflammatory markers and course of the disease in patients with COVID-19 infection

Abstract

Purpose The aim of the study was to investigate the association between serum 25-hydroxyvitamin D status within the last 6 months prior to COVID-19 infection and parameters of immune function and clinical outcomes. Methods Fifty-six patients, who were admitted to the emergency clinic and diagnosed with COVID–19 infection, were included in the study. Data on clinical characteristics, inflammatory parameters and vitamin D status were recorded for each patient. All the participants had data on 25-hydroxyvitamin D status within the last 6 months prior to COVID-19 infection. Results The patients were stratified as those with vitamin D status less than 20 ng/mL and higher than 20 ng/mL. A group with vitamin D status less than 20 ng/mL had lower lymphocyte counts and lower haemoglobin levels that was statistically significant (respectively; p = 0.021, p = 0.035). Higher C-reactive protein (CRP) levels were seen in the vitamin D–deficient group ( p = 0.013). It was observed that vitamin D status of the patients who required oxygen therapy were lower than those who did not require oxygen therapy, not statistically significant ( p = 0.05). Patients who did not use vitamin D supplementation within 6 months prior to COVID-19 infection had more likely to be diagnosed with pneumonia ( p = 0.004). Conclusion Cases with lower vitamin D status had increased inflammatory markers and worse clinical outcomes than patients with higher vitamin D status. This study suggests that vitamin D status can be used as a prognostic factor in COVID-19 patients, and vitamin D supplementation can be recommended to improve the clinical outcomes in COVID-19 infection.

Vitamin D and COVID-19: An Overview of Recent Evidence

“…In the patients that received 60,000 IU of daily supplemental vitamin D for eight days, levels of C-reactive protein, lactase dehydrogenase, IL-6, ferritin, as well as neutrophil to lymphocyte ratios showed significant improvement compared to patients receiving no supplements. This was corroborated by a retrospective cohort study where COVID-19 patients with vitamin D deficiency had significantly lower haemoglobin and lymphocyte counts and higher levels of inflammatory markers, including C-reactive protein [ 120 ]. In addition, vitamin D deficient patients tended to require oxygen therapy and patients who had not corrected their vitamin D levels six months prior to SARS-CoV-2 infection were more likely to be diagnosed with pneumonia [ 120 ].…”

“…This was corroborated by a retrospective cohort study where COVID-19 patients with vitamin D deficiency had significantly lower haemoglobin and lymphocyte counts and higher levels of inflammatory markers, including C-reactive protein [ 120 ]. In addition, vitamin D deficient patients tended to require oxygen therapy and patients who had not corrected their vitamin D levels six months prior to SARS-CoV-2 infection were more likely to be diagnosed with pneumonia [ 120 ]. A randomised controlled trial (RCT) in Spain [ 121 ] investigated the effects of hydroxychloroquine and azithromycin in combination with oral calcifediol in the treatment of COVID-19.…”

Vitamin D and COVID-19: where are we now?

“…In a study involving 56 patients admitted with COVID-19, in which all participants had data on 25(OH)D3 status in the 6 months prior to COVID-19 infection, it was found lower lymphocyte counts and higher C-reactive protein levels in patients with vitamin D deficiency (<20 ng/mL). In addition, the vitamin D status of patients requiring oxygen therapy was found to be lower than those not requiring oxygen therapy, and even patients un-supplemented with vitamin D in the 6 months prior to COVID-19 infection were more likely to be diagnosed with pneumonia [ 75 ]. In this line, Baktash et al .…”

“…In addition, vitamin D deficiency correlated with a higher inflammatory status which, together with comorbidity burden, negatively influenced the length of hospital stay. Ünsal et al, 2021,Turkey [ 75 ] Retrospective cohort study 56 Significantly lower lymphocyte counts and higher levels of inflammatory markers were found in patients with COVID-19 and vitamin D deficiency. Panagiotou et al, 2020, UK [ 77 ] Retrospective cohort study 134 When comparing patients who required admission to ICU versus those who were treated in medical wards, a higher prevalence of vitamin D deficiency was observed in the former.…”

Does vitamin D level have an effect on COVID-19 positivity and COVID-19 related mortality? A retrospective study

“…i s i o n a l l y A c c e p t e d f o r P u b l i c a t i o n and that serum levels of 25(OH)D should be maintained within the range of 40-60ng/mL to minimise the risk and severity of COVID-19.²º A study conducted in patients with COVID-19 reported a more frequent occurrence of pneumonia in patients without vitamin D supplementation 6 months before diagnosing COVID-19 26. The present study could not find a relationship between vitamin D supplementation and the disease.In the present study, the mean vitamin D levels were low in both PCR-positive and PCRnegative cases, and no significant difference was found between the groups.…”