Vitamin D deficiency is associated with COVID‐19 positivity and severity of the disease

Abstract

The present study examined the relationship between polymerase chain reaction (PCR) test positivity and clinical outcomes of vitamin D levels measured within the 6 months before the PCR test in coronavirus disease 2019 (COVID-19)-positive patients. In this retrospective cohort study, and non-COVID-19 patients (260) were divided into four groups according to their vitamin D levels:Group I (0-10 ng/ml), Group II (10-20 ng/ml), Group III (20-30 ng/ml), and Group IV (vitamin D > 30 ng/ml). Laboratory test results and the radiological findings were evaluated. In addition, for comparative purposes, medical records of 1200 patients who had a hospital visit in the November 1, 2019-November 1, 2020 period for complaints due to reasons not related to COVID-19 were investigated for the availability of vitamin D measurements. This search yielded 260 patients with tested vitamin D levels. Vitamin D levels were below 30 ng/ml in 94.27% of 227 COVID-19-positive patients (average age, 46.32 ± 1.24 years [range, 20-80 years] and 56.54% women) while 93.07% of 260 non-COVID-19 patients (average age, 44.63 ± 1.30 years [range, 18-75 years] and 59.50% women) had vitamin D levels below 30 ng/ml. Nevertheless, very severe vitamin D deficiency (<10 ng/ml) was considerably more common in COVID-19 patients (44%) (average age, 44.15 ± 1.89 years [range, 23-80 years] and 57.57% women) than in non-COVID-19 ones (31%) (average age, 46.50 ± 2.21 years [range, 20-75 years] and 62.5% women). Among COVID-19-positive patients, the group with vitamin D levels of >30 ng/ml had significantly lower D-dimer and C-reactive protein (CRP) levels, number levels, number of affected lung segments and shorter hospital stays. No difference was found among the groups in terms of age and gender distribution. Elevated vitamin D levels could decrease COVID-19 PCR positivity, D-dime and CRP levels and the number of affected lung segments in COVID-19-positive patients, thereby shortening the duration of hospital stays and alleviating the intensity of COVID-19.

Investigating the Relationship between Vitamin D and Persistent Symptoms Following SARS-CoV-2 Infection

“…There have been a large number of studies looking at the impact of vitamin D on acute SARS-CoV-2 infection, with variable results reported [ 26 , 27 , 28 ]. Vitamin D deficiency appears to be associated with severe disease, with some evidence suggesting that vitamin D plays a protective role [ 29 , 30 ]. A recent comprehensive systematic review of 23 studies concluded that while vitamin D deficiency seems to be associated with increased severity and mortality in COVID-19, these findings do not imply causality, and further well-designed prospective studies are required to decipher if deficiency is an epiphenomenon or consequence of the inflammatory response in severe COVID-19 illness [ 31 ].…”

Vitamin D and COVID-19 Severity and Related Mortality: A Prospective Study in Italy

“…Likewise, as 25OHD levels were measured when patients were admitted to the hospital, the finding of lower 25OHD in COVID-19 hospitalized patients may be expected, in view of the fact that vitamin D is considered an acute phase reactant and might decrease in case of severe acute infection [42,43]. In this respect, however, most of the studies that assessed the relationship between 25OHD levels measured before SARS-Cov-2 infection, evidenced a similar association between vitamin D deficiency and the severity of COVID-19 disease [26,[44][45][46]. These include a very recent update from the large UK Biobank cohort (n = 353, 299 participants with 1082 SARS-Cov-2 affected cases) showing a significantly positive association between vitamin D insufficiency (as assessed in the baseline visit performed between 2006 and 2010) and COVID-19 hospitalization or severity [46], thus disconfirming previous information derived from the same cohort with a much lower number of SARS-Cov-2 affected cases [47][48][49].…”

Prevention is always better than Cure: Immunity Boosting to Fight Infections

“…also found that the deficiency of vitamin D was associated with greater infection probability by coronavirus. The patients who were found to be COVID-19 positive having adequate levels of vitamin D showed remarkably lesser D-dimer levels in blood also lower CRP level, which is the inflammatory marker, decreased recurrence of ground-glass opacity in CT scan of chest region and brief hospital stay [63].…”