Association of Serum Vitamin D level and COVID-19 infection: A Case-control Study
Najat Abdrabbo Alyafei, Bushra Naaz Fathima Jaleel, Abdel-Salam G. Abdel-Salam, Hamda Ali Al-Saadi, Samya Ahmad Al Abdulla
Qatar Medical Journal, doi:10.5339/qmj.2022.48
Background: Vitamin D is considered a potent modulator of the immune system, albeit its role in COVID-19 infection is a matter of debate. The present study aimed to estimate the association between serum vitamin D levels and COVID-19 among people in Qatar. Methods: This case-control study, approved by the Institutional Review Board of Primary Health Care Corporation (PHCC) Qatar, retrospectively evaluated the principal public healthcare sector population data repository retrieved from the cloud-based Electronic Health Record (EHR) software-Cerner, during April 2020-2021. The health records of all adult patients aged .18 years who had undergone the reverse transcription-polymerase chain reaction (RT-PCR) test and whose medical records had documented serum 25-hydroxyvitamin D [25 (OH)D] levels were analyzed. Results: A total of 924,173 EHRs were extracted, of which 62,451 EHR comprised of 16,446 (26.3%) COVID-19 patients and 46,005 (73.7%) negativecontrol group patients met the inclusion criteria. The odds ratio (OR) among different categories of vitamin D deficiency (VDD) revealed that people with mild/ moderate VDD were 1.18 times (95% CI 1.126-1.258) and those with severe VDD were 1.90 times (95% CI 1.116-1.251) more likely to have COVID-19 infection when compared to the people with optimal serum vitamin D level. On applying multiple logistic regression, the odds of having COVID-19 infection were found to be 1.27 times (95% CI 1.184-1.371) higher among those with mild/moderate VDD and 1.32 times (95% CI 1.206-1.405) higher among those with severe VDD when compared to people with optimal vitamin D level ( p , 0.001).
Conflicts of Interest The authors declare no conflicts of interest.
Authors' Contribution All authors contributed to the design, data collection, data analysis, and interpretation of the results. NAA, BNFJ, HAA and SAA led the data collection. ASG led the data analysis. NAA, BNFJ, ASG, SAA and HAA led the interpretation and presentation of results. NAA and BNFJ wrote the initial draft of the manuscript. All the authors read and approved the final manuscript.
References
Abdollahi, Sarvestani, Rafat, Ghaderkhani, Mahmoudialiabadi et al., The association between the level of serum 25(OH) vitamin D, obesity, and underlying diseases with the risk of developing COVID-19 infection: a case-control study of hospitalized patients in Tehran, Iran, J Med Virol,
doi:10.1002/jmv.26726Abrishami, Dalili, Torbati, Asgari, Arab-Ahmadi et al., Possible association of vitamin D status with lung involvement and outcome in patients with COVID-19: a retrospective study, Eur J Nutr,
doi:10.1007/s00394-020-02411-0Angelidi, Belanger, Lorinsky, Karamanis, Chamorro-Pareja et al., Vitamin D status is associated with in-hospital mortality and mechanical ventilation: a cohort of COVID-19 hospitalized patients, Mayo Clin Proc
Beigmohammadi, Bitarafan, Hoseindokht, Abdollahi, Amoozadeh et al., The effect of supplementation with vitamins A, B, C, D, and E on disease severity and inflammatory responses in patients with COVID-19: a randomized clinical trial, Trials,
doi:10.1186/s13063-021-05795-4Carpagnano, Lecce, Quaranta, Zito, Buonamico et al., Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19, J Endocrinol. Investig
Chen, Mei, Xie, Yuan, Ma et al., Low vitamin D levels do not aggravate COVID-19 risk or death, and vitamin D supplementation does not improve outcomes in hospitalized patients with COVID-19: a meta-analysis and GRADE assessment of cohort studies and RCTs, Nutr J,
doi:10.1186/s12937-021-00744-yDavoudi, Najafi, Aarabi, Tayebi, Nikaeen et al., Lack of association between vitamin D insufficiency and clinical outcomes of patients with COVID-19 infection, BMC Infect Dis,
doi:10.1186/s12879-021-06168-7Diaz-Curiel, Cabello, Arboiro-Pinel, Mansur, Heili-Frades et al., The relationship between 25(OH) Vitamin D levels and COVID-19 onset and disease course in Spanish patients, J Steroid Biochem Mol Biol
Getachew, Tizabi, Vitamin D and COVID-19: role of ACE2, age, gender, and ethnicity, J Med Virol,
doi:10.1002/jmv.27075Ghasemian, Shamshirian, Heydari, Malekan, Alizadeh-Navaei et al., The role of vitamin D in the age of COVID-19: a systematic review and meta-analysis, Int J Clin Pract,
doi:10.1111/ijcp.14675Hamad, Qa, Our organization
Hernández, Nan, Fernandez-Ayala, García-Unzueta, Hernándezhernández et al., Vitamin D status in hospitalized patients with SARS-CoV-2 infection, J Clin Endocrinol Metab,
doi:10.1210/clinem/dgaa733Holick, Vitamin D deficiency, N Engl J Med
Ilie, Stefanescu, Smith, The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality, Aging Clin Exp Res,
doi:10.1007/s40520-020-01570-8Jahromi, Tabriz, Togha, Ariyanfar, Ghorbani et al., The correlation between serum selenium, zinc, and COVID-19 severity: an observational study, BMC Infect Dis,
doi:10.1186/s12879-021-06617-3Khan, Chen, Geiger, Role of endolysosomes in severe acute respiratory syndrome coronavirus-2 infection and coronavirus disease 2019 pathogenesis: implications for potential treatments, Front Pharmacol,
doi:10.3389/fphar.2020.595888Latif, Ahmed, Farhan, Watt, Azeem, Predictors of psychological distress in health care staff in Qatar during COVID-19 pandemic, Pak J Med Sci,
doi:10.12669/pjms.37.7.4533Licata, Minissale, Montalto, Soresi, Is vitamin D deficiency predictor of complications development in patients with HCV-related cirrhosis?, Intern Emerg Med
Luo, Liao, Shen, Li, Cheng, Vitamin D deficiency is associated with COVID-19 incidence and disease severity in Chinese people, J Nutr,
doi:10.1093/jn/nxaa332Meltzer, Best, Zhang, Vokes, Arora et al., Association of vitamin D status and other clinical characteristics with COVID-19 test results, JAMA Netw Open,
doi:10.1001/jamanetworkopen.2020.19722Merzon, Tworowski, Gorohovski, Vinker, Cohen et al., Low plasma 25(OH) vitamin D level is associated with increased risk of COVID-19 infection: an Israeli population-based study, FEBS J,
doi:10.1111/febs.15495Mg, Sa, Abdulla, Bakri, Mohammed et al., Epidemiological health assessment in primary healthcare in the State of Qatar-2019, Qatar Med J,
doi:10.5339/qmj.2021.57Mohamed, Almonaem, Mansour, Algebaly, Khattab et al., Importance of studying the levels of hepcidin and vitamin D in Egyptian children with chronic hepatitis C, J Transl Int Med,
doi:10.2478/jtim-2019-0004Nimavat, Singh, Singh, Singh, Sinha, Vitamin D deficiency and COVID-19: A case-control study at a tertiary care hospital in India, Ann Med Surg (Lond),
doi:10.1016/j.amsu.2021.102661Pang, Cardosa, Guzman, Of cascades and perfect storms: the immunopathogenesis of dengue haemorrhagic fever-dengue shock syndrome (DHF/ DSS), Immunol Cell Biol,
doi:10.1038/sj.icb.7100008Parchani, Vidhya, Panda, Rawat, Bahurupi et al., Fear, anxiety, stress, and depression of novel coronavirus (COVID-19) pandemic among patients and their healthcare workers-a descriptive study, Psychol Res Behav Manag
Paria, Paul, Chowdhury, Pyne, Chakraborty et al., Synergy of melanin and vitamin-D may play a fundamental role in preventing SARS-CoV-2 infections and halt COVID-19 by inactivating furin protease, Transl Med Commun,
doi:10.1186/s41231-020-00073-yQu, Li, Hu, Jiang, An imperative need for research on the role of environmental factors in transmission of novel coronavirus
Salari, Hosseinian-Far, Jalali, Vaisi-Raygani, Rasoulpoor et al., Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis, Global Health,
doi:10.1186/s12992-020-00589-wSiddiqui, Manansala, Abdulrahman, Nasrallah, Smatti et al., Immune modulatory effects of vitamin D on viral infections, Nutrients,
doi:10.3390/nu12092879Taneri, Gómez-Ochoa, Llanaj, Raguindin, Rojas et al., Anemia and iron metabolism in COVID-19: a systematic review and meta-analysis, Eur J Epidemiol,
doi:10.1007/s10654-020-00678-5Teshome, Adane, Girma, Mekonnen, The impact of vitamin D level on COVID-19 infection: systematic review and meta-analysis, Front Public Health,
doi:10.3389/fpubh.2021.624559Viard, Souberbielle, Kirk, Reekie, Knysz et al., Vitamin D and clinical disease progression in HIV infection: results from the EuroSIDA study, AIDS (Lond Engl),
doi:10.1097/qad.0-b013e328347f6f7Ye, Tang, Liao, Shaw, Deng et al., Does serum vitamin level affect COVID-19 infection and its severity?-A case-control study, J Am Coll Nutr,
doi:10.1080/07315724.2020.1826005Zainel, Qotba, Nuaimi, Syed, Vitamin D status among adults (18-65 years old) attending primary healthcare centres in Qatar: a cross-sectional analysis of the Electronic Medical Records for the year 2017, BMJ Open,
doi:10.1136/bmjopen-2019-029334DOI record:
{
"DOI": "10.5339/qmj.2022.48",
"ISSN": [
"0253-8253",
"2227-0426"
],
"URL": "http://dx.doi.org/10.5339/qmj.2022.48",
"author": [
{
"affiliation": [
{
"name": "Primary Health Care Corporation, Qatar. Email & ORCID ID: nalyafei@phcc.gov.qa & https://orcid.org/0000-0002-8071-3646"
}
],
"family": "Abdrabbo AlYafei",
"given": "Najat",
"sequence": "first"
},
{
"affiliation": [
{
"name": "Primary Health Care Corporation, Qatar. Email & ORCID ID: nalyafei@phcc.gov.qa & https://orcid.org/0000-0002-8071-3646"
}
],
"family": "Fathima Jaleel",
"given": "Bushra Naaz",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Department of Mathmatics, Statistics and Physics, College of Art and Sciences, Qatar unitversity, Doha, Box. 2713, Qatar."
}
],
"family": "Abdel-Salam",
"given": "Abdel-Salam G.",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Primary Health Care Corporation, Qatar. Email & ORCID ID: nalyafei@phcc.gov.qa & https://orcid.org/0000-0002-8071-3646"
}
],
"family": "Ali Al-Saadi",
"given": "Hamda",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "Primary Health Care Corporation, Qatar. Email & ORCID ID: nalyafei@phcc.gov.qa & https://orcid.org/0000-0002-8071-3646"
}
],
"family": "Al Abdulla",
"given": "Samya Ahmad",
"sequence": "additional"
}
],
"container-title": "Qatar Medical Journal",
"content-domain": {
"crossmark-restriction": false,
"domain": []
},
"created": {
"date-parts": [
[
2022,
12,
3
]
],
"date-time": "2022-12-03T14:30:51Z",
"timestamp": 1670077851000
},
"deposited": {
"date-parts": [
[
2022,
12,
6
]
],
"date-time": "2022-12-06T08:31:34Z",
"timestamp": 1670315494000
},
"indexed": {
"date-parts": [
[
2022,
12,
7
]
],
"date-time": "2022-12-07T06:15:22Z",
"timestamp": 1670393722575
},
"is-referenced-by-count": 0,
"issue": "4",
"issued": {
"date-parts": [
[
2022,
12,
5
]
]
},
"journal-issue": {
"issue": "4",
"published-print": {
"date-parts": [
[
2022,
12,
5
]
]
}
},
"language": "en",
"link": [
{
"URL": "https://www.qscience.com/content/journals/10.5339/qmj.2022.48?crawler=true&mimetype=application/pdf",
"content-type": "unspecified",
"content-version": "vor",
"intended-application": "similarity-checking"
}
],
"member": "3277",
"original-title": [],
"prefix": "10.5339",
"published": {
"date-parts": [
[
2022,
12,
5
]
]
},
"published-print": {
"date-parts": [
[
2022,
12,
5
]
]
},
"publisher": "Hamad bin Khalifa University Press (HBKU Press)",
"reference-count": 0,
"references-count": 0,
"relation": {},
"resource": {
"primary": {
"URL": "https://www.qscience.com/content/journals/10.5339/qmj.2022.48"
}
},
"score": 1,
"short-title": [],
"source": "Crossref",
"subject": [
"General Medicine"
],
"subtitle": [],
"title": "Association of Serum Vitamin D level and COVID-19 infection: A Case-control Study",
"type": "journal-article",
"volume": "2022"
}
