The role of vitamin D as a preventive strategy in COVID-19 infections: evidence from South Asia

DOI record: { "DOI": "10.21203/rs.3.rs-3964082/v1", "URL": "http://dx.doi.org/10.21203/rs.3.rs-3964082/v1", "abstract": "<jats:title>Abstract</jats:title>\n <jats:p>Background\n Regional evidence on prevention of COVID-19 and its sequalae by vitamin D remains inconclusive and sparse.\nAim/Objective\n This study aimed to determine the association between COVID-19 and Vitamin D deficiency among adults in Colombo District, Sri Lanka.\nMethods\n A sex-matched case-control study was conducted among 104 RT-PCR-confirmed COVID-19 patients and 104 RT-PCR negative adults recruited from community. Non-fasting blood samples were analysed for serum 25(OH)D using chemiluminescence assay and vitamin D deficiency identified (&lt; 50.0nmol/L).\nResults\n Cases (34.2; SD = 15.4nmol/L) had significantly lower 25(OH)D compared to controls (39.8; SD = 17.8nmol/L) (p = 0.02) which persisted after adjustments (p = 0.02), along with Sinhalese ethnicity (p &lt; 0.001). VDD was significantly more prevalent in cases (83.7% vs. 71.2%; crude odds ratio (OR) = 2.1; 95%-CI:1.1,4.1), although not an independent COVID-19 predictor (adjusted OR = 1.9; 95%-CI:0.6,5.7). A significantly lower 25(OH)D level was observed in moderate/severe cases (39.7; SD = 12.3nmol/L) vs mild (32.9; SD = 15.8nmol/L) (p = 0.015). Neither low serum concentrations nor deficiency showed an independent relationship with severity (p &gt; 0.05). Diabetes was the sole predictor of COVID-19 severity (p = 0.022).\nConclusions\n Vitamin D has potential as a cost-effective primary, but not secondary, preventive strategy.</jats:p>", "accepted": { "date-parts": [ [ 2024, 2, 17 ] ] }, "author": [ { "affiliation": [ { "name": "University of Colombo" } ], "family": "Arambepola", "given": "Carukshi", "sequence": "first" }, { "affiliation": [ { "name": "Postgraduate Institute of Medicine, University of Colombo, Sri Lanka" } ], "family": "Seneviratne", "given": "Ruwanika", "sequence": "additional" }, { "affiliation": [ { "name": "University of Colombo" } ], "family": "Wijeratne", "given": "Sumedha", "sequence": "additional" }, { "affiliation": [ { "name": "World Health Organization Regional Office for South-East Asia" } ], "family": "Gunawardena", "given": "Nalika", "sequence": "additional" }, { "affiliation": [ { "name": "Department of Public Health, Colombo Municipal Council" } ], "family": "Wijayamuni", "given": "Ruwan", "sequence": "additional" }, { "affiliation": [ { "name": "World Bank, South Asia Region" } ], "family": "Attygalle", "given": "Deepika", "sequence": "additional" } ], "container-title": [], "content-domain": { "crossmark-restriction": false, "domain": [] }, "created": { "date-parts": [ [ 2024, 3, 28 ] ], "date-time": "2024-03-28T18:19:17Z", "timestamp": 1711649957000 }, "deposited": { "date-parts": [ [ 2024, 3, 28 ] ], "date-time": "2024-03-28T18:20:37Z", "timestamp": 1711650037000 }, "group-title": "In Review", "indexed": { "date-parts": [ [ 2024, 3, 29 ] ], "date-time": "2024-03-29T01:20:21Z", "timestamp": 1711675221200 }, "institution": [ { "name": "Research Square" } ], "is-referenced-by-count": 0, "issued": { "date-parts": [ [ 2024, 3, 28 ] ] }, "license": [ { "URL": "https://creativecommons.org/licenses/by/4.0/", "content-version": "unspecified", "delay-in-days": 0, "start": { "date-parts": [ [ 2024, 3, 28 ] ], "date-time": "2024-03-28T00:00:00Z", "timestamp": 1711584000000 } } ], "link": [ { "URL": "https://www.researchsquare.com/article/rs-3964082/v1", "content-type": "text/html", "content-version": "vor", "intended-application": "text-mining" }, { "URL": "https://www.researchsquare.com/article/rs-3964082/v1.html", "content-type": "unspecified", "content-version": "vor", "intended-application": "similarity-checking" } ], "member": "8761", "original-title": [], "posted": { "date-parts": [ [ 2024, 3, 28 ] ] }, "prefix": "10.21203", "published": { "date-parts": [ [ 2024, 3, 28 ] ] }, "publisher": "Research Square Platform LLC", "reference": [ { "DOI": "10.1210/jcem.96.12.zeg3908a", "author": "Holick MF", "doi-asserted-by": "publisher", "key": "ref1", "unstructured": "Holick MF, Binkley NC, Bischoff-Ferrari HA et al. 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