Relationship between vitamin D level and clinical status in COVID-19 patients
Fatih Davran, Ceyhan Hacioğlu, Pelin Kamuran Duran, Elif Nisa Unlu, Banu Hümeyra Keskin, Eda Kayabaşi, Elif Eşcan, Şengül Cangür, Cihadiye Öztürk
Konuralp Tıp Dergisi, doi:10.18521/ktd.1134319
Objective: Vitamin D plays an important role in maintaining the integrity of mucosal barriers and in natural and acquired immunity. In the COVID-19 pandemic, the strength of personal immunity is very important in the course of the disease, despite the presence of variants of the virus or vaccination status. Method: In this study, we investigated the relationship between the clinical course and vitamin D levels of outpatient and inpatient follow-up patients admitted to our hospital due to COVID-19. A total of 94 patients, 47 outpatients and 47 inpatients, were included in the study.
Results: The mean age and gender distributions of both groups were similar. Vitamin D levels were found to be normal in only 7 of 94 patients who were followed up in our hospital due to COVID-19. Patients with vitamin D levels ≥30 were significantly lower than those with "<10" and "10-29.9" (p<0.01 for each). Hospitalized patients (71%) with vitamin D levels <10 were significantly higher than those (0%) with vitamin D levels ≥30. Additionally, the outpatients (29%) with vitamin D levels <10 were significantly lower than those (100%) with vitamin D levels ≥30.
Conclusion: The data showed that vitamin D deficiency may be associated with the severe clinical course of COVID-19, even in patients without comorbidities, and may also be one of the predisposing factors resulting in death in COVID-19. As a result, vitamin D levels in COVID-19 patients may be important for the course of the disease.
References
Ali, Role of vitamin D in preventing of COVID-19 infection, progression and severity, J Infect Public Health
Alshishtawy, Vitamin D Deficiency: This clandestine endemic disease is veiled no more, Sultan Qaboos Univ Med J
Beard, Bearden, Striker, Vitamin D and the anti-viral state, J Clin Virol
Christakos, Ajibade, Dhawan, Fechner, Mady, Vitamin D: metabolism, Endocrinol Metab Clin North Am
Grant, Lahore, Mcdonnell, Baggerly, French et al., Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths, Nutrients
Hewison, Vitamin D and innate and adaptive immunity, Vitam Horm
Kim, Lee, Yang, Lee, Effenberger et al., Immunopathogenesis and treatment of cytokine storm in COVID-19, Theranostics
Kumar, Rathi, Haq, Wimalawansa, Sharma, Putative roles of vitamin D in modulating immune response and immunopathology associated with COVID-19, Virus Res
Merzon, 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
Munshi, Hussein, Toraih, Elshazli, Jardak et al., Vitamin D insufficiency as a potential culprit in critical COVID-19 patients, J Med Virol
Pereira, Damascena, Azevedo, De Almeida Oliveira, Da et al., Vitamin D deficiency aggravates COVID-19: systematic review and meta-analysis, Crit Rev Food Sci Nutr
Rondanelli, Miccono, Lamburghini, Avanzato, Riva et al., Self-Care for Common Colds: The Pivotal Role of Vitamin D, Vitamin C, Zinc, and Echinacea in Three Main Immune Interactive Clusters (Physical Barriers, Innate and Adaptive Immunity) Involved during an Episode of Common Colds-Practical Advice on Dosages and on the Time to Take These Nutrients/Botanicals in order to Prevent or Treat Common Colds, Evid Based Complement Alternat Med
Schmid, Walther, Natural vitamin D content in animal products, Adv Nutr
Schwalfenberg, A review of the critical role of vitamin D in the functioning of the immune system and the clinical implications of vitamin D deficiency, Mol Nutr Food Res
Simpson, Kay, Abbara, Bhalla, Chung et al., Radiological Society of North America Expert Consensus Document on Reporting Chest CT Findings Related to COVID-19: Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA, Radiol Cardiothorac Imaging
Smith, Grenier, Batte, Spieler, A Characteristic Chest Radiographic Pattern in the Setting of the COVID-19 Pandemic, Radiol Cardiothorac Imaging
Tsujino, Ushikoshi-Nakayama, Yamazaki, Matsumoto, Saito, Pulmonary activation of vitamin D3 and preventive effect against interstitial pneumonia, J Clin Bioc hem Nutr
Wacker, Holick, Sunlight and Vitamin D: A global perspective for health, Dermatoendocrinol
Yu, Zhu, Zhang, Han, A Familial Cluster of Infection Associated with the 2019 Novel Coronavirus Indicating Possible Person-to-Person Transmission During the Incubation Period, J Infect Dis
DOI record:
{
"DOI": "10.18521/ktd.1134319",
"ISSN": [
"1309-3878"
],
"URL": "http://dx.doi.org/10.18521/ktd.1134319",
"abstract": "<jats:p xml:lang=\"en\">Objective: Vitamin D plays an important role in maintaining the integrity of mucosal barriers and in natural and acquired immunity. In the COVID-19 pandemic, the strength of personal immunity is very important in the severe or lightening of the disease, even if there are variants of the virus or if you are vaccinated. 
\nMethods: In this study, we investigated the relationship between the clinical course and vitamin D levels of outpatient and inpatient follow-up patients admitted to our hospital due to COVID-19. A total of 94 patients, 47 outpatients and 47 inpatients, were included in the study. 
\nResult: The mean age and gender distributions of both groups were similar. Vitamin D levels were found to be normal in only 7 of 94 patients who were followed up in our hospital due to COVID-19. Patients with vitamin D levels ≥30 were significantly lower than those with \"</jats:p>",
"accepted": {
"date-parts": [
[
2022,
12,
2
]
]
},
"author": [
{
"affiliation": [
{
"name": "DÜZCE ÜNİVERSİTESİ"
}
],
"family": "DAVRAN",
"given": "Fatih",
"sequence": "first"
},
{
"ORCID": "http://orcid.org/0000-0002-0993-6118",
"affiliation": [
{
"name": "Düzce Üniversitesi"
}
],
"authenticated-orcid": true,
"family": "HACIOĞLU",
"given": "Ceyhan",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "DÜZCE ÜNİVERSİTESİ"
}
],
"family": "DURAN",
"given": "Pelin",
"sequence": "additional"
},
{
"ORCID": "http://orcid.org/0000-0002-4801-8854",
"affiliation": [
{
"name": "DÜZCE ÜNİVERSİTESİ"
}
],
"authenticated-orcid": true,
"family": "UNLU",
"given": "Elif Nisa",
"sequence": "additional"
},
{
"ORCID": "http://orcid.org/0000-0002-2102-3952",
"affiliation": [
{
"name": "DÜZCE ÜNİVERSİTESİ"
}
],
"authenticated-orcid": true,
"family": "KESKİN",
"given": "Banu Hümeyra",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "DÜZCE ÜNİVERSİTESİ"
}
],
"family": "KAYABAŞI",
"given": "Eda",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "DÜZCE ÜNİVERSİTESİ"
}
],
"family": "EŞCAN",
"given": "Elif",
"sequence": "additional"
},
{
"affiliation": [
{
"name": "DÜZCE ÜNİVERSİTESİ"
}
],
"family": "CANGÜR",
"given": "Şengül",
"sequence": "additional"
},
{
"ORCID": "http://orcid.org/0000-0002-4330-2864",
"affiliation": [
{
"name": "İSTANBUL AREL ÜNİVERSİTESİ"
}
],
"authenticated-orcid": true,
"family": "ÖZTÜRK",
"given": "Cihadiye",
"sequence": "additional"
}
],
"container-title": "Konuralp Tıp Dergisi",
"content-domain": {
"crossmark-restriction": false,
"domain": []
},
"created": {
"date-parts": [
[
2022,
12,
2
]
],
"date-time": "2022-12-02T08:48:18Z",
"timestamp": 1669970898000
},
"deposited": {
"date-parts": [
[
2022,
12,
2
]
],
"date-time": "2022-12-02T08:48:32Z",
"timestamp": 1669970912000
},
"indexed": {
"date-parts": [
[
2022,
12,
3
]
],
"date-time": "2022-12-03T06:05:34Z",
"timestamp": 1670047534863
},
"is-referenced-by-count": 0,
"issued": {
"date-parts": [
[
2022,
12,
2
]
]
},
"member": "7783",
"original-title": [],
"prefix": "10.18521",
"published": {
"date-parts": [
[
2022,
12,
2
]
]
},
"published-online": {
"date-parts": [
[
2022,
12,
2
]
]
},
"publisher": "Konuralp Medical Journal",
"reference": [
{
"key": "ref1",
"unstructured": "World Health Organization. Director-General’s remarks at the media briefing on 2019-nCoV on 11 February 2020. http://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020. Accessed 12 Feb 2020"
},
{
"DOI": "10.1093/infdis/jiaa077",
"doi-asserted-by": "crossref",
"key": "ref2",
"unstructured": "Yu P, Zhu J, Zhang Z, Han Y. A Familial Cluster of Infection Associated with the 2019 Novel Coronavirus Indicating Possible Person-to-Person Transmission During the Incubation Period. J Infect Dis. 2020;221(11):1757-61."
},
{
"DOI": "10.4161/derm.24494",
"doi-asserted-by": "crossref",
"key": "ref3",
"unstructured": "Wacker M, Holick MF. Sunlight and Vitamin D: A global perspective for health. Dermatoendocrinol. 2013;5(1):51-108."
},
{
"DOI": "10.1016/j.ecl.2010.02.002",
"doi-asserted-by": "crossref",
"key": "ref4",
"unstructured": "Christakos S, Ajibade DV, Dhawan P, Fechner AJ, Mady LJ. Vitamin D: metabolism. Endocrinol Metab Clin North Am. 2010;39(2):243-53."
},
{
"DOI": "10.12816/0003106",
"doi-asserted-by": "crossref",
"key": "ref5",
"unstructured": "Alshishtawy MM. Vitamin D Deficiency: This clandestine endemic disease is veiled no more. Sultan Qaboos Univ Med J. 2012;12(2):140-52."
},
{
"DOI": "10.1016/B978-0-12-386960-9.00002-2",
"doi-asserted-by": "crossref",
"key": "ref6",
"unstructured": "Hewison M. Vitamin D and innate and adaptive immunity. Vitam Horm. 2011;86:23-62."
},
{
"DOI": "10.1016/j.jcv.2010.12.006",
"doi-asserted-by": "crossref",
"key": "ref7",
"unstructured": "Beard JA, Bearden A, Striker R. Vitamin D and the anti-viral state. J Clin Virol. 2011;50(3):194-200."
},
{
"DOI": "10.1002/jmv.26360",
"doi-asserted-by": "crossref",
"key": "ref8",
"unstructured": "Munshi R, Hussein MH, Toraih EA, Elshazli RM, Jardak C, Sultana N, et al. Vitamin D insufficiency as a potential culprit in critical COVID-19 patients. J Med Virol. 2021;93(2):733-40."
},
{
"DOI": "10.1111/febs.15495",
"doi-asserted-by": "crossref",
"key": "ref9",
"unstructured": "Merzon E, Tworowski D, Gorohovski A, Vinker S, Golan Cohen A, Green I, 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. 2020;287(17):3693-702."
},
{
"DOI": "10.1016/j.virusres.2020.198235",
"doi-asserted-by": "crossref",
"key": "ref10",
"unstructured": "Kumar R, Rathi H, Haq A, Wimalawansa SJ, Sharma A. Putative roles of vitamin D in modulating immune response and immunopathology associated with COVID-19. Virus Res. 2021;292:198235."
},
{
"DOI": "10.1148/ryct.2020200152",
"doi-asserted-by": "crossref",
"key": "ref11",
"unstructured": "Simpson S, Kay FU, Abbara S, Bhalla S, Chung JH, Chung M, et al. Radiological Society of North America Expert Consensus Document on Reporting Chest CT Findings Related to COVID-19: Endorsed by the Society of Thoracic Radiology, the American College of Radiology, and RSNA. Radiol Cardiothorac Imaging. 2020;2(2):e200152."
},
{
"DOI": "10.1148/ryct.2020200280",
"doi-asserted-by": "crossref",
"key": "ref12",
"unstructured": "Smith DL, Grenier JP, Batte C, Spieler B. A Characteristic Chest Radiographic Pattern in the Setting of the COVID-19 Pandemic. Radiol Cardiothorac Imaging. 2020;2(5):e200280."
},
{
"DOI": "10.3945/an.113.003780",
"doi-asserted-by": "crossref",
"key": "ref13",
"unstructured": "Schmid A, Walther B. Natural vitamin D content in animal products. Adv Nutr. 2013;4(4):453-62."
},
{
"DOI": "10.1155/2018/5813095",
"doi-asserted-by": "crossref",
"key": "ref14",
"unstructured": "Rondanelli M, Miccono A, Lamburghini S, Avanzato I, Riva A, Allegrini P, et al. Self-Care for Common Colds: The Pivotal Role of Vitamin D, Vitamin C, Zinc, and Echinacea in Three Main Immune Interactive Clusters (Physical Barriers, Innate and Adaptive Immunity) Involved during an Episode of Common Colds-Practical Advice on Dosages and on the Time to Take These Nutrients/Botanicals in order to Prevent or Treat Common Colds. Evid Based Complement Alternat Med. 2018;2018:5813095."
},
{
"DOI": "10.3390/nu12040988",
"doi-asserted-by": "crossref",
"key": "ref15",
"unstructured": "Grant WB, Lahore H, McDonnell SL, Baggerly CA, French CB, Aliano JL, et al. Evidence that Vitamin D Supplementation Could Reduce Risk of Influenza and COVID-19 Infections and Deaths. Nutrients. 2020;12(4):988."
},
{
"DOI": "10.1002/mnfr.201000174",
"doi-asserted-by": "crossref",
"key": "ref16",
"unstructured": "Schwalfenberg GK. A review of the critical role of vitamin D in the functioning of the immune system and the clinical implications of vitamin D deficiency. Mol Nutr Food Res. 2011;55(1):96-108."
},
{
"DOI": "10.1016/j.jiph.2020.06.021",
"doi-asserted-by": "crossref",
"key": "ref17",
"unstructured": "Ali N. Role of vitamin D in preventing of COVID-19 infection, progression and severity. J Infect Public Health. 2020;13(10):1373-1380."
},
{
"DOI": "10.7150/thno.49713",
"doi-asserted-by": "crossref",
"key": "ref18",
"unstructured": "Kim JS, Lee JY, Yang JW, Lee KH, Effenberger M, Szpirt W, et al. Immunopathogenesis and treatment of cytokine storm in COVID-19. Theranostics. 2021;11(1):316-329."
}
],
"reference-count": 18,
"references-count": 18,
"relation": {},
"resource": {
"primary": {
"URL": "https://dergipark.org.tr/en/doi/10.18521/ktd.1134319"
}
},
"score": 1,
"short-title": [],
"source": "Crossref",
"subject": [
"General Medicine"
],
"subtitle": [],
"title": "Relationship between vitamin D level and clinical status in COVID-19 patients",
"type": "journal-article"
}