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0 0.5 1 1.5 2+ Severe case 22% Improvement Relative Risk Vitamin D for COVID-19  Karonova et al.  Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Retrospective study in Russia (November 2020 - March 2021) Lower severe cases with higher vitamin D levels (p=0.01) Karonova et al., Pharmaceuticals, March 2022 Favors vitamin D Favors control

Vitamin D Status and Immune Response in Hospitalized Patients with Moderate and Severe COVID-19

Karonova et al., Pharmaceuticals, doi:10.3390/ph15030305
Mar 2022  
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Retrospective 331 hospitalized patients in Russia, showing lower risk of severe cases with higher vitamin D levels.
This is the 123rd of 184 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 712 vigintillion).
risk of severe case, 22.5% lower, OR 0.78, p = 0.01, cutoff 11.4ng/mL, adjusted per study, inverted to make OR<1 favor high D levels (≥11.4ng/mL), multivariable, RR approximated with OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Karonova et al., 2 Mar 2022, retrospective, Russia, peer-reviewed, 11 authors, study period 30 November, 2020 - 20 March, 2021.
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This PaperVitamin DAll
Vitamin D Status and Immune Response in Hospitalized Patients with Moderate and Severe COVID-19
Tatiana L Karonova, Igor V Kudryavtsev, Ksenia A Golovatyuk, Arthur D Aquino, Olga V Kalinina, Alena T Chernikova, Ekaterina K Zaikova, Denis A Lebedev, Ekaterina S Bykova, Alexey S Golovkin, Evgeny V Shlyakhto
Pharmaceuticals, doi:10.3390/ph15030305
A low 25-hydroxyvitamin D (25(OH)D) level is considered as an independent risk factor for COVID-19 severity. However, the association between vitamin D status and outcomes in COVID-19 is controversial. In the present study we investigate the association between the serum 25(OH)D level, immune response, and clinical disease course in patients with COVID-19. A total of 311 patients hospitalized with COVID-19 were enrolled. For patients with a vitamin D deficiency/insufficiency, the prevalence of severe COVID-19 was higher than in those with a normal 25(OH)D level (p < 0.001). The threshold of 25(OH)D level associated with mortality was 11.4 ng/mL (p = 0.003, ROC analysis). The frequency of CD3+CD4+ T helper (Th) cells was decreased in patients with 25(OH)D level ≤ 11.4 ng/mL, compared to healthy controls (HCs). There were no differences in the frequency of naive, central memory (CM), effector memory (EM), and terminally differentiated effector memory Th cells in patients with COVID-19 compared to HCs. The frequency of T-follicular helpers was decreased both in patients with 25(OH)D level > 11.4 ng/mL (p < 0.001) and 25(OH)D level ≤ 11.4 ng/mL (p = 0.003) compared to HCs. Patients with 25(OH)D level > 11.4 ng/mL had an increased frequency of Th2 CM (p = 0.010) and decreased Th17 CM (p < 0.001). While the frequency of Th2 EM was significantly increased, the frequency of Th17 EM was significantly decreased in both groups compared to HCs. Thus, 25(OH)D level is an independent risk factor for the disease severity and mortality in patients with COVID-19. We demonstrate that the serum 25(OH)D level ≤ 11.4 ng/mL is associated with the stimulation of Th2 and the downregulation of Th17 cell polarization of the adaptive immunity in patients with COVID-19.
Conflicts of Interest: The authors declare no conflict of interest.
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