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Prospective study of 81 hospitalized COVID+ patients in India, showing low vitamin D levels associated with COVID-19 severity and mortality.
This study is excluded in the after exclusion results of meta
analysis:
unadjusted results with no group details.
risk of death, 89.8% lower, RR 0.10, p < 0.001, high D levels (≥10ng/mL) 5 of 64 (7.8%), low D levels (<10ng/mL) 13 of 17 (76.5%), NNT 1.5.
risk of mechanical ventilation, 90.3% lower, RR 0.10, p < 0.001, high D levels (≥10ng/mL) 4 of 64 (6.2%), low D levels (<10ng/mL) 11 of 17 (64.7%), NNT 1.7.
Abstract: Clinical Study
Correlation of Vitamin D Levels with COVID-19
Severity and Outcome
GURDEEP KAUR*, GAURAV SHARMA†, JAINENDRA SHARMA†, SHWETA BIYANI‡, RANJNA VEERWAL†
Abstract
Background and aims: Low vitamin D levels have been associated with an increase in inflammatory cytokines and a
significantly increased risk of pneumonia and viral upper respiratory tract infections. Vitamin D deficiency is associated with
an increase in thrombotic episodes, which are frequently observed in coronavirus disease 2019 (COVID-19). These conditions
are reported to carry a higher mortality in COVID-19. So, we conducted a study to prove the correlation of vitamin D levels
with COVID-19 infection and severity. Material and methods: The present study was conducted at RNT Medical College,
Udaipur, Rajasthan. This study was done over a period of 2 months after getting approval from Institutional Ethics Committee.
Written and informed consent was obtained from patients. In this study, 81 patients admitted in COVID wards and ICU,
with COVID reverse transcriptase-polymerase chain reaction (RT-PCR) positive reports were included. Results: Out of a
total 81 patients, 37 (45.7%) were in the 41-60 years age group, 29 (35.8%) were more than 60 years of age and 15 (18.5%)
were less than 40 years of age. Seventeen patients had severe vitamin D deficiency, 27 patients had moderate vitamin D
deficiency, 20 patients had mild vitamin D deficiency and 17 patients had normal vitamin D level. Out of 17 patients who
had severe vitamin D deficiency, 11 (64.7%) patients required invasive mechanical ventilation and out of these 17 patients,
13 (76.47%) patients died. Out of 17 patients who had normal level of vitamin D, 16 (94.1%) maintained SpO2 at room air
and only 1 patient required invasive mechanical ventilation. As the level of vitamin D increased from severely low to normal
level, requirement of high oxygen support decreased and SpO2 at room air increased. Mean of vitamin D among the patients
who died was 10.4963 while mean of vitamin D level among patients who survived and were discharged was 27.2362. All
17 patients who had normal level of vitamin D were discharged from the hospital. Mean of serum ferritin and mean of
interleukin (IL)-6 was high in patients who died and low in patients who were discharged. Conclusions: Vitamin D level
plays an important role in COVID-19 disease. Vitamin D have significant role in protection from severe form of disease.
Keywords: COVID-19, vitamin D, T regulatory lymphocytes, acute respiratory distress syndrome, IL-6, serum ferritin
T
he severity of coronavirus disease 2019 (COVID-19)
is influenced by several factors, including the
evidence of pneumonia, severe acute respiratory
distress, myocarditis, microvascular thrombosis and/or
cytokine storm. All these conditions have underlying
inflammation. A major defense against inflammation,
and viral infection in general, is the T regulatory
lymphocytes (Tregs). It has been reported that Treg
levels can be low in COVID-19 patients and can be
*Professor, Dept. of Medicine
†Senior Resident, Dept. of General Medicine
‡Associate Professor, Dept. of Biochemistry
RNT Medical College, Udaipur, Rajasthan
Address for correspondence
Dr Gaurav Sharma
Senior Resident
Dept. of General Medicine
RNT Medical College, Udaipur, Rajasthan
E-mail: gauravsharma1280@gmail.com
18
Indian Journal of Clinical Practice, Vol. 32, No. 6, November 2021
increased with vitamin D supplementation.1 Treg levels
can be..
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