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Comparison of the cardiovascular system, clinical condition, and laboratory results in COVID-19 patients with and without vitamin D insufficiency

Kazemi et al., BMC Infectious Diseases, doi:10.1186/s12879-022-07438-8
May 2022  
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Mortality 76% Improvement Relative Risk Severe case -5% Vitamin D for COVID-19  Kazemi et al.  Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Retrospective 202 patients in Iran Lower mortality with higher vitamin D levels (not stat. sig., p=0.26) c19early.org Kazemi et al., BMC Infectious Diseases, May 2022 Favorsvitamin D Favorscontrol 0 0.5 1 1.5 2+
Vitamin D for COVID-19
8th treatment shown to reduce risk in October 2020, now with p < 0.00000000001 from 122 studies, recognized in 9 countries.
No treatment is 100% effective. Protocols combine treatments.
5,100+ studies for 112 treatments. c19early.org
Retrospective 202 hospitalized COVID-19 patients in Iran, showing no significant difference in outcomes based on vitamin D levels.
This is the 135th of 211 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 248,027,826 vigintillion).
risk of death, 75.8% lower, RR 0.24, p = 0.26, high D levels (≥30ng/mL) 1 of 75 (1.3%), low D levels (<30ng/mL) 7 of 127 (5.5%), NNT 24.
risk of severe case, 4.8% higher, RR 1.05, p = 1.00, high D levels (≥30ng/mL) 13 of 75 (17.3%), low D levels (<30ng/mL) 21 of 127 (16.5%).
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Kazemi et al., 7 May 2022, retrospective, Iran, peer-reviewed, mean age 56.0, 4 authors. Contact: h1a1sheyban@gmail.com (corresponding author), sheybani@shmu.ac.ir.
This PaperVitamin DAll
Comparison of the cardiovascular system, clinical condition, and laboratory results in COVID-19 patients with and without vitamin D insufficiency
Erfan Kazemi, Ali Mansoursamaei, Marzieh Rohani-Rasaf, Hossein Sheibani
BMC Infectious Diseases, doi:10.1186/s12879-022-07438-8
Background: Serum vitamin D levels may have a protective role against severe coronavirus disease 2019 . Studies have shown that deficiency in vitamin D may be a significant risk factor for poor outcomes. This study aims to compare the outcome and clinical condition of patients diagnosed with COVID-19 infection considering serum vitamin D levels. Methods: In this cross-sectional study, 202 COVID-19 patients without known cardiovascular disease (reduced ejection fraction, uncontrolled arrhythmia, pericardial effusion, cardiac block, valvular disease, or hypertension) were included. Patients were divided into three groups of insufficient (< 30 ng/mL), normal (30 to 50 ng/mL), and high (> 50 ng/mL) serum vitamin D levels. Clinical outcome was defined as severe if invasive respiratory intervention and ICU admission was required. Results: The patients were divided into three groups based on their vitamin D level: 127 cases in the insufficient vitamin D group, 53 cases in the normal vitamin D group, and 22 cases in the high vitamin D group. The mean age of the population study was 56 years. Thirty-four patients had severe clinical outcomes. The distribution of this group was as follows: 21 patients in the insufficient vitamin D group (16.5%), eight patients in the normal vitamin D group (15.1%), and five patients in the high vitamin D group (22.7%); P = 0.74. No significant differences were found between the groups in terms of mortality rate (P = 0.46). Moreover, the mean of leukocytes (mean ± SD = 6873.5 ± 4236.2), ESR (mean ± SD = 38.42 ± 26.7), and CPK-MB (mean ± SD = 63 ± 140.7) were higher in the insufficient vitamin D group, but it was not statistically significant (P > 0.05). Conclusion: The finding of the present study showed that vitamin D could not make a significant difference in cardiovascular systems, laboratory results, and severity of the disease in COVID-19 patients.
Abbreviations Author contributions EK and AM gathered the required data. AM, EK, and HSh reviewed the literature. HSh and MRR interpreted the laboratory and clinical findings. All authors participated in writing the manuscript. All authors read and approved the final manuscript. Declarations Ethics approval and consent to participate This project was approved by the Ethical Committee of Shahroud University of Medical Sciences, Shahroud, Iran. The study was conducted according to the guidelines of the Declaration of Helsinki. Informed consent was waived by the Ethics Committee as no intervention was done, and informed consent is routinely obtained from the patients at our hospital upon admission to receive medical care and diagnostic procedures. Consent for publication Not applicable. Competing interests The authors declare no competing interests. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Impact of cardiovascular disease and risk factors on fatal ' 'outcomes in patients with COVID-19 according to age: a systematic review ' 'and meta-analysis. Heart. 2021;107(5):373.', 'journal-title': 'Heart'}, { 'issue': '1', 'key': '7438_CR27', 'doi-asserted-by': 'publisher', 'first-page': '450', 'DOI': '10.1186/s12879-021-06168-7', 'volume': '21', 'author': 'A Davoudi', 'year': '2021', 'unstructured': 'Davoudi A, et al. Lack of association between vitamin D insufficiency ' 'and clinical outcomes of patients with COVID-19 infection. BMC Infect ' 'Dis. 2021;21(1):450.', 'journal-title': 'BMC Infect Dis'}, { 'issue': '3', 'key': '7438_CR28', 'doi-asserted-by': 'publisher', 'first-page': '160', 'DOI': '10.1016/j.tcm.2019.05.003', 'volume': '30', 'author': 'JM Flack', 'year': '2020', 'unstructured': 'Flack JM, Adekola B. Blood pressure and the new ACC/AHA hypertension ' 'guidelines. Trends Cardiovasc Med. 2020;30(3):160–4.', 'journal-title': 'Trends Cardiovasc Med'}, { 'issue': '1', 'key': '7438_CR29', 'doi-asserted-by': 'publisher', 'first-page': '137', 'DOI': '10.1186/s12931-020-01405-0', 'volume': '21', 'author': 'C Mathyssen', 'year': '2020', 'unstructured': 'Mathyssen C, et al. Local expression profiles of vitamin D-related genes ' 'in airways of COPD patients. Respir Res. 2020;21(1):137.', 'journal-title': 'Respir Res'}, { 'issue': '4', 'key': '7438_CR30', 'doi-asserted-by': 'publisher', 'first-page': '561', 'DOI': '10.1016/j.dsx.2020.04.050', 'volume': '14', 'author': 'CE Hastie', 'year': '2020', 'unstructured': 'Hastie CE, et al. Vitamin D concentrations and COVID-19 infection in UK ' 'Biobank. 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' 'https://doi.org/10.1002/14651858.CD015043.', 'journal-title': 'Cochrane Database Syst Rev', 'DOI': '10.1002/14651858.CD015043'}, { 'issue': '13', 'key': '7438_CR33', 'doi-asserted-by': 'publisher', 'first-page': '1239', 'DOI': '10.1001/jama.2020.2648', 'volume': '323', 'author': 'Z Wu', 'year': '2020', 'unstructured': 'Wu Z, McGoogan JM. Characteristics of and important lessons from the ' 'coronavirus disease 2019 (COVID-19) Outbreak in China: summary of a ' 'report of 72 314 cases from the Chinese center for disease control and ' 'prevention. JAMA. 2020;323(13):1239–42.', 'journal-title': 'JAMA'}, { 'issue': '4', 'key': '7438_CR34', 'doi-asserted-by': 'publisher', 'first-page': '988', 'DOI': '10.3390/nu12040988', 'volume': '12', 'author': 'WB Grant', 'year': '2020', 'unstructured': 'Grant WB, et al. Evidence that vitamin D supplementation could reduce ' 'risk of influenza and COVID-19 infections and deaths. Nutrients. 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' 'Postgrad Med J. 2020;98(1156):87–90.', 'journal-title': 'Postgrad Med J'}, { 'issue': '7', 'key': '7438_CR39', 'doi-asserted-by': 'publisher', 'first-page': '2129', 'DOI': '10.3390/nu13072129', 'volume': '13', 'author': 'S Zelzer', 'year': '2021', 'unstructured': 'Zelzer S, et al. Vitamin D metabolites and clinical outcome in ' 'hospitalized COVID-19 patients. Nutrients. 2021;13(7):2129.', 'journal-title': 'Nutrients'}, { 'issue': '1', 'key': '7438_CR40', 'doi-asserted-by': 'publisher', 'first-page': '166', 'DOI': '10.1186/s12967-021-02838-x', 'volume': '19', 'author': 'NM Al-Daghri', 'year': '2021', 'unstructured': 'Al-Daghri NM, et al. Vitamin D status of Arab Gulf residents screened ' 'for SARS-CoV-2 and its association with COVID-19 infection: a ' 'multi-centre case–control study. 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Vitamin D 25OH deficiency in COVID-19 patients admitted ' 'to a tertiary referral hospital. Clin Nutr. 2021;40(4):2469–72.', 'journal-title': 'Clin Nutr'}, { 'issue': '11', 'key': '7438_CR44', 'doi-asserted-by': 'publisher', 'DOI': '10.1111/ijcp.14649', 'volume': '75', 'author': 'AP da Rocha', 'year': '2021', 'unstructured': 'da Rocha AP, et al. Insufficient evidence for vitamin D use in COVID-19: ' 'A rapid systematic review. Int J Clin Pract. 2021;75(11): e14649.', 'journal-title': 'Int J Clin Pract'}, { 'issue': '5', 'key': '7438_CR45', 'doi-asserted-by': 'publisher', 'first-page': '1636', 'DOI': '10.1093/advances/nmab012', 'volume': '12', 'author': 'A Kazemi', 'year': '2021', 'unstructured': 'Kazemi A, et al. Association of vitamin D status with SARS-CoV-2 ' 'infection or COVID-19 severity: a systematic review and meta-analysis. ' 'Adv Nutr. 2021;12(5):1636–58.', 'journal-title': 'Adv Nutr'}, { 'issue': '5', 'key': '7438_CR46', 'doi-asserted-by': 'publisher', 'first-page': '1308', 'DOI': '10.1080/10408398.2020.1841090', 'volume': '62', 'author': 'M Pereira', 'year': '2020', 'unstructured': 'Pereira M, et al. Vitamin D deficiency aggravates COVID-19: systematic ' 'review and meta-analysis. Crit Rev Food Sci Nutr. 2020;62(5):1308–16.', 'journal-title': 'Crit Rev Food Sci Nutr'}, { 'key': '7438_CR47', 'volume': '2015', 'author': 'I Mozos', 'year': '2015', 'unstructured': 'Mozos I, Marginean O. Links between vitamin D deficiency and ' 'cardiovascular diseases. Biomed Res Int. 2015;2015: 109275.', 'journal-title': 'Biomed Res Int'}, { 'issue': '24', 'key': '7438_CR48', 'doi-asserted-by': 'publisher', 'first-page': '1949', 'DOI': '10.1016/j.jacc.2008.08.050', 'volume': '52', 'author': 'JH Lee', 'year': '2008', 'unstructured': 'Lee JH, et al. Vitamin D deficiency an important, common, and easily ' 'treatable cardiovascular risk factor? J Am Coll Cardiol. ' '2008;52(24):1949–56.', 'journal-title': 'J Am Coll Cardiol'}, { 'issue': '6', 'key': '7438_CR49', 'doi-asserted-by': 'publisher', 'first-page': '447', 'DOI': '10.1016/j.repc.2020.10.014', 'volume': '40', 'author': 'A Naghedi', 'year': '2021', 'unstructured': 'Naghedi A, et al. Effect of vitamin D supplements on left ventricular ' 'ejection fraction in patients with heart failure: A systematic review ' 'and meta-analysis of randomized controlled trials. Rev Port Cardiol. ' '2021;40(6):447–55.', 'journal-title': 'Rev Port Cardiol'}, { 'issue': '8', 'key': '7438_CR50', 'doi-asserted-by': 'publisher', 'first-page': '774', 'DOI': '10.3390/medicina57080774', 'volume': '57', 'author': 'C Batsi', 'year': '2021', 'unstructured': 'Batsi C, et al. Vitamin D deficiency as a risk factor for myocardial ' 'ischemia. Medicina. 2021;57(8):774.', 'journal-title': 'Medicina'}, { 'issue': '4', 'key': '7438_CR51', 'doi-asserted-by': 'publisher', 'first-page': '754', 'DOI': '10.1093/ajcn/83.4.754', 'volume': '83', 'author': 'SS Schleithoff', 'year': '2006', 'unstructured': 'Schleithoff SS, et al. Vitamin D supplementation improves cytokine ' 'profiles in patients with congestive heart failure: a double-blind, ' 'randomized, placebo-controlled trial. Am J Clin Nutr. 2006;83(4):754–9.', 'journal-title': 'Am J Clin Nutr'}, { 'issue': '5', 'key': '7438_CR52', 'doi-asserted-by': 'publisher', 'first-page': '780', 'DOI': '10.1016/j.amjcard.2018.05.013', 'volume': '122', 'author': 'A Turin', 'year': '2018', 'unstructured': 'Turin A, et al. Interactions among vitamin D, atrial fibrillation, and ' 'the renin–angiotensin–aldosterone system. Am J Cardiol. ' '2018;122(5):780–4.', 'journal-title': 'Am J Cardiol'}, { 'issue': '5', 'key': '7438_CR53', 'doi-asserted-by': 'publisher', 'first-page': '605', 'DOI': '10.21470/1678-9741-2018-0322', 'volume': '34', 'author': 'L Bie', 'year': '2019', 'unstructured': 'Bie L. The status and research progress on vitamin D deficiency and ' 'atrial fibrillation. Braz J Cardiovasc Surg. 2019;34(5):605–9.', 'journal-title': 'Braz J Cardiovasc Surg'}, { 'issue': '5', 'key': '7438_CR54', 'doi-asserted-by': 'publisher', 'first-page': '259', 'DOI': '10.1038/s41569-020-0360-5', 'volume': '17', 'author': 'YY Zheng', 'year': '2020', 'unstructured': 'Zheng YY, et al. COVID-19 and the cardiovascular system. Nat Rev ' 'Cardiol. 2020;17(5):259–60.', 'journal-title': 'Nat Rev Cardiol'}, { 'issue': '8', 'key': '7438_CR55', 'doi-asserted-by': 'publisher', 'first-page': '573', 'DOI': '10.1016/j.repc.2020.11.007', 'volume': '40', 'author': 'D Mesquita', 'year': '2021', 'unstructured': 'Mesquita D, et al. Cardiac arrhythmias in patients presenting with ' 'COVID-19 treated in Portuguese hospitals: A national registry from the ' 'Portuguese association of arrhythmology, pacing and electrophysiology. ' 'Rev Port Cardiol. 2021;40(8):573–80.', 'journal-title': 'Rev Port Cardiol'}, { 'issue': '6', 'key': '7438_CR56', 'doi-asserted-by': 'publisher', 'first-page': '1062', 'DOI': '10.1111/pace.14247', 'volume': '44', 'author': 'S Garcia-Zamora', 'year': '2021', 'unstructured': 'Garcia-Zamora S, et al. Arrhythmias and electrocardiographic findings in ' 'Coronavirus disease 2019: A systematic review and meta-analysis. Pacing ' 'Clin Electrophysiol. 2021;44(6):1062–74.', 'journal-title': 'Pacing Clin Electrophysiol'}, { 'issue': '1', 'key': '7438_CR57', 'doi-asserted-by': 'publisher', 'first-page': '255', 'DOI': '10.1016/j.atherosclerosis.2008.10.033', 'volume': '205', 'author': 'J Kendrick', 'year': '2009', 'unstructured': 'Kendrick J, et al. 25-Hydroxyvitamin D deficiency is independently ' 'associated with cardiovascular disease in the third national health and ' 'nutrition examination survey. Atherosclerosis. 2009;205(1):255–60.', 'journal-title': 'Atherosclerosis'}, { 'issue': '3', 'key': '7438_CR58', 'doi-asserted-by': 'publisher', 'first-page': '181', 'DOI': '10.34172/jcvtr.2021.30', 'volume': '13', 'author': 'S Mirmoeeni', 'year': '2021', 'unstructured': 'Mirmoeeni S, et al. Cardiovascular manifestations in COVID-19 patients: ' 'a systematic review and meta-analysis. J Cardiovasc Thorac Res. ' '2021;13(3):181.', 'journal-title': 'J Cardiovasc Thorac Res.'}], 'container-title': 'BMC Infectious Diseases', 'original-title': [], 'language': 'en', 'link': [ { 'URL': 'https://link.springer.com/content/pdf/10.1186/s12879-022-07438-8.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/article/10.1186/s12879-022-07438-8/fulltext.html', 'content-type': 'text/html', 'content-version': 'vor', 'intended-application': 'text-mining'}, { 'URL': 'https://link.springer.com/content/pdf/10.1186/s12879-022-07438-8.pdf', 'content-type': 'application/pdf', 'content-version': 'vor', 'intended-application': 'similarity-checking'}], 'deposited': { 'date-parts': [[2022, 5, 7]], 'date-time': '2022-05-07T13:02:44Z', 'timestamp': 1651928564000}, 'score': 1, 'resource': { 'primary': { 'URL': 'https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-022-07438-8'}}, 'subtitle': [], 'short-title': [], 'issued': {'date-parts': [[2022, 5, 7]]}, 'references-count': 58, 'journal-issue': {'issue': '1', 'published-print': {'date-parts': [[2022, 12]]}}, 'alternative-id': ['7438'], 'URL': 'http://dx.doi.org/10.1186/s12879-022-07438-8', 'relation': {}, 'ISSN': ['1471-2334'], 'subject': ['Infectious Diseases'], 'container-title-short': 'BMC Infect Dis', 'published': {'date-parts': [[2022, 5, 7]]}, 'assertion': [ { 'value': '5 November 2021', 'order': 1, 'name': 'received', 'label': 'Received', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '3 May 2022', 'order': 2, 'name': 'accepted', 'label': 'Accepted', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, { 'value': '7 May 2022', 'order': 3, 'name': 'first_online', 'label': 'First Online', 'group': {'name': 'ArticleHistory', 'label': 'Article History'}}, {'order': 1, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Declarations'}}, { 'value': 'This project was approved by the Ethical Committee of Shahroud University of ' 'Medical Sciences, Shahroud, Iran. The study was conducted according to the ' 'guidelines of the Declaration of Helsinki. Informed consent was waived by the ' 'Ethics Committee as no intervention was done, and informed consent is routinely ' 'obtained from the patients at our hospital upon admission to receive medical ' 'care and diagnostic procedures.', 'order': 2, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Ethics approval and consent to participate'}}, { 'value': 'Not applicable.', 'order': 3, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Consent for publication'}}, { 'value': 'The authors declare no competing interests.', 'order': 4, 'name': 'Ethics', 'group': {'name': 'EthicsHeading', 'label': 'Competing interests'}}], 'article-number': '441'}
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Please send us corrections, updates, or comments. c19early involves the extraction of 100,000+ datapoints from thousands of papers. Community updates help ensure high accuracy. Treatments and other interventions are complementary. All practical, effective, and safe means should be used based on risk/benefit analysis. No treatment or intervention is 100% available and effective for all current and future variants. We do not provide medical advice. Before taking any medication, consult a qualified physician who can provide personalized advice and details of risks and benefits based on your medical history and situation. FLCCC and WCH provide treatment protocols.
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