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Clinical and Prognostic Significance of Baseline Serum Vitamin D Levels in Hospitalized Egyptian Covid-19 Patients

Mostafa et al., International Journal of General Medicine, doi:10.2147/IJGM.S386815

Nov 2022

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Vitamin D for COVID-19

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^*, now known with p < 0.00000000001 from 120 studies, recognized in 8 countries.

Lower risk for mortality, ICU admission, hospitalization, progression, recovery, cases, and viral clearance.

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Retrospective hospitalized patients in Egypt, showing lower vitamin D levels associated with COVID-19 severity and mortality. Adjusted results are only provided for vitamin D as a continuous variable.

This is the 151st of 196 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 11,637 vigintillion).

This study is excluded in the after exclusion results of meta analysis: categorical results are unadjusted with significant differences between groups.

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risk of death, 92.8% lower, RR 0.07, p < 0.001, high D levels (≥20ng/mL) 4 of 135 (3.0%), low D levels (<20ng/mL) 21 of 51 (41.2%), NNT 2.6, unadjusted, normal vs. deficiency.

risk of mechanical ventilation, 95.0% lower, RR 0.05, p < 0.001, high D levels (≥20ng/mL) 4 of 135 (3.0%), low D levels (<20ng/mL) 30 of 51 (58.8%), NNT 1.8, unadjusted, normal vs. deficiency.

risk of ICU admission, 90.6% lower, RR 0.09, p < 0.001, high D levels (≥20ng/mL) 9 of 135 (6.7%), low D levels (<20ng/mL) 36 of 51 (70.6%), NNT 1.6, unadjusted, normal vs. deficiency.

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Mostafa et al., 30 Nov 2022, retrospective, Egypt, peer-reviewed, 10 authors, study period November 2020 - December 2021. Contact: hebahamed182@gmail.com.

This Paper Vitamin D All

Clinical and Prognostic Significance of Baseline Serum Vitamin D Levels in Hospitalized Egyptian Covid-19 Patients

Sadek Mostafa, Shaymaa A Mohammed, Salwa I Elshennawy, Doaa Mohammed Zakaria, Sammar Ahmed Kasim Mahmoud, Amira Mohammed Alsadek, Inass Hassan Ahmad, Doaa Sayed Mohammed, Marwa Abdelmonim Mohammed, Heba H Eltrawy

International Journal of General Medicine, doi:10.2147/ijgm.s386815

Background and Aim: Vitamin D is a hormone with essential roles in both cellular metabolism and immunity. It controls calcium homeostasis and modulates innate and adaptive immune system responses. Many studies suggested an association between vitamin D deficiency and clinical outcomes of covid-19 infection, while others failed to document such a relation. The present study aimed to evaluate the clinical and prognostic significance of baseline vitamin D levels in hospitalized Egyptian covid-19 patients. Patients and Methods: The present retrospective study included 300 hospitalized covid-19 patients. Patients were submitted to standard clinical, laboratory, and radiological assessment. According to vitamin D levels, patients were classified to have normal levels (≥30), insufficient levels (20-29) or deficient levels (<20). Results: According to their vitamin D levels, patients were classified into those with normal vitamin D (n=135), others with vitamin D insufficiency (n=114), and a third group with vitamin D deficiency (n=51). Patients with normal vitamin D levels and vitamin D insufficiency are significantly younger [median (IQR): 49.0 (39.0-57.0) versus 51.0 (40.0-61.0) and 55.0 (43.0-62.0) years, respectively, p=0.012] and had less frequency of severe disease (24.4% versus 40.4% and 51.0%, respectively) when compared with those with vitamin D deficiency. Moreover, they had significantly lower levels of D dimer [median (IQR): 1.5 (0.9-2.5) versus 1.8 (0.9-3.1) and 2.0 (1.0-3.2)], CRP [median (IQR): 58.0 (30.0-120.0) versus 76.0 (42.5-160.0) and 105.0 (74.0-208.0), respectively, p<0.001], ferritin [median (IQR): 458.0 (240.0-759.0) versus 606.0 (433.8-897.8) and 820.0 (552.0-1087.0), respectively, p<0.001], and procalcitonin [median (IQR): 290.0 (152.0-394.0) versus 372.5 (227.0-530.5) and 443.0 (272.0-575.0), respectively, p<0.001]. Only lower vitamin D levels were significant predictors of mortality in multivariate analysis [OR (95% CI): 0.88 (0.84-0.92), p<0.001]. Conclusion: Low vitamin D levels are related to exaggerated inflammatory response, disease severity, and poor clinical outcome in hospitalized covid-19 patients.

Consent for Publication All authors reviewed the manuscript and approved its submission. Ethics Approval and Consent to Participate This article was approved by the ethical committee of Al-Azhar Faculty of Medicine in accordance with the Helsinki Declaration on clinical research involving human subjects. A written informed consent was obtained from all patients. Informed Consent Informed consent was obtained from all patients. Author Contributions All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising, or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work. Disclosure The authors declare that they have no competing interests. International Journal of General Medicine Dovepress

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