Clinical and Prognostic Significance of Baseline Serum Vitamin D Levels in Hospitalized Egyptian Covid-19 Patients
Mostafa et al.,
Clinical and Prognostic Significance of Baseline Serum Vitamin D Levels in Hospitalized Egyptian Covid-19..,
International Journal of General Medicine, doi:10.2147/IJGM.S386815
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 study is excluded in the after exclusion results of meta
analysis:
categorical results are unadjusted with significant differences between groups.
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.
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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.
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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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Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
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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.
Abstract: International Journal of General Medicine
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Open Access Full Text Article
ORIGINAL RESEARCH
Clinical and Prognostic Significance of Baseline
Serum Vitamin D Levels in Hospitalized Egyptian
Covid-19 Patients
Sadek Mostafa 1 , Shaymaa A Mohammed 2 , Salwa I Elshennawy 2 , Doaa Mohammed Zakaria 1 ,
Sammar Ahmed Kasim Mahmoud 1 , Amira Mohammed Alsadek 3 , Inass Hassan Ahmad 4 ,
Doaa Sayed Mohammed 4 , Marwa Abdelmonim Mohammed 1 , Heba H Eltrawy 3
1
Internal Medicine Department, Al-Azhar University, Cairo, Egypt; 2Clinical Pathology Department, Al-Azhar University, Cairo, Egypt; 3Chest Diseases
Department, Al-Azhar University, Cairo, Egypt; 4Endocrinology and Metabolism Department, Al-Azhar University, Cairo, Egypt
Correspondence: Heba H Eltrawy, Chest Diseases Department, Al-Azhar University, Cairo, Egypt, Tel +201006381297, Email hebahamed182@gmail.com
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.
Keywords: covid-19, vitamin D, vitamin D deficiency
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