Vitamin D Levels among Hospitalized and Non-Hospitalized COVID-19 Patients in Dr. M. Djamil General Hospital Padang
Putra et al.
, Vitamin D Levels among Hospitalized and Non-Hospitalized COVID-19 Patients in Dr. M. Djamil General Hospital..
, European Journal of Medical and Health Sciences, doi:10.24018/ejmed.2021.3.6.1131
Case control study in Indonesia with 31 moderate to critical hospitalized COVID-19 patients, and 31 asymptomatic or mild non-hospitalized COVID-19 patients, showing lower vitamin D levels in the hospitalized patients, without reaching statistical significance.
risk of hospitalization, 25.6% lower, OR 0.74, p = 0.59, high D levels 9 of 31 (29.0%) cases,
11 of 31 (35.5%) controls, NNT 14, case control OR.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Putra et al., 10 Dec 2021, retrospective, Indonesia, peer-reviewed, 3 authors, study period February 2020 - September 2020.
Abstract: RESEARCH ARTICLE
European Journal of Medical and Health Sciences
Vitamin D Levels among Hospitalized and
Non-Hospitalized COVID-19 Patients in
Dr. M. Djamil General Hospital Padang
Harika Putra, Efrida, and Rismawati Yaswir
Coronavirus Disease 2019 (COVID-19) causes immune system
dysregulation and an exaggerated systemic inflammatory response.
Vitamin D acts as an immunomodulator that enhances the immunity
defense. Degression of vitamin D levels affect the severity of COVID-19
infection Our case-control study compared the vitamin D levels between
hospitalized and non-hospitalized COVID-19 patients at RSUP dr. M.
Djamil, Padang from February to September 2020. Serum vitamin D levels
were categorized as deficiency if the level was less than 20 ng/mL based on
the Chemiluminescent Microparticle Immunoassay. The hospitalized group
consisted of moderate to critical COVID-19 patients, whereas the nonhospitalized group consisted of the asymptomatic and mild COVID-19
patients according to the Indonesian Ministry of Health Guidelines. Data
analysis were performed using T-test and Chi-square with a significant pvalue of less than 0.05. The results showed that most subjects were women
between 21–60 years. The mean level of vitamin D (ng/mL) in the
hospitalized group was lower than in the non-hospitalized group (15.5 ± 7.72
vs. 19.2 ± 14.30; 95% CI -9.509–2.167; p=0.213). Vitamin D deficiency was
found more among hospitalized group than the non-hospitalized group, but
not statistically significant (71% vs. 64.5%, p=0.566). It indicated the role
of vitamin D in preventing immune system hyperactivation causing
COVID-19 cytokine storm. This study concluded no difference in vitamin D
levels among the study groups. Nevertheless, further research on vitamin D
is needed to determine its role and benefits against COVID-19 infection.
Keywords: COVID-19, cytokine storm, inflammation, vitamin D deficiency.
Coronavirus Disease 2019 (COVID-19) is a newly
discovered infectious disease caused by the Severe Acute
Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) .
The SARS-CoV-2 virus exhibits the ability to evade the
immune defense, so it can avoid the immune system which
plays a significant role in viral clearance during the ongoing
infection process . This mechanism causes a strong
inflammatory response that enhances immune system
hyperactivation and cytokine storm. This pathological
process results in serious damage to the host, leading to acute
respiratory distress syndrome (ARDS) and mortality.
Vitamin D, known for its immunomodulatory effect, has been
reported to suppress this process, thereby assumed to prevent
the severity of COVID-19 infection -. Vitamin D
metabolite is an endogenous steroid hormone synthesized
through the effects of ultraviolet radiation on the skin. It also
can be exogenously derived through daily supplements and
dietary sources . Deficiency of vitamin D is one of the
global nutritional health problems, affecting 5.9–13% of the
worldwide population . Vitamin D provides an essential
role in many physiological functions. Several studies
emphasized the effect of vitamin D in the modulation of the
Submitted : November 3, 2021
Published : December 10, 2021
Program, Faculty of Medicine,
Andalas University, Dr. M. Djamil
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