Decreased serum vitamin D level as a prognostic marker in patients with COVID-19
Retrospective 719 COVID-19 patients in China, showing higher vitamin D levels associated with faster viral clearance and lower severity.
Qu et al., 25 Dec 2022, retrospective, China, peer-reviewed, median age 76.0, 9 authors, study period 13 April, 2022 - 6 June, 2022.
Contact:
22310050@tongji.edu.cn (corresponding author), 2180129@tongji.edu.cn.
Abstract: Title: Decreased serum vitamin D level as a prognostic marker in patients with
COVID-19
Ruyi Qu 1#, Qiuji Yang 1#, Yingying Bi 2#, Jiajing Cheng 2, Mengna He 3, Xin Wei
4, Yiqi Yuan 5, Yuxin Yang 6* and Jinlong Qin2*
1
Department of Geriatrics, Shanghai Fourth People's Hospital, School of Medicine,
Tongji University, Shanghai 200434, China
2
Department of Obstetrics and Gynecology, Shanghai Fourth People’s Hospital,
School of Medicine, Tongji University, Shanghai 200434, China
3
Information Department, Shanghai Fourth People's Hospital, School of Medicine,
Tongji University, Shanghai 200434, China
4
Department of Radiology, Shanghai Fourth People's Hospital, School of Medicine,
Tongji University, Shanghai 200434, China
5
Clinical Laboratory, Shanghai Fourth People's Hospital, School of Medicine, Tongji
University, Shanghai 200434, China
6
Department of Obstetrics and Gynecology, Shanghai Fourth People’s Hospital,
School of Life and Sciences and Technology, Tongji University, Shanghai 200434,
China
* Correspondence: 22310050@tongji.edu.cn (Yuxin Yang); 2180129@tongji.edu.cn
(Jinlong Qin)
# These authors contributed equally to this work.
Abstract
Background: The corona virus disease 2019 (COVID-19) pandemic, which is caused
by severe acute respiratory syndrome coronavirus 2, is still localized outbreak and has
resulted in a high rate of infection and severe disease in older patients with
comorbidities. The vitamin D status of the population has been found to be an important
factor that could influence outcome of COVID-19. However, whether vitamin D can
lessen the symptoms or severity of COVID-19 still remains controversial.
Methods:
A total of 719 patients with confirmed COVID-19 were enrolled
retrospectively in this study from April 13 to June 6, 2022 at Shanghai Forth People’s
Hospital. The circulating levels of 25(OH)D3, inflammatory factors, and clinical
parameters were assayed. Time to viral RNA clearance (TVRC), classification and
prognosis of COVID-19 were used to evaluate the severity of COVID-19 infection.
Results: The median age was 76 years (interquartile range, IQR, 64.5-84.6), 44.1% of
patients were male, and the TVRC was 11 days (IQR, 7-16) in this population. The
median level of 25(OH)D3 was 27.15 (IQR, 19.31-38.89) nmol/L. Patients with lower
serum 25(OH)D3 had prolonged time to viral clearance, more obvious inflammatory
response, more severe respiratory symptoms and higher risks of impaired hepatic and
renal function. Multiple regression analyses revealed that serum 25(OH)D3 level was
negatively associated with TVRC independently. ROC curve showed the serum
vitamin D level could predict the severity classification and prognosis of COVID-19
significantly.
Conclusions: Serum 25(OH)D3 level is independently associated with the severity of
COVID-19 in elderly, and it could be used as a predictor of the severity of COVID-19.
In addition, supplementation with vitamin D might provide beneficial effects in old
patients with COVID-19.
Keywords: COVID-19; vitamin D; time to viral RNA clearance; inflammatory
response
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