Low levels of vitamin D were associated with coagulopathy among hospitalized coronavirus disease-19 (COVID-19) patients: A single-centered study in Indonesia
Hani Susianti, Cesarius Wahono, Perdana Aditya Rahman, Mirza Pratama, Indah Adhita Wulanda, Khoirunisah Dwi Hartanti, Elvira Sari Dewi, Kusworini Handono
Journal of Medical Biochemistry, doi:10.5937/jomb0-30228
Background: This study was aimed to explore the association of vitamin D in the risk of coagulopathy in coronavirus disease-19 . Methods: Clinical and laboratory findings were obtained from 50 confirmed COVID-19 patients hospitalized in Saiful Anwar General Hospital, Malang, Indonesia, from September to November 2020. Thrombotic events during hospitalization were recorded, and the ISTH disseminated intravascular coagulation (DIC) score was used to classify overt DIC. Hypovitaminosis D was defined by serum vitamin D level <49.92 nmol/L. Results: Among 50 patients, 42 (84%) had hypovitaminosis D, and 6 (12%) developed thrombotic events. Vitamin D levels were lower in patients with thrombotic events (p=0.015), D-dimer >2 mg/L (p=0.006), ISTH DIC score 5 (p=0.020), admitted on ICU (p=0.002), and non-survivor groups (p=0.007). Multivariate analysis for the risk in increased D-dimer levels showed low vitamin D as the only significant risk factor with OR 1.8 (1.2-4.4), p=0.034. Low vitamin D also increased the risk for developing overt DIC with OR. 5.4 (1.0-30.2), p=0.039. Vitamin D level had negative correlations with ferritin (R=-0.316, p=0.044) and CRP (R=-0.530, p=0.000).
Kratak sadr`aj Uvod: Cilj ove studije je bio da istra`i povezanost vitamina D sa rizikom od koagulopatije kod koronavirusne bolesti 2019 (COVID-19). Metode: Klini~ki i laboratorijski nalazi dobijeni su od 50 potvr|enih pacijenata sa COVID-19 hospitalizovanih u op{toj bolnici Saiful Anvar u Malangu u Indoneziji, od septembra do novembra 2020. Zabele`eni su tromboti~ni doga|aji tokom hospitalizacije, a rezultati ISTH diseminovane intravaskularne koagulacije (DIC) kori{}eni su za klasifikaciju o~igledne DIC. Hipovitaminoza D je definisana nivoom vitamina D u serumu <49,92 nmol/L. Rezultati: Od 50 pacijenata, 42 (84%) je imalo hipovitaminozu D, a 6 (12%) je razvilo tromboti~ke doga|aje. Nivoi vitamina D su bili ni`i kod pacijenata sa tromboti~kim doga|ajima (p=0,015), D-dimerom >2 mg/L (p=0,006), ISTH DIC rezultatima 5 (p=0,020), primljenih na intenzivnu negu (p=0,002), i grupa koje nisu pre`ivele (p=0,007). Multivarijantna analiza rizika za pove}ane nivoe D-dimera pokazala je nizak nivo vitamina D kao jedini zna~ajni faktor rizika sa OR 1,8 (1,2-4,4), p=0,034. Nizak nivo vitamina D je tako|e pove}ao rizik od razvoja o~iglednog DIC-a sa OR 5,4 (1,0-30,2), p=0,039. Nivo
Conflict of interest statement All the authors declare that they have no conflict of interest in this work.
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'abstract': '<jats:p>Background: This study was aimed to explore the association of vitamin D in the risk '
'of coagulopathy in coronavirus disease-19 (COVID-19). Methods: Clinical and laboratory '
'findings were obtained from 50 confirmed COVID-19 patients hospitalized in Saiful Anwar '
'General Hospital, Malang, Indonesia, from September to November 2020. Thrombotic events '
'during hospitalization were recorded, and the ISTH disseminated intravascular coagulation '
'(DIC) score was used to classify overt DIC. Hypovitaminosis D was defined by serum vitamin D '
'level <49.92 nmol/L. Results: Among 50 patients, 42 (84%) had hypovitaminosis D, and 6 '
'(12%) developed thrombotic events. Vitamin D levels were lower in patients with thrombotic '
'events (p=0.015), D-dimer >2 mg/L (p=0.006), ISTH DIC score 5 (p=0.020), admitted on ICU '
'(p=0.002), and non-survivor groups (p=0.007). Multivariate analysis for the risk in increased '
'D-dimer levels showed low vitamin D as the only significant risk factor with OR 1.8 '
'(1.2-4.4), p=0.034. Low vitamin D also increased the risk for developing overt DIC with OR. '
'5.4 (1.0-30.2), p=0.039. Vitamin D level had negative correlations with ferritin (R=-0.316, '
'p=0.044) and CRP (R=-0.530, p=0.000). Conclusions: In conclusion, a low level of vitamin D '
'was found in most hospitalized COVID-19 patients and might be associated with the development '
'of coagulopathy.</jats:p>',
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'sa koronavirusom (COVID-19) - jednocentrična studija u Indoneziji'],
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