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Retrospective analysis of vitamin D status on ınflammatory markers and course of the disease in patients with COVID-19 infection

Ünsal et al., Journal of Endocrinological Investigation, doi:10.1007/s40618-021-01566-9
Apr 2021  
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Mortality 81% Improvement Relative Risk Oxygen therapy 73% Vitamin D for COVID-19  Ünsal et al.  Sufficiency Are vitamin D levels associated with COVID-19 outcomes? Retrospective 56 patients in Turkey Lower mortality (p=0.23) and lower oxygen therapy (p=0.073), not sig. c19early.org Ünsal et al., J. Endocrinological Inve.., Apr 2021 Favorsvitamin D Favorscontrol 0 0.5 1 1.5 2+
Vitamin D for COVID-19
8th treatment shown to reduce risk in October 2020
 
*, now with p < 0.00000000001 from 122 studies, recognized in 9 countries.
No treatment is 100% effective. Protocols combine treatments. * >10% efficacy, ≥3 studies.
4,300+ studies for 77 treatments. c19early.org
Retrospective 56 patients in Turkey showing greater need for oxygen therapy and higher mortality with vitamin D deficiency, and significantly lower risk of pneumonia with vitamin D supplementation.
This is the 61st of 198 COVID-19 sufficiency studies for vitamin D, which collectively show higher levels reduce risk with p<0.0000000001 (1 in 361,397 vigintillion).
risk of death, 80.6% lower, RR 0.19, p = 0.23, high D levels 0 of 29 (0.0%), low D levels 2 of 27 (7.4%), NNT 14, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), >=20ng/mL.
risk of oxygen therapy, 73.4% lower, RR 0.27, p = 0.07, high D levels 2 of 29 (6.9%), low D levels 7 of 27 (25.9%), NNT 5.3, >=20ng/mL.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Ünsal et al., 5 Apr 2021, retrospective, Turkey, peer-reviewed, 10 authors.
This PaperVitamin DAll
Retrospective analysis of vitamin D status on ınflammatory markers and course of the disease in patients with COVID-19 infection
Y A Ünsal, Ö Ö Gül, S Cander, C Ersoy, E Aydemir, C Ateş, Z Uzun, E Armağan, O Ünsal, E Ertürk
Journal of Endocrinological Investigation, doi:10.1007/s40618-021-01566-9
Purpose The aim of the study was to investigate the association between serum 25-hydroxyvitamin D status within the last 6 months prior to COVID-19 infection and parameters of immune function and clinical outcomes. Methods Fifty-six patients, who were admitted to the emergency clinic and diagnosed with COVID-19 infection, were included in the study. Data on clinical characteristics, inflammatory parameters and vitamin D status were recorded for each patient. All the participants had data on 25-hydroxyvitamin D status within the last 6 months prior to COVID-19 infection. Results The patients were stratified as those with vitamin D status less than 20 ng/mL and higher than 20 ng/mL. A group with vitamin D status less than 20 ng/mL had lower lymphocyte counts and lower haemoglobin levels that was statistically significant (respectively; p = 0.021, p = 0.035). Higher C-reactive protein (CRP) levels were seen in the vitamin D-deficient group (p = 0.013). It was observed that vitamin D status of the patients who required oxygen therapy were lower than those who did not require oxygen therapy, not statistically significant (p = 0.05). Patients who did not use vitamin D supplementation within 6 months prior to COVID-19 infection had more likely to be diagnosed with pneumonia (p = 0.004). Conclusion Cases with lower vitamin D status had increased inflammatory markers and worse clinical outcomes than patients with higher vitamin D status. This study suggests that vitamin D status can be used as a prognostic factor in COVID-19 patients, and vitamin D supplementation can be recommended to improve the clinical outcomes in COVID-19 infection.
Declarations Conflict of interest On behalf of all authors, the corresponding author states that there is no conflict of interest. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
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Reumatismo 72(4):189–196', 'journal-title': 'Reumatismo'}, { 'key': '1566_CR40', 'doi-asserted-by': 'publisher', 'first-page': '38', 'DOI': '10.1016/j.thromres.2016.11.007', 'volume': '149', 'author': 'M Levi', 'year': '2017', 'unstructured': 'Levi M, van der Poll T (2017) Coagulation and sepsis. Thromb Res ' '149:38–44', 'journal-title': 'Thromb Res'}, { 'key': '1566_CR41', 'doi-asserted-by': 'publisher', 'first-page': '1256', 'DOI': '10.1373/clinchem.2011.166249', 'volume': '57', 'author': 'A Tripodi', 'year': '2011', 'unstructured': 'Tripodi A (2011) D-dimer testing in laboratory practice. Clin Chem ' '57:1256–1262', 'journal-title': 'Clin Chem'}, { 'key': '1566_CR42', 'doi-asserted-by': 'publisher', 'DOI': '10.1056/NEJMoa2002032', 'author': 'WJ Guan', 'year': '2020', 'unstructured': 'Guan WJ, Ni ZY, Hu Y et al (2020) China medical treatment expert group ' 'for C. Clinical characteristics of coronavirus disease 2019 in China. N ' 'Engl J Med. https://doi.org/10.1056/NEJMoa2002032 (Epub ahead of print)', 'journal-title': 'N Engl J Med'}, { 'key': '1566_CR43', 'doi-asserted-by': 'publisher', 'first-page': '844', 'DOI': '10.1111/jth.14768', 'volume': '18', 'author': 'N Tang', 'year': '2020', 'unstructured': 'Tang N, Li D, Wang X, Sun Z (2020) Abnormal coagulation parameters are ' 'associated with poor prognosis in patients with novel coronavirus ' 'pneumonia. J Thrombosis Haemostasis: JTH 18:844–847', 'journal-title': 'J Thrombosis Haemostasis: JTH'}, { 'key': '1566_CR44', 'first-page': '303', 'volume': '7', 'author': 'K Khademvatani', 'year': '2014', 'unstructured': 'Khademvatani K, Seyyed-Mohammadzad MH, Akbari M, Rezaei Y, Eskandari R, ' 'Rostamzadeh A (2014) The relationship between vitamin D status and ' 'idiopathic lower-extremity deep vein thrombosis. 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Infect Dis (except HIV/AIDS) 79–80:111017 (preprint)', 'journal-title': 'Infect Dis (except HIV/AIDS)'}, { 'key': '1566_CR49', 'doi-asserted-by': 'publisher', 'first-page': '1053', 'DOI': '10.1001/jama.2020.26848', 'volume': '325', 'author': 'IH Murai', 'year': '2021', 'unstructured': 'Murai IH, Fernandes AL, Sales LP et al (2021) Effect of a single high ' 'dose of vitamin D3\xa0on hospital length of stay in patients with ' 'moderate to severe COVID-19:\xa0a randomized clinical trial. 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