Does Serum Vitamin D Level Affect COVID-19 Infection and Its Severity?-A Case-Control Study
Kun Ye, Fen Tang, Fen Tang b à Xin Liao, Benjamin A Shaw, Meiqiu Deng, Guangyi Huang, Zhiqiang Qin, Xiaomei Peng, Hewei Xiao, Chunxia Chen, Xiaochun Liu, Leping Ning, Bangqin Wang, Ningning Tang, Min Li, Fan Xu, Shao Lin, Jianrong Yang
Journal of the American College of Nutrition, doi:10.1080/07315724.2020.1826005
Background: As effective medication to treat COVID-19 is currently unavailable, preventive remedies may be particularly important. Objective: To examine the relationship between serum 25-hydroxy vitamin D (25(OH)D) level and COVID-19 infection, its severity, and its clinical case characteristics. Methods: This case-control study compared serum 25(OH)D levels and rates of vitamin D deficiency (VDD) between 80 healthy controls and 62 patients diagnosed with COVID-19 and admitted to Guangxi People's Hospital, China, 2/16/2020-3/16/2020. Cases were categorized into asymptomatic, mild/moderate, and severe/critical disease. Logistic regression analysis was conducted to examine the associations between 25(OH)D level, or VDD, and case status/severity of COVID-19 while controlling for demographics and comorbidities. A threshold level of vitamin D for conveying COVID-19 risk was estimated. Results: Severe/critical COVID-19 cases were significantly older and had higher percentages of comorbidity (renal failure) compared to mild cases. The serum 25(OH)D concentration in COVID-19 patient was much lower than that in healthy control. And 25(OH)D level was the lowest in severe/ critical cases, compared with mild cases. In further, significantly higher rates of VDD were found in COVID-19 cases (41.9%) compared to healthy controls (11.1%). And VDD was the greatest in severe/critical cases (80%), compared with mild cases (36%). These statistically significant associations remained even after controlling for demographics and comorbidities. A potential threshold of 25(OH)D (41.19 nmol/L) to protect against COVID-19 was identified. Conclusion: Elderly and people with comorbidities were susceptible to severe COVID-19 infection. VDD was a risk factor for COVID-19, especially for severe/critical cases. While further confirmation is needed, vitamin D supplementation may have prevention or treatment potential for COVID-19 disease.
Authors' contributions K. Ye, S. Lin, F. Xu. Designed research; F.Tang, X.Liao, G. Huang, C. Chen, N. Tang conducted research; H. Xiao, X. Liao performed statistical analysis; F. Tang, X. Liao, M. Deng wrote the paper; Z. Qin, X. Peng, X. Liu, L. Ning, B. Wang, M. Li, J. Yang provided essential technical and material support; F. Xu, S. Lin, J. Yang, K. Ye had primary responsibility for final content. All authors read and approved the final manuscript.
Disclosure statement All authors have no conflict of interest.
ORCID Bangqin Wang http://orcid.org/0000-0002-1592-7074
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