Abstract
COVID-19 is characterized by marked variability in clinical severity. Vitamin D had recently been reviewed as one of the factors that may affect the severity in COVID-19. The objective of current study is to analyze the vitamin D level in COVID-19 patients and its impact on the disease severity. After approval from Ethics Committee, M.L.B Medical College the current study was undertaken as continuous prospective observational study of 6 weeks. Participants were COVID-19 patients of age group 30–60 years admitted during the study period of 6 weeks. Study included either asymptomatic COVID-19 patients (Group A) or severely ill patients requiring ICU admission (Group B). Serum concentration of 25 (OH)D, were measured along with serum IL-6; TNFα and serum ferritin. Standard statistical analysis was performed to analyze the differences. Current Study enrolled 154 patients, 91 in Group A and 63 patients in Group B. The mean level of vitamin D (in ng/mL) was 27.89 ± 6.21 in Group A and 14.35 ± 5.79 in Group B, the difference was highly significant. The prevalence of vitamin D deficiency was 32.96% and 96.82% respectively in Group A and Group B. Out of total 154 patients, 90 patients were found to be deficient in vitamin D (Group A: 29; Group B: 61). Serum level of inflammatory markers was found to be higher in vitamin D deficient COVID-19 patients viz. IL-6 level (in pg/mL) 19.34 ± 6.17 vs 12.18 ± 4.29; Serum ferritin 319.17 ± 38.21 ng/mL vs 186.83 ± 20.18 ng/mL; TNFα level (in pg/mL) 13.26 ± 5.64 vs 11.87 ± 3.15. The fatality rate was high in vitamin D deficient (21% vs 3.1%). Vitamin D level is markedly low in severe COVID-19 patients. Inflammatory response is high in vitamin D deficient COVID-19 patients. This all translates into increased mortality in vitamin D deficient COVID-19 patients. As per the flexible approach in the current COVID-19 pandemic authors recommend mass administration of vitamin D supplements to population at risk for COVID-19.
Highlights
COVID-19 is characterized by marked variability in clinical severity
The interleukin 6 (IL-6), tumor necrosis factor α (TNFα) and ferritin concentration was measured in all patients and correlated with serum 25(OH) D concentration
372 COVID-19 patients were admitted in the institute in the study span of six weeks, out of which 202 patients were enrolled in current study after applying inclusion criteria
Summary
COVID-19 is characterized by marked variability in clinical severity. Vitamin D had recently been reviewed as one of the factors that may affect the severity in COVID-19. The objective of current study is to analyze the vitamin D level in COVID-19 patients and its impact on the disease severity. Study included either asymptomatic COVID-19 patients (Group A) or severely ill patients requiring ICU admission (Group B). Inflammatory response is high in vitamin D deficient COVID-19 patients. COVID-19 is characterized by its high infectivity and marked variability in clinical severity, of which 40–45% patients remain asymptomatic and 30–40% develop only mild symptoms. Authors after reviewing the literature available postulated the hypothesis that vitamin D level plays significant role in determining the severity of COVID-19. To confirm the hypothesis authors performed the present observational study in which authors measured the vitamin D levels of all COVID-19 patients who had been advised admission in COVID-ICU and simultaneously in COVID -19 patients who were asymptomatic. The interleukin 6 (IL-6), tumor necrosis factor α (TNFα) and ferritin concentration was measured in all patients and correlated with serum 25(OH) D concentration
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