Association of vitamin D levels with severity and outcome of COVID-19 infection among inward patients at a tertiary care unit in Sri Lanka

Abstract

Introduction: A link between vitamin D and COVID-19 infection has been expressed by many experts. In this study, we aim to investigate the association of the prevalence of vitamin D deficiency with the severity and outcome of COVID-19 infection in patients who are admitted to Teaching Hospital Batticaloa, Sri Lanka. Methods: A retrospective cross-sectional study was conducted among COVID-19 patients over a period of one month in May 2021. All patients who tested positive for COVID-19 were included. Patients with chronic kidney disease, known vitamin D deficiency, and patients on vitamin D supplements were excluded from the study. The vitamin D deficiency was defined according to the Oxford Academic Endocrine Society guidelines. The severity of the COVID-19 was defined according to the Provisional Clinical Practice Guidelines on COVID-19 suspected and confirmed patients. Primary endpoints of this study were 'recovered from COVID-19' or 'death'. Data was analysed to report the proportion of patients with different vitamin D levels and disease severity. Chi-squared and Fisher's exact tests were used to analyse the results. A p-value of <0.05 was considered as statistically significant. Results: Out of 141, 58% were males. Mild, moderate, and severe COVID-19 were observed in 29.8%, 48.2%, and 22.0% of patients respectively. Only 30.5% of the population had normal vitamin D levels while the rest had some degree of vitamin D insufficiency. None of the patient population had severe vitamin D deficiency status. A 52.9% in the moderate category of COVID-19 severity had insufficient levels of vitamin D levels. Those that recovered from COVID-19 were 93.6%. No significant association was observed between the severity of COVID-19 and vitamin D deficiency (p=.1041 ). Interestingly hypoxia was significantly prevalent among those with normal vitamin D levels (p=.0005). vitamin D deficiency does not impact the mortality rate among COVID-19 patients (p=.6559). Conclusions: The association of vitamin D levels with COVID-19 severity and mortality was not statistically significant.