Abstract
Background: The COVID-19 can cause serious life-threatening complications. Vitamin D deficiency has been proposed to mediate the disease by some studies, however, there is a lack of sufficient data. Methods: In this descriptive-analytical study, 72 Iranian adult patients with COVID-19 were examined. At the beginning of hospitalization, serum levels of vitamin D were checked and patients were divided into four groups as vitamin D above normal, normal, insufficient, or deficient. The prognosis of patients has been evaluated based on serum levels of vitamin D and other underlying factors. Results: Only 30% of patients had normal vitamin D concentrations. Vitamin D status was associated with COVID-19 complications, but not with underlying diseases. In the multivariable logistic regression, COVID-19 prognosis was associated with being male, length of stay in an intensive care unit (ICU), need for intubation, acute respiratory disease syndrome (ARDS), and myocarditis. The serum vitamin D correlated with COVID-19 complications including ARDS, QT length, the requirement to ICU, and intubation. Conclusion: This study showed a mediating role for vitamin D in COVID-19 complications and identified the frequent complications in these patients and contributing variables exaggerating prognosis for health authorities to properly manage COVID-19 in hospitals. Further relevant examinations are highly encouraged.
Highlights
The COVID-19 can cause serious life-threatening complications
The patient prognosis, length of hospitalization, ward of hospitalization, response to treatment based on SPO2 and requirement of oxygenation with reserve bag-mask, existence, and type of life-threatening complications and transfer to intensive care unit (ICU) were recorded through a checklist
Vitamin D deficiency has been suggested as a COVID-19 mediator because of its significant role in innate immune regulation [18,19], its modulatory effects on inflammatory responses to infections, and the existence of several vitamin D receptors in different tissues and organs from airways to the heart, especially in leucocytes [8,9,10,11,20]. vitamin D counteracts tumor necrosis factor (TNF), Low-density lipoprotein (LDL), and other inflammatory mediators by reducing the expression of CD40 in inflammatory cells, downregulation of tissue factor, and up-regulation of thrombomodulin in monocyte cells [21]
Summary
The COVID-19 can cause serious life-threatening complications. The pathogen of this pneumonia was initially called the 2019 novel-coronavirus (2019nCoV) [4]. Most people who become infected are asymptomatic and carrier, but it can cause serious side effects and lifethreatening complications, including acute respiratory distress syndrome, pneumonia, myocarditis, acute kidney injury, and failure of other organs [5]. Respiratory failure is the most common dangerous complication of 2019-nCoV [6]. The most important risk factors for the 2019 coronavirus disease (COVID-19) progression are aging, immunodeficiency, and past underlying disease. Recent epidemiologic evidence suggested that vitamin D deficiency might be another potential risk factor for the disease [7]
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