Abstract
Vitamin D deficiency (VDD) owing to its immunomodulatory effects is believed to influence outcomes in COVID-19. We conducted a prospective, observational study of patients, hospitalized with COVID-19. Serum 25-OHD level < 20 ng/mL was considered VDD. Patients were classified as having mild and severe disease on basis of the WHO ordinal scale for clinical improvement (OSCI). Of the 410 patients recruited, patients with VDD (197,48.2%) were significantly younger and had lesser comorbidities. The levels of PTH were significantly higher in the VDD group (63.5 ± 54.4 vs. 47.5 ± 42.9 pg/mL). The proportion of severe cases (13.2% vs.14.6%), mortality (2% vs. 5.2%), oxygen requirement (34.5% vs.43.4%), ICU admission (14.7% vs.19.8%) was not significantly different between patients with or without VDD. There was no significant correlation between serum 25-OHD levels and inflammatory markers studied. Serum parathormone levels correlated with D-dimer (r 0.117, p- 0.019), ferritin (r 0.132, p-0.010), and LDH (r 0.124, p-0.018). Amongst VDD patients, 128(64.9%) were treated with oral cholecalciferol (median dose of 60,000 IU). The proportion of severe cases, oxygen, or ICU admission was not significantly different in the treated vs. untreated group. In conclusion, serum 25-OHD levels at admission did not correlate with inflammatory markers, clinical outcomes, or mortality in hospitalized COVID-19 patients. Treatment of VDD with cholecalciferol did not make any difference to the outcomes.
Highlights
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induced coronavirus disease-19 (COVID-19) pandemic has affected more than 60 million individuals and has claimed more than 1.4 million lives globally since it first broke out in China in November 2 0191
In general vitamin D deficiency (VDD) has been observed to lead to dysregulated immune response leading to excessive pro-inflammatory cytokines, implicated in the damage caused by COVID-199,10
Observational study of 410 Indian patients hospitalized for COVID-19, there was a high prevalence of vitamin D deficiency
Summary
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induced coronavirus disease-19 (COVID-19) pandemic has affected more than 60 million individuals and has claimed more than 1.4 million lives globally since it first broke out in China in November 2 0191. India has been one of the worst affected countries in terms of the total number of cases (more than 9 million) second only to the United States of A merica[1]. Evidence from observational studies suggests an association between low serum 25-hydroxyvitamin D (25-OHD) level and susceptibility to acute respiratory infections[2]. Observational studies have documented a negative correlation between VDD and the total number of COVID-19 cases and COVID-19 associated mortality per Scientific Reports | (2021) 11:6258. In the present prospective observational study, we estimated the prevalence of VDD in consecutive hospitalized Indian patients and studied the association of baseline 25-OHD levels with the severity of COVID-19 infection. The study provided us an opportunity to see if treatment with cholecalciferol is associated with a change in the outcome of COVID-19
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