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Vitamin D status and COVID-19 severity
Senrina Kalichuran1, Sarah A van Blydenstein1,2, Michelle Venter1,3
1Department of Internal Medicine, Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, South Africa.
Insights
Vitamin D deficiency is common in COVID-19 patients and linked to increased disease severity. Low vitamin D levels and less sunlight exposure significantly increase the risk of symptomatic coronavirus disease 2019 (COVID-19).
Area of Science:
- Nutritional Immunology
- Infectious Diseases
- Public Health
Background:
- Known risk factors for severe COVID-19 include age, BMI, and comorbidities.
- The role of vitamin D status in COVID-19 severity requires further investigation.
Purpose of the Study:
- To explore the relationship between vitamin D status and COVID-19 severity.
- To determine if vitamin D deficiency is a predictor of symptomatic coronavirus disease 2019.
Main Methods:
- A prospective, cross-sectional study enrolled 100 COVID-19 patients in Johannesburg, South Africa.
- Data collected included patient demographics, sunlight exposure, BMI, and blood levels of vitamin D, calcium, albumin, magnesium, and alkaline phosphatase.
- Patients were categorized into symptomatic (COVID-19 pneumonia) and asymptomatic groups.
Main Results:
- An 82% prevalence of vitamin D deficiency or insufficiency was observed among COVID-19 patients.
- Symptomatic patients had significantly lower vitamin D levels (18.1 ng/mL) compared to asymptomatic patients (25.9 ng/mL).
- Vitamin D deficient patients had a 2.5-fold increased risk of symptomatic COVID-19. Age and vitamin D levels were independent predictors of severity.
Conclusions:
- A high prevalence of vitamin D deficiency and insufficiency exists in hospitalized COVID-19 patients.
- Vitamin D deficiency is associated with an increased risk of developing symptomatic coronavirus disease 2019.
- Maintaining adequate vitamin D levels may be important for mitigating COVID-19 severity.
Background:
Age, body mass index (BMI) and pre-existing comorbidities are known risk factors of severe coronavirus disease 2019 (COVID-19). In this study we explore the relationship between vitamin D status and COVID-19 severity.
Methods:
We conducted a prospective, cross-sectional descriptive study. We enrolled 100 COVID-19 positive patients admitted to a tertiary level hospital in Johannesburg, South Africa. Fifty had symptomatic disease (COVID-19 pneumonia) and 50 who were asymptomatic (incidental diagnosis). Following written informed consent, patients were interviewed regarding age, gender and sunlight exposure during the past week, disease severity, BMI, calcium, albumin, magnesium and alkaline phosphatase levels. Finally, blood was collected for vitamin D measurement.
Results:
We found an 82% prevalence rate of vitamin D deficiency or insufficiency among COVID-19 patients. Vitamin D levels were lower in the symptomatic group (18.1 ng/mL ± 8.1 ng/mL) than the asymptomatic group (25.9 ng/mL ± 7.1 ng/mL) with a p-value of 0.000. The relative risk of symptomatic COVID-19 was 2.5-fold higher among vitamin D deficient patients than vitamin D non-deficient patients (confidence interval [CI]: 1.14-3.26). Additional predictors of symptomatic disease were older age, hypocalcaemia and hypoalbuminaemia. Using multiple regression, the only independent predictors of COVID-19 severity were age and vitamin D levels. The patients exposed to less sunlight had a 2.39-fold increased risk for symptomatic disease compared to those with more sunlight exposure (CI: 1.32-4.33).
Conclusion:
We found a high prevalence of vitamin D deficiency and insufficiency among patients admitted to hospital with COVID-19 and an increased risk for symptomatic disease in vitamin D deficient patients.
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