Volume 7, Issue 4 (12-2021)                   RABMS 2021, 7(4): 228-235 | Back to browse issues page

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Samimagham H, Hassaniazad M, Arabi M, Hooshyar D, Abbasi M A, Abbasi T et al . The Association of Vitamin D Deficiency with COVID- 19 Severity and Mortality. RABMS. 2021; 7 (4) :228-235
URL: http://ijrabms.umsu.ac.ir/article-1-156-en.html
Endocrinology and Metabolism Research Center, Hormozgan University of Medical Sciences, Bandarabbas, Iran , mitra.kazemijahromi@gmail.com
Abstract:   (256 Views)
Background & Aims: There are few studies showing the association between vitamin D deficiency and COVID-19 severity and mortality. This study designed to investigate the relationship between vitamin D deficiency and the severity and mortality of COVID-19.
Materials & Methods: The present cross-sectional study was conducted on 48 COVID-19 patients with positive PCR test results. Patients were divided into three groups according to their serum 25-OH vitamin D3 levels: group 1 <20 ng/mL, group 2. 20-50 ng/mL, and group 3, ≥50 ng/ml. The relationship of the levels of vitamin D3, as well as the history of diabetes, hypertension, Ischemic Heart Disease (IHD), Glomerular Filtration Rate (GFR) ≤60 mL/min, LDH ≥500 U/L, and Lymphocyte count ≤1500 with the severity of the disease and its mortality were investigated.
Results: A significant relationship was observed between vitamin D ≤20 ng/mL and the severity (P<0.001) and mortality (P=0.001, adjusted OR=2.4) of the disease in COVID-19 patients. It was also shown that GFR ≤60 mL/min (P=0.02, adjusted OR=3.6), IHD (P=0.04, adjusted OR=2.8), LDH ≥500 U/L (P=0.027, adjusted OR=1.8), and lymphocyte count ≤1500 (P=0.002, adjusted OR=2.2) significantly affected the mortality.
Conclusion: The present study showed a significant relationship between vitamin D deficiency and the severity of the disease and mortality in COVID-19 patients. These results suggest the need for appropriate health policies during the COVID-19 pandemic.
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Type of Study: orginal article | Subject: General

1. Cucinotta D, Vanelli M. WHO declares COVID-19 a pandemic. Acta Biomedica 2020;91(1):157-60. [URL]
2. Gorbalenya AE, Baker SC, Baric RS, de Groot RJ, Drosten C, Gulyaeva AA, et al. The species Severe acute respiratory syndrome-related coronavirus: classifying 2019-nCoV and naming it SARS-CoV-2. Nat Microbiol 2020;5(4):536-44. [DOI:10.1038/s41564-020-0695-z] [PMID] [PMCID]
3. Rhodes JM, Subramanian S, Laird E, Kenny RA. Editorial: low population mortality from COVID-19 in countries south of latitude 35 degrees North supports vitamin D as a factor determining severity. Aliment Pharmacol Ther 2020;51(12):1434-7. [DOI:10.1111/apt.15777] [PMID] [PMCID]
4. Garg M, Al-Ani A, Mitchell H, Hendy P, Christensen B. Editorial: low population mortality from COVID-19 in countries south of latitude 35 degrees North-supports vitamin D as a factor determining severity. Authors' reply. Aliment Pharmacol Ther 2020;51(12):1438-9. [DOI:10.1111/apt.15796] [PMID] [PMCID]
5. Chen T, Wu D, Chen H, Yan W, Yang D, Chen G, et al. Clinical characteristics of 113 deceased patients with coronavirus disease 2019: Retrospective study. The BMJ 2020 Mar 26;368:m1091. [DOI:10.1136/bmj.m1091] [PMID] [PMCID]
6. Vaduganathan M, Vardeny O, Michel T, McMurray JJV, Pfeffer MA, Solomon SD. Renin-angiotensin-aldosterone system inhibitors in patients with covid-19. N Engl J Med 2020 Apr 23;382(17):1653-9. [DOI:10.1056/NEJMsr2005760] [PMID] [PMCID]
7. Mansur J. Letter: low population mortality from COVID-19 in countries south of latitude 35 degrees North supports vitamin D as a factor determining severity. Aliment Pharmacol Ther 2020 Jul;52(2):411-2. [DOI:10.1111/apt.15820] [PMID] [PMCID]
8. Shi Y, Liu T, Yao L, Xing Y, Zhao X, Fu J, et al. Chronic vitamin D deficiency induces lung fibrosis through activation of the renin-angiotensin system. Sci Rep 2017;(36):1-10. [DOI:10.1038/s41598-017-03474-6] [PMID] [PMCID]
9. Margarita V, Giménez M, Inserra F, Tajer CD, Mariani J. Lungs as target of COVID-19 infection: Protective common molecular mechanisms of vitamin D and melatonin as a new potential synergistic treatment. Life Sci 2020 Aug 1;254:117808. [DOI:10.1016/j.lfs.2020.117808] [PMID] [PMCID]
10. Grant WB, Lahore H, McDonnell SL, Baggerly CA, French CB, Aliano JL, et al. Evidence that vitamin d supplementation could reduce risk of influenza and covid-19 infections and deaths. Nutrients 2020;12(4):1-19. [DOI:10.3390/nu12040988] [PMID] [PMCID]
11. Infusino F, Marazzato M, Mancone M, Fedele F, Mastroianni CM, Severino P, et al. Diet Supplementation, Probiotics, and Nutraceuticals in SARS-CoV-2 Infection: A Scoping Review. Nutrients 2020 Jun 812(6):1718. Available from: https://www.mdpi.com/2072-6643/12/6/1718 [DOI:10.3390/nu12061718] [PMID] [PMCID]
12. Tsujino I, Ushikoshiinakayama R, Yamazaki T, Matsumoto N, Saito I. Pulmonary activation of vitamin D 3 and preventive effect against interstitial pneumonia. J Clin Biochem Nutr 2019;65(3):245-51. Available from: https://www.jstage.jst.go.jp/article/jcbn/65/3/65_19-48/_article/-char/ja/ [DOI:10.3164/jcbn.19-48] [PMID] [PMCID]
13. Facchiano A, Facchiano A, Bartoli M, Ricci A, Facchiano F. Reply to Jakovac: About COVID-19 and vitamin D. Am J Physiol Endocrinol Metab 2020 Jun 1;318(6):E838. [DOI:10.1152/ajpendo.00185.2020] [PMID] [PMCID]
14. Daly RM, Gagnon C, Lu ZX, Magliano DJ, Dunstan DW, Sikaris KA, et al. Prevalence of vitamin D deficiency and its determinants in Australian adults aged 25 years and older: A national, population-based study. Clin Endocrinol 2012;77(1):26-35. [DOI:10.1111/j.1365-2265.2011.04320.x] [PMID]
15. Chapuy MC, Preziosi P, Maamer M, Arnaud S, Galan P, Hercberg S, et al. Prevalence of vitamin D insufficiency in an adult normal population. Osteoporos Int 1997;7(5):439-43. [DOI:10.1007/s001980050030] [PMID]
16. Tian Y, Rong L. Letter: Covid-19, and vitamin D. Authors' reply. Aliment. Pharmacol. Ther 2020;51(10):995-6. [DOI:10.1111/apt.15764] [PMID] [PMCID]
17. Panarese A, Shahini E. Letter: Covid-19, and vitamin D. Aliment. Pharmacol. Ther 2020;51(10):993-5. [DOI:10.1111/apt.15752] [PMID] [PMCID]
18. D'avolio A, Avataneo V, Manca A, Cusato J, de Nicolò A, Lucchini R, et al. 25-hydroxyvitamin D concentrations are lower in patients with positive PCR for SARS-CoV-2. Nutrients 2020;12(5):1-7. [DOI:10.3390/nu12051359] [PMID] [PMCID]
19. Fasano A, Cereda E, Barichella M, Cassani E, Ferri V, Zecchinelli AL, Pezzoli G. COVID‐19 in Parkinson's disease patients living in Lombardy, Italy. Mov Disord 2020 Jul;35(7):1089-93. [DOI:10.1002/mds.28176] [PMID] [PMCID]
20. Hastie CE, Mackay DF, Ho F, Celis-Morales CA, Katikireddi SV, Niedzwiedz CL, et al. Vitamin D concentrations and COVID-19 infection in UK Biobank. Diabetes Metab Syndr 2020 Jul-Aug;14(4):561-5. [DOI:10.1016/j.dsx.2020.04.050] [PMID] [PMCID]
21. Raisi-Estabragh Z, McCracken C, Bethell MS, et al. Greater risk of severe COVID-19 in Black, Asian and Minority Ethnic populations is not explained by cardiometabolic, socioeconomic or behavioural factors, or by 25 (OH)-vitamin D status: study of 1326 cases from the UK Biobank. J Public Health 2020 Aug 18;42(3):451-60. Available from: https://academic.oup.com/jpubhealth/article-abstract/doi/10.1093/pubmed/fdaa095/5859581 [DOI:10.1093/pubmed/fdaa095] [PMID] [PMCID]
22. Tehrani S, Khabiri N, Moradi H, Mosavat MS, Khabiri SS. Evaluation of vitamin D levels in COVID-19 patients referred to Labafinejad Hospital in Tehran and its relationship with disease severity and mortality. Clin Nutr ESPEN 2021 Apr 1; 42:313-7. [DOI:10.1016/j.clnesp.2021.01.014] [PMID] [PMCID]
23. Mariani J, Giménez VMM, Bergam I, Tajer C, Antonietti L, Inserra F, et al. Association between Vitamin D efficiency and COVID-19 Incidence , Complications, and Mortality in 46 Countries : An ecological Study . Health Secur 2020 Dec 14 [cited 2021 May 27]; Available from: www.liebertpub.com [DOI:10.1089/hs.2020.0137] [PMID]
24. Akbar MR, Wibowo A, Pranata R, Setiabudiawan B. Low Serum 25-hydroxyvitamin D (Vitamin D) Level Is Associated With Susceptibility to COVID-19, Severity, and Mortality: A Systematic Review and Meta-Analysis. Front nutr 2021 Mar 29;8:131. Available from: www.frontiersin.org [DOI:10.3389/fnut.2021.660420] [PMID] [PMCID]
25. Liu Y, Yang Y, Zhang C, Huang F, Wang F, Yuan J, et al. Clinical and biochemical indexes from 2019-nCoV infected patients linked to viral loads and lung injury. Sci China Life Sci 2020;63(3):364-74. [DOI:10.1007/s11427-020-1643-8] [PMID] [PMCID]
26. Martineau AR, Jolliffe DA, Hooper RL, Greenberg L, Aloia JF, Bergman P, et al. Vitamin D supplementation to prevent acute respiratory tract infections: Systematic review and meta-analysis of individual participant data. BMJ 2017;356. [DOI:10.1136/bmj.i6583] [PMID] [PMCID]
27. Gysin DV, Dao D, Gysin CM, Lytvyn L. Effect of Vitamin D3 Supplementation on Respiratory Tract Infections in Healthy Individuals : A Systematic Review and Meta- Analysis of Randomized Controlled Trials. PLoS One 2016 Sep 15;11(9):e0162996. [DOI:10.1371/journal.pone.0162996] [PMID] [PMCID]
28. Inciardi RM, Adamo M, Lupi L, Cani DS, di Pasquale M, Tomasoni D, et al. Characteristics and outcomes of patients hospitalized for COVID-19 and cardiac disease in Northern Italy. Eur Heart J 2020;41(19):1821-9. [DOI:10.1093/eurheartj/ehaa388] [PMID] [PMCID]
29. Du Y, Tu L, Zhu P, Mu M, Wang R, Yang P, et al. Clinical Features of 85 Fatal Cases of COVID-19 from Wuhan. A Retrospective Observational Study. Am J Respir Crit Care Med 2020;201(11):1372-9. [DOI:10.1164/rccm.202003-0543OC] [PMID] [PMCID]
30. Zheng Z, D M, Peng F, D B, Xu B, D M, et al. Risk factors of critical & mortal COVID-19 cases: A systematic literature review and meta-analysis. J Infect 2020 Aug;81(2):e16-e25. [DOI:10.1016/j.jinf.2020.04.021] [PMID] [PMCID]
31. Wang F, Wang H, Liang K, Deng L, Luo M, Mo P. Clinical characteristics of refractory COVID-19 pneumonia in Wuhan , China. Clin Infect Dis 2021 Dec 6;73(11):e4208-e13. [DOI:10.1093/cid/ciaa270] [PMID] [PMCID]
32. Zhao D, Yao F, Wang L, Zheng L, Gao Y, Ye J, et al. A comparative study on the clinical features of COVID-19 pneumonia to other pneumonias. Clin Infect Dis 2020 Jul 28;71(15):756-61. [DOI:10.1093/cid/ciaa247] [PMID] [PMCID]
33. Qin C, Zhou L, Hu Z, Zhang S, Yang S, Tao Y, et al. Dysregulation of immune response in patients with COVID-19 in Wuhan, China. Clin Infect Dis 2020 Jul 28;71(15):762-8. [DOI:10.1093/cid/ciaa248] [PMID] [PMCID]
34. Henry BM, Helena M, Oliveira S de, Benoit S. Hematologic , biochemical and immune biomarker abnormalities associated with severe illness and mortality in coronavirus disease 2019 ( COVID-19 ): a meta-analysis. Clin Chem Lab Med 2020 Jun 25;58(7):1021-8. doi: 10.1515/cclm-2020-0369. 2020;58(7):1021-8. [DOI:10.1515/cclm-2020-0369] [PMID]
35. Wang K, Zuo P, Liu Y, Zhang M, Zhao X, Xie S, et al. Clinical and Laboratory Predictors of In-Hospital Mortality in 305 Patients with COVID-19: A Cohort Study in Wuhan, China. BMC Infect Dis 2020 Dec 10;20(1):943. [DOI:10.2139/ssrn.3546115]
36. Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, et al. Kidney disease is associated with in-hospital death of patients with COVID-19. Kidney Int 2020 May;97(5):829-38. [DOI:10.1016/j.kint.2020.03.005] [PMID] [PMCID]
37. Caccialanza R, Laviano A, Lobascio F, Montagna E, Bruno R, Ludovisi S, et al. Early nutritional supplementation in non-critically ill patients hospitalized for the 2019 novel coronavirus disease (COVID-19): Rationale and feasibility of a shared pragmatic protocol. Nutrition 2020 Jun;74:110835. [DOI:10.1016/j.nut.2020.110835] [PMID] [PMCID]

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