Association of Serum Vitamin D Levels with Inflammatory Markers in Hospitalized COVID-19 Patients
Mohammad Esmaeil Hejazi 1*, Hoorieh Shojaan1, Niusha Kalami, Babak Alinejati1, Veghar Hejazi2, Akbar Javan Biparva3
Journal of Angiotherapy 8(8) 1-6 https://doi.org/10.25163/angiotherapy.889891
Submitted: 12 August 2024 Revised: 12 August 2024 Published: 12 August 2024
This study determined no significant link between serum Vitamin D levels and COVID-19 mortality, except with LDH.
Abstract
Background: In recent years, global concern has focused on Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Multiple studies have suggested a potential connection between 1,25-dihydroxy Vitamin D levels and patient prognosis. Inflammatory markers have been identified as useful indicators for assessing the prognosis of hospitalized patients. This study aimed to evaluate the relationship between Vitamin D levels, inflammatory markers, and patient prognosis in cases of COVID-19. Methods: This descriptive-analytical study included 906 patients with COVID-19. Serum Vitamin D levels were measured and categorized into three groups: less than 20 ng/mL, between 20–30 ng/mL, and more than 30 ng/mL. Additionally, inflammatory markers, such as C-reactive protein (CRP) and Lactate Dehydrogenase (LDH), were evaluated. The study also addressed the analysis of CT scan findings and patient prognosis. Results: Of the total patients, 497 (54.9%) were male and 409 were female. The mean serum Vitamin D level was 40.10 ± 37.06 ng/mL, while the mean LDH and mean WBC levels were recorded at 696.38 ± 610.19 U/L and 9058.46 ± 6309.80 per microliter, respectively. CRP levels were classified as +1 in 296 patients (32.7%), +2 in 260 patients (28.7%), and +3 in 7 patients (0.8%). In terms of patient prognosis, 62 patients (6.8%) required intubation, and the mortality rate was 18.0% (163 patients). A statistically significant relationship was found between serum Vitamin D and LDH levels (p = 0.015). The findings indicated an insignificant relationship of serum Vitamin D levels with lymphocyte levels (p = 0.619), body mass index (BMI; p = 0.225), and CRP levels (p = 0.985). Furthermore, no relationship was found between patient mortality and serum Vitamin D levels (p = 0.5). Conclusion: Although Vitamin D has confirmed immunomodulatory effects in many studies, this study found no significant relationship between serum Vitamin D levels and mortality or other inflammatory markers in hospitalized COVID-19 patients. However, a statistically significant correlation was observed between LDH levels and serum Vitamin D.
Keywords: Vitamin D, COVID-19, inflammatory markers, serum LDH, immune response
References
Baktash, V., Hosack, T., Patel, N., et al. (2020). Vitamin D status and outcomes for hospitalized older patients with COVID-19. Postgraduate Medical Journal.
Bassatne, A., Basbous, M., Chakhtoura, M., El Zein, O., Rahme, M., & Fuleihan, G. E. (2021). The link between COVID-19 and vitamin D (VIVID): A systematic review and meta-analysis. Metabolism, 154753.
Beard, J. A., Bearden, A., & Striker, R. (2011). Vitamin D and the anti-viral state. Journal of Clinical Virology, 50(3), 194-200.
Bishop, L., Ismailova, A., Dimeloe, S., Hewison, M., & White, J. H. (2021). Vitamin D and immune regulation: Antibacterial, antiviral, anti-inflammatory. JBMR Plus, 5(1), e10405.
Carpagnano, G. E., Di Lecce, V., Quaranta, V. N., et al. (2020). Vitamin D deficiency as a predictor of poor prognosis in patients with acute respiratory failure due to COVID-19. Journal of Endocrinological Investigation.
Damascena, A. D., Azevedo, L. M., Oliveira, T. D., Santana, J. D., & Pereira, M. (2021). Addendum to vitamin D deficiency aggravates COVID-19: Systematic review and meta-analysis. Critical Reviews in Food Science and Nutrition.
Dissanayake, H. A., de Silva, N. L., Sumanatilleke, M., de Silva, S. D., Gamage, K. K., Dematapitiya, C., Kuruppu, D. C., Ranasinghe, P., Pathmanathan, S., & Katulanda, P. (2021). Prognostic and therapeutic role of vitamin D in COVID-19: Systematic review and meta-analysis. The Journal of Clinical Endocrinology & Metabolism.
Haghighi, M., Ebadi, S. S., Soleimantabar, H., Shadkam, A., Ebadi, S. A., & Afzali, H. (2021). Association between vitamin D level and prognostic factors among patients infected with SARS-CoV-2. Hormones and Molecular Biology Clinical Investigations, 42(4), 345-350.
Hernández, J. L., Nan, D., Fernandez-Ayala, M., et al. (2020). Vitamin D status in hospitalized patients with SARS-CoV-2 infection. Journal of Clinical Endocrinology and Metabolism.
Hewison, M. (2011). Vitamin D and innate and adaptive immunity. Vitamins & Hormones, 86, 23-62.
Ilie, P. C., Stefanescu, S., & Smith, L. (2020). The role of vitamin D in the prevention of coronavirus disease 2019 infection and mortality. Aging Clinical and Experimental Research.
Jain, A., Chaurasia, R., Sengar, N. S., Singh, M., Mahor, S., & Narain, S. (2020). Analysis of vitamin D level among asymptomatic and critically ill COVID-19 patients and its correlation with inflammatory markers. Scientific Reports, 10, 20191.
Jolliffe, D. A., Greenberg, L., Hooper, R. L., Mathyssen, C., Rafiq, R., de Jongh, R. T., Camargo, C. A., Griffiths, C. J., Janssens, W., & Martineau, A. R. (2019). Vitamin D to prevent exacerbations of COPD: Systematic review and meta-analysis of individual participant data from randomised controlled trials. Thorax, 74(4), 337-345.
Karahan, S., & Katkat, F. (2020). Impact of serum 25(OH) vitamin D level on mortality in patients with COVID-19 in Turkey. Journal of Nutrition, Health & Aging.
Kazemi, A., Mohammadi, V., Aghababaee, S. K., Golzarand, M., Clark, C. C., & Babajafari, S. (2021). Association of vitamin D status with SARS-CoV-2 infection or COVID-19 severity: A systematic review and meta-analysis. Advances in Nutrition.
Luong, K. V., & Nguyen, L. T. (2011). Impact of vitamin D in the treatment of tuberculosis. The American Journal of the Medical Sciences, 341(6), 493-498.
Maghbooli, Z., Sahraian, M. A., Ebrahimi, M., et al. (2020). Vitamin D sufficiency, a serum 25-hydroxyvitamin D at least 30 ng/mL, reduced risk for adverse clinical outcomes in patients with COVID-19 infection. PLoS ONE.
Nnoaham, K. E., & Clarke, A. (2008). Low serum vitamin D levels and tuberculosis: A systematic review and meta-analysis. International Journal of Epidemiology, 37(1), 113-119.
Panagiotou, G., Tee, S. A., Ihsan, Y., et al. (2020). Low serum 25-hydroxyvitamin D (25[OH]D) levels in patients hospitalized with COVID-19 are associated with greater disease severity. Clinical Endocrinology.
Petrelli, F., Luciani, A., Perego, G., Dognini, G., Colombelli, P. L., & Ghidini, A. (2021). Therapeutic and prognostic role of vitamin D for COVID-19 infection: A systematic review and meta-analysis of 43 observational studies. The Journal of Steroid Biochemistry and Molecular Biology, 105883.
Pizzini, A., Aichner, M., Sahanic, S., et al. (2020). Impact of vitamin D deficiency on COVID-19: A prospective analysis from the CovILD registry. Nutrients.
Radujkovic, A., Hippchen, T., Tiwari-Heckler, S., Dreher, S., Boxberger, M., & Merle, U. (2020). Vitamin D deficiency and outcome of COVID-19 patients. Nutrients.
SACN. (2020). Rapid review: Vitamin D and acute respiratory tract infections.
Shah, K., Varna, V. P., Sharma, U., & Mavalankar, D. (2022). Does vitamin D supplementation reduce COVID-19 severity?: A systematic review. QJM, 115(10), 665-672. https://doi.org/10.1093/qjmed/hcac040
Sîrbe, C., Rednic, S., Grama, A., & Pop, T. L. (2022). An update on the effects of vitamin D on the immune system and autoimmune diseases. International Journal of Molecular Sciences, 23, 9784. https://doi.org/10.3390/ijms23179784
Sobczak, M., & Pawliczak, R. (2024). Effect of vitamin D3 supplementation on severe COVID-19: A meta-analysis of randomized clinical trials. Nutrients, 16, 1402. https://doi.org/10.3390/nu16101402
Spector, S. A. (2011). Vitamin D and HIV: Letting the sun shine in. Topics in Antiviral Medicine, 19(1), 6.
View Dimensions
View Altmetric
Save
Citation
View
Share