Lower levels of vitamin D are associated with SARS-CoV-2 infection and mortality in the Indian population: An observational study

Padhi, Sunali; Suvankar, Subham; Panda, Venketesh K.; Panda, Aditya K.

doi:10.1016/j.intimp.2020.107001

Cited by 29 publications

(36 citation statements)

References 109 publications

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“…Furthermore, no adjustments were made for country-specific differences in COVID-19 testing rates, social distancing strategies, population demographics, comorbidities and/or other factors. Similar findings were also observed for data acquired from 27 states and union territories of India with inverse correlations observed in mid-August SARS-CoV-2 infection and mortality and mean 25(OH)D levels from previously published data ( 232 ).…”

Section: Vitamin D and Covid-19supporting

confidence: 89%

Investigating the Potential for Ultraviolet Light to Modulate Morbidity and Mortality From COVID-19: A Narrative Review and Update

Gorman

Weller

2020

Front. Cardiovasc. Med.

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During the COVID-19 (coronavirus disease of 2019) pandemic, researchers have been seeking low-cost and accessible means of providing protection from its harms, particularly for at-risk individuals such as those with cardiovascular disease, diabetes and obesity. One possible way is via safe sun exposure, and/or dietary supplementation with induced beneficial mediators (e.g., vitamin D). In this narrative review, we provide rationale and updated evidence on the potential benefits and harms of sun exposure and ultraviolet (UV) light that may impact COVID-19. We review recent studies that provide new evidence for any benefits (or otherwise) of UV light, sun exposure, and the induced mediators, vitamin D and nitric oxide, and their potential to modulate morbidity and mortality induced by infection with SARS-CoV-2 (severe acute respiratory disease coronavirus-2). We identified substantial interest in this research area, with many commentaries and reviews already published; however, most of these have focused on vitamin D, with less consideration of UV light (or sun exposure) or other mediators such as nitric oxide. Data collected to-date suggest that ambient levels of both UVA and UVB may be beneficial for reducing severity or mortality due to COVID-19, with some inconsistent findings. Currently unresolved are the nature of the associations between blood 25-hydroxyvitamin D and COVID-19 measures, with more prospective data needed that better consider lifestyle factors, such as physical activity and personal sun exposure levels. Another short-coming has been a lack of measurement of sun exposure, and its potential to influence COVID-19 outcomes. We also discuss possible mechanisms by which sun exposure, UV light and induced mediators could affect COVID-19 morbidity and mortality, by focusing on likely effects on viral pathogenesis, immunity and inflammation, and potential cardiometabolic protective mechanisms. Finally, we explore potential issues including the impacts of exposure to high dose UV radiation on COVID-19 and vaccination, and effective and safe doses for vitamin D supplementation.

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Section: Vitamin D and Covid-19supporting

confidence: 89%

Investigating the Potential for Ultraviolet Light to Modulate Morbidity and Mortality From COVID-19: A Narrative Review and Update

Gorman

Weller

2020

Front. Cardiovasc. Med.

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“…These studies suggest the role of vitamin D in preventing viral multiplication and cause immunomodulation to decrease inflammatory damage in COVID-19 infection [ 10 – 18 , 20 ]. A recent study in the United States has showed that both sunlight and vitamin D in combination can be related to reduced risk of infection and death by COVID-19 [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

“…Also, multiple studies have advocated role of vitamin D deficiency in COVID-19 severity and mortality [ 9 – 16 ]. In addition to its probable role to COVID, vitamin D deficiency has been associated with fatigue, muscle pain and weakness, together included under fibromyalgia syndrome [ 17 , 18 ]. After the partial release of this lockdown, many citizens have increased their physical activity and subsequently complained of body pains, which has an association with Vitamin D levels.…”

Section: Introductionmentioning

confidence: 99%

Need for Testing and Supplementation of Vitamin D3 After Release of COVID-19 Lockdown in Patients with Increased Musculoskeletal Pain

Dhatt

Kumar

Neradi

et al. 2021

IJOO

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Aims To evaluate vitamin D3 levels in patients who presented with increased musculo-skeletal pain after release of lockdown period when compared to pre-lockdown status. Introduction During this COVID pandemic, many countries have implemented lockdown measures and people have to work from home and many students and workers have to restrict themselves to home. During this period, their outdoor activities were limited. After the partial release of this lockdown many of them started to have some kind of physical activity and started experiencing body pains. We evaluated such patients for vitamin D3 levels and symptoms of fibromyalgia. Methods This is a retrospective analysis of patients from age group 18–60 presented to outpatient department or on telephonic consultation after partial release of lockdown. All patients who had mild back ache before lockdown and had symptoms exaggerated during this lockdown release were included. All patients were investigated for vitamin D3, PTH, thyroid profile, liver functional and kidney functional tests. Results Out of 120 patients presented to us in a period of 3 months, 31 patients had increased symptoms when compared to pre-lockdown status. 20 out of 31 patients had low vitamin D3 levels. 14 patients also developed symptoms of fibromyalgia. Conclusion There might be many reasons for increased pain during lockdown, but we focussed specially only on vitamin D3 because of its association with increased symptoms of COVID-19. This is a gentle reminder to test for vitamin D3 levels and supplement if found deficient. Supplementary Information The online version contains supplementary material available at 10.1007/s43465-021-00376-8.

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“…A study from India correlated historically published data on mean 25-OHD levels with mortality reported from different states, and suggested that mortality may be higher in VDD areas. However this study has major limitations as 25-OHD levels were not measured and most of the historical data used was heterogenous and scant 22 . Several hospitalbased studies have reported an association between low 25-OHD and severe/critical COVID-19 disease 14,15,23 , higher rates of ICU admission 13 , higher levels of in ammatory markers 15 and mortality 14,24 .…”

Section: Discussionmentioning

confidence: 99%

Lack of Association of Baseline 25-Hydroxyvitamin D Levels and Cholecalciferol Treatment With Disease Severity and Mortality in Indian Patients Hospitalized for Covid-19

Jevalikar

Mithal

Singh

et al. 2020

Preprint

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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 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 60000 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.

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Lower levels of vitamin D are associated with SARS-CoV-2 infection and mortality in the Indian population: An observational study

Abstract: Highlights Differential distributions of vitamin D were observed in the Indian population. Vitamin D levels was inversely correlated with SARS-CoV-2 infection rate. COVID-19 mortality rate was negatively associated with mean vitamin D levels.

Cited by 29 publications

References 109 publications

Investigating the Potential for Ultraviolet Light to Modulate Morbidity and Mortality From COVID-19: A Narrative Review and Update

Investigating the Potential for Ultraviolet Light to Modulate Morbidity and Mortality From COVID-19: A Narrative Review and Update

Need for Testing and Supplementation of Vitamin D3 After Release of COVID-19 Lockdown in Patients with Increased Musculoskeletal Pain

Lack of Association of Baseline 25-Hydroxyvitamin D Levels and Cholecalciferol Treatment With Disease Severity and Mortality in Indian Patients Hospitalized for Covid-19

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